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Thiem A, Mashhadiakbar P, Cussigh C, Hassel JC, Grimmelmann I, Gutzmer R, Schlaak M, Heppt MV, Dücker P, Hüning S, Schulmeyer L, Schilling B, Haferkamp S, Ziemer M, Moritz RKC, Hagelstein V, Terheyden P, Posch C, Gaiser MR, Kropp P, Emmert S, Müller B, Tietze JK. Immune checkpoint inhibition and targeted therapy for melanoma: A patient‐oriented cross‐sectional comparative multicenter study. J Eur Acad Dermatol Venereol 2022; 37:884-893. [PMID: 36433671 DOI: 10.1111/jdv.18778] [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] [Received: 05/03/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Choosing the adequate systemic treatment for melanoma is driven by clinical parameters and personal preferences. OBJECTIVE Evaluation of the impact of disease and treatment on the daily life of patients receiving systemic therapy for melanoma. METHODS A German-wide, cross-sectional comparative study was conducted at 13 specialized skin cancer centres from 08/2020 to 03/2021. A questionnaire was distributed to assess patients' perception of disease and symptoms, the impact of their current treatment on quality of life (QOL) and activities, adverse events (AEs), therapeutic visits, as well as believe in and satisfaction with their current systemic melanoma treatment. Patient-reported outcomes (PROs) were rated on a continuous numerical rating scale or selected from a given list. RESULTS Four hundred and fourteen patients with systemic melanoma therapy were included. 359 (87%) received immune checkpoint inhibition (ICI) and 55 (13%) targeted therapy (TT). About 1/3 of patients were adjuvantly treated, the remaining because of unresectable/metastatic melanoma. In subgroup analyses, only in the adjuvant setting, TT patients reported a significant decrease in their treatment associated QOL compared to patients with ICI (p = 0.02). Patients with TT were 1.9 times more likely to report AEs than patients with ICI, a difference being significant just for the adjuvant setting (p = 0.01). ICI treatment intervals differed significantly between adjuvant and unresectable/metastatic setting (p = 0.04), though all patients, regardless of their specific ICI drug, evaluated their treatment frequency as adequate. TT patients with dabrafenib/trametinib (n = 37) or encorafenib/binimetinib (n = 15) did not differ regarding the strain of daily pill intake. Patients older than 63 years rated various PROs better than younger patients. CONCLUSIONS Patients evaluated their treatment mainly positively. ICI might be preferred over TT regarding QOL and patient-reported AEs in the adjuvant setting. Older melanoma patients appeared to be less impacted by their disease and more satisfied with their treatment.
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Affiliation(s)
- A. Thiem
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - P. Mashhadiakbar
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - C. Cussigh
- Department of Dermatology and National Center for Tumor Diseases (NCT) Heidelberg University Hospital Heidelberg Germany
| | - J. C. Hassel
- Department of Dermatology and National Center for Tumor Diseases (NCT) Heidelberg University Hospital Heidelberg Germany
| | - I. Grimmelmann
- Skin Cancer Center Hannover, Department of Dermatology Hannover Medical School Hannover Germany
| | - R. Gutzmer
- Skin Cancer Center Hannover, Department of Dermatology Hannover Medical School Hannover Germany
- Skin Cancer Center Minden, Department of Dermatology, Johannes‐Wesling‐Klinikum Minden/Ruhr‐University, Bochum Minden Germany
| | - M. Schlaak
- Department of Dermatology and Allergy University Hospital of Munich (LMU) Munich Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Department of Dermatology, Venereology and Allergology Berlin Germany
| | - M. V. Heppt
- Department of Dermatology and Comprehensive Cancer Center Erlangen‐European Metropolitan Area of Nuremberg (CCC ER‐EMN), Universitätsklinikum Erlangen, Friedrich‐Alexander‐University Erlangen‐Nürnberg Erlangen Germany
| | - P. Dücker
- Department of Dermatology, Hospital of Dortmund Dortmund Germany
| | - S. Hüning
- Department of Dermatology, Hospital of Dortmund Dortmund Germany
| | - L. Schulmeyer
- Department of Dermatology, Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - B. Schilling
- Department of Dermatology, Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - S. Haferkamp
- Department of Dermatology University Hospital Regensburg Regensburg Germany
| | - M. Ziemer
- Department of Dermatology, Venereology and Allergology University Medical Center Leipzig Leipzig Germany
