Six-year experience with treatment of early donor-specific anti-HLA antibodies in pediatric lung transplantation using a human immunoglobulin-based protocol.

Objectives: Experience with the treatment of early donor-specific anti-HLA antibodies (eDSA) after lung transplantation in children is very limited. At our institution, we have treated patients with eDSA since 2013 with successive infusions of intravenous human immunoglobulins (IVIG), combined in some cases with a single dose of Rituximab and plasmapheresis (therapeutic plasma exchange [tPE]) or immunoabsorption. The aim of this study was to present the 6-year results of IVIG-based therapy in pediatric lung recipients.

[A specialized university outpatient clinic of the department of Plastic and Aesthetic Surgery].

Unlabelled: University outpatient clinics are essential for medical research, teaching and treatment of complex and special diseases based on current knowledge and guidelines. Furthermore new therapeutic approaches are developed for complicated and rare diseases. The diversity of disease entities and treatment decisions provided by a specialized university outpatient clinic for plastic and aesthetic surgery is so far unknown and subject to our research.

IgM-Enriched Human Intravenous Immunoglobulin-Based Treatment of Patients With Early Donor Specific Anti-HLA Antibodies After Lung Transplantation.

Background: At our institution, until April 2013, patients who showed early donor specific anti-HLA antibodies (DSA) after lung transplantation were preemptively treated with therapeutic plasma exchange (tPE) and a single dose of Rituximab. In April 2013, we moved to a therapy based on IgM-enriched human immunoglobulins (IVIG), repeated every 4 weeks, and a single dose of Rituximab.

Methods: This observational study was designed to evaluate the short-term patient and graft survival in patients who underwent IVIG-based DSA treatment (group A, n = 57) versus contemporary patients transplanted between April 2013 and January 2015 without DSA (group C, n = 180), as well as to evaluate DSA clearance in IVIG-treated patients versus historic patients who had undergone tPE-based treatment (group B, n = 56).

[After the crisis is before the crisis: Coping-strategies for public health emergency situations on different levels--experiences of the German E. coli outbreak 2011].

The German E. coli crisis in 2011 posed multifaceted challenges to the actors of the German health care system. This paper analyzes the outbreak from a multidisciplinary perspective.

The influence of clinical course after lung transplantation on rehabilitation success.

Pulmonary rehabilitation (PR) is a cornerstone of treatment following lung transplantation (LTx). The aim of this study was to observe the influence of a prolonged postsurgical clinical course on success of a 3-week inpatient PR. LTx recipients were divided according to their clinical course defined by their individual length of stay (LOS) in the transplant center (cohort 1: LOS >; cohort 2: ≤42 days).

Neurosurgical intensive care unit--essential for good outcomes in neurosurgery?

Introduction: Neurosurgical intensive care units were increasingly agglomerated in large centralized interdisciplinary intensive care units in the last two decades. In the majority, these centralized interdisciplinary intensive care units were directed and managed by intensivists coming from anaesthesiology. We sought to review the evidence supporting neurosurgical intensive care as a highly specialized discipline resulting in benefits for the treated patients.

Virus-associated hemophagocytic syndrome as a major contributor to death in patients with 2009 influenza A (H1N1) infection.

Introduction: Virus-associated hemophagocytic syndrome (VAHS) is a severe complication of various viral infections often resulting in multiorgan failure and death. The purpose of this study was to describe baseline characteristics, development of VAHS, related treatments and associated mortality rate of consecutive critically ill patients with confirmed 2009 influenza A (H1N1) infection and respiratory failure.

Methods: We conducted a prospective observational study of 25 critically ill patients with 2009 influenza A (H1N1) infection at a single-center intensive care unit in Germany between 5 October 2009 and 4 January 2010.

[Enhancement of quality by employing qualification-oriented staff and team-oriented cooperation].

Taking three practical examples from a university hospital the present article describes how quality can be improved by linking deployment of qualification-oriented staff with team-oriented cooperation, especially with regard to the professional groups of physicians and nurses. In the first example, a cross-professional work group defined tasks which--in a legally acceptable manner--allow selected activities to be transferred from physicians to nurses, improving the work processes of all persons concerned. Work and duty profiles, training and modified work processes were created and implemented according to the PDCA circle-based process.