1
|
Li J, Stadlbauer A, Terrazas A, Floerchinger B, Pfister K, Creutzenberg M, Oikonomou K, Schmid C, Rupprecht L. Mid-Term Outcomes of a Hybrid Approach Involving Open Surgery Plus TEVAR of the Descending Aorta in the Treatment of Complex Type A Dissection. Thorac Cardiovasc Surg 2022; 70:607-615. [PMID: 35263792 DOI: 10.1055/s-0042-1743592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Type A aortic dissection with true lumen collapse and malperfusion downstream is associated with a devastating prognosis. This study compares the clinical outcomes of two operative strategies for this disease: hybrid approach of ascending aorta (and hemiarch replacement) supplemented with retrograde stenting of the descending aorta (thoracic endovascular aortic repair [TEVAR]) and standard ascending aorta (and hemiarch) replacement without stent placement. METHODS From January 1, 2016 to December 31, 2019, 81 patients with type A aortic dissection were studied. The hybrid technique was applied in 30 patients (group 1), while 51 patients received standard surgical repair (group 2). Patient demographics, clinical and operative findings, postoperative outcome, follow-up interventions, and mid-term survival were analyzed. RESULTS Baseline characteristics were similar among the groups, except that more preoperative malperfusion was evident in group 1. The postoperative incidence of visceral malperfusion (0 vs. 15.7%, p = 0.02) and low cardiac output syndrome requiring extracorporeal membrane oxygenation support (3.3 vs. 19.6%, p = 0.04) was significantly less in group 1. In-hospital mortality was also significantly lower in group 1 as in group 2 (13.3 vs. 33.3%, p = 0.04). At follow-up, the need for secondary endovascular stenting (3.3 vs. 7.8%, p = 0.65) and surgical aortic reintervention (6.7 vs. 2.0%, p = 0.55) was comparable. One-year, 2-year, and 3-year survival rates were 83.3, 83.3, and 62.5% in group 1, and 58.7, 58.7, and 52.6% in group 2 (p = 0.05), respectively. CONCLUSION The combination of open surgical replacement of the ascending aorta (and hemiarch) with TEVAR of the descending aorta for true lumen compromise is a feasible treatment option for patients with type A aortic dissection and is associated with a better perioperative outcome and improved mid-term survival rate.
Collapse
Affiliation(s)
- J Li
- Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - A Stadlbauer
- Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - A Terrazas
- Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - B Floerchinger
- Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - K Pfister
- Department of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - M Creutzenberg
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - K Oikonomou
- Department of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - C Schmid
- Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - L Rupprecht
- Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
| |
Collapse
|
2
|
Trum M, Schollmeier E, Riechel J, Lebek S, Reuthner K, Keller K, Wester M, Provaznik Z, Schmid C, Maier L, Arzt M, Wagner S. Empagliflozin inhibits increased Na influx in HFpEF cardiomyocytes and reduces arrhythmic activity in human atrial trabeculae. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure with preserved ejection fraction (HFpEF) is a major health problem associated with substantial morbidity and mortality. However, the underlying pathophysiological mechanisms are poorly understood, and effective treatment strategies are scarce. Importantly, SGLT2i, which have been suggested to improve cellular Na and Ca homeostasis in HFrEF, have recently been shown to also improve clinical outcomes in patients with HFpEF. Interestingly, post-hoc analyses of clinical data suggest an involvement of anti-arrhythmic effects of SGLT2i.
Purpose
We tested, if isolated human atrial cardiomyocytes from patients with HFpEF exhibit an increased Na influx that is responsive to treatment with the SGLT2i empagliflozin (Empa) and if Empa has anti-arrhythmic properties in human atrial trabeculae.
Methods
Atrial biopsies were obtained from 101 patients undergoing elective cardiac surgery. Na influx was measured as increase in [Na]i during Na/K-ATPase inhibition in isolated cardiomyocytes loaded with the Na-sensitive fluorescence dye Asante Natrium Green–2 AM (ANG-2). Western Blot and HDAC4 pulldown assay were used to investigate NaV1.5 expression/phosphorylation as well as CaMKII expression/autophosphorylation and activity. Anti-arrhythmic effects of Empa were evaluated as the reduction in premature atrial complexes (PACs), which were induced in electrically field-stimulated (1Hz) human atrial trabeculae by superfusion with isoproterenol (100 nM) and high Ca (3.5 mM).
Results
Compared to patients without heart failure (NF), Na influx was almost doubled in HFpEF patients (NF vs HFpEF: 0.21±0.02 vs 0.38±0.04 mmol/L/min (N=7 vs 18); p=0.005) (Fig. 1D, E). CaMKII expression, CaMKII autophosphorylation, CaMKII activity, and CaMKII-dependent NaV1.5 phosphorylation were significantly increased in atrial biopsies of HFpEF patients, whereas NaV1.5 protein abundance remained unchanged (Fig. 1A–C). Consistent with these results, the increased Na influx was significantly reduced by treatment with the specific CaMKII inhibitor autocamtide-2 related inhibitory peptide (AIP) and the late INa inhibitor tetrodotoxin (TTX) (Fig. 1D, E). Importantly, Empa also abolished the increased Na influx in HFpEF cardiomyocytes (Fig. 1D, E). Multivariate linear regression analysis, adjusting for clinical co-variates, revealed HFpEF to be an independent predictor of cardiomyocyte Na handling. In line with Empa-mediated inhibition of Na influx, the frequency of PACs in human atrial trabeculae was significantly reduced by Empa (Fig. 1F, G).
Conclusion
This is the first study to demonstrate increased Na influx in human cardiomyocytes from HFpEF patients potentially by an increased CaMKII-dependent NaV1.5 phosphorylation. Excitingly, treatment with Empa decreases this Na influx in HFpEF cardiomyocytes and reduces isoproterenol-induced arrhythmic activity in human atrial trabeculae, which could contribute to the cardioprotective effects of this drug in patients with HFpEF.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Else Kröner-Fresenius-Stiftung,Deutsche Forschungsgemeinschaft
Collapse
Affiliation(s)
- M Trum
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - E Schollmeier
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - J Riechel
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - S Lebek
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - K Reuthner
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - K Keller
- Hospital Barmherzige Bruder , Regensburg , Germany
| | - M Wester
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - Z Provaznik
- University Hospital Regensburg, Cardiothoracic Surgery , Regensburg , Germany
| | - C Schmid
- University Hospital Regensburg, Cardiothoracic Surgery , Regensburg , Germany
| | - L Maier
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - M Arzt
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| | - S Wagner
- University Hospital Regensburg, Internal Medicine II , Regensburg , Germany
| |
Collapse
|
3
|
Filippini Velázquez G, Schiele S, Gerken M, Neumaier S, Hackl C, Mayr P, Klinkhammer-Schalke M, Illerhaus G, Schlitt HJ, Anthuber M, Kröncke T, Messmann H, Märkl B, Schmid C, Trepel M, Müller G, Claus R, Hackanson B. Predictive preoperative clinical score for patients with liver-only oligometastatic colorectal cancer. ESMO Open 2022; 7:100470. [PMID: 35461024 PMCID: PMC9271475 DOI: 10.1016/j.esmoop.2022.100470] [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] [Received: 11/16/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background Resection of liver metastases from colorectal cancer (CRC) in the oligometastatic stage improves survival and is a potentially curative treatment. Thus, predictive scores that reliably identify those patients who especially benefit from surgery are essential. Patients and methods In this multicenter analysis, 512 patients had undergone surgery for liver metastases from CRC. We investigated distinct cancer-specific risk factors that are routinely available in clinical practice and developed a predictive preoperative score using a training cohort (TC), which was thereafter tested in a validation cohort (VC). Results Inflammatory response to the tumor, a right-sided primary tumor, multiple liver metastases, and node-positive primary tumor were significant adverse variables for overall survival (OS). Patients were stratified in five groups according to the cumulative score given by the presence of these risk factors. Median OS for patients without risk factors was 133.8 months [95% confidence interval (CI) 81.2-not reached (nr)] in the TC and was not reached in the VC. OS decreased significantly for each subsequent group with increasing number of risk factors. Median OS was significantly shorter (P < 0.0001) for patients presenting all four risk factors: 14.3 months (95% CI 10.5 months-nr) in the TC and 16.6 months (95% CI 14.6 months-nr) in the VC. Conclusions Including easily obtainable variables, this preoperative score identifies oligometastatic CRC patients with prolonged survival rates that may be cured, and harbors potential to be implemented in daily clinical practice. We identified four variables of adverse outcome for patients treated with surgical resection of liver metastases from CRC. Adverse variables were inflammatory response to the tumor, multiple metastases, right-sided primary tumor, node-positive primary tumor. We developed a preoperative clinical score according to the number of risk factors present. Using easily obtainable variables, this score identified patients with oligometastatic CRC with good prognosis. Patients without risk factors should strongly be considered for surgical resection of their metastases.
Collapse
Affiliation(s)
- G Filippini Velázquez
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - S Schiele
- Faculty of Applied Mathematics and Statistics, University of Augsburg, Augsburg, Germany
| | - M Gerken
- Tumor Center Regensburg, Institute for Quality Assurance and Health Service Research, University of Regensburg, Regensburg, Germany
| | - S Neumaier
- Department of Haematology and Oncology, Katharinen Hospital Stuttgart, Stuttgart, Germany
| | - C Hackl
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - P Mayr
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - M Klinkhammer-Schalke
- Tumor Center Regensburg, Institute for Quality Assurance and Health Service Research, University of Regensburg, Regensburg, Germany
| | - G Illerhaus
- Department of Haematology and Oncology, Katharinen Hospital Stuttgart, Stuttgart, Germany
| | - H J Schlitt
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - M Anthuber
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - T Kröncke
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - H Messmann
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - B Märkl
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - C Schmid
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - M Trepel
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - G Müller
- Faculty of Applied Mathematics and Statistics, University of Augsburg, Augsburg, Germany
| | - R Claus
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany; General Pathology and Molecular Diagnostics, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - B Hackanson
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| |
Collapse
|
4
|
Lebek S, Rohde J, Hegner P, Tafelmeier M, Floerchinger B, Rupprecht L, Schmid C, Sossalla ST, Maier LS, Arzt M, Wagner S. Increased NaV1.8 expression in patients with sleep-disordered breathing induces pro-arrhythmic activity. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sleep-disordered breathing (SDB) is often associated with atrial fibrillation, but detailed mechanisms remain elusive. Interestingly, late Na current (late INa) has been shown to be increased in patients with SDB, while expression of cardiac Na channel NaV1.5 and peak Na current were decreased. Indeed, recent data demonstrated that enhanced NaV1.8-dependent late INa may also induce pro-arrhythmic activity.
