1
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Boeselt T, Terhorst P, Kroenig J, Nell C, Spielmanns M, Boas U, Veith M, Vogelmeier C, Greulich T, Koczulla AR, Beutel B, Huber J, Heers H. Specific molecular peak analysis by ion mobility spectrometry of volatile organic compounds in urine of COVID-19 patients: A novel diagnostic approach. J Virol Methods 2024; 326:114910. [PMID: 38452823 DOI: 10.1016/j.jviromet.2024.114910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/08/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION SARS-CoV-2 is usually diagnosed from naso-/oropharyngeal swabs which are uncomfortable and prone to false results. This study investigated a novel diagnostic approach to Covid-19 measuring volatile organic compounds (VOC) from patients' urine. METHODS Between June 2020 and February 2021, 84 patients with positive RT-PCR for SARS-CoV-2 were recruited as well as 54 symptomatic individuals with negative RT-PCR. Midstream urine samples were obtained for VOC analysis using ion mobility spectrometry (IMS) which detects individual molecular components of a gas sample based on their size, configuration, and charge after ionization. RESULTS Peak analysis of the 84 Covid and 54 control samples showed good group separation. In total, 37 individual specific peaks were identified, 5 of which (P134, 198, 135, 75, 136) accounted for significant differences between groups, resulting in sensitivities of 89-94% and specificities of 82-94%. A decision tree was generated from the relevant peaks, leading to a combined sensitivity and specificity of 98% each. DISCUSSION VOC-based diagnosis can establish a reliable separation between urine samples of Covid-19 patients and negative controls. Molecular peaks which apparently are disease-specific were identified. IMS is an additional non-invasive and cheap device for the diagnosis of this ongoing endemic infection. Further studies are needed to validate sensitivity and specificity.
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Affiliation(s)
- T Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - P Terhorst
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Kroenig
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Nell
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Spielmanns
- Pulmonary Rehabilitation, Zuercher Reha Zentren Klinik Wald, Switzerland; Faculty of Health, Department of Pneumology, University of Witten, Herdecke, Germany
| | - U Boas
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - A R Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany; Department of Pulmonology, Schoen-Kliniken Berchtesgaden, Philipps-University Marburg, Germany
| | - B Beutel
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Huber
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany
| | - H Heers
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany.
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2
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Eyfferth T, Koczulla AR, Freytag HW, Krahl G, Ackermann C, Bultmann S, Reimertz R, Dresing K. [The problem of long/post-COVID in expert assessments]. Unfallchirurgie (Heidelb) 2023; 126:373-386. [PMID: 37079057 PMCID: PMC10117274 DOI: 10.1007/s00113-023-01297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 04/21/2023]
Abstract
Assessing long/post-COVID syndrome (PCS) following an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a multidisciplinary challenge due to the diverse and complex symptoms. Besides discipline-specific evaluation of infection-related organ damage, the main issue is expert objectivity and causality assessment regarding subjective symptoms. The consequences of long/PCS raise questions of insurance rights in all fields of law. In cases of persistent impairment of performance, determining reduction in earning capacity is crucial for those affected. Recognition as an occupational disease (BK no. 3101) is vital for employees in healthcare and welfare sectors, along with occupational accident recognition and assessing the illness's consequences, including the reduction in earning capacity (MdE) in other sectors or work areas. Therefore, expert assessments of illness consequences and differentiation from previous illnesses or damage disposition are necessary in all areas of law, individually based on corresponding organ manifestations in medical fields and interdisciplinarily for complex late sequelae, for instance, by internists with appropriate qualifications for pulmonary or cardiac manifestations and neurologists, psychiatrists, and neuropsychologists for neurological and psychiatric manifestations, etc.
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Affiliation(s)
- T Eyfferth
- BG Service- und Rehabilitationszentrum, BG Unfallklinik Frankfurt am Main gGmbH, Akademisches Lehrkrankenhaus, Johann-Wolfgang-Goethe Universität Frankfurt Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland.
- Sektion Begutachtung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Berlin, Deutschland.
| | - A R Koczulla
- Schön Klinik Berchtesgadener Land, Schönau am Königssee, Deutschland
- Professur für Pneumologische Rehabilitation Philipps Universität Marburg, Deutsches Zentrum für Lungenforschung, Marburg, Deutschland
| | - H W Freytag
- Psychotraumatologie (PZDT), BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland
| | - G Krahl
- Psychotraumatologie (PZDT), BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Ch Ackermann
- Psychotraumatologie (PZDT), BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland
| | - S Bultmann
- Sozialgericht Hamburg, Hamburg, Deutschland
| | - R Reimertz
- BG Service- und Rehabilitationszentrum, BG Unfallklinik Frankfurt am Main gGmbH, Akademisches Lehrkrankenhaus, Johann-Wolfgang-Goethe Universität Frankfurt Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland
| | - K Dresing
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
- Sektion Begutachtung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Berlin, Deutschland
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3
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Koczulla AR, Ankermann T, Behrends U, Berlit P, Böing S, Brinkmann F, Franke C, Glöckl R, Gogoll C, Hummel T, Kronsbein J, Maibaum T, Peters EMJ, Pfeifer M, Platz T, Pletz M, Pongratz G, Powitz F, Rabe KF, Scheibenbogen C, Stallmach A, Stegbauer M, Wagner HO, Waller C, Wirtz H, Zeiher A, Zwick R. [S1 Guideline "Post-COVID/Long-COVID"]. Chirurg 2022. [PMID: 35041036 DOI: 10.1007/s00104-021-01543-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A R Koczulla
- LL-Sekretariat Anja Flender, Schön Klinik Berchtesgadener Land, Malterhöh 1, 83471, Schönau am Königssee, Deutschland.
