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Search Results: 1 - 10 of 14774 matches for " Christian Stoppe "
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Tabuthemen in der Postmenopause: Demenz
Stoppe G
Journal für Menopause , 2000,
Abstract: Der Beitrag widmet sich der besonderen Rolle frauenspezifischer Probleme für die Demenzerkrankungen, insbesondere die Alzheimer-Demenz (AD). Neuere epidemiologische Untersuchungen deuten darauf hin, da Frauen h ufiger an den beiden Hauptformen der Demenz, der AD und der vaskul ren Demenz (VaD), erkranken. Dennoch ist nicht unumstritten, ob es sich um einen reinen Geschlechtseffekt handelt, weil die Unterschiede in Bildung, Lebenserwartung, psychosozialer Entwicklung und Gesundheitsverhalten, um nur einige Faktoren zu nennen, berücksichtigt werden müssen. Die Menopause rückte in den letzten Jahren deshalb zus tzlich besonders in das Interesse der Demenzforschung, weil sich retrospektiv zeigte, da Frauen, die eine strogensubstitution (HRT) erhalten hatten, ein bis zu 50 % geringeres Risiko, zumindest für die Entwicklung der AD, aufwiesen. Trotz wohlbekannter positiver "Effekte" von strogenen auf das ZNS ist dennoch derzeit eine pr ventive Wirkung der HRT bezüglich des Nutzen-Risiko-Verh ltnissen noch nicht ausreichend belegt.
Changes in S-100 protein serum levels in survivors of out-of-hospital cardiac arrest treated with mild therapeutic hypothermia: a prospective, observational study
Matthias Derwall, Christian Stoppe, David Brücken, Rolf Rossaint, Michael Fries
Critical Care , 2009, DOI: 10.1186/cc7785
Abstract: This was a prospective, observational study performed during a two-year period, involving medical emergency services and five collaborating hospitals at the city of Aachen, Germany. Sixty-eight subjects were enrolled by the emergency physician on duty by taking blood samples after successful attempts at resuscitation with return of spontaneous circulation (ROSC), followed by samples at 6, 12, 24, 72 and 120 hours post ROSC by the appropriate intensive care unit staff. Depending on the decision of the attending physician, subjects were cooled down to 33°C (n = 37) for 24 hours or were held at 37°C (n = 31). Patients were tracked for estimating mortality and gross neurological outcome for 14 days.S-100 levels in patients not receiving mild therapeutic hypothermia (normothermia (NT)) showed equivalent numbers as compared with cooled patients (mild therapeutic hypothermia (MTH)) on baseline (NT = 1.38 μg/l versus MTH = 1.30 μg/l; P = 0.886). S-100 levels on baseline were significantly lower in patients with a good neurological outcome at 14 days after the event in comparison to their peers with adverse outcome (P = 0.014). Although the difference in S-100 levels of MTH patients with adverse or favourable neurological outcome reached statistical significance, it did not in NT patients.Although the predictive power of S-100 levels were best on admission but not at later time points, MTH had no influence on S-100 serum levels in survivors of non-traumatic out-of-hospital cardiac arrest in the particular setting of this investigation.Sudden cardiac arrest (SCA) is the leading cause of death in the USA and Europe affecting about 750,000 people annually [1,2]. Because of improved public training of cardiopulmonary resuscitation (CPR) and advances in professional emergency medical response [3], the rate of return of spontaneous circulation (ROSC) has risen in the past decades. However, depending on the duration of the arrest, neurological survival is still a major concern [4].