Purpose
We tested whether Na-V1.8 expression and subsequent NaV1.8-dependent pro-arrhythmic activity are increased in patients with SDB.
Methods
We prospectively analysed 29 right atrial appendage biopsies of patients undergoing elective coronary artery bypass grafting. SDB was assessed using polygraphy in the preoperative night and an apnoea-hypopnea index (AHI) ≥15/h defined SDB. Micro-dissected atrial trabeculae were electrically field stimulated (at 1 Hz, 5 V for 50 ms, at 37°C) to elicit regular contractions. Trabecular arrhythmias were induced using 100 nM isoproterenol at [Ca]o of 3.5 mmol/L and pro-arrhythmic activity was scored from 0 (no arrhythmias) to 5 (salve). Sarcoplasmic reticulum Ca leak was estimated by the contractility after paused stimulation (at 2 Hz, normalized to before pause). To correlate functional and expression data for each individual patient, NaV1.8 mRNA expression was quantified in each trabeculum using qPCR.
Results
NaV1.8 mRNA expression was increased in patients with SDB, leading to a significant positive correlation with the severity of SDB (i.e. AHI, p=0.02, r2=0.22, Fig. 1A). Multivariate regression analysis revealed that this association was independent from age, sex, atrial fibrillation, heart failure, diabetes mellitus, and renal function (p=0.03, r2=0.35). Accordingly, selective NaV1.8 blockade with PF-01247324 (PF, 1 μM, 30 min) significantly improved post-pause contractility of isolated trabeculae from 1.69±0.31 to 2.95±0.54 in patients with SDB (p=0.001), whereas no significant improvement was observed in patients without SDB. This resulted in significant positive correlations between the PF-dependent improvement of post-pause contractility and both AHI (p=0.047, r2=0.19) and NaV1.8 mRNA expression (p=0.03, r2=0.17). Most importantly, we also observed a significant increase in arrhythmia severity in patients with SDB of 2.21±0.52 (vs. 1.00±0.49, p=0.03) that could be significantly reduced by selective NaV1.8 inhibition with PF to 0.25±0.18 (p=0.0008, Fig. 1B). In accordance, there was a significant positive correlation between arrhythmia severity and AHI (p=0.01, r2=0.28) that was abolished in the presence of PF (interaction analysis: p=0.ehab724.33141, r2=0.46).
Conclusion
In patients with SDB, enhanced NaV1.8 expression contribute to atrial pro-arrhythmic activity independent from comorbidities. Selective NaV1.8 inhibition may have therapeutic implications for patients with SDB.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Part of the study was supported by grants from Philips Respironics (Murrysville, PA 15668) and the Medical Faculty at the University of Regensburg. Figure 1
Collapse
Affiliation(s)
- S Lebek
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - J Rohde
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - P Hegner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Tafelmeier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - B Floerchinger
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L Rupprecht
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schmid
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S T Sossalla
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L S Maier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Arzt
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Wagner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| |
Collapse
|
5
|
Gainey M, Qu K, Garbern S, Barry M, Lee J, Nasrin S, Nelson E, Rosen R, Alam N, Schmid C, Levine A. 288 Assessing the Performance of Clinical Diagnostic Models for Dehydration among Patients With Cholera and Undernutrition in Bangladesh. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.301] [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: 11/27/2022]
|
6
|
Büter M, Schmid C, Schertzinger G, aus der Beek T, Dopp E. Effect-based analysis of endocrine activity in sediment samples from lakes in Taihu Basin, China. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00709-8] [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]
|
7
|
Fischer T, Schmid C, Kompis M, Mantokoudis G, Caversaccio M, Wimmer W. Effects of temporal fine structure preservation on spatial hearing in bilateral cochlear implant users. J Acoust Soc Am 2021; 150:673. [PMID: 34470279 DOI: 10.1121/10.0005732] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
Typically, the coding strategies of cochlear implant audio processors discard acoustic temporal fine structure information (TFS), which may be related to the poor perception of interaural time differences (ITDs) and the resulting reduced spatial hearing capabilities compared to normal-hearing individuals. This study aimed to investigate to what extent bilateral cochlear implant (BiCI) recipients can exploit ITD cues provided by a TFS preserving coding strategy (FS4) in a series of sound field spatial hearing tests. As a baseline, we assessed the sensitivity to ITDs and binaural beats of 12 BiCI subjects with a coding strategy disregarding fine structure (HDCIS) and the FS4 strategy. For 250 Hz pure-tone stimuli but not for broadband noise, the BiCI users had significantly improved ITD discrimination using the FS4 strategy. In the binaural beat detection task and the broadband sound localization, spatial discrimination, and tracking tasks, no significant differences between the two tested coding strategies were observed. These results suggest that ITD sensitivity did not generalize to broadband stimuli or sound field spatial hearing tests, suggesting that it would not be useful for real-world listening.
Collapse
Affiliation(s)
- T Fischer
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - C Schmid
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - M Kompis
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - G Mantokoudis
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - M Caversaccio
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| | - W Wimmer
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
| |
Collapse
|
8
|
Toenges R, Greinix H, Lawitschka A, Halter J, Baumgartner A, Simon A, Arends J, Jäger P, Middeke M, Hilgendorf I, Klein S, Wagner-Drouet EM, Schmid C, Bug G, Wolff D. Current practice in nutrition after allogeneic hematopoietic stem cell transplantation - Results from a survey among hematopoietic stem cell transplant centers. Clin Nutr 2021; 40:1571-1577. [PMID: 33744601 DOI: 10.1016/j.clnu.2021.02.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (alloHSCT) is frequently associated with impaired oral intake and malnutrition, which potentially increases morbidity and mortality. Therefore, nutrition is one of the major challenges in the post-transplant period. METHODS To document the current clinical approach in nutritional treatment, we designed a questionnaire concerning the current practice in nutrition after alloHSCT and distributed it to German speaking centers performing alloHSCT in Germany, Austria and Switzerland between November 2018 and March 2020. Twenty-eight (39%) of 72 contacted centers completed the survey, 23 from Germany, two from Austria and three from Switzerland, representing 50% of alloHSCT activity within the participating countries in 2018. RESULTS All centers reported having nutritional guidelines for patients undergoing alloHSCT, whereby 86% (n = 24) provided a low-microbial diet during the neutropenic phase. The criteria to start parenteral nutrition (PN) directly after alloHSCT seemed to be consistent, 75% (n = 21) of the corresponding centers started PN if the oral nutritional intake or the bodyweight dropped below a certain limit. In the setting of intestinal graft-versus-host disease (GvHD) the current practice appeared to be more heterogenous. About 64% (n = 18) of the centers followed a special diet, added food stepwise modulated by GvHD symptoms, while only four centers regularly stopped oral intake completely (intestinal GvHD grade >1). Half of the centers (54%, n = 15) applied a lactose-free diet, followed by 43% (n = 12) which provided fat- and 18% (n = 5) gluten-free food in patients with intestinal GvHD. Supplementation of micronutrients in acute intestinal GvHD patients was performed by 54% (n = 15) of the centers, whereas vitamin D (89%, n = 25) and vitamin B12 (68%, n = 19) was added regularly independently of the presence of GvHD. Only 5 (18%) participating centers ever observed a food-associated infection during hospitalization, whereas food-associated infections were reported to occur more often in the outpatient setting (64%, n = 18). CONCLUSION The survey documented a general consensus about the need for nutritional guidelines for patients undergoing alloHSCT. However, the nutritional treatment in clinical practice (i.e. lactose-, gluten- or fat-free in intestinal GvHD) as well as the use of food supplements was very heterogeneous. In line with current general recommendations the centers seemed to focus on safe food handling practice rather than providing a strict neutropenic diet. More high-quality data are required to provide evidence-based nutrition to patients during and after alloHSCT.
Collapse
Affiliation(s)
- R Toenges
- Department of Medicine, Hematology/Oncology, Goethe-University, 60590 Frankfurt, Germany.
| | - H Greinix
- Division of Hematology, Medical University of Graz, Austria.
| | | | - J Halter
- Dept. of Hematology, University Hospital Basel, Switzerland.
| | - A Baumgartner
- Dept. of Endocrinology, Medical University Klinik Kantonsspital Aarau, Aarau, Switzerland.
| | - A Simon
- Pediatric Oncology and Hematology, Saarland University Hospital, Saar, Homburg, Germany.
| | - J Arends
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - P Jäger
- Department of Hematology, Oncology and Clinical Immunology, University Hospital Duesseldorf, Medical Faculty, Duesseldorf, Germany.
| | - M Middeke
- Dept. of Internal Medicine I, University Hospital Dresden, Dresden, Germany.
| | - I Hilgendorf
- Universitätsklinikum Jena, Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Jena, Germany.
| | - S Klein
- III. Medizinische Klinik Hämatologie und Onkologie Universitätsmedizin Mannheim, Mannheim, Germany.
| | - E M Wagner-Drouet
- 3rd Medical Dept., Hematology, Oncology and Pneumology, University Medical Center Mainz, Germany.
| | - C Schmid
- Department of Hematology and Oncology, Universitätsklinikum Augsburg, Augsburg, Germany.
| | - G Bug
- Department of Medicine, Hematology/Oncology, Goethe-University, 60590 Frankfurt, Germany.
| | - D Wolff
- Dept. of Internal Medicine III, University Hospital, Regensburg, Germany.
