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Straßburg S, Linker CM, Brato S, Schöbel C, Taube C, Götze J, Stehling F, Sutharsan S, Welsner M, Weinreich G. Investigation of respiratory rate in patients with cystic fibrosis using a minimal-impact biomotion system. BMC Pulm Med 2022; 22:59. [PMID: 35148739 PMCID: PMC8832687 DOI: 10.1186/s12890-022-01855-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background In this study we tested the hypothesis that in patients with cystic fibrosis (pwCF) respiratory rate (RR) is associated with antibiotic treatment, exacerbation status, forced expiratory volume in one second (FEV1) and C-reactive protein (CRP). Methods Between June 2018 and May 2019, we consecutively enrolled pwCF who were referred to our hospital. We determined RR and heart rate (HR) by using the minimal-impact system VitaLog during the hospital stay. Furthermore, we performed spirometry and evaluated CRP. Results We included 47 patients: 20 with pulmonary exacerbation and 27 without. RR decreased in patients with exacerbation (27.5/min (6.0/min) vs. 24.4/min (6.0/min), p = 0.004) and in patients with non-exacerbation (22.5/min (5.0/min) vs. 20.9/min (3.5/min), p = 0.024). Patients with exacerbation showed higher RR than patients with non-exacerbation both at the beginning (p = 0.004) and at the end of their hospital stay (p = 0.023). During the hospital stay, HR did not change in the total cohort (66.8/min (11.0/min) vs. 66.6/min (12.0/min), p = 0.440). Furthermore, we did not find significant differences between patients with exacerbation and patients with non-exacerbation (67.0/min (12.5/min) vs. 66.5/min (10.8/min), p = 0.658). We observed a correlation of ρ = -0.36 between RR and FEV1. Moreover, we found a correlation of ρ = 0.52 between RR and CRP. Conclusion In pwCF requiring intravenous therapy, respiratory rate is higher at their hospital admittance and decreased by the time of discharge; it is also associated with C-reactive protein. Monitoring RR could provide important information about the overall clinical conditions of pwCF.
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Affiliation(s)
- Svenja Straßburg
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany.
| | - Carolin-Maria Linker
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany.,Information Processing Lab, Faculty of Electrical Engineering, Information Engineering - TU Dortmund, Dortmund, Germany
| | | | - Christoph Schöbel
- Center of Sleep and Telemedicine, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Essen, Germany
| | - Christian Taube
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
| | - Jürgen Götze
- Information Processing Lab, Faculty of Electrical Engineering, Information Engineering - TU Dortmund, Dortmund, Germany
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children'S Hospital, University Duisburg-Essen, Essen, Germany
| | - Sivagurunathan Sutharsan
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
| | - Matthias Welsner
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
| | - Gerhard Weinreich
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, University Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany
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Kerscher D, Hammer S, Jung M. Therapie-Adhärenz bei Patient*innen mit Mukoviszidose im Erwachsenenalter. PHYSIOSCIENCE 2021. [DOI: 10.1055/a-1448-4954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Zusammenfassung
Hintergrund Um die Folgen der Progression von Mukoviszidose möglichst gering zu halten, benötigen Patient*innen ein Konzept für lebenslange medikamentöse Interventionen und intensive Physiotherapie, gepaart mit einer sehr hohen Therapie-Adhärenz. Durch die Erhöhung der durchschnittlichen Lebenswartung auf über 50 Jahre bei über der Hälfte der Betroffenen stehen medizinische Fachkräfte vor neuen Herausforderungen bei der Versorgung. Die nötigte Implementierung von Übergangsprogrammen für junge Erwachsene, aus den Kinderambulanzen heraus, sind jedoch noch immer nicht flächendeckend vollzogen. Niedrige Raten bei der Adhärenz verdeutlichen die problematische Situation.
Ziel Erfassung der Wahrnehmung von jungen Erwachsenen mit Mukoviszidose in Bezug auf Faktoren, die einen Einfluss auf ihre Therapie-Adhärenz haben.
Methode Das Erleben der Behandlungen sowie die Adhärenz beeinflussenden Faktoren wurden anhand von Leitfadeninterviews (n = 10) erhoben. Die Auswertung erfolgte mithilfe der inhaltlich strukturierenden Inhaltsanalyse nach Kuckartz.
Ergebnisse Es zeigt sich ein komplexes Gesamtbild von Einflussfaktoren, mit einem auffälligen Wechselverhalten zwischen Adhärenz und Non-Adhärenz zu medizinisch notwendigen Therapien. Aus Sicht der Befragten ist die partizipative Entscheidungsfindung der zentrale Ansatzpunkt zur Förderung der Adhärenz, Minderung des Wechselverhaltens und Stärkung der Bewältigung und Aufrechterhaltung von Selbstwirksamkeit.
Schlussfolgerung Die Ergebnisse geben Implikationen für die Ausbildung von Physiotherapeut*innen und Mediziner*innen bezüglich theoretischer Grundlagen zum Gesundheitsverhalten, zur Verhaltensänderung, Adhärenz und zu Entscheidungsprozessen von Patient*innen.
