Korrelation virologischer und klinischer Daten bei Kindern mit einer Adenovirus-Infektion nach allogener Stammzelltransplantation

ADV-Infektionen nach allogener Stammzelltransplantation sind jeher mit erhöhter Morbidität und Mortalität, insbesondere bei pädiatrischen Patienten assoziiert. Aus der Vergangenheit existieren zahlreiche Studien über Symptome, Komplikationen, Therapiemaßnahmen und klinischen Outcomes bei diesen Patienten. Der Darstellung einzelner Infektionsverläufe der Patienten anhand ihrer ADV-DNA-Kopienzahl im Blut (per Echtzeit-PCR gemessen), wurden diverse laborchemische Parameter, Symptome, Komplikationen und spezifische Therapiemaßnahmen mit dem Virustatikum Cidofovir gegenüber-gestellt. Ergebnisse: Folgende signifikante Korrelationskoeffizienten wurden ermittelt: Viruslast /GOT=0,973; Viruslast/GPT=0,961; Viruslast/LDH=0,956. Angesichts der Therapie mit Cidofovir konnte die ADV-Infektion bei 81% der Patienten kontrolliert werden. Insgesamt wurde ein zuverlässiger viruslastsenkender Effekt von Cidofovir bei 94% der Patienten beobachtet. Eine Wirkungs-abschwächung der Cidofovir-Therapie durch zusätzliche Immunsuppressiva konnte mit hoher Wahrscheinlichkeit ausgeschlossen werden. Häufigste klinische Manifestationen während der ADV-Infektion waren: hohes Fieber (82%), Diarrhoe/Enteritis (64%), Übelkeit und Erbrechen (76%). 6 Patienten verstarben während der akuten ADV-Infektion. Die ADV-assoziierte Mortalitätsrate lag trotz Cidofovir-Therapie bei 19%

A coordinated multi-element current differential protection scheme for active distribution systems

This paper introduces a current differential protection scheme, appropriate for application in medium voltage active distribution systems, where it is desired to keep the greatest possible number of loads and DG units energized during a fault. Conventional two-terminal percentage current differential relays are used to form successive, time-current-coordinated, differential protection zones. Multiple time-delayed differential elements in each protection zone guarantee coordination with the zone’s lateral protection devices, as well as between successive differential protection zones. Sensitive time-delayed differential elements protect against relatively high-resistance faults, while instantaneous differential elements minimize protection speed whenever possible. Additional emergency differential elements deal with post-fault topology changes and breaker failure conditions enhancing the overall scheme's performance. The proposed scheme is applied to a model of real medium voltage distribution system with distributed generation, considering a ring topology operation. A detailed simulation-based study proves the applicability and enhanced performance of the proposed scheme

Long QT syndrome provoked by induction of general anesthesia -A case report-

Long QT syndrome (LQTS) is an arrhythmogenic cardiovascular disorder resulting from mutations in cardiac ion channels. LQTS is characterized by prolonged ventricular repolarization and frequently manifests itself as QT interval prolongation on the electrocardiogram (ECG). A variety of commonly prescribed anesthetic drugs possess the adverse property of prolonging cardiac repolarization and may provoke serious ventricular tachyarrhythmia called 'torsades de pointes', ventricular fibrillation, and sudden death. We experienced a case of ventricular tachycardia and ventricular fibrillation after anesthetic induction and it came out into the open that anesthetic induction provoked long QT syndrome

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016.

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

Background: Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis.Method: Studies comparing resting state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. Results: Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterised by lower HRV (high frequency: Hedges’ g = -.29. 95%CI: -.41 to -.17, p < 0.001; time domain: Hedges’ g = -0.45, 95%CI: -0.57 to -0.33, p < .001) than controls. Panic Disorder (n=447), Post-Traumatic Stress Disorder (n=192), Generalized Anxiety Disorder (n=68), and Social anxiety disorder (n=90), but not Obsessive Compulsive Disorder (n=40), displayed reductions in high frequency HRV relative to controls (all ps < .001). Conclusions: Anxiety disorders are associated with reduced HRV, findings associated with a small to moderate effect size. Findings have important implications for future physical health and wellbeing of patients, highlighting a need for comprehensive cardiovascular risk reduction

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]