المؤلفون: Christoph Heintze, Katrina M Turner, Sabine Gehrke-Beck, Jochen Gensichen, Konrad FR Schmidt, M Baenfer, LM Baldwin, C Berhold, M Beuthling, A Bindara-Klippel, FM Brunkhorst, M Corea, D Davydov, L Eckholdt, F Eissler, Ch Engel, A Freytag, A Geist, H Gerlach, A Goldmann, J Graf, F Hamzei, M Hartmann, M Hesse, K Huelle, U Jakobi, S Kerth, D Keh, F Klefisch, R Kuehnemund, H Kuhnsch, Th Lehmann, J Lehmke, P Lehmkuhl, A Meier-Hellmann, J Muehlberg, F Mueller, F Oehmichen, G Ollenschlaeger, M Oppert, M Pohl, Z Puthucheary, S Rademacher, L Reil, K Reinhart, A Sablotzki, M Schelle, G Schelling, A Scherag, N Schilling, N Schneider, T Schreiber, D Schwarzkopf, C Spies, P Thiel, G Tiedemann, L Toepfer, S Toussaint, M Wensing, S Worrack, M von Korff, C Fleischmann-Struzek, M Böde

المصدر: BMJ Open, Vol 11, Iss 2 (2021)

مصطلحات موضوعية: Medicine

الوصف: Background Patients surviving critical illnesses, such as sepsis, often suffer from long-term complications. After discharge from hospital, most patients are treated in primary care. Little is known how general practitioners (GPs) perform critical illness aftercare and how it can be improved. Within a randomised controlled trial, an outreach training programme has been developed and applied.Objectives The aim of this study is to describe GPs’ views and experiences of caring for postsepsis patients and of participating a specific outreach training.Design Semistructured qualitative interviews.Setting 14 primary care practices in the metropolitan area of Berlin, Germany.Participants 14 GPs who had participated in a structured sepsis aftercare programme in primary care.Results Themes identified in sepsis aftercare were: continuity of care and good relationship with patients, GP’s experiences during their patient’s critical illness and impact of persisting symptoms. An outreach education as part of the intervention was considered by the GPs to be acceptable, helpful to improve knowledge of the management of postintensive care complications and useful for sepsis aftercare in daily practice.Conclusions GPs provide continuity of care to patients surviving sepsis. Better communication at the intensive care unit–GP interface and training in management of long-term complications of sepsis may be helpful to improve sepsis aftercare.Trial registration number ISRCTN61744782.

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/11/2/e040533.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/7f5ecd802fb64e9a9167e8e5f66c33c8Test