| | | |
Collapse
|
9
|
Flörchinger B, Provaznik Z, Philipp A, Foltan M, Camboni D, Rupprecht L, Lunz D, Schmid C. Use of Levosimendan in Adult Patients with Postcardiotomy Extracorporeal Life Support: A Single-Center Experience. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
10
|
Stadlbauer A, Philipp A, Kmiec L, Terrazas JA, Stadlbauer C, Flörchinger B, Camboni D, Lange T, Keyser A, Rupprecht L, Schmid C. Long-Term Follow-up and Quality of Life in Patients Receiving Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism and Cardiogenic Shock. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
11
|
Pabel S, Knierim M, Alebrand F, Paulus M, Herting J, Hollemann D, Sedej S, Von Lewinski D, Fischer T, Schmid C, Hasenfuss G, Brochhausen C, Maier L, Streckfuss-Boemeke K, Sossalla S. Atrial fibrillation impairs ventricular function by altering excitation-contraction coupling in the human heart. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Atrial fibrillation (AF) often co-exists in patients with heart failure (HF). Recent clinical evidence suggests that the arrhythmic component of AF alone may contribute to ventricular dysfunction. However, the pathophysiological effects of a non-tachycardic AF on the human ventricle are unknown. To investigate the effects of normofrequent AF on the human ventricle we investigated ventricular myocardium from patients with preserved ejection fraction with sinus rhythm (SR) or AF in the absence of HF (compensated hypertrophy, EF>50%, matched clinical characteristics). In histological analysis we detected no difference between SR (n=9) vs. AF (n=6) regarding the amount and distribution of fibrosis. For functional investigation, Ca-handling was studied (Fura-2 AM). While systolic Ca-transient amplitude was in trend reduced in isolated human ventricular AF cardiomyocytes, we found a significantly prolonged Ca-elimination time (n=17–22 cells/4 pat.). Using caffeine application, a decreased SR Ca-load in AF was detected, which may be explained by a significant decrease in SERCA2a activity (ksys-kCaff, n=10–12/4 pat.). Patch-clamp experiments revealed a prolonged action potential duration in AF cardiomyocytes (n=5/15 cells).
For the standardized evaluation of the mechanisms of persistent normofrequent arrhythmia, we simulated AF in vitro by using arrhythmic (1 Hz, 40% R-R-variability) or rhythmic (1 Hz) field stimulation. We performed contractility experiments using in-toto isolated human ventricular trabeculae from explanted human hearts. After 8h of pacing, arrhythmically stimulated human trabeculae showed a significantly reduced systolic force, an increase in diastolic tension and a prolonged relaxation (n=11–12 trabeculae/11 pat.). For studying the cellular effects of persistent normofrequent arrhythmia in a model suitable for chronic pacing (up to 7 days), we utilized human iPSC cardiomyocytes (iPSC-CM) from healthy donors (n=6). After 7 days, arrhythmic paced iPSC-CM showed a significantly reduced systolic Ca-transient amplitude, a prolonged Ca-elimination time (n=35/45 cells) as well as a reduced SR Ca-load and a trend towards a lower SERCA2a activity compared to control (n=11 cells). Confocal line-scans (Fluo-4 AM) showed an increased diastolic SR Ca-release, which might also explain the reduced SR Ca-content (n=45/35 cells). Moreover, in irregularly paced iPSC-CM we found significant increased levels of cytosolic Na (n=69 cells each) and in patch-clamp experiments a significantly prolonged action potential duration (n=14/11 cells/3 diff.).
This study demonstrates that a normofrequent arrhythmic ventricular excitation as it occurs in AF impairs human ventricular myocardial function by altering cardiomyocyte excitation-contraction coupling. Thus, this study provides the first translational mechanistic characterization and the potential negative impact of isolated AF in the absence of tachycardia on the human ventricle.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- S Pabel
- University hospital Regensburg, Regensburg, Germany
| | - M Knierim
- University Medical Center Gottingen (UMG), Dept. of Cardiology and Pneumology, Heart Center, Gottingen, Germany
| | - F Alebrand
- University Medical Center Gottingen (UMG), Dept. of Cardiology and Pneumology, Heart Center, Gottingen, Germany
| | - M Paulus
- University hospital Regensburg, Regensburg, Germany
| | - J Herting
- University Medical Center Gottingen (UMG), Dept. of Cardiology and Pneumology, Heart Center, Gottingen, Germany
| | - D Hollemann
- University of Regensburg, Institute of Pathology, Regensburg, Germany
| | - S Sedej
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - D Von Lewinski
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - T Fischer
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - C Schmid
- University hospital Regensburg, Regensburg, Germany
| | - G Hasenfuss
- University Medical Center Gottingen (UMG), Dept. of Cardiology and Pneumology, Heart Center, Gottingen, Germany
| | - C Brochhausen
- University of Regensburg, Institute of Pathology, Regensburg, Germany
| | - L Maier
- University hospital Regensburg, Regensburg, Germany
| | - K Streckfuss-Boemeke
- University Medical Center Gottingen (UMG), Dept. of Cardiology and Pneumology, Heart Center, Gottingen, Germany
| | - S Sossalla
- University hospital Regensburg, Regensburg, Germany
| |
Collapse
|
12
|
Lebek S, Wester M, Tafelmeier M, Fisser C, Hirt S, Schopka S, Schmid C, Maier L, Arzt M, Wagner S. Abnormal P-waves found in patients with sleep-disordered breathing are associated with triggered pro-arrhythmic activity. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sleep-disordered breathing (SDB) is frequently associated with atrial arrhythmias, but diagnostic markers that predict the propensity for atrial arrhythmias are missing. Abnormal P-wave terminal force in lead V1 (PTFV1) has been associated with atrial structural/electrical remodeling and arrhythmias.
Purpose
Here we investigate the association of triggered pro-arrhythmic activity with abnormal PTFV1 in human right atrial appendage biopsies of patients without and with SDB.
Methods
30 patients undergoing elective coronary artery bypass grafting were screened for SDB by polygraphy. An apnoea-hypopnea index (AHI) of ≥15/h defined SDB. PTFV1 was measured as product of negative P-wave amplitude and duration in lead V1 and was defined as abnormal if >4000 ms*μV. Ca/Calmodulin-dependent protein kinase II (CaMKII) activity was measured in human right atrial appendage biopsies by a specific HDAC4 pull-down assay. Premature atrial contractions (PACs) were triggered by exposure to 100 nM isoproterenol (at 3.5 mM [Ca]o) in human atrial trabeculae. PACs severity was classified by a score from 0 points (no arrhythmias) to 5 points (salve). In addition, atrial fibrosis was quantified by Masson's trichrome stain in cryo-sectioned atrial tissue. Multivariate linear regression analyses were performed accounting for age, sex, BMI, existing AF, heart failure, diabetes, and creatinine.
Results
Interestingly, the AHI was independently associated with the magnitude of PTFV1 (fig. A+B, B=57.47±21.03, R2=0.48, P=0.01). Importantly, patients with an abnormal PTFV1 had a significantly increased CaMKII activity (fig. C, P=0.04) and showed significantly more severe triggered PACs (fig. D, P=0.02). Moreover, the magnitude of PTFV1 correlated significantly and independently with PAC severity (fig. D, B=0.0005±0.0002, R2=0.50, P=0.03). Consistently, these arrhythmias could be significantly reduced by acute CaMKII inhibition (5 μM KN93, P<0.01), which abolished the correlation between PTFV1 and PAC severity (P=N.S.). Surprisingly, atrial fibrosis was significantly decreased in patients with an abnormal PTFV1 (fig. E, P=0.02), suggesting that abnormal PTFV1 is a marker of proarrhythmic atrial electrical remodeling of functional cardiomyocytes but not of fibrotic tissue.
Conclusion
The severity of sleep-disordered breathing (AHI) is independently associated with an abnormal PTFV1. Intriguingly, this abnormality is associated with an increased CaMKII activity and with CaMKII-dependent arrhythmias, suggesting PTFV1 to be a potential tool to evaluate the pro-arrhythmic risk of patients with SDB.
Figure 1
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Part of this study was funded by Philips Respironics.
Collapse
Affiliation(s)
- S Lebek
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Wester
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Tafelmeier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Fisser
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Hirt
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Schopka
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schmid
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L.S Maier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Arzt
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Wagner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| |
Collapse
|
13
|
Rastogi P, Philipp A, Camboni D, Flörchinger B, Holzamer A, Schopka S, Vasin S, Hilker M, Rupprecht L, Schmid C. Economic Aspects of ECMO-Assisted Resuscitation (ECPR). Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
14
|
Li J, Zilz C, Schach C, Flörchinger B, Holzamer A, Reinhold K, Marcus C, Schmid C. Long-Term Results of Patch Repair in Destructive Native and Prosthetic Valve Endocarditis. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
15
|
Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
Collapse
Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Magnin A, Iversen VC, Calvo G, Čečetková B, Dale O, Demlova R, Blasko G, Keane F, Kovacs GL, Levy-Marchal C, Monteiro EC, Palmisano L, Pella D, Portolés Pérez A, Rascol O, Schmid C, Tay F, von der Leyen H, Ohmann C. European survey on national training activities in clinical research. Trials 2019; 20:616. [PMID: 31665085 PMCID: PMC6821032 DOI: 10.1186/s13063-019-3702-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/03/2019] [Accepted: 09/04/2019] [Indexed: 11/17/2022] Open
Abstract
Background Investigator-initiated clinical studies (IITs) are crucial to generate reliable evidence that answers questions of day-to-day clinical practice. Many challenges make IITs a complex endeavour, for example, IITs often need to be multinational in order to recruit a sufficient number of patients. Recent studies highlighted that well-trained study personnel are a major factor to conduct such complex IITs successfully. As of today, however, no overview of the European training activities, requirements and career options for clinical study personnel exists. Methods To fill this knowledge gap, a survey was performed in all 11 member and observer countries of the European Clinical Research Infrastructure Network (ECRIN), using a standardised questionnaire. Three rounds of data collection were performed to maximize completeness and comparability of the received answers. The survey aimed to describe the landscape of academic training opportunities, to facilitate the exchange of expertise and experience among countries and to identify new fields of action. Results The survey found that training for Good Clinical Practice (GCP) and investigator training is offered in all but one country. A specific training for study nurses or study coordinators is also either provided or planned in ten out of eleven countries. A majority of countries train in monitoring and clinical pharmacovigilance and offer specific training for principal investigators but only few countries also train operators of clinical research organisations (CRO) or provide training for methodology and quality management systems (QMS). Minimal requirements for study-specific functions cover GCP in ten countries. Only three countries issued no requirements or recommendations regarding the continuous training of study personnel. Yet, only four countries developed a national strategy for training in clinical research and the career options for clinical researchers are still limited in the majority of countries. Conclusions There is a substantial and impressive investment in training and education of clinical research in the individual ECRIN countries. But so far, a systematic approach for (top-down) strategic and overarching considerations and cross-network exchange is missing. Exchange of available curricula and sets of core competencies between countries could be a starting point for improving the situation.
