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Zlabinger K, Lukovic D, Gugerell A, Winkler J, Spannbauer A, Emmert M, Hoerstrup SP, Gyoengyoesi M. P474Stable PET-reporter gene transfection of MSCs for in vivo long-term cell tracking in xenogeneic transplanted tissue engineered heart valves. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mueller C, Spannbauer A, Traxler D, Lukovic D, Borger A, Zlabinger K, Winkler J, Gugerell A, Gyongyosi M. P541Evaluation of plasma exosomal miRNA-1, miRNA-133 and miRNA-208 levels in a porcine model during acute myocardial infarction. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gugerell A, Zlabinger K, Lukovic D, Winkler J, Hemetsberger R, Mandic LJ, Traxler D, Spannbauer A, Pavo N, Gyongyosi M. P110Effect of MMP-2 on compromised homing of intracoronary delivery of mesenchymal stem cell in a porcine reperfused myocardial infarction: comparison with intramyocardial cell delivery. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lukovic D, Zlabinger K, Spannbauer A, Gugerell A, Pavo N, Traxler D, Jakab A, Bergler-Klein J, Gyongyosi M, Winkler J. 403Induction of interferon-related genes limits the cardiotoxicity of liposomal doxorubicin in pigs. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Spannbauer A, Traxler D, Pavo N, Riesenhuber M, Mueller C, Gugerell A, Winkler J, Zlabinger K, Lukovic D, Gyongyosi M. P476Intraventricular measurement of electrophysiological parameters in pre- or post-conditioned myocardial infarction. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wenger R, Oehme F, Winkler J, Perren SM, Babst R, Beeres FJP. Absolute or relative stability in minimal invasive plate osteosynthesis of simple distal meta or diaphyseal tibia fractures? Injury 2017; 48:1217-1223. [PMID: 28302305 DOI: 10.1016/j.injury.2017.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/28/2017] [Accepted: 03/06/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Minimal invasive plate osteosynthesis in simple distal meta or diaphyseal tibia fractures can be applied using absolute (lag screw and neutralisation plate; LSN) or relative stability (bridge plate; BP). The primary aim of the study was to compare time to radiological union and time to full weight bearing in the two groups (LSN vs. BP). Reduction was performed either percutaneously or by a minimally open approach (mini open). Secondary aim was to analyse the number of complications between both groups. METHODS Retrospective single centre review of patients with a simple distal meta or diaphyseal tibia fracture operated with a Locking Compression Plate (LCP) between 2009 and 2015 in a Level one Trauma Centre. Postoperative radiographs were assessed in a standardised manner. Time to radiological fracture union and time to full weight bearing were observed. Callus index and postoperative complications were analysed. RESULTS Fifty-seven patients with a minimum follow-up of 6 months were analysed. Forty-eight patients had a shaft (AO/OTA Type 42) and nine a distal tibia fracture (AO/OTA Type 43). Forty patients were treated with using the LSN concept and 17 patients with the BP concept. Median time to radiological fracture union was statistically significant shorter (p=0.04) in the LSN group with 19 weeks compared to 27 weeks in the BP-group. Time to full weight bearing was 10 weeks in both groups. A total (including implant removal) of 35 reoperations were performed in the LSN-group and 18 in the BP-group. Wound healing disorders (deep surgical site infections) were seen less the LSN group in 3/40 (7.5%) compared to the BP-group with 3/17 (17.6%). In the LSN group, there was no statistical difference in time to union or weight bearing between a percutaneous or mini open approach. CONCLUSION Stable osteosynthesis of simple distal meta or diaphyseal tibia fractures leads to faster radiologic fracture healing without an increase in complications or number of revisions compared to bridge plating. If a percutaneous reduction is not feasible for the insertion of a lag screw, a mini-open approach does not lead to a delay in fracture healing.
