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Telehealth has comparable outcomes to in-person diabetic foot care during the COVID-19 pandemic

World Journal of Methodology 2022年第4期12卷 285-292页

作者： Nikolaos Kamaratos-Sevdalis Alexandros Kamaratos Marios Papadakis Christos Tsagkaris Diabetes Center and 1st Department of Internal Medicine Tzaneio General Hospital of PiraeusPiraeus 18536Greece Surgery II University of Witten-HerdeckeWuppertal 42283Germany

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has posed obstacles to the delivery of diabetic foot *** response to this remote healthcare services have been deployed offering monitoring,follow-up,and referral services to patients with diabetic foot ulcers and related ***,remote diabetic foot care has been studied before the COVID-19 pandemic as an alternative to inperson care,the peculiar situation of the pandemic,which dictates that remote care would be the sole available option for healthcare practitioners and patients,necessitates an evaluation of the relevant knowledge obtained since the beginning of the severe acute respiratory syndrome coronavirus 2 *** To perform a thorough search in PubMed/Medline and Cochrane to identify original records on the *** To identify relevant peer-reviewed publications and gray literature,the authors searched PubMed-MEDLINE and Cochrane Library-Cochrane Central Register of Controlled Trials starting September 27 till October 31,*** reference lists of the selected sources and relevant systematic reviews were also hand–searched to identify potentially relevant ***,the authors searched Reference Citation Analysis(https://***/).RESULTS A number of randomized prospective studies,case series,and case reports have shown that the effectiveness of remote care is comparable to in-person care in terms of hospitalizations,amputations,and *** level of satisfaction of patients’receiving this type of care was *** cost of remote healthcare was not significantly lower than in-person care *** It is noteworthy that remote care during the COVID-19 pandemic appeared to be more effective and well-received than remote care in the ***,larger studies spanning over longer time intervals are necessary in order to validate these results and provide additional insights.

关键词： Diabetes Diabetic foot Telehealth Telemedicine COVID-19 SARS-CoV-2

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Acute traumatic coagulopathy：Incidence, risk stratification and therapeutic options

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World Journal of Emergency Medicine 2010年第1期1卷 12-21页

作者： Marc Maegele Department of Trauma and Orthopedic Surgery and Institute for Research in Operative Medicine (IFOM) University of Witten/Herdecke Cologne-Merheim Medical Center (CMMC) Ostmerheimerstr. 200 D-51109 Cologne Germany

Uncontrolled hemorrhage is responsible for over 50% of all trauma-related deaths within the first 48 hours after admission. Clinical observations together with recent research resulted in an appreciation of the central role of coagulopathy in acute trauma care. A synopsis is presented of different retrospective analyses based upon datasets from severe multiply injured patients derived from the TR-DGU database （Trauma Registry of the Deutsche Gesellschaft for Unfallchirurgie （DGU）/German Society of Trauma Surgery） with respect to frequency, risk stratification and therapeutic options of acute traumatic coagulopathy （ATC）. The synopsis of different analyses based upon the datasets from severe multiply injured patients derived from the TR-DGU database and development/validation of a scoring system （TASH-score = Trauma Associated Severe Hemorrhage） that allows an early and reliable estimation for the probability of massive transfusion as a surrogate for life-threatening hemorrhage after severe multiple injuries. The high frequency of ATC upon emergency room admission is associated with significant morbidity and mortality in multiply injured patients. The TASH-score is recognized as an easy-to-calculate and valid scoring system to predict the individual＇s probability for massive transfusion and thus ongoing life-threatening hemorrhage at a very early stage after severe multiple injuries. An early aggressive management of ATC including a more balanced administration of blood products to improve outcome is advocated.