Early cognitive function, recovery and well-being after sevoflurane and xenon anaesthesia in the elderly: a double-blinded randomized controlled trial
Jan Cremer, Christian Stoppe, Astrid V Fahlenkamp, Gereon Sch?lte, Steffen Rex, Rolf Rossaint, Mark Coburn
Medical Gas Research , 2011, DOI: 10.1186/2045-9912-1-9
Abstract: The study was approved by the local ethics committee and written informed consent was obtained from each patient. Patients aged 65-75 years (ASA I-III) scheduled for elective surgery (duration 60-180 min) were enrolled. Investigators performing cognitive testing and patients were blinded towards allocation to either xenon or sevoflurane anaesthesia. Baseline assessment of cognitive function was carried out 12-24 h before the operation. The results were compared to follow-up tests 6-12 and 66-72 h after surgery. Primary outcome parameter was the subtest "Alertness" of the computerized Test of Attentional Performance (TAP). Secondary outcome parameters included further subtests of the TAP, several Paper-Pencil-Tests, emergence times from anaesthesia, modified Aldrete scores and patients' well-being.40 patients were randomized and equally allocated to both groups. No significant differences were found in the TAP or the Paper-Pencil-Tests at 6-12 and 66-72 h after the operation. All emergence times were faster after xenon anaesthesia. The modified Aldrete scores were significantly higher during the first hour in the xenon group. No difference in well-being could be detected between both groups.The results show no difference in the incidence of postoperative cognitive dysfunction (POCD) after xenon or sevoflurane anaesthesia. Emergence from general anaesthesia was faster in the xenon group.Age is a known risk factor for postoperative cognitive dysfunction (POCD) after cardiac and non-cardiac surgery [1-3]. Up to 41% of patients aged 60 years and older are affected by POCD and exposed to an increased risk of death within the first 12 months after major non-cardiac surgery [1].Although a growing number of researchers are concentrating on POCD [4], no significant progress can be seen in the prevention of POCD.The noble gas xenon offers good haemodynamic stability [5-10] and favours rapid recovery from anaesthesia [11,12], both of which have been hypothesized to be beneficia
Does a 4 diagram manual enable laypersons to operate the laryngeal mask supreme?? A pilot study in the manikin
Gereon Sch?lte, Christian Stoppe, Rolf Rossaint, Laura Gilles, Maike Heuser, Steffen Rex, Mark Coburn, Norbert Zoremba, Annette Rieg
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-21
Abstract: An instruction manual of four illustrations with speech bubbles displaying the correct use of the LMAS was designed. Laypersons were handed a bag containing a LMAS, a bag mask valve device (BMV), a syringe prefilled with air and the instruction sheet, and were asked to perform and ventilate the manikin as displayed. Time to ventilation was recorded and degree of success evaluated.A total of 150 laypersons took part. Overall 145 participants (96.7%) inserted the LMAS in the manikin in the right direction. The device was inserted inverted or twisted in 13 (8.7%) attempts. Eight (5.3%) individuals recognized this and corrected the position. Within the first 2 minutes 119 (79.3%) applicants were able to insert the LMAS and provide tidal volumes greater than 150 ml (estimated dead space). Time to insertion and first ventilation was 83.2 ± 29 s. No significant difference related to previous BLS training (P = 0.85), technical education (P = 0.07) or gender could be demonstrated (P = 0.25).In manikin laypersons could insert LMAS in the correct direction after onsite instruction by a simple manual with a high success rate. This indicates some basic procedural understanding and intellectual transfer in principle. Operating errors (n = 91) were frequently not recognized and corrected (n = 77). Improvements in labeling and the quality of instructional photographs may reduce individual error and may optimize understanding.Layperson resuscitation plays an important role in providing lifesaving cardiopulmonary resuscitation (CPR) and bridging the interval to the arrival of healthcare professionals. However, only 50% of laypersons actually administer "first aid" in such situations [1,2]. Reasons given are various and include a lacking sense of personal responsibility when there are many other people "on site", an aversion to strangers' bodily fluids and the percieved risk of infection during "mouth to mouth" ventilation. Individuals may be discouraged from administering CPR by a la
