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2.
J Acoust Soc Am ; 152(1): 295, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35931542

RESUMO

Application of a kurtosis correction to frequency-weighted sound exposure level (SEL) improved predictions of risk of hearing damage in humans and terrestrial mammals for sound exposures with different degrees of impulsiveness. To assess whether kurtosis corrections may lead to improved predictions for marine mammals, corrections were applied to temporary threshold shift (TTS) growth measurements for harbor porpoises (Phocoena phocoena) exposed to different sounds. Kurtosis-corrected frequency-weighted SEL predicted accurately the growth of low levels of TTS (TTS1-4 < 10 dB) for intermittent sounds with short (1-13 s) silence intervals but was not consistent with frequency-weighted SEL data for continuous sound exposures.


Assuntos
Phocoena , Estimulação Acústica , Animais , Fadiga Auditiva , Limiar Auditivo , Audição , Humanos , Ruído/efeitos adversos
3.
Braz J Med Biol Res ; 54(9): e11116, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076145

RESUMO

The interplay between obesity and gastrointestinal (GI) motility is contradictory, and the transgenerational influence on this parameter is unknown. We aimed to evaluate the GI function in a model of paternal obesity and two subsequent generations of their male offspring. Newborn male rats were treated with monosodium glutamate (MSG) and composed the F1 generation, while control rats (CONT) received saline. At 90 days, male F1 were mated with non-obese females to obtain male offspring (F2), which later mated with non-obese females for obtaining male offspring of F3 generation. Lee Index analysis was adopted to set up the obesity groups. Alternating current biosusceptometry (ACB) technique was employed to calculate GI transit parameters: mean gastric emptying time (MGET), mean cecum arrival time (MCAT), mean small intestinal transit time (MSITT), and gastric frequency and amplitude of contractions. Glucose, insulin, and leptin levels and duodenal morphometry were measured. F1 obese rats showed a decrease in the frequency and amplitude of gastric contractions, while obese rats from the F2 generation showed accelerated MGET and delayed MCAT and MSITT. Glucose and leptin levels were increased in F1 and F2 generations. Insulin levels decreased in F1, F2, and F3 generations. Duodenal morphometry was altered in all three generations. Obesity may have paternal transgenerational transmission, and it provoked disturbances in the gastrointestinal function of three generations.


Assuntos
Obesidade , Exposição Paterna , Animais , Feminino , Motilidade Gastrointestinal , Trânsito Gastrointestinal , Insulina , Leptina , Masculino , Obesidade/etiologia , Gravidez , Ratos
4.
J Acoust Soc Am ; 149(4): 2908, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33940877

RESUMO

Modern active sonar systems can (almost) continuously transmit and receive sound, which can lead to more masking of important sounds for marine mammals than conventional pulsed sonar systems transmitting at a much lower duty cycle. This study investigated the potential of 1-2 kHz active sonar to mask echolocation-based foraging of sperm whales by modeling their echolocation detection process. Continuous masking for an echolocating sperm whale facing a sonar was predicted for sonar sound pressure levels of 160 dB re 1 µPa2, with intermittent masking at levels of 120 dB re 1 µPa2, but model predictions strongly depended on the animal orientation, harmonic content of the sonar, click source level, and target strength of the prey. The masking model predicted lower masking potential of buzz clicks compared to regular clicks, even though the energy source level is much lower. For buzz clicks, the lower source level is compensated for by the reduced two-way propagation loss to nearby prey during buzzes. These results help to predict what types of behavioral changes could indicate masking in the wild. Several key knowledge gaps related to masking potential of sonar in echolocating odontocetes were identified that require further investigation to assess the significance of masking.


