Einfluss niedermolekularer Hydroxyethylstärke unterschiedlicher Ausgangssubstanz auf die Hämostase

Die Infusion von Hydroxyethylstärke (HES) kann potentiell über verschiedene Mechanismen die Hämostase beeinflussen. Aufgrund der Variabilität des HES- Moleküls steht eine Vielfalt an Präparaten mit unterschiedlichen pharmakologischen und -kinetischen Eigenschaften zur Verfügung. In einer prospektiven randomisierten Studie untersuchten wir den Einfluss zweier niedermolekularer Hydroxyethylstärkelösungen auf Kartoffel- und Maisstärkebasis auf die Hämostase im Vergleich zu einer Kontrollgruppe mit Ringerlösung. Bei 37 Patienten, die sich elektiven orthopädischen Eingriffen unterzogen, wurden zu den Zeitpunkten vor Infusion sowie 30 min und 4h nach Infusion die Globalteste der plasmatischen Gerinnung (aPTT,Quick), Fibrinogen, Faktor VIIIc und die Thrombozytenaggregation gemessen. Das von-Willebrand-Antigen bestimmten wir mittels Elektroimmundiffusion nach Laurell, den Ristocetin-Cofaktor aggregometrisch. Die primäre Hämostase untersuchten wir im in-vitro-Blutungstest mit dem PFA 100. Zusätzlich wurden Hämatokrit, Hämoglobin und Thrombozyten, zur Beurteilung rheologischer Veränderungen die Plasmaviskosität und der kolloidosmotische Druck(KOD)bestimmt. In allen drei Untersuchungsgruppen zeigte sich am zweiten Messzeitpunkt ein signifikanter Verdünnungseffekt, erkennbar am Verlauf von Hämoglobin, Hämatokrit, Plasmaviskosität, KOD sowie aPTT und Fibrinogen. In der Messung der primären Hämostase zeigte sich ebenfalls initial der Effekt der Hämodilution, am dritten Messzeitpunkt jedoch eine signifikante Aktivierung der primären Hämostase. Diese ist als Akute-Phase-Reaktion infolge perioperativer Stressfaktoren zu erklären. Es zeigten sich keine klinisch relevanten Auswirkungen auf die Hämostase. Trotz verschiedener physikochemischer Charakteristika der beiden Hydroxyethylstärken zeigen beide Lösungen hinsichtlich der untersuchten rheologischen und hämostaseologischen Parameter keine Unterschiede, was beide Präparate für den perioperativen Einsatz als gleichwertig erscheinen lässt

The Autoimmune Disease Database: a dynamically compiled literature-derived database

BACKGROUND: Autoimmune diseases are disorders caused by an immune response directed against the body's own organs, tissues and cells. In practice more than 80 clinically distinct diseases, among them systemic lupus erythematosus and rheumatoid arthritis, are classified as autoimmune diseases. Although their etiology is unclear these diseases share certain similarities at the molecular level i.e. susceptibility regions on the chromosomes or the involvement of common genes. To gain an overview of these related diseases it is not feasible to do a literary review but it requires methods of automated analyses of the more than 500,000 Medline documents related to autoimmune disorders. RESULTS: In this paper we present the first version of the Autoimmune Disease Database which to our knowledge is the first comprehensive literature-based database covering all known or suspected autoimmune diseases. This dynamically compiled database allows researchers to link autoimmune diseases to the candidate genes or proteins through the use of named entity recognition which identifies genes/proteins in the corresponding Medline abstracts. The Autoimmune Disease Database covers 103 autoimmune disease concepts. This list was expanded to include synonyms and spelling variants yielding a list of over 1,200 disease names. The current version of the database provides links to 541,690 abstracts and over 5,000 unique genes/proteins. CONCLUSION: The Autoimmune Disease Database provides the researcher with a tool to navigate potential gene-disease relationships in Medline abstracts in the context of autoimmune diseases

A Linked Open Data–Based Terminology to Describe Libre/Free and Open-source Software: Incremental Development Study

BackgroundThere is a variety of libre/free and open-source software (LIFOSS) products for medicine and health care. To support health care and IT professionals select an appropriate software product for given tasks, several comparison studies and web platforms, such as Medfloss.org, are available. However, due to the lack of a uniform terminology for health informatics, ambiguous or imprecise terms are used to describe the functionalities of LIFOSS. This makes comparisons of LIFOSS difficult and may lead to inappropriate software selection decisions. Using Linked Open Data (LOD) promises to address these challenges. ObjectiveWe describe LIFOSS systematically with the help of the underlying Health Information Technology Ontology (HITO). We publish HITO and HITO-based software product descriptions using LOD to obtain the following benefits: (1) linking and reusing existing terminologies and (2) using Semantic Web tools for viewing and querying the LIFOSS data on the World Wide Web. MethodsHITO was incrementally developed and implemented. First, classes for the description of software products in health IT evaluation studies were identified. Second, requirements for describing LIFOSS were elicited by interviewing domain experts. Third, to describe domain-specific functionalities of software products, existing catalogues of features and enterprise functions were analyzed and integrated into the HITO knowledge base. As a proof of concept, HITO was used to describe 25 LIFOSS products. ResultsHITO provides a defined set of classes and their relationships to describe LIFOSS in medicine and health care. With the help of linked or integrated catalogues for languages, programming languages, licenses, features, and enterprise functions, the functionalities of LIFOSS can be precisely described and compared. We publish HITO and the LIFOSS descriptions as LOD; they can be queried and viewed using different Semantic Web tools, such as Resource Description Framework (RDF) browsers, SPARQL Protocol and RDF Query Language (SPARQL) queries, and faceted searches. The advantages of providing HITO as LOD are demonstrated by practical examples. ConclusionsHITO is a building block to achieving unambiguous communication among health IT professionals and researchers. Providing LIFOSS product information as LOD enables barrier-free and easy access to data that are often hidden in user manuals of software products or are not available at all. Efforts to establish a unique terminology of medical and health informatics should be further supported and continued