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Siegwardt L, Glößner V, Boehm A, Schneider M, Gallei M. Poly(4-vinylpyridine) and Poly(methacrylic acid) Particle Architectures for pH-Responsive and Mechanochromic Opal Films. ACS Appl Mater Interfaces 2024; 16:10722-10735. [PMID: 38350063 DOI: 10.1021/acsami.3c17974] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
While stimuli-responsive structural colors are commonly found in nature, mimicking these in artificial materials is challenging. Dynamically switchable and tunable coloration, however, is in high demand in widespread fields of applications, including advanced display and monitoring technologies, smart sensing, and anticounterfeiting. This work reports a scalable protocol for the synthesis of tailor-made core-shell particles and subsequent processing to opal films with iridescent, pH-responsive, and mechanochromic structural color. Novel monodisperse core-shell architectures based on hard polystyrene core particles are synthesized via stepwise emulsion polymerization in a starved-feed mode. The incorporation of 4-vinylpyridine and methacrylic acid as functional comonomers in the soft particle shell facilitates pH-responsive swelling and deswelling. Mechanically stable and well-ordered colloidal crystal films are obtained by the self-assembly of the particles during processing with the powerful melt-shear organization technique. Thereby obtained opal films show Bragg-scattering at the colloidal crystalline structure and exhibit brilliant green-turquoise to blue-violet reflection colors, dependent on the angle of view and illumination. Upon changes in the pH value or mechanical deformation, the reflected wavelength shifts by more than 100 nm, leading to intriguing changes in the visible structural color. Excellent reversibility is achieved by the subsequent application of a convenient UV cross-linking strategy, corroborating the high application potential of these advanced functional materials.
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Affiliation(s)
- Lukas Siegwardt
- Polymer Chemistry, Saarland University, Saarbrücken 66123, Germany
| | - Victoria Glößner
- Polymer Chemistry, Saarland University, Saarbrücken 66123, Germany
| | - Anna Boehm
- Polymer Chemistry, Saarland University, Saarbrücken 66123, Germany
| | - Marc Schneider
- Department of Pharmacy, Biopharmaceutics and Pharmaceutical Technology, Saarland University, Saarbrücken 66123, Germany
| | - Markus Gallei
- Polymer Chemistry, Saarland University, Saarbrücken 66123, Germany
- Saarene, Saarland Center for Energy Materials and Sustainability, Saarbrücken 66123, Germany
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Rass V, Tymoszuk P, Sahanic S, Heim B, Ausserhofer D, Lindner A, Kofler M, Mahlknecht P, Boehm A, Hüfner K, Pizzini A, Sonnweber T, Kurz K, Pfeifer B, Kiechl S, Peball M, Kindl P, Putnina L, Fava E, Djamshidian A, Huber A, Wiedermann CJ, Sperner-Unterweger B, Wöll E, Beer R, Schiefecker AJ, Bellmann-Weiler R, Bachler H, Tancevski I, Pfausler B, Piccoliori G, Seppi K, Weiss G, Löffler-Ragg J, Helbok R. Distinct smell and taste disorder phenotype of post-acute COVID-19 sequelae. Eur Arch Otorhinolaryngol 2023; 280:5115-5128. [PMID: 37670171 PMCID: PMC10562286 DOI: 10.1007/s00405-023-08163-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/26/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE Olfactory dysfunction (OD) commonly accompanies coronavirus disease 2019 (COVID-19). We investigated the kinetics of OD resolution following SARS-CoV-2 infection (wild-type and alpha variant) and its impact on quality of life, physical and mental health. METHODS OD prevalence was assessed in an ambulatory COVID-19 survey (n = 906, ≥ 90 days follow-up) and an observational cohort of ambulatory and hospitalized individuals (n = 108, 360 days follow-up). Co-occurrence of OD with other symptoms and effects on quality of life, physical and mental health were analyzed by multi-dimensional scaling, association rule mining and semi-supervised clustering. RESULTS Both in the ambulatory COVID-19 survey study (72%) and the observational ambulatory and hospitalized cohort (41%) self-reported OD was frequent during acute COVID-19. Recovery from self-reported OD was slow (survey: median 28 days, observational cohort: 90 days). By clustering of the survey data, we identified a predominantly young, female, comorbidity-free group of convalescents with persistent OD and taste disorders (median recovery: 90 days) but low frequency of post-acute fatigue, respiratory or neurocognitive symptoms. This smell and taste disorder cluster was characterized by a high rating of physical performance, mental health, and quality of life as compared with convalescents affected by prolonged fatigue or neurocognitive complaints. CONCLUSION Our results underline the heterogeneity of post-acute COVID-19 sequelae calling for tailored management strategies. The persistent smell and taste disorder phenotype is characterized by good clinical, physical, and mental recovery and may pose a minor challenge for public health. STUDY REGISTRATION ClinicalTrials.gov: NCT04661462 (survey study), NCT04416100 (observational cohort).
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Affiliation(s)
- Verena Rass
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy
| | - Anna Lindner
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Mario Kofler
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Mahlknecht
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Pfeifer
- Tyrolean Federal Institute for Integrated Care, Innsbruck, Austria
- Division for Health Networking and Telehealth, Biomedical Informatics and Mechatronics, UMIT, Hall in Tyrol, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Marina Peball
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Kindl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lauma Putnina
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elena Fava
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Huber
- Tyrolean Federal Institute for Integrated Care, Innsbruck, Austria
| | - Christian J Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Ronny Beer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Bachler
- Institute of General Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Pfausler
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
- Department of Neurology, Johannes Kepler University, Linz, Austria.
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Beyer C, Boehm A, Pizzini A, Grubwieser P, Feuchtner G, Bauer A, Weiss G, Loeffler-Ragg J, Friedrich G, Plank F. Undiagnosed chronic respiratory disorders in symptomatic patients with initially suspected and excluded coronary artery disease: insights from a prospective pilot study. Front Med (Lausanne) 2023; 10:1181831. [PMID: 37396893 PMCID: PMC10310789 DOI: 10.3389/fmed.2023.1181831] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/24/2023] [Indexed: 07/04/2023] Open
Abstract
Background Chronic respiratory diseases represent the third-leading cause of death on a global scale. Due to mutual symptoms with cardiovascular diseases and potential inappropriate attribution of symptoms, pulmonary diseases often remain undiagnosed. Therefore, we aimed to evaluate the prevalence of chronic respiratory disorders among symptomatic patients in whom suspected coronary artery disease (CAD) was ruled out. Methods After CAD was excluded by invasive coronary angiography (ICA), 50 patients with chest pain or dyspnea were prospectively enrolled in this study. All patients underwent lung function testing, including spirometry and diffusion measurements. At baseline and the 3-month follow-up, standardized assessments of symptoms (CCS chest pain, mMRC score, CAT score) were performed. Results Chronic respiratory disease was diagnosed in 14% of patients, with a prevalence of 6% for chronic obstructive ventilation disorders. At 3-month follow-up, patients with normal lung function tests revealed a substantial improvement in symptoms (mean mMRC 0.70 to 0.33, p = 0.06; median CAT 8 to 2, p = 0.01), while those with pulmonary findings showed non-significant alterations or unchanged symptoms (mean mMRC 1.14 to 0.71, p = 0.53; median CAT 6 to 6, p = 0.52). Conclusion A substantial proportion of patients with an initial suspicion of coronary artery disease was diagnosed with underlying chronic respiratory diseases and exhibited persistent symptoms.
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Affiliation(s)
- Christoph Beyer
- Department of Internal Medicine III – Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II – Infectious Diseases, Pneumology and Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II – Infectious Diseases, Pneumology and Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
- Servizio Pneumologico Aziendale, Azienda Sanitaria dell’ Alto Adige, Bolzano, Italy
| | - Philipp Grubwieser
- Department of Internal Medicine II – Infectious Diseases, Pneumology and Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gudrun Feuchtner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Axel Bauer
- Department of Internal Medicine III – Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Department of Internal Medicine II – Infectious Diseases, Pneumology and Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II – Infectious Diseases, Pneumology and Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Guy Friedrich
- Department of Internal Medicine III – Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Fabian Plank
- Department of Internal Medicine III – Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
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Hüfner K, Tymoszuk P, Sahanic S, Luger A, Boehm A, Pizzini A, Schwabl C, Koppelstätter S, Kurz K, Asshoff M, Mosheimer-Feistritzer B, Pfeifer B, Rass V, Schroll A, Iglseder S, Egger A, Wöll E, Weiss G, Helbok R, Widmann G, Sonnweber T, Tancevski I, Sperner-Unterweger B, Löffler-Ragg J. Persistent somatic symptoms are key to individual illness perception at one year after COVID-19 in a cross-sectional analysis of a prospective cohort study. J Psychosom Res 2023; 169:111234. [PMID: 36965396 PMCID: PMC10022460 DOI: 10.1016/j.jpsychores.2023.111234] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE Subjective illness perception (IP) can differ from physician's clinical assessment results. Herein, we explored patient's IP during coronavirus disease 2019 (COVID-19) recovery. METHODS Participants of the prospective observation CovILD study (ClinicalTrials.gov: NCT04416100) with persistent somatic symptoms or cardiopulmonary findings one year after COVID-19 were analyzed (n = 74). Explanatory variables included demographic and comorbidity, COVID-19 course and one-year follow-up data of persistent somatic symptoms, physical performance, lung function testing, chest computed tomography and trans-thoracic echocardiography. Factors affecting IP (Brief Illness Perception Questionnaire) one year after COVID-19 were identified by regularized modeling and unsupervised clustering. RESULTS In modeling, 33% of overall IP variance (R2) was attributed to fatigue intensity, reduced physical performance and persistent somatic symptom count. Overall IP was largely independent of lung and heart findings revealed by imaging and function testing. In clustering, persistent somatic symptom count (Kruskal-Wallis test: η2 = 0.31, p < .001), fatigue (η2 = 0.34, p < .001), diminished physical performance (χ2 test, Cramer V effect size statistic: V = 0.51, p < .001), dyspnea (V = 0.37, p = .006), hair loss (V = 0.57, p < .001) and sleep problems (V = 0.36, p = .008) were strongly associated with the concern, emotional representation, complaints, disease timeline and consequences IP dimensions. CONCLUSION Persistent somatic symptoms rather than abnormalities in cardiopulmonary testing influence IP one year after COVID-19. Modifying IP represents a promising innovative approach to treatment of post-COVID-19 condition. Besides COVID-19 severity, individual IP should guide rehabilitation and psychological therapy decisions.