Laypersons can successfully place supraglottic airways with 3 minutes of training. A comparison of four different devices in the manikin
Gereon Sch?lte, Christian Stoppe, Meral Aktas, Mark Coburn, Steffen Rex, Marlon Schwarz, Rolf Rossaint, Norbert Zoremba
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2011, DOI: 10.1186/1757-7241-19-60
Abstract: Four different supraglottic airway devices: Laryngeal Mask Classic (LMA), Laryngeal Tube (LT), Intubating Laryngeal Mask (FT) and CobraPLA (Cobra) were tested in 141 volunteers recruited in a technical university cafeteria and in a shopping mall. All volunteers received a brief standardized training session. Primary endpoint was the time required to definitive insertion. In a short questionnaire applicants were asked to assess the devices and to answer some general questions about BLS.The longest time to insertion was observed for Cobra (31.9 ± 27.9 s, range: 9-120, p < 0.0001; all means ± standard deviation). There was no significant difference between the insertion times of the other three devices. Fewest insertion attempts were needed for the FT (1.07 ± 0.26), followed by the LMA (1.23 ± 0.52, p > 0.05), the LT (1.36 ± 0.61, p < 0.05) and the Cobra (1.45 ± 0.7, p < 0.0001). Ventilation was achieved on the first attempt significantly more often with the FT (p < 0.001) compared to the other devices. Nearly 90% of the participants were in favor of implementing supraglottic airway devices in first aid algorithms and classes.Laypersons are able to operate supraglottic airway devices in manikin with minimal instruction. Ventilation was achieved with all devices tested after a reasonable time and with a high success rate of > 95%. The use of supraglottic airway devices in first aid and BLS algorithms should be considered.The securing of the airway and ventilation of the lungs is of paramount importance following initial chest compressions during cardiopulmonary resuscitation (CPR). In the preclinical setting, physical contact with the patient (in particular their mouth) presents a strong deterrent to many lay responders. Disgust and fear of infection, associated with contact with bodily fluids are frequently cited as preventing immediate care [1-3]. This may coincide with a fear of incorrect mouth-to-mouth ventilation and potential malpractice consequences.To facilitate
Blood Levels of Macrophage Migration Inhibitory Factor after Successful Resuscitation from Cardiac Arrest
Christian Stoppe, Michael Fries, Rolf Rossaint, Gerrit Grieb, Mark Coburn, David Simons, David Brücken, Jürgen Bernhagen, Norbert Pallua, Steffen Rex
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0033512
Abstract: Introduction Ischemia-reperfusion injury following cardiopulmonary resuscitation (CPR) is associated with a systemic inflammatory response, resulting in post-resuscitation disease. In the present study we investigated the response of the pleiotropic inflammatory cytokine macrophage migration inhibitory factor (MIF) to CPR in patients admitted to the hospital after out-of-hospital cardiac arrest (OHCA). To describe the magnitude of MIF release, we compared the blood levels from CPR patients with those obtained in healthy volunteers and with an aged- and gender-matched group of patients undergoing cardiac surgery with the use of extracorporeal circulation. Methods Blood samples of 17 patients with return of spontaneous circulation (ROSC) after OHCA were obtained upon admission to the intensive care unit, and 6, 12, 24, 72 and 96 h later. Arrest and treatment related data were documented according to the Utstein style. Results In patients after ROSC, MIF levels at admission (475.2±157.8 ng/ml) were significantly higher than in healthy volunteers (12.5±16.9 ng/ml, p<0.007) and in patients after cardiac surgery (78.2±41.6 ng/ml, p<0.007). Six hours after admission, MIF levels were decreased by more than 50% (150.5±127.2 ng/ml, p<0.007), but were not further reduced in the subsequent time course and remained significantly higher than the values observed during the ICU stay of cardiac surgical patients. In this small group of patients, MIF levels could not discriminate between survivors and non-survivors and were not affected by treatment with mild therapeutic hypothermia. Conclusion MIF shows a rapid and pronounced increase following CPR, hence allowing a very early assessment of the inflammatory response. Further studies are warranted in larger patient groups to determine the prognostic significance of MIF. Trial Registration ClinicalTrials.gov NCT01412619
Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study
Jan Spillner, Christian Stoppe, Nima Hatam, Andrea Amerini, Ares Menon, Christoph Nix, Ulrich Steinseifer, Yousef Abusabha, Hanna Giessen, Rüdiger Autschbach, Marcus Haushofer
Journal of Cardiothoracic Surgery , 2012, DOI: 10.1186/1749-8090-7-15
Abstract: From a microaxial pump (Abiomed), a low resistance oxygenator (Maquet and Novalung) and two cannulas (28 and 27 Fr) a system was set up and evaluated in an ovine model (n = 7). Connection with the heart was the right and left atrium. One hour the system was operated without RVF and turned of again. Then a RVF was induced and the course with the system running was evaluated. Complete hemodynamic monitoring was performed as well as echocardiography, flow measurement and blood gas analysis.The overall performance of the system was reliable. Without RVF no relevant changes of hemodynamics occurred; blood gases were supra normal. In RVF a cardiogenic shock developed (MAP 35 ± 13 mmHg, CO 1,1 ± 0,7 l/min). Immediately after starting the system the circulation normalized (significant increase of MAP to 85 ± 13 mmHg, of CO to 4,5 ± 1,9). Echocardiography also revealed right ventricular recovery. After stopping the system, RVF returned.Bypassing the right ventricle and pulmonary circulation with an oxygenating assist device, which may offer the advantages of enhanced right ventricular decompression and augmented left atrial filling, is feasible and effective in the treatment of acute RVF. Long time experiments are needed.Right ventricular failure is an often deleterious condition and associated with a high mortality [1,2]. The pathophysiology of RVF is complex, reflecting the challenges in treatment of RVF [3]. Surgical options to treat RVF are very limited and besides transplantation the only proven surgical option is a right ventricular exclusion with a "fontanisation" of blood circulation [4,5]. Conventional implantation of assist devices in RVF shows poor long-term results [6], what in our point of view is due to the fact that major mechanisms of RVF are not eliminated despite mechanical circulatory assistance. An important mechanism, which leads to low cardiac output in RVF, is the reduced trans-pulmonary blood flow with reduced left atrial-, and consecutively left vent
The Role of Macrophage Migration Inhibitory Factor in Anesthetic-Induced Myocardial Preconditioning
Andreas Goetzenich, Sandra Kraemer, Rolf Rossaint, Christian Bleilevens, Florian Dollo, Laura Siry, Setareh Rajabi-Alampour, Christian Beckers, Josefin Soppert, Hongqi Lue, Steffen Rex, Jürgen Bernhagen, Christian Stoppe
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0092827
Abstract: Introduction Anesthetic-induced preconditioning (AIP) is known to elicit cardioprotective effects that are mediated at least in part by activation of the kinases AMPK and PKCε as well as by inhibition of JNK. Recent data demonstrated that the pleiotropic cytokine macrophage migration inhibitory factor (MIF) provides cardioprotection through activation and/or inhibition of kinases that are also known to mediate effects of AIP. Therefore, we hypothesized that MIF could play a key role in the AIP response. Methods Cardiomyocytes were isolated from rats and subjected to isoflurane preconditioning (4 h; 1.5 vol. %). Subsequently, MIF secretion and alterations in the activation levels of protective kinases were compared to a control group that was exposed to ambient air conditions. MIF secretion was quantified by ELISA and AIP-induced activation of protein kinases was assessed by Western blotting of cardiomyocyte lysates after isoflurane treatment. Results In cardiomyocytes, preconditioning with isoflurane resulted in a significantly elevated secretion of MIF that followed a biphasic behavior (30 min vs. baseline: p = 0.020; 24 h vs. baseline p = 0.000). Moreover, quantitative polymerase chain reaction demonstrated a significant increase in MIF mRNA expression 8 h after AIP. Of note, activation of AMPK and PKCε coincided with the observed peaks in MIF secretion and differed significantly from baseline. Conclusions These results suggest that the pleiotropic mediator MIF is involved in anesthetic-induced preconditioning of cardiomyocytes through stimulation of the protective kinases AMPK and PKCε.