المؤلفون: R. Di Pasquale, F. Zand, C. Chavez, P. Hopkins, G. Almekhlafi, H. Haake, A. Martinho, A. Jung, R. Montoiro Allue, T. Pellis, R. Ferrer Roca, S. Busani, A. Gordon, N. Salahuddin, F. Belda, J. Rubio Mateo-Sidron, A. Goldmann, P. Deschamps, K. Mach, J. Nentwich, F. Rubulotta, G. Lunch, A. Jonas, R. Matos, A. Carvalho, T. Vymazal, M. Guillot, D. Morocho, D. Barrios, K. Koopmans, J. Machon, D. Tomescu, X. Wu, N. Cimic, C. de Cabo, M. Kol, M. Papanikolaou, C. Aragon, S. Afonso, S. Mukkera, T. Szakmany, Z. Mitrev, A. Alsheikhly, P. Garcia Olivares, M. de la Torre-Prados, A. Donnelly, M. Girardis, V. Schiavone, N. Unni, A. Vujiaklija Brajkovic, J. van den Bosch, F. Udwadia, R. Losser, L. Bormans, J. Tomás Marsilla, F. Bloos, A. Puerto-Morlan, F. Guarracino, M. Faraz, E. Meany, K. Ravi, J. Vincent, K. Zacharowski, R. Shetty, B. Misset, V. Pota, L. Sanchez-Hurtado, B. Villamagua, C. Pierrakos, C. Nutt, S. Humphreys, P. Dennesen, M. de Groot, J. Robles, J. Meyer, W. Samaniego, Q. Zhai, L. Yu, V. Koulouras, P. Gottardo, E. Caser, M. Cecconi, S. John, I. von Osten, G. Kekstas, C. Leite Mendes, H. Jamaati, A. Raj, P. Csabi, N. Catorze, R. Gueret, F. Sifrer, G. Plantefeve, A. Macri, S. Den Boer, C. Ortiz-Leyba, M. Gurjar, J. Palo, S. Hoersch, G. Kyriazopoulos, M. Balla, Z. Kheladze, M. Hobrok, T. Nguyen, L. Srinivasa, S. Henderson, G. Dominguez, A. Maghrabi, S. Mathew, M. Blahut-Zugaj, S. Spadaro, A. Lange, K. Fiedler, L. Chao, G. Pellerano, A. Rojas, L. Brochard, S. Brett, I. Soultati, A. Albis, J. Timsit, R. Quispe Sierra, A. Pais-de-Lacerda, N. Di Tomasso, E. Scarlatescu, Y. Sakr, M. Hegazi, A. Gottschalk, N. Anguel, C. Volta, M. Alvarez, K. Psaroulis, P. Monedero, L. Fernandes, M. Niesen, G. Francois, D. Debels, M. Stotz, R. Riessen, J. Auer, E. Massa, Y. Ikeda-Maquiling, J. Izura, M. Chruscikowski, F. Franco, G. Aguilar, R. Bigornia, J. Teboul, K. Bhowmick, R. Srinivasan, J. Mallat, G. Bellani, C. Van Haren, F. Philippart, F. Honig, I. Gornik, D. Filipescu, M. Fulop, M. Albarrak, S. Behrens, E. Bermudez-Aceves, K. Schwarzkopf, N. Ramakrishnan, P. Mazzini, K. Mccalman, V. Tomic, R. Catalan, M. Giannakou, D. Molano, M. Savioli, M. Watters, X. Zhang, X. Jing, P. Araujo Aguilar, C. Joya, R. Beale, M. Garfield, A. Nichol, G. Barraza, H. Siegel, D. Gkika, L. Bouadma, T. Helmes, A. Bendtsen, R. Moreno, U. Kaisers, B. Thompson, A. Araujo, C. Teixeira, T. Hurst, M. Ostermann, T. Anguseva, I. Serra, M. Deja, J. Blanquer, A. Faltlhauser, J. Strachan, V. Corcoles Gonzalez, U. Goebel, V. Karosas, J. Wauters, F. Taccone, A. Wieczorek, C. Fernandez Gonzalez, R. Smith, A. Kübler, N. Petrucci, G. Kluge, T. Pham, U. Jaschinski, M. Vander Laenen, A. Molin, G. Barberet, M. Kuiper, C. Santos, R. Medici, J. Nielsen, S. Whittle, P. Meybohm, E. Schreurs, C. Dao, J. Bedford, R. Cardiga, G. Schatzl, M. Baumgaertel, O. Balogun, J. Gutierrez Rubio, I. Martins, G. Vlachogianni, K. Guerra, E. Novy, A. Gatta, M. Mikaszewska-Sokolewicz, B. Adamik, J. Baltazar-Torres, S. Hraech, D. Higgs, A. Ferguson, F. Cecchini, E. Zogheib, S. Dixit, M. Darmon, Z. Costa, S. O’Kane, B. Siepe, S. Ñamendys-Silva, R. Ferrer, M. Popescu, B. Floccard, O. Beck, M. Christ, F. Daviaux, N. Smalley, P. Alexander, J. Lopez-Delgado, K. Reinhart, R. Jha, J. Chiche, C. Lovesio, J. Fried, D. Rodriguez, P. Vera Aratcoz, A. Cortegiani, T. Aisa, N. Remache-Vargas, E. Salgado-Yepez, A. Olmo, E. Rupnik, M. Haap, C. Motherway, M. Sungur, R. Stoica, R. Nikandish, P. Reddy, M. Miclo, N. Chinellato, E. Mouloudi, O. O’Neill, J. Lehmke, G. Nikos, P. Bauer, M. Barger, H. Atalan, J. Ferrer Agüero, A. Bellini, G. Janssen, S. Allgaeuer, G. Strandvik, P. Simon, D. Castanares, H. Ceunen, A. Rhodes, S. Simran, S. Hashemian, A. Pravin, I. Sagoschen, E. Rezende, H. Wong, J. Sole Violan, V. Castelain, S. Raineri, K. Indraratna, E. Nives Carbonell, T. Suonsyrjä, D. Wu, G. Brescia, H. Gruber, M. Sim, T. Lazowski, C. Gonzalez, C. Dellera, J. Rajasinhe