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Laubenthal L, Ruda L, Sultana N, Winkler J, Rehage J, Meyer U, Dänicke S, Sauerwein H, Häussler S. Effect of increasing body condition on oxidative stress and mitochondrial biogenesis in subcutaneous adipose tissue depot of nonlactating dairy cows. J Dairy Sci 2017; 100:4976-4986. [DOI: 10.3168/jds.2016-12356] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/09/2017] [Indexed: 01/08/2023]
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Scheibe G, Wörz O, Haimerl F, Seiffert W, Winkler J. Circular dichroism spectra of adsorbed dye-aggregates. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1968650146] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Winkler J, Lorenz W, Wimberger P. Retrospektive Analyse transfusionspflichtiger peripartaler Blutungen und Festlegung eines klinikinternen Standards zur Bereitstellung von Blutprodukten. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1601507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Neubert M, Nitzsche K, Winkler J, Wimberger P. Fallvorstellung einer seltenen postpartal diagnostizierten symptomatischen Epilepsie. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1601508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Knappe T, Gütz S, Schiefer C, Winkler J. Bronchoskopische und systemische antimykotische Therapie eines Aspergilloms mit zusätzlicher Infektion durch Actinomyces spec. und Bacteriodes spec. Pneumologie 2017. [DOI: 10.1055/s-0037-1598489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Knappe T, Gütz S, Schiefer C, Winkler J. Bronchoskopische und systemische antimykotische Therapie eines superinfizierten Aspergilloms. Pneumologie 2016; 70:826-830. [PMID: 27931065 DOI: 10.1055/s-0036-1596070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Winkler J, Raina K, Altieri M, Dong H, Wang J, Chen X, Crew A, Crews C, Qian Y, Kleinfield R, Coleman K. PROTAC BET degraders are more broadly effective than BET inhibitors. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32621-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Marxreiter F, Gassner H, Barth J, Thun C, Volc D, Schlachetzki J, Winkler J, Eskofier B, Klucken J. EP 96. Sensor based gait analysis application for apomorphine titration. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hassel J, Flossdorf M, Hänzelmann S, Winkler J, Appel L, Streit E, Halama N, Faryna M, Poschke I. 489 Investigation of the immune infiltrate of metastatic melanoma under immune checkpoint inhibition. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Marxreiter F, Storch A, Winkler J. [Cellular replacement strategies and adult neurogenesis in idiopathic Parkinson's disease]. DER NERVENARZT 2016; 87:805-13. [PMID: 27389601 DOI: 10.1007/s00115-016-0157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Parkinson's disease (PD) is the most common age-related movement disorder and characterized by slowly progressive neurodegeneration resulting in motor symptoms, such as bradykinesia, rigidity, tremor and postural instability. Moreover, non-motor symptoms, such as hyposmia, anxiety and depression reduce the quality of life in PD. Motor symptoms are associated with a distinct striatal dopaminergic deficit resulting from axonal dysfunction and neuronal loss in the substantia nigra (SN). Recent progress in stem cell technology allows the optimization of cellular transplantation strategies in order to alleviate the motor deficit, which potentially leads to a reactivation of this therapeutic strategy. Besides neurodegenerative processes impaired adult neurogenesis and consequentially reduced endogenous cellular plasticity may play an important role in PD. This article discusses the notion that non-motor symptoms in PD may partly be explained by reduced adult neurogenesis in the olfactory bulb and hippocampus.
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Marxreiter F, Winkler J. [Vascular parkinsonism]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2016; 84 Suppl 1:S8-S13. [PMID: 27299942 DOI: 10.1055/s-0042-107076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Parkinsonism may result from cerebral vascular disorders that feature white matter lesions and small vessel pathology. Vascular Parkinsonism typically presents as lower body Parkinsonism with predominant gait impairment. Urinary incontinence and cognitive decline are additional features of the disease. There is a considerable overlap between vascular Parkinsonism and vascular dementia. We review the clinical characteristics of vascular Parkinsonism and discuss the current treatment approaches, as well as the role of brain imaging for the diagnostic workup. .
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Ng D, Ljung BM, Bardales R, Abad M, Cedano M, Constant TH, Winkler J, Balassanian R. Developing a Breast Fine Needle Aspiration Biopsy Service in Peru. J Glob Oncol 2016. [DOI: 10.1200/jgo.2016.003897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract 6 Background: Breast cancer incidence is increasing in developing countries. In 2010, 57.8% of breast cancers in Peru were at least stage III at diagnosis. Federal and regional Peruvian institutions partnered with several organizations, including UCSF, to improve access and quality of breast cancer care in Peru. Phase 1 involved screening with clinical breast exam, creating a community-based referral system for women with masses, and promoting evaluation of lesions using fine needle aspiration biopsy (FNAB) by trained physicians, with treatment at the regional cancer institute. Curricula for each activity were developed and validated. During phase 1, in-country FNAB expertise was recognized as limited. For phase 2, the critical objective was to solidify local capacity for high-quality FNAB and integrate FNAB into standard of care for breast cancer. Methods: Three main activities were completed during phase 2. 1) Develop a Training of Trainers (ToT) curriculum for FNAB, and identify master trainers and trainees. 2) Facilitate endorsement of a national approach to training FNAB and undertake preliminary rollout in La Libertad region. 3) Strengthen interpretation and reporting of FNAB results. Results: A 5-day ToT pilot course occurred during October 19-23, 2014. Prior to the course, women with palpable masses were identified during a breast screening campaign and scheduled for FNAB. Regional, national and international clinical teams observed, procured and interpreted FNAB. Four new cases of cancer and eight cases of granulomatous mastitis were diagnosed. Slide quality before and after the training intervention will be compared. Following the course, a one-day validation meeting including physicians and national leaders took place at the national cancer center in Lima, Peru. FNAB was endorsed for early diagnosis and triage. Conclusions: To ensure sustainability of FNAB, cytology fellowships and training centers are needed. Strengthening partnerships will be critical for long-term capacity. An electronic reporting system will be developed to replace paper-based methods. Funding: Norwegian Cancer Society/Norwegian Breast Cancer Society (NCS/NBCS), Susan G. Komen for the Cure, The PATH Catalyst Fund. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.
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Natale C, Duperret E, Zhang J, Sadeghi R, Dahal A, O’Brien K, Winkler J, Ridky T. 609 Estrogen and progesterone reciprocally regulate melanin production through G protein-coupled receptors. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Llaudó J, Anta L, Ayani I, Martínez-González J, Gutierro I, Faelens R, Winkler J, Snoeck E. Population pharmacokinetic modeling and simulations of dopamine Dd2 receptor occupancy of long-acting intramuscular risperidone-ISM. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionRisperidone-ISM is a new long-acting intramuscular formulation intended to achieve sustained plasma concentrations over 4 weeks without oral supplementation. The clinical efficacy to risperidone has been associated with 65–80% occupancy of dopamine D2 receptor (D2RO) and a mean Cmax between 7.5 ng/mL and 80 ng/mL.AimUse a population PK/PD model to predict the PK and the D2RO for Risperidone-ISM in schizophrenic patients and to characterize the relationship among doses, in order to guide dose selection for a future Phase-III trial.MethodsA population PK/PD analysis for Risperidone-ISM using Monolix software was conducted based on 6641 plasma samples from two Phase-I studies (17 healthy subjects and 31 schizophrenic subjects, respectively) and 1 Phase-II study (60 schizophrenic subjects). Simulations were subsequently undertaken predicting the steady state PK and D2RO after multiple Risperidone-ISM doses administered every 28 days for 12 weeks.ResultsDoses of 75 and 100 mg, administered either in gluteal or deltoid muscle, were predicted to result in median Cmax and Ctrough that stayed between 7.5 ng/mL and 80 ng/mL. At steady state 75 mg and 100 mg dose (gluteal) achieved a D2RO average [min–max] of 70.8% [61.4–80.4] and 74.3% [66.2–82.1], respectively; a 75-mg and 100-mg dose (deltoid) achieved a D2RO average [min–max] of 69.3% [56.5–80.3] and 73.0% [61.8–82.1], respectively. The model estimated that the 65% D2RO occurs within first 8 h after treatment.ConclusionsSimulations were carried out supporting doses of 75 mg and 100 mg Risperidone-ISM to show the greatest efficacy and safety potential to be assessed in the future Phase-III trial.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Seyfarth HJ, Wirtz H, Gille J, Gerlach S, Grachtrup S, Winkler J, Sablotzki A. [Management and Outcome of Surgery in Patients with Severe Pulmonary Hypertension--A Single-Center Experience]. Pneumologie 2016; 70:117-22. [PMID: 26894393 DOI: 10.1055/s-0041-110294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patients with pulmonary hypertension (PH) are at high risk when undergoing surgery. Up to one-third of patients suffer complications; recent studies report a mortality rate of 1 to 7%. Frequent events are deterioration of right heart function and infectious or bleeding complications. METHODS Data of patients (age ≥ 18) with precapillary PH who need to undergo elective surgery between January 2006 and March 2015 were included in this retrospective analysis. All patients who were planned for surgery underwent the same procedure. First, patients were evaluated in the PH center. Thereafter, PH-relevant data were discussed with the surgeon/anesthesiologist team for risk-adapted planning of anesthesia and intervention. The present analysis comprises patient characteristics and information about surgery and post-interventional course. RESULTS This study analyzes 31 surgical procedures carried out in PH patients (male: n = 8; PH-group I: n = 23, group III: n = 3, group IV: n = 5, mean age: 59.5 ± 15.3 years). Patients were characterized by compromised hemodynamics and exercise capacity: pulmonary vascular resistance: 805.4 ± 328.5 dyn*s*cm(-5), mean pulmonary arterial pressure: 46.3 ± 9.3 mmHg, 6-minute walking distance: 350.3 ± 123.3 m.The majority of interventions were performed under general anesthesia (n = 24). In 25 cases, the intraoperative monitoring was complemented with right heart catheterization.Eight interventions were associated with complications, three of which were serious. One patient died postoperatively owing to sepsis and right heart failure. CONCLUSION A careful and structured planning of surgical interventions in patients with PH and the choice of surgical procedure and anesthesia adapted to the conditions of PH might help avoid complications. Further multicentric studies are needed.