| | - R. K. C. Moritz
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Department of Dermatology, Venereology and Allergology Berlin Germany
- Department of Dermatology and Venereology, Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - V. Hagelstein
- Department of Dermatology, Allergology, and Venereology University of Lübeck Germany
| | - P. Terheyden
- Department of Dermatology, Allergology, and Venereology University of Lübeck Germany
| | - C. Posch
- Department of Dermatology, Venereology and Allergology, Clinic Hietzing Vienna Healthcare Group Vienna Austria
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK) Technical University of Munich Munich Germany
- Faculty of Medicine Sigmund Freud University Vienna Vienna Austria
| | - M. R. Gaiser
- Department of Dermatology, Venerology and Allergology, Medical Faculty Mannheim, University Medical Center Mannheim Heidelberg University Mannheim Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg Germany
| | - P. Kropp
- Institute of Medical Psychology and Medical Sociology University Medical Center Rostock Rostock Germany
| | - S. Emmert
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
| | - B. Müller
- Institute of Medical Psychology and Medical Sociology University Medical Center Rostock Rostock Germany
| | - J. K. Tietze
- Clinic and Policlinic for Dermatology and Venereology University Medical Center Rostock Rostock Germany
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Stege HM, Haist M, Schultheis S, Fleischer MI, Mohr P, Ugurel S, Terheyden P, Thiem A, Kiecker F, Leiter U, Becker JC, Meissner M, Kleeman J, Pföhler C, Hassel J, Grabbe S, Loquai C. Response durability after cessation of immune checkpoint inhibitors in patients with metastatic Merkel cell carcinoma: a retrospective multicenter DeCOG study. Cancer Immunol Immunother 2021; 70:3313-3322. [PMID: 33870464 PMCID: PMC8505278 DOI: 10.1007/s00262-021-02925-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) have led to a prolongation of progression-free and overall survival in patients with metastatic Merkel cell carcinoma (MCC). However, immune-mediated adverse events due to ICI therapy are common and often lead to treatment discontinuation. The response duration after cessation of ICI treatment is unknown. Hence, this study aimed to investigate the time to relapse after discontinuation of ICI in MCC patients. METHODS We analyzed 20 patients with metastatic MCC who have been retrospectively enrolled at eleven skin cancer centers in Germany. These patients have received ICI therapy and showed as best overall response (BOR) at least a stable disease (SD) upon ICI therapy. All patients have discontinued ICI therapy for other reasons than disease progression. Data on treatment duration, tumor response, treatment cessation, response durability, and tumor relapse were recorded. RESULTS Overall, 12 of 20 patients (60%) with MCC relapsed after discontinuation of ICI. The median response durability was 10.0 months. Complete response (CR) as BOR to ICI-treatment was observed in six patients, partial response (PR) in eleven, and SD in three patients. Disease progression was less frequent in patients with CR (2/6 patients relapsed) as compared to patients with PR (7/11) and SD (3/3), albeit the effect of initial BOR on the response durability was below statistical significance. The median duration of ICI therapy was 10.0 months. Our results did not show a correlation between treatment duration and the risk of relapse after treatment withdrawal. Major reasons for discontinuation of ICI therapy were CR (20%), adverse events (35%), fatigue (20%), or patient decision (25%). Discontinuation of ICI due to adverse events resulted in progressive disease (PD) in 71% of patients regardless of the initial response. A re-induction of ICI was initiated in 8 patients upon tumor progression. We observed a renewed tumor response in 4 of these 8 patients. Notably, all 4 patients showed an initial BOR of at least PR. CONCLUSION Our results from this contemporary cohort of patients with metastatic MCC indicate that MCC patients are at higher risk of relapse after discontinuation of ICI as compared to melanoma patients. Notably, the risk of disease progression after discontinuation of ICI treatment is lower in patients with initial CR (33%) as compared to patients with initial PR (66%) or SD (100%). Upon tumor progression, re-induction of ICI is a feasible option. Our data suggest that the BOR to initial ICI therapy might be a potential predictive clinical marker for a successful re-induction.
