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  1. Article ; Online: SARS-CoV-2 Altered Hemorheological and Hematological Parameters during One-Month Observation Period in Critically Ill COVID-19 Patients

    Daniel Alexander Bizjak / Lucas John / Lynn Matits / Alisa Uhl / Sebastian Victor Waldemar Schulz / Jana Schellenberg / Johannes Peifer / Wilhelm Bloch / Manfred Weiß / Beate Grüner / Hendrik Bracht / Jürgen Michael Steinacker / Marijke Grau

    International Journal of Molecular Sciences, Vol 23, Iss 15332, p

    2022  Volume 15332

    Abstract: Hematological and hemorheological parameters are known to be altered in COVID-19; however, the value of combined monitoring in order to deduce disease severity is only scarcely examined. A total of 44 acute SARS-CoV-2-infected patients (aCOV) and 44 age- ... ...

    Abstract Hematological and hemorheological parameters are known to be altered in COVID-19; however, the value of combined monitoring in order to deduce disease severity is only scarcely examined. A total of 44 acute SARS-CoV-2-infected patients (aCOV) and 44 age-matched healthy controls (Con) were included. Blood of aCOV was sampled at admission (T0), and at day 2 (T2), day 5 (T5), day 10 (T10), and day 30 (T30) while blood of Con was only sampled once. Inter- and intra-group differences were calculated for hematological and hemorheological parameters. Except for mean cellular volume and mean cellular hemoglobin, all blood cell parameters were significantly different between aCOV and Con. During the acute disease state (T0–T5), hematological and hemorheological parameters were highly altered in aCOV; in particular, anemic conditions and increased immune cell response/inflammation, oxidative/nitrosative stress, decreased deformability, as well as increased aggregation, were observed. During treatment and convalescence until T30, almost all abnormal values of aCOV improved towards Con values. During the acute state of the COVID-19 disease, the hematological, as well as the hemorheological system, show fast and potentially pathological changes that might contribute to the progression of the disease, but changes appear to be largely reversible after four weeks. Measuring RBC deformability and aggregation, as well as oxidative stress induction, may be helpful in monitoring critically ill COVID-19 patients.
    Keywords COVID-19 ; hemorheology ; RBC deformability ; aggregation ; inflammation ; thrombosis ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: A multifaceted educational intervention improved anti-infectious measures but had no effect on mortality in patients with severe sepsis

    Daniel Schwarzkopf / Claudia Tanja Matthaeus-Kraemer / Daniel O. Thomas-Rüddel / Hendrik Rüddel / Bernhard Poidinger / Friedhelm Bach / Herwig Gerlach / Matthias Gründling / Matthias Lindner / Christian Scheer / Philipp Simon / Manfred Weiss / Konrad Reinhart / Frank Bloos / MEDUSA study group

    Scientific Reports, Vol 12, Iss 1, Pp 1-

    2022  Volume 13

    Abstract: Abstract Sepsis is a major reason for preventable hospital deaths. A cluster-randomized controlled trial on an educational intervention did not show improvements of sepsis management or outcome. We now aimed to test an improved implementation strategy in ...

    Abstract Abstract Sepsis is a major reason for preventable hospital deaths. A cluster-randomized controlled trial on an educational intervention did not show improvements of sepsis management or outcome. We now aimed to test an improved implementation strategy in a second intervention phase in which new intervention hospitals (former controls) received a multifaceted educational intervention, while controls (former intervention hospitals) only received feedback of quality indicators. Changes in outcomes from the first to the second intervention phase were compared between groups using hierarchical generalized linear models controlling for possible confounders. During the two phases, 19 control hospitals included 4050 patients with sepsis and 21 intervention hospitals included 2526 patients. 28-day mortality did not show significant changes between study phases in both groups. The proportion of patients receiving antimicrobial therapy within one hour increased in intervention hospitals, but not in control hospitals. Taking at least two sets of blood cultures increased significantly in both groups. During phase 2, intervention hospitals showed higher proportion of adequate initial antimicrobial therapy and de-escalation within 5 days. A survey among involved clinicians indicated lacking resources for quality improvement. Therefore, quality improvement programs should include all elements of sepsis guidelines and provide hospitals with sufficient resources for quality improvement. Trial registration: ClinicalTrials.gov, NCT01187134. Registered 23 August 2010, https://www.clinicaltrials.gov/ct2/show/study/NCT01187134 .
    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Association of adiponectin levels and insulin demand in critically ill patients

    Andreas Hillenbrand / Manfred Weiss / Uwe Knippschild

    Diabetes, Metabolic Syndrome and Obesity, Vol 2011, Iss default, Pp 45-

    2011  Volume 51

    Abstract: Andreas Hillenbrand1, Manfred Weiss3, Uwe Knippschild1, Hans G Stromeyer1, Doris Henne-Bruns1, Markus Huber-Lang2,† Anna M Wolf1,†1Department of General, Visceral, and Transplantation Surgery, 2Department of Traumatology, Hand and Reconstructive Surgery, ...