| | - T Ankermann
- Gesellschaft für Pädiatrische Pneumologie (DGPP), Berlin, Deutschland
| | - U Behrends
- Chronisches Fatigue Centrum, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - P Berlit
- Deutsche Gesellschaft f. Neurologie (DGN), Berlin, Deutschland
| | - S Böing
- Berufsverband der Pneumologen (BdP), Heidenheim, Deutschland
| | - F Brinkmann
- Gesellschaft für Pädiatrische Pneumologie (DGPP), Berlin, Deutschland
| | - C Franke
- Berufsverband der Pneumologen (BdP), Heidenheim, Deutschland
| | - R Glöckl
- Deutsche Gesellschaft f. Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - C Gogoll
- Deutsche Gesellschaft f. Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - T Hummel
- Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn, Deutschland
| | - J Kronsbein
- Deutsche gesetzliche Unfallversicherung (DGUV), Berlin, Deutschland
| | - T Maibaum
- Deutsche Gesellschaft f. Neurologie (DGN), Berlin, Deutschland
| | - E M J Peters
- Deutsche Gesellschaft f. Psychosomatische Medizin und Ärztliche Psychotherapie (DGPM), Stuttgart, Deutschland
| | - M Pfeifer
- Deutsche Gesellschaft f. Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - T Platz
- Deutsche Gesellschaft für Neurorehabilitation (DGNR), Rheinbach, Deutschland
| | - M Pletz
- Sektion Infektiologie, Paul Ehrlich Gesellschaft für Chemotherapie e.V. (PEG), Köln, Deutschland
| | - G Pongratz
- Deutsche Schmerzgesellschaft der Deutschen Migräne und Kopfschmerzgesellschaft, Königstein im Taunus, Deutschland.,Deutsche Gesellschaft für Rheumatologie, Berlin, Deutschland
| | - F Powitz
- Berufsverband der Pneumologen (BdP), Heidenheim, Deutschland
| | - K F Rabe
- Deutsche Gesellschaft f. Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | | | - A Stallmach
- Deutsche Gesellschaft f. Gastroenterologie, Verdauungs- und Stoffwechselerkrankungen (DGVS), Berlin, Deutschland.,Deutsche Gesellschaft f. Infektiologie (DGI), Berlin, Deutschland
| | - M Stegbauer
- Deutsche gesetzliche Unfallversicherung (DGUV), Berlin, Deutschland
| | - H O Wagner
- Deutsche Gesellschaft f. Allgemeinmedizin und Familienmedizin (DEGAM), Berlin, Deutschland
| | - C Waller
- Deutsches Kollegium für Psychosomatische Medizin (DKPM), Berlin, Deutschland
| | - H Wirtz
- Deutsche Gesellschaft f. Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - A Zeiher
- Deutsche Gesellschaft f. Kardiologie - Herz- und Kreislaufforschung (DGK), Düsseldorf, Deutschland
| | - R Zwick
- Österreichische Gesellschaft für Pneumologie (ÖGP), Wien, Österreich
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4
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Schneeberger T, Weise S, Kenn K, Koczulla AR. Physiotherapie bei chronischem Husten – Schritt für Schritt. Pneumologie 2021; 75:226-234. [PMID: 33728630 DOI: 10.1055/a-1114-1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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5
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Glöckl R, Buhr-Schinner H, Koczulla AR, Schipmann R, Schultz K, Spielmanns M, Stenzel N, Dewey S. [Recommendations from the German Respiratory Society for Pulmonary Rehabilitation in Patients with COVID-19]. Pneumologie 2020; 74:496-504. [PMID: 32583378 PMCID: PMC7516360 DOI: 10.1055/a-1193-9315] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vor dem Hintergrund der Pandemie durch Infektionen mit dem SARS-CoV-2 hat die Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP e. V.) die Sektion 12 „Rehabilitation, Prävention und Tabakkontrolle“ beauftragt, Empfehlungen zur Umsetzung pneumologischer Rehabilitation bei Patienten nach COVID-19 zu erstellen. Dieses Positionspapier basiert auf dem momentanen aktuellen Wissen, das sich täglich weiterentwickelt. Neben einer Beschreibung der gesundheitlichen Folgen von COVID-19 wird die Indikationsstellung aufgezeigt. Rehabilitative Therapien bei COVID-19 sind bereits auf der Normalstation bzw. Intensivstation indiziert, setzen sich fort als pneumologische Frührehabilitation im Akutkrankenhaus und als Anschlussheilbehandlung oder Reha-Heilverfahren in pneumologischen Rehabilitationskliniken. Im Fokus dieses Positionspapiers stehen Empfehlungen zur inhaltlichen Durchführung einer multimodalen, interdisziplinären pneumologischen Rehabilitation bei COVID-19.
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Affiliation(s)
- R Glöckl
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Schönau am Königssee.,Philipps-Universität Marburg, Abteilung für Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) Marburg
| | - H Buhr-Schinner
- Ostseeklinik Schönberg-Holm, Abteilung Pneumologie, Schönberg
| | - A R Koczulla
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Schönau am Königssee.,Philipps-Universität Marburg, Abteilung für Pneumologische Rehabilitation, Deutsches Zentrum für Lungenforschung (DZL) Marburg.,Lehrkrankenhaus Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
| | - R Schipmann
- Klinik Martinusquelle, Abteilung Pneumologie und Kardiologie, MZG Bad Lippspringe, Bad Lippspringe
| | - K Schultz
- Klinik Bad Reichenhall der Deutschen Rentenversicherung Bayern Süd, Zentrum für Rehabilitation, Pneumologie und Orthopädie, Bad Reichenhall
| | - M Spielmanns
- Pneumologie Zürcher RehaZentren Klinik Wald, Schweiz und Medizinische Fakultät, Lehrstuhl für Pneumologie Universität Witten-Herdecke, Witten
| | - N Stenzel
- Psychologische Hochschule Berlin (PHB), Berlin
| | - S Dewey
- Strandklinik St. Peter-Ording, Abteilung für Pneumologie, St. Peter-Ording
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6
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Greulich T, Fähndrich S, Clarenbach C, Gleiber W, Hautmann H, Heine R, Idzko M, Schmidt-Scherzer K, Skowasch D, Wiewrodt R, Bals R, Koczulla AR. [Alpha-1 Antitrypsin Deficiency (AATD) - D-A-CH-Expert Statement]. Pneumologie 2020; 74:436-442. [PMID: 32492720 DOI: 10.1055/a-1143-8186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Philips-Universität, Marburg.,PneumoPraxis-Marburg, Marburg
| | - S Fähndrich
- Medizinische Klinik und Poliklinik Innere Medizin V Abteilung Pneumologie, Universitätsklinikum Freiburg, Freiburg
| | - C Clarenbach
- Universitätsspital Zürich, Klinik für Pneumologie, Zürich, Schweiz
| | - W Gleiber
- Medizinische Klinik I: Pneumologie und Allergologie, Universitätsklinikum Frankfurt am Main, Goethe-Universität, Frankfurt am Main
| | - H Hautmann
- Klinik für Innere Medizin und Pneumologie, Klinikverbund Allgäu, Ottobeuren
| | - R Heine
- Krankenhaus St. Elisabeth und St. Barbara, Halle
| | - M Idzko
- Medizinische Universität Wien, Klinik für Innere Medizin II, Wien, Österreich
| | - K Schmidt-Scherzer
- Zweite Medizinische Abteilung mit Pneumologie mit Ambulanz, Wilhelminenspital, Wien, Österreich
| | - D Skowasch
- Medizinische Klinik + Poliklinik II Schwerpunkt Pneumologie, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelm-Universität, Bonn
| | - R Wiewrodt
- Medizinische Klinik A Schwerpunkt Pneumologie, Universitätsklinikum Münster, Münster
| | - R Bals
- Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg
| | - A R Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Philips-Universität, Marburg.,Fachzentrum für Pneumologie, Schön Klinik Berchtesgadener Land, Schönau am Königssee
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7
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Glöckl R, Schneeberger T, Boeselt T, Kenn K, Koczulla AR, Held M, Oberhoffer R, Halle M. [Exercise Training in Patients with Pulmonary Hypertension: A Systematic Review and Meta-analysis]. Pneumologie 2019; 73:677-685. [PMID: 31715636 DOI: 10.1055/a-1005-8678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is defined as an elevation of mean pulmonary-arterial pressure by > 20 mmHg at rest, which may lead to right heart failure. Physical exercise has not been regularly recommended for PH patients for fear of symptom deterioration or occurrence of exercise-induced adverse events. METHODS Three electronic databases were searched for randomized, controlled trials investigating exercise training in PH patients using the following keywords: "pulmonary hypertension" OR "pulmonary arterial hypertension" AND "exercise" OR "pulmonary rehabilitation" AND "randomized". RESULTS Five studies involving 187 PH patients were included in this systematic review. Exercise programs lasted for 3 - 12 weeks (e. g. endurance training for 10 - 45 minutes; 60 - 80 % of the peak heart rate). PH patients significantly improved exercise capacity compared to controls in 6-minute walk distance (+ 45 m; 95 % CI: 26 m - 64 m) or peak oxygen consumption (+ 2.3 ml/kg/min; 95 % CI: 1.8 - 2.9 ml/kg/min), both p < 0.001. Also, physical and mental quality of life improved significantly by exercise training. No exercise-induced adverse events were observed. CONCLUSION Supervised exercise training can safely and significantly improve physical performance and quality of life in clinically stable PH patients with optimal drug treatment. However, larger studies including a wider range of PH are mandatory.
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Affiliation(s)
- R Glöckl
- Forschungsinstitut für Pneumologische Rehabilitation, Schön Klinik Berchtesgadener Land, Schönau am Königssee.,Medizinische Fakultät, Universitätsklinik "Klinikum rechts der Isar", Technische Universität München (TUM), Zentrum für Prävention, Rehabilitation und Sportmedizin
| | - T Schneeberger
- Forschungsinstitut für Pneumologische Rehabilitation, Schön Klinik Berchtesgadener Land, Schönau am Königssee.,Philipps-Universität Marburg (Standort Schönau), Deutsches Zentrum für Lungenforschung (DZL) Marburg
| | - T Boeselt
- Universitätsklinikum der Philipps-Universität Marburg, Klinik für Innere Medizin, Schwerpunkt Pneumologie
| | - K Kenn
- Forschungsinstitut für Pneumologische Rehabilitation, Schön Klinik Berchtesgadener Land, Schönau am Königssee.,Philipps-Universität Marburg (Standort Schönau), Deutsches Zentrum für Lungenforschung (DZL) Marburg
| | - A R Koczulla
- Forschungsinstitut für Pneumologische Rehabilitation, Schön Klinik Berchtesgadener Land, Schönau am Königssee.,Philipps-Universität Marburg (Standort Schönau), Deutsches Zentrum für Lungenforschung (DZL) Marburg
| | - M Held
- Klinikum Würzburg Mitte, Standort Missioklinik, Med. Klinik mit Schwerpunkt Pneumologie und Beatmungsmedizin
| | - R Oberhoffer
- Lehrstuhl für präventive Pädiatrie, Technische Universität München (TUM)
| | - M Halle
- Medizinische Fakultät, Universitätsklinik "Klinikum rechts der Isar", Technische Universität München (TUM), Zentrum für Prävention, Rehabilitation und Sportmedizin.,Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Munich Heart Alliance, München
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8
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Kay L, Bauer S, Koczulla AR, Librizzi D, Vadasz D, Knake S, Rosenow F, Strzelczyk A. Ondine's curse and temporal lobe seizures: anti-Hu- and Zic4-associated paraneoplastic brainstem and limbic encephalitis. Eur J Neurol 2018; 25:e59-e60. [PMID: 29667352 DOI: 10.1111/ene.13629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Affiliation(s)
- L Kay
- Goethe-University, Frankfurt, Germany
| | - S Bauer
- Goethe-University, Frankfurt, Germany.,Philipps-University, Marburg, Germany
| | - A R Koczulla
- Philipps-University, Marburg, Germany.,Schön Klinik Berchtesgadener Land, Schönau am Königssee, Germany
| | | | - D Vadasz
- Philipps-University, Marburg, Germany.,Jewish Hospital Berlin, Berlin, Germany
| | - S Knake
- Philipps-University, Marburg, Germany
| | - F Rosenow
- Goethe-University, Frankfurt, Germany.,Philipps-University, Marburg, Germany
| | - A Strzelczyk
- Goethe-University, Frankfurt, Germany.,Philipps-University, Marburg, Germany
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9
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Schneeberger T, Stegemann A, Glöckl R, Schönheit-Kenn U, Koczulla AR, Kenn K. Akute Effekte einer nicht-invasiven Beatmung während Training bei hyperkapnischen COPD Patienten – eine randomisierte cross-over Studie. Pneumologie 2018. [DOI: 10.1055/s-0037-1619272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - R Glöckl
- Schön Klinik Berchtesgadener Land; Klinikum Rechts der Isar, Technische Universität München (TUM)
| | | | - AR Koczulla
- Schön Klinik Berchtesgadener Land; Philipps-Universität Marburg, Deutsches Zentrum für Lungenforschung (DZL)
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps-Universität Marburg, Deutsches Zentrum für Lungenforschung (DZL)
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10
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Stegemann A, Schneeberger T, Schönheit-Kenn U, Glöckl R, Jarosch I, Köhnlein T, Koczulla AR, Kenn K. Nächtliche nicht-invasive Beatmung bei COPD Patienten on top eines 3-wöchigen pneumologischen Rehabilitationprogramms – eine randomisierte, kontrollierte Studie. Pneumologie 2018. [DOI: 10.1055/s-0037-1619406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - T Schneeberger
- Schön Klinik Berchtesgadener Land; Philipps-Universität Marburg
| | | | - R Glöckl
- Schön Klinik Berchtesgadener Land; Klinikum Rechts der Isar, Technische Universität München (TUM)
| | | | - T Köhnlein
- Klinikum St. Georg gGmbH; Robert-Koch-Klinik, Leipzig
| | - AR Koczulla
- Schön Klinik Berchtesgadener Land; Philipps-Universität Marburg
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps-Universität Marburg
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11
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Leitl D, Glöckl R, Schneeberger T, Müller E, Koczulla AR, Kenn K. Effekte eines Laufband- versus Fahrradtrainings auf die Gangqualität und Leistungsfähigkeit bei Patienten mit schwerer COPD – Eine Pilotstudie. Pneumologie 2018. [DOI: 10.1055/s-0037-1619404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Leitl
- Schön Klinik Berchtesgadener Land; Paris Lodron Universität Salzburg
| | - R Glöckl
- Schön Klinik Berchtesgadener Land; Technische Universität München (TUM)
| | - T Schneeberger
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - E Müller
- Paris Lodron Universität Salzburg
| | - AR Koczulla
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
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12
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Glöckl R, Schneeberger T, Jarosch I, Bold N, Drechsler C, Koczulla AR, Charususin N, Langer D, Gosselink R, Kenn K. Effekte eines zusätzlichen Atemmuskeltrainings im Rahmen pneumologischer Rehabilitation bei COPD Patienten mit Atemmuskelschwäche – eine randomisiert, kontrollierte Studie. Pneumologie 2018. [DOI: 10.1055/s-0037-1619403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R Glöckl
- Schön Klinik Berchtesgadener Land; Klinikum Rechts der Isar, Technische Universität München (TUM)
| | | | | | - N Bold
- Schön Klinik Berchtesgadener Land
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13
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Greulich T, Regner W, Branscheidt M, Herr C, Koczulla AR, Vogelmeier CF, Bals R. Altered blood levels of vitamin D, cathelicidin and parathyroid hormone in patients with sepsis-a pilot study. Anaesth Intensive Care 2017; 45:36-45. [PMID: 28072933 DOI: 10.1177/0310057x1704500106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
It has been recognised that vitamin D (VitD) has a potential role in the regulation of inflammation and protection from infection. In a prospective clinical observational pilot study, we investigated the serum levels of 25-hydroxyvitamin-D3 (25(OH)D3), 1,25-hydroxyvitamin-D3 (1,25(OH)2D3), parathyroid hormone (PTH), and cathelicidin in intensive care unit (ICU) patients with or without systemic inflammatory response syndrome (SIRS). We included 32 patients with SIRS (septic patients), 16 ICU patients without SIRS, and 16 healthy controls. To substantiate the findings of the clinical study, we stimulated monocyte-derived macrophages with microbial patterns and analysed the impact of VitD on release of cytokines and antimicrobial activity. We found that patients with or without SIRS had relatively low levels of 25(OH)D3 and 1,25(OH)2D3. Patients with sepsis had significantly lower levels of 25(OH)D3 as compared to ICU control patients and healthy controls (10.53 ± 11.3 µg/l versus 16.46 ± 12.58 µg/l versus 24.04 ± 12.07 µg/l); the same was true for 1,25(OH)2D3. Serum levels of PTH and cathelicidin were significantly increased in sepsis patients, as compared to the other groups. In vitro, VitD significantly decreased the release of pro-inflammatory cytokines from macrophages and increased the antimicrobial activity of the cells. We concluded that patients with sepsis have significantly lower VitD levels. In vitro, VitD modulates inflammation and increases the antibacterial activity of innate immune cells. These findings suggest that VitD insufficiency is mechanistically related to increased susceptibility to SIRS and sepsis.
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Affiliation(s)
- T Greulich
- Senior Physician, Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - W Regner
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - M Branscheidt
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - C Herr
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | - A R Koczulla
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - C F Vogelmeier
- Professor, Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg, Germany
| | - R Bals
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University Marburg, Marburg Department of Internal Medicine V-Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
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14
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Spielmanns M, Müller K, Schott N, Winkler A, Polanski H, Nell C, Boeselt T, Koczulla AR, Storre JH, Windisch W, Magnet FS, Baum K. [Impact of a Senso-Motoric Intervention in COPD-Patients Participating in an Outpatient Pulmonary Rehabilitation Program: A Randomized Controlled Trial]. REHABILITATION 2017; 56:159-166. [PMID: 28231596 DOI: 10.1055/s-0042-119248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective Exercise training provides a cornerstone of pulmonary rehabilitation (PR) in COPD-patients. However, the components of the training are not yet fully investigated. We conducted a randomized controlled trial to investigate the effectiveness of a sensory-motoric training (SMT) in comparison to a conventional strength training (KT) according to the physical performance. Patients and Methods: 43 COPD patients were randomized and participated either in the intervention group (SMT = 30 minutes SMT per day) or in the control group (KT = 30 minutes KT per day). The SMT was performed as circuit training with five stations. The primary endpoint was the difference between T1 (start of the PR) and T2 (end of the PR) in 5-Times Sit-to-stand test (5-STST) in the intergroup comparison. Secondary endpoints were the intra- and intergroup comparisons of T1 and T2 in the 6-Minute Walk Test (6-MWT), COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), Hospital Anxiety- and Depression Scale (HADS) and in lung function. Results No significant differences were seen in the results of the 5-STST between the groups. Likewise, in the 6-MWT, SGRQ, CAT, HADS and lung function. The intragroup comparison between T1 and T2 showed significant differences in 5-STST, 6-MWT, SGRQ, CAT and HADS in both groups. The differences in lung function were not significantly, neither in the inter- nor in the intragroup comparison. Conclusion Similarly to a conventional strength training improvements in exercise capacity could be achieved with a SMT during PR in COPD patients. Further studies are necessary to define the role of the SMT in regards to postural control.