المساهمون: UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de soins intensifs

المصدر: Intensive Care Medicine
Intensive care medicine, Vol. 44, no.1, p. 144-152 (2018)

مصطلحات موضوعية: Male, medicine.medical_specialty, Severe acute respiratory infections, Critical Care and Intensive Care Medicine, Severe Acute Respiratory Syndrome, Risk Assessment, Severity of Illness Index, Severe acute respiratory infection, Seven-Day Profile Publication, Risk Factors, Intensive care, Medicine, Humans, Hospital Mortality, Prospective Studies, Intensive care medicine, Outcome, Aged, business.industry, Age Factors, Correction, Pneumonia, Middle Aged, INCEPTION COHORT, Intensive Care Units, Female, business

الوصف: Purpose In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). Methods All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. Results Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk. Conclusions Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients. Electronic supplementary material The online version of this article (doi:10.1007/s00134-015-4206-2) contains supplementary material, which is available to authorized users.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3a45d2fbb2753989844e4a1b44b624faTest
http://europepmc.org/articles/PMC7608195Test

المؤلفون: J. Lehmke, Harm Peters, D. Felsenberg, Horst Schleusener, U. Bogner

المصدر: Clinical Endocrinology. 36:511-517

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Bone density, Endocrinology, Diabetes and Metabolism, Hyperthyroidism, Absorptiometry, Photon, Endocrinology, Bone Density, Internal medicine, medicine, Humans, Quantitative computed tomography, Aged, Subclinical infection, Aged, 80 and over, Bone mineral, medicine.diagnostic_test, biology, Bone decalcification, business.industry, Middle Aged, medicine.disease, Osteopenia, Bone Diseases, Metabolic, Calcaneus, Radius, Thyroxine, Thyroidectomy, Osteocalcin, biology.protein, Female, Menopause, Tomography, X-Ray Computed, Nuclear medicine, business

