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Nguyen-Huu KD, Schober W, Fromme H, Koczulla R, Nowak D, Jörres RA. Analyse der Ausatemluft mittels elektronischer Nase nach Rauchen elektronischer Zigaretten. Pneumologie 2014. [DOI: 10.1055/s-0034-1368021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nguyen-Huu KD, Jung P, Koczulla R, Nowak D, Jörres RA, Ochmann U. Analyse der Ausatemluft kardiologischer Patienten mittels elektronischer Nase. Pneumologie 2014. [DOI: 10.1055/s-0034-1368078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Zilz C, Blaas S, Jörres R, Pfeifer M, Budweiser S. Biomarker und psychische Gesundheit bei der schweren COPD. Pneumologie 2014. [DOI: 10.1055/s-0034-1367823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pöschinger S, Wanka ER, Nowak D, Jörres RA, Ochmann U. Meta-Analyse der Wirkungen von Ozon und Anwendung auf Expositionsprofile im Flugbetrieb. Pneumologie 2014. [DOI: 10.1055/s-0034-1368019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wanka ER, Kutschenreuter L, Seng S, Jörres RA, Budweiser S. Wetter und Luftschadstoffe: Einfluss auf die tägliche Anzahl von Notarzteinsätzen aufgrund von Atemwegsbeschwerden in Graz. Pneumologie 2014. [DOI: 10.1055/s-0034-1367882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dias A, Gorzelniak L, Schultz K, Wittmann M, Rudnik J, Jörres R, Horsch A. Classification of exacerbation episodes in chronic obstructive pulmonary disease patients. Methods Inf Med 2014; 53:108-14. [PMID: 24515082 DOI: 10.3414/me12-01-0108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 12/01/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting the airways, which constitutes a major cause of chronic morbidity and a significant economic and social burden throughout the world. Despite the fact that in COPD patients exacerbations are common acute events causing significant and often fatal worsening of symptoms, an accurate prognostication continues to be difficult. OBJECTIVES To build computational models capable of distinguishing between normal life days from exacerbation days in COPD patients, based on physical activity measured by accelerometers. METHODS We recruited 58 patients suffering from COPD and measured their physical activity with accelerometers for 10 days or more, from August 2009 to March 2010. During this period we recorded six exacerbation episodes in the patients, accounting for 37 days. We were able to analyse data for 52 patients (369 patient days), and extracted three distinct sets of features from the data, one set of basic features such as average, one set based on the frequency domain and the last exploring the cross-information among sensors pairs. These were used by three machine-learning techniques (logarithmic regression, neural networks, support vector machines) to distinguish days with exacerbation events from normal days. RESULTS The support vector machine classifier achieved an AUC of 90% ± 9, when supplied with a set of features resulting from sequential feature selection method. Neu- ral networks achieved an AUC of 83% ± 16 and the logarithmic regression an AUC of 67% ± 15. CONCLUSIONS None of the individual feature sets provided robust for reasonable classification of PA recording days. Our results indicate that this approach has the potential to extract useful information for, but are not robust enough for medical application of the system.
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Schneckenpointner R, Jörres RA, Meidenbauer N, Kollert F, Pfeifer M, Budweiser S. The clinical significance of anaemia and disturbed iron homeostasis in chronic respiratory failure. Int J Clin Pract 2014; 68:130-8. [PMID: 24341307 DOI: 10.1111/ijcp.12216] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 05/20/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Anaemia is a frequent, clinically relevant condition in various chronic diseases. It seems also to be prevalent in patients with chronic respiratory failure (CRF). We studied the characteristics of anaemia in CRF and its associations with clinical outcome. METHODS In a prospective design, 271 consecutive patients with CRF were evaluated; patients with other conditions often associated with anaemia were excluded. Haematological laboratory and physiological parameters, health-related quality of life (HRQL), dyspnoea and 48-month survival were determined. Anaemia was defined according to WHO [haemoglobin (Hb)< 13 g/l (male); Hb< 12 g/dl (female)] and using an established algorithm. RESULTS Among 185 patients included, 18.4% showed anaemia, not depending on chronic obstructive pulmonary disease (COPD) vs. non-COPD (17.6% vs. 19.0%; p = 0.851) or on gender [16.5% (female) vs. 19.8% (male); p = 0.702]. Anaemic patients had higher age, creatinine (p < 0.05 each) and erythropoietin levels (p < 0.001), but lower transferrin saturation (TSAT), serum iron and vitamin B12 levels (p < 0.01 each). By definition, most anaemic patients (67.6%) had disturbances in iron homeostasis according to 'anaemia of chronic disease' and/or true iron deficiency anaemia. Hb was independently related to dyspnoea and HRQL, while TSAT ≥ 20% was linked to less dyspnoea and better subjective exercise capability. Non-survivors had lower Hb and serum iron levels (p < 0.05 each). In multivariate analysis, lower serum iron levels and TSAT were independently associated with mortality (p < 0.05 each). CONCLUSION Anaemia was common in patients with CRF and often because of disturbed iron homeostasis. Hb and TSAT were linked to functional outcome and HRQL. Lower serum iron levels and TSAT were independent prognostic parameters.
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Schulz H, Flexeder C, Behr J, Holle R, Huber RM, Jörres RA, Nowak D, Peters A, Wichmann HE, Heinrich J, Karrasch S. Referenzwerte für impulsoszillometrische Parameter bei Erwachsenen: Ergebnisse der KORA F4L und KORA Age Studie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ehret M, Karrasch S, Kronseder A, Peters S, Nowak D, Jörres RA, Ochmann U. Wirkung einer kurzzeitigen Inhalation von hypertoner Kochsalzlösung oder Sauerstoff auf nichtinvasive Lungenfunktionsmarker bei Gesunden. Pneumologie 2013. [DOI: 10.1055/s-0033-1334508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Karrasch S, Behr J, Huber RM, Nowak D, Peters A, Heinrich J, Jörres RA, Schulz H. Diffusionskapazität für NO und CO im Alter bei anamnestisch Lungengesunden mit besseren oder schlechteren Spirometriewerten. Pneumologie 2013. [DOI: 10.1055/s-0033-1334641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kronseder A, Schramm T, Truger M, Peters S, Karrasch S, Koczulla RA, Nowak D, Jörres RA. Phänotypisierung von COPD-Patienten durch die Analyse der Ausatemluft mittels Ionenmobilitäts-Spektrometrie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Schulz H, Albrecht E, Behr J, Huber RM, Nowak D, Klopp N, Codd V, Saman N, Gieger C, Heinrich J, Wichmann HE, Peters A, Jörres RA, Karrasch S. Are spirometric lung function indices associated with telomere length of circulating leukocytes? Pneumologie 2012. [DOI: 10.1055/s-0032-1315556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Peters A, Döring A, Ladwig KH, Meisinger C, Linkohr B, Autenrieth C, Baumeister SE, Behr J, Bergner A, Bickel H, Bidlingmaier M, Dias A, Emeny RT, Fischer B, Grill E, Gorzelniak L, Hänsch H, Heidbreder S, Heier M, Horsch A, Huber D, Huber RM, Jörres RA, Kääb S, Karrasch S, Kirchberger I, Klug G, Kranz B, Kuch B, Lacruz ME, Lang O, Mielck A, Nowak D, Perz S, Schneider A, Schulz H, Müller M, Seidl H, Strobl R, Thorand B, Wende R, Weidenhammer W, Zimmermann AK, Wichmann HE, Holle R. [Multimorbidity and successful aging: the population-based KORA-Age study]. Z Gerontol Geriatr 2012; 44 Suppl 2:41-54. [PMID: 22270973 DOI: 10.1007/s00391-011-0245-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public. PATIENTS AND METHODS In the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics. RESULTS A total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%). CONCLUSION The KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.