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Affiliation(s)
- H M Stege
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
| | - M Haist
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - S Schultheis
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - M I Fleischer
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - P Mohr
- Department of Dermatology, Elbe-Kliniken Buxtehude, Buxtehude, Germany
| | - S Ugurel
- Department of Dermatology, University Medical Center Essen, Essen, Germany
| | - P Terheyden
- Department of Dermatology, Allergology and Venerology, University Lübeck, Lübeck, Germany
| | - A Thiem
- Department of Dermatology, University Medical Center Würzburg, Würzburg, Germany
- Department of Dermatology, University Medical Center Rostock, Rostock, Germany
| | - F Kiecker
- Department of Dermatology and Allergology at the Charité, University Medical Center Berlin, Berlin, Germany
| | - U Leiter
- Dermato-Oncology, Department of Dermatology, University Medical Center Tübingen, Tübingen, Germany
| | - J C Becker
- Department of Dermatology, University Medical Center Essen, Essen, Germany
- German Consortium for Translational Oncology (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Meissner
- Department of Dermatology, University Medical Center Frankfurt, Frankfurt, Germany
| | - J Kleeman
- Department of Dermatology, University Medical Center Frankfurt, Frankfurt, Germany
| | - C Pföhler
- Department of Dermatology, University Medical Center Homburg, Homburg, Germany
| | - J Hassel
- Department of Dermatology, University Medical Center Heidelberg, Heidelberg, Germany
| | - S Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - C Loquai
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Salem M, Friedrich C, Herbers L, Reimers J, Friedrichs A, Lutter G, Thiem A, Panholzer B, Puehler T, Schoettler J, Frank D, Schoeneich F, Cremer J, Haneya A. Surgical Treatment for Active Infective Prosthetic Valve Endocarditis: A Single-Center Experience. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725753] [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: 10/21/2022]
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Salem M, Friedrich C, Herbers L, Reimers J, Friedrichs A, Panholzer B, Thiem A, Puehler T, Cremer J, Haneya A. Risk Factors and Predictors of Mortality after Surgery for Infective Endocarditis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725665] [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: 10/21/2022]
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Friedrich C, Salem M, Puehler T, Panholzer B, Herbers L, Reimers J, Friedrichs A, Thiem A, Cremer J, Haneya A. Gender-Related 30-Day and Long-Term Surgical Outcome in Patients with Infective Endocarditis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725663] [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: 10/21/2022]
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Emmert S, van Welzen A, Masur K, Gerling T, Bekeschus S, Eschenburg C, Wahl P, Bernhardt T, Schäfer M, Semmler ML, Grabow N, Fischer T, Thiem A, Jung O, Boeckmann L. Kaltes Atmosphärendruckplasma zur Behandlung akuter und chronischer Wunden. Hautarzt 2020; 71:855-862. [DOI: 10.1007/s00105-020-04696-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Emmert S, Panzer R, Rode S, Thiem A, Tietze J, Blaschke V, Fischer T, Böckmann L. Die Klinik und Poliklinik für Dermatologie und Venerologie der Universitätsmedizin Rostock – von Fischschuppenerkrankungen, Mondscheinkindern und viel, viel Mee(h)r! Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1147-3103] [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: 10/23/2022]
Abstract
ZusammenfassungDie Universität Rostock und die Universitätsmedizin als Gründungsfakultät ist die drittälteste Alma Mater in Mitteleuropa – 2019 hat sie ihr 600-jähriges Bestehen gefeiert. Die Klinik und Poliklinik für Dermatologie und Venerologie der Universitätsmedizin Rostock kann auf eine ähnlich lange Tradition zurückblicken – sie ist das drittälteste Ordinariat nach Breslau und der Charité in Berlin. Gemäß dem universitären Motto „Traditio et Innovatio“ hat sich aus dieser Tradition, begründet durch angesehene Ordinarien wie Wolters, Frieboes oder auch Flegel zu DDR-Zeiten, in den letzten 4 Jahren eine moderne universitäre Dermatologische Universitätsklinik (DUK) mit hoher Entwicklungsdynamik und einem Masterplan DUK2030 für alle Bereiche der Krankenversorgung, Forschung und Lehre entwickelt. Unter einem Dach sind stationäre, teilstationäre, ambulante und operative Patientenversorgung zusammen mit dem histologischen und klinischen Labor und den Forschungslaboren vereint. Unter anderem durch Zentrumsgründungen vor Ort (Hautkrebszentrum, Immuntherapiezentrum, Allergologisches Zentrum, Gefäß- und Wundzentrum, Zentrum für Seltene (Haut-) Erkrankungen) und auf europäischer Ebene (Europäisches Referenznetzwerkzentrum für seltene Hauterkrankungen) hat diese interdisziplinäre Zusammenarbeit die Klinik lokal und überregional sehr gut vernetzt. Ein junges, hochengagiertes und noch expandierendes Team hat diese bisherige Entwicklung ermöglicht. Dafür kann allen Beteiligten nicht genug gedankt werden. Dieser und die folgenden Artikel geben einen Einblick in die dermatologische Welt der Universitätsmedizin Rostock.
