Showing papers by "Danube University Krems published in 2008"

Practice Parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies

Abstract: Background: Trigeminal neuralgia (TN) is a common cause of facial pain. Purpose: To answer the following questions: 1) In patients with TN, how often does routine neuroimaging (CT, MRI) identify a cause? 2) Which features identify patients at increased risk for symptomatic TN (STN; i.e., a structural cause such as a tumor)? 3) Does high-resolution MRI accurately identify patients with neurovascular compression? 4) Which drugs effectively treat classic and symptomatic trigeminal neuralgia? 5) When should surgery be offered? 6) Which surgical technique gives the longest pain-free period with the fewest complications and good quality of life? Methods: Systematic review of the literature by a panel of experts. Conclusions: In patients with trigeminal neuralgia (TN), routine head imaging identifies structural causes in up to 15% of patients and may be considered useful (Level C). Trigeminal sensory deficits, bilateral involvement of the trigeminal nerve, and abnormal trigeminal reflexes are associated with an increased risk of symptomatic TN (STN) and should be considered useful in distinguishing STN from classic trigeminal neuralgia (Level B). There is insufficient evidence to support or refute the usefulness of MRI to identify neurovascular compression of the trigeminal nerve (Level U). Carbamazepine (Level A) or oxcarbazepine (Level B) should be offered for pain control while baclofen and lamotrigine (Level C) may be considered useful. For patients with TN refractory to medical therapy, Gasserian ganglion percutaneous techniques, gamma knife, and microvascular decompression may be considered (Level C). The role of surgery vs pharmacotherapy in the management of TN in patients with MS remains uncertain. Neurology ® 2008;71:1183–1190

Efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer's disease: a systematic review and meta-analysis.

Abstract: Pharmacologic treatments for Alzheimer’s disease include the cholinesterase inhibitors donepezil, galantamine, and rivastigmine. We reviewed their evidence by searching MEDLINE®, Embase, The Cochrane Library, and the International Pharmaceutical Abstracts from 1980 through 2007 (July) for placebo-controlled and comparative trials assessing cognition, function, behavior, global change, and safety. Thirty-three articles on 26 studies were included in the review. Meta-analyses of placebo-controlled data support the drugs’ modest overall benefits for stabilizing or slowing decline in cognition, function, behavior, and clinical global change. Three open-label trials and one double-blind randomized trial directly compared donepezil with galantamine and rivastigmine. Results are conflicting; two studies suggest no differences in efficacy between compared drugs, while one study found donepezil to be more efficacious than galantamine, and one study found rivastigmine to be more efficacious than donepezil. Adjusted indirect comparison of placebo-controlled data did not find statistically significant differences among drugs with regard to cognition, but found the relative risk of global response to be better with donepezil and rivastigmine compared with galantamine (relative risk = 1.63 and 1.42, respectively). Indirect comparisons also favored donepezil over galantamine with regard to behavior. Across trials, the incidence of adverse events was generally lowest for donepezil and highest for rivastigmine.

Visual Methods for Analyzing Time-Oriented Data

Abstract: Providing appropriate methods to facilitate the analysis of time-oriented data is a key issue in many application domains. In this paper, we focus on the unique role of the parameter time in the context of visually driven data analysis. We will discuss three major aspects - visualization, analysis, and the user. It will be illustrated that it is necessary to consider the characteristics of time when generating visual representations. For that purpose, we take a look at different types of time and present visual examples. Integrating visual and analytical methods has become an increasingly important issue. Therefore, we present our experiences in temporal data abstraction, principal component analysis, and clustering of larger volumes of time-oriented data. The third main aspect we discuss is supporting user-centered visual analysis. We describe event-based visualization as a promising means to adapt the visualization pipeline to needs and tasks of users.

Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians.

Abstract: The authors reviewed the evidence of the benefits and harms of second-generation antidepressants for the treatment of depressive disorders in adults. They found that second-generation antidepressan...