Collapse
Affiliation(s)
- A Magnin
- SCTO - Swiss Clinical Trial Organisation, Bern, Switzerland
| | - V Cabral Iversen
- NorCRIN - Norwegian Clinical Research Infrastructures Network, Trondheim, Norway
| | - G Calvo
- SCReN - Spanish Clinical Research Network, Madrid, Spain
| | - B Čečetková
- SLOVACRIN - Slovak Clinical Research Infrastructure Network, Bratislava, Slovakia
| | - O Dale
- NorCRIN - Norwegian Clinical Research Infrastructures Network, Trondheim, Norway
| | - R Demlova
- CZECRIN - Czech Clinical Research Infrastructure Network, Prague, Czech Republic
| | - Gy Blasko
- HECRIN - Hungarian Clinical Research Infrastructure Network, Budapest, Hungary
| | - F Keane
- HRB CRCI - Health Research board, Clinical Research Coordination Ireland, Dublin, Ireland
| | - G L Kovacs
- HECRIN - Hungarian Clinical Research Infrastructure Network, Budapest, Hungary
| | - C Levy-Marchal
- F-CRIN - French Clinical Research Infrastructure Network, Paris, France
| | - E C Monteiro
- PTCRIN - Portuguese Clinical Research Infrastructure Network, Lisboa, Portugal
| | - L Palmisano
- ItaCRIN - Italian Clinical Research Infrastructure Network, Rome, Italy
| | - D Pella
- SLOVACRIN - Slovak Clinical Research Infrastructure Network, Bratislava, Slovakia
| | | | - O Rascol
- F-CRIN - French Clinical Research Infrastructure Network, Paris, France
| | - C Schmid
- SCTO - Swiss Clinical Trial Organisation, Bern, Switzerland
| | - F Tay
- SCTO - Swiss Clinical Trial Organisation, Bern, Switzerland
| | - H von der Leyen
- KKSN - Netzwerk der Koordinierungszentren für Klinische Studien, Hannover, Germany
| | - C Ohmann
- ECRIN - European Clinical Research Infrastructure Network, Kaiserswerther Str, 70 40477, Düsseldorf, Germany.
| |
Collapse
|
17
|
Camboni D, Philipp A, Foltan M, Schmid C. Extrakorporale Lungenunterstützung mithilfe der venovenösen Membranoxygenierung. Z Herz- Thorax- Gefäßchir 2019. [DOI: 10.1007/s00398-018-0271-5] [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: 11/28/2022]
|
18
|
Lebek S, Tafelmeier M, Schach C, Schopka S, Holzamer A, Schmid C, Maier LS, Arzt M, Wagner S. P4521C-reactive protein as a predictor for diastolic dysfunction in patients with sleep-disordered breathing. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sleep-disordered breathing (SDB) is often associated with left ventricular diastolic dysfunction, but the mechanisms are poorly understood. SDB may increase systemic inflammation that could induce myocardial fibrosis leading to diastolic dysfunction.
Purpose
Systemic inflammation and diastolic dysfunction were analysed in patients with SDB.
Methods
295 patients undergoing coronary artery bypass grafting were included in the prospective observational trial CONSIDER-AF (NCT02877745). They were screened for SDB in the preoperative night and an apnoea-hypopnea index (AHI) of ≥15/h defined SDB. Preoperative echocardiography was used to measure the ratio of early (E) and late (A) diastolic transmitral flows (E/A), early diastolic mitral annular velocity (E'), the ratio E/E', LA volume index, and tricuspid regurgitation velocity. Left ventricular diastolic dysfunction was graded I-IV according to current guidelines. Patients with ventricular ejection fraction of less than 45% were excluded. We used serum C-reactive protein (CRP) as a marker for systemic inflammation, resulting in a full data set for 170 patients.
Results
In patients with SDB, serum CRP levels were 3.036 mg/L higher than in control patients (95% confidence interval: −0.393–6.466, P=0.082). Intriguingly, the severity of SDB (AHI) correlated significantly with the CRP levels (coefficient B: 0.13±0.06, P=0.021). CRP also correlated with the severity of diastolic dysfunction (coefficient B: 0.010±0.004, P=0.009). Importantly, multivariable linear regression analysis accounting for the potential confounders age, sex, body-mass index, existing atrial fibrillation, diabetes, AHI, and creatinine indicated that CRP was an independent predictor for the severity of diastolic dysfunction (coefficient B: 0.009±0.004, P=0.016). Interestingly, the latter effect was still present considering just patients with SDB (coefficient B: 0.013±0.005, P=0.015, N=72), but was completely abolished in patients without SDB (coefficient B: 0.001±0.007, P=0.912, N=98), indicating a potential SDB-dependence.
Conclusion
Systemic inflammation (CRP) is associated with the severity of SDB (AHI). Interestingly, only in SDB patients CRP predicts significantly and independently the severity of diastolic dysfunction. Consequently, anti-inflammatory therapeutic strategies could be beneficial for patients with SDB and diastolic dysfunction.
Acknowledgement/Funding
This study was supported by Philips Respironics and the Medical Faculty of the University of Regensburg.
Collapse
Affiliation(s)
- S Lebek
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Tafelmeier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schach
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Schopka
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - A Holzamer
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schmid
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L S Maier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Arzt
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Wagner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| |
Collapse
|
19
|
Lebek S, Schach C, Reuthner K, Tafelmeier M, Camboni D, Rupprecht L, Schmid C, Maier LS, Arzt M, Wagner S. P3508A novel mouse model of sleep-disordered breathing is associated with contractile dysfunction and CaMKII overexpression. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with sleep-disordered breathing (SDB) develop arrhythmias and contractile dysfunction, but the mechanisms are poorly understood, possibly due to the lack of mouse models that mimic airway obstruction in spontaneously sleeping mice. Interestingly, New Zealand obese mice have been shown to develop airway obstruction with inspiratory flow limitation resulting in apneas, but these mice also develop diabetes.
Purpose
We developed a novel mouse model of increased airway obstruction in spontaneously sleeping lean mice and investigated the impact on sleep-related apneas and contractile function.
Methods and results
Male C57BL6 mice at 8–12 weeks of age were subjected to polytetrafluoroethylene (PTFE) injection (100 μl) into the tongue. This resulted in an increased tongue volume and reduced pharyngeal luminal diameter. Conscious mice behave normal and there was no difference in body weight between PTFE injected mice and untreated littermates (control). Whole body plethysmography was used to monitor spontaneous breathing for 8h in a quiet environment. Interestingly, compared to control, mice with PTFE injection showed a significantly increased frequency of apneas (lasting >1s, fig. A, * indicated P<0.05, t-test). Echocardiographic analysis revealed that ejection fraction was significantly reduced in PTFE-treated mice 8 weeks after surgery (vs. control, fig. B). In accordance, the developed force of isolated papillary muscles from hearts of PTFE mice was significantly reduced compared to control (fig. C). Ca/calmodulin-dependent protein kinase II (CaMKII) has been implicated in the development of heart failure. Intriguingly, compared to control, CaMKII expression was significantly increased in ventricular heart homogenates of PTFE-treated mice (fig. D). Moreover, the magnitude of CaMKII overexpression correlated significantly with the frequency of apneas (fig. E). Papillary muscle post-pause contractions can be used as measure of diastolic sarcoplasmic reticulum (SR) Ca leak, which is known to be enhanced by CaMKII. Compared to control, post-pause contraction amplitude was significantly smaller in PTFE-treated mice, indicating an increased SR Ca leak (fig. F).
Figure 1
Conclusion
PTFE injection in mice results in an increased frequency of spontaneous apneas. PTFE-treated mice develop mild contractile dysfunction, which is accompanied by CaMKII overexpression. This novel mouse model offers great opportunities for investigation of sleep-related breathing disorders.
Acknowledgement/Funding
This study was supported by the Medical Faculty of the University of Regensburg (ReForM programme).
Collapse
Affiliation(s)
- S Lebek
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schach
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - K Reuthner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Tafelmeier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - D Camboni
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L Rupprecht
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schmid
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L S Maier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Arzt
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Wagner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| |
Collapse
|
20
|
Merle M, Fischbacher D, Liepert A, Grabrucker C, Kroell T, Kremser A, Dreyssig J, Freudenreich M, Schuster F, Borkhardt A, Kraemer D, Koehne CH, Kolb HJ, Schmid C, Schmetzer HM. Serum Chemokine-release Profiles in AML-patients Might Contribute to Predict the Clinical Course of the Disease. Immunol Invest 2019; 49:365-385. [PMID: 31535582 DOI: 10.1080/08820139.2019.1661429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In cancer or hematologic disorders, chemokines act as growth- or survival factors, regulating hematopoiesis and angiogenesis, determining metastatic spread and controlling leukocyte infiltration into tumors to inhibit antitumor immune responses. The aim was to quantify the release of CXCL8, -9, -10, CCL2, -5, and IL-12 in AML/MDS-pts' serum by cytometric bead array and to correlate data with clinical subtypes and courses. Minimal differences in serum-levels subdivided into various groups (e.g. age groups, FAB-types, blast-proportions, cytogenetic-risk-groups) were seen, but higher release of CXCL8, -9, -10 and lower release of CCL2 and -5 tendentially correlated with more favorable subtypes (<50 years of age, <80% blasts in PB). Comparing different stages of the disease higher CCL5-release in persisting disease and a significantly higher CCL2-release at relapse were found compared to first diagnosis - pointing to a change of 'disease activity' on a chemokine level. Correlations with later on achieved response to immunotherapy and occurrence of GVHD were seen: Higher values of CXCL8, -9, -10 and CCL2 and lower CCL5-values correlated with achieved response to immunotherapy. Predictive cut-off-values were evaluated separating the groups in 'responders' and 'non-responders'. Higher levels of CCL2 and -5 but lower levels of CXCL8, -9, -10 correlated with occurrence of GVHD. We conclude, that in AML-pts' serum higher values of CXCL8, -9, -10 and lower values of CCL5 and in part of CCL2 correlate with more favorable subtypes and improved antitumor'-reactive function. This knowledge can contribute to develop immune-modifying strategies that promote antileukemic adaptive immune responses.