Schwindende Akzeptanz des lterwerdens?
St?helin HB,Stoppe G
Journal für Menopause , 2004,
Abstract: Die anhaltend steigende individuelle Lebenserwartung und der Geburtenrückgang führen zu einem historisch einmaligen hohen Anteil an alten Menschen, der sich zur Zeit vor allem in den Industrienationen, aber in naher Zukunft in noch viel gr erem Ausma in den Entwicklungsl ndern bemerkbar macht. Fortschritte der Medizin, aber auch bessere Ern hrung, Lebens- und Arbeitsbedingungen und die technischen M glichkeiten, Defizite in vielen Bereichen des Alltags zu kompensieren, haben zu dieser Entwicklung beigetragen. Der Gesundheitszustand und die Leistungsf higkeit der 65 80j hrigen hat sich in den letzten Dezennien stark verbessert, soda diese gegenüber früher funktionell 10 Jahre jünger erscheinen. Vor allem Pr vention und eine bessere Behandlung von chronischen Krankheiten und Behinderungen führten zu diesem Ergebnis. Die eigentlichen physiologischen Alterungsprozesse werden kaum beeinflu t. Die Langlebigkeit in den Industrienationen geht auch parallel mit dem wirtschaftlichen Wachstum und bedingt sich gegenseitig. Trotz dieser positiven Entwicklung ist die gesellschaftliche Wahrnehmung des Alters speziell in westlichen Kulturen immer noch von starken negativen, m nnlich dominierten Stereotypien gepr gt. Dies führt zu einem wachsenden Interesse an Anti-Aging-Konzepten, die aber mehr das Erscheinungsbild als den unterliegenden Proze beeinflussen. Die sich rasch ndernden Bedingungen verlangen aber von den Jüngeren und lteren eine Bereitschaft, sich Neuem auszusetzen, es aufzunehmen und anzuwenden und auch neue Lebensformen und Sozialstrukturen zu entwickeln, die den Alten eine aktive Rolle in der Gesellschaft erm glichen.
European Union and German law on co-existence: Individualisation of a systemic problem
Gerd Winter, Sarah Stoppe-Ramadan
Environmental Sciences Europe , 2011, DOI: 10.1186/2190-4715-23-28
Abstract: Still, co-existence entails conflicts which the law strives to solve. European Union law is reticent as to binding co-existence measures and has left this task to the member states. Taking Germany as a case, the established rules have not been effective because they shift conflict resolution to the local and individual level. A systemic approach suggests the use of landscape planning as a means of clustering different kinds of agriculture.The pertinent European Union and German law is summarised and interpreted. Its effects are analysed and explained. From this reform, suggestions are derived.According to the European Union, conception measures aiming at reducing health and environmental risks of genetically modified organisms must be separated from measures aiming at ensuring the economic co-existence of different kinds of agriculture. In contrast, German law on gene technology does not precisely separate risk mitigation measures from co-existence measures. The measures all aim at solving the conflicts between the individual landowners and thus fail to recognise the systemic character of the conflict between agricultures. The systemic conflict can better be solved by non-binding landscape planning or a legally binding agrarian utilisation plan, yet to be developed. Legislation addressing the conflict of agriculture must respect its constitutional dimension, i.e. the clash of basic rights to property and entrepreneurial freedom of conventional, organic and genetically modified organism farmers, industry, commerce and consumers. Binding and non-binding planning measures are compatible with constitutional guarantees as well as with European Union lawCo-existence and freedom of choice between the different agricultures is not effectively achieved by the existing individual solutions. Binding agricultural planning should therefore be introduced establishing e.g. genetically modified organism-free zones. Such measures are compatible with constitutional guarantees and wit
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