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Affiliation(s)
- Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabine Koppelstätter
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Malte Asshoff
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Bernhard Pfeifer
- Division for Health Networking and Telehealth, Biomedical Informatics and Mechatronics, UMIT, Hall in Tyrol, Austria
| | - Verena Rass
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Schroll
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sarah Iglseder
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
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Sahanic S, Tymoszuk P, Luger AK, Hüfner K, Boehm A, Pizzini A, Schwabl C, Koppelstätter S, Kurz K, Asshoff M, Mosheimer-Feistritzer B, Coen M, Pfeifer B, Rass V, Egger A, Hörmann G, Sperner-Unterweger B, Helbok R, Wöll E, Weiss G, Widmann G, Tancevski I, Sonnweber T, Löffler-Ragg J. COVID-19 and its continuing burden after 12 months: a longitudinal observational prospective multicentre trial. ERJ Open Res 2023; 9:00317-2022. [PMID: 36960350 PMCID: PMC10030059 DOI: 10.1183/23120541.00317-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/25/2022] [Indexed: 03/18/2023] Open
Abstract
Background Recovery trajectories from coronavirus disease 2019 (COVID-19) call for longitudinal investigation. We aimed to characterise the kinetics and status of clinical, cardiopulmonary and mental health recovery up to 1 year following COVID-19. Methods Clinical evaluation, lung function testing (LFT), chest computed tomography (CT) and transthoracic echocardiography were conducted at 2, 3, 6 and 12 months after disease onset. Submaximal exercise capacity, mental health status and quality of life were assessed at 12 months. Recovery kinetics and patterns were investigated by mixed-effect logistic modelling, correlation and clustering analyses. Risk of persistent symptoms and cardiopulmonary abnormalities at the 1-year follow-up were modelled by logistic regression. Findings Out of 145 CovILD study participants, 108 (74.5%) completed the 1-year follow-up (median age 56.5 years; 59.3% male; 24% intensive care unit patients). Comorbidities were present in 75% (n=81). Key outcome measures plateaued after 180 days. At 12 months, persistent symptoms were found in 65% of participants; 33% suffered from LFT impairment; 51% showed CT abnormalities; and 63% had low-grade diastolic dysfunction. Main risk factors for cardiopulmonary impairment included pro-inflammatory and immunological biomarkers at early visits. In addition, we deciphered three recovery clusters separating almost complete recovery from patients with post-acute inflammatory profile and an enrichment in cardiopulmonary residuals from a female-dominated post-COVID-19 syndrome with reduced mental health status. Conclusion 1 year after COVID-19, the burden of persistent symptoms, impaired lung function, radiological abnormalities remains high in our study population. Yet, three recovery trajectories are emerging, ranging from almost complete recovery to post-COVID-19 syndrome with impaired mental health.
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Affiliation(s)
- Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
- Data Analytics as a Service Tirol, Innsbruck, Austria
| | - Anna K. Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabine Koppelstätter
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Malte Asshoff
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Maximilian Coen
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Pfeifer
- Division for Health Networking and Telehealth, Biomedical Informatics and Mechatronics, UMIT, Hall in Tyrol, Austria
| | - Verena Rass
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Gregor Hörmann
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St Vinzenz Hospital, Zams, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
- Corresponding author: Thomas Sonnweber ()
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
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Sonnweber T, Grubwieser P, Pizzini A, Boehm A, Sahanic S, Luger A, Schwabl C, Widmann G, Egger A, Hoermann G, Wöll E, Puchner B, Kaser S, Theurl I, Nairz M, Tymoszuk P, Weiss G, Joannidis M, Löffler-Ragg J, Tancevski I. Pulmonary recovery from COVID-19 in patients with metabolic diseases: a longitudinal prospective cohort study. Sci Rep 2023; 13:2599. [PMID: 36788324 PMCID: PMC9926446 DOI: 10.1038/s41598-023-29654-1] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
The severity of coronavirus disease 2019 (COVID-19) is related to the presence of comorbidities including metabolic diseases. We herein present data from the longitudinal prospective CovILD trial, and investigate the recovery from COVID-19 in individuals with dysglycemia and dyslipidemia. A total of 145 COVID-19 patients were prospectively followed and a comprehensive clinical, laboratory and imaging assessment was performed at 60, 100, 180, and 360 days after the onset of COVID-19. The severity of acute COVID-19 and outcome at early post-acute follow-up were significantly related to the presence of dysglycemia and dyslipidemia. Still, at long-term follow-up, metabolic disorders were not associated with an adverse pulmonary outcome, as reflected by a good recovery of structural lung abnormalities in both, patients with and without metabolic diseases. To conclude, dyslipidemia and dysglycemia are associated with a more severe course of acute COVID-19 as well as delayed early recovery but do not impair long-term pulmonary recovery.
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Affiliation(s)
- Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| | - Philipp Grubwieser
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Bernhard Puchner
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
- The Karl Landsteiner Institute, Reha Zentrum Münster, Münster, Austria
| | - Susanne Kaser
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Igor Theurl
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
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7
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Sviridenko A, Boehm A, di Santo G, Uprimny C, Nilica B, Fritz J, Giesel FL, Haberkorn U, Sahanic S, Decristoforo C, Tancevski I, Widmann G, Loeffler-Ragg J, Virgolini I. Enhancing Clinical Diagnosis for Patients With Persistent Pulmonary Abnormalities After COVID-19 Infection: The Potential Benefit of 68 Ga-FAPI PET/CT. Clin Nucl Med 2022; 47:1026-1029. [PMID: 36257062 PMCID: PMC9653058 DOI: 10.1097/rlu.0000000000004437] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PATIENTS AND METHODS Six post COVID-19 patients suspected for pulmonary fibrosis were scheduled for dual-tracer PET/CT with 18 F-FDG and 68 Ga-fibroblast activation protein inhibitor (FAPI)-46. The uptake of 68 Ga-FAPI-46 in the involved lung was compared with a control group of 9 non-COVID-19 patients. Clinical data and PET/CT imaging were collected and analyzed. RESULTS PET/CT revealed in all 6 pulmonary impaired patients the reduced glucose avidity on 18 F-FDG and clear positivity on 68 Ga-FAPI-46 PET/CT in comparison to the control group. CONCLUSIONS Enhancing fibrotic repair mechanisms, 68 Ga-FAPI PET/CT may improve noninvasive clinical diagnostic performance in patients with long-term CT abnormalities after severe COVID-19. Although this study shows promising results, additional studies in larger populations are required to establish a general diagnostic guideline.
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Affiliation(s)
| | | | | | | | | | - Josef Fritz
- Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Frederik L. Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg,Department of Nuclear Medicine, University Hospital Düsseldorf, Heinrich-Heine-University, Medical Faculty, Düsseldorf, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg
| | | | | | | | - Gerlig Widmann
- Department of Medical Statistic and Informatics, Medical University of Innsbruck, Innsbruck, Austria
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8
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Luger AK, Sonnweber T, Gruber L, Schwabl C, Cima K, Tymoszuk P, Gerstner AK, Pizzini A, Sahanic S, Boehm A, Coen M, Strolz CJ, Wöll E, Weiss G, Kirchmair R, Feuchtner GM, Prosch H, Tancevski I, Löffler-Ragg J, Widmann G. Chest CT of Lung Injury 1 Year after COVID-19 Pneumonia: The CovILD Study. Radiology 2022; 304:462-470. [PMID: 35348379 PMCID: PMC8988857 DOI: 10.1148/radiol.211670] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background The long-term pulmonary sequelae of COVID-19 is not well known. Purpose To characterize patterns and rates of improvement of chest CT
abnormalities 1 year after COVID-19 pneumonia. Materials and Methods This was a secondary analysis of a prospective, multicenter observational
cohort study conducted from April 29 to August 12, 2020, to assess
pulmonary abnormalities at chest CT approximately 2, 3, and 6 months and
1 year after onset of COVID-19 symptoms. Pulmonary findings were graded
for each lung lobe using a qualitative CT severity score (CTSS) ranging
from 0 (normal) to 25 (all lobes involved). The association of
demographic and clinical factors with CT abnormalities after 1 year was
assessed with logistic regression. The rate of change of the CTSS at
follow-up CT was investigated by using the Friedmann test. Results Of 142 enrolled participants, 91 underwent a 1-year follow-up CT
examination and were included in the analysis (mean age, 59 years
± 13 [SD]; 35 women [38%]). In 49 of 91 (54%) participants, CT
abnormalities were observed: 31 of 91 (34%) participants showed subtle
subpleural reticulation, ground-glass opacities, or both, and 18 of 91
(20%) participants had extensive ground-glass opacities, reticulations,
bronchial dilation, microcystic changes, or a combination thereof. At
multivariable analysis, age of more than 60 years (odds ratio [OR], 5.8;
95% CI: 1.7, 24; P = .009), critical COVID-19 severity
(OR, 29; 95% CI: 4.8, 280; P < .001), and male
sex (OR, 8.9; 95% CI: 2.6, 36; P < .001) were
associated with persistent CT abnormalities at 1-year follow-up.
Reduction of CTSS was observed in participants at subsequent follow-up
CT (P < .001); during the study period, 49% (69
of 142) of participants had complete resolution of CT abnormalities.
Thirty-one of 49 (63%) participants with CT abnormalities showed no
further improvement after 6 months. Conclusion Long-term CT abnormalities were common 1 year after COVID-19
pneumonia. © RSNA, 2022 Online supplemental material is available for this
article. See also the editorial by Leung in this issue.
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Affiliation(s)
- Anna K Luger
- Department for Radiology, Medical University of Innsbruck, Austria
| | - Thomas Sonnweber
- Department for Radiology, Medical University of Innsbruck, Austria
| | - Leonhard Gruber
- Department for Radiology, Medical University of Innsbruck, Austria
| | | | - Katharina Cima
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Anna K Gerstner
- Department for Radiology, Medical University of Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Sabina Sahanic
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Anna Boehm
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Maximilian Coen
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Carola J Strolz
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Ewald Wöll
- Deptartment of Internal Medicine, St Vinzenz Hospital, Zams, Austria
| | - Günter Weiss
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Rudolf Kirchmair
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | | | - Helmut Prosch
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Ivan Tancevski
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck 6020, Austria
| | - Gerlig Widmann
- Department for Radiology, Medical University of Innsbruck, Austria
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9
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Sonnweber T, Tymoszuk P, Sahanic S, Boehm A, Pizzini A, Luger A, Schwabl C, Nairz M, Grubwieser P, Kurz K, Koppelstätter S, Aichner M, Puchner B, Egger A, Hoermann G, Wöll E, Weiss G, Widmann G, Tancevski I, Löffler-Ragg J. Investigating phenotypes of pulmonary COVID-19 recovery - a longitudinal observational prospective multicenter trial. eLife 2022; 11:72500. [PMID: 35131031 PMCID: PMC8896831 DOI: 10.7554/elife.72500] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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] [Received: 07/26/2021] [Accepted: 01/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background: The optimal procedures to prevent, identify, monitor, and treat long-term pulmonary sequelae of COVID-19 are elusive. Here, we characterized the kinetics of respiratory and symptom recovery following COVID-19. Methods: We conducted a longitudinal, multicenter observational study in ambulatory and hospitalized COVID-19 patients recruited in early 2020 (n = 145). Pulmonary computed tomography (CT) and lung function (LF) readouts, symptom prevalence, and clinical and laboratory parameters were collected during acute COVID-19 and at 60, 100, and 180 days follow-up visits. Recovery kinetics and risk factors were investigated by logistic regression. Classification of clinical features and participants was accomplished by unsupervised and semi-supervised multiparameter clustering and machine learning. Results: At the 6-month follow-up, 49% of participants reported persistent symptoms. The frequency of structural lung CT abnormalities ranged from 18% in the mild outpatient cases to 76% in the intensive care unit (ICU) convalescents. Prevalence of impaired LF ranged from 14% in the mild outpatient cases to 50% in the ICU survivors. Incomplete radiological lung recovery was associated with increased anti-S1/S2 antibody titer, IL-6, and CRP levels at the early follow-up. We demonstrated that the risk of perturbed pulmonary recovery could be robustly estimated at early follow-up by clustering and machine learning classifiers employing solely non-CT and non-LF parameters. Conclusions: The severity of acute COVID-19 and protracted systemic inflammation is strongly linked to persistent structural and functional lung abnormality. Automated screening of multiparameter health record data may assist in the prediction of incomplete pulmonary recovery and optimize COVID-19 follow-up management. Funding: The State of Tyrol (GZ 71934), Boehringer Ingelheim/Investigator initiated study (IIS 1199-0424). Clinical trial number: ClinicalTrials.gov: NCT04416100
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Affiliation(s)
- Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Grubwieser
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabine Koppelstätter
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Aichner
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
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10
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Sahanic S, Tymoszuk P, Ausserhofer D, Rass V, Pizzini A, Nordmeyer G, Hüfner K, Kurz K, Weber PM, Sonnweber T, Boehm A, Aichner M, Cima K, Boeckle B, Holzner B, Rumpold G, Puelacher C, Kiechl S, Huber A, Wiedermann CJ, Sperner-Unterweger B, Tancevski I, Bellmann-Weiler R, Bachler H, Piccoliori G, Helbok R, Weiss G, Loeffler-Ragg J. Phenotyping of acute and persistent COVID-19 features in the outpatient setting: exploratory analysis of an international cross-sectional online survey. Clin Infect Dis 2021; 75:e418-e431. [PMID: 34849652 PMCID: PMC8767855 DOI: 10.1093/cid/ciab978] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long COVID, defined as presence of COVID-19 symptoms 28 days or more after clinical onset, is an emerging challenge to healthcare systems. The objective of this study was to explore recovery phenotypes in non-hospitalized COVID-19 individuals. METHODS A dual cohort, online survey study was conducted between September 2020 and July 2021 in the neighboring European regions Tyrol (TY, Austria, n = 1157) and South Tyrol (STY, Italy, n = 893). Data on demographics, comorbidities, COVID-19 symptoms and recovery adult outpatients were collected. Phenotypes of acute COVID-19, post-acute sequelae and risk of protracted recovery were explored by semi-supervised clustering and multi-parameter LASSO modeling. RESULTS Working age subjects (TY: 43 yrs (IQR: 31 – 53), STY: 45 yrs (IQR: 35 – 55)) and females (TY: 65.1%, STY: 68.3%) predominated the study cohorts. Nearly half of the participants (TY: 47.6%, STY: 49.3%) reported symptom persistence beyond 28 days. Two acute COVID-19 phenotypes were discerned: the non-specific infection phenotype and the multi-organ phenotype (MOP). Acute MOP symptoms encompassing multiple neurological, cardiopulmonary, gastrointestinal and dermatological complaints were linked to elevated risk of protracted recovery. The major subset of long COVID individuals (TY: 49.3%, STY: 55.6%) displayed no persistent hyposmia or hypogeusia but high counts of post-acute MOP symptoms and poor self-reported physical recovery. CONCLUSION The results of our two-cohort analysis delineated phenotypic diversity of acute and post-acute COVID-19 manifestations in home-isolated patients which needs to be considered for predicting protracted convalescence and allocation of medical resources.
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Affiliation(s)
- Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.,Data Analytics As a Service Tirol, Innsbruck, Austria
| | | | - Verena Rass
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Paulina Maria Weber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Aichner
- Department of Dermatology and Venereology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Cima
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Boeckle
- Department of Dermatology and Venereology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.,Evaluation Software Development, Innsbruck, Austria
| | - Gerhard Rumpold
- Evaluation Software Development, Innsbruck, Austria.,Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Puelacher
- REHA-MED Tirol, Center for outpatient cardiac and pulmonary rehabilitation, Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Huber
- Tyrolean Federal Institute for Integrated Care, Innsbruck, Austria
| | | | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Bachler
- Institute of General Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
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11
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Boehm A, Luger AK, Schmitz K, Cima K, Patscheider DH, Augustin F, Jakob LM, Obermayer A, Weiss G, Stoiber W, Widmann G, Loeffler-Ragg J. A spark of hope: histopathological and functional recovery after critical COVID-19. Infection 2021; 50:263-267. [PMID: 34435313 PMCID: PMC8386898 DOI: 10.1007/s15010-021-01678-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/05/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND There are substantial concerns about fibrotic and vascular pulmonary sequelae after coronavirus disease 2019 (COVID-19) associated acute respiratory distress syndrome (ARDS).AQ1 Histopathology reports of lung biopsies from COVID-19 survivors are scarce. CASE We herein report results of functional and histopathological studies in a 70 year-old man undergoing a co-incidental tumor lobectomy six months after long-term mechanical ventilation for COVID-19 pneumonia. CONCLUSION Despite several unfavorable risk factors, this case presentation shows a completed pulmonary recovery process within a few months.
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Affiliation(s)
- Anna Boehm
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Anna K Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Katharina Cima
- Department of Pneumology, Tirol Kliniken, Hospital Hochzirl-Natters, Natters, Austria
| | | | - Florian Augustin
- Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Lisa Maria Jakob
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Astrid Obermayer
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Walter Stoiber
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
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12
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Laumer IB, Massen JJM, Boehm PM, Boehm A, Geisler A, Auersperg AMI. Individual Goffin´s cockatoos (Cacatua goffiniana) show flexible targeted helping in a tool transfer task. PLoS One 2021; 16:e0253416. [PMID: 34185776 PMCID: PMC8241052 DOI: 10.1371/journal.pone.0253416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/04/2021] [Indexed: 11/18/2022] Open
Abstract
Flexible targeted helping is considered an advanced form of prosocial behavior in hominoids, as it requires the actor to assess different situations that a conspecific may be in, and to subsequently flexibly satisfy different needs of that partner depending on the nature of those situations. So far, apart from humans such behaviour has only been experimentally shown in chimpanzees and in Eurasian jays. Recent studies highlight the prosocial tendencies of several bird species, yet flexible targeted helping remained untested, largely due to methodological issues as such tasks are generally designed around tool-use, and very few bird species are capable of tool-use. Here, we tested Goffin's cockatoos, which proved to be skilled tool innovators in captivity, in a tool transfer task in which an actor had access to four different objects/tools and a partner to one of two different apparatuses that each required one of these tools to retrieve a reward. As expected from this species, we recorded playful object transfers across all conditions. Yet, importantly and similar to apes, three out of eight birds transferred the correct tool more often in the test condition than in a condition that also featured an apparatus but no partner. Furthermore, one of these birds transferred that correct tool first more often before transferring any other object in the test condition than in the no-partner condition, while the other two cockatoos were marginally non-significantly more likely to do so. Additionally, there was no difference in the likelihood of the correct tool being transferred first for either of the two apparatuses, suggesting that these birds flexibly adjusted what to transfer based on their partner´s need. Future studies should focus on explanations for the intra-specific variation of this behaviour, and should test other parrots and other large-brained birds to see how this can be generalized across the class and to investigate the evolutionary history of this trait.
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Affiliation(s)
- I. B. Laumer
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
- Department of Anthropology, University of California, Los Angeles, Los Angeles, California, United States of America
| | - J. J. M. Massen
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
- Animal Behaviour and Cognition, Department of Biology, Utrecht University, Utrecht, the Netherlands
| | - P. M. Boehm
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
| | - A. Boehm
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
| | - A. Geisler
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
| | - A. M. I. Auersperg
- Messerli Research Institute, University of Veterinary Medicine, Vienna, Austria
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13
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Sonnweber T, Sahanic S, Pizzini A, Luger A, Schwabl C, Sonnweber B, Kurz K, Koppelstätter S, Haschka D, Petzer V, Boehm A, Aichner M, Tymoszuk P, Lener D, Theurl M, Lorsbach-Köhler A, Tancevski A, Schapfl A, Schaber M, Hilbe R, Nairz M, Puchner B, Hüttenberger D, Tschurtschenthaler C, Aßhoff M, Peer A, Hartig F, Bellmann R, Joannidis M, Gollmann-Tepeköylü C, Holfeld J, Feuchtner G, Egger A, Hoermann G, Schroll A, Fritsche G, Wildner S, Bellmann-Weiler R, Kirchmair R, Helbok R, Prosch H, Rieder D, Trajanoski Z, Kronenberg F, Wöll E, Weiss G, Widmann G, Löffler-Ragg J, Tancevski I. Cardiopulmonary recovery after COVID-19: an observational prospective multicentre trial. Eur Respir J 2021; 57:13993003.03481-2020. [PMID: 33303539 PMCID: PMC7736754 DOI: 10.1183/13993003.03481-2020] [Citation(s) in RCA: 261] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND After the 2002/2003 severe acute respiratory syndrome outbreak, 30% of survivors exhibited persisting structural pulmonary abnormalities. The long-term pulmonary sequelae of coronavirus disease 2019 (COVID-19) are yet unknown, and comprehensive clinical follow-up data are lacking. METHODS In this prospective, multicentre, observational study, we systematically evaluated the cardiopulmonary damage in subjects recovering from COVID-19 at 60 and 100 days after confirmed diagnosis. We conducted a detailed questionnaire, clinical examination, laboratory testing, lung function analysis, echocardiography and thoracic low-dose computed tomography (CT). RESULTS Data from 145 COVID-19 patients were evaluated, and 41% of all subjects exhibited persistent symptoms 100 days after COVID-19 onset, with dyspnoea being most frequent (36%). Accordingly, patients still displayed an impaired lung function, with a reduced diffusing capacity in 21% of the cohort being the most prominent finding. Cardiac impairment, including a reduced left ventricular function or signs of pulmonary hypertension, was only present in a minority of subjects. CT scans unveiled persisting lung pathologies in 63% of patients, mainly consisting of bilateral ground-glass opacities and/or reticulation in the lower lung lobes, without radiological signs of pulmonary fibrosis. Sequential follow-up evaluations at 60 and 100 days after COVID-19 onset demonstrated a vast improvement of symptoms and CT abnormalities over time. CONCLUSION A relevant percentage of post-COVID-19 patients presented with persisting symptoms and lung function impairment along with radiological pulmonary abnormalities >100 days after the diagnosis of COVID-19. However, our results indicate a significant improvement in symptoms and cardiopulmonary status over time.
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Affiliation(s)
- Thomas Sonnweber
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.,Contributed equally as first authors
| | - Sabina Sahanic
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.,Contributed equally as first authors
| | - Alex Pizzini
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Luger
- Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Katharina Kurz
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabine Koppelstätter
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - David Haschka
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Verena Petzer
- Dept of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Aichner
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Piotr Tymoszuk
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniela Lener
- Dept of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
| | - Markus Theurl
- Dept of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Amra Tancevski
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Schapfl
- Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria
| | - Marc Schaber
- Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria
| | - Richard Hilbe
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Manfred Nairz
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Puchner
- The Karl Landsteiner Institute, Reha Zentrum Münster, Münster, Austria
| | - Doris Hüttenberger
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Malte Aßhoff
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Peer
- Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Frank Hartig
- Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Romuald Bellmann
- Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Dept of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Johannes Holfeld
- Dept of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Gudrun Feuchtner
- Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
| | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria.,Dept of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,MLL Munich Leukemia Laboratory, Munich, Germany
| | - Andrea Schroll
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gernot Fritsche
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sophie Wildner
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Rudolf Kirchmair
- Dept of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.,The Karl Landsteiner Institute, Reha Zentrum Münster, Münster, Austria
| | - Raimund Helbok
- Dept of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helmut Prosch
- Dept of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Dietmar Rieder
- Institute for Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Zlatko Trajanoski
- Institute for Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ewald Wöll
- Dept of Internal Medicine, St Vinzenz Hospital, Zams, Austria
| | - Günter Weiss
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerlig Widmann
- Dept of Radiology, Medical University of Innsbruck, Innsbruck, Austria.,Contributed equally to this article as lead authors and supervised the work
| | - Judith Löffler-Ragg
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.,Contributed equally to this article as lead authors and supervised the work
| | - Ivan Tancevski
- Dept of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.,Contributed equally to this article as lead authors and supervised the work
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14
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Boehm A, Aichner M, Sonnweber T, Tancevski I, Fischer T, Sahanic S, Joannidis M, Weiss G, Pizzini A, Loeffler-Ragg J. COPD exacerbations are related to poor air quality in Innsbruck: A retrospective pilot study. Heart Lung 2021; 50:499-503. [PMID: 33836440 DOI: 10.1016/j.hrtlng.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/13/2020] [Revised: 01/31/2021] [Accepted: 02/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Triggers of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are diverse, potentially including airborne pollutants. OBJECTIVES To analyze whether daily air pollution levels correlate with AECOPD frequency. METHODS In this retrospective pilot-study, AECOPD frequency was recorded between 2010 and 2016 at the University Hospital of Innsbruck's emergency department and correlated with daily air quality parameters. Data was compared to pulmonary embolism (PE) frequency, a disease not directly involving the airways. RESULTS In total, 669 AECOPD and 857 PE events were registered. Days with AECOPD revealed significantly higher concentrations of CO and SO2, whereas days with PE displayed an elevation of NO. Higher frequencies of AECOPD during winter months correlated with higher CO and SO2 levels, disclosing a seasonal trend, while no such pattern was observed for PE. CONCLUSION Air pollution is linked to AECOPD frequency, however, prospective studies are needed to confirm this possible, underrecognized trigger of AECOPD.