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Affiliation(s)
- M Spielmanns
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen.,Lehrstuhl Pneumologie, Universität Witten/Herdecke
| | - K Müller
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen
| | - N Schott
- Lehrstuhl Sport- und Gesundheitswissenschaften II, Universität Stuttgart
| | - A Winkler
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen
| | - H Polanski
- Medizinischen Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), Remigius-Krankenhaus, Leverkusen-Opladen
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin, Philipps-Universität Marburg
| | - T Boeselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin, Philipps-Universität Marburg
| | - A R Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie und Intensivmedizin, Philipps-Universität Marburg
| | - J H Storre
- Universitätsklinikum Freiburg.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
| | - W Windisch
- Lehrstuhl Pneumologie, Universität Witten/Herdecke.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
| | - F S Magnet
- Lehrstuhl Pneumologie, Universität Witten/Herdecke.,Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
| | - K Baum
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH
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15
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Spielmanns M, Müller K, Schott N, Winkler A, Polanski H, Nell C, Böselt T, Koczulla AR, Storre JH, Windisch W, Magnet F, Baum K. Effektivität eines senso-motorischen Krafttrainings im Rahmen einer ambulanten pneumologischen Rehabilitation bei COPD-Patienten: eine randomisierte, kontrollierte Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Spielmanns
- Medizinische Klinik, St. Remigius Krankenhaus, Lehrstuhl Pneumologie, Universität Witten/Herdecke
| | | | | | | | | | | | | | | | | | | | | | - K Baum
- Trainingsinstitut Prof. Baum, Köln
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16
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Böselt T, Spielmanns M, Glöckl R, Klutsch A, Fischer H, Polanski H, Nell C, Storre JH, Windisch W, Koczulla AR. Low volume whole body vibration training improves exercise capacity in subjects with mild to severe COPD. Pneumologie 2017. [DOI: 10.1055/s-0037-1598476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Böselt
- Schwerpunkt Pneumologie, Klinik für Innere Medizin, Philipps Universität Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - R Glöckl
- Schön Klinik Berchtesgadener Land, Klinikum Rechts der Isar, Technische Universität München
| | - A Klutsch
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - H Fischer
- Institut für Medizin, Training und Gesundheit, Philipps Universität Marburg
| | - H Polanski
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - C Nell
- Schwerpunkt Pneumologie, Klinik für Innere Medizin, Philipps Universität Marburg
| | - JH Storre
- Abt. Pneumologie, Lungenklinik, Klinken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - W Windisch
- Abt. Pneumologie, Lungenklinik, Klinken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Philipps-Universität Marburg
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17
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Kölpin J, Kaufhold F, Böselt T, Nell C, Herth FJF, Vogelmeier C, Alter P, Kähler CM, Veith M, Greulich T, Spielmanns M, Kenn K, Kreuter M, Koczulla AR. Drei-Center Studie (DZL) zur Untersuchung von Trainingstherapieauswirkungen eines dreimonatigen Ganzkörpervibrationstrainings bei Patienten mit Lungenfibrose auf Muskelkraft, Lungenfunktion, gesundheitsbezogene Lebensqualität und Inflammationsmarker. Pneumologie 2017. [DOI: 10.1055/s-0037-1598477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J Kölpin
- Pneumologie, Philipps Universität Marburg
| | - F Kaufhold
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - C Nell
- Pneumologie, Philipps Universität Marburg
| | - FJF Herth
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - P Alter
- Pneumologie, Philipps Universität Marburg
| | | | - M Veith
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg, Member of the German Center for Lung Research (Dzl)
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
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18
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Jimenez Siebert M, Böselt T, Greulich T, Alter P, Herth FJF, Kahn N, Bornitz F, Vogelmeier C, Nell C, Kähler CJ, Hummler S, Koczulla AR. Effects of a 6 week whole-body vibration training (WBVT) in stable COPD patients: a randomized clinical trial. Pneumologie 2017. [DOI: 10.1055/s-0037-1598478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Jimenez Siebert
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - T Böselt
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - T Greulich
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - P Alter
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - FJF Herth
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - N Kahn
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - F Bornitz
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - C Vogelmeier
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - C Nell
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
| | - CJ Kähler
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Fachkliniken Wangen
| | - S Hummler
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg; Pulmonology, Thoraxklinik Universitaetsklinikum Heidelberg
| | - AR Koczulla
- Pulmonology, Institute for Internal Medicine, Philipps-University Marburg
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Spielmanns M, Böselt T, Nell C, Koczulla AR, Magnet F, Storre JH, Windisch W, Baum K. Die Teilnahme von Patienten mit einer COPD an einer ambulanten pneumologischen Rehabilitation führt zu einer Steigerung der Inspirationskapazität im 6-Minutengehtest: eine kontrollierte Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Spielmanns
- St. Remigius Krankenhaus; Medizinische Klinik; Lehrstuhl Pneumologie, Universität Witten/Herdecke
| | | | | | | | | | | | | | - K Baum
- Trainingsistitut Prof. Baum, Köln
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20
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Böselt T, Spielmanns M, Nell C, Storre JH, Windisch W, Magerhans L, Beutel B, Kenn K, Greulich T, Alter P, Vogelmeier C, Koczulla AR. Validity and usability of physical activity monitoring in patients with chronic obstructive pulmonary disease (COPD). Pneumologie 2017. [DOI: 10.1055/s-0037-1598310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Böselt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - M Spielmanns
- Medizinische Klinik und Ambulante Pneumologische Rehabilitation in Leverkusen (April)
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - JH Storre
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - W Windisch
- Abt. Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, University of Witten/Herdecke
| | - L Magerhans
- Klinik für Innere Medizin, Schwerpunkt Nephrologie, Philipps Universität Marburg
| | - B Beutel
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps Universität Marburg
| | - K Kenn
- Schön Klinik Berchtesgadener Land; Philipps Universität Marburg
| | - T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - P Alter
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - AR Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
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Spielmanns M, Axer F, Nell C, Koczulla AR, Boeselt T, Magnet F, Storre JH, Windisch W. [Outcome predictors for COPD patients hospitalized for acute exacerbation]. Med Klin Intensivmed Notfmed 2017; 112:708-716. [PMID: 28044184 DOI: 10.1007/s00063-016-0245-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/11/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prognostic factors for clinical failure of acute exacerbation in patients with COPD (AECOPD) are of special importance in order to choose an adequate therapy and resources during inpatient treatment. Our database was analyzed to identify predictors for a negative outcome. MATERIALS AND METHODS In a retrospective analysis medical records of 616 patients (299 women; 317 men) hospitalized for AECOPD between January 2011 and January 2016 were analyzed in order to evaluate demographic and clinical parameters leading to adverse events. Only the first admission was considered. Logistic regression analysis was performed to determine the relative risk (odds ratio (OR) leading to severe adverse events such as intensive care unit (ICU) admission, mechanical ventilation (invasive or noninvasive), early readmission to ICU and hospital and death). RESULTS An increased risk of an ICU admission was found for patients with a coronary heart disease (OR = 5.734; p = 0.009) and for patients requiring an antibiotic therapy (OR = 11.721; p = 0.003). An increased risk for rehospitalisation and mortality was found for age (OR = 1.034; p = 0.028) and a longer duration of the hospital stay (OR = 1.063; p = 0.042). A lower C‑reactive protein (CRP) level was associated with a lower risk of readmission to the hospital (OR = 0.991; p = 0.03). An increased risk of ventilator therapy was found for patients with chronic heart failure (OR = 6.166; p = 0.02) and sleep apnea syndrome (OR = 6.698; p = 0.003), diabetes (OR = 3.754; p = 0.041) and a long stay in the ICU (OR = 2.018; p = 0.000). CONCLUSIONS Comorbidities in patients with AECOPD were found to be a major risk factor for ICU admission and mechanical ventilation. Elderly patients and patients with prolonged hospital stay showed a higher risk for readmission and mortality. Patients with a low CRP blood level seemed to have a lower risk for rehospitalisation.