Assuntos
Ecolocação , Cachalote , Animais , Som , Espectrografia do Som , Baleias
5.
J Acoust Soc Am ; 149(3): 1878, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33765827

RESUMO

An analysis is presented of sound measurements performed near two detonations of unexploded ordnance (UXO) in the North Sea, at distances ranging from 1.5 to 12 km. The charge masses of the detonations were 325 and 140 kg TNT equivalent. The objective of the measurements was to improve the accuracy of model predictions of the area where UXO detonations affect harbour porpoises in the North Sea. For the predictions, an explosion emission model is combined with a shallow-water propagation model. The prediction model was previously validated for distances up to 2 km. The measurements reported here allowed validation up to a distance of 12 km. The measured levels and spectra are well explained by the model calculations. The model results depend strongly on the sea sediment layering. The propagation of high-frequency components appears to be affected primarily by the silty top layer, while low-frequency components are affected also by deeper sandy layers. Measured and calculated noise levels are used to determine permanent-threshold-shift effect distances for harbour porpoises (Phocoena phocoena). Values ranging from 2 to 6 km are found for the two detonations.

6.
Braz. j. med. biol. res ; 54(9): e11116, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1249338

RESUMO

The interplay between obesity and gastrointestinal (GI) motility is contradictory, and the transgenerational influence on this parameter is unknown. We aimed to evaluate the GI function in a model of paternal obesity and two subsequent generations of their male offspring. Newborn male rats were treated with monosodium glutamate (MSG) and composed the F1 generation, while control rats (CONT) received saline. At 90 days, male F1 were mated with non-obese females to obtain male offspring (F2), which later mated with non-obese females for obtaining male offspring of F3 generation. Lee Index analysis was adopted to set up the obesity groups. Alternating current biosusceptometry (ACB) technique was employed to calculate GI transit parameters: mean gastric emptying time (MGET), mean cecum arrival time (MCAT), mean small intestinal transit time (MSITT), and gastric frequency and amplitude of contractions. Glucose, insulin, and leptin levels and duodenal morphometry were measured. F1 obese rats showed a decrease in the frequency and amplitude of gastric contractions, while obese rats from the F2 generation showed accelerated MGET and delayed MCAT and MSITT. Glucose and leptin levels were increased in F1 and F2 generations. Insulin levels decreased in F1, F2, and F3 generations. Duodenal morphometry was altered in all three generations. Obesity may have paternal transgenerational transmission, and it provoked disturbances in the gastrointestinal function of three generations.


Assuntos
Animais , Masculino , Feminino , Gravidez , Ratos , Exposição Paterna , Obesidade/etiologia , Trânsito Gastrointestinal , Leptina , Motilidade Gastrointestinal , Insulina
7.
Clin Res Cardiol ; 109(9): 1099-1106, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31989251

RESUMO

OBJECTIVE: The aim of this study was to compare the outcome of nonagenarians (≥ 90 years) with that of younger (< 90 years) patients undergoing transcatheter aortic valve implantation (TAVI) in current practice. METHODS: Data are collected from the German Aortic Valve Registry (GARY), which was designed to evaluate current practice in the invasive treatment of patients with aortic valve diseases in Germany. Data were analyzed regarding procedural outcome, 30-day, and 1-year outcomes of nonagenarians in comparison to that of younger patients. RESULTS: Between 2011 and 2015, 2436/33,051 (7.3%) nonagenarians underwent TAVI and were included in GARY. Nonagenarians were significantly more often male (45.2% vs. 40.0%, p < 0.001), frail (38.7% vs. 34.7%, p < 0.001), and had higher EuroSCORE scores than younger patient group (23.2% vs. 17.0%). Nonagenarians were significantly less often treated via transapical access (16.3% vs. 22.3%, p < 0.001). Procedure was performed significantly less often in general anesthesia (58.2% vs. 60.7%, p = 0.02) in nonagenarians, while necessity of pacemaker implantation was significantly higher in nonagenarians (27.2% vs. 24.8%, p > 0.001). The incidence of other typical postprocedural complications such as severe bleeding events and vascular complications were comparable between groups. However, 30-day (5.2% vs. 3.9%) and 1-year (22.7% vs. 17.7%) mortality rates were significantly higher among nonagenarians and age ≥ 90 years could be identified as an isolated risk factor for mortality. CONCLUSION: TAVI is a highly standardized procedure that can be performed safely with high procedural success even in very old patients. Although mortality is significantly higher in these patients-most probably due to the intrinsic higher risk profile of the very old patients-the results are still acceptable. To optimize outcome, especially elderly patients seem to profit from a procedure under local anesthesia or conscious sedation, to minimize the rate of postoperative delirium and the length of stay and to facilitate early mobilization.