关键词： Coagulopathy Epidemiology Management Risk stratification Trauma

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Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism,adrenergic stress and hypothalamic regulation-a systematic review

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Burns & Trauma 2022年第1期10卷 272-282页

作者： Viktoria Mertin Patrick Most Martin Busch Stefan Trojan Christian Tapking Valentin Haug Ulrich Kneser Gabriel Hundeshagen Department of Hand Plastic and Reconstructive SurgeryBurn Trauma CenterBG Trauma Center LudwigshafenUniversity of Heidelberg67071 Ludwigshafen am RheinGermany Division of Molecular and Translational Cardi-ology Department of Internal MedicineⅢUniversity Hospital Heidelberg69120 HeidelbergGermany Deutsches Zentrum für Herz-und Kreislaufforschung(GCCR) Partner site Heidelberg/MannheimGermany Department of Anesthesiology and Intensive Care Medicine Merheim Medical CenterHospitals of CologneUniversity of Witten/Herdecke51109 CologneGermany

Background:In this systematic review,we summarize the aetiology as well as the current knowl-edge regarding thermo(dys)regulation and hypothermia after severe burn trauma and aim to present key concepts of pathophysiology and treatment *** burn injuries with>20%total body surface area(TBSA)affected commonly leave the patient requiring several surgical procedures,prolonged hospital stays and cause substantial changes to body composition and metabolism in the acute and long-term *** in severely burned patients,the loss of intact skin and the dysregulation of peripheral and central thermoregulatory processes may lead to substantial ***:A systematic and protocol-based search for suitable publications was conducted fol-lowing the PRISMA *** were screened and included if deemed *** encompasses animal-based in vivo studies as well as clinical studies examining the control-loops of thermoregulation and metabolic stability within burn patients Results:Both experimental animal studies and clinical studies examining thermoregulation and metabolic functions within burn patients have produced a general understanding of core concepts which are,nonetheless,lacking in *** describe the wide range of pathophysiological alterations observed after severe burn trauma and highlight the association between thermoregulation and hypermetabolism as well as the interactions between nearly all organ ***,the current clinical standards of mitigating the negative effects of thermodysregulation and hypothermia are summarized,as a comprehensive understanding and implementation of the key concepts is critical for patient survival and long-term ***:The available in vivo animal models have provided many insights into the interwoven pathophysiology of severe burn injury,especially concerning *** offer an outlook on concepts of altered central thermoregulation from non-burn research

关键词： Animal model Burn shock Hypothermia Thermoregulation Temperature management Burn injury Hypermetabolism

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Vitamin E treatment for children with chronic hepatitis B:A randomized placebo controlled trial

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World Journal of Gastroenterology 2008年第47期14卷 7208-7213页

作者： Patrick Gerner Hans-Georg Posselt Andreas Krahl Antje Ballauff Albina Innerhofer Christa Binder Tobias G Wenzl Matthias Zense Ariadne Hector Gerhard Dockter Rüdiger Adam Jenny Neubert Martin Claβen Robert van Gemmern Stefan Wirth Children's Hospital Duisburg-Essen university Klinik 2Essen 45122Germany witten/herdecke university HELIOS KlinikumWuppertalGermany Children's Hospital Frankfurt university Frankfurt am Main 60590Germany Children's Hospital Darmstadt 64287Germany Children's Hospital Essen university Klinik 2Essen 45122Germany Children's Hospital St.Anna Wien Austria 1090Germany Children's Hospital Aachen university Aachen 52074Germany Children's Hospital St.Clemens Münster 48153Germany Children's Hospital Homburg university Homburg/Saar 66421Germany Children's Hospital Mannheim university Mannheim 68167Germany Children's Hospital Düsseldorf university Düsseldorf 40225Germany Children's Hospital Bremen university Bremen 28195Germany Pharmacy of HELIOS Klinikum Wuppertal 42883Germany Children's Hospital HELIOS Klinikum Wuppertal42283Germany witten/herdecke university Witten/HerdeckeGermany