الوصف: OBJECTIVE There is evidence that treatment with L-thyroxine increases the risk of early osteopaenia. The aim of our study was to investigate the effect of subclinical hyperthyroidism in patients on TSH-suppressive L-thyroxine in view of the increased risk of decalcification. DESIGN Measurements of bone mineral density were performed in patients with subclinical hyperthyroidism at different scanning sites of varying trabecular portion. Bone mineral values as well as biochemical data were compared to those of normal controls. PATIENTS Fifty patients (nine men, 25 premenopausal and 16 post-menopausal women) on TSH-suppressive doses of L-thyroxine were investigated after removal of thyroid cancer. MEASUREMENTS Dual energy quantitative computed tomography was used for osteodensitometry in the lumbar spine. Single photon absorptiometry from a 125I source was applied to the calcaneus, midshaft radius and distal as well as proximal scanning sites of the distal radius. Normal bone mineral values for each measurement site were taken from healthy reference populations. RESULTS A significant decrease of bone mineral density in the calcaneus was found in 26 of 50 patients. Bone mass assessment yielded a 9.1% decrease of mean bone mineral content in all patients compared to controls (P less than 0.01). The decrease in post-menopausal women was 22% (P less than 0.001). In premenopausal women bone mineral density changes in the calcaneus were not statistically significant. Cortical measurement sites like the midshaft radius and the proximal scanning site of the distal forearm showed a 14.8% (P less than 0.05) and 10.8% (P = NS) decalcification in post-menopausal women but normal values at the distal scanning site. The lumbar spine was not affected by subclinical hyperthyroidism in either pre or post-menopausal women. In hypoparathyroid patients, bone density did not essentially differ from normals. There was no significant correlation between bone mineral values and duration of treatment or osteocalcin values. CONCLUSIONS Our data suggest that TSH suppressive L-thyroxine treatment has a detrimental effect on the appendicular skeleton in post-menopausal women. Additional effects of oestrogen deficiency and subclinical hyperthyroidism might lead to accelerated bone loss requiring close supervision to determine the smallest dose needed for suppression of the pituitary-thyroid axis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ced75974a9250950b0f110e413335d87Test
https://doi.org/10.1111Test/j.1365-2265.1992.tb02254.x

المؤلفون: J, Lehmke

المصدر: Medizinische Klinik (Munich, Germany : 1983). 89(9)

مصطلحات موضوعية: Adult, Cardiomyopathy, Dilated, Male, Enalapril, Hypertension, Humans, Angioedema, Tongue Diseases

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::cdab3c18d27a49f7e4910321643ca73aTest
https://pubmed.ncbi.nlm.nih.gov/7968889Test

المؤلفون: F. Haberey, J. Lehmke

المصدر: Physica Status Solidi (a). 28:417-424

مصطلحات موضوعية: Chemistry, Condensed Matter Physics, Electronic, Optical and Magnetic Materials

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::df91f4a93cdc56d169e2f9723fcfda5eTest
https://doi.org/10.1002/pssa.2210280204Test

المؤلفون: J. Lehmke, K. Rehse

المصدر: Chemischer Informationsdienst. 16

مصطلحات موضوعية: Chemistry, medicine.drug_class, Anticoagulant, medicine, General Medicine, Medicinal chemistry, Ene reaction

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::fa92ecc3a2f3acbab0722dc9a4224360Test
https://doi.org/10.1002/chin.198506178Test

المؤلفون: K, Rehse, J, Lehmke

المصدر: Archiv der Pharmazie. 318(1)

مصطلحات موضوعية: Chemistry, Chemical Phenomena, Animals, Anticoagulants, In Vitro Techniques, Furans, Rats

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::df02b3293128ff80762eb2d171d6ba52Test
https://pubmed.ncbi.nlm.nih.gov/3985769Test

المؤلفون: K. Rehse, J. Lehmke

المصدر: Chemischer Informationsdienst. 15

مصطلحات موضوعية: medicine.drug_class, Chemistry, Anticoagulant, medicine, General Medicine, Medicinal chemistry, Ene reaction

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::4228a3cf1676f4b64b9bdc00970a88fbTest
https://doi.org/10.1002/chin.198450171Test

المؤلفون: K, Rehse, J, Lehmke

المصدر: Archiv der Pharmazie. 317(8)

مصطلحات موضوعية: Chemistry, Chemical Phenomena, Animals, Anticoagulants, Prothrombin, Cyclopentanes, Rats

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::72904a509605e450be0062eee5f5ed38Test
https://pubmed.ncbi.nlm.nih.gov/6497600Test

المؤلفون: J. Lehmke, K. Rehse

المصدر: Chemischer Informationsdienst. 16

مصطلحات موضوعية: chemistry.chemical_compound, chemistry, medicine.drug_class, Aryl, Anticoagulant, medicine, Organic chemistry, General Medicine

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::89b73484d2bc5aa3c18e442498cb0580Test
https://doi.org/10.1002/chin.198519193Test