Assuntos
Anestesia Geral/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Substituição da Valva Aórtica Transcateter/métodos , Fatores Etários , Idoso de 80 Anos ou mais , Estimulação Cardíaca Artificial/estatística & dados numéricos , Feminino , Alemanha , Humanos , Masculino , Sistema de Registros , Fatores de Risco , Fatores de Tempo , Substituição da Valva Aórtica Transcateter/mortalidade , Resultado do Tratamento
8.
J Acoust Soc Am ; 145(3): 1401, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31067938

RESUMO

To understand the consequences of underwater noise exposure for cetaceans, there is a need for assessments of behavioural responses over increased spatial and temporal scales. Bottom-moored acoustic recorders and satellite tags provide such long-term and large spatial coverage of behaviour compared to short-duration acoustic-recording tags. However, these tools result in a decreased resolution of data from which an animal response can be inferred, and no direct recording of the sound received at the animal. This study discusses the consequence of the decreased resolution of data from satellite tags and fixed acoustic recorders on the acoustic dose estimated by propagation modelling and presents a method for estimating the range of sound levels that animals observed with these methods have received. This problem is illustrated using experimental results obtained during controlled exposures of northern bottlenose whales (Hyperoodon ampullatus) exposed to naval sonar, carried out near Jan Mayen, Norway. It is shown that variability and uncertainties in the sound field, resulting from limited sampling of the acoustic environment, as well as decreased resolution in animal locations, can lead to quantifiable uncertainties in the estimated acoustic dose associated with the behavioural response (in this case avoidance and cessation of foraging).


Assuntos
Acústica/instrumentação , Ecolocação , Comunicações Via Satélite/instrumentação , Baleias/fisiologia , Animais , Comunicações Via Satélite/normas
9.
Nat Commun ; 9(1): 4659, 2018 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-30405105

RESUMO

Short wavelength free-electron lasers (FELs), providing pulses of ultrahigh photon intensity, have revolutionized spectroscopy on ionic targets. Their exceptional photon flux enables multiple photon absorptions within a single femtosecond pulse, which in turn allows for deep insights into the photoionization process itself as well as into evolving ionic states of a target. Here we employ ultraintense pulses from the FEL FERMI to spectroscopically investigate the sequential emission of electrons from gaseous, atomic argon in the neutral as well as the ionic ground state. A pronounced forward-backward symmetry breaking of the angularly resolved emission patterns with respect to the light propagation direction is experimentally observed and theoretically explained for the region of the Cooper minimum, where the asymmetry of electron emission is strongly enhanced. These findings aim to originate a better understanding of the fundamentals of photon momentum transfer in ionic matter.

10.
Med Klin Intensivmed Notfmed ; 113(6): 478-486, 2018 09.
Artigo em Alemão | MEDLINE | ID: mdl-29967938

RESUMO

Extracorporeal cardiopulmonary resuscitation (eCPR) may be considered as a rescue attempt for highly selected patients with refractory cardiac arrest and potentially reversible etiology. Currently there are no randomized, controlled studies on eCPR, and valid predictors of benefit and outcome which might guide the indication for eCPR are lacking. Currently selection criteria and procedures differ across hospitals and standardized algorithms are lacking. Based on expert opinion, the present consensus statement provides a proposal for a standardized treatment algorithm for eCPR.


Assuntos
Reanimação Cardiopulmonar , Oxigenação por Membrana Extracorpórea , Parada Cardíaca , Consenso , Parada Cardíaca/terapia , Humanos , Seleção de Pacientes
11.
Anaesthesist ; 67(8): 607-616, 2018 08.
Artigo em Alemão | MEDLINE | ID: mdl-30014276

RESUMO

Extracorporeal cardiopulmonary resuscitation (eCPR) may be considered as a rescue attempt for highly selected patients with refractory cardiac arrest and potentially reversible etiology. Currently there are no randomized, controlled studies on eCPR, and valid predictors of benefit and outcome which might guide the indication for eCPR are lacking. Currently selection criteria and procedures differ across hospitals and standardized algorithms are lacking. Based on expert opinion, the present consensus statement provides a proposal for a standardized treatment algorithm for eCPR.


Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Algoritmos , Consenso , Oxigenação por Membrana Extracorpórea/métodos , Humanos
12.
J Chem Phys ; 145(12): 124501, 2016 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-27782649

RESUMO

A series of transition and post-transition metal ion (Mn, Cu, Zn, Pb, Bi) binary borate glasses was studied with special consideration of the cations impact on the borate structure, the cations cross-linking capacity, and more generally, structure-property correlations. Infrared (IR) and Raman spectroscopies were used for the structural characterization. These complementary techniques are sensitive to the short-range order as in the differentiation of tetrahedral and trigonal borate units or regarding the number of non-bridging oxygen ions per unit. Moreover, vibrational spectroscopy is also sensitive to the intermediate-range order and to the presence of superstructural units, such as rings and chains, or the combination of rings. In order to clarify band assignments for the various borate entities, examples are given from pure vitreous B2O3 to meta-, pyro-, ortho-, and even overmodified borate glass compositions. For binary metaborate glasses, the impact of the modifier cation on the borate speciation is shown. High field strength cations such as Zn2+ enhance the disproportionation of metaborate to polyborate and pyroborate units. Pb2+ and Bi3+ induce cluster formation, resulting in PbOn- and BiOn-pseudophases. Both lead and bismuth borate glasses show also a tendency to stabilize very large superstructural units in the form of diborate polyanions. Far-IR spectra reflect on the bonding states of modifier cations in glasses. The frequency of the measured cation-site vibration band was used to obtain the average force constant for the metal-oxygen bonding, FM-O. A linear correlation between glass transition temperature (Tg) and FM-O was shown for the metaborate glass series. The mechanical properties of the glasses also correlate with the force constant FM-O, though for cations of similar force constant the fraction of tetrahedral borate units (N4) strongly affects the thermal and mechanical properties. For paramagnetic Cu- and Mn-borate glasses, N4 was determined from the IR spectra after deducing the relative absorption coefficient of boron tetrahedral versus boron trigonal units, α = α4/α3, using NMR literature data of the diamagnetic glasses.

13.
Brain Res ; 1650: 224-231, 2016 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-27620649

RESUMO

Perinatal hypoxia is a critical complication during delivery and is mostly studied in animal models of postnatal hypoxic-ischemic brain injury. We here studied the effects of postnatal hypoxic-ischemic brain injury in two different sub-strains of C57BL/6 mice, i.e. C57BL/6J and C57BL/6N mice. These two sub-strains show different metabolic properties, for instance an impaired glucose tolerance in C57BL/6J mice. Genetically, this was linked to differences in their nicotinamide nucleotide transhydrogenase (Nnt) genes: In C57BL/6J mice, exons 7-11 of the Nnt gene are deleted, resulting in the absence of functional Nnt protein. The mitochondrial Nnt-protein is one of several enzymes that catalyses the generation of NADPH, which in turn is important for the elimination of reactive oxygen species (ROS). As ROS is thought to contribute to the pathophysiology of hypoxia-ischemia, the lack of Nnt might indirectly increase ROS levels and therefore result in increased brain damage. We therefore hypothesize that lesion score and lesion size will increase in C57BL/6J mice as compared to C57BL/6N mice. Surprisingly, the results showed exactly the opposite: C57BL/6J mice showed a decrease in lesion score and size, associated with a reduced number of apoptotic cells and activated microglia. In contrast, the number of cells with ROS-induced DNA modifications (detected by 8OHdG) was higher in C57BL/6J than C57BL/6N mice. In conclusion, C57BL/6J mice showed reduced ischemic consequences after postnatal hypoxic-ischemic brain injury compared to C57BL/6N mice, with the exception of the amount of ROS-induced DNA-damage. These differences might relate to the lack of Nnt, but also to a modified metabolic setting (cardiovascular parameters, oxygen and glucose metabolism, immune function) in C57BL/6J mice.