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Oeder S, Dietrich S, Weichenmeier I, Schober W, Pusch G, Jörres RA, Schierl R, Nowak D, Fromme H, Behrendt H, Buters JTM. Toxicity and elemental composition of particulate matter from outdoor and indoor air of elementary schools in Munich, Germany. INDOOR AIR 2012; 22:148-58. [PMID: 21913995 DOI: 10.1111/j.1600-0668.2011.00743.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
UNLABELLED Outdoor particulate matter (PM(10)) is associated with detrimental health effects. However, individual PM(10) exposure occurs mostly indoors. We therefore compared the toxic effects of classroom, outdoor, and residential PM(10). Indoor and outdoor PM(10) was collected from six schools in Munich during teaching hours and in six homes. Particles were analyzed by scanning electron microscopy and X-ray spectroscopy (EDX). Toxicity was evaluated in human primary keratinocytes, lung epithelial cells and after metabolic activation by several human cytochromes P450. We found that PM(10) concentrations during teaching hours were 5.6-times higher than outdoors (117 ± 48 μg/m(3) vs. 21 ± 15 μg/m(3), P < 0.001). Compared to outdoors, indoor PM contained more silicate (36% of particle number), organic (29%, probably originating from human skin), and Ca-carbonate particles (12%, probably originating from paper). Outdoor PM contained more Ca-sulfate particles (38%). Indoor PM at 6 μg/cm(2) (10 μg/ml) caused toxicity in keratinocytes and in cells expressing CYP2B6 and CYP3A4. Toxicity by CYP2B6 was abolished with the reactive oxygen species scavenger N-acetylcysteine. We concluded that outdoor PM(10) and indoor PM(10) from homes were devoid of toxicity. Indoor PM(10) was elevated, chemically different and toxicologically more active than outdoor PM(10). Whether the effects translate into a significant health risk needs to be determined. Until then, we suggest better ventilation as a sensible option. PRACTICAL IMPLICATIONS Indoor air PM(10) on an equal weight base is toxicologically more active than outdoor PM(10). In addition, indoor PM(10) concentrations are about six times higher than outdoor air. Thus, ventilation of classrooms with outdoor air will improve air quality and is likely to provide a health benefit. It is also easier than cleaning PM(10) from indoor air, which has proven to be tedious.
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Schulz H, Albrecht E, Karrasch S, Behr J, Huber RM, Nowak D, Klopp N, Codd V, Samani N, Gieger C, Heinrich J, Wichmann HE, Peters A, Jörres RA. Gibt es eine Assoziation zwischen spirometrischen Kennwerten und der Telomerenlänge in Leukozyten des peripheren Bluts? Pneumologie 2012. [DOI: 10.1055/s-0032-1302538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ochmann U, Kellberger J, Kotschy-Lang N, Raab W, Nowak D, Jörres RA. Evaluation der stationären Rehabilitation von Patienten mit pneumologischen Berufskrankheiten. Pneumologie 2012. [DOI: 10.1055/s-0032-1302535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ochmann U, Kellberger J, Kotschy-Lang N, Raab W, Nowak D, Jörres RA. Beziehungen zwischen maximaler Ergometerleistung und 6-Minuten-Gehtest – Ist eine Prädiktion von Wmax bei Patienten mit pneumologischen Erkrankungen möglich? Pneumologie 2012. [DOI: 10.1055/s-0032-1302715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Peters S, Kronseder A, Karrasch S, Neff P, Haaks M, Koczulla RA, Nowak D, Jörres RA. Wasserstoffperoxid in der Ausatemluft: Eine Fehlerquelle, eine Paradoxie und ihre Auflösung. Pneumologie 2012. [DOI: 10.1055/s-0032-1302734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Luszpinski MA, Jörres RA, Schierl R, de la Motte D, Kramer M, Nowak D. Experimentelle Exposition gegenüber Nanopartikeln: Effekte auf Lungenfunktion und Befindlichkeit bei anamnestisch Gesunden. Pneumologie 2012. [DOI: 10.1055/s-0032-1302537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Arzt M, Obermeier R, Jörres RA, Wieland WF, Pfeifer M, Budweiser S. Einfluss von CPAP auf die erektile Dysfunktion bei Patienten mit obstruktiver Schlafapnoe. Pneumologie 2012. [DOI: 10.1055/s-0032-1302782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kollert F, Müller C, Tippelt A, Jörres RA, Heidinger D, Probst C, Pfeifer M, Budweiser S. Anaemia in chronic respiratory failure. Int J Clin Pract 2011; 65:479-86. [PMID: 21401836 DOI: 10.1111/j.1742-1241.2011.02631.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In patients with severe chronic obstructive pulmonary disease (COPD), anaemia is common and associated with impaired long-term survival and quality of life. Whether anaemia is also prevalent in patients with other severe, non-inflammatory respiratory diseases has not yet been systematically tested. METHODS In 595 patients with obstructive (OD, 54.8%) or restrictive disease (RD, 45.2%) and chronic respiratory failure (CRF), anthropometric data, laboratory parameters, lung function, blood gases and comorbidities were assessed prior to initiation of home mechanical ventilation. Patients were classified as anaemic based on haemoglobin (Hb) levels (Hb<12/13 g/dl, female patients/male patients). Patients with known causes for anaemia were excluded. RESULTS In patients with CRF the prevalence of anaemia was 13.3% and not different between RD (11.5%) and OD (14.7%) (p=0.276). A sex-related difference occurred only in OD [7.9% (f) vs. 17.3% (m); p=0.035]. Patients with OD and anaemia presented with higher age (p=0.003), pH (p=0.014) and arterial oxygen pressure (PaO(2) ) (p=0.012), lower body mass index (BMI) (p=0.011) and total protein (p=0.012) and higher rates of coronary heart disease (p=0.01), cardiac arrhythmia (p=0.014) and diabetes mellitus (p=0.003) in comparison to non-anaemic patients. In patients with RD anaemia was associated with higher age, (p=0.008), pH (p=0.011) and lower leucocytes numbers (p=0.006). CONCLUSIONS Anaemia is frequent not only in COPD but also in other severe respiratory diseases combined with CRF. It was associated with advanced age, several comorbidities, impaired nutritional state and elevations of pH and PaO(2) , probably because of hyperventilation. Its prognostic impact has to be elucidated in future studies.