AIM:To evaluate the safety and efficacy of vitamin E in children with chronic hepatitis ***:We randomly assigned patients with chronic hepatitis B,positive for hepatitis B e antigen(HBeAg),to receive either vitamin E or placebo once daily for 6 mo in a 3:1 ratio and double-blind *** primary end point was HBeAg seroconversion,defined as the loss of HBeAg,undetectable levels of serum hepatitis B virus DNA,and the appearance of antibodies against HBeAg 12 mo after ***:At baseline visit,49 patients had normal and 43 had increased serum aminotransferase ***-nine patients did not respond to previous treatment with interferon-α or ***-six children completed the study;16 were non-compliant(n = 7),lost to follow-up(n = 7),or started another antiviral treatment(n = 3).Intention-to-treat analysis showed HBeAg seroconversion in 16 children(23.2%) treated with vitamin E and two(8.7%) in the placebo group(P = 0.13).Vitamin E was well ***:There is only a tendency that vitamin E may promote HBeAg *** larger studies are needed to clarify the role of antioxidants in the therapy of chronic hepatitis B.

关键词： Vertical transmission Immune tolerance Re-treatment Infant

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The questionnaire on autonomic regulation： a useful concept for integrative medicine？

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Journal of Integrative Medicine 2016年第5期14卷 315-321页

作者： Matthias Kroz Marcus Reif Danilo Pranga Roland Zerm Friedemann Schad Erik Wim Baars Matthias Girke Research Institute Havelhohe D-14089 Berlin Germany Department of Internal Medicine Havelhohe Hospital D-14089 Berlin Germany Institute for Social Medicine Epidemiology and Health Economics D-10117 Berlin Germany Institute for Integrative Medicine University of Witten/Herdecke D-58313 Witten/Herdecke Germany Society for Clinical Research D-10623 Berlin Germany Professorship Anthroposophic Healthcare University of Applied Sciences Leiden NL-2300 AJ Leiden the Netherlands

The concept of autonomic regulation （aR） reflects the relevance of the function of different autonomic systems for health, aR can be captured by questionnaires. We differentiate between a trait or constitutional aR questionnaire version including 12 （short-version） or 18 items, respectively, with three subscales （orthostatic-circulatory, rest/activity and digestive regulation）, and an 18-item state aR questionnaire on the preceding week with four subscales （rest/activity, orthostatic-circulatory, thermo- and digestive regulation）. The validated questionnaires show satisfying to good reliability and robust validity with clear construct validity. In this article, we summarized the actually available literature on aR and the use of aR questionnaires in clinical and observational studies. We described the relationship of high aR with health and in case of low aR or loss of regulation with disease and functional disorder in the three （four） different subscales and functional systems, such as rest/activity, orthostatic-circulatory or digestive regulation （thermoregulation） with the consecutive therapeutJc need. Finally, we gave perspectives of its further application in clinical research.

关键词： anthroposophic medicine autonomic regulation delivery of health care integrative medicine questionnaire

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Liver cancer:Targeted future options

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World Journal of Hepatology 2011年第2期3卷 38-44页

作者： Andreas Pircher Michael Medinger Joachim Drevs Department for Hematology and Oncology Medical University InnsbruckAnichstr.35Innsbruck 6020 Austria Hematology Department University Hospital BaselPetersgraben 4Basel 4031Switzerland Department for Internal Medicine Hematology and OncologyGemeinschaftskrankenhaus HerdeckeGerhard-Kienle-Weg 4Herdecke 58313Germany

Hepatocellular carcinoma(HCC)has a poor prognosis an d systemic chemotherapies have disappointing *** increasing knowledge of the molecular biolog y of HCC has resulted in novel targets,with the vascular endothelial growth factor and epidermal growth factor receptor(EGFR)-related pathways being of special *** blood vessel formation(angiogenesis)is essential for the growth of solid ***-angiogenic strategies have become an important therapeutic modality for solid *** agents targeting angiogenesis-related pathways have entered clinical trials or have been already approved for the treatment of solid *** include monoclonal antibodies,receptor tyrosine kinase inhibitors and immunomodulatory *** is a highly vascular tumor,and angiogenesis is be-lieved to play an important role in its development and *** review summarizes recent advances in the basic understanding of the role of angiogenesis in HCC as well as clinical trials with novel therapeutic approaches targeting angiogenesis and EGFR-related pathways.

