Gefäßmedizin heute: Die Berner Sicht

Zusammenfassung: Die moderne Behandlung von Gefäßpatienten stellt eine reizvolle und anspruchsvolle Aufgabe dar, welche aufgrund der Komplexität und der Breite des Spektrums heute in interdisziplinären Gefäßzentren durchgeführt werden sollte. Die enge Zusammenarbeit zwischen Gefäßchirurgen und Angiologen hat an der Universität Bern eine lange Tradition. Der vorliegende Artikel legt die grundlegende Philosophie unserer gefäßchirurgisch-angiologischen Freundschaft und Zusammenarbeit dar und schildert deren Umsetzung im klinischen Allta

Use of biomarkers or echocardiography in pulmonary embolism: the Swiss Venous Thromboembolism Registry

Background: Cardiac biomarkers and echocardiography for assessing right ventricular function are recommended to risk stratify patients with acute non-massive pulmonary embolism (PE), but it remains unclear if these tests are performed systematically in daily practice. Design and methods: Overall, 587 patients with acute non-massive PE from 18 hospitals were enrolled in the Swiss Venous Thromboembolism Registry (SWIVTER): 178 (30%) neither had a biomarker test nor an echocardiographic evaluation, 196 (34%) had a biomarker test only, 47 (8%) had an echocardiogram only and 166 (28%) had both tests. Results: Among the 409 (70%) patients with biomarkers or echocardiography, 210 (51%) had at least one positive test and 67 (16%) had positive biomarkers and right ventricular dysfunction. The ICU admission rates were 5.1% without vs. 5.6% with testing (P = 0.78), and thrombolysis or embolectomy were performed in 2.8% vs. 4.9%, respectively (P = 0.25). In multivariate analysis, syncope [odds ratio (OR): 3.49, 95% confidence interval (CI): 1.20-10.15; P = 0.022], tachycardia (OR: 2.31, 95% CI: 1.37-3.91; P = 0.002) and increasing age (OR: 1.02; 95% CI: 1.01-1.04; P < 0.001) were associated with testing of cardiac risk; outpatient status at the time of PE diagnosis (OR: 2.24, 95% CI: 1.49-3.36; P < 0.001), cancer (OR: 1.81, 95% CI: 1.17-2.79; P = 0.008) and provoked PE (OR: 1.58, 95% CI: 1.05-2.40; P = 0.029) were associated with its absence. Conclusions: Although elderly patients and those with clinically severe PE were more likely to receive a biomarker test or an echocardiogram, these tools were used in only two-thirds of the patients with acute non-massive PE and rarely in combinatio

Gain without inversion in a biased superlattice

Intersubband transitions in a superlattice under homogeneous electric field is studied within the tight-binding approximation. Since the levels are equi-populated, the non-zero response appears beyond the Born approximation. Calculations are performed in the resonant approximation with scattering processes exactly taken into account. The absorption coefficient is equal zero for the resonant excitation while a negative absorption (gain without inversion) takes place below the resonance. A detectable gain in the THz spectral region is obtained for the low-doped $GaAs$-based superlattice and spectral dependencies are analyzed taking into account the interplay between homogeneous and inhomogeneous mechanisms of broadening.Comment: 6 pages, 4 figure

Effect of continuous positive airway pressure therapy on a large hemangioma complicated with obstructive sleep apnea syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hemangiomas involving the upper airway can be an uncommon cause of obstructive sleep apnea syndrome.</p> <p>Case presentation</p> <p>A 26-year-old Caucasian man with a known history of a large hemangioma of his head and neck presented with sleep-disordered breathing to the sleep unit of our hospital. Severe obstructive sleep apnea syndrome was revealed on polysomnography. Nasal continuous positive airway pressure was implemented effectively, reducing daytime hypersomnolence and significantly improving sleep parameters. After three years of adherent use, the patient remains in a good condition and the hemangioma is stable.</p> <p>Conclusion</p> <p>Application of continuous positive airway pressure can be an effective treatment for patients with obstructive sleep apnea syndrome complicated with vascular tumors. Periodic follow-up of these patients is necessary, as little is known about the long-term effects of continuous positive airway pressure therapy.</p

