Hyperadrenergic Postural Tachycardia Syndrome: Clinical Biomarkers and Response to Guanfacine.

Background: A subset of patients with postural tachycardia syndrome (POTS) are thought to have a primary hyperadrenergic cause. We assessed clinical biomarkers to identify those that would benefit from sympatholytic therapy.

Methods: We measured sympathetic function (supine muscle sympathetic nerve activity, upright plasma norepinephrine, and blood pressure responses to the Valsalva maneuver) in 28 patients with POTS (phenotyping cohort) to identify clinical biomarkers that are associated with responsiveness to the central sympatholytic guanfacine in a separate uncontrolled treatment cohort of 38 patients that had received guanfacine clinically for suspected hyperadrenergic POTS (HyperPOTS).

Acquired Factor XIII Deficiency in Patients with Multiple Trauma.

Introduction: Fibrin stabilizing factor (FXIII) plays a crucial role in blood clotting, tissue repair, and immune defense. FXIII deficiency after trauma can lead to prolonged wound healing due to persistent infections or coagulation disorders. The aim of this study was to describe the prevalence of acquired FXIII deficiency after trauma and to provide a description of the time-course changes of important coagulation parameters in relation to FXIII activity.

Cardiogenic Shock in Perioperative and Intraoperative Settings: A Team Approach.

Cardiogenic shock (CS) is a multifactorial disease process with high morbidity and mortality. When it occurs in a peri- or intraoperative setting, factors such as surgery, anesthesia, and post-surgical physiology can negatively affect patient outcomes. Since patient needs often escalate during CS-from medications to mechanical support to palliative care-this disease demands a multidisciplinary approach that encompasses all aspects of medical delivery.

The Impact of Forced Migration on Mortality: Evidence From German Pension Insurance Records.

We examine the long-run effects of forced migration for individuals who were displaced from Eastern Europe to Germany in the aftermath of World War II. Evidence suggests that displaced individuals were worse off economically, facing a considerably lower income and a higher unemployment risk than comparable nondisplaced Germans, even 20 years after being expelled. We extend this literature by investigating mortality outcomes.

Acetabular Fractures in an Advanced Age - Current Knowledge and Treatment Options.

The demographic change in industrial countries leads to an increasing population that sustains an acetabular fracture in an advanced age. Some authors predicted elderly individuals to be the most rapidly growing subgroup of patients currently sustaining acetabular fractures. Gold standard of treatment of acetabular fractures remains the open reduction and internal fixation.

Complexing Cations by Poly(ethylene oxide): Binding Site and Binding Mode.

The binding of K and Ba cations to short poly(ethylene oxide) (PEO) chains with ca. 4-25 monomeric units in methanol was studied by determining the effective charge of the polymer through a combination of electrophoretic NMR and diffusion NMR experiments. These cations were previously found to bind to long PEO chains in a similar strong manner.

Treatment of Tibial Non-Unions - State of the Art and Future Implications.

healing disturbances occur in 5-10% of the cases. The anatomical region of the lower limb predisposes the tibia for bone healing disturbances. Reports about the incidence of non-unions of the tibial shaft are inhomogeneous.

Binding of Monovalent and Multivalent Metal Cations to Polyethylene Oxide in Methanol Probed by Electrophoretic and Diffusion NMR.

Complex formation in methanol between monodisperse polyethylene oxide (PEO) and a large set of cations was studied by measuring the effective charge acquired by PEO upon complexation. Quantitative data were obtained at a low ionic strength of 2 mM (for some salts, also between 0.5 and 6 mM) by a combination of diffusion nuclear magnetic resonance (NMR) and electrophoretic NMR experiments.

High-dose recombinant human bone morphogenetic protein-2 impacts histological and biomechanical properties of a cervical spine fusion segment: results from a sheep model.

The 'off-label' use of high-dose recombinant human bone morphogenetic protein-2 (rhBMP-2) in lumbar and cervical fusion leads to heterotopic bone formation and vertebral osteolysis. These radiographically assessed side-effects in patients were frequently associated with an over-dosage of BMP-2. However, little is so far known about the histological, functional or biomechanical tissue consequences of over-dosage of rhBMP-2 in these specific clinical situations.