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Affiliation(s)
- M Spielmanns
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius Krankenhaus Leverkusen-Opladen, An St. Remigius 29, 51379, Leverkusen, Deutschland. .,Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland.
| | - F Axer
- Medizinische Klinik und ambulante pneumologische Rehabilitation in Leverkusen (APRiL), St. Remigius Krankenhaus Leverkusen-Opladen, An St. Remigius 29, 51379, Leverkusen, Deutschland
| | - C Nell
- Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland
| | - A R Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland
| | - T Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, University Marburg, Marburg, Deutschland
| | - F Magnet
- Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.,Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland
| | - J H Storre
- Universitätsklinikum Freiburg, Freiburg, Deutschland.,Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland
| | - W Windisch
- Abteilung Pneumologie, Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln, Deutschland.,Lehrstuhl Pneumologie, Universität Witten/Herdecke, Witten, Deutschland
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Lorenz J, Bals R, Ewert R, Jany B, Koczulla AR, Köhnlein T, Randerath WJ, Steinkamp G, Watz H, Welte T. [Expert Meeting on COPD: Personalized Treatment of COPD - Wishful Thinking or Reality?]. Pneumologie 2016; 70:638-650. [PMID: 27723914 DOI: 10.1055/s-0042-112044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is considered to be a complex and heterogeneous disease comprising multiple components. Its clinical presentation, pattern of functional disturbance, disease presentation and pathology varies tremendously between individuals despite the common feature of incompletely reversible airflow obstruction. It is therefore widely accepted that COPD is characterized by discriminable phenotypes that represent specific patterns of these disease features. COPD phenotypes are believed to correlate with outcome parameters such as severity of symptoms, exacerbations, functional loss or death and to require different treatment algorithms.This survey is the result of presentations that were given during an expert conference. It highlights the significance of major comorbidities, genetic, morphologic and inflammatory COPD-phenotypes and their impact on disease progression and treatment modalities.
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Affiliation(s)
- J Lorenz
- Klinik für Pneumologie und Internistische Intensivmedizin, Klinikum Lüdenscheid
| | - R Bals
- Pneumologie, Allergologie, Beatmungsmedizin, Universitätsklinikum des Saarlandes
| | - R Ewert
- Innere Medizin, Pneumologie, Internistische Intensivmedizin, Universitätsmedizin Greifswald
| | - B Jany
- Innere Medizin, Missionsärztliche Klinik Würzburg
| | - A R Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Marburg
| | - T Köhnlein
- Klinik für Pneumologie und Intensivmedizin, Klinikum St. Georg, Leipzig
| | - W J Randerath
- Klinik für Pneumologie und Allergologie, Krankenhaus Bethanien, Solingen
| | - G Steinkamp
- Medizinisch-wissenschaftliches Publizieren, Schwerin
| | - H Watz
- Pneumologisches Forschungsinstitut an der LungenClinic Großhansdorf
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
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23
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Gaida A, Holz O, Nell C, Schuchardt S, Lavae-Mokhtari B, Kruse L, Boas U, Langejuergen J, Allers M, Zimmermann S, Vogelmeier C, Koczulla AR, Hohlfeld JM. A dual center study to compare breath volatile organic compounds from smokers and non-smokers with and without COPD. J Breath Res 2016; 10:026006. [PMID: 27082437 DOI: 10.1088/1752-7155/10/2/026006] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There is increasing evidence that breath volatile organic compounds (VOC) have the potential to support the diagnosis and management of inflammatory diseases such as COPD. In this study we used a novel breath sampling device to search for COPD related VOCs. We included a large number of healthy controls and patients with mild to moderate COPD, recruited subjects at two different sites and carefully controlled for smoking. 222 subjects were recruited in Hannover and Marburg, and inhaled cleaned room air before exhaling into a stainless steel reservoir under exhalation flow control. Breath samples (2.5 l) were continuously drawn onto two Tenax(®) TA adsorption tubes and analyzed in Hannover using thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS). Data of 134 identified VOCs from 190 subjects (52 healthy non-smokers, 52 COPD ex-smokers, 49 healthy smokers, 37 smokers with COPD) were included into the analysis. Active smokers could be clearly discriminated by higher values for combustion products and smoking related VOCs correlated with exhaled carbon monoxide (CO), indicating the validity of our data. Subjects from the study sites could be discriminated even after exclusion of cleaning related VOCs. Linear discriminant analysis correctly classified 89.4% of COPD patients in the non/ex-smoking group (cross validation (CV): 85.6%), and 82.6% of COPD patients in the actively smoking group (CV: 77.9%). We extensively characterized 134 breath VOCs and provide evidence for 14 COPD related VOCs of which 10 have not been reported before. Our results show that, for the utilization of breath VOCs for diagnosis and disease management of COPD, not only the known effects of smoking but also site specific differences need to be considered. We detected novel COPD related breath VOCs that now need to be tested in longitudinal studies for reproducibility, response to treatment and changes in disease severity.