关键词： Angiogenesis Epidermal growth factor receptor Hepatocellular carcinoma Targeted therapy Vascular endothelial growth factor

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用一种新的混合香料做斑贴试验:各组分的反应性和相关化妆品中的化学检测

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世界核心医学期刊文摘（皮肤病学分册） 2005年第9期1卷 9-11页

作者： Frosch P.J. Rastogi S.C. Pirker C. 刘艳 Department of Dermatology Klinikum Dortmund gGmbH and University of Witten/Herdecke Dortmund Germany

A new fragrance mix (FM II), with 6 frequently used chemicals not present in the currently used fragrance mix (FM I), was evaluated in 6 dermatological centres in Europe, as previously reported. In this publication, test results with the individual constituents and after repeated open application test (ROAT) of FM II are described. Furthermore, cosmetic products which had caused a contact dermatitis in patients were analysed for the presence of the individual constituents. In 1701 patients, the individual constituents of the medium (14%) and the highest (28%) concentration of FM II were simultaneously applied with the new mix at 3 concentrations (break-down testing for the lowest concentration of FM II (2.8%) was performed only if the mix was positive). ROAT was performed with the concentration of the FM II which had produced a positive or doubtful (+or ?+) patch test reaction. Patients’products were ana-lysed for the 6 target compounds by gas chromatography-mass spectrometry (GC-MS). Results:50 patients (2.9%) showed a positive reaction to 14%FM II and 70 patients (4.1%) to 28%FM II. 24/50 (48%) produced a positive reaction to 1 or more of the individual constituents of 14%FM II and 38/70 (54.3%) to 28%FM II, respectively. If doubtful reactions to individual constituents are included, the break-down testing was positive in 74%and 70%, respectively. Patients with a positive reaction to 14%FM II showed a higher rate of reactions to the individual constituent of the 28%FM II:36/50 (72%). Positive reactions to individual constituents in pa-tients negative to FM II were exceedingly rare. If doubtful reactions are regarded as negative, the sensitivity, specificity, positive predictive value and negative predictive value for the medium concentration of FM II towards at least 1 individual constituent was 92.3%(exact 95%confidence interval 74.9-99.1%), 98.4%(97.7-99.0%), 48%(33.7-62.6%) and 99.9%(99.6-100.0%), respectively. For the high concentration, the figures were very

关键词：斑贴试验柠檬醛光谱测定法金合欢醇阳性反应香草醇气相色谱仪阳性预测值己基环己烯

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Fibroadhesive scarring of grafted collagen scaffolds interferes with implant–host neural tissue integration and bridging in experimental spinal cord injury

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Regenerative Biomaterials 2019年第2期6卷 75-87页

作者： Haktan Altinova Sebastian Hammes Moniek Palm Jose Gerardo-Nava Pascal Achenbach Ronald Deumens Emmanuel Hermans Tobias Fuhrmann Arne Boecker Sabien Geraldine Antonia van Neerven Ahmet Bozkurt Joachim Weis Gary Anthony Brook Department of Neurosurgery RWTH Aachen University HospitalAachenGermany Institute of Neuropathology RWTH Aachen University HospitalAachenGermany Police Headquarters Berlin Medical CommissionBerlinGermany Institute of Neuroscience Universite Catholique de LouvainBrusselsBelgium Donnelly Centre for Cellular&Biomolecular Research University of TorontoTorontoCanada Department of Hand- Plastic and Reconstructive SurgeryBurn Centre Trauma CentreBG Trauma Centre LudwigshafenUniversity of HeidelbergLudwigshafenGermany Department of Plastic Reconstructive and Hand SurgeryBurn CentreRWTH Aachen University HospitalAachenGermany Department of Plastic AestheticHand and Burn SurgeryHelios University Hospital WuppertalUniversity Witten/HerdeckeWuppertalGermany