Antimicrobial Peptides and Skin: A Paradigm of Translational Medicine

Antimicrobial peptides (AMPs) are small, cationic, amphiphilic peptides with broad-spectrum microbicidal activity against both bacteria and fungi. In mammals, AMPs form the first line of host defense against infections and generally play an important role as effector agents of the innate immune system. The AMP era was born more than 6 decades ago when the first cationic cyclic peptide antibiotics, namely polymyxins and tyrothricin, found their way into clinical use. Due to the good clinical experience in the treatment of, for example, infections of mucus membranes as well as the subsequent understanding of mode of action, AMPs are now considered for treatment of inflammatory skin diseases and for improving healing of infected wounds. Based on the preclinical findings, including pathobiochemistry and molecular medicine, targeted therapy strategies are developed and first results indicate that AMPs influence processes of diseased skin. Importantly, in contrast to other antibiotics, AMPs do not seem to propagate the development of antibiotic-resistant micro-organisms. Therefore, AMPs should be tested in clinical trials for their efficacy and tolerability in inflammatory skin diseases and chronic wounds. Apart from possible fields of application, these peptides appear suited as an example of the paradigm of translational medicine for skin diseases which is today seen as a `two-way road' - from bench to bedside and backwards from bedside to bench. Copyright (c) 2012 S. Karger AG, Base

Electron Counting Capacitance Standard with an improved five-junction R-pump

The Electron Counting Capacitance Standard currently pursued at PTB aims to close the Quantum Metrological Triangle with a final precision of a few parts in 10^7. This paper reports the considerable progress recently achieved with a new generation of single-electron tunnelling devices. A five-junction R-pump was operated with a relative charge transfer error of five electrons in 10^7, and was used to successfully perform single-electron charging of a cryogenic capacitor. The preliminary result for the single-electron charge quantum has an uncertainty of less than two parts in 10^6 and is consistent with the value of the elementary charge.Comment: 16 pages, 9 figures, 1 tabl

Transforming chaos to periodic oscillations

We demonstrate that the dynamics of an autonomous chaotic class C laser can be controlled to a periodic state via external modulation of the pump. In the absence of modulation, above the chaos threshold, the laser exhibits Lorenz-like chaotic pulsations. The average amplitude and frequency of these pulsations depend on the pump power. We find that there exist parameter windows where modulation of the pump power extinguishes the chaos in favor of simpler periodic behavior. Moreover we find a number of locking ratios between the pump and laser output follow the Farey sequence

Declining Sleep Quality among Nurses: A Population-Based Four-Year Longitudinal Study on the Transition from Nursing Education to Working Life

Background: Several studies have established impaired sleep is a common problem among nurses. Overworked, fatigued and stressed nurses are at a higher risk of making mistakes that threaten patient safety as well as their own health. The aim of the present study was to longitudinally monitor the development of sleep quality in nurses, starting from the last semester at the university, with three subsequent annual follow-ups once the nurses had entered working life. Methodology/Principal Findings: Nationwide, longitudinal questionnaire study of nursing students and newly qualified nurses in Sweden. The results imply a continuous decline in sleep quality among nurses during the three years of follow-up, starting from their last semester of nursing education and continuing for three years into their working life. The most pronounced short-term decline in sleep quality seems to occur in the transition between student life and working life. Conclusion/Significance: This finding is important since it may affect the quality of care and the health of nurses negatively

Direct assessment of mental health and metabolic syndrome amongst Indonesian adolescents: a study design for a mixed-methods study sampled from school and community settings

Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, with the burden largely borne by people living in low- and middle-income countries. Adolescents are central to NCD control through the potential to modify risks and alter the trajectory of these diseases across the life-course. However, an absence of epidemiological data has contributed to the relative exclusion of adolescents from policies and responses. This paper documents the design of a study to measure the burden of metabolic syndrome (a key risk for NCDs) and poor mental health (a key outcome) amongst Indonesian adolescents. Using a mixed-method design, we sampled 16-18-year-old adolescents from schools and community-based settings across Jakarta and South Sulawesi. Initial formative qualitative enquiry used focus group discussions to understand how young people conceptualise mental health and body weight (separately); what they perceive as determinants of these NCDs; and what responses to these NCDs should involve. These findings informed the design of a quantitative survey that adolescents self-completed electronically. Mental health was measured using the Centre for Epidemiologic Studies Depression Scale-Revised (CESD-R) and Kessler-10 (both validated against formal psychiatric interview in a subsample), with the metabolic syndrome measured using biomarkers and anthropometry. The survey also included scales relating to victimisation, connectedness, self-efficacy, body image and quality of life. Adolescents were sampled from schools using a multistage cluster design, and from the community using respondent-driven sampling (RDS). This study will substantially advance the field of NCD measurement amongst adolescents, especially in settings like Indonesia. It demonstrates that high quality, objective measurement is acceptable and feasible, including the collection of biomarkers in a school-based setting. It demonstrates how comparable data can be collected across both in-school and out of school adolescents, allowing a more comprehensive measure of NCD burden, risk and correlates.Peter S. Azzopardi, Lisa Willenberg, Nisaa Wulan, Yoga Devaera ... Peter Azzopardi ... Alexander Brown ... et al