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Affiliation(s)
- A Gaida
- Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Clinical Airway Research, Hannover, Germany. Leibniz Universität Hannover, Institute of Inorganic Chemistry, Research Group Analytical Chemistry, Hannover, Germany. Contributed equally
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Gutmann A, Koepke J, Aepinus C, Schmeck B, Burchert A, Neubauer A, Sohlbach K, Vogelmeier C, Wilhem C, Koczulla AR. Nicht-invasiver Nachweis von Aspergillus fumigatus im Atemwegskondensat von Patienten mit neutropenem Fieber. Pneumologie 2015. [DOI: 10.1055/s-0035-1548644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Greulich T, Boeselt T, Nell C, Koepke J, Fechtel J, Franke M, Schmeck B, Haid D, Apelt S, Filipovic S, Kenn K, Janciauskiene S, Vogelmeier C, Koczulla AR. Aktive Muskelstimulation hat einen positiven Effekt auf hospitalisierte Patienten mit exazerbierter COPD. Pneumologie 2015. [DOI: 10.1055/s-0035-1548661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gutmann A, Koepke J, Aepinus C, Schmeck B, Burchert A, Sohlbach K, Neubauer A, Vogelmeier C, Wilhelm C, Koczulla AR. Nicht-invasiver Nachweis von Aspergillus fumigatus im Atemwegskondensat von Patienten mit neutropenem Fieber. Pneumologie 2015. [DOI: 10.1055/s-0035-1544854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Groß JC, Wilhelm C, Vogelmeier C, Wollmer E, Baumbach JI, Nell C, Boas U, Hattesohl A, Burchert A, Neubauer A, Koczulla AR. Erkennung von pulmonaler Graft-versus-Host-Krankheit (GvHD) in allogen stammzelltransplantierten Patienten durch elektronische Nase und Ionenmobilitätsspektrometer. Pneumologie 2015. [DOI: 10.1055/s-0035-1544658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alter P, van des Sand K, Nell C, Figiel JH, Greulich T, Vogelmeier C, Koczulla AR. Lung function in COPD is correlated with increased left ventricular wall stress in coincident heart failure. Pneumologie 2015. [DOI: 10.1055/s-0035-1544768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alter P, Luetteken L, Nell C, Haid D, Kehr K, Greulich T, Apelt S, Langenhan K, Hohmann C, Vogelmeier CF, Koczulla AR. Exercise training leads to physiological left ventricular hypertrophy in COPD. Int J Cardiol 2014; 174:156-7. [PMID: 24726167 DOI: 10.1016/j.ijcard.2014.03.160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- P Alter
- University of Marburg, Internal Medicine, Cardiology, Germany.
| | - L Luetteken
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C Nell
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - D Haid
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - K Kehr
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - T Greulich
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - S Apelt
- University of Marburg, Physiotherapy, Germany
| | - K Langenhan
- University of Marburg, Physiotherapy, Germany
| | - C Hohmann
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C F Vogelmeier
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - A R Koczulla
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany.
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Greulich T, Nell C, Kehr K, Kotke V, Wiedmann S, Herr C, Bals R, Vogelmeier C, Koczulla AR. Detektion von Patienten mit Alpha-1-Antitrypsin-Mangel in Deutschland – 10 Jahre Erfahrung. Pneumologie 2014. [DOI: 10.1055/s-0034-1367833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Data about the clinical presentation of chronic obstructive pulmonary disease (COPD) have resulted in a new classification of the disease. The degree of airflow limitation has been amended by symptoms and exacerbation rate. The standard pharmacotherapy of stable COPD is in transition, as fixed combinations of long acting beta agonists and long acting anticholinergics are in the late stages of clinical development. On this background inhaled corticosteroids will need to be re-evaluated. Roflumilast is a recently approved therapeutic option that primarily diminishes exacerbation frequency in patients with chronic bronchitis and severe airflow obstruction (FEV(1) < 50%). In COPD patients with acute exacerbations procalcitonin levels can be used to guide antibiotic therapy. Comparable clinical outcomes can be achieved while using significantly less amounts of antibiotics.
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Affiliation(s)
- T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Giessen und Marburg, Philipps-Universität Marburg, Deutschland.
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Schmid ST, Koepke J, Dresel M, Hattesohl A, Frenzel E, Perez J, Lomas DA, Miranda E, Greulich T, Noeske S, Wencker M, Teschler H, Vogelmeier C, Janciauskiene S, Koczulla AR. The effects of weekly augmentation therapy in patients with PiZZ α1-antitrypsin deficiency. Int J Chron Obstruct Pulmon Dis 2012; 7:687-96. [PMID: 23055718 PMCID: PMC3468059 DOI: 10.2147/copd.s34560] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The major concept behind augmentation therapy with human α1-antitrypsin (AAT) is to raise the levels of AAT in patients with protease inhibitor phenotype ZZ (Glu342Lys)-inherited AAT deficiency and to protect lung tissues from proteolysis and progression of emphysema. Objective To evaluate the short-term effects of augmentation therapy (Prolastin®) on plasma levels of AAT, C-reactive protein, and chemokines/cytokines. Materials and methods Serum and exhaled breath condensate were collected from individuals with protease inhibitor phenotype ZZ AAT deficiency-related emphysema (n = 12) on the first, third, and seventh day after the infusion of intravenous Prolastin. Concentrations of total and polymeric AAT, interleukin-8 (IL-8), monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, vascular endothelial growth factor, and C-reactive protein were determined. Blood neutrophils and primary epithelial cells were also exposed to Prolastin (1 mg/mL). Results There were significant fluctuations in serum (but not in exhaled breath condensate) levels of AAT polymers, IL-8, monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, and vascular endothelial growth factor within a week of augmentation therapy. In general, augmented individuals had higher AAT and lower serum levels of IL-8 than nonaugmented subjects. Prolastin added for 3 hours to neutrophils from protease inhibitor phenotype ZZ individuals in vitro reduced IL-8 release but showed no effect on cytokine/chemokine release from human bronchial epithelial cells. Conclusion Within a week, augmentation with Prolastin induced fluctuations in serum levels of AAT polymers and cytokine/chemokines but specifically lowered IL-8 levels. It remains to be determined whether these effects are related to the Prolastin preparation per se or to the therapeutic efficacy of augmentation with AAT.