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Affiliation(s)
- Anna Boehm
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Magdalena Aichner
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Thomas Sonnweber
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Ivan Tancevski
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Thomas Fischer
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Sabina Sahanic
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Guenter Weiss
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Alex Pizzini
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
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15
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Winter T, Boehm A, Presser V, Gallei M. Dye-Loaded Mechanochromic and pH-Responsive Elastomeric Opal Films. Macromol Rapid Commun 2020; 42:e2000557. [PMID: 33251645 DOI: 10.1002/marc.202000557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 09/27/2020] [Revised: 10/19/2020] [Indexed: 01/30/2023]
Abstract
In this work, the preparation and fabrication of elastomeric opal films revealing reversible mechanochromic and pH-responsive features are reported. The core-interlayer-shell (CIS) particles are synthesized via stepwise emulsion polymerization leading to hard core (polystyrene), crosslinked interlayer (poly(methyl methacrylate-co-allyl methacrylate), and soft poly(ethyl acrylate-co-butyl acrylate-co-(2-hydroxyethyl) methacrylate) shell particles featuring a size of 294.9 ± 14.8 nm. This particle architecture enables the application of the melt-shear organization technique leading to elastomeric opal films with orange, respectively, green brilliant reflection colors dependent on the angle of view. Moreover, the hydroxyl moieties as part of the particle shell are advantageously used for subsequent thermally induced crosslinking reactions enabling the preparation of reversibly tunable mechanochromic structural colors based on Bragg's law of diffraction. Additionally, the CIS particles can be loaded upon extrusion or chemically by a postfunctionalization strategy with organic dyes implying pH-responsive features. This convenient protocol for preparing multi-responsive, reversibly stretch-tunable opal films is expected to enable a new material family for anti-counterfeiting applications based on external triggers.
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Affiliation(s)
- Tamara Winter
- Ernst-Berl-Institute of Chemical Engineering and Macromolecular Chemistry, Technische Universität Darmstadt, Alarich-Weiss-Straße 4, Darmstadt, 64287, Germany.,Department of Materials Science and Engineering, Saarland University, Campus D2 2, Saarbrücken, 66123, Germany
| | - Anna Boehm
- Chair in Polymer Chemistry, Saarland University, Campus Saarbrücken C4 2, Saarbrücken, 66123, Germany
| | - Volker Presser
- Department of Materials Science and Engineering, Saarland University, Campus D2 2, Saarbrücken, 66123, Germany.,INM - Leibniz-Institute for New Materials, Campus D2 2, Saarbrücken, 66123, Germany
| | - Markus Gallei
- Chair in Polymer Chemistry, Saarland University, Campus Saarbrücken C4 2, Saarbrücken, 66123, Germany
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16
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Sonnweber T, Boehm A, Sahanic S, Pizzini A, Aichner M, Sonnweber B, Kurz K, Koppelstätter S, Haschka D, Petzer V, Hilbe R, Theurl M, Lehner D, Nairz M, Puchner B, Luger A, Schwabl C, Bellmann-Weiler R, Wöll E, Widmann G, Tancevski I, Judith-Löffler-Ragg, Weiss G. Persisting alterations of iron homeostasis in COVID-19 are associated with non-resolving lung pathologies and poor patients' performance: a prospective observational cohort study. Respir Res 2020; 21:276. [PMID: 33087116 PMCID: PMC7575703 DOI: 10.1186/s12931-020-01546-2] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [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] [Received: 09/01/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Severe coronavirus disease 2019 (COVID-19) is frequently associated with hyperinflammation and hyperferritinemia. The latter is related to increased mortality in COVID-19. Still, it is not clear if iron dysmetabolism is mechanistically linked to COVID-19 pathobiology. METHODS We herein present data from the ongoing prospective, multicentre, observational CovILD cohort study (ClinicalTrials.gov number, NCT04416100), which systematically follows up patients after COVID-19. 109 participants were evaluated 60 days after onset of first COVID-19 symptoms including clinical examination, chest computed tomography and laboratory testing. RESULTS We investigated subjects with mild to critical COVID-19, of which the majority received hospital treatment. 60 days after disease onset, 30% of subjects still presented with iron deficiency and 9% had anemia, mostly categorized as anemia of inflammation. Anemic patients had increased levels of inflammation markers such as interleukin-6 and C-reactive protein and survived a more severe course of COVID-19. Hyperferritinemia was still present in 38% of all individuals and was more frequent in subjects with preceding severe or critical COVID-19. Analysis of the mRNA expression of peripheral blood mononuclear cells demonstrated a correlation of increased ferritin and cytokine mRNA expression in these patients. Finally, persisting hyperferritinemia was significantly associated with severe lung pathologies in computed tomography scans and a decreased performance status as compared to patients without hyperferritinemia. DISCUSSION Alterations of iron homeostasis can persist for at least two months after the onset of COVID-19 and are closely associated with non-resolving lung pathologies and impaired physical performance. Determination of serum iron parameters may thus be a easy to access measure to monitor the resolution of COVID-19. TRIAL REGISTRATION ClinicalTrials.gov number: NCT04416100.
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Affiliation(s)
- Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Magdalena Aichner
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Bettina Sonnweber
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Sabine Koppelstätter
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - David Haschka
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Verena Petzer
- Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Richard Hilbe
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Markus Theurl
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniela Lehner
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Bernhard Puchner
- Clinic for Rehabilitation Münster and Karl Landsteiner Institut für Interdisziplinäre Forschung am Reha Zentrum Münster, Münster, Austria
| | - Anna Luger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Schwabl
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Judith-Löffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. .,Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Innsbruck, Austria.
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17
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Demetz E, Tymoszuk P, Hilbe R, Volani C, Haschka D, Heim C, Auer K, Lener D, Zeiger LB, Pfeifhofer-Obermair C, Boehm A, Obermair GJ, Ablinger C, Coassin S, Lamina C, Kager J, Petzer V, Asshoff M, Schroll A, Nairz M, Dichtl S, Seifert M, von Raffay L, Fischer C, Barros-Pinkelnig M, Brigo N, Valente de Souza L, Sopper S, Hirsch J, Graber M, Gollmann-Tepeköylü C, Holfeld J, Halper J, Macheiner S, Gostner J, Vogel GF, Pechlaner R, Moser P, Imboden M, Marques-Vidal P, Probst-Hensch NM, Meiselbach H, Strauch K, Peters A, Paulweber B, Willeit J, Kiechl S, Kronenberg F, Theurl I, Tancevski I, Weiss G. The haemochromatosis gene Hfe and Kupffer cells control LDL cholesterol homeostasis and impact on atherosclerosis development. Eur Heart J 2020; 41:3949-3959. [PMID: 32227235 DOI: 10.1093/eurheartj/ehaa140] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/16/2019] [Accepted: 02/18/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS Imbalances of iron metabolism have been linked to the development of atherosclerosis. However, subjects with hereditary haemochromatosis have a lower prevalence of cardiovascular disease. The aim of our study was to understand the underlying mechanisms by combining data from genome-wide association study analyses in humans, CRISPR/Cas9 genome editing, and loss-of-function studies in mice. METHODS AND RESULTS Our analysis of the Global Lipids Genetics Consortium (GLGC) dataset revealed that single nucleotide polymorphisms (SNPs) in the haemochromatosis gene HFE associate with reduced low-density lipoprotein cholesterol (LDL-C) in human plasma. The LDL-C lowering effect could be phenocopied in dyslipidaemic ApoE-/- mice lacking Hfe, which translated into reduced atherosclerosis burden. Mechanistically, we identified HFE as a negative regulator of LDL receptor expression in hepatocytes. Moreover, we uncovered liver-resident Kupffer cells (KCs) as central players in cholesterol homeostasis as they were found to acquire and transfer LDL-derived cholesterol to hepatocytes in an Abca1-dependent fashion, which is controlled by iron availability. CONCLUSION Our results disentangle novel regulatory interactions between iron metabolism, KC biology and cholesterol homeostasis which are promising targets for treating dyslipidaemia but also provide a mechanistic explanation for reduced cardiovascular morbidity in subjects with haemochromatosis.