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Affiliation(s)
- Dirk Kerscher
- Hochschule Fresenius, Fachbereich Gesundheit und Soziales, Frankfurt am Main, Deutschland
| | - Sabine Hammer
- Hochschule Fresenius, Fachbereich Gesundheit und Soziales, Frankfurt am Main, Deutschland
| | - Michael Jung
- Hochschule Fresenius, Fachbereich Gesundheit und Soziales, Frankfurt am Main, Deutschland
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Thee S, Stahl M, Fischer R, Sutharsan S, Ballmann M, Müller A, Lorenz D, Urbanski-Rini D, Püschner F, Amelung VE, Fuchs C, Mall MA. A multi-centre, randomized, controlled trial on coaching and telemonitoring in patients with cystic fibrosis: conneCT CF. BMC Pulm Med 2021; 21:131. [PMID: 33882893 PMCID: PMC8058751 DOI: 10.1186/s12890-021-01500-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background The extend of lung disease remains the most important prognostic factor for survival in patients with cystic fibrosis (CF), and lack of adherence is the main reason for treatment failure. Early detection of deterioration in lung function and optimising adherence are therefore crucial in CF care. We implement a randomized controlled trial to evaluate efficacy of telemonitoring of adherence, lung function, and health condition in combination with behavior change interventions using innovative digital technologies. Methods This is a multi-centre, randomized, controlled, non-blinded trial aiming to include 402 patients ≥ 12 years-of-age with CF. A standard-of-care arm is compared to an arm receiving objective, continuous monitoring of adherence to inhalation therapies, weekly home spirometry using electronic devices with data transmission to patients and caring physicians combined with video-conferencing, a self-management app and professional telephone coaching. The duration of the intervention phase is 18 months. The primary endpoint is time to the first protocol-defined pulmonary exacerbation. Secondary outcome measures include number of and time between pulmonary exacerbations, adherence to inhalation therapy, changes in forced expiratory volume in 1 s from baseline, number of hospital admissions, and changes in health-related quality of life. CF-associated medical treatment and care, and health care related costs will be assessed by explorative analysis in both arms. Discussion This study offers the opportunity to evaluate the effect of adherence interventions using telemedicine capable devices on adherence and lung health, possibly paving the way for implementation of telemedicine in routine care for patients with CF. Trial registration: This study has been registered with the German Clinical Trials Register (Identifier: DRKS00024642, date of registration 01 Mar 2021, URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024642). Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01500-y.
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Affiliation(s)
- Stephanie Thee
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Division of Cystic Fibrosis, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mirjam Stahl
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Division of Cystic Fibrosis, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Lung Research (DZL), Associated Partner, Berlin, Germany
| | | | - Sivagurunathan Sutharsan
- Department of Pulmonary Medicine, Division of Cystic Fibrosis, University Medicine Essen -Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Manfred Ballmann
- Department of Pediatrics, University Medicine Rostock, Rostock, Germany
| | | | | | | | - Franziska Püschner
- Private Institute for Applied Health Services Research (Inav) GmbH, Berlin, Germany
| | - Volker Eric Amelung
- Private Institute for Applied Health Services Research (Inav) GmbH, Berlin, Germany
| | | | - Marcus Alexander Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Division of Cystic Fibrosis, Charité - Universitätsmedizin Berlin, Berlin, Germany. .,German Centre for Lung Research (DZL), Associated Partner, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany.
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Ciprofloxacin-loaded lipid-core nanocapsules as mucus penetrating drug delivery system intended for the treatment of bacterial infections in cystic fibrosis. Int J Pharm 2017; 527:92-102. [PMID: 28499793 DOI: 10.1016/j.ijpharm.2017.05.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 11/22/2022]
Abstract
Treatment of bacterial airway infections is essential for cystic fibrosis therapy. However, effectiveness of antibacterial treatment is limited as bacteria inside the mucus are protected from antibiotics and immune response. To overcome this biological barrier, ciprofloxacin was loaded into lipid-core nanocapsules (LNC) for high mucus permeability, sustained release and antibacterial activity. Ciprofloxacin-loaded LNC with a mean size of 180nm showed a by 50% increased drug permeation through mucus. In bacterial growth assays, the drug in the LNC had similar minimum inhibitory concentrations as the free drug in P. aeruginosa and S. aureus. Interestingly, formation of biofilm-like aggregates, which were observed for S. aureus treated with free ciprofloxacin, was avoided by exposure to LNC. With the combined advantages over the non-encapsulated drug, ciprofloxacin-loaded LNC represent a promising drug delivery system with the prospect of an improved antibiotic therapy in cystic fibrosis.
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Mainz JG, Gerber A, Arnold C, Baumann J, Baumann I, Koitschev A. [Rhinosinusitis in cystic fibrosis]. HNO 2016; 63:809-20. [PMID: 26495450 DOI: 10.1007/s00106-015-0069-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In cystic fibrosis (CF) mucociliary clearance of the entire respiratory system is impaired. This allows pathogens, such as Pseudomonas aeruginosa to persist and proliferate, which by progressive pulmonary destruction causes 90 % of premature deaths due to this inherited disease. The dramatic improvement in life expectation of patients due to intensive therapy has resulted in the inevitable but variably expressed sinonasal involvement coming into the clinical and scientific focus. Thereby, almost all CF patients reveal sinonasal pathology and many suffer from chronic rhinosinusitis. Recently, the sinonasal niche has been recognized as a site of initial and persistent colonization by pathogens. This article presents the pathophysiological background of this multiorgan disease as well as general diagnostic and therapeutic standards. The focus of this article is on sinonasal involvement and conservative and surgical options for treatment. Prevention of pathogen acquisition is an essential issue in the otorhinolaryngological treatment of CF patients.
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Affiliation(s)
- J G Mainz
- Mukoviszidosezentrum für Kinder und Erwachsene, Universitätsklinikum Jena, Jena, Deutschland
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Draft Genome Sequence of a Pseudomonas aeruginosa Strain Able To Decompose
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-Dimethyl Formamide. GENOME ANNOUNCEMENTS 2016; 4:4/1/e01609-15. [PMID: 26847883 PMCID: PMC4742680 DOI: 10.1128/genomea.01609-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pseudomonas aeruginosa is a Gram-negative bacterium, which uses a variety of organic chemicals as carbon sources. Here, we report the genome sequence of the Cu1510 isolate from wastewater containing a high concentration of N,N-dimethyl formamide.
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