Abt. Perioperative Inflammation und Infektion
Department für Humanmedizin
Fakultät für Medizin und Gesundheitswissenschaften
Carl von Ossietzky Universität Oldenburg
Perioperative major adverse cardiac events (MACE) are frequent (≈ 9% of all procedures). MACE thus claims a significant portion of the therapeutic benefit of surgical procedures. Prediction, diagnosis and treatment of this condition are difficult. 80% of all MIs are caused by rupture of unstable plaques. This proportion is declining due to widely used plaque stabilizing statin therapy. The rates of events and the burden of myocardial infacrtions (MI) has however not changed significantly. The identification of biomarkers for improved detection of patients at risk prior to surgery is thus warranted. We have devised a complex strategy to
- Identify candidate molecules for detection and therapy
- Test these candidates in vitro, ex vivo and in vivo
- Design new hypothesese based on the derived information
We have carried out a registry study in more than 700 vascular surgery patients collecting plasma samples before and 24h after surgery along with vessel wall specimen and observed clinical outcomes for 30 days post surgery. (see publications) Of those 705 patients about 70 suffered cardiac events like myocardial infarctions (STEMI and NSTEMI). We are studying the predictive value of known biomarkers and will identify novel candidate molecules using the biomaterials that were collected by comparing transcriptional and translational patterns of patients with and without complications. To that end we are cooperating with groups of the Cardiavascular Division and the OMICs facilities at Stanford University and with the Department of Pediatrics and Anesthesiology and Intensive Care Medicine at the UMCG in Groningen.
Several additional clinical registries are planned as well as randomized controlled trials in order to test biomarker-based interventions in patients at risk undergoing surgical procedures.
Folkert Kuipers, Uwe Tietge, Pediatrie, UMCG
Anne Marie De Smet, Matijs van Meurs, Jill Moser, ICV UMCG
Michel Struys, Thomas Scheeren, Anesthesiologie, UMCG
Phil Tsao, Stanford University
Antje Meinders, Hans-Jörg Gillmann, MHH
We have developed in vivo models for perioperative atherosclerotic complications in order to examine mechanisms that precipitate these complications. Likewise, can therapies be tested that can help to avoid such complications. Observations are confirmed in the biomaterials of our registry study to aid translation of model data to patient care. This way various strategies to avoid complications have been examined and validated before they are taken to the clinical arena in cooperation with clinical Departments in Oldenburg and Groningen.
Jan Larmann, University of Heidelberg
Bernhard Schieffer, Harald Schütt, KArsten Grote, University of Marburg
In close cooperation with the Department of Medical Microbiology and Infection Prevention at the UMCG in Groningen, strategies are evaluated to avoid building of resistance to antibiotics by
1. Synchronizing Education and Qualification of Hygiene Specialists in Gemany and The Netherlands with a focus on Gender issues. Project grant: Eur Health One Health InterReg V
2. Developing strategies in close cooperation with Jade HS and Brandes Innovation. Project grant: Health-i-care; InterRegV
Roland Brandes, Brandes Innovation
Joachim Willms, Triage GmbH
Alex Friedrich, Medische MIkrobiologie en Infektiepreventie, UMCG
Leadership is the central motif of success of organizations in academic medicine. The tension between economic pressure on one side and patient wellbeing and academic freedom in the other have put leaders in academic medicine in a difficult position in recent years.
By comparing leadership mechanisms and structures in Dutch Academic Medical Centers with those in Germany mechanisms that are helpful to cope with the changing environment for leadership in academic medical centers is investigated.
Peter Fischer, Hanna Heinrich, University of Regensburg
Doerte Dehe, GfeO
Daniel Wichelhaus, Hochschule Hannover