Schnieder, Marlena

[["dc.bibliographiccitation.artnumber","e0196174"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","PLoS One"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Maier, Ilko L."],["dc.contributor.author","Becker, Johannes C."],["dc.contributor.author","Leyhe, Johanna Rosemarie"],["dc.contributor.author","Schnieder, Marlena"],["dc.contributor.author","Behme, Daniel"],["dc.contributor.author","Psychogios, Marios-Nikos"],["dc.contributor.author","Liman, Jan"],["dc.date.accessioned","2019-07-09T11:45:41Z"],["dc.date.available","2019-07-09T11:45:41Z"],["dc.date.issued","2018"],["dc.description.abstract","BACKGROUND: Stroke-induced immunodepression is a well characterized complication of acute ischemic stroke. In experimental studies beta-blocker therapy reversed stroke-induced immunodepression, reduced infection rates and mortality. Recent, heterogeneous studies in stroke patients could not provide evidence of a protective effect of beta-blocker therapy. Aim of this study is to investigate the potential preventive effect of beta-blockers in subgroups of patients at high risk for stroke-induced immunodepression. METHODS: Data from a prospectively derived registry of major stroke patients receiving endovascular therapy between 2011-2017 in a tertiary stroke center (University Medical Center Göttingen. Germany) was used. The effect of beta-blocker therapy on pneumonia, urinary tract infection, sepsis and mortality was assessed using multivariate logistic regression analysis. RESULTS: Three hundred six patients with a mean age of 72 ± 13 years and a median NIHSS of 16 (IQR 10.75-20) were included. 158 patients (51.6%) had pre-stroke- and continued beta-blocker therapy. Beta-blocker therapy did not reduce the incidence of pneumonia (OR 0.78, 95% CI 0.31-1.92, p = 0.584), urinary tract infections (OR 1.51, 0.88-2.60, p = 0.135), sepsis (OR 0.57, 0.18-1.80, p = 0.334) or mortality (OR 0.59, 0.16-2.17, p = 0.429). Strokes involving the insula and anterio-medial cortex increased the risk for pneumonia (OR 4.55, 2.41-8.56, p<0.001) and sepsis (OR 4.13, 1.81-9.43, p = 0.001), while right hemispheric strokes increased the risk for pneumonia (OR 1.60, 0.92-2.77, p = 0.096). There was a non-significantly increased risk for urinary tract infections in patients with beta-blocker therapy and insula/anterio-medial cortex strokes (OR 3.12, 95% CI 0.88-11.05, p = 0.077) with no effect of beta-blocker therapy on pneumonia, sepsis or mortality in both subgroups. CONCLUSIONS: In major ischemic stroke patients, beta-blocker therapy did not lower post-stroke infection rates and was associated with urinary tract infections in a subgroup with insula/anterio-medial strokes."],["dc.identifier.doi","10.1371/journal.pone.0196174"],["dc.identifier.pmid","29694433"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15285"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59286"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.issn","1932-6203"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.subject.mesh","Adrenergic beta-Antagonists"],["dc.subject.mesh","Aged"],["dc.subject.mesh","Aged, 80 and over"],["dc.subject.mesh","Death"],["dc.subject.mesh","Female"],["dc.subject.mesh","Humans"],["dc.subject.mesh","Incidence"],["dc.subject.mesh","Male"],["dc.subject.mesh","Middle Aged"],["dc.subject.mesh","Pneumonia"],["dc.subject.mesh","Prospective Studies"],["dc.subject.mesh","Registries"],["dc.subject.mesh","Sepsis"],["dc.subject.mesh","Stroke"],["dc.subject.mesh","Tertiary Care Centers"],["dc.subject.mesh","Urinary Tract Infections"],["dc.title","Influence of beta-blocker therapy on the risk of infections and death in patients at high risk for stroke induced immunodepression"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","118"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Neurology"],["dc.bibliographiccitation.volume","21"],["dc.contributor.author","Schnieder, Marlena"],["dc.contributor.author","Chebbok, Mohammed"],["dc.contributor.author","Didié, Michael"],["dc.contributor.author","Wolf, Frieder"],["dc.contributor.author","Badr, Mostafa"],["dc.contributor.author","Allam, Ibrahim"],["dc.contributor.author","Bähr, Mathias"],["dc.contributor.author","Hasenfuß, Gerd"],["dc.contributor.author","Liman, Jan"],["dc.contributor.author","Schroeter, Marco R."],["dc.date.accessioned","2021-04-14T08:28:09Z"],["dc.date.accessioned","2022-08-18T12:34:55Z"],["dc.date.available","2021-04-14T08:28:09Z"],["dc.date.available","2022-08-18T12:34:55Z"],["dc.date.issued","2021-03-17"],["dc.date.updated","2022-07-29T12:07:15Z"],["dc.description.abstract","Abstract\r\n \r\n Background\r\n Echocardiography is one of the main diagnostic tools for the diagnostic workup of stroke and is already well integrated into the clinical workup. However, the value of transthoracic vs. transesophageal echocardiography (TTE/TEE) in stroke patients is still a matter of debate. Aim of this study was to characterize relevant findings of TTE and TEE in the management of stroke patients and to correlate them with subsequent clinical decisions and therapies.\r\n \r\n \r\n Methods\r\n We evaluated n = 107 patients admitted with an ischemic stroke or transient ischemic attack to our stroke unit of our university medical center. They underwent TTE and TEE examination by different blinded investigators.\r\n \r\n \r\n Results\r\n Major cardiac risk factors were found in 8 of 98 (8.2%) patients and minor cardiac risk factors for stroke were found in 108 cases. We found a change in therapeutic regime after TTE or TEE in 22 (22.5%) cases, in 5 (5%) cases TEE leads to the change of therapeutic regime, in 4 (4%) TTE and in 13 cases (13.3%) TTE and TEE lead to the same change in therapeutic regime. The major therapy change was the indication to close a patent foramen ovale (PFO) in 9 (9.2%) patients with TTE and in 10 (10.2%) patients with TEE (p = 1.000).\r\n \r\n \r\n Conclusion\r\n Major finding with clinical impact on therapy change is the detection of PFO. But for the detection of PFO, TTE is non inferior to TEE, implicating that TTE serves as a good screening tool for detection of PFO, especially in young age patients.\r\n \r\n \r\n Trial registration\r\n The trial was registered and approved prior to inclusion by our local ethics committee (1/3/17)."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2021"],["dc.identifier.citation","BMC Neurology. 2021 Mar 17;21(1):118"],["dc.identifier.doi","10.1186/s12883-021-02136-5"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/17746"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/82515"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/112935"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-399"],["dc.notes.intern","Merged from goescholar"],["dc.publisher","BioMed Central"],["dc.relation.eissn","1471-2377"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject","Stroke"],["dc.subject","Echocardiography"],["dc.subject","Patent foramen ovale"],["dc.subject","Cardio-embolic stroke"],["dc.title","Comparing the diagnostic value of Echocardiography In Stroke (CEIS) – results of a prospective observatory cohort study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]