Comparative risk for harms of second-generation antidepressants: A systematic review and meta-analysis

Abstract: Background: Evidence indicates that only minor differences in efficacy exist among second-generation antidepressants for the treatment of major depressive disorder (MDD). However, a comprehensive assessment of both benefits and harms is crucial to evaluate the net benefit. Objective: To review systematically the comparative harms of second-generation antidepressants for the treatment of MDD in adults by including both experimental and observational evidence. Data sources: We searched MEDLINE®, EMBASE, PsychLit, The Cochrane Library and the International Pharmaceutical Abstracts from 1980 to April 2007. We manually searched reference lists of pertinent review articles and explored the Center for Drug Evaluation and Research database to identify unpublished research. Study selection: Eligible study designs were trials and observational studies comparing one drug of interest with another. Data extraction: Two persons independently reviewed abstracts and full-text articles. One investigator extracted relevant data. A senior reviewer checked data for completeness and accuracy. Data synthesis: We included 104 experimental and observational studies. If data were sufficient, we conducted meta-analyses of randomized controlled trials on the relative risk of specific adverse events. Findings indicate that the spectrum of adverse events is similar. The frequency of specific adverse events, however, differed across drugs. Venlafaxine was associated with a significantly higher rate of nausea and vomiting than selective serotonin reuptake inhibitors. Compared with other drugs, paroxetine frequently led to more sexual adverse effects and bupropion to fewer such effects; mirtazapine and paroxetine was associated with more weight gain and sertraline with a higher rate of diarrhoea. Overall, however, these differences did not lead to different discontinuation rates. The evidence is insufficient to draw conclusions about rare but severe adverse events. Conclusions: Adverse event profiles are similar among second-generation antidepressants. However, different frequencies of specific adverse events might be clinically relevant and influence the choice of a treatment.

Tissue engineering for total meniscal substitution: animal study in sheep model.

Abstract: Objective: The aim of the study was to investigate the use of a novel hyaluronic acid/polycaprolactone material for meniscal tissue engineering and to evaluate the tissue regeneration after the augmentation of the implant with expanded autologous chondrocytes. Two different surgical implantation techniques in a sheep model were evaluated. Methods: Twenty-four skeletally mature sheep were treated with total medial meniscus replacements, while two meniscectomies served as empty controls. The animals were divided into two groups: cell-free scaffold and scaffold seeded with autologous chondrocytes. Two different surgical techniques were compared: in 12 animals, the implant was sutured to the capsule and to the meniscal ligament; in the other 12 animals, also a transtibial fixation of the horns was used. The animals were euthanized after 4 months. The specimens were assessed by gross inspection and histology. Results: All implants showed excellent capsular ingrowth at the periphery. Macroscopically, no difference was observed between cell-seeded and cell-free groups. Better implant appearance and integrity was observed in the group without transosseous horns fixation. Using the latter implantation technique, lower joint degeneration was observed in the cell-seeded group with respect to cell-free implants. The histological analysis indicated cellular infiltration and vascularization throughout the implanted constructs. Cartilaginous tissue formation was significantly more frequent in the cell-seeded constructs. Conclusion: The current study supports the potential of a novel HYAFF/polycaprolactone scaffold for total meniscal substitution. Seeding of the scaffolds with autologous chondrocytes provides some benefit in the extent of fibrocartilaginous tissue repair.

Meta-analysis of major depressive disorder relapse and recurrence with second-generation antidepressants.

Abstract: Objective To review data on the efficacy and effectiveness of second-generation antidepressants for preventing major depression relapse and recurrence during continuation and maintenance phase treatment, respectively.

Results of Chondrocyte Implantation with a Fibrin-Hyaluronan Matrix: A Preliminary Study