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Affiliation(s)
- Egon Demetz
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Richard Hilbe
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Chiara Volani
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - David Haschka
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Christiane Heim
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Kristina Auer
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Daniela Lener
- Department of Internal Medicine III, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Lucas B Zeiger
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Christa Pfeifhofer-Obermair
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Gerald J Obermair
- Department of Physiology and Medical Physics, Medical University of Innsbruck, Fritz-Pregl-Straße 3, 6020 Innsbruck, Austria
- Division of Physiology, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Cornelia Ablinger
- Department of Physiology and Medical Physics, Medical University of Innsbruck, Fritz-Pregl-Straße 3, 6020 Innsbruck, Austria
| | - Stefan Coassin
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Schöpfstraße 41, 6020 Innsbruck, Austria
| | - Claudia Lamina
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Schöpfstraße 41, 6020 Innsbruck, Austria
| | - Juliane Kager
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Verena Petzer
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Malte Asshoff
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Andrea Schroll
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Manfred Nairz
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Stefanie Dichtl
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Markus Seifert
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
- Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Innsbruck, Austria
| | - Laura von Raffay
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Christine Fischer
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Marina Barros-Pinkelnig
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Natascha Brigo
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Lara Valente de Souza
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
- Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Innsbruck, Austria
| | - Sieghart Sopper
- Department of Internal Medicine V, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Jakob Hirsch
- Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Michael Graber
- Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Can Gollmann-Tepeköylü
- Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Johannes Holfeld
- Department of Cardiac Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Julia Halper
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Sophie Macheiner
- Department of Internal Medicine I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Johanna Gostner
- Division of Medical Biochemistry, Medical University of Innsbruck, Innrain 80/IV, 6020 Innsbruck, Austria
| | - Georg F Vogel
- Department of Pediatrics I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Raimund Pechlaner
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Patrizia Moser
- Department of Pathology, Innsbruck University Hospital, Anichstraße 35, 6020 Innsbruck, Austria
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Socinstraße 57, 4051 Basel, Switzerland
- Department of Public Health, University of Basel, Bernoullistraße 28, 4056 Basel, Switzerland
| | - Pedro Marques-Vidal
- Department of Internal Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Nicole M Probst-Hensch
- Swiss Tropical and Public Health Institute, Socinstraße 57, 4051 Basel, Switzerland
- Department of Public Health, University of Basel, Bernoullistraße 28, 4056 Basel, Switzerland
| | - Heike Meiselbach
- Department of Nephrology and Hypertension, University Hospital Erlangen, Maximiliansplatz 2, 91054 Erlangen, Germany
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377 Munich, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- German Center for Diabetes Research, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- German Center for Cardiovascular Research, Lazarettstraße 36, 80636 Munich, Germany
| | - Bernhard Paulweber
- First Department of Medicine, Paracelsus Medical University Salzburg, Strubergasse 21, 5020 Salzburg, Austria
| | - Johann Willeit
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Florian Kronenberg
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Schöpfstraße 41, 6020 Innsbruck, Austria
| | - Igor Theurl
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
- Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Innsbruck, Austria
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18
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Beyer C, Pizzini A, Boehm A, Loeffler-Ragg J, Weiss G, Feuchtner G, Bauer A, Friedrich G, Plank F. Current symptom-based risk scores for stable coronary artery disease evaluation are not applicable in COPD patients. ERJ Open Res 2020; 6:00492-2020. [PMID: 33123555 PMCID: PMC7569160 DOI: 10.1183/23120541.00492-2020] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022] Open
Abstract
Background Cardiovascular diseases are arguably the most important comorbidity in patients with COPD. Despite an increased prevalence of coronary artery disease (CAD) in COPD patients, there are no dedicated diagnostic recommendations. Objectives We investigated whether COPD patients receive adequate primary evaluation of CAD despite overlapping symptoms. Methods In total, 302 patients with COPD who underwent invasive coronary angiography (ICA) were retrospectively matched (for age, body mass index and cardiovascular risk factors) with 302 patients without functional lung diseases. Quality and onset of symptoms prior to ICA were documented, and individual patients’ pretest probabilities according to European Society of Cardiology (ESC) guidelines were calculated. Endpoints were delay of ICA referral after symptom onset and clinical outcome, defined as subsequent revascularisation. Results Mean delay between symptom onset and ICA was 19.9±22.0 months in COPD patients compared to 8.3±12.7 months in the control group (p<0.0001). COPD patients had a lower rate of typical chest pain (25.2% versus 38.1%, p=0.0009), and dyspnoea only (18.2% versus 26.8%, p=0.015). Sub-analysis of Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades revealed an incremental delay with increasing COPD severity: GOLD 1: 16.1±17.3 months; GOLD 2: 17.6±22.1 months; GOLD 3: 20.1±21.3 months; and GOLD 4: 24.2±23.4 months. Overall significant CAD prevalence (>70% stenosis) was 35.3%; the revascularisation rate increased with higher pretest probability for the control group but decreased for patients with COPD GOLD 1–4. Conclusion Patients with COPD are insufficiently evaluated for CAD due to overlapping symptoms. Current CAD risk scores for stable chest pain appear inappropriate for patients with COPD. Coronary artery disease evaluation is delayed in COPD patients compared to patients without obstructive lung disease. Due to overlapping symptoms, pretest probabilities of current stable angina models do not fit patients with COPD.https://bit.ly/318RkNz
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Affiliation(s)
- Christoph Beyer
- Dept of Internal Medicine III - Cardiology and Angiology, Medical University Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Dept of Internal Medicine II - Infectious Diseases, Pneumology and Rheumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Dept of Internal Medicine II - Infectious Diseases, Pneumology and Rheumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Dept of Internal Medicine II - Infectious Diseases, Pneumology and Rheumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Dept of Internal Medicine II - Infectious Diseases, Pneumology and Rheumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Gudrun Feuchtner
- Dept of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Axel Bauer
- Dept of Internal Medicine III - Cardiology and Angiology, Medical University Innsbruck, Innsbruck, Austria
| | - Guy Friedrich
- Dept of Internal Medicine III - Cardiology and Angiology, Medical University Innsbruck, Innsbruck, Austria
| | - Fabian Plank
- Dept of Internal Medicine III - Cardiology and Angiology, Medical University Innsbruck, Innsbruck, Austria
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Sahanic S, Boehm A, Pizzini A, Sonnweber T, Aichner M, Weiss G, Loeffler-Ragg J, Tancevski I. Assessing self-medication for obstructive airway disease during COVID-19 using Google Trends. Eur Respir J 2020; 56:13993003.02851-2020. [PMID: 32943405 PMCID: PMC7674776 DOI: 10.1183/13993003.02851-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/07/2020] [Indexed: 11/27/2022]
Abstract
COPD is a leading cause of morbidity and mortality worldwide, affecting approximately 294 million people worldwide, and accounting for over 3 million deaths annually. Similarly, asthma affects approximately 268 million people worldwide, leading to an enormous health burden [1]. With the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) set a main emphasis on recommendations focused on the regular use of bronchodilator maintenance therapy, and the Global Initiative for Asthma (GINA) guidelines 2020 explicitly state that inhaler therapy, especially the maintenance therapy with inhaled corticosteroids (ICS), should not be interrupted during the pandemic [2, 3]. Google Trends reveals public information-seeking for self-medication in patients with obstructive respiratory disease during the COVID-19 outbreak, illustrating the urgent need to implement digital health support in patients with respiratory diseasehttps://bit.ly/2GRccSU
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Affiliation(s)
- Sabina Sahanic
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria.,S. Sahanic and A. Boehm contributed equally to this manuscript
| | - Anna Boehm
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria.,S. Sahanic and A. Boehm contributed equally to this manuscript
| | - Alex Pizzini
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Aichner
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
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20
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Orthofer M, Valsesia A, Mägi R, Wang QP, Kaczanowska J, Kozieradzki I, Leopoldi A, Cikes D, Zopf LM, Tretiakov EO, Demetz E, Hilbe R, Boehm A, Ticevic M, Nõukas M, Jais A, Spirk K, Clark T, Amann S, Lepamets M, Neumayr C, Arnold C, Dou Z, Kuhn V, Novatchkova M, Cronin SJF, Tietge UJF, Müller S, Pospisilik JA, Nagy V, Hui CC, Lazovic J, Esterbauer H, Hagelkruys A, Tancevski I, Kiefer FW, Harkany T, Haubensak W, Neely GG, Metspalu A, Hager J, Gheldof N, Penninger JM. Identification of ALK in Thinness. Cell 2020; 181:1246-1262.e22. [PMID: 32442405 DOI: 10.1016/j.cell.2020.04.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 01/28/2020] [Accepted: 04/20/2020] [Indexed: 12/25/2022]
Abstract
There is considerable inter-individual variability in susceptibility to weight gain despite an equally obesogenic environment in large parts of the world. Whereas many studies have focused on identifying the genetic susceptibility to obesity, we performed a GWAS on metabolically healthy thin individuals (lowest 6th percentile of the population-wide BMI spectrum) in a uniquely phenotyped Estonian cohort. We discovered anaplastic lymphoma kinase (ALK) as a candidate thinness gene. In Drosophila, RNAi mediated knockdown of Alk led to decreased triglyceride levels. In mice, genetic deletion of Alk resulted in thin animals with marked resistance to diet- and leptin-mutation-induced obesity. Mechanistically, we found that ALK expression in hypothalamic neurons controls energy expenditure via sympathetic control of adipose tissue lipolysis. Our genetic and mechanistic experiments identify ALK as a thinness gene, which is involved in the resistance to weight gain.
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Affiliation(s)
- Michael Orthofer
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Armand Valsesia
- Metabolic Phenotyping, Nestlé Research, EPFL Innovation Park, Lausanne 1015, Switzerland
| | - Reedik Mägi
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu 51010, Estonia
| | - Qiao-Ping Wang
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Guangzhou 510275, China
| | | | - Ivona Kozieradzki
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Alexandra Leopoldi
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Domagoj Cikes
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Lydia M Zopf
- Vienna BioCenter Core Facilities GmbH (VBCF), Vienna 1030, Austria
| | - Evgenii O Tretiakov
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Spitalgasse 4, Vienna 1090, Austria
| | - Egon Demetz
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck 6020, Austria
| | - Richard Hilbe
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck 6020, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck 6020, Austria
| | - Melita Ticevic
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Margit Nõukas
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu 51010, Estonia
| | - Alexander Jais
- Department of Laboratory Medicine, Medical University of Vienna, Vienna 1090, Austria
| | - Katrin Spirk
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna 1090, Austria
| | - Teleri Clark
- Dr. John and Anne Chong Lab for Functional Genomics, Charles Perkins Centre, Centenary Institute, and School of Life and Environmental Sciences, University of Sydney, Camperdown, NSW 2006, Australia
| | - Sabine Amann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna 1090, Austria
| | - Maarja Lepamets
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu 51010, Estonia
| | | | - Cosmas Arnold
- IMP, Institute of Molecular Pathology, Vienna 1030, Austria
| | - Zhengchao Dou
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Volker Kuhn
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck 6020, Austria
| | | | - Shane J F Cronin
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Uwe J F Tietge
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institute, 141 52 Huddinge, Sweden; Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Simone Müller
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
| | - J Andrew Pospisilik
- Center for Epigenetics, Van Andel Research Institute, Grand Rapids, MI 49503, USA
| | - Vanja Nagy
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, 1090 Vienna, Austria
| | - Chi-Chung Hui
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jelena Lazovic
- Vienna BioCenter Core Facilities GmbH (VBCF), Vienna 1030, Austria
| | - Harald Esterbauer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna 1090, Austria
| | - Astrid Hagelkruys
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Innsbruck Medical University, Innsbruck 6020, Austria
| | - Florian W Kiefer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna 1090, Austria
| | - Tibor Harkany
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Spitalgasse 4, Vienna 1090, Austria; Section for Chemical Neurotransmission, Department of Neuroscience, Biomedicum 7D, Solnavägen 9, 17165 Solna, Sweden
| | - Wulf Haubensak
- IMP, Institute of Molecular Pathology, Vienna 1030, Austria
| | - G Gregory Neely
- Dr. John and Anne Chong Lab for Functional Genomics, Charles Perkins Centre, Centenary Institute, and School of Life and Environmental Sciences, University of Sydney, Camperdown, NSW 2006, Australia
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu 51010, Estonia
| | - Jorg Hager
- Metabolic Phenotyping, Nestlé Research, EPFL Innovation Park, Lausanne 1015, Switzerland.
| | - Nele Gheldof
- Metabolic Phenotyping, Nestlé Research, EPFL Innovation Park, Lausanne 1015, Switzerland.