Collapse
Affiliation(s)
- M Merle
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - D Fischbacher
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - A Liepert
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - C Grabrucker
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - T Kroell
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - A Kremser
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - J Dreyssig
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - M Freudenreich
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany
| | - F Schuster
- Department for Pediatric Hematology and Oncology, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - A Borkhardt
- Department for Pediatric Hematology and Oncology, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - D Kraemer
- Department for Hematology, Municipal Hospital Oldenburg, Oldenburg, Germany
| | - C-H Koehne
- Department for Hematology, Municipal Hospital Oldenburg, Oldenburg, Germany
| | - H J Kolb
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany.,Helmholtz Center, Clinical Cooperative Group Human Cell Transplantation (CCG-HCT), Munich, Germany
| | - C Schmid
- Department for Hematology, University Hospital Augsburg, Augsburg, Germany
| | - H M Schmetzer
- Department for Hematopoietic Transplantations, Med III, University Hospital of Munich, Munich, Germany.,Helmholtz Center, Clinical Cooperative Group Human Cell Transplantation (CCG-HCT), Munich, Germany
| |
Collapse
|
21
|
Bugaj TJ, Blohm M, Schmid C, Koehl N, Huber J, Huhn D, Herzog W, Krautter M, Nikendei C. Peer-assisted learning (PAL): skills lab tutors' experiences and motivation. BMC Med Educ 2019; 19:353. [PMID: 31521146 PMCID: PMC6744669 DOI: 10.1186/s12909-019-1760-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/20/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Peer-assisted learning (PAL) is a common teaching and learning method in medical education worldwide. In the setting of skills laboratories (skills labs), student tutors are often employed as an equivalent alternative to faculty teachers. However, to the best of our knowledge, there is a lack of qualitative studies which explore the reasons for the personal commitment of student tutors. The aim of our study was to examine how undergraduate students experienced and evaluated their roles as skills lab student tutors, what their motivation was, and whether social and cognitive congruence played a role in their teaching experiences. METHODS We conducted in-depth, semi-structured interviews with student tutors who were currently teaching in a skills lab. After the interviews had been transcribed verbatim, two independent investigators performed a qualitative content analysis according to Mayring. RESULTS In total, we conducted nine interviews with student tutors. Our results revealed that all student tutors showed great enthusiasm and motivation for their jobs as peer teachers. One of the main motivating factors for student tutors to teach in a skills lab was the possibility to simultaneously share and improve their knowledge and expertise. In general, the participants of our study had high aspirations for their teaching. They found it particularly important to be empathetic with the student learners. At the same time, they thought they would personally benefit from their teaching activities and develop a certain expertise as student tutors. CONCLUSIONS With the present study we are able to gain some insight into what motivates student tutors to teach in a skills lab and what kind of experiences they have. Our results provide an important input for the future training of highly qualified student tutors.
Collapse
Affiliation(s)
- T. J. Bugaj
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - M. Blohm
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Esslingen, Esslingen, Germany
| | - C. Schmid
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - N. Koehl
- Practice Drs./NL Albertus Arends, Heidelberg, Germany
| | - J. Huber
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - D. Huhn
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - W. Herzog
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - M. Krautter
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
- Clinic for Kidney, Hypertension and Autoimmune Diseases, Klinikum Stuttgart, Stuttgart, Germany
| | - C. Nikendei
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| |
Collapse
|
22
|
Burney C, Robinson S, Boumendil A, Finel H, Khvedelidze I, Hunter H, Poire X, Lioure B, Peggs K, Foa R, Pillai S, van Meerten T, Bargay Lleonart J, Schmid C, Vergote V, Ganser A, Castagna L, Mufti G, Montoto S. THE EFFICACY OF IBRUTINIB IN PATIENTS WITH RELAPSED MANTLE CELL LYMPHOMA AFTER FIRST LINE INTENSIVE CHEMO-IMMUNOTHERAPY AND ASCT - A RETROSPECTIVE STUDY FROM THE LWP-EBMT. Hematol Oncol 2019. [DOI: 10.1002/hon.53_2630] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C.N. Burney
- Department of Haematology; University Hospitals Bristol NHS Trust; Bristol United Kingdom
| | - S. Robinson
- Department of Haematology; University Hospitals Bristol NHS Trust; Bristol United Kingdom
| | - A. Boumendil
- Lymphoma Working Party; European Society for Blood and Marrow Transplantation; Paris France
| | - H. Finel
- Lymphoma Working Party; European Society for Blood and Marrow Transplantation; Paris France
| | - I. Khvedelidze
- Lymphoma Working Party; European Society for Blood and Marrow Transplantation; Paris France
| | - H. Hunter
- Department of Haematology; University Hospitals Plymouth NHS Trust; Plymouth United Kingdom
| | - X. Poire
- Section of Haematology; Cliniques Universitaires St-Luc; Brussels Belgium
| | - B. Lioure
- Onco-Hematologie; Nouvel Hopital Civil; Strasbourg France
| | - K. Peggs
- Department of Haematology; University College London Hospitals NHS Trust; London United Kingdom
| | - R. Foa
- Division of Haematology; Univ. La Sapienza; Rome Italy
| | - S. Pillai
- Department of Haematology; University Hospital of North Staffordshire; Stoke-On-Trent United Kingdom
| | - T. van Meerten
- Hematologie Groningen; University Medical Center; Groningen Netherlands
| | - J. Bargay Lleonart
- Department of haematology; Hospital son Llatzer; Palma de Mallorca Spain
| | - C. Schmid
- Department of oncology and hematology; Klinikum Augsburg; Augsburg Germany
| | - V. Vergote
- Department of haematologie; University Hospital Gasthuisberg; Leuven Belgium
| | - A. Ganser
- Department of Hematology; Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School; Hannover Germany
| | - L. Castagna
- Bone Marrow Transplant Unit; Istituto Clinico Humanitas; Rozzano Milan Italy
| | - G. Mufti
- Department of Haematological Medicine; GKT School of Medicine; London United Kingdom
| | - S. Montoto
- Centre for Haemato-Oncology; Barts NHS Health Trust; London United Kingdom
| |
Collapse
|
23
|
Bazarbachi A, Boumendil A, Finel H, Castagna L, Dominietto A, Blaise D, Diez-Martin J, Tischer J, Gülbas Z, Labussière Wallet H, Lopez Corral L, Mohty M, Koc Y, Yakoub-Agha I, Schmid C, el Cheikh J, Arat M, Forcade E, Dreger P, Rocha V, Gutiérrez García G, Chalandon Y, Ferra C, Orvain C, Robinson S, Montoto S, Sureda A. HOW TO SELECT DONOR, STEM CELL SOURCE, AND CONDITIONING REGIMEN FOR HAPLOIDENTICAL TRANSPLANTS WITH POST-TRANSPLANT CYCLOPHOSPHAMIDE FOR LYMPHOMA: A REPORT OF THE EBMT LWP. Hematol Oncol 2019. [DOI: 10.1002/hon.108_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- A. Bazarbachi
- Internal medicine American University of Beirut Medical Center Beirut, Lebanon
| | - A. Boumendil
- Lymphoma Working Party EBMT LWP Paris Office/Hôpital Saint-Antoine Paris; France
| | - H. Finel
- Lymphoma Working Party EBMT LWP Paris Office/Hôpital Saint-Antoine Paris; France
| | - L. Castagna
- Hematology Istituto Clinico Humanitas Rozzano Milano, Italy
| | - A. Dominietto
- Hematology Second Division of Hematology and Bone Marrow Transplantation, IRCCS AOU San Martino-IST Genoa, Italy
| | - D. Blaise
- Hematology Institut Paoli Calmettes Marseille, France
| | | | - J. Tischer
- Hematology Klinikum Grosshadern Munich, Germany
| | - Z. Gülbas
- Hematology Anadolu Medical Center Hospital Kocaeli, Turkey
| | | | | | - M. Mohty
- Hematology Hôpital Saint Antoine Paris, France
| | - Y. Koc
- Hematology Medical Park Hospitals Antalya, Turkey
| | | | - C. Schmid
- Hematology Klinikum Augsburg Augsburg, Germany
| | - J. el Cheikh
- Internal medicine American University of Beirut Medical Center Beirut, Lebanon
| | - M. Arat
- Hematology Florence Nightingale Sisli HospitalIstanbul, Turkey
| | | | - P. Dreger
- Hematology University of Heidelberg Heidelberg, Germany
| | - V. Rocha
- Hematology Hospital Sirio-Libanes Sao Paulo, Brazil
| | - G. Gutiérrez García
- Hematology Hospital Clinic, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - Y. Chalandon
- Hematology Hôpitaux Universitaires Geneva, Switzerland
| | - C. Ferra
- Hematology ICO-Hospital Universitari Germans Trias i Pujol Barcelona, Spain
| | | | - S. Robinson
- Hematology Bristol Oncology Centre Bristol, United Kingdom
| | - S. Montoto
- Hematology Barts Health NHS TrustLondon, United kingdom
| | - A. Sureda
- Hematology ICO - Hospital Duran i Reynals Barcelona, Spain
| |
Collapse
|
24
|
Atzler M, Rank A, Inngjerdingen M, Rabe A, Deen D, Wang R, Eiz-Vesper B, Schmid C, Schmetzer H. Increased detection of (leukemiaspecific) adaptive and innate immune-reactive cells under treatment of AML-diseased rats and one therapy-refractory AML-patient with blastmodulating, clinically approved response modifiers. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
25
|
Merle M, Fischbacher D, Liepert A, Grabrucker C, Kroell T, Kremser A, Dreyssig J, Freudenreich M, Schuster F, Borkhardt A, Kraemer D, Koehne C, Kolb H, Schmid C, Schmetzer H. Conversion of AML-blasts to leukemia-derived dendritic cells (DCleu) in ‘DC-culture-media’ shifts the (serum) chemokine-release profile to a more ‘inflammatory’ (in culture) going along with improved antileukemic T-cell-reactivity. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
26
|
Freudenreich M, Tischer J, Kroell T, Kremser A, Dreyßig J, Grabrucker C, Liepert A, Kolb H, Schmid C, Schmetzer H. Clinical relevance of in vitro generated dendritic cells of leukemic origin to predict response to immunotherapy in patients with AML and MDS. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.088] [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: 11/30/2022]
|
27
|
Kmiec L, Holzamer A, Philipp A, Zerdzitzki M, Fischer M, Hilker M, Schmid C. Use of a Large-Bore Percutaneous Vascular Closure Device after va-ECMO Therapy. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1679014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- L. Kmiec
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - A. Holzamer
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - A. Philipp
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - M. Zerdzitzki
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - M. Fischer
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Innere Medizin II, Regensburg, Germany
| | - M. Hilker
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - C. Schmid
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| |
Collapse
|
28
|
Provaznik Z, Philipp A, Foltan M, Camboni D, Rupprecht L, Lunz D, Unterbuchner C, Flörchinger B, Schmid C. Extracorporeal Life Support in Cardiac Surgery Patients—Does Scenario of Support Affect Outcome? Experience of 235 Cases. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Z. Provaznik
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - A. Philipp
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - M. Foltan
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - D. Camboni
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - L. Rupprecht
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - D. Lunz
- Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany
| | - C. Unterbuchner
- Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany
| | - B. Flörchinger
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - C. Schmid
- Universitätsklinikum Regensburg, Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| |
Collapse
|
29
|
Holzamer A, Zerdzitzki M, Debl K, Creutzenberg M, Fischer M, Schmid C, Hilker M. Early Experience with a Novel Transcatheter Tricuspid Heart Valve Prosthesis. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A. Holzamer
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - M. Zerdzitzki
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - K. Debl
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Innere Medizin II, Regensburg, Germany
| | - M. Creutzenberg
- Klinikum der Universität Regensburg, Klinik für Anästhesiologie, Regensburg, Germany
| | - M. Fischer
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Innere Medizin II, Regensburg, Germany
| | - C. Schmid
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| | - M. Hilker
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Herz-, Thorax- und Herznahe Gefäßchirurgie, Regensburg, Germany
| |
Collapse
|
30
|
Lebek S, Pichler K, Mustroph J, Tafelmeier M, Camboni D, Rupprecht L, Schmid C, Maier LS, Arzt M, Wagner S. P2833Sleep-disordered breathing is associated with enhanced CaMKII-dependent late INa and pro-arrhythmic activity. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2833] [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)
- S Lebek
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - K Pichler
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - J Mustroph
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Tafelmeier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - D Camboni
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L Rupprecht
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - C Schmid
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - L S Maier
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - M Arzt
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| | - S Wagner
- University Hospital Regensburg, University Heart Centre Regensburg, Regensburg, Germany
| |
Collapse
|
31
|
Mustroph J, Wagemann O, Trum M, Lebek S, Tarnowski D, Reinders J, Schmid C, Schopka S, Hilker M, Graf B, Pabel S, Sossalla S, Schweda F, Maier LS, Wagner S. 3145Empagliflozin potently reduces sarcoplasmic Ca leak and increases Ca transient amplitude of human failing ventricular cardiomyocytes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3145] [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: 11/15/2022] Open
Affiliation(s)
- J Mustroph
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - O Wagemann
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - M Trum
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - S Lebek
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - D Tarnowski
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - J Reinders
- University of Regensburg, Institute of Functional Genomics, Regensburg, Germany
| | - C Schmid
- University Hospital Regensburg, Department of Cardio-thoracic surgery, Regensburg, Germany
| | - S Schopka
- University Hospital Regensburg, Department of Cardio-thoracic surgery, Regensburg, Germany
| | - M Hilker
- University Hospital Regensburg, Department of Cardio-thoracic surgery, Regensburg, Germany
| | - B Graf
- University Hospital Regensburg, Department of Anesthesiology, Regensburg, Germany
| | - S Pabel
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - S Sossalla
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - F Schweda
- University of Regensburg, Department of Physiology, Regensburg, Germany
| | - L S Maier
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| | - S Wagner
- University Hospital Regensburg, Internal Medicine II, Regensburg, Germany
| |
Collapse
|
32
|
Abstract
Two cases of extracranial meningiomas respectively in the left frontal region in a 64-year-old woman and in the right frontal sinus in a 13-year-old boy are reported. Both cases were associated with an intracranial meningioma later detected after primary histologic diagnosis of the extracranial surgical specimen. The possibility of an extracranial meningioma, expecially when an angioblastic, fibroblastic or meningothelial pattern is prominent, must always be considered together with the existence of an intracranial equivalent, as our 2 cases clearly demonstrate.
Collapse
|
33
|
Abstract
A case of subscapular elastofibroma in a 61-year-old male was studied by light and electron microscopy. Sixty-two cases of this lesion have been to date reported. At light microscopy, the mass was unencapsulated and consisted of dense collagen bundles with many thick elastinophilic fibers and globules. The ultrastructural examination showed the fibers contained a clear core of mature elastic tissue surrounded by a more electron-dense fibrillar material, which was attributed to newly formed elastin. After elastase digestion, the fibers failed to stain with orcein. The cells were very scanty and identified as fibroblasts. The hypothesis formulated by various authors about the nature of elastinophilic fibers and about the pathogenesis of elastofibroma are reviewed. Our findings seems to support those of most authors, who consider the lesion an abnormally increased reactive production of elastic tissue by fibroblasts in response to a mechanical stimulus.
Collapse
|
34
|
Abstract
Light and electron microscopy study of an unusual primary liver neoplasm observed in a 36-year-old woman. By light microscopy the tumor, initially detected by a needle biopsy and later surgically removed, was mainly composed of spindle-shaped and multinucleated cells which were similar to rhabdomyoblasts. These cells, however, showed ultrastructural features of hepatocytes.
Collapse
|
35
|
Craddock C, Versluis J, Labopin M, Socie G, Huynh A, Deconinck E, Volin L, Milpied N, Bourhis JH, Rambaldi A, Chevallier P, Blaise D, Manz M, Vellenga E, Vekemans MC, Maertens J, Passweg J, Vyas P, Schmid C, Löwenberg B, Ossenkoppele G, Mohty M, Cornelissen JJ, Nagler A. Distinct factors determine the kinetics of disease relapse in adults transplanted for acute myeloid leukaemia. J Intern Med 2018; 283:371-379. [PMID: 29214689 DOI: 10.1111/joim.12720] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Disease recurrence remains the major cause of death in adults with acute myeloid leukaemia (AML) treated using either intensive chemotherapy (IC) or allogenic stem cell transplantation (allo-SCT). AIMS The timely delivery of maintenance drug or cellular therapies represent emerging strategies with the potential to reduce relapse after both treatment modalities, but whilst the determinants of overall relapse risk have been extensively characterized the factors determining the timing of disease recurrence have not been characterized. MATERIALS AND METHODS We have therefore examined, using a series of sequential landmark analyses, relapse kinetics in a cohort of 2028 patients who received an allo-SCT for AML in CR1 and separately 570 patients treated with IC alone. RESULTS In the first 3 months after allo-SCT, the factors associated with an increased risk of relapse included the presence of the FLT3-ITD (P < 0.001), patient age (P = 0.012), time interval from CR1 to transplant (P < 0.001) and donor type (P = 0.03). Relapse from 3 to 6 months was associated with a higher white cell count at diagnosis (P = 0.001), adverse-risk cytogenetics (P < 0.001), presence of FLT3-ITD mutation (P < 0.001) and time interval to achieve first complete remission (P = 0.013). Later relapse was associated with adverse cytogenetics, mutated NPM1, absence of chronic graft-versus-host disease (GVHD) and the use of in vivo T-cell depletion. In patients treated with IC alone, the factors associated with relapse in the first 3 months were adverse-risk cytogenetics (P < 0.001) and FLT3-ITD status (P = 0.001). The factors predicting later relapse were the time interval from diagnosis to CR1 (P = 0.22) and time interval from CR1 to IC (P = 0.012). DISCUSSION AND CONCLUSION Taken together, these data provide novel insights into the biology of disease recurrence after both allo-SCT and IC and have the potential to inform the design of novel maintenance strategies in both clinical settings.