Abstract: Fibrin, a homologous polymer, is the natural scaffold of wound healing and therefore a candidate as a carrier for cell transplantation. We explored a novel matrix-based implant cartilage repair composed of both fibrin and hyaluronan in a defined ratio that takes advantage of the biological and mechanical properties of these two elements. The matrix was seeded with autologous chondrocytes expanded in the presence of a proprietary growth factor variant designed to preserve their chondrogenic potential. We prospectively followed eight patients with symptomatic-chronic cartilage defects treated with this carrier. Patients had arthroscopy to harvest autologous chondrocytes then grown in autologous serum. Chondrocytes were cultured in the presence of the FGF variant and then seeded on the fibrin-hyaluronan matrix. About 4 weeks following biopsy, the patients underwent implantation of the constructs by miniarthrotomy. Three of the eight patients had transient effusion. Clinical performance was measured by Lysholm and IKDC scores, MRI, and the need for secondary surgery. The clinical outcome of a 1-year followup demonstrated increase of clinical scores. The MRI followup showed good filling of the defect with tissue having the imaging appearance of cartilage in all patients. Apart from the transient effusion in three patients we observed no other adverse events during the followup.

Removal of the uremic retention solute p-cresol using fractionated plasma separation and adsorption.

Abstract: Removal of protein-bound uremic retention solutes, including p-cresol, by peritoneal dialysis and hemodialysis (HD) is limited. p-Cresol, mainly circulating as sulfate conjugate (p-cresyl sulfate [PCS]), is independently associated with mortality. Fractionated plasma separation and adsorption (FPSA) is a nonbiologic detoxification system for the treatment of liver failure. The FPSA clearance of uremic retention solutes is unknown. We studied PCS clearance by FPSA, using the Prometheus system. The neutral resin adsorbent and the anion exchange adsorbent bind PCS in vitro (reduction ratios [RRs] 37 and 70%). Ex vivo, the adsorbent mass removal (MR) (median 47.5 mg) contributes more than half to total MR (median 89.6 mg). In vivo, PCS RR during FPSA (50%) exceeded the RR during high flux HD (30%). We halted the study after four inclusions due to repeated thrombosis of the arterio-venous conduit. In conclusion, FPSA is a promising technique to improve clearance of protein-bound uremic retention solutes.

Direct versus indirect comparisons : A summary of the evidence

Abstract: Objectives The aim of this study was to provide a comprehensive summary and interpretation of the current evidence on the use and validity of statistical methods to conduct indirect comparisons of treatment effects. Methods A narrative review was conducted. Results Well-conducted methodological studies provide good evidence that adjusted indirect comparisons can lead to results similar to those from direct comparisons. The internal validity of several statistical methods to conduct indirect comparisons, therefore, has been established. Meta-regression, logistic regression, or adjusted indirect comparisons should be the methods of first choice. Unadjusted indirect comparisons are always unacceptable. Deciding whether to combine direct and indirect evidence will be a matter of informed judgment based on the similarities and dissimilarities of populations and interventions. Unverifiable assumptions with respect to the similarity of compared studies and low power are serious limitations of indirect comparisons. Conclusions In the absence of sufficient head-to-head evidence, adjusted indirect comparisons can be viewed as additional analytical tools to determine the comparative efficacy and effectiveness of competing interventions. Researchers who use indirect comparisons need to keep the limitations in mind.

Efficacy and tolerability of second-generation antidepressants in social anxiety disorder

Abstract: A systematic review and meta-analysis was conducted to evaluate the comparative efficacy and tolerability of second-generation antidepressants in social anxiety disorder. Studies were identified by searching MEDLINE®, Embase, The Cochrane Library, PsychLit, and the International Pharmaceutical Abstracts from January 1980 through October 2006. Comparative evidence was summarized and indirect comparisons were made using network meta-analysis. Only three head-to-head trials were identified; comparative trials found only minimal differences in efficacy between escitalopram and paroxetine, and no statistically significant differences in efficacy between extended-release venlafaxine and paroxetine. Pooled evidence from 15 placebo-controlled trials suggests that escitalopram (relative benefit 1.3; 95% CI 1.2 to 1.5), paroxetine (relative benefit 1.9; 95% CI 1.5 to 2.3), sertraline (relative benefit 1.8; 95% CI 1.5 to 2.2), and venlafaxine (relative benefit 1.7; 95% CI 1.5 to 1.9) all produce significantly more responders than placebo; evidence favored fluvoxamine over placebo but was not significant (relative benefit 1.5; 95% CI 0.9 to 2.4). Network meta-analysis did not reveal differences in efficacy among drugs. Overall, fair evidence supports the efficacy of escitalopram, fluvoxamine, paroxetine, sertraline, and venlafaxine in social anxiety disorder. The drugs do not differ in efficacy, although their adverse event profiles do.