| | - Josef M Penninger
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna 1030, Austria; Department of Medical Genetics, Life Science Institute, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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Dietz A, Wichmann G, Kuhnt T, Pfreundner L, Hagen R, Scheich M, Kölbl O, Hautmann MG, Strutz J, Schreiber F, Bockmühl U, Schilling V, Feyer P, de Wit M, Maschmeyer G, Jungehülsing M, Schroeder U, Wollenberg B, Sittel C, Münter M, Lenarz T, Klussmann JP, Guntinas-Lichius O, Rudack C, Eich HT, Foerg T, Preyer S, Westhofen M, Welkoborsky HJ, Esser D, Thurnher D, Remmert S, Sudhoff H, Görner M, Bünzel J, Budach V, Held S, Knödler M, Lordick F, Wiegand S, Vogel K, Boehm A, Flentje M, Keilholz U. Induction chemotherapy (IC) followed by radiotherapy (RT) versus cetuximab plus IC and RT in advanced laryngeal/hypopharyngeal cancer resectable only by total laryngectomy-final results of the larynx organ preservation trial DeLOS-II. Ann Oncol 2019; 29:2105-2114. [PMID: 30412221 DOI: 10.1093/annonc/mdy332] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The German multicenter randomized phase II larynx organ preservation (LOP) trial DeLOS-II was carried out to prove the hypothesis that cetuximab (E) added to induction chemotherapy (IC) and radiotherapy improves laryngectomy-free survival (LFS; survival with preserved larynx) in locally advanced laryngeal/hypopharyngeal cancer (LHSCC). Patients and methods Treatment-naïve patients with stage III/IV LHSCC amenable to total laryngectomy (TL) were randomized to three cycles IC with TPF [docetaxel (T) and cisplatin (P) 75 mg/m2/day 1, 5-FU (F) 750 mg/m2/day days 1-5] followed by radiotherapy (69.6 Gy) without (A) or with (B) standard dose cetuximab for 16 weeks throughout IC and radiotherapy (TPFE). Response to first IC-cycle (IC-1) with ≥30% endoscopically estimated tumor surface shrinkage (ETSS) was used to define early responders; early salvage TL was recommended to non-responders. The primary objective was 24 months LFS above 35% in arm B. Results Of 180 patients randomized (July 2007 to September 2012), 173 fulfilled eligibility criteria (A/B: larynx 44/42, hypopharynx 41/46). Because of 4 therapy-related deaths among the first 64 randomized patients, 5-FU was omitted from IC in the subsequent 112 patients reducing further fatal toxicities. Thus, IC was TPF in 61 patients and TP in 112 patients, respectively. The primary objective (24 months LFS above 35%) was equally met by arms A (40/85, 47.1%) as well as B (41/88, 46.6%). One hundred and twenty-three early responders completed IC+RT; their overall response rates (TPF/TP) were 94.7%/87.2% in A versus 80%/86.0% in B. The 24 months overall survival (OS) rates were 68.2% and 69.3%. Conclusions Despite being accompanied by an elevated frequency in adverse events, the IC with TPF/TP plus cetuximab was feasible but showed no superiority to IC with TPF/TP regarding LFS and OS at 24 months. Both early response and 24 months LFS compare very well to previous LOP trials and recommend effective treatment selection and stratification by ETSS. Clinical trial information NCT00508664.
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Affiliation(s)
- A Dietz
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany.
| | - G Wichmann
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - T Kuhnt
- Department of Radiation Oncology, University Leipzig, Leipzig, Germany
| | - L Pfreundner
- Department of Radiation Oncology, University Würzburg, Würzburg, Germany
| | - R Hagen
- Department of Otolaryngology, Head and Neck Surgery, University Würzburg, Würzburg, Germany
| | - M Scheich
- Department of Otolaryngology, Head and Neck Surgery, University Würzburg, Würzburg, Germany
| | - O Kölbl
- Department of Radiation Oncology, University Regensburg, Regensburg, Germany
| | - M G Hautmann
- Department of Radiation Oncology, University Regensburg, Regensburg, Germany
| | - J Strutz
- Department of Otolaryngology, Head and Neck Surgery, University Regensburg, Regensburg, Germany
| | - F Schreiber
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Kassel, Kassel, Germany
| | - U Bockmühl
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Kassel, Kassel, Germany
| | - V Schilling
- Department of Otolaryngology, Head and Neck Surgery, Vivantes, Berlin, Neukölln, Germany
| | - P Feyer
- Department of Radiation Oncology, Vivantes, Berlin, Neukölln, Germany
| | - M de Wit
- Department of Hemato-Oncology, Vivantes, Berlin, Neukölln, Germany
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - M Jungehülsing
- Department of Otolaryngology, Head and Neck Surgery, Potsdam Klinikum, Potsdam, Germany
| | - U Schroeder
- Department of Otolaryngology, Head and Neck Surgery, University Lübeck, Lübeck, Germany
| | - B Wollenberg
- Department of Otolaryngology, Head and Neck Surgery, University Lübeck, Lübeck, Germany
| | - C Sittel
- Department of Otolaryngology, Head and Neck Surgery, Katharinen Hospital, Stuttgart, Germany
| | - M Münter
- Department of Radiation Oncology, Katharinen Hospital, Stuttgart, Germany
| | - T Lenarz
- Department of Otolaryngology, Head and Neck Surgery, MHH Hannover, Hannover, Germany
| | - J P Klussmann
- Department of Otolaryngology, Head and Neck Surgery, University Gießen, Gießen, Germany
| | - O Guntinas-Lichius
- Department of Otolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany
| | - C Rudack
- Department of Otolaryngology, Head and Neck Surgery, University Münster, Münster, Germany
| | - H T Eich
- Department of Radiation Oncology, University Münster, Münster, Germany
| | - T Foerg
- Department of Radiation Oncology, Head and Neck Surgery, St. Vincentius, ViDia Christliche Kliniken Karlsruhe, Karlsruhe, Germany
| | - S Preyer
- Department of Otolaryngology, Head and Neck Surgery, St. Vincentius, ViDia Christliche Kliniken Karlsruhe, Karlsruhe, Germany
| | - M Westhofen
- Department of Otolaryngology, Head and Neck Surgery, University Aachen, Aachen, Germany
| | - H J Welkoborsky
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Nordstadt, Hannover, Germany
| | - D Esser
- Department of Otolaryngology, Head and Neck Surgery, Helios Klinikum, Erfurt, Germany
| | - D Thurnher
- Department of Otolaryngology, Head and Neck Surgery, University Graz, Graz, Austria
| | - S Remmert
- Department of Otolaryngology, Head and Neck Surgery, Malteser Hospital Duisburg, Duisburg, Germany
| | - H Sudhoff
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - M Görner
- Department of Hemato-Oncology, Klinikum Bielefeld, Bielefeld, Germany
| | - J Bünzel
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Nordhausen, Nordhausen, Germany
| | - V Budach
- Department of Radiation Oncology, CCC, Charité-University Medicine, Berlin, Germany
| | - S Held
- ClinAssess GmbH, Leverkusen, Germany
| | - M Knödler
- Department of Oncology, University Cancer Center Leipzig (UCCL), Leipzig, Germany
| | - F Lordick
- Department of Oncology, University Cancer Center Leipzig (UCCL), Leipzig, Germany
| | - S Wiegand
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - K Vogel
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - A Boehm
- Department of Otolaryngology, Head and Neck Surgery, St. Georg Hospital Leipzig, Leipzig, Germany
| | - M Flentje
- Department of Radiation Oncology, University Würzburg, Würzburg, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Berlin, Germany
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Boehm A, Pizzini A, Sonnweber T, Loeffler-Ragg J, Lamina C, Weiss G, Tancevski I. Using Google Trends to investigate global COPD awareness. Eur Respir J 2019; 54:54/2/1901339. [PMID: 31395673 DOI: 10.1183/13993003.01339-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 07/09/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Anna Boehm
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Innsbruck Medical University, Innsbruck, Austria.,A. Boehm and A. Pizzini contributed equally to this manuscript
| | - Alex Pizzini
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Innsbruck Medical University, Innsbruck, Austria .,A. Boehm and A. Pizzini contributed equally to this manuscript
| | - Thomas Sonnweber
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Innsbruck Medical University, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Innsbruck Medical University, Innsbruck, Austria
| | - Claudia Lamina
- Division of Genetic Epidemiology, Innsbruck Medical University, Innsbruck, Austria
| | - Guenter Weiss
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Innsbruck Medical University, Innsbruck, Austria
| | - Ivan Tancevski
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Innsbruck Medical University, Innsbruck, Austria
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Boehm A, Pizzini A, Sonnweber T, Loeffler-Ragg J, Lamina C, Weiss G, Tancevski I. Assessing global COPD awareness with Google Trends. Eur Respir J 2019; 53:13993003.00351-2019. [PMID: 31097517 DOI: 10.1183/13993003.00351-2019] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/23/2019] [Indexed: 12/31/2022]
Abstract
Although chronic obstructive pulmonary disease (COPD) prevalence and mortality rates rise continuously, patients often remain undiagnosed, probably due to a lack of disease-related awareness. The aim of this study was to quantify public interest in COPD by analysing the frequency of web queries via Google.Data from 2004 to 2018 were collected using the search engine query data analysis tool Google Trends. The relative search volume of the topic "chronic obstructive pulmonary disease" was compared with the relative search volume of nine topics representing the major causes of death in high-income countries according to the World Health Organization.Our analysis showed highest relative search volumes for the topics "diabetes mellitus", followed by "stroke" and "breast cancer". The topic "chronic obstructive pulmonary disease" ranked eighth and its relative search volume clearly displayed a seasonal variation, with peaks in the first and the fourth quarter of the year.This analysis reveals that COPD is highly under-represented in the public interest, while real-world prevalence constantly rises, indicating that there is still an urgent need to raise the levels of awareness for COPD.
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Affiliation(s)
- Anna Boehm
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria.,These two authors contributed equally to this work
| | - Alex Pizzini
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria .,These two authors contributed equally to this work
| | - Thomas Sonnweber
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Claudia Lamina
- Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Dept of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
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Wolf R, Grammbauer S, Boehm A, Jedlitschky G, Rauch BH. P6067Specific inhibition of MRP4/ABCC4 decreases calcium influx and glycoprotein IIb/IIIa activation in human platelets. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Wolf
- University Medicine of Greifswald, Department of Pharmacology, Greifswald, Germany
| | - S Grammbauer
- University Medicine of Greifswald, Department of Pharmacology, Greifswald, Germany
| | - A Boehm
- University Medicine of Greifswald, Department of Pharmacology, Greifswald, Germany
| | - G Jedlitschky
- University Medicine of Greifswald, Department of Pharmacology, Greifswald, Germany
| | - B H Rauch
- University Medicine of Greifswald, Department of Pharmacology, Greifswald, Germany
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Moritz E, Witschel V, Luehr J, Joseph C, Boehm A, Rauch BH. P1845The pro-inflammatory signaling lipid sphingosine-1-phosphate regulates gene and protein expression of both tissue factor and plasminogen activator inhibitor-1 in differentiated fat cells. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1845] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Moritz
- University Medicine of Greifswald, Institute of Pharmacology, Greifswald, Germany
| | - V Witschel
- University Medicine of Greifswald, Institute of Pharmacology, Greifswald, Germany
| | - J Luehr
- University Medicine of Greifswald, Institute of Pharmacology, Greifswald, Germany
| | - C Joseph
- University Medicine of Greifswald, Institute of Pharmacology, Greifswald, Germany
| | - A Boehm
- University Medicine of Greifswald, Institute of Pharmacology, Greifswald, Germany
| | - B H Rauch
- University Medicine of Greifswald, Institute of Pharmacology, Greifswald, Germany
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Boehm A, Bruyère F. [Dermato-urology: Male genital lesions urologist should know]. Prog Urol 2018; 28:251-281. [PMID: 29428190 DOI: 10.1016/j.purol.2018.01.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/13/2017] [Accepted: 01/02/2018] [Indexed: 10/18/2022]
Abstract
This article aimed to gather male genital dermatoses that may lead to consult a urologist, except pre-neoplastic or neoplastic lesion. METHOD This review is based on a research on Pubmed and EM-consult database, in English and in French, using the following key terms "male genital dermatoses", "male genital lesions", "balanitis", "balanoposthitis", "dermatoses des organes génitaux externes masculines", "lésions des organes génitaux externes de l'homme", "balanoposthites". RESULTS It highlights normal morphological aspects, acute balanoposthitis (nonspecific, infectious, allergic, irritative and traumatic), common skin disease localized to male genital and male genital specific dermatoses. CONCLUSION Any suspicious, fixed, must lead to a skin biopsy.
