1
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Von Stein P, Seitz L, Wienemann H, Hohmann C, Baar T, Baldus S, Halbach M. Early in-hospital discontinuation of aspirin following coronary stent implantation in patients with indication for direct oral anticoagulation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2035] [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 and purpose
5–10% of patients undergoing percutaneous coronary intervention (PCI) have an indication for oral anticoagulation (OAC). Triple therapy, i.e. anticoagulation plus dual antiplatelet therapy, is associated with a high bleeding rate. Discontinuation of aspirin while continuing direct OAC (DOAC) and a P2Y12 inhibitor (so-called dual therapy) after PCI, was investigated in four randomized trials demonstrating a reduction in bleeding without significant differences in ischemic events. Since randomization was performed several days after the index PCI, these trials allowed for a short period of triple therapy. Whether exclusive procedural application of aspirin and early discontinuation of aspirin at the first postprocedural day is safe, is unknown and was the scope of this work.
Methods and results
We retrospectively analysed 3613 patients (4564 PCIs) treated from 2017 to 2020 at our centre. 871 (24.1%) patients (1059 PCIs, 23.2%) had an indication for OAC. In 284 PCIs with stenting, patients received DOAC (71.8% Rivaroxaban, 25.7% Apixaban, 1.8% Dabigatran, 0.7% Edoxaban) + P2Y12 inhibitor (100% clopidogrel) + aspirin only at the day of procedure (group 1). In 52 PCIs with stenting, patients received DOAC (59.6% Rivaroxaban, 34.6% Apixaban, 1.9% Dabigatran, 3.9% Edoxaban) + P2Y12 inhibitor (100% clopidogrel) + 100 mg aspirin/d at ≥1 postprocedural day (group 2). Based on our local patient database, we analysed the rate of ischemic events (myocardial infarction, stent thrombosis, stroke/transient ischemic attack (TIA), pulmonary/systemic embolism (PE/SE), deep vein thrombosis) as well as major and minor bleeding according to the Thrombolysis in Myocardial Infarction (TIMI) criteria during hospitalisation. Data are presented as mean±standard deviation or median (range).
Baseline characteristics were similar (group 1 vs. group 2: 74.3% vs. 73.1% male, age 75.9±8.5 vs. 74.3±9.3 years, atrial fibrillation 91.2% vs. 88.5%), except previous PE (3.5% vs. 11.5%; p=0.024), type of preprocedural DOAC (Rivaroxaban 52.5% vs. 34.6%; p=0.023) and creatinine clearance (62.4±19.7 vs. 68.9±20.3 ml/min; p=0.029). Median duration of postprocedural hospitalisation was 1 day for both groups (0–20 days vs. 1–21 days). In both groups, one TIA occurred (p=0.292), there were no other ischemic events. 36 (12.7%) bleeding events occurred in group 1 and 11 (21.2%) in group 2 (p=0.126). A subgroup analysis of cases being hospitalised for ≥2 postprocedural days (group 1: 87 cases, median 4 (2–20) days; group 2: 20 cases, median 2 (2–21) days) found no ischemic events and no difference regarding bleeding events (34.5% vs. 45.0%; p=0.443).