Collapse
Affiliation(s)
- C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - J Versluis
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - M Labopin
- Department of Haematology, Hospital Saint Antoine, Paris, France
| | - G Socie
- Department of Hematology, Hospital Saint-Louis, Sorbonne University, Paris, France
| | - A Huynh
- Department of Haematology, CHU, Toulouse, France
| | - E Deconinck
- Department of Hematology, CHU, Besancon, France
| | - L Volin
- Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland
| | - N Milpied
- Department of Hamatology, CHU, Nantes, France
| | - J H Bourhis
- Department of Medical Oncology, Institute of Cancer, Villejuif, France
| | - A Rambaldi
- Department of Hematology, University of Milan, Milan, Italy
| | | | - D Blaise
- Department of Hematology, Centre of Cancer Research, Marseille, France
| | - M Manz
- Center for Hemato-Oncology, University Hospital Zurich, Zurich, Switzerland
| | - E Vellenga
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - M-C Vekemans
- Department of Hematology, Saint-Luc University, Brussels, Belgium
| | - J Maertens
- Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - J Passweg
- Department of Haematology, University of Basel, Basel, Switzerland
| | - P Vyas
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - C Schmid
- Stem Cell Transplantation Unit, Department of Medicine, University of Munich, Munich, Germany
| | - B Löwenberg
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - G Ossenkoppele
- Department of Haematology, University Medical Center, Amsterdam, The Netherlands
| | - M Mohty
- Hospital Saint-Antoine, University UPMC, Paris, France
| | - J J Cornelissen
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - A Nagler
- Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.,ALWP office of the EBMT Hospital Saint Antoine, Paris, France
| | | |
Collapse
|
36
|
Schmid C, Atzler M, Rank A, Inngjerdingen M, Rabe A, Deen D, Wang R, Eiz-Vesper B, Schmetzer H. Immune modulation of AML-blasts in therapy-refractory AML-patient in vivo with clinically approved response modifiers improves clinical status, blood cell regeneration and gives rise to leukemia specific adaptive and innate immune reactive cells. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
37
|
Ringdén O, Labopin M, Sadeghi B, Mailhol A, Beelen D, Fløisand Y, Ghavamzadeh A, Finke J, Ehninger G, Volin L, Socié G, Kröger N, Stuhler G, Ganser A, Schmid C, Giebel S, Mohty M, Nagler A. What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease? J Intern Med 2018; 283:166-177. [PMID: 29027756 DOI: 10.1111/joim.12695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute graft-versus-host disease (aGVHD) is a major complication of allogeneic haematopoietic stem cell transplantation (HSCT). With new promising therapies, survival may improve for severe aGVHD. OBJECTIVES We wanted to analyze the long-term outcome in patients who survive severe aGVHD. METHODS This study was a landmark analysis of 23 567 patients with acute Leukaemia who survived for more than 6 months after HSCT, 2002-2014. Patients alive after severe aGVHD (n = 1738) were compared to controls. RESULTS Patients with severe aGVHD had higher non-relapse mortality (NRM) and higher rate of extensive chronic GVHD (cGVHD) than the controls (P < 10-5 ). The probability of relapse was significantly lower in the severe aGVHD group, but Leukaemia-free survival (LFS) and overall survival were significantly lower than for the controls (P < 10-5 ). Five-year LFS in patients with severe aGVHD was 49%, as opposed to 61% in controls with no or mild GVHD and 59% in patients with moderate GVHD. CONCLUSIONS HSCT patients who survive severe aGVHD have higher risk of developing extensive cGVHD, a higher NRM, a lower relapse probability, and lower LFS than other HSCT patients. This study is a platform for outcome analysis in patients treated with novel therapies for acute GVHD.
Collapse
Affiliation(s)
- O Ringdén
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Labopin
- Hôpital Saint Antoine, Paris, France
| | - B Sadeghi
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - A Mailhol
- Hôpital Saint Antoine, Paris, France
| | - D Beelen
- University of Essen, Duisburg, Germany
| | - Y Fløisand
- Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Ghavamzadeh
- Shariati Hospital, Hematology-Oncology and BMT Research, Tehran, Iran
| | - J Finke
- Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik 1, Universitätsklinikum Dresden, Dresden, Germany
| | - L Volin
- Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland
| | - G Socié
- Department of Hematology - BMT, Hopital St. Louis, Paris, France
| | - N Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - G Stuhler
- Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany
| | - A Ganser
- Medical University Hannover, Hannover, Germany
| | - C Schmid
- University of Munich, Munich, Germany
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - M Mohty
- Hôpital Saint Antoine, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| |
Collapse
|
38
|
Huber GF, Hüllner M, Schmid C, Brunner A, Sah B, Vetter D, Kaufmann PA, von Schulthess GK. Benefit of 18F-fluorocholine PET imaging in parathyroid surgery. Eur Radiol 2018; 28:2700-2707. [PMID: 29372312 DOI: 10.1007/s00330-017-5190-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To assess the additional diagnostic value of 18F-fluorocholine PET imaging in preoperative localization of pathologic parathyroid glands in clinically manifest hyperparathyroidism in case of negative or conflicting ultrasound and scintigraphy results. METHODS A retrospective, single-institution study of 26 patients diagnosed with hyperparathyroidism. In cases where ultrasound and scintigraphy failed to detect the location of an adenoma in order to allow a focused surgical approach, an additional 18F-fluorocholine PET scan was performed and its results were compared with the intraoperative findings. RESULTS A total of 26 patients underwent 18F-fluorocholine PET/CT (n = 11) or PET/MRI (n = 15). Adenomas were detected in 25 patients (96.2%). All patients underwent surgery, and the location predicted by PET hybrid imaging was confirmed intraoperatively by frozen section and adequate parathyroid hormone drop after removal. None of the patients needed revision surgery during follow-up. CONCLUSIONS These results demonstrate that 18F-fluorocholine PET imaging is a highly accurate method to detect parathyroid adenomas even in case of previous localization failure by other imaging examinations. KEY POINTS • With 18 F-fluorocholine PET imaging, parathyroid adenomas could be detected in 96.2%. • 18 F-fluorocholine imaging is a highly accurate method to detect parathyroid adenomas. • We encourage its use, where ultrasound fails to detect an adenoma.
Collapse
Affiliation(s)
- G F Huber
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
| | - M Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - C Schmid
- Department of Endocrinology, Diabetology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - A Brunner
- Department of Endocrinology, Diabetology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - B Sah
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - D Vetter
- Department of General Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - P A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - G K von Schulthess
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| |
Collapse
|
39
|
Veríssimo D, Schmid C, Kimario FF, Eves HE. Measuring the impact of an entertainment-education intervention to reduce demand for bushmeat. Anim Conserv 2018. [DOI: 10.1111/acv.12396] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D. Veríssimo
- David H. Smith Conservation Research Fellow; Department of Environmental Health and Engineering; Whiting School of Engineering; Johns Hopkins University; Baltimore MD USA
| | | | - F. F. Kimario
- Wildlife Tourism Department; College of African Wildlife Management, Mweka; Moshi Tanzania
| | - H. E. Eves
- Virginia Polytechnic Institute and State University; Blacksburg VA USA
| |
Collapse
|
40
|
Vasin S, Lamby P, Holzamer A, Philipp A, Flörchinger B, Camboni D, Schmid C. Extracorporeal Circulation in a Trauma Patient: An Unusual Case of Selected Lower Limb Perfusion. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Vasin
- Abteilung für Herz-, Thorax- und herznahe Gefäßchirurgie, Universität Regensburg, Regensburg, Germany
| | - P. Lamby
- Zentrum für Plastische, Hand- und Wiederherstellungschirurgie, Universität Regensburg, Regensburg, Germany
| | - A. Holzamer
- Abteilung für Herz-, Thorax- und herznahe Gefäßchirurgie, Universität Regensburg, Regensburg, Germany
| | - A. Philipp
- Abteilung für Herz-, Thorax- und herznahe Gefäßchirurgie, Universität Regensburg, Regensburg, Germany
| | - B. Flörchinger
- Abteilung für Herz-, Thorax- und herznahe Gefäßchirurgie, Universität Regensburg, Regensburg, Germany
| | - D. Camboni
- Abteilung für Herz-, Thorax- und herznahe Gefäßchirurgie, Universität Regensburg, Regensburg, Germany
| | - C. Schmid
- Abteilung für Herz-, Thorax- und herznahe Gefäßchirurgie, Universität Regensburg, Regensburg, Germany
| |
Collapse
|
41
|
Holzamer A, Zerdzitzki M, Camboni D, Debl K, Zausig Y, Fischer M, Hilker M, Schmid C. Prediction of Suitable Fluoroscopic Implantation Planes for Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve Anatomy - Clinical Validation of a Novel Approach. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Holzamer
- Klinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - M. Zerdzitzki
- Klinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - D. Camboni
- Klinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - K. Debl
- Klinik für Kardiologie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Y. Zausig
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - M. Fischer
- Klinik für Kardiologie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - M. Hilker
- Klinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Regensburg, Germany
| | - C. Schmid
- Klinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Regensburg, Germany
| |
Collapse
|
42
|
Schmid C, Reichel A, Kerstan A, Gesierich A, Hamm H. [Slate-gray macules in the axillae]. Hautarzt 2017; 69:177-179. [PMID: 29264631 DOI: 10.1007/s00105-017-4098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Schmid
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
| | - A Reichel