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Mrochen A, Marxreiter F, Kohl Z, Schlachetzki J, Renner B, Schenk T, Winkler J, Klucken J. From sweet to sweat: Hedonic olfactory range is impaired in Parkinson's disease. Parkinsonism Relat Disord 2015; 22:9-14. [PMID: 26627940 DOI: 10.1016/j.parkreldis.2015.09.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 08/15/2015] [Accepted: 09/17/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Olfactory dysfunction and neuropsychological symptoms like depression and anhedonia are common non-motor symptoms in Parkinson's disease (PD). The assessment of both functional domains includes clinical examination, olfactory testing, and standardized questionnaires. While olfaction is readily assessed by functional tests, the distinction of anhedonia as a separate symptom from other depressive symptoms is challenging. Thus, a test focusing on the assessment of hedonic olfaction may be helpful in the assessment of neuropsychological symptoms in PD. METHODS We examined anhedonia by evaluating the perception of pleasantness of odors in PD patients (n = 57) and healthy controls (n = 46). Pleasantness of odors was registered on a visual 9-point scale. For the assessment of anhedonia we used the Snaith-Hamilton-Pleasure-Scale (SHAPS). Depression was evaluated with the Zung Self-Rating Depression Scale and the Beck Depression Inventory II. RESULTS PD patients showed a substantial reduction in hedonic olfaction compared to controls (hedonic score: 1.5 vs. 2.2). Hyposmia, one of the most prevalent non-motor symptoms in PD, was a confounding factor. However, even normosmic PD patients showed a reduced hedonic olfaction compared to controls (hedonic score: 1.6 vs. 2.2). Furthermore, we observed a correlation between hedonic olfaction and the SHAPS-score for PD patients even though positive SHAPS-rating was observed in 9% of PD patients only, while no correlation to depression was present. CONCLUSION These findings suggest that reduced hedonic olfaction might be an additional neuropsychological feature, probably giving insights into changes in hedonic tone complementary to hyposmia and depression in PD.
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Vogelgsang J, Wiltfang J, Masliah E, Winkler J, Klucken J. Dopaminergic stimulation in a transgenic model of neurodegeneration restores decreased proliferation and viability in subventricular zone derived adult neural precursor cells. PHARMACOPSYCHIATRY 2015. [DOI: 10.1055/s-0035-1558039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vogelgsang J, Wiltfang J, Masliah E, Winkler J, Klucken J. Dopaminergic stimulation in a transgenic model of neurodegeneration restores decreased proliferation and viability in subventricular zone derived adult neural precursor cells. PHARMACOPSYCHIATRY 2015. [DOI: 10.1055/s-0035-1558001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mühle A, Obst A, Winkler J, Ewert R. [Cardiopulmonary exercise testing in chronic obstructive pulmonary disease (COPD) - breath-functional characterization and disease severity assessment]. Pneumologie 2015. [PMID: 26205842 DOI: 10.1055/s-0034-1392576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
COPD is a heterogeneous disease with a wide range of clinical phenotypes and breath-functional dysfunctions. Cardiopulmonary exercise testing (CPET) allows describing all component parts of breathing and determining exercise capacity and the mechanisms of exercise limitation. From these aspects 64 COPD patient stages II, III and IV according to the conventional GOLD classification were examined by means of CPET to evaluate whether CPET can provide a better functional characterization of COPD than the standard investigation procedures in pulmonary practice.We could show that in pulmonary practice CPET is safely and effectively practicable in stable COPD patients of all GOLD stages. This method allowed a clinical and prognostic disease severity assessment of all patients, proving important differences of peak oxygen uptake in each GOLD stage, so that patients in spite of identical GOLD disease severity were to be assigned to different prognostic groups according CPET criteria. Furthermore, we found relevant differences of individual breath-functional patterns in exercise, which can neither be objectified nor be prognosticated by standard investigation procedures at rest.Therefore CPET allows, aside from an objective clinical and prognostic disease severity assessment, also a breath-functional evaluation in a subtly way in COPD patients reflecting the multidimensional background of the disease with variable dysfunctions in pulmonary ventilation, gas exchange, circulation and muscular function as well as associated cardio vascular comorbidities. The breath-functional phenotyping of the COPD patient seems to be meaningful in particular for an individualised therapy management.
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