Syntactical negation detection in clinical practice guidelines.

Abstract: In clinical practice guidelines (CPGs) the medical information is stored in a narrative way. A large part of this information occurs in a negated form. The detection of negation in CPGs is an important task since it helps medical personnel to identify not occurring symptoms and diseases as well as treatment actions that should not be accomplished. We developed algorithms capable of Negation Detection in this kind of medical documents. According to our results, we are convinced that the involvement of syntactical methods can improve Negation Detection, not only in medical writings but also in arbitrary narrative texts.

The masticatory organ and stress management

Abstract: In humans, the strong grinding and clenching function of the masticatory muscles known as bruxism has been thought to play an important role in mitigating stress-induced psychosomatic disorders by down-regulating the limbic system, the autonomic nervous system, and the hypothalamic-pituitary-adrenal axis. Experimental research results showed that bruxism-like activity has beneficial effects on stress-induced reactions such as increasing expression of Fos protein, neuronal nitric oxide synthase, phosphorylated extracellular signal-regulated kinase 1/2, corticotropin-releasing factor, and free radicals in the paraventricular nucleus of hypothalamus, alterations in the blood neutrophil/lymphocyte ratio and adrenocorticotropic hormone level, and stomach ulcer formation in animal studies, as well as increasing amygdala neuronal activity and salivary chromogranin A level in human studies. All of these findings strongly suggest that bruxism-like activity of the masticatory organ has the ability to decrease stress-induced allostatic overload. The health of the masticatory organ depends critically on occlusion, which must be of sufficient quality to successfully carry out its important role in managing stress. Occlusion and the brain must function in harmony. For these reasons, we must integrate the study of occlusion into the broader scope of medical science; in so doing, we will meaningfully advance the state of the art of dental care and general health care.

The imbalance between osteoprotegerin and cathepsin K in the serum of patients with longstanding rheumatoid arthritis.

Abstract: Osteoprotegerin (OPG) and soluble receptor activator of NF-kappa B ligand (sRANKL) together regulate the bone metabolism among other cytokines, whereby cathepsin K has a potent collagen-degrading activity. An imbalance of this system may be partly responsible for the skeletal complications of RA. Expanding on a previous study, we investigated the relationship between OPG, sRANKL and cathepsin K levels in the serum of patients with longstanding RA. We measured serum levels of OPG, sRANKL and cathepsin K of 100 patients with active, longstanding RA. We detected elevated serum levels of cathepsin K (median 54.8 pmol/l) and OPG (median 4.8 pmol/l), but normal sRANKL levels (median 0.2 pmol/l). Cathepsin K did not show a correlation with the overexpressed OPG (P=0.64) and sRANKL (P=0.81). The radiological destruction correlates significantly with cathepsin K (P=0.004) and OPG (P=0.007). We speculate that the increased levels of OPG are effective in compensating the action of sRANKL, but do not directly prevent bone degradation, as reflected by the elevated serum levels of cathepsin K.

Engaging youth through deliberative e-participation: a case study

Abstract: The Austrian e-participation project "mitmachen.at - move your future", looked at young people involved in an online public discussion. Results from this case study show that there is interest in online deliberation and is a method of participation which is both accepted and will be used by young people. The participants expressed optimism: they want this form of participation to be made possible and results to be made available to politicians. Their criticism and feedback must be used both to improve the services offered and motivate citizens to take an interest in political and civic issues.

Increased serum levels of cartilage oligomeric matrix protein in patients with psoriasis vulgaris: a marker for unknown peripheral joint involvement?

