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Struthers A.D.,University of Dundee | Unger T.,Charit University Medicine Berlin
European Heart Journal, Supplement | Year: 2011

New adverse effects of aldosterone are now apparent: endothelial dysfunction, myocardial fibrosis and LV remodelling. Aldosterone blockade is able to reverse these adverse effects and so reduce mortality in heart failure. Pharmacological differences between spironolactone and eplerenone are discussed. © 2011 The Author. Source

Monnig G.,University of Munster | Kobe J.,University of Munster | Loher A.,University of Munster | Wasmer K.,University of Munster | And 9 more authors.
Europace | Year: 2012

Aims The use of implantable cardioverter defibrillators (ICD) in patients with torsade de pointes (TdP) and ventricular fibrillation in the presence of acquired long QT syndrome (aLQTS) is under debate, partly due to the fact that aLQTS is potentially reversible and currently no long-term follow-up data are available. We aimed to evaluate the long-term follow-up of patients with acquired long QT syndrome (aLQTS) who had received an implantable cardioverter defibrillator (ICD) for secondary prevention of sudden cardiac arrest (SCA). Method and resultsOver a 10 year period, 43 patients with an ICD after survived cardiac arrest (SCA) due to an aLQTS were included [female n 27 (63%); mean age 61±16 years]. There was no clinical evidence for congenital LQTS (Schwartz score 1.25±0.8). Structural heart disease was present in 29 patients (47%; ischaemic n 13; dilated cardiomyopathy n 9; mean EF 41±12). The most common proarrhythmic trigger happened to be antiarrhythmic drugs (n 34; 79). Other triggers included contrast agent (n 1), haloperidol (n 2), severe hypokalaemia (n 2), drug abuse/alcohol (n 2), and mere severe bradycardia (n 2). Under trigger QTc interval measured 536±58 vs. 438±33 ms without trigger (P< 0.001). During a mean follow-up of 84 ± 55 months, appropriate shocks occurred in 19 patients (44%); inappropriate shocks in 13 patients (30; only inappropriate n 3). Appropriate shocks were almost as common in patients without as in those with structural heart disease (35 vs. 48%; P = 0.32). None of the patients were re-exposed to the initial trigger during the follow-up period. Beta-blocker medication did not prevent ICD shocks (12 of 19 vs. 11 of 24 on medication). ConclusionAppropriate ICD shocks are a common finding in patients with aLQTS and SCA irrespective of the underlying cause or structural heart disease. Thus, even in the presence of relevant acquired proarrhythmia ICD may be beneficial. © The Author 2011. Source

Muschalla B.,Charit University Medicine Berlin | Linden M.,Charit University Medicine Berlin
Psychopathology | Year: 2012

Objective: Job anxiety is a severe problem in many patients with chronic mental disorders, as it usually results in specific participation problems in the workplace and long-term sick leave. The aim of this study was to explore the development of sick leave in dependence on general psychosomatic complaints and job anxiety from admission to a psychosomatic inpatient treatment until 6 months after discharge. Method: A convenience sample of 91 patients, suffering from multiple mental disorders, filled in self-rating questionnaires on job anxiety (Job Anxiety Scale) and on general psychosomatic symptom load (Symptom Checklist-90-Revised) at the beginning, the end, and 6 months after discharge from an inpatient psychosomatic treatment. Additionally, sick leave status and employment status were assessed before and 6 months after the treatment. Results: 15.4% of 91 patients were on sick leave before inpatient treatment and at follow-up (SS group), 20.9% were fit for work at intake and follow-up (FF group), 6.6% were fit for work initially and on sick leave later (FS group), and 57.1% on sick leave first and working at follow-up (SF group). In regard to general psychosomatic complaints, there were initially high scores on the SCL, a marked reduction during inpatient treatment, and a bouncing back to initial levels at follow-up for all 4 patient groups. SS and FS patients showed the highest scores at intake and follow-up. Concerning job anxiety, SS patients had the highest scores at all three assessments, while FF patients had significantly lower scores, with only low variation between assessments. SF patients started with comparatively high scores of job anxiety, which even increased before reentering work, but decreased in the follow-up period when they were confronted with work again. FS patients started low (like the FF patients) at intake, reduced their job anxiety further till discharge, but increased to higher scores at follow-up. Conclusions: General psychosomatic symptom load and job anxiety show a different course during treatment and are differently related to sick leave. General psychosomatic symptom load can be understood as a measure of the degree of the chronic illness status, whereas job anxiety reflects specific additional context-related problems, i.e. problems with work. A core finding is that job anxiety is related to work avoidance, but work exposure may reduce job anxiety. This has direct consequences for putting patients on sick leave or not. Copyright © 2012 S. Karger AG, Basel. Source

Kuzmicheva O.,University of Bremen | Focke Martinez S.,University of Bremen | Krebs U.,University of Bremen | Spranger M.,Neurological Rehabilitation Center Friedehorst | And 3 more authors.
Proceedings - IEEE International Conference on Robotics and Automation | Year: 2016

This paper presents the novel mobile robotic gait rehabilitation system MOPASS and the first results from its usability testing in the clinics. Consisting of an adjustable mobile platform and a modular powered orthosis attached to the platform, the MOPASS system is able to cope with individual needs of patients during the overground walking training. The control system of MOPASS allows generation of individual gait patterns. The adjustment of the gait patterns to the patient is done over a graphical user interface by simple manipulation of the gait pattern curves displayed on the screen. The first results on the system application were obtained in two clinics with 20 patients in total. The results show a high degree of acceptance by both, therapists and patients, and indicate good prospects for the MOPASS system. © 2016 IEEE. Source

Brockmann T.,Charit University Medicine Berlin | Steger C.,Charit University Medicine Berlin | Dawczynski J.,University of Leipzig
Ophthalmologica | Year: 2012

The purpose of this study was to evaluate photodynamic properties of indocyanine green (ICG), brilliant blue G (BBG) and trypan blue (TB) as currently used vital dyes for chromovitrectomy. Under consideration of intraoperative illumination intensities and dye concentrations, a simulative in vitro investigation was set up. Therefore, standardized dilutions of original ICG, BBG and TB vials were irradiated at a wavelength of 366 nm with an intensity of 14 μW/cm2 between 0 and 48 h. After this, all samples were measured spectroscopically in a 220-to 750-nm bandwidth. Analyzing the vital dyes over the time course, an exponential photolysis was observed for ICG, whereas BBG and TB presented photostable properties. Regarding ICG, 5% of the concentration was degraded to toxic metabolites every 20 min. For this reason, our study provides evidence that intraocular dye concentrations and modern endoillumination systems alone cannot fully prevent ICG photodegradation. © 2012 S. Karger AG, Basel. Source

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