    Abstract Andreas Hillenbrand1, Manfred Weiss3, Uwe Knippschild1, Hans G Stromeyer1, Doris Henne-Bruns1, Markus Huber-Lang2,† Anna M Wolf1,†1Department of General, Visceral, and Transplantation Surgery, 2Department of Traumatology, Hand and Reconstructive Surgery, 3Department of Anesthesiology, University Hospital of Ulm, Ulm, Germany †These authors contributed equallyPurpose: Intensive care unit patients usually have a deregulated glucose homeostasis and present with hyperglycemia and hyperinsulinemia, suggesting overall insulin resistance. Adiponectin has significant anti-inflammatory and insulin-sensitizing effects and is diminished in morbidly obese and in critically ill patients. Reduced adiponectin could contribute to insulin resistance in these patients. We examined how far insulin demand in critically ill patients is correlated with patient adiponectin levels.Patients and methods: Adiponectin, resistin, leptin, insulin demand, minimal and maximal blood sugar levels, epinephrine, and hydrocortisone demand were measured 1 day after diagnosis of severe sepsis or septic shock in 25 patients (8 female, 17 male; median age 65 years; range: 31 to 87 years).Results: Insulin demand (range: 0–8 IU/h; median 3.5 IU) was positively correlated with serum adiponectin levels (median: 10.1 µg/mL; range: 2.9–47.6 µg/mL; r = +0.56, P < 0.01). There was no significant correlation between insulin demand and leptin serum levels (median: 18.1 ng/mL; range: 0.3–80.7 ng/mL; r = +0.29, P = 0.08) or resistin serum levels (median: 103.9 ng/mL; range: 14.7–352.3 ng/mL; r = +0.13, P = 0.27). Epinephrine demand (median: 0.08 µg/kg*min; range: 0.02–0.63 µg/kg*min) was negatively correlated with male adiponectin levels (r = -0.58; P < 0.01; females: r = -0.36; P = 0.19) and positively correlated with resistin levels (r = 0.43; P = 0.02). Patient body mass index (median 26 kg/m²; range: 18–37) was positively correlated with serum leptin (r = 0.60; P < 0.01) but was not correlated with insulin demand (r = 0.19; P = 0.19), or ...
    Keywords Specialties of internal medicine ; RC581-951
    Subject code 616
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Dove Medical Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Bioassay for Endothelial Damage Mediators Retrieved by Hemoadsorption

    Maximilian Denzinger / Ludger Staendker / Keno Ehlers / Julian M. Schneider / Tanja Schulz / Tabea Hein / Sebastian Wiese / Annika Roecker / Ruediger Gross / Jan Münch / Hendrik Bracht / Eberhard Barth / Manfred Weiss / Michael Georgieff / E. Marion Schneider

    Scientific Reports, Vol 9, Iss 1, Pp 1-

    2019  Volume 13

    Abstract: Abstract Hemoadsorption devices are used to treat septic shock by adsorbing inflammatory cytokines and as yet incompletely defined danger and pathogen associated molecular patterns. In an ideal case, hemoadsorption results in immediate recovery of ... ...

    Abstract Abstract Hemoadsorption devices are used to treat septic shock by adsorbing inflammatory cytokines and as yet incompletely defined danger and pathogen associated molecular patterns. In an ideal case, hemoadsorption results in immediate recovery of microvascular endothelial cells’ (mEC) function and rapid recovery from catecholamine-dependency and septic shock. We here tested a single device, which consists of polystyrene-divinylbenzene core particles of 450 μm diameter with a high affinity for hydrophobic compounds. The current study aimed at the proof of concept that endothelial-specific damage mediators are adsorbed and can be recovered from hemoadsorption devices. Because of excellent clinical experience, we tested protein fractions released from a hemoadsorber in a novel endothelial bioassay. Video-based, long-term imaging of mEC proliferation and cell death were evaluated and combined with apoptosis and ATP measurements. Out of a total of 39 fractions recovered from column fractionation, we identified 3 fractions that caused i) inhibition of mEC proliferation, ii) increased cell death and iii) induction of apoptosis in mEC. When adding these 3 fractions to mEC, their ATP contents were reduced. These fractions contained proteins of approximately 15 kDa, and high amounts of nucleic acid, which was at least in part oxidized. The efficacy for endothelial cell damage prevention by hemoadsorption can be addressed by a novel endothelial bioassay and long-term video observation procedures. Protein fractionation of the hemoadsorption devices used is feasible to study and define endothelial damage ligands on a molecular level. The results suggest a significant effect by circulating nucleic acids – bound to an as yet undefined protein, which may constitute a major danger-associated molecular pattern (DAMP) in the exacerbation of inflammation when patients experience septic shock. Hemoadsorption devices may thus limit endothelial damage, through the binding of nucleic acid-bearing aggregates and thus contribute to improved endothelial barrier function.
    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2019-10-01T00:00:00Z
    Publisher Nature Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Sepsis-Induced Adipokine Change with regard to Insulin Resistance

    Andreas Hillenbrand / Manfred Weiss / Uwe Knippschild / Anna Maria Wolf / Markus Huber-Lang