Assuntos
Hipóxia-Isquemia Encefálica/fisiopatologia , Camundongos Endogâmicos/metabolismo , Animais , Encéfalo/metabolismo , Lesões Encefálicas/fisiopatologia , Traumatismo Cerebrovascular/fisiopatologia , Éxons , Intolerância à Glucose/patologia , Macrófagos/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos/genética , NADP/genética , NADP/metabolismo , NADP Trans-Hidrogenases/genética , NADP Trans-Hidrogenases/metabolismo , Espécies Reativas de Oxigênio/metabolismo
14.
Rev Sci Instrum ; 87(5): 053116, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27250401

RESUMO

We report about the development and implementation of a new setup for time-resolved X-ray absorption fine structure spectroscopy at beamline P11 utilizing the outstanding source properties of the low-emittance PETRA III synchrotron storage ring in Hamburg. Using a high intensity micrometer-sized X-ray beam in combination with two positional feedback systems, measurements were performed on the transition metal complex fac-Tris[2-phenylpyridinato-C2,N]iridium(III) also referred to as fac-Ir(ppy)3. This compound is a representative of the phosphorescent iridium(III) complexes, which play an important role in organic light emitting diode (OLED) technology. The experiment could directly prove the anticipated photoinduced charge transfer reaction. Our results further reveal that the temporal resolution of the experiment is limited by the PETRA III X-ray bunch length of ∼103 ps full width at half maximum (FWHM).

15.
R Soc Open Sci ; 2(6): 140484, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26543576

RESUMO

Although northern bottlenose whales were the most heavily hunted beaked whale, we have little information about this species in its remote habitat of the North Atlantic Ocean. Underwater anthropogenic noise and disruption of their natural habitat may be major threats, given the sensitivity of other beaked whales to such noise disturbance. We attached dataloggers to 13 northern bottlenose whales and compared their natural sounds and movements to those of one individual exposed to escalating levels of 1-2 kHz upsweep naval sonar signals. At a received sound pressure level (SPL) of 98 dB re 1 µPa, the whale turned to approach the sound source, but at a received SPL of 107 dB re 1 µPa, the whale began moving in an unusually straight course and then made a near 180° turn away from the source, and performed the longest and deepest dive (94 min, 2339 m) recorded for this species. Animal movement parameters differed significantly from baseline for more than 7 h until the tag fell off 33-36 km away. No clicks were emitted during the response period, indicating cessation of normal echolocation-based foraging. A sharp decline in both acoustic and visual detections of conspecifics after exposure suggests other whales in the area responded similarly. Though more data are needed, our results indicate high sensitivity of this species to acoustic disturbance, with consequent risk from marine industrialization and naval activity.

16.
Thorac Cardiovasc Surg ; 62(5): 380-92, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24995534

RESUMO

On the basis of a voluntary registry of the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), data of all cardiac surgical procedures performed in 79 German cardiac surgical units during the year 2013 are presented. In 2013, a total of 99,128 cardiac surgical procedures (implantable cardioverter defibrillator [ICD] and pacemaker procedures excluded) were submitted to the registry. More than 13.8% of the patients were older than 80 years, which remains equal in comparison to the previous year. In-hospital mortality in 40,410 isolated coronary artery bypass grafting procedures (84.5% on-pump and 15.5% off-pump) was 2.9%. In 29,672 isolated valve procedures (including 7,722 catheter-based procedures), an in-hospital mortality of 4.7% was observed. This long-lasting registry of the GSTCVS will continue to be an important tool for quality control and voluntary public reporting by illustrating current facts and developments of cardiac surgery in Germany.


Assuntos
Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos , Sistema de Registros , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Sistema de Registros/estatística & dados numéricos , Sociedades Médicas
18.
J Acoust Soc Am ; 134(3): 2409-17, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23968038

RESUMO

Reliable localization of marine mammals using towed arrays is often required for mitigation, population density estimates, and bioacoustics research. The accuracy of the range estimates using towed arrays is often not well quantified. Triangulation methods using multiple hydrophones allow for fast range estimates but are sensitive to the species type, location of the animal with respect to the array, sound propagation conditions, and array stability. A simple model is presented that is used to estimate the range accuracy of towed arrays for different vocalizations and is compared to measured range accuracies of sperm whale clicks recorded with a 15 m baseline towed array. The ranging performance is particularly sensitive to hydrophone position errors which are found to dominate. Hydrophone position errors could be estimated using heading sensors placed in the array and are taken into account in the model. A good agreement is found between the empirical range errors and theoretically predicted ones. Extrapolation of the model to other species suggests that species emitting high frequency clicks and calls can be localized from distances out to a few kilometers with a baseline of 15 m, but baleen whales transmitting low frequency calls require longer baselines to obtain range estimates.


