TY  - JOUR
A1  - Schmidt-Hieber, M.
A1  - Silling, G.
A1  - Schalk, E.
A1  - Heinz, W.
A1  - Panse, J.
A1  - Penack, O.
A1  - Christopeit, M.
A1  - Buchheidt, D.
A1  - Meyding-Lamadé, U.
A1  - Hähnel, S.
A1  - Wolf, H. H.
A1  - Ruhnke, M.
A1  - Schwartz, S.
A1  - Maschmeyer, G.
T1  - CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)
JF  - Annals of Oncology
N2  - Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients. However, identification of CNS infections in immunocompromised patients could represent a major challenge since metabolic disturbances, side-effects of antineoplastic or immunosuppressive drugs and CNS involvement of the underlying hematological disorder may mimic symptoms of a CNS infection. The prognosis of CNS infections is generally poor in these patients, albeit the introduction of novel substances (e.g. voriconazole) has improved the outcome in distinct patient subgroups. This guideline has been developed by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) with the contribution of a panel of 14 experts certified in internal medicine, hematology/oncology, infectious diseases, intensive care, neurology and neuroradiology. Grades of recommendation and levels of evidence were categorized by using novel criteria, as recently published by the European Society of Clinical Microbiology and Infectious Diseases.
KW  - Central nervous system
KW  - Polymerase chain raction
KW  - Herpes simplex encephalitis
KW  - Invasive fungal-infections
KW  - Clinical practice guidelines
KW  - Liposomal amphotericin-B
KW  - Immunocompromised patient
KW  - Progressive multifocal leukoencephalopathy
KW  - Varicella-zoster-virus
KW  - Diagnosis
KW  - Treatment
KW  - Bone-marrow-transplantation
KW  - Real-time PCR
KW  - Guideline
KW  - Central nervous system infection
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-188210
VL  - 27
IS  - 7
ER  - 
TY  - JOUR
A1  - Barlinn, J.
A1  - Winzer, S.
A1  - Worthmann, H.
A1  - Urbanek, C.
A1  - Häusler, K. G.
A1  - Günther, A.
A1  - Erdur, H.
A1  - Görtler, M.
A1  - Busetto, L.
A1  - Wojciechowski, C.
A1  - Schmitt, J.
A1  - Shah, Y.
A1  - Büchele, B.
A1  - Sokolowski, P.
A1  - Kraya, T.
A1  - Merkelbach, S.
A1  - Rosengarten, B.
A1  - Stangenberg-Gliss, K.
A1  - Weber, J.
A1  - Schlachetzki, F.
A1  - Abu-Mugheisib, M.
A1  - Petersen, M.
A1  - Schwartz, A.
A1  - Palm, F.
A1  - Jowaed, A.
A1  - Volbers, B.
A1  - Zickler, P.
A1  - Remi, J.
A1  - Bardutzky, J.
A1  - Bösel, J.
A1  - Audebert, H. J.
A1  - Hubert, G. J.
A1  - Gumbinger, C.
T1  - Telemedizin in der Schlaganfallversorgung – versorgungsrelevant für Deutschland
T1  - Telemedicine in stroke—pertinent to stroke care in Germany
JF  - Der Nervenarzt
N2  - Hintergrund und Ziel
Telemedizinische Schlaganfall-Netzwerke tragen dazu bei, die Schlaganfallversorgung und insbesondere den Zugang zu zeitkritischen Schlaganfalltherapien in vorrangig strukturschwachen, ländlichen Regionen zu gewährleisten. Ziel ist eine Darstellung der Nutzungsfrequenz und regionalen Verteilung dieser Versorgungsstruktur.

Methoden
Die Kommission „Telemedizinische Schlaganfallversorgung“ der Deutschen Schlaganfall-Gesellschaft führte eine Umfragestudie in allen Schlaganfall-Netzwerken durch.

Ergebnisse
In Deutschland sind 22 telemedizinische Schlaganfall-Netzwerke aktiv, welche insgesamt 43 Zentren (pro Netzwerk: Median 1,5, Interquartilsabstand [IQA] 1–3) sowie 225 Kooperationskliniken (pro Netzwerk: Median 9, IQA 4–17) umfassen und an einem unmittelbaren Zugang zur Schlaganfallversorgung für 48 Mio. Menschen teilhaben. Im Jahr 2018 wurden 38.211 Telekonsile (pro Netzwerk: Median 1340, IQA 319–2758) durchgeführt. Die Thrombolyserate betrug 14,1 % (95 %-Konfidenzintervall 13,6–14,7 %), eine Verlegung zur Thrombektomie wurde bei 7,9 % (95 %-Konfidenzintervall 7,5–8,4 %) der ischämischen Schlaganfallpatienten initiiert. Das Finanzierungssystem ist uneinheitlich mit einem Vergütungssystem für die Zentrumsleistungen in nur drei Bundesländern.

