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Rezension zu Petra Renneke: Poesie und Wissen. Poetologie des Wissens der Moderne. Heidelberg (Winter) 2008 (= Beiträge zur neueren Literaturgeschichte, Bd. 261). 382 S.
Die Germanistin Petra Renneke legt mit ihrer Monographie 'Poesie und Wissen. Poetologie des Wissens der Moderne' die Buchfassung ihrer an der Universität Paderborn eingereichten Habilitation vor.
Die Möglichkeit Katastrophen politisch einzusetzen hängt unmittelbar mit der medialen Darstellung und der grundsätzlichen Frage nach ihrer Darstellbarkeit zusammen. Kai Fischer untersucht in seinem Beitrag 'Tschernobyl und die Katastrophe nach der Katastrophe' die Probleme fiktionaler und historiographischer Darstellung von Katastrophen in Alexander Kluges literarischen Bearbeitungen des Reaktorunglücks in Tschernobyl. Die Form der offenen Montage erlaubt es Kluge, die sich zum Teil widersprechenden Perspektiven unmittelbarer Erfahrung und ›objektiver Wissensanteile‹ in der 'Dokumentation' zu konfrontieren und damit die 'Unverhältnismäßigkeit der Dimensionen' anschaulich zu machen. Der sich so offenbarende Konflikt zwischen 'Realität' und Darstellung erweist sich als konstitutiv für das Verständnis von Katastrophen als Teil moderner Welterfahrung.
Background: Point of care devices for performing targeted coagulation substitution in patients who are bleeding have become increasingly important in recent years. New on the market is the Quantra. It is a device that uses sonorheometry, a sonic estimation of elasticity via resonance, which is a novel ultrasound-based technology that measures viscoelastic properties of whole blood. Several studies have already shown the comparability of the Quantra with devices already established on the market, such as the rotational thromboelastometry (ROTEM) device.
Objective: In contrast to existing studies, this study is the first prospective interventional study using this new system in a cardiac surgical patient cohort. We will investigate the noninferiority between an already existing coagulation algorithm based on the ROTEM/Multiplate system and a new algorithm based on the Quantra system for the treatment of coagulopathic cardiac surgical patients.
Methods: The study is divided into two phases. In an initial observation phase, whole blood samples of 20 patients obtained at three defined time points (prior to surgery, after completion of cardiopulmonary bypass, and on arrival in the intensive care unit) will be analyzed using both the ROTEM/Multiplate and Quantra systems. The obtained threshold values will be used to develop a novel algorithm for hemotherapy. In a second intervention phase, the new algorithm will be tested for noninferiority against an algorithm used routinely for years in our department.
Results: The main objective of the examination is the cumulative loss of blood within 24 hours after surgery. Statistical calculations based on the literature and in-house data suggest that the new algorithm is not inferior if the difference in cumulative blood loss is <150 mL/24 hours.
Conclusions: Because of the comparability of the Quantra sonorheometry system with the ROTEM measurement methods, the existing hemotherapy treatment algorithm can be adapted to the Quantra device with proof of noninferiority.
Trial Registration: ClinicalTrials.gov NCT03902275; https://clinicaltrials.gov/ct2/show/NCT03902275
International Registered Report Identifier (IRRID): DERR1-10.2196/17206
In Eurotransplant kidney allocation system (ETKAS), candidates can be considered unlimitedly for repeated re‐transplantation. Data on outcome and benefit are indeterminate. We performed a retrospective 15‐year patient and graft outcome data analysis from 1464 recipients of a third or fourth or higher sequential deceased donor renal transplantation (DDRT) from 42 transplant centers. Repeated re‐DDRT recipients were younger (mean 43.0 vs. 50.2 years) compared to first DDRT recipients. They received grafts with more favorable HLA matches (89.0% vs. 84.5%) but thereby no statistically significant improvement of patient and graft outcome was found as comparatively demonstrated in 1st DDRT. In the multivariate modeling accounting for confounding factors, mortality and graft loss after 3rd and ≥4th DDRT (P < 0.001 each) and death with functioning graft (DwFG) after 3rd DDRT (P = 0.001) were higher as compared to 1st DDRT. The incidence of primary nonfunction (PNF) was also significantly higher in re‐DDRT (12.7%) than in 1st DDRT (7.1%; P < 0.001). Facing organ shortage, increasing waiting time, and considerable mortality on dialysis, we question the current policy of repeated re‐DDRT. The data from this survey propose better HLA matching in first DDRT and second DDRT and careful selection of candidates, especially for ≥4th DDRT.