Assuntos
Acústica/instrumentação , Monitoramento Ambiental/instrumentação , Biologia Marinha/instrumentação , Cachalote/fisiologia , Transdutores , Vocalização Animal , Animais , Monitoramento Ambiental/métodos , Desenho de Equipamento , Biologia Marinha/métodos , Modelos Teóricos , Oceanos e Mares , Dinâmica Populacional , Reprodutibilidade dos Testes , Processamento de Sinais Assistido por Computador , Espectrografia do Som , Cachalote/psicologia
19.
Herzschrittmacherther Elektrophysiol ; 24(2): 123-4, 2013 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-23754588

RESUMO

Medical qualifications to perform operations with cardiac electronic implantable devices as well as for preoperative and postoperative therapy, including follow-up in this patient population are not well defined. Based on recommendations which have been worked out and published by an interdisciplinary consensus of cardiac surgeons, cardiologists and electrophysiologists, a certificate with three modules has been developed by the Working Group for Electrophysiologic Surgery of the German Society for Thoracic and Cardiovascular Surgery (GSTCVS, Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, DGTHG). First examinations for this certificate will be held in 2013 and transitional regulations apply until 1st April 2014. Further details are available on the homepage of the GSTCVS.


Assuntos
Estimulação Cardíaca Artificial/normas , Certificação/normas , Desfibriladores Implantáveis/normas , Técnicas Eletrofisiológicas Cardíacas/normas , Implantação de Prótese/normas , Alemanha
20.
Thorac Cardiovasc Surg ; 60(5): 319-25, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22859310

RESUMO

Background The increasing prevalence of severe aortic valve defects correlates with the increase of life expectancy. For decades, surgical aortic valve replacement (AVR), under the use of extracorporeal circulation, has been the gold standard for treatment of severe aortic valve diseases. In Germany ~12,000 patients receive isolated aortic valve surgery per year. For some time, percutaneous balloon valvuloplasty has been used as a palliative therapeutic option for very few patients. Currently, alternatives for the established surgical procedures such as transcatheter aortic valve implantation (TAVI) have become available, but there are only limited data from randomized studies or low-volume registries concerning long-time outcome. In Germany, the implementation of this new technology into hospital care increased rapidly in the past few years. Therefore, the German Aortic Valve Registry (GARY) was founded in July 2010 including all available therapeutic options and providing data from a large quantity of patients.Methods The GARY is assembled as a complete survey for all invasive therapies in patients with relevant aortic valve diseases. It evaluates the new therapeutic options and compares them to surgical AVR. The model for data acquisition is based on three data sources: source I, the mandatory German database for external performance measurement; source II, a specific registry dataset; and source III, a follow-up data sheet (generated by phone interview). Various procedures will be compared concerning observed complications, mortality, and quality of life up to 5 years after the initial procedure. Furthermore, the registry will enable a compilation of evidence-based indication criteria and, in addition, also a comparison of all approved operative procedures, such as Ross or David procedures, and the use of different mechanical or biological aortic valve prostheses.Results Since the launch of data acquisition in July 2010, almost all institutions performing aortic valve procedures in Germany joined the registry. By now, 91 sites which perform TAVI in Germany participate and more than 15,000 datasets are already in the registry.Conclusion The implementation of new or innovative medical therapies needs supervision under the conditions of a well-structured scientific project. Up to now relevant data for implementation of TAVI and long-term results are missing. In contrast to randomized controlled trials, GARY is a prospective, controlled, 5-year observational multicenter registry, and a real world investigation with only one exclusion criterion, the absence of patients' written consent.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Cateterismo Cardíaco , Implante de Prótese de Valva Cardíaca/métodos , Sistema de Registros , Idoso , Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/psicologia , Seguimentos , Alemanha/epidemiologia , Implante de Prótese de Valva Cardíaca/mortalidade , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Fatores de Risco , Índice de Gravidade de Doença , Taxa de Sobrevida/tendências , Resultado do Tratamento , Adulto Jovem
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