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Affiliation(s)
- S. Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - R. Panzer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Rode
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Thiem
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - J. Tietze
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - V. Blaschke
- Leiter Medizincontrolling, Universitätsmedizin Rostock
| | - T. Fischer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - L. Böckmann
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
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Boeckmann L, Bernhardt T, Schäfer M, Semmler ML, Glatzel A, Martens MC, Ulrich M, Thiem A, Tietze J, Jung O, Panzer R, Fischer T, Emmert S. Experimentelle Forschung an der Klinik und Poliklinik für Dermatologie und Venerologie. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1147-5015] [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: 10/23/2022]
Abstract
ZusammenfassungSeit Antritt von Prof. Dr. med. Steffen Emmert als Ordinarius der Klinik und Poliklinik für Dermatologie und Venerologie im Jahr 2015 konnte das dermatologische Forschungslabor sukzessive aufgebaut und erweitert werden. Im Einklang mit dem onkologischen Schwerpunkt der Universitätsmedizin Rostock sowie dem von der Landesregierung forcierten „Gesundheitsland Mecklenburg-Vorpommern“ wird grundlagenorientierten und translationalen Projekten nachgegangen. Das vorwiegend drittmittelfinanzierte und stetig wachsende Forschungsteam bearbeitet diverse Fragestellungen in den Bereichen der Dermato-Onkologie, Plasmamedizin und seltenen Hauterkrankungen. Inzwischen auf einem soliden Fundament stehend, befindet sich der Forschungsbereich weiterhin in einem dynamischen Entwicklungsprozess. Nicht nur personell, sondern auch thematisch und methodisch wird er derzeit durch die Integration weiterer Arbeitsgruppen unter der Leitung von Ärzten aus der Klinik ergänzt und ausgebaut. Diverse Kollaborationen an der Universitätsmedizin Rostock und im Land zeugen von einem freundlichen, unterstützenden und kollegialen Umfeld, das die Integration am Standort befördert hat.
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Affiliation(s)
- L. Boeckmann
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - T. Bernhardt
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. Schäfer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. L. Semmler
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Glatzel
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. C. Martens
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. Ulrich
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Thiem
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - J. Tietze
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - O. Jung
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - R. Panzer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - T. Fischer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
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Grünwald P, Krebs S, Troitzsch P, Roewer J, Emmert S, Thiem A. Etablierung des Schwerpunktes Psoriasis an der Universitätshautklinik Rostock und eine praxisbezogene Übersicht über die Biologikatherapie der Psoriasis. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1147-4666] [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: 10/23/2022]
Abstract
ZusammenfassungDie Diagnostik und Behandlung der Psoriasis stellt einen Schwerpunkt an der Universitätshautklinik Rostock dar. Aufgrund des breiten Spektrums verfügbarer Biologikatherapien für die Behandlung der Psoriasis werden in diesem Artikel praxisbezogene Ratschläge für diese Therapieform gegeben. Dabei wird aufgezeigt, wie das optimale Biologikum für einen individuellen Patienten unter Berücksichtigung möglicher Kontraindikationen, krankheitsspezifischer Aspekte und unerwünschter Wirkungen ausgewählt werden kann. Außerdem wird ein mögliches Vorgehen bei Unterbrechung, Wiederaufnahme oder Umstellung von Biologika erwähnt.
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Affiliation(s)
- P. Grünwald
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Krebs
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - P. Troitzsch
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - J. Roewer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Thiem
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
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Troitzsch P, Panzer R, Emmert S, Thiem A. Aquagener Pruritus als Warnzeichen eines inneren Tumorleidens – eine Fallvorstellung und Literaturübersicht. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1150-0796] [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: 10/23/2022]
Abstract
ZusammenfassungAquagener Pruritus (AP), d. h. Jucken, Kribbeln, Brennen nach Wasserkontakt, ist ein häufiges Symptom bei Polycythaemia vera und anderen myeloproliferativen Neoplasien, kann aber auch unabhängig davon auftreten. Wie andere Formen des Pruritus schränkt AP die Lebensqualität der Betroffenen häufig ein und kann zu einem hohen Leidensdruck führen. Zur Pathogenese existieren unterschiedliche Erklärungsansätze, jedoch kein einheitliches Konzept. Passend dazu sprechen Patienten auch nur zum Teil auf vorhandene Therapien an, die überwiegend off label sind. In dieser Literaturübersicht zum AP werden beschriebene Pathomechanismen diskutiert und mögliche Therapieformen genannt. Ein verbessertes Verständnis von AP soll dazu beitragen, dieses Symptom zu erkennen und an mögliche zugrunde liegende Erkrankungen, insbesondere an ein inneres Tumorleiden, zu denken.
