Vasko, Radovan

[["dc.bibliographiccitation.artnumber","598"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Journal of Medical Case Reports"],["dc.bibliographiccitation.volume","5"],["dc.contributor.author","Patschan, Daniel"],["dc.contributor.author","Korsten, Peter"],["dc.contributor.author","Behlau, Arne"],["dc.contributor.author","Vasko, Radovan"],["dc.contributor.author","Heeg, Malte H. J."],["dc.contributor.author","Sweiss, Nadera J."],["dc.contributor.author","Müller, Gerhard A."],["dc.contributor.author","Koziolek, Michael Johann"],["dc.date.accessioned","2019-07-09T11:53:25Z"],["dc.date.available","2019-07-09T11:53:25Z"],["dc.date.issued","2011"],["dc.description.abstract","Introduction Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome is a life-threatening condition with various etiopathogeneses. Without therapy approximately 90% of all patients die from the disease. Case presentation We report the case of a 17-year-old Caucasian woman with widespread hematomas and headache. Due to hemolytic anemia, thrombocytopenia, and schistocytosis, thrombotic thrombocytopenic purpura-hemolytic uremic syndrome was suspected and plasma exchange therapy was initiated immediately. Since her thrombocyte level did not increase during the first week of therapy, plasma treatment had to be intensified to a twice-daily schedule. Further diagnostics showed markedly reduced activities of both ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 - also known as von Willebrand factor-cleaving protease) and factor H. Test results for antibodies against both proteins were positive. While plasma exchange therapy was continued, rituximab was given once weekly for four consecutive weeks. After the last dose, thrombocytes and activities of ADAMTS-13 and factor H increased into the normal range. Our patient improved and was discharged from the hospital. Conclusions Since no clinical symptoms/laboratory findings indicated a malignant or specific autoimmune-mediated disorder, the diagnosis made was thrombotic thrombocytopenic purpura-hemolytic uremic syndrome due to idiopathic combined, autoantibody-mediated ADAMTS-13/factor H deficiency."],["dc.identifier.doi","10.1186/1752-1947-5-598"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/7456"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/60419"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.notes.intern","In goescholar not merged with http://resolver.sub.uni-goettingen.de/purl?gs-1/15282 but duplicate"],["dc.rights","Goescholar"],["dc.rights.access","openAccess"],["dc.rights.holder","Patschan et al.; licensee BioMed Central Ltd."],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.title","Idiopathic combined, autoantibody-mediated ADAMTS-13/factor H deficiency in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in a 17-year-old woman: a case report"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","e0199345"],["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","PloS one"],["dc.bibliographiccitation.lastpage","e0199345"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Korsten, Peter"],["dc.contributor.author","Mavropoulou, Eirini"],["dc.contributor.author","Wienbeck, Susanne"],["dc.contributor.author","Ellenberger, David"],["dc.contributor.author","Patschan, Daniel"],["dc.contributor.author","Zeisberg, Michael"],["dc.contributor.author","Vasko, Radovan"],["dc.contributor.author","Tampe, Björn"],["dc.contributor.author","Müller, Gerhard A."],["dc.date.accessioned","2019-07-09T11:45:40Z"],["dc.date.available","2019-07-09T11:45:40Z"],["dc.date.issued","2018"],["dc.description.abstract","RATIONALE: Central venous catheter (CVC) placement is a standard procedure in critical care. Ultrasound guidance during placement is recommended by current guidelines, but there is no consensus on the best method for evaluating the correct CVC tip position. Recently, the \"rapid atrial swirl sign\" (RASS) has been investigated in a limited number of studies. OBJECTIVES: We performed a prospective diagnostic accuracy study of focused echocardiography for the evaluation of CVC tip position in our medical ICU and IMC units. METHODS: We performed a prospective diagnostic accuracy study in 100 patients admitted to the Intensive Care Unit and Intermediate Care Unit at our center. The first 10 subjects were assessed by one staff physician investigator (reference cohort), the remaining 90 patients by different residents (test cohort). All patients received a post-procedural chest radiograph (CXR) as gold standard. CVC placement was assessed with focused echocardiography performed by residents after a short training session. A rapid opacification of the right atrium (RASS) after injection of 10 mL of normal saline was regarded as \"positive\", flush after more than two seconds was defined as \"delayed\", no flush was a \"negative\" test result. MEASUREMENTS AND MAIN RESULTS: Overall sensitivity of the RASS was 100% (95% CI 73.54-100%), specificity was 94.32% (CI 87.24-98.13%). Positive and negative predictive values were 70.59% (CI 44.04-89.09%) and 100% (CI 95.65-100%), respectively. Median time for echocardiographic testing was 5 minutes (1-28) in the whole cohort, CXRs were available after 49.5 minutes (13-254). Interrater agreement of the RASS was 0.77 (Cohen's kappa), Measurement of CVC tip position was not different between two observers. Test characteristics were similar among differently experienced residents. CONCLUSIONS: Presence of the RASS by focused echocardiography showed excellent sensitivity and specificity and was equally performed by residents after minimal training. In patients with a positive RASS, routine CXR can be safely omitted, reducing time, costs and radiation exposure. A negative RASS should lead to a search for misplaced catheters. CLINICAL TRIAL REGISTRATION: The study was registered with www.clinicaltrials.gov (NCT02661607)."],["dc.identifier.doi","10.1371/journal.pone.0199345"],["dc.identifier.pmid","30011285"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15276"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59280"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.issn","1932-6203"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.title","The \"rapid atrial swirl sign\" for assessing central venous catheters: Performance by medical residents after limited training."],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]