Diskussion
Etwa jeder 10. Schlaganfallpatient wird telemedizinisch behandelt. Die telemedizinischen Schlaganfall-Netzwerke erreichen vergleichbar hohe Lyseraten und Verlegungen zur Thrombektomie wie neurologische Stroke-Units und tragen zur Sicherstellung einer flächendeckenden Schlaganfallversorgung bei. Eine netzwerkübergreifende Sicherstellung der Finanzierung und einheitliche Erhebung von Qualitätssicherungsdaten haben das Potenzial diese Versorgungsstruktur zukünftig weiter zu stärken.
N2  - Background and objective
Telemedical stroke networks improve stroke care and provide access to time-dependent acute stroke treatment in predominantly rural regions. The aim is a presentation of data on its utility and regional distribution.

Methods
The working group on telemedical stroke care of the German Stroke Society performed a survey study among all telestroke networks.

Results
Currently, 22 telemedical stroke networks including 43 centers (per network: median 1.5, interquartile range, IQR, 1–3) as well as 225 cooperating hospitals (per network: median 9, IQR 4–17) operate in Germany and contribute to acute stroke care delivery to 48 million people. In 2018, 38,211 teleconsultations (per network: median 1340, IQR 319–2758) were performed. The thrombolysis rate was 14.1% (95% confidence interval 13.6–14.7%) and transfer for thrombectomy was initiated in 7.9% (95% confidence interval 7.5–8.4%) of ischemic stroke patients. Financial reimbursement differs regionally with compensation for telemedical stroke care in only three federal states.

Conclusion
Telemedical stroke care is utilized in about 1 out of 10 stroke patients in Germany. Telemedical stroke networks achieve similar rates of thrombolysis and transfer for thrombectomy compared with neurological stroke units and contribute to stroke care in rural regions. Standardization of network structures, financial assurance and uniform quality measurements may further strengthen the importance of telestroke networks in the future.
KW  - Schlaganfall
KW  - Stroke-Unit
KW  - Telemedizin
KW  - Schlaganfall-Netzwerk
KW  - Umfragestudie
KW  - stroke
KW  - stroke unit
KW  - telemedicine
KW  - stroke networks
KW  - survey
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307752
SN  - 0028-2804
SN  - 1433-0407
VL  - 92
IS  - 6
ER  - 
TY  - JOUR
A1  - Dunster, L.M.
A1  - Schneider-Schaulies, Jürgen
A1  - Löffler, S.
A1  - Lankes, W.
A1  - Schwartz-Albiez, R.
A1  - Lottspeich, F.
A1  - ter Meulen, V.
T1  - Moesin: a cell membrane protein linked with susceptibility to measles virus infection
N2  - Measles virus is a highly contagious virus causing acute and persistent diseases in man, the receptor of which is still not weil characterized. We have isolated a monoclonal antibody (mAb), designated mAb 119, which specifically inhibits measles virus infection of susceptible celllines in a dosa-dependent manner. This antibody precipitates a protein with an apparent molecular mass of 75 kDa from 1251 surface-labeled cells and its epitope is present on human peripheral blood mononuclear cells, human celllines, and the African green monkey cellline Vero. Affinity chromatography of detergent-solubilized cell membrane proteins over a Sepharose column with covalently bound mAb 119 led to the partial purification of the 75-kOa protein. Preincubation of measles virus with this affinity-purified protein inhibited measles virus infection dose dependently. Aminoacid microseq,uencing of this protein revealed its identity with the human membrane-organizing extension spike protein moesin, a protein intra- and extracellularly associated with the plasma membrane of cells. Subsequently, an antibody raised against purified moesin (mAb 38/87) was also found to specifically inhibit measles virus infection of susceptible cells and confirmed our data obtained with mAb 119. Our data suggest that moesin is acting as a receptor for measles virus.
KW  - Immunologie
Y1  - 1994
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-54931
ER  -