    International Journal of Inflammation, Vol

    2012  Volume 2012

    Keywords Pathology ; RB1-214 ; Medicine ; R ; DOAJ:Pathology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Language English
    Publishing date 2012-01-01T00:00:00Z
    Publisher Hindawi Publishing Corporation
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: One-year follow-up of the CAPSID randomized trial for high-dose convalescent plasma in severe COVID-19 patients

    Sixten Körper / Beate Grüner / Daniel Zickler / Thomas Wiesmann / Patrick Wuchter / Rainer Blasczyk / Kai Zacharowski / Peter Spieth / Torsten Tonn / Peter Rosenberger / Gregor Paul / Jan Pilch / Joachim Schwäble / Tamam Bakchoul / Thomas Thiele / Julian Knörlein / Matthias M. Dollinger / Jörg Krebs / Martin Bentz /
    Victor M. Corman / Dzenan Kilalic / Gerlinde Schmidtke-Schrezenmeier / Philipp M. Lepper / Lucas Ernst / Hinnerk Wulf / Alexandra Ulrich / Manfred Weiss / Jan Matthias Kruse / Thomas Burkhardt / Rebecca Müller / Harald Klüter / Michael Schmidt / Bernd Jahrsdörfer / Ramin Lotfi / Markus Rojewski / Thomas Appl / Benjamin Mayer / Philipp Schnecko / Erhard Seifried / Hubert Schrezenmeier

    The Journal of Clinical Investigation, Vol 132, Iss

    2022  Volume 24

    Abstract: BACKGROUND Results of many randomized trials on COVID-19 convalescent plasma (CCP) have been reported, but information on long-term outcome after CCP treatment is limited. The objectives of this extended observation of the randomized CAPSID trial are to ... ...

    Abstract BACKGROUND Results of many randomized trials on COVID-19 convalescent plasma (CCP) have been reported, but information on long-term outcome after CCP treatment is limited. The objectives of this extended observation of the randomized CAPSID trial are to assess long-term outcome and disease burden in patients initially treated with or without CCP.METHODS Of 105 randomized patients, 50 participated in the extended observation. Quality of life (QoL) was assessed by questionnaires and a structured interview. CCP donors (n = 113) with asymptomatic to moderate COVID-19 were included as a reference group.RESULTS The median follow-up of patients was 396 days, and the estimated 1-year survival was 78.7% in the CCP group and 60.2% in the control (P = 0.08). The subgroup treated with a higher cumulative amount of neutralizing antibodies showed a better 1-year survival compared with the control group (91.5% versus 60.2%, P = 0.01). Medical events and QoL assessments showed a consistent trend for better results in the CCP group without reaching statistical significance. There was no difference in the increase in neutralizing antibodies after vaccination between the CCP and control groups.CONCLUSION The trial demonstrated a trend toward better outcome in the CCP group without reaching statistical significance. A predefined subgroup analysis showed a significantly better outcome (long-term survival, time to discharge from ICU, and time to hospital discharge) among those who received a higher amount of neutralizing antibodies compared with the control group. A substantial long-term disease burden remains after severe COVID-19.Trial registration EudraCT 2020-001310-38 and ClinicalTrials.gov NCT04433910.Funding Bundesministerium für Gesundheit (German Federal Ministry of Health).
    Keywords COVID-19 ; Therapeutics ; Medicine ; R
    Subject code 796
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher American Society for Clinical Investigation
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Active Cytomegalovirus Infection in Patients with Septic Shock

    Lutz von Müller / Anke Klemm / Manfred Weiss / Marion Schneider / Heide Suger-Wiedeck / Nilgün Durmus / Walter Hampl / Thomas Mertens

    Emerging Infectious Diseases, Vol 12, Iss 10, Pp 1517-

    2006  Volume 1522

    Abstract: Cytomegalovirus (CMV) is a pathogen of emerging importance for patients with septic shock. In this prospective study, 25 immunocompetent CMV-seropositive patients with septic shock and an intensive care unit stay of >7 days were monitored by using ... ...

    Abstract Cytomegalovirus (CMV) is a pathogen of emerging importance for patients with septic shock. In this prospective study, 25 immunocompetent CMV-seropositive patients with septic shock and an intensive care unit stay of >7 days were monitored by using quantitative pp65-antigenemia assay, shell vial culture, and virus isolation. Within 2 weeks, active CMV infection with low-level pp65-antigenemia (median 3 positive/5 × 105 leukocytes) developed in 8 (32%) patients. Infection was controlled within a few weeks (median 26 days) without use of antiviral therapy. Duration of intensive care and mechanical ventilation were significantly prolonged in patients with active CMV infection. CMV reactivation was associated with concomitant herpes simplex virus reactivation (p = 0.004). The association between active CMV infection and increased illness could open new therapeutic options for patients with septic shock. Future interventional studies are required.
    Keywords sepsis ; reactivation ; cytomegalovirus ; herpes simplex virus ; diagnostic assays ; Germany ; Medicine ; R ; Infectious and parasitic diseases ; RC109-216
    Language English
    Publishing date 2006-10-01T00:00:00Z
    Publisher Centers for Disease Control and Prevention
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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