Ion association in aqueous and non-aqueous solutions probed by diffusion and electrophoretic NMR.

The results of diffusion and electrophoretic NMR (eNMR) measurements are reported for a series of tetramethylammonium (TMA) electrolytes (with sulphate, fluoride, acetate, chloride, bromide, nitrate, iodide and perchlorate as anions) in deuterated solvents such as water, dimethylsulphoxide (DMSO), acetonitrile, methanol and ethanol. In addition, similar data are presented for aqueous solutions of tetraalkylammonium salts with increasing alkyl chain length. The combination of diffusion NMR and eNMR yields the effective charge for the TMA cation.

Impact of high prevalence of pseudomonas and polymicrobial gram-negative infections in major sub-/total traumatic amputations on empiric antimicrobial therapy: a retrospective study.

Introduction: Emergency treatment of major sub-/total traumatic amputations continue to represent a clinical challenge due to high infection rates and serious handicaps. Effective treatment is based on two columns: surgery and antimicrobial therapy. Detailed identification of pathogen spectrum and epidemiology associated with these injuries is of tremendous importance as it guides the initial empiric antibiotic regimen and prevents adverse septic effents.

On electrophoretic NMR. Exploring high conductivity samples.

The performance of a new electrophoretic NMR (eNMR) method that uses a Carr-Purcell-Meiboom-Gill echo train with repeated electric field reversal is investigated. We show that this pulse sequence, with acronym CPMGER, yields strongly reduced artifacts from convective flow effects caused by the simultaneous presence of electroosmotic and thermal driving forces. We demonstrate the achieved improvements in various aqueous solutions.

Requirement for a structured algorithm in cardiac arrest following major trauma: epidemiology, management errors, and preventability of traumatic deaths in Berlin.

Background: Despite continuous innovation in trauma care, fatal trauma remains a significant medical and socioeconomic problem. Traumatic cardiac arrest (tCA) is still considered a hopeless situation, whereas management errors and preventability of death are neglected. We analyzed clinical and autopsy data from tCA patients in an emergency-physician-based rescue system in order to reveal epidemiologic data and current problems in the successful treatment of tCA.

Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease.

Objective: Use of robotically assisted hysterectomy for benign gynecologic conditions is increasing. Using the most recent, available nationwide data, we examined clinical outcomes, safety, and cost of robotic compared with laparoscopic hysterectomy.

Methods: Women undergoing robotic or laparoscopic hysterectomy for benign disease were identified from the United States 2009 and 2010 Nationwide Inpatient Sample.

Trauma-related preventable deaths in Berlin 2010: need to change prehospital management strategies and trauma management education.

Background: Fatal trauma is one of the leading causes of death in Western industrialized countries. The aim of the present study was to determine the preventability of traumatic deaths, analyze the medical measures related to preventable deaths, detect management failures, and reveal specific injury patterns in order to avoid traumatic deaths in Berlin.

Materials And Methods: In this prospective observational study all autopsied, direct trauma fatalities in Berlin in 2010 were included with systematic data acquisition, including police files, medical records, death certificates, and autopsy records.

Constant-time chemical-shift selective imaging.

We demonstrate that chemical-shift-selective constant-time imaging (CTI) can be performed by simply inserting selective saturation into the original imaging pulse sequence. The performance of the proposed method is illustrated by (7)Li CTI imaging in a battery model that contains both Li metal electrodes and an electrolyte containing a dissolved Li salt.

Quantifying mass transport during polarization in a Li ion battery electrolyte by in situ 7Li NMR imaging.

Poor mass transport in the electrolyte of Li ion batteries causes large performance losses in high-power applications such as vehicles, and the determination of transport properties under or near operating conditions is therefore important. We demonstrate that in situ (7)Li NMR imaging in a battery electrolyte can directly capture the concentration gradients that arise when current is applied. From these, the salt diffusivity and Li(+) transport number are obtained within an electrochemical transport model.

Overall distribution of trauma-related deaths in Berlin 2010: advancement or stagnation of German trauma management?

Background: Trauma is the leading cause of death among children, adolescents, and young adults. The latest data from the German Trauma Registry reveals a constant decrease in trauma mortality, indicating that 11.6 % of all trauma patients in 2010 died in hospital.