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Affiliation(s)
- S T Schmid
- Department of Internal Medicine, Division for Pulmonary Diseases, University Hospital Marburg, Marburg, Germany
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Koepke J, Dresel M, Hattesohl A, Muramatsu R, Greulich T, Vogelmeier C, Koczulla AR. Short term effects of alpha1-antitrypsin substitution therapy on the degranulation of neutrophil granulocytes. Pneumologie 2012. [DOI: 10.1055/s-0032-1315494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dresel M, Koepke J, Muramatsu R, Hattesohl A, Greulich T, Vogelmeier C, Koczulla AR. Auswirkungen von oxidiertem α1-Antitrypsin auf neutrophile Granulozyten und humanes Lungenepithel. Pneumologie 2011. [DOI: 10.1055/s-0031-1296105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Koepke J, Dresel M, Hattesohl A, Greulich T, Vogelmeier C, Koczulla AR. Einfluss von Alpha 1-Antitrypsin auf die Ausbildung von NET-Strukturen bei Alpha-1-Antitrypsinmangelpatienten. Pneumologie 2011. [DOI: 10.1055/s-0031-1296116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Greulich T, Müller S, Fechtel J, Nell C, Holland A, Bach JP, Tackenberg B, Schubert H, Kenn K, Vogelmeier C, Koczulla AR. [Special training therapy to reduce inflammation in Anti-Jo-1 syndrome]. Pneumologie 2011; 65:624-7. [PMID: 21866491 DOI: 10.1055/s-0030-1256669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A 46-year-old patient was frequently seen with a medically treated Anti-Jo-1 syndrome. The patient had already been treated with azathioprine and oral corticosteroids on account of decreasing lung function, dyspnoea, fatigue, and beginning signs of myositis. Although high doses of steroids and azathioprine were administered, the muscleskeletal syndromes increased steadily. The patient used to be an active long-distance runner (20 km), but now was unable to perform that kind of physical exercise. It was decided to start a treatment with the GalileoTM training device for active muscle training of the lower extremities. Before and after three months of training the following assessment was performed: measurement of health-related quality of life (St. Georges respiratory questionnaire, SGRQ), ultrasound measurement of the cross-sectional area of the quadriceps muscle, 6 minute walk test (6 MWT), lung function testing, and assessment of serum markers of inflammation (TNF-alpha, interleukin-8, CRP, CK, myoglobin). After only two months, training with the GalileoTM five times a week has improved the patient's conditions dramatically. The training will be continued.
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Affiliation(s)
- T Greulich
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps-Universität Marburg, Baldingerstrasse 1, Marburg
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Hüttmann EM, Gecks A, Noeske S, Schmid S, Bals R, Scheuch G, Jörres RA, Vogelmeier C, Koczulla AR. Vergleich von forcierter Atmung und Ruheatmung. Pneumologie 2010. [DOI: 10.1055/s-0030-1251307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hattesohl A, Noeske S, Schmid S, Jörres RA, Vogelmeier C, Bals R, Koczulla AR. Distinguishing the exhaled breath of two patient groups with an electronic nose. Pneumologie 2010. [DOI: 10.1055/s-0030-1251102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Koczulla AR, Noeske S, Herr C, Römmelt H, Jörres RA, Vogelmeier C, Bals R. Akute und chronische Effekte von Zigarettenrauch auf Inflammationsmarker im Atemwegskondensat von Rauchern. Pneumologie 2010. [DOI: 10.1055/s-0030-1251270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Koczulla AR, Biller H, Hattesohl A, Hofbauer J, Jörres RA, Oeser C, Wirtz H. Vergleichsmessungen von vier elektronischen Nasen mit drei unterschiedlichen Messapparaturen. Pneumologie 2010. [DOI: 10.1055/s-0030-1251311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hofbauer J, Dressel H, Seissler J, Koczulla AR, Nowak D, Jörres RA. Analyse der Ausatemluft mittels Elektronischer Nase bei Patienten mit Diabetes mellitus. Pneumologie 2010. [DOI: 10.1055/s-0030-1251268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zakharkina T, Koczulla AR, Mardanova O, Hattesohl A, Bals R. Detection of microorganisms in exhaled breath condensate during acute exacerbations of COPD. Pneumologie 2010. [DOI: 10.1055/s-0030-1251156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Greulich T, Groenewold W, Herr C, Koczulla AR, Bals R. Alpha-1-Antitrypsin ist erhöht bei Patienten mit einem Systemischen Inflammatorischen Response Syndrom. Pneumologie 2010. [DOI: 10.1055/s-0030-1251204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Koczulla AR, Noeske S, Herr C, Jörres RA, Römmelt H, Vogelmeier C, Bals R. Akute und chronische Effekte von Zigarettenrauch auf Inflammationsmarker im Atemwegskondensat bei Rauchern. Pneumologie 2010. [DOI: 10.1055/s-0029-1247927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zakharkina T, Koczulla AR, Mardanova O, Hattesohl A, Bals R. Detection of microorganisms in exhaled breath condensate during acute exacerbations of COPD. Pneumologie 2010. [DOI: 10.1055/s-0029-1247963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Koczulla AR, Noeske S, Herr C, Jörres RA, Römmelt H, Vogelmeier C, Bals R. Akute und chronische Effekte von Zigarettenrauch auf Inflammationsmarker im Atemwegskondensat bei Rauchern. Pneumologie 2009. [DOI: 10.1055/s-0029-1243726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Koczulla AR, Bals R, Greulich T, Vogelmeier C. [Diagnosis and therapy of COPD]. MMW Fortschr Med 2009; 151:55-60. [PMID: 19504842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- A R Koczulla
- Zentrum für Innere Medizin, Abteilung für Pulmonologie, Universitätsklinikum Marburg.
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Herr C, Kotke V, Koczulla AR, Vogelmeier C, Bals R. Identifikation und Analyse unbekannter und seltener Mutationen des Alpha-1-Antitrypsin Gens. Pneumologie 2009. [DOI: 10.1055/s-0029-1214115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Koczulla AR, Hattesohl A, Noeske S, Vogelmeier C, Bals R. An electronic nose distinguishes the exhaled breath condensates of alpha-1-antitrypsin deficiency patients and healthy controls. Pneumologie 2009. [DOI: 10.1055/s-0029-1214113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Koczulla AR, Noeske S, Herr C, Vogelmeier C, Bals R. Alpha 1-Antitrypsin als Biomarker der COPD Exazerbation. Pneumologie 2009. [DOI: 10.1055/s-0029-1202416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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