Severe traumatic spinal cord injury(SCI)results in a devastating and permanent loss of function,and is currently an incurable *** is generally accepted that future intervention strategies will require combinational approaches,including bioengineered scaffolds,to support axon growth across tissue scarring and cystic ***,we demonstrated that implantation of a microporous type-I collagen scaffold into an experimental model of SCI was capable of supporting functional recovery in the absence of extensive implant–host neural tissue ***,we demonstrate the reactive host cellular responses that may be detrimental to neural tissue integration after implantation of collagen scaffolds into unilateral resection injuries of the adult rat spinal *** demonstrated scattered fibroblast-like cell infiltration throughout the scaffolds as well as the presence of variable layers of densely packed cells,the fine processes of which extended along the graft–host *** reactive astroglial or regenerating axonal profiles could be seen traversing this *** encapsulation-type behaviour around bioengineered scaffolds impedes the integration of host neural tissues and reduces the intended bridging role of the *** of the cellular and molecular mechanisms underpinning this behaviour will be pivotal in the future design of collagen-based bridging scaffolds intended for regenerative medicine.

关键词： spinal cord injury CNS-scarring type-I collagen scaffold astrogliosis fibrosis encapsulation

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Prehospital care for multiple trauma patients in Germany

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Chinese Journal of Traumatology 2015年第3期18卷 125-134页

作者： Marc Maegele Departrnent for Traumatology and Orthopedic Surgery Cologne-Merheim Medical Center (CMMC) University of Witten/Herdecke (UW/H) Ostmerheimerstr. 200 D-51109 Koln Germany

For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system. The ＂Primary Survey＂ is performed by the emergency physician at the scene according to the Prehospital Trauma Life Support （PHTLS）-concept. The overall aim is to rapidly assess and treat life-threatening conditions even in the absence of patient history and diagnosis （＂treat-first-what-kills-first＂）. If no immediate treatment is necessary, a ＂Secondary Sur- vey＂ follows with careful and structured body examination and detailed assessment of the trauma mechanism. Massive and life-threatening states of hemorrhage should be addressed immediately even disregarding the ABCDE-scheme. Critical trauma patients should be referred without any delay （＂work and go＂） to TR-DGU certified trauma centers of the local trauma networks. Due to the difficult prehospital environment the number of quality studies in the field is low and, as consequence, the level of evidence for most recommendations is also low. Much information has been obtained from different care systems and the interchangeability of results is limited. The present article provides a synopsis of recommendations for early prehospital care for the severely injured based upon the 2011 updated multidisciplinary S3-Guideline ＂Polytrauma/Schwerstverletzten Behandlung＂, the most recently updated European Trauma guideline and the current PHTLS-algorithms including grades of recommendation whenever possible.

关键词： Trauma Prehospital care PHTLS Shock Surgical measures

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Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy

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Chinese Journal of Traumatology 2017年第3期20卷 125-132页

作者： Marc Maegele Zheng-Tao Gu Qiao-Bing Huang Hong Yang Department for Trauma and Orthopedic Surgery Cologne-Merheim Medical Center (CMMC) University Witten/Herdecke (UW/H) Campus Cologne-Merheim Ostmerheimerstr 200 D-51109 Koln Germany Institute for Research in Operative Medicine (IFOM) University Witten/Herdecke (UW/H) Campus Cologne-Merheim Ostmerheimerstr 200 D-51109 Koln Germany Department of Intensive Care The Third Affiliated Hospital of Southern Medical University Cuangzhou 510630 PR China Department of Pathophysiology Guangdong Provincial Key Laboratory of Shock and Microcirculation Research Southern Medical University Guangzhou 510515 PR China

Uncontrolled hemorrhage and subsequent trauma-induced coagulopathy （TIC） are still the principle causes for preventable death after trauma and early detection and aggressive management have been associated with reduced mortality. Despite increasing knowledge about trauma resuscitation, best practice to treat this newly defined entity is still under debate. A synopsis of best current knowledge with reference to the updated European trauma guideline on the management of severe trauma hemorrhage and TIC is presented. The implementation of evidence-based local protocols and algorithms including clinical quality and safety management systems together with parameters to assess key measures of bleeding control and outcome is advocated.

关键词： Hemorrhage Blood coagulation disorders Hemostatics Blood transfusion

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