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Affiliation(s)
- A Boehm
- Service d'urologie, CHRU de Tours, université François-Rabelais, 37000 Tours, France.
| | - F Bruyère
- Service d'urologie, CHRU de Tours, université François-Rabelais, 37000 Tours, France; Université François-Rabelais de Tours, PRES centre Val-de-Loire, 37000 Tours, France
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Siegel F, Boehm A, Brun M, Colombo S, Imboden D, Martin C, Ngo T, Retaux X, Reuter M, Weill M. Engager le dialogue RPS dans les PE ou TPE. ARCH MAL PROF ENVIRO 2017. [DOI: 10.1016/j.admp.2017.06.033] [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: 10/18/2022]
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Garnier M, Champeaux E, Laurent E, Boehm A, Briard O, Wachter T, Vaillant L, Patat F, Bens G, Machet L. High-frequency ultrasound quantification of acute radiation dermatitis: pilot study of patients undergoing radiotherapy for breast cancer. Skin Res Technol 2017; 23:602-606. [PMID: 28513053 DOI: 10.1111/srt.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acute radiation dermatitis (ARD) is a frequent complication after breast cancer radiotherapy and is usually assessed by semi-quantitative clinical scores, which may be subject to inter-observer variability. High-frequency ultrasound imaging of the skin can reliably quantify thickness and edema in diseased skin. We aimed to compare the relative increase in dermal thickness of the irradiated zone in breast-cancer patients undergoing radiotherapy, with clinical severity. METHODS A consecutive series of patients undergoing treatment for breast cancer by lumpectomy and radiotherapy in a 6-month period also underwent clinical and ultrasound evaluation of ARD. RESULTS We included 34 female patients 17 had grade 1 (group 1), 17 had grade 2 or grade 3 ARD (group 2). The mean relative increase in dermal thickness in irradiated skin (RIDTIS) was greater for group 2 than 1: 0.53 vs 0.29 mm (P=.023). On univariate analysis, ARD was associated with skin phototype, breast volume and RIDTIS, and on multivariable analysis, breast volume and age remained predictive of the disease. CONCLUSION Patients with more severe dermatitis showed significantly increased dermal thickness. Dermal thickness is a quantitative variable that could help quantify the efficacy of drugs and improve the treatment of this disease in patients undergoing radiotherapy.
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Affiliation(s)
- M Garnier
- Department of Dermatology, CHRU Tours, Tours, France.,Department of Radiotherapy, CHR Orléans, Orléans, France
| | - E Champeaux
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - E Laurent
- Department of Epidemiology, CHRU Tours, Tours, France
| | - A Boehm
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - O Briard
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - T Wachter
- Department of Radiotherapy, CHR Orléans, Orléans, France
| | - L Vaillant
- Department of Dermatology, CHRU Tours, Tours, France.,Inserm U930, Université François-Rabelais de Tours, Tours, France
| | - F Patat
- Inserm U930, Université François-Rabelais de Tours, Tours, France
| | - G Bens
- Department of Dermatology, CHR Orléans, Orléans, France
| | - L Machet
- Department of Dermatology, CHRU Tours, Tours, France.,Inserm U930, Université François-Rabelais de Tours, Tours, France
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Pradere B, Freton L, Olivier J, Langouet Q, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayotopoulos P, Betari R, Matillon X, Chebbi A, Caes T, Boehm A, Patard P, Szabla N, Brichart N, Sabourin L, Guleryuz K, Lebacle C, Rizk J, Gryn A, Nouhaud F, Madec F, Dariane C, Bensalah K, Fiard G, Peyronnet B. Incidence et facteur prédictifs des pseudo-anévrysmes au cours des traumatismes du rein : résultats de l’étude multicentrique nationale Traumafuf. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.259] [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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Diogo R, Purz S, Gawlitza M, Barthel H, Boehm A, Kahn T, Sabri O, Stumpp P. 18F-FDG-PET/CT und 18F-FDG-PET/MRT zur Diagnostik von HNO-Rezidivtumoren im Vergleich. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581591] [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: 10/22/2022]
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Surov A, Stumpp P, Meyer H, Gawlitza M, Höhn A, Boehm A, Sabri O, Kahn T, Purz S. Simultanes 18F-FDG-PET/MRT bei Patienten mit Plattenepithelkarzinom der Kopf-Hals-Region: Zusammenhänge zwischen funktioneller Bildgebung und histopathologischen Parametern. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581773] [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: 10/22/2022]
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Zebralla V, Pohle N, Singer S, Neumuth T, Dietz A, Stier-Jarmer M, Boehm A. [Introduction of the Screening Tool OncoFunction for Functional Follow-up of Head and Neck Patients]. Laryngorhinootologie 2015; 95:118-24. [PMID: 26190042 DOI: 10.1055/s-0035-1549858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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
INTRODUCTION The follow-up for head and neck cancer (HNC) focussed on therapy control. Accessory long term functionality is important. Impairment of function is observed, but a comparable documentation is not established. Additional we frequently see psychooncological comorbidities, what complicates the assessment. This was the reason why Tschiesner et al. developed on the base of the "ICF Core set for head and neck cancer" a guideline for the Assessment of Function in HNC. In consequence of good results in other tumour entities we developed an electronic version (OncoFunction). METHODS In a proof of concept study all patients of our follow up consultation from 07/13 to 03/14 were included. OncoFunction was given to patients in a digital form using tablet computers. The results were visible to the physician in a concentrated form before consultation and were supplemented by a physician questionnaire. Furthermore we evaluated the usability in 202 patients. RESULTS We had 682 patient contacts. 530 patient contacts (77, 7%) used the questionnaire. The physician questionnaire was answered in 470 times. Finally there are from 69.8% of the patient contacts full datasets available. Between users and non-users of the questionnaire we see no difference. CONCLUSION The use of a computer-based screening and feedback system (OncoFunction) in clinical use is feasible and excellent assessed by patients. The patient data are visible in a compact form for the physician and problems can clear addressed to the patient. One more benefit is the standardized follow up documentation and the use of comparable data in research.
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Affiliation(s)
- V Zebralla
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Leipzig AöR, Leipzig
| | - N Pohle
- Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig
| | - S Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, Mainz
| | - T Neumuth
- Scientific Director, BMBF-Innovation Center Computer Assisted Surgery ICCAS, Leipzig
| | - A Dietz
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Plastische Operationen, Universität Leipzig, Leipzig
| | - M Stier-Jarmer
- Lehrstuhl für Public Health und Versorgungsforschung - IBE, Ludwig-Maximilians-Universität, München
| | - A Boehm
- Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig
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Dietz A, Wichmann G, Boehm A, Mozet C. SP-027: Response evaluation in a clinical trial. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34787-3] [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: 11/29/2022]
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Grünwald V, Keilholz U, Boehm A, Guntinas-Lichius O, Hennemann B, Schmoll HJ, Ivanyi P, Abbas M, Lehmann U, Koch A, Karch A, Zörner A, Gauler TC. TEMHEAD: a single-arm multicentre phase II study of temsirolimus in platin- and cetuximab refractory recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) of the German SCCHN Group (AIO). Ann Oncol 2014; 26:561-7. [PMID: 25527417 DOI: 10.1093/annonc/mdu571] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [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: 12/27/2022] Open
Abstract
BACKGROUND Squamous cell carcinoma of the head and neck (SCCHN) is a common disease, which has a poor prognosis after failure of therapy. Activation of the PI3K-AKT-mTOR axis is commonly detected in recurrent or metastatic SCCHN, and provided the rationale for the clinical phase II trial in pretreated SCCHN. PATIENTS AND METHODS The primary end point was the progression-free survival rate (PFR) at 12 weeks. Forty eligible patients have been recruited after failure of platinum chemotherapy and cetuximab. A preplanned futility analysis was successfully passed after ≥1 success was detected in 20 patients. Secondary objectives consisted of progression-free survival (PFS), disease control rate (DCR), overall survival (OS), safety and tolerability, and predictive biomarkers for KRAS, BRAF, PIK3CA mutations, and HPV status. Archived tumor tissue was analyzed for DNA sequence. RESULTS A total of 40 patients were eligible. The PFR at 12 weeks was 40% (95% CI 25.0-54.6). The median PFS and OS were 56 days (95% CI 36-113 days) and 152 days (76-256 days), respectively. In 33 assessable patients, disease stabilization occurred in 57.6%, with tumor shrinkage in 13 patients (39.4%). Overall, the treatment was well tolerated. Fatigue (47.5%), anemia (25.0%), nausea (20.0%), and pneumonia (20.0%) were the most common adverse events. Neither PIK3CA mutations, nor HPV status were predictive for success with temsirolimus treatment. No mutations were found for KRAS or BRAF. CONCLUSION Tumor shrinkage and efficacy parameter indicate that inhibition of the PI3K-AKT-mTOR axis was a putative novel treatment paradigm for SCCHN. We could not identify parameters predictive for treatment success of temsirolimus, which underscores the need for refinement of the molecular analysis in future studies. CLINICAL TRIALS NUMBER NCT01172769.
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Affiliation(s)
- V Grünwald
- Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover
| | - U Keilholz
- Charité Comprehensive Cancer Center, Berlin
| | - A Boehm
- Clinic and Policlinic for Ear, Nose and Throat, University Hospital, Leipzig
| | | | - B Hennemann
- Department for Hematology and Oncology, Ev. Bethesda- Johanniter Hospital, Duisburg
| | - H J Schmoll
- Clinic for Internal Medicine IV, University Hospital, Halle
| | - P Ivanyi
- Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover
| | | | | | | | | | - A Zörner
- Clinical Pharmacology, Hannover Medical School, Hannover
| | - T C Gauler
- West-German Cancer Center, University Hospital, Essen, Germany
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Boehm A, Lindner F, Wichmann G, Bauer U, Wittekind C, Knoedler M, Lordick F, Dietzsch S, Scholz M, Kortmann R, Dietz A. Impact of indication-shift of primary and adjuvant chemo radiation in advanced laryngeal and hypopharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2014; 272:2017-25. [PMID: 24961436 DOI: 10.1007/s00405-014-3134-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 06/03/2014] [Indexed: 01/15/2023]
Abstract
Based on level I evidence, postoperative platinum-based radiochemotherapy (PORCT) is the recommended standard of care in defined risk situations after resection of squamous cell carcinomas of the larynx and hypopharynx (LHSCC). The value of the addition of chemotherapy to adjuvant radiation in intermediate and high risk situations other than extracapsular spread or R1-/R2 resection is still debated. From 1993 to 2009, 555 patients (median follow-up: 24.4 months) with advanced LHSCC (UICC stages III-IVB) were treated in a curative intent. Patient data were continuously documented in the county of Leipzig cancer registry and were retrospectively analyzed as mono institutional survey. PORCT was introduced into the standard procedures in 2004, but also applied before in selected cases. Based on this paradigm shift, the patient population was divided into two comparative groups treated before and after 2004. 361 patients were treated before 2004. 43.8 % received primary surgery (OP) + postoperative radiotherapy (PORT) and 20.2 % OP + PORCT. 194 patients were treated after 2004: 21.1 % received OP + PORT and 35.6 % OP + PORCT. Regarding the PORCT groups, 20.6 % received cisplatin plus 5FU before 2004 which shifted to 59.4 % after 2004. The 3-year tumor-specific-survival rate of the whole cohort was improved from 47 to 60 % (p = 0.006). The subgroup treated with OP + PORT or PORCT improved from 56.1 to 68.5 % (p = 0.028). Localization proved to be a significant and independent factor. Only patients with advanced laryngeal cancer had significant improved survival (p < 0.01), while the improvement for hypopharyngeal cancer patients was not significant (p < 0.2). After 2004, there was a slight increase (+10.2 %) of primary radiochemotherapy (pRCT) due to stronger selection if R0 > 5 mm-resectability is unlikely. Standardised use of PORCT and pRCT considering clear indications showed to be significantly involved in improved survival in advanced LHSCC.