Abstract: Objective. Cartilage oligomeric matrix protein (COMP) is a parameter for the current extent of cartilage destruction. It has been shown that the release pattern of cartilage oligomeric matrix protein in serum reflects cartilage turnover. The aim of our study was to explore the utility of sCOMP as a marker for disease activity in patients with active psoriatic arthritis (PsA) in comparison to a control group only with psoriasis vulgaris (PV). Methods. Serum levels of COMP were measured in 64 patients with PsA and psoriasis vulgaris. The control group consisted of a population with PV from a dermatological outpatient clinic. ELISA-tests were used to detect sCOMP levels according to the manufacturers instructions. Results. In our 64 patients with PsA, we found increased sCOMP levels, which correlated significantly with inflammatory parameters and the number of swollen joints. Patients with active PsA had significantly higher sCOMP levels (p<0.0001) than the 39 patients with a low inflammatory status. In our control group with PV we also found elevated sCOMP levels, which correlated significantly with the increased C-reactive protein (CRP) levels in this group. The difference between the PsA and the PV group was not significant (p=0.092). Conclusion. In our study, sCOMP has been demonstrated to be an indicator for disease activity in patients with PsA. Patients with active PsA showed significantly elevated sCOMP levels compared to the patients with low clinical and laboratory disease activity. The increased sCOMP levels in our control group with PV indicate that all patients with psoriatic lesions should be screened for additional joint involvement and should lead to an exact joint examination.

Computerized axiography in TMD patients before and after therapy with ‘function generating bites’

Abstract: The study evaluates the temporomandibular joint (TMJ) movements of patients with signs and symptoms of temporomandibular disorders (TMD) before and after therapy with the functional appliances of the 'function generating bite' (FGB) type. Thirty subjects suffering from TMD were selected and divided into two groups: group A (young patients: four males, nine females, mean age +/- standard deviation: 13.3+/-1.5 years); group B (adults: three males, 14 females, mean age +/- standard deviation: 23.2+/-4.4 years). A control group comprised 13 healthy subjects with perfect normal occlusion, TMD-free, was matched for age and sex with patient groups and was examined at T0 and after 12 months (T1). Computerized axiography was performed before and after therapy (average 13 months) with FGBs to evaluate any difference in condyle border movements. Results showed a statistically significant improvement after treatment, for groups A and B, in length, clicks, tracings with normal morphology, superimposition, deviations, regularity and return to starting position and speed (statistical analysis: chi-squared test) except for the symmetry of tracings which was significantly improved only for the young patient group. No statistically significant differences at time T0/T1 were found in the control group. In conclusion, the study shows that the TMJ tracings of TMD patients before and after therapy with 'FGB' significantly improve especially in young patients. FGB may be a useful appliance to improve TMJ function in young and adult TMD patients requiring orthodontic treatment.

Visualizations at First Sight: Do Insights Require Training?

Abstract: Understanding novel visualizations can be a challenge even forexperienced users. During iterative usability engineering phases inthe DisCō project, visualizations of time-oriented data areexplored by domain experts and non-experts. The aim of our study isto analyze the generation of knowledge and understanding by meansof visualizations without previous user training. Focusing onapplicability in various business domains for personnel planningand time scheduling, we tested mockups of visualizations with amethod based on user-reported insights. Results show almostidentical behavior of domain experts and non-experts whengenerating insights into the data from scratch. In the course ofworking with a visualization, an interchange of insights into thevisualization and insights into the data was found.

A Comparison of Programming Platforms for Interactive Visualization in Web Browser Based Applications

Abstract: Recently, Web browser based applications have become very popular in many domains. However, the specific requirements of interactive Information Visualization (InfoVis) applications in terms of graphics performance and interactivity have not yet been investigated systematically in this context. In order to assess browser-based application platforms, we provide a systematic comparison of server-based rendering, Java Applets, Flash, and Silverlight from several points of view. We aim to aid InfoVis developers in choosing the appropriate technology for their needs.

Visualization methods to support guideline-based care management.

Abstract: Authoring clinical guidelines as well as observing the execution and the maintenance of these is a time-consuming and cumbersome task. Usually, clinical guidelines are represented in conceptual models, which are very hard to understand by domain experts. Furthermore, to analyze the effectiveness and usefulness of clinical guidelines they need to be shown in connection with the patients’ data. In this overview book chapter we present different methods to visualize clinical guidelines, patients’ data, and the connection thereof. Finally, we illustrate how the different visualization methods support the various tasks in plan management.

Visual Aspects of Intercultural Technical Communication: A Cognitive Scientific and Semiotic Point of View

Abstract: This article presents a cognitive scientific view of the role of verbal and visual aspects in the translation of technical texts. The semiotic differentiation between symbols and icons is discussed from both the cognitive scientific and the translation studies perspectives. The article refers to the definition of text as a unit of communication (and translation) that includes both verbal and visual aspects and thus emphasises the function of the visual dimension in translation. The theoretical discussion is related to professional practices in the modern translation workplace: through its discussion of the results of a recent empirical field study based on participant observation over an extended period of time in a translation agency, the present research seeks to determine the extent to which the visual dimension can be taken into account in technical translation. In particular, the results point to the consequences of the use of translation technologies (translation memories, translation management systems, localisation software, etc.) in the modern translation workplace. The dominance of the verbal aspect induced by the use of some such technologies can make it increasingly difficult for translators to pay attention to the visual elements in translation. This stresses the importance of the inclusion of courses on the critical and professional use of translation technologies within translation studies programmes.

e-government: state and perspectives

Abstract: The state of e-Government in Europe is presented which is based on the results of the European e-Government Awards 2007 competition. It starts with an overall view on progress and the development of public services. Waves of progress can be discerned as well as diversities in pace and sophistication. Then the contribution focuses on selected challenges: joining up administrations by having interoperability and identity management; higher usage achieved by better service and knowledge enhancement; improvements in citizen participation.

Editorial: Stroke units in Austria: structure, performance and results.

Abstract: A hospital-based survey of stroke care in Austria performed in 1990 [1] had shown that in 146 hospitals that were caring for a total of 23,425 stroke patients, 69% of them had been admitted to departments of internal medicine and 31% to neurological departments. At that time only 18% of departments of internal medicine performed CT on a routine basis (which was defined as being applied tomore than 90%of all stroke patients), whereas this was the case in 68% at all neurological departments. Availability of MRI for acute stroke was generally less than 5% in all departments. At that time one was content when patients arrived within 12 h after onset of stroke symptoms and this was the case for 40% of all hospitalized strokes. Since 1990matters have turned around. Thirty two acute stroke units have, in the meantime, been established within neurological departments and by 2006, already 57% of all ischemic stroke patients hospitalized in Austria were admitted to these stroke units and only 32% to departments of internal medicine. Today, already more than two-thirds of all hospitalized acute strokes are admitted to stroke units. Importantly, more than 40% of patients arrive within 3 h of onset and CT or MRI is performed on practically all patients. While trends to admit strokes (ischemic as well as hemorrhagic) to stroke units continue, there is a continuing trend to diagnose TIAs at departments of internal medicine (Figs. 1–3). The followingpublications inthis issueshowthat, in Austria, rapid admission and management of stroke patients to stroke unit has increasingly become possible. Within the past years, the main responsibility for acute stroke care has been shifted towards neurology and internal departments now play a minor role. The structure quality criteria for stroke units have been laid down, are well established and are being continuously controlled [3, 10]. The advantage of this system is that in the whole of Austria there is a unified structure with a performance that can be easily compared and can be at visualised any time on a passworded website. The structure quality criteria, which hadbeen set up in themid 90s compare to those that have recently been established as ideal on a Europe-wide scale and have been recommended by the European Stroke Organisation [5, 7, 8]. The fruitful collaboration between the Austrian Society for Stroke Research and Gesundes Österreich GmbH, GÖG (formely: Österreichisches Bundesinstitut

Anticoagulation in combined membrane/adsorption systems.