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Hüttmann EM, Hattesohl A, Schmid S, Greulich T, Noeske S, John G, Jörres R, Müller B, Vogelmeier C, Bals R, Koczulla RM. Vergleich von zwei Geräten und zwei Atemmustern bei der Gewinnung von exhaliertem Atemwegskondensat. Pneumologie 2011. [DOI: 10.1055/s-0031-1274954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Koczulla R, Hattesohl A, Biller H, Hofbauer J, Hohlfeld J, Oeser C, Wirtz H, Jörres RA. [Comparison of four identical electronic noses and three measurement set-ups]. Pneumologie 2011; 65:465-70. [PMID: 21437859 DOI: 10.1055/s-0030-1256280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Volatile organic compounds (VOCs) can be used as biomarkers in exhaled air. VOC profiles can be detected by an array of nanosensors of an electronic nose. These profiles can be analysed using bioinformatics. It is, however, not known whether different devices of the same model measure identically and to which extent different set-ups and the humidity of the inhaled air influence the VOC profile. METHODS Three different measuring set-ups were designed and three healthy control subjects were measured with each of them, using four devices of the same model (Cyranose 320™, Smiths Detection). The exhaled air was collected in a plastic bag. Either ambient air was used as reference (set-up Leipzig), or the reference air was humidified (100% relative humidity) (set-up Marburg and set-up Munich). In the set-up Marburg the subjects inhaled standardised medical air (Aer medicinalis Linde, AGA AB) out of a compressed air bottle through a demand valve; this air (after humidification) was also used as reference. In the set-up Leipzig the subjects inhaled VOC-filtered ambient air, in the set-up Munich unfiltered room air. The data were evaluated using either the real-time data or the changes in resistance as calculated by the device. RESULTS The results were clearly dependent on the set-up. Apparently, humidification of the reference air could reduce the variance between devices, but this result was also dependent on the evaluation method used. When comparing the three subjects, the set-ups Munich and Marburg mapped these in a similar way, whereas not only the signals but also the variance of the set-up Leipzig were larger. CONCLUSION Measuring VOCs with an electronic nose has not yet been standardised and the set-up significantly affects the results. As other researchers use further methods, it is currently not possible to draw generally accepted conclusions. More systematic tests are required to find the most sensitive and reliable but still feasible set-up so that comparability is improved.
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Koczulla A, Hattesohl A, Biller H, Hofbauer J, Hohlfeld J, Oeser C, Gessner C, Vogelmeier C, Baumbach J, Wirtz H, Jörres R. Krankheiten erriechen? Eine kurze Übersicht über elektronische Nasen. Pneumologie 2011; 65:401-5. [DOI: 10.1055/s-0030-1256252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Koczulla RA, Hüttmann E, Jörres RA, Noeske S, Bals R, Schmid S, Hattesohl A, Greulich T, John G, Müller B, Vogelmeier C. Vergleich von zwei Geräten und zwei Atemmustern bei der Gewinnung von exhaliertem Atemwegskondensat. Pneumologie 2011. [DOI: 10.1055/s-0031-1272089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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