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Affiliation(s)
- P. Troitzsch
- Klinik und Poliklinik für Dermatologie, Universitätsmedizin Rostock
| | - R. Panzer
- Klinik und Poliklinik für Dermatologie, Universitätsmedizin Rostock
| | - S. Emmert
- Klinik und Poliklinik für Dermatologie, Universitätsmedizin Rostock
| | - A. Thiem
- Klinik und Poliklinik für Dermatologie, Universitätsmedizin Rostock
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Thiem A, Bagheri M, Große-Siestrup C, Zehbe R. Gelatin-poly(lactic-co-glycolic acid) scaffolds with oriented pore channel architecture — From in vitro to in vivo testing. Materials Science and Engineering: C 2016; 62:585-95. [DOI: 10.1016/j.msec.2016.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 01/07/2023]
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Affiliation(s)
- A Thiem
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - S Kütt
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany.,Private Practice, Würzburg, Germany
| | - H Hamm
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
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Grothusen C, Thiem A, Engler A, Matz K, Schöttler J, Cremer J, Attmann T. Short-term outcome after surgical embolectomy in pulmonary embolism: A single-center experience. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367425] [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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Thiem A, Ernst K, Kowalski A, Hoffmann G, Haneya A, Schoeneich F, Cremer J, Schöttler J. Effects on antiarrhythmic and anticoagulation therapy after concomitant epicardial left atrial ablation procedure - one year results. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367439] [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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Haneya A, Jussli-Melchers J, Eckmann S, Berndt R, Thiem A, Hoffmann G, Schöttler J, Cremer J. Outcome of total arterial versus conventional myocardial revascularization in the elderly: a single center experience. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367217] [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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Thiem A, Kowalski A, Schoeneich F, Buessow M, Friedrich C, Lutter G, Cremer J, Schöttler J. Concomitant surgical ablation in cardiac surgery patients: Does sinus rhythm 12 months postoperatively result in a better quality of life? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332670] [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: 10/27/2022]
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Abstract
Coronary artery bypass grafting (CABG), a modern and safe procedure, is considered the therapy of choice in the care of patients with multi-vessel disease. The 3-year results of the SYNTAX trial not only showed surgical advantages in terms of repeat revascularisation, but the results also demonstrated significant surgical benefit for myocardial infarction and survival rates. More differentiated analyses showed distinct disadvantages in percutaneous coronary intervention (PCI) associated with the greater complexity of coronary pathology. PCI tends to be a comparable therapeutic option only in certain cases of left main stem lesions or multi-vessel disease. The findings from the SYNTAX study herald a new era in the treatment of coronary heart disease in which, as recommended in the updated guidelines issued by the EACTS/ESC in 2010, the interventionalist and the surgeon, working closely together as a"heart team", provide a sound therapy plan for affected patients.
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Affiliation(s)
- A Thiem
- Klinik für Herz- und Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 18, 24105, Kiel, Deutschland
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Schöneich F, Fraund S, Lutter G, Brelie MVD, Kowalski A, Thiem A, Cremer J. Bilateral IMA-grafting in patients with left main coronary artery stenosis. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967629] [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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Thiem A, Cremer J, Lutter G. Percutaneous valve replacement: weird or wonderful? Minerva Cardioangiol 2006; 54:23-30. [PMID: 16467739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Percutaneous treatment of valve diseases has proven to be an effective alternative to open surgery since the early 1980's. For most patients with rheumatic mitral stenosis, use of percutaneous catheter-based techniques as balloon valvuloplasty for the treatment of both congenital pulmonary stenosis as well as trans-septal commissurotomy has become a good therapeutic option. Furthermore in the mid 1990's in vitro studies demonstrated the feasibility of percutaneous catheter-based valve implantation first in pulmonary and subsequently in aortic position. Afterwards initial in vivo implantations were successfully undertaken. Limitations of this new branch of transcatheter-based techniques are: risk of embolization due to pre-dilatation; difficult deployment; migration of valved stent; paravalvular leakage and limited durability of the implanted valve. Hence, many advances and improvements are necessary prior to pronouncing a new real alternative and safe therapeutic option. Up to now the gold standard for the treatment of heart valve disease is still open surgical valve repair and replacement. Percutaneous valve replacement procedures offer substantial advantages both to patients and medical care providers. From a medical point of view, they may help reduce surgical risks, offer a less invasive procedure, lower complication rates and shorten rehabilitation times in future. From an economic standpoint, shorter hospital stays result in overall cost reduction.
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Affiliation(s)
- A Thiem
- Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Kiel, Germany
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Liebetrau B, Thiem A, Hanf R. [Room air humidifiers as a source of health disorders]. Z Gesamte Hyg 1974; 20:17-23. [PMID: 4828135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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