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - A Kerstan
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - A Gesierich
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - H Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| |
Collapse
|
43
|
Camboni D, Schmid C. Wo bleibt die künstliche Lunge? Z Herz- Thorax- Gefäßchir 2017. [DOI: 10.1007/s00398-017-0148-z] [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: 11/28/2022]
|
44
|
Robinson C, Zwimpfer C, Schuurmans M, Murer C, Benden C, Schmid C. P150 Insulin-like growth factor 1, leptin and adiponectin in patients with cystic fibrosis. Chest 2017. [DOI: 10.1016/j.chest.2017.04.051] [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: 11/16/2022] Open
|
45
|
Ženka J, Caisová V, Uher O, Nedbalová P, Kvardová K, Masáková K, Krejčová G, Paďouková L, Jochmanová I, Wolf KI, Chmelař J, Kopecký J, Loumagne L, Mestadier J, D’agostino S, Rohaut A, Ruffin Y, Croize V, Lemaître O, Sidhu SS, Althammer S, Steele K, Rebelatto M, Tan T, Wiestler T, Spitzmueller A, Korn R, Schmidt G, Higgs B, Li X, Shi L, Jin X, Ranade K, Koeck S, Amann A, Gamerith G, Zwierzina M, Lorenz E, Zwierzina H, Kern J, Riva M, Baert T, Coosemans A, Giovannoni R, Radaelli E, Gsell W, Himmelreich U, Van Ranst M, Xing F, Qian W, Dong C, Xu X, Guo S, Shi Q, Quandt D, Seliger B, Plett C, Amberger DC, Rabe A, Deen D, Stankova Z, Hirn A, Vokac Y, Werner J, Krämer D, Rank A, Schmid C, Schmetzer H, Guerin M, Weiss JM, Regnier F, Renault G, Vimeux L, Peranzoni E, Feuillet V, Thoreau M, Guilbert T, Trautmann A, Bercovici N, Amberger DC, Doraneh-Gard F, Boeck CL, Plett C, Gunsilius C, Kugler C, Werner J, Schmohl J, Kraemer D, Ismann B, Rank A, Schmid C, Schmetzer HM, Markota A, Ochs C, May P, Gottschlich A, Gosálvez JS, Karches C, Wenk D, Endres S, Kobold S, Hilmenyuk T, Klar R, Jaschinski F, Gamerith G, Augustin F, Lorenz E, Manzl C, Hoflehner E, Moser P, Zelger B, Köck S, Amann A, Kern J, Schäfer G, Öfner D, Maier H, Zwierzina H, Sopper S, Prado-Garcia H, Romero-Garcia S, Sandoval-Martínez R, Puerto-Aquino A, Lopez-Gonzalez J, Rumbo-Nava U, Klar R, Hilmenyuk T, Jaschinski F, Coosemans A, Baert T, Van Hoylandt A, Busschaert P, Vergote I, Baert T, Van Hoylandt A, Busschaert P, Vergote I, Coosemans A, Laengle J, Pilatova K, Budinska E, Bencsikova B, Sefr R, Nenutil R, Brychtova V, Fedorova L, Hanakova B, Zdrazilova-Dubska L, Allen C, Ku YC, Tom W, Sun Y, Pankov A, Looney T, Hyland F, Au-Young J, Mongan A, Becker A, Tan JBL, Chen A, Lawson K, Lindsey E, Powers JP, Walters M, Schindler U, Young S, Jaen JC, Yin S, Chen Y, Gullo I, Gonçalves G, Pinto ML, Athelogou M, Almeida G, Huss R, Oliveira C, Carneiro F, Merz C, Sykora J, Hermann K, Hussong R, Richards DM, Fricke H, Hill O, Gieffers C, Pinho MP, Barbuto JAM, McArdle SE, Foulds G, Vadakekolathu JN, Abdel-Fatah TMA, Johnson C, Hood S, Moseley P, Rees RC, Chan SYT, Pockley AG, Rutella S, Geppert C, Hartmann A, Kumar KS, Gokilavani M, Wang S, Merz C, Richards DM, Sykora J, Redondo-Müller M, Heinonen K, Marschall V, Thiemann M, Fricke H, Gieffers C, Hill O, Zhang L, Mao B, Jin Y, Zhai G, Li Z, Wang Z, Qian W, An X, Qiao M, Zhang J, Shi Q, Weber J, Kluger H, Halaban R, Sznol M, Roder H, Roder J, Grigorieva J, Asmellash S, Oliveira C, Meyer K, Steingrimsson A, Blackmon S, Sullivan R, Boeck CL, Amberger DC, Doraneh-Gard F, Sutanto W, Guenther T, Schmohl J, Schuster F, Salih H, Babor F, Borkhardt A, Schmetzer H, Kim Y, Oh I, Park C, Ahn S, Na K, Song S, Choi Y, Fedorova L, Poprach A, Lakomy R, Selingerova I, Demlova R, Pilatova K, Kozakova S, Valik D, Petrakova K, Vyzula R, Zdrazilova-Dubska L, Aguilar-Cazares D, Galicia-Velasco M, Camacho-Mendoza C, Islas-Vazquez L, Chavez-Dominguez R, Gonzalez-Gonzalez C, Prado-Garcia H, Lopez-Gonzalez JS, Yang S, Moynihan KD, Noh M, Bekdemir A, Stellacci F, Irvine DJ, Volz B, Kapp K, Oswald D, Wittig B, Schmidt M, Chavez-Dominguez R, Aguilar-Cazares D, Prado-Garcia H, Islas-Vazquez L, Lopez-Gonzalez JS, Kleef R, Bohdjalian A, McKee D, Moss RW, Saeed M, Zalba S, Debets R, ten Hagen TLM, Javed S, Becher J, Koch-Nolte F, Haag F, Gordon EM, Sankhala KK, Stumpf N, Tseng W, Chawla SP, Suárez NG, Báez GB, Rodríguez MC, Pérez AG, García LC, Fernández DH, Pous JR, Ramírez BS, Jacoberger-Foissac C, Saliba H, Seguin C, Brion A, Frisch B, Fournel S, Heurtault B, Otterhaug T, Håkerud M, Nedberg A, Edwards V, Selbo P, Høgset A, Jaitly T, Dörrie J, Schaft N, Gross S, Schuler-Thurner B, Gupta S, Taher L, Schuler G, Vera J, Rataj F, Kraus F, Grassmann S, Chaloupka M, Lesch S, Heise C, Endres S, Kobold S, Cadilha BML, Dorman K, Heise C, Rataj F, Endres S, Kobold S. Abstracts from the 4th ImmunoTherapy of Cancer Conference. J Immunother Cancer 2017. [PMCID: PMC5374589 DOI: 10.1186/s40425-017-0219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
46
|
Holzamer A, Zerdzitzki M, Debl K, Zausig Y, Hilker M, Schmid C. Development and Clinical Evaluation of a New TAVI Sizing Software. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Holzamer
- University of Regensburg Medical Center, Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Regensburg, Germany
| | - M. Zerdzitzki
- University of Regensburg Medical Center, Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Regensburg, Germany
| | - K. Debl
- University of Regensburg Medical Center, Klinik und Poliklinik für Innere Medizin II, Regensburg, Germany
| | - Y. Zausig
- University of Regensburg Medical Center, Klinik für Anästhesiologie, Regensburg, Germany
| | - M. Hilker
- University of Regensburg Medical Center, Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Regensburg, Germany
| | - C. Schmid
- University of Regensburg Medical Center, Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Regensburg, Germany
| |
Collapse
|
47
|
Zerdzitzki M, Holzamer A, Debl K, Endemann D, Camboni D, Zausig Y, Hilker M, Schmid C. Impact of Near-Term Contrast Application Prior to TAVI on Postoperative Renal Failure. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Zerdzitzki
- Universitätsklinikum Regensburg, Herz, Thorax und herznahe Gefäßchirurgie, Regensburg, Germany
| | - A. Holzamer
- Universitätsklinikum Regensburg, Herz, Thorax und herznahe Gefäßchirurgie, Regensburg, Germany
| | - K. Debl
- Universitätsklinikum Regensburg, Innere Medizin II, Kardiologie, Regensburg, Germany
| | - D. Endemann
- Universitätsklinikum Regensburg, Innere Medizin II, Kardiologie, Regensburg, Germany
| | - D. Camboni
- Universitätsklinikum Regensburg, Herz, Thorax und herznahe Gefäßchirurgie, Regensburg, Germany
| | - Y. Zausig
- Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany
| | - M. Hilker
- Universitätsklinikum Regensburg, Herz, Thorax und herznahe Gefäßchirurgie, Regensburg, Germany
| | - C. Schmid
- Universitätsklinikum Regensburg, Herz, Thorax und herznahe Gefäßchirurgie, Regensburg, Germany
| |
Collapse
|
48
|
Affiliation(s)
- S Allelein
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - A Kuebart
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - M Haase
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - T Dringenberg
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - C Schmid
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - M Schott
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - M Ehlers
- Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| |
Collapse
|
49
|
Allelein S, Ehlers M, Goretzki S, Hermsen D, Feldkamp J, Haase M, Dringenberg T, Schmid C, Hautzel H, Schott M. Clinical Evaluation of the First Automated Assay for the Detection of Stimulating TSH Receptor Autoantibodies. Horm Metab Res 2016; 48:795-801. [PMID: 27923250 DOI: 10.1055/s-0042-121012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Until recently, stimulating TSH receptor autoantibodies (sTRAbs) could only be measured by bioassays. A new assay system, which directly detects sTRAb in sera by applying bridge technology, has been established and is now available as automated chemiluminescence (bridge) immunoassay. We evaluated the automated bridge assay in clinical routine and compared it with a conventional automated TRAb assay (competition assay). Altogether, 226 Graves' disease (GD), 57 autoimmune thyroiditis, 74 non-autoimmune nodular goiter and 49 thyroid cancer patients, as well as 41 healthy controls were retrospectively evaluated. ROC plot analysis based on sera of newly diagnosed GD patients revealed an area under curve of 0.99 (95% CI: 0.99-1.0) indicating a high assay sensitivity and specificity. The highest sensitivity (100%) and specificity (99%) were seen at a cut-off level of 0.55 IU/l. The calculated positive predictive value was 94%, whereas the negative was 100%. Applying a ROC plot-derived cut-off of≥0.30 IU/l, derived from sera of GD patients already receiving antithyroid drug therapy for≤6 months, the sensitivity was 99% whereas the specificity was 98%. Detailed comparison of both assay systems used revealed a slightly different distribution of sTRAb and TRAb. Measurement of sTRAb during follow-up revealed a steady decline over one year of follow-up. In summary, our results demonstrate that the new automated bridge assay system for detecting sTRAb has a high sensitivity and specificity for diagnosing GD and to discriminate from other thyroid diseases, respectively. Our study, however, does not provide full evidence that the bridge assay is specific for sTRAb only.
Collapse
Affiliation(s)
- S Allelein
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - M Ehlers
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - S Goretzki
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - D Hermsen
- Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, University of Düsseldorf, Duesseldorf, Germany
| | - J Feldkamp
- Department for Endocrinology and Diabetes, Municipal Hospital Bielefeld, Bielefeld, Germany
| | - M Haase
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - T Dringenberg
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - C Schmid
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - H Hautzel
- Department for Nuclear Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - M Schott
- Division for Specific Endocrinology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
50
|
Süsskind MV, Keil L, Schaub AL, Schmid C, Hirt SW, Lehle K. Eine Kombination aus Rezeptor-Tyrosin-Kinase-Inhibitoren und Everolimus reduziert das chronische Transplantatversagen nach experimenteller Lungentransplantation. Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1587530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|