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Affiliation(s)
- A Boehm
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Leipzig, Liebigstraße 10-14, 04103, Leipzig, Germany,
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Gawlitza M, Purz S, Boehm A, Kahn T, Sabri O, Stumpp P. Glukosemetabolismus, Zellularität und mikrozirkulatorische Parameter bei Patienten mit Kopf-Hals-Tumoren: Simultane Akquisition von 18F-FDG-PET, DWI und T1-DCE in einem integrierten PET/MRT. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373258] [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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Lassalle R, Marold J, Schöbel M, Manzey D, Bohn S, Dietz A, Boehm A. [Decision process in a multidisciplinary cancer team with limited evidence]. Laryngorhinootologie 2013; 93:237-43. [PMID: 24327352 DOI: 10.1055/s-0033-1353199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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 The Head and Neck Cancer Tumor Board is a multispeciality comprehensive conference that brings together experts with different backgrounds to make group decisions about the appropriate treatment. Due to the complexity of the patient cases and the collaboration of different medical disciplines most of these decisions have to be made under uncertainty, i. e., with-out knowing all relevant factors and without being quite sure about the outcome. METHODS To develop effective team decision making under uncertainty, it is necessary to understand how medical experts perceive and handle uncertainties. The aim of this field study was to develop a knowledge base by exploring additionally the factors that influence group decision making processes. A structured nonparticipant observational study was employed to address the research goal. Video data were analyzed by 2 independent observers using an observation checklist. A total of 20 videotaped case discussions were studied. Observations were complemented by a questionnaire gathering subjective evaluations of board members about the process and quality of their decisions (N=15). RESULTS The results show that uncertainty is recognized by board members. Reasons for uncertainty may stem from the complexity of the cases (e. g. therapy options) or the assessment from different disciplines coming together at the board. CONCLUSION With respect to handling uncertainty and guaranteeing an optimal decision making process potential for improvement could be defined. This pertains to the handling of different levels of competence, the promotion of a positive discussion culture as well as structuring of the decision making process.
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Affiliation(s)
- R Lassalle
- Arbeits-, Ingenieur- und Organisationspsychologie, Institut für Psychologie und Arbeitswissenschaft, Technische Universität Berlin, Berlin
| | - J Marold
- Arbeits-, Ingenieur- und Organisationspsychologie, Institut für Psychologie und Arbeitswissenschaft, Technische Universität Berlin, Berlin
| | - M Schöbel
- Fakultät für Psychologie, Universität Basel, Basel, Switzerland
| | - D Manzey
- Lehrstuhl Arbeits- und Organisationspsychologie, Psychologie und Ergonomie, Berlin
| | - S Bohn
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig
| | - A Dietz
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig
| | - A Boehm
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Plastische Opera-tionen, Universität Leipzig, Leipzig
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Stumpp P, Kubiessa K, Purz S, Gawlitza M, Kühn A, Fuchs J, Steinhoff KG, Boehm A, Kluge R, Sabri O, Kahn T. Erste klinische Ergebnisse der simultanen 18F-FDG-PET/MRT im Vergleich zur 18F-FDG-PET/CT bei Patienten mit Kopf-Hals-Tumoren. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346268] [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: 10/26/2022]
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Boehm A, Hafez J, Köhler C, Handwerk J, Korb W. Development of a simulation and training system for head and neck tumour diagnosis. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-J/bmt-2013-4230/bmt-2013-4230.xml. [DOI: 10.1515/bmt-2013-4230] [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: 11/15/2022]
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Schreiber S, Ehrensperger C, Koscielny S, Boehm A, Kubitza W, Meister E, Pabst F, Vogel HJ, Oeken J, Dietz A, Singer S, Meyer A. [Use of cancer support groups by laryngectomees in central Germany]. Laryngorhinootologie 2012; 92:97-101. [PMID: 23247549 DOI: 10.1055/s-0032-1329979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cancer support groups provide information and coping resources as well as represent patients' interests. To date it is unknown how often cancer patients post-laryngectomy use support groups and in which parameters users of support groups differ from non-users. MATERIAL AND METHODS In a multicentre study, 224 laryngectomees were asked about their support group membership. Further, possible predictors for membership one year post-surgery were assessed. Data were collected with a semi-structured interview and standardized instruments. RESULTS Overall, 23% of the laryngectomized patients are actively involved in cancer support groups. The probability of a membership increases if patients are well-educated, are living in good economic conditions and in a partnership, if they perceive low family support and wish additional counselling with a physician. CONCLUSION A cancer support group seems to "buffer" family support perceived to be insufficient. However, support group users are living more frequently in a partnership and in good economic conditions compared to non-users. Physicians and speech therapists are important mediators to cancer support groups. They particularly should inform laryngectomees who are living in bad economic conditions and who are not living in a partnership about the availability of cancer support groups.
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Affiliation(s)
- S Schreiber
- Zentrales Patientenmanagement, Universitätsklinikum Leipzig AÖR, Leipzig.
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Grünwald V, Keilholz U, Boehm A, Guntinas-Lichius O, Hennemann B, Schmoll H, Ivanyi P, Zörner A, Zapf A, Gauler T. Temsirolimus Is Active in Refractory Squamous Cell Carcinoma of the Head and Neck (SCCHN) Failing Platinum-Based Chemotherapy and Cetuximab: Efficacy and Toxicity Data from the Phase II Temhead Study. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33622-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
This article presents the current data and discussion on multimodal laryngeal preservation strategies in advanced laryngeal/hypopharyngeal carcinoma. Principally a distinction is made between simultaneous and induction chemoradiation protocols. In terms of late toxicity and related functional limitations, induction protocols are far superior to simultaneous platinum-based chemoradiation. Currently, the individual response to the first cycle of (short) induction chemotherapy appears to be the most reliable clinical marker for making treatment decisions, and this is under clinical investigation. No standard multimodal therapeutic alternative to laryngectomy exists; therefore, at this time multimodal strategies should only be carried out within the framework of clinical trials.
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Affiliation(s)
- A Dietz
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinik Leipzig, Liebigstr. 10-14, 04103, Leipzig, Deutschland.
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Bohn S, Neumuth T, Meier J, Strauß G, Boehm A. An integrated IT-platform for personalized healthcare in oncologic ENT treatment. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4022] [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: 11/15/2022]
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Boehm A, Müller S, Pankau T, Straub G, Bohn S, Fuchs M, Dietz A. [Computer assistance to improve therapy planning for head neck oncology]. Laryngorhinootologie 2011; 90:732-8. [PMID: 22161631 DOI: 10.1055/s-0031-1295410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The ongoing development in therapies of head and neck malignomas has led to a further differentiation of treatment options. Complex surgical procedures, a wide variety of multi modal therapy options, changing radiation technologies (IMRT - Intensity-modulated radiation therapy) and numerous "targeted therapies" emphasize the need for a precise treatment plan. Beside this, imaging has seen significant improvements beyond the technical ones, e. g. with the implementation of PET/CT scanners. This increase in pre-therapeutic data volume, together with a diversification of treatment options calls for a further discussion of the basics of therapeutic decisions. Planning relevant data processing by computer assisted systems can aid in these decisions. This work describes the current status of relevant computer assisted systems undergoing first testing for head and neck cancer therapy planning. Here, the integration of 3-dimensional patient data plays a central role. This planning tool forms the integrated base for a further development in the areas of radiation planning, documentation and study management.
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Affiliation(s)
- A Boehm
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Leipzig.
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Dietzsch S, Melzer R, Boehm A, Wolf U, Kortmann R, Fuchs M. [Treatment related swallowing dysfunction and the potentialities of IMRT]. Laryngorhinootologie 2011; 90:657-62. [PMID: 22083858 DOI: 10.1055/s-0031-1291303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Altered fractionated radiotherapy and concurrent chemoradiation could improve local control and survival for patients with locally advanced head and neck cancer. However, intensified treatment seems to increase late toxicity. Late swallowing dysfunction is common and has a large impact on quality of life and can get life-threatening character. Recent studies could show interrelations between the radiation dose to certain anatomical structures involved in the swallowing process and the risk of swallowing dysfunction. Important structures seem to be the pharyngeal constrictors and the supraglottic and glottic larynx. Further prospective clinical validations using standardized diagnostic protocols for dysphagia are necessary to establish dose constraints to anatomical structures involved in swallowing.
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Affiliation(s)
- S Dietzsch
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Leipzig AöR.
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Singer S, Hofmeister D, Spiegel K, Boehm A. [Current developments in measuring quality of life with instruments of the European organisation for research and treatment of cancer (EORTC)]. Laryngorhinootologie 2011; 90:591-4. [PMID: 22016255 DOI: 10.1055/s-0031-1286302] [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: 10/16/2022]
Abstract
Since many years, the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group develops and validates measures for the assessment of quality of life in cancer patients, using high standards of methodology. These questionnaires are meant to be used primarily in clinical trials.As treatment strategies are changing and because of some -methodological criticism, the head and neck module EORTC QLQ-H&N35 is currently being revised and updated.In this paper, we will present the current state of work and other recent developments regarding the EORTC Quality of Life questionnaire development.
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Affiliation(s)
- S Singer
- Abteilung Gesundheitspsychologie und Angewandte Diagnostik, Wuppertal.
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Mueller S, Boehm A, Wichmann G, Stumpp P, Preim B, Dornheim L, Strauss G, Bertolini J, Dietz A. DIFFERENT APPROACHES TO VOLUME ASSESSMENT OF LYMPH NODES IN CT SCANS OF HNSCC IN COMPARISON WITH A REAL GOLD STANDARD. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70118-9] [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: 11/25/2022]
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Abstract
Recurrent disease is one of the main reasons for the persistently poor prognosis of squamous cell carcinoma of the head and neck (HNSCC; European 5-year survival, 42%). The main treatment option for primary and secondary malignancy as well as recurrent disease is surgical therapy. If R0 resection (resection margin >5 mm) for a primary tumor is not viable, survival probability is reduced by 50%. In recurrent or secondary tumors with R1- or -2 resection or in the presence of non-resectable metastases, a palliative situation results in more than 80% of cases. In the case of surgery following radiotherapy or radiochemotherapy, attention should be paid to the criteria for salvage surgery (tissue perfusion, fibrosis, wound healing) and the procedure adapted to focus on functionality. In the case of relapse, primary surgery can potentially be supplemented with adjuvant therapy protocols such as (re-) irradiation, as well as possibly with chemotherapeutic agents or targeted therapies. Interdisciplinary collaboration and case discussions should take place in the context of a tumor board.
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Affiliation(s)
- A Boehm
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde/Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstrasse 10-14, 04103, Leipzig, Deutschland.
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