Abstract: For extracorporeal blood purification treatments, an effective anticoagulation is needed to avoid contact activation via the intrinsic pathway of the blood-clotting system. While heparin is the standard anticoagulant in dialysis, it shows some disadvantages which have to be considered when it is used in membrane/adsorption-based blood purification systems. An alternative option for anticoagulation in these systems is citrate, which is effective as an anticoagulant by reducing the ionized calcium concentration in the extracorporeal circuit. However, to avoid citrate accumulation in the patient during treatment, the amount of citrate infusion and the citrate removal by the patient's metabolism as well as by dialysis have to be taken into consideration. The aim of this study was to elucidate the characteristics of heparin removal in membrane/adsorption-based blood purification systems, to find the correct way to pre-coat adsorbents in order to avoid excessive adsorption of heparin by anionic exchanging resins, and also to find an appropriate dosage of heparin for treatments with these systems to ensure patient safety. A further aim was to find the correct ionized calcium concentration to suppress complement activation, and to compare different dialysis filters regarding their citrate clearance in order to be able to recommend the correct dialysis setup to achieve appropriate citrate clearance. We were able to show that the adsorptive removal of heparin can be significantly reduced by pre-coating the adsorbents with heparin without a perceptible impact on the adsorption kinetics of bilirubin. Furthermore, we recommend the use of unfractionated heparin due to its lower sieving coefficient and therefore lower removal compared to fractionated heparins. Reducing the extracorporeal Ca(2+) concentration to 0.2 mmol/L by infusion of citrate solution to the extracorporeal circuit results in an effective suppression of the complement activation. To avoid citrate accumulation, we recommend the use of high flux filters when citrate anticoagulation is applied.

Particle Transfer and Detection in a Microspheres Based Detoxification System

Abstract: Extracorporeal blood purification by means of the adsorption system MDS is based on high specific microparticle adsorbent for toxin removal. A thin-wall hollow-fiber membrane filter separates the microparticle-plasma suspension from the bloodstream. For patient safety, it is necessary to have a means to detect membrane ruptures that could lead to a release of microparticles into the patient's bloodstream. A non invasive optical detection system was developed to monitor the extracorporeal venous bloodstream for the presence of released microparticles. For detection, labeled microspheres are suspended with the adsorbent particles. In the case of a membrane rupture, the labeled particles would be released together with the microadsorbent. A detailed description for the system setup is introduced.

A patient with Melorheostosis manifesting with features similar to tricho-dento-osseous syndrome: a case report

Abstract: A case of melorheostosis in association with tricho-dento-osseous (TDO) syndrome has been encountered. The clinical and the radiographic manifestations of melorheostosis have been encountered in a 41-year-old man. Mutations in the 13 exons and flanking intronic regions of the LEMD3-gene have not been detected. His phenotypic features were consistent but not completely diagnostic for tricho-dento-osseous syndrome (TDO). We report what might be a novel syndromic association. Melorheostosis has not previously been reported to be a part of TDO and an extensive review of the literature suggests that the constellation of hair, tooth and bone abnormalities found in our patient either represents an unusual variant of tricho-dento-osseous syndrome or a new syndrome.

Easing the Formalization of Clinical Guidelines with a User-tailored, Extensible Agile Model Driven Development (AMDD)

Abstract: Transforming a text-based clinical guideline in a computer-interpretable form is a time-consuming and demanding task due to the various users involved, who have different technical and medical background. In the past, different guideline representation languages and supporting tools have been developed, however, these approaches seldom address the various users' demands and needs in the different steps of the guidelines' life cycle. Our approach is oriented on the guideline life-cycle and takes the requirements and the interactions of the various actors into account to formalize guidelines in a computer-interpretable guideline representation by using a semi-automatic way based on NLP techniques. We analyzed the guideline life-cycle and the roles of the actors to build such a model. This model is prototypical implemented and showed the usefulness and utility for the various users.

Towards a Positive Assessment Policy for Computer and Console Games

Abstract: The emergence of new media tends to trigger moral panics, quite often leading to overreactions within political systems. Such an overreaction can currently be observed in some European countries in connection with a legal ban of violent video games. In contrast to these countries, Austrian youth policy makers have decided to follow a path of positive assessment for computer and console games rather than rigid legislative regulations. In implementing this strategy, two research studies were carried out. The first discussed scenarios for a public authority providing information on quality computer and console games. The second study analysed the acceptance of a quality seal for games. In this paper we discuss these studies. In addition, we outline continuing research carried out to improve and refine the process of assessment as well as the information and communication process between the authorities and the parents, children and youngsters.