Conclusions
Exclusive procedural application of aspirin and start of dual therapy at the first postprocedural day appears safe regarding ischemic events in a real-world population. Nearly ¼ of patients undergoing PCI had an indication for OAC, which is much more frequent than previously reported.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Von Stein
- Cologne University Hospital - Heart Center, Department III for Internal Medicine , Cologne , Germany
| | - L Seitz
- Cologne University Hospital - Heart Center, Department III for Internal Medicine , Cologne , Germany
| | - H Wienemann
- Cologne University Hospital - Heart Center, Department III for Internal Medicine , Cologne , Germany
| | - C Hohmann
- Cologne University Hospital - Heart Center, Department III for Internal Medicine , Cologne , Germany
| | - T Baar
- University of Cologne, Institute of Medical Statistics and Computational Biology , Cologne , Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Department III for Internal Medicine , Cologne , Germany
| | - M Halbach
- Cologne University Hospital - Heart Center, Department III for Internal Medicine , Cologne , Germany
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2
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Cramer H, Hohmann C, Lauche R, Choi KE(A, Schneider N, Steckhan N, Rathjens F, Anheyer D, Paul A, von Scheidt C, Ostermann T, Schneider E, Koppold-Liebscher DA, Kessler CS, Dobos G, Michalsen A, Jeitler M. Effects of Fasting and Lifestyle Modification in Patients with Metabolic Syndrome: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11164751. [PMID: 36012990 PMCID: PMC9410059 DOI: 10.3390/jcm11164751] [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: 06/13/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lifestyle interventions, such as fasting, diet, and exercise, are increasingly used as a treatment option for patients with metabolic syndrome (MS). This study assesses the efficacy and safety of fasting followed by lifestyle modification in patients with MS compared to lifestyle modification only. METHODS Single-blind, multicenter, parallel, randomized controlled trial in two German tertiary referral hospitals in metropolitan areas. INTERVENTIONS (a) 5-day fasting followed by 10 weeks of lifestyle modification (modified DASH diet, exercise, mindfulness; n = 73); (b) 10 weeks of lifestyle modification only (n = 72). MAIN OUTCOMES AND MEASURES Co-primary outcomes were ambulatory systolic blood pressure and the homeostasis model assessment (HOMA) index at week 12. Further outcomes included anthropometric, laboratory parameters, and the PROCAM score at weeks 1, 12, and 24. RESULTS A total of 145 patients with metabolic syndrome (62.8% women; 59.7 ± 9.3 years) were included. No significant group differences occurred for the co-primary outcomes at week 12. However, compared to lifestyle modification only, fasting significantly reduced HOMA index (Δ = -0.8; 95% confidence interval [CI] = -1.7, -0.1), diastolic blood pressure (Δ = -4.8; 95% CI = -5.5, -4.1), BMI (Δ = -1.7; 95% CI = -2.0, -1.4), weight (Δ = -1.7; 95% CI = -2.0, -1.4), waist circumference (Δ = -2.6; 95% CI = -5.0, -0.2), glucose (Δ = -10.3; 95% CI = -19.0, -1.6), insulin (Δ = -2.9; 95% CI = -5.3, -0.4), HbA1c (Δ = -0.2; 95% CI = -0.4, -0.05;), triglycerides (Δ = -48.9; 95% CI = -81.0, -16.9), IL-6 (Δ = -1.2; 95% CI = -2.5, -0.005), and the 10-year risk of acute coronary events (Δ = -4.9; 95% CI = -9.5, -0.4) after week 1. Fasting increased uric acid levels (Δ = 1.0; 95% CI = 0.1, 1.9) and slightly reduced eGRF (Δ = -11.9; 95% CI = -21.8, -2.0). Group differences at week 24 were found for weight (Δ = -2, 7; 95% CI = -4.8, -0.5), BMI (Δ = -1.0; 95% CI = -1.8, -0.3), glucose (Δ = -7.7; 95% CI = -13.5, -1.8), HDL (Δ = 5.1; 95% CI = 1.5, 8.8), and CRP (Δ = 0.2; 95% CI = 0.03, 0.4). No serious adverse events occurred. CONCLUSIONS A beneficial effect at week 24 was found on weight; fasting also induced various positive short-term effects in patients with MS. Fasting can thus be considered a treatment for initializing lifestyle modification for this patient group; however, it remains to be investigated whether and how the multilayered effects of fasting can be maintained in the medium and longer term.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Evangelische Kliniken Essen-Mitte, University of Duisburg-Essen, 45276 Essen, Germany
- Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, 72076 Tuebingen, Germany
- Bosch Health Campus, 70376 Stuttgart, Germany
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore 2480, Australia
| | - Christoph Hohmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore 2480, Australia
| | - Kyung-Eun (Anna) Choi
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Nadia Schneider
- Department of Internal and Integrative Medicine, Evangelische Kliniken Essen-Mitte, University of Duisburg-Essen, 45276 Essen, Germany
| | - Nico Steckhan
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, 14469 Potsdam, Germany
| | - Florian Rathjens
- Department of Internal and Integrative Medicine, Evangelische Kliniken Essen-Mitte, University of Duisburg-Essen, 45276 Essen, Germany
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evangelische Kliniken Essen-Mitte, University of Duisburg-Essen, 45276 Essen, Germany
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore 2480, Australia
| | - Anna Paul
- Department of Internal and Integrative Medicine, Evangelische Kliniken Essen-Mitte, University of Duisburg-Essen, 45276 Essen, Germany
| | - Christel von Scheidt
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, 14109 Berlin, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Witten/Herdecke University, 58455 Witten, Germany
| | - Elisabeth Schneider
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Daniela A. Koppold-Liebscher
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, 14109 Berlin, Germany
| | - Christian S. Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evangelische Kliniken Essen-Mitte, University of Duisburg-Essen, 45276 Essen, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, 14109 Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, 14109 Berlin, Germany
- Correspondence:
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3
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Kuffer L, Koerber MI, Nettersheim F, Tichelbaecker T, Hohmann C, Schaetzle AK, Kabbasch K, Borrega JG, Boell B, Kohle F, Warnke C, Baldus S, Ten Freyhaus H. P630 Recovery of non-bacterial thrombotic endocarditis and severe aortic regurgitation in a young patient with acute promyelocytic leukemia. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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
Introduction
Non-bacterial thrombotic endocarditis (NBTE) is characterised by non-infectious vegetations on the cardiac valves and is typically seen in patients with malignancies or systemic lupus erythematosus. Risk of thromboembolic events is high and treatment of choice consists of anticoagulation, if feasible, as well as treatment of the underlying disease. Severe valvular dysfunction is rarely seen and in these cases, surgical valve replacement is usually performed.
Case presentation
A 28-year old female patient presented with left-sided hemiparesis persisting for several hours. Angio-CT scan of the brain revealed a branch occlusion of the middle cerebral artery with a correlating infarct core and without an area of penumbra. Blood tests showed decreased thrombocyte levels (45 x109/l). Given the thrombocytopenia and the time between the onset of symptoms and presentation, no thrombolysis was administered.
A subsequently performed transoesophageal echocardiography for diagnostic work-up of cardioembolic sources of stroke revealed a right ventricular thrombus and vegetations on the aortic valve causing severe aortic regurgitation with a holodiastolic flow reversal in the descending aorta (Fig. 1 (a) and (b) showing a large central coaptation defect). There were no of signs of infection or inflammation and blood cultures remained negative, thus infectious endocarditis was unlikely. A bone marrow biopsy led to the diagnosis of acute promyeolocytic leukemia (PML). Despite the inherent high risk of bleeding due to PML, anticoagulation with unfractionated heparin was initiated and treatment with prednisolone, all-trans retinoic acid and arsenic trioxide was started. After three weeks of therapy aortic valve vegetation size decreased considerably leading to dramatic reduction of aortic regurgitation (Fig. 1 (c) and (d)). No further embolic event or bleeding occurred.
Conclusion
This case is remarkable in many aspects. First, PML typically causes bleeding complications whereas NBTE is characterised by a high risk of thromboembolic events. Thus, the decision to start or not to start anticoagulation is challenging.
Second, NBTE, unlike infectious endocarditis, rarely causes severe valvular dysfunction and reported treatment in most cases consisted of surgical valve replacement or repair. However, in this case, conservative treatment alone led to almost complete resolution of valvular vegetations and of aortic regurgitation.
We conclude that conservative treatment of severe valvular disease in the setting of NBTE should be strongly considered, especially given the small number of cases reported worldwide.
Abstract P630 Figure. Fig.1
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Affiliation(s)
- L Kuffer
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - M I Koerber
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - F Nettersheim
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - T Tichelbaecker
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - C Hohmann
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - A K Schaetzle
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - K Kabbasch
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - J G Borrega
- University of Cologne, Department of Internal Medicine I, Cologne, Germany
| | - B Boell
- University of Cologne, Department of Internal Medicine I, Cologne, Germany
| | - F Kohle
- University of Cologne, Department of Neurