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Search Results: 1 - 10 of 208950 matches for " Eberhard L Renner "
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Thromboelastography to Monitor Clotting/Bleeding Complications in Patients Treated with the Molecular Adsorbent Recirculating System
Esther B. Bachli,J?rg B?siger,Markus Béchir,John F. Stover,Reto Stocker,Marco Maggiorini,Eberhard L. Renner,Beat Müllhaupt,Reto A. Schuepbach
Critical Care Research and Practice , 2011, DOI: 10.1155/2011/313854
Abstract: Background. The Molecular Adsorbent Recirculating System (MARS) has been shown to clear albumin-bound toxins from patients with liver failure but might cause bleeding complications potentially obscuring survival benefits. We hypothesized that monitoring clotting parameters and bed-side thromboelastography allows to reduce bleeding complications. Methods. Retrospective analysis of 25 MARS sessions during which clotting parameters were monitored by a standardized protocol. Results. During MARS therapy median INR increased significantly from 1.7 to 1.9 platelet count and fibrinogen content decreased significantly from 57?fL?1 to 42?fL?1 and 2.1?g/L to 1.5?g/L. Nine relevant complications occurred: the MARS system clotted 6 times 3 times we observed hemorrhages. Absent thrombocytopenia and elevated plasma fibrinogen predicted clotting of the MARS system (ROC 0.94 and 0.82). Fibrinolysis, detected by thromboelastography, uniquely predicted bleeding events. Conclusion. Bed-side thromboelastography and close monitoring of coagulation parameters can predict and, therefore, help prevent bleeding complications during MARS therapy. 1. Introduction Due to limited donor liver availability, only selected patients with acute or acute-on-chronic liver failure profit from liver transplantation [1]. The majority of patients receive supportive therapy, and mortality remains high [2]. Various artificial liver support systems have been developed and proposed as bridging therapy until liver function recovers or a donor organ becomes available [3]. The Molecular Adsorbent Recirculating System (MARS), a cell-free albumin dialysis device, has been shown to remove albumin bound compounds and toxins and to exert a number of beneficial hemodynamic effects in patients with acute and acute-on-chronic liver failure [4]. However, to date, neither MARS nor any other liver support system has been unequivocally proven to alter clinical outcomes such as survival, a conclusion based on a meta-analysis [5] and yet unpublished multicenter clinical trials (HELIOS study, RELIEF trial; European Association for the Study of the Liver 2010). Bleeding disorders are a major concern in all patients with liver failure [6]. MARS involves an extracorporeal blood circuit through a filter. This can lead to activation of platelets and the coagulation system [7]. Recent reports describe an association of severe and potentially fatal bleeding complications with MARS therapy [8–10]. Patients’ age, vasopressor therapy, pretreatment INR, fibrin D-dimer and fibrinogen concentrations [8], factor VIII, von
Liver transplantation in the critically ill: a multicenter Canadian retrospective cohort study
Constantine J Karvellas, Thomas Lescot, Peter Goldberg, Michael D Sharpe, Juan J Ronco, Eberhard L Renner, Hina Vahidy, Zafrina Poonja, Prosanto Chaudhury, Norman M Kneteman, Markus Selzner, Earl F Cook, Sean M Bagshaw, the Canadian Liver Failure Study Group
Critical Care , 2013, DOI: 10.1186/cc12508
Abstract: Multi-center retrospective cohort study consisting of two datasets: 1) all critically-ill cirrhotic patients requiring intensive care unit (ICU) admission prior to LT at five transplant centers in Canada from 2000-2009 (one site 1990-2009) and 2) critically ill cirrhotics receiving LT from ICU (n=115) and those listed but not receiving LT prior to death (n=106) from two centres where complete data was available.In the first dataset, 198 critically ill cirrhotics receiving LT (mean [SD] age 53 [10] years, 66% male, median [IQR] model for end-stage liver disease (MELD) 34 [26-39]) were included. Mean (SD) SOFA scores at ICU admission, at 48 hours, and at LT were 12.5 (4), 13.0 (5) and 14.0 (4). Survival at 90-days was 84% (n=166). In multivariable analysis, only older age was independently associated with reduced 90-day survival (Odds Ratio [OR] 1.07; 95% CI, 1.01-1.14, p=0.013). SOFA score did not predict 90-day mortality at any time-point. In the second dataset, 47.9% (n=106) of cirrhotics listed for LT died in ICU waiting for LT. In multivariable analysis, higher SOFA at 48 hours after admission was independently associated with lower probability of receiving LT (OR 0.89; 95% CI, 0.82-0.97, p=0.006). When including serum lactate and SOFA at 48 hours in the final model, elevated lactate (at 48 hours) was also significantly associated with lower likelihood of receiving LT (0.32; 0.17-0.61, p=0.001).SOFA appears poor at predicting 90-day survival in critically ill cirrhotics following LT, but higher SOFA score and elevated lactate 48 hours after ICU admission are associated with a lower probability receiving LT. Older critically ill cirrhotics (over 60) receiving LT have worse 90-day survival and should be considered for LT with caution.
Comparing strength properties of natural and synthetic rubber mixtures
Renner, T.,Pek, L.
Sustainable Construction & Design , 2011,
Historia é um esbo?o: a nova autenticidade narrativa na historiografia e no romance
L?mmert, Eberhard;
Estudos Avan?ados , 1995, DOI: 10.1590/S0103-40141995000100019
Abstract: for two centuries historiography and the novel have been developing in competition with one another in many respects. at the same time, they are both compelled to confirm the narrated event in a more detailed manner than before. the reasons for this lie in the fact that the educational advantage of the author over the reader is diminishing. furthermore, as soon as the responsibility for the course of history is no longer attributed to individuals but rather to collective or impersonal historic forces, new patterns of representation become necessary for the historiographer and the novelist alike. they have responded to this emerging crisis of narration in various ways: by means of specialization, through pluralization of perspective, through description of structure rather than narration of events, and finally, through a radical avowal of the subjective judgment of the depicted events. the portion that any historiography shares with fiction as well as the present -and future - oriented character of history represented in the novel are thus legitimated.
Zoonotic helminths affecting the human eye
Domenico Otranto, Mark L Eberhard
Parasites & Vectors , 2011, DOI: 10.1186/1756-3305-4-41
Abstract: Homines amplius oculis, quam auribus creduntSeneca Ep 6,5Men believe their eyes more than their earsBlindness and ocular diseases represent one of the most traumatic events for human patients as they have the potential to severely impair both their quality of life and their psychological equilibrium. Although it is highly unusual, blindness has always been of great interest in human medicine. For example, the evaluation of the emotional and quality of life impacts in patients with some diseases causing blindness (e.g., macular degeneration) gave results similar to those found in diseases such as AIDS, chronic obstructive pulmonary disease, cardiac disorders and leukemia [1]. In addition, blindness has profound human and socio-economic consequences with high costs for the individual, and society, linked to lost productivity and rehabilitation estimated at $42 USD billion per year in 2000, and predicted to reach as high as $110 USD billion per year in 2020 [2].There are many causes of blindness and those induced by parasitic agents (i.e., Protozoa, Helminths and Diptera) are of major public health concern in developed and developing countries. For example, eye disease caused by river blindness (Onchocerca volvulus), affects more than 17.7 million people inducing visual impairment and blindness elicited by microfilariae that migrate to the eyes after being released by female adult worms in the subcutaneous tissues [3]. Several parasites localize in human eyes as an effect of a specific neurotropism (e.g., Toxoplasma gondii in the foetuses), larval migration (e.g., ascarids, Dirofilaria spp., Trichinella spp.) and, in a few cases, as a primary localization being released directly into the eyes (e.g., Thelazia callipaeda eyeworm and some oestrid fly larvae causing myiasis) [4].The present article focuses on those zoonotic helminths transmitted from animals to humans that affect the human eye. Undoubtedly, the parasitic zoonotic diseases and their epidemiology have been c
Perspective in the History of Science and Technology  [PDF]
Eberhard Knobloch
Advances in Historical Studies (AHS) , 2013, DOI: 10.4236/ahs.2013.23014
Abstract: Perspective in the History of Science and Technology
Melanotic neuroectodermal tumour of infancy (progonoma) treated by radical maxillary surgery
L.A Renner, A.E Abdulai
Ghana Medical Journal , 2009,
Abstract: Two cases of melanotic neuroectodermal tumour of infancy (MNTI), otherwise known as melanotic progonoma, both arising from the maxilla are presented here. The two infants both presented within three months of each other and though clinically Burkitt’s lymphoma was stated as a possible diagnosis, the correct diagnosis was made on biopsy specimens. Radical surgery consisting of wide resection of the tumour with margins of healthy tissue via hemi-maxillectomy was performed in each case as an initial method of treatment. At follow up four months later, both infants appeared clinically well. One infant was then lost to follow up thereafter but the other was reviewed three years later, and apart from slight facial asymmetry, there was no evidence of tumour recurrence.
Canonical Modeling of the Multi-Scale Regulation of the Heat Stress Response in Yeast
Luis L. Fonseca,Po-Wei Chen,Eberhard O. Voit
Metabolites , 2012, DOI: 10.3390/metabo2010221
Abstract: Heat is one of the most fundamental and ancient environmental stresses, and response mechanisms are found in prokaryotes and shared among most eukaryotes. In the budding yeast Saccharomyces cerevisiae, the heat stress response involves coordinated changes at all biological levels, from gene expression to protein and metabolite abundances, and to temporary adjustments in physiology. Due to its integrative multi-level-multi-scale nature, heat adaptation constitutes a complex dynamic process, which has forced most experimental and modeling analyses in the past to focus on just one or a few of its aspects. Here we review the basic components of the heat stress response in yeast and outline what has been done, and what needs to be done, to merge the available information into computational structures that permit comprehensive diagnostics, interrogation, and interpretation. We illustrate the process in particular with the coordination of two metabolic responses, namely the dramatic accumulation of the protective disaccharide trehalose and the substantial change in the profile of sphingolipids, which in turn affect gene expression. The proposed methods primarily use differential equations in the canonical modeling framework of Biochemical Systems Theory (BST), which permits the relatively easy construction of coarse, initial models even in systems that are incompletely characterized.
Time-dependent electron localization function
Tobias Burnus,Miguel A. L. Marques,Eberhard K. U. Gross
Physics , 2004, DOI: 10.1103/PhysRevA.71.010501
Abstract: In this article we present a generalization of the electron localization function (ELF) that can be used to analyze time-dependent processes. The time-dependent ELF allows the time-resolved observation of the formation, the modulation, and the breaking of chemical bonds, and can thus provide a visual understanding of complex reactions involving the dynamics of excited electrons. We illustrate the usefulness of the time-dependent ELF by two examples: the pi-pi* transition induced by a laser field, and the destruction of bonds and formation of lone pairs in a scattering process.
BOOK REVIEW: Field techniques for sea ice research
Angelika Renner
Polar Research , 2012, DOI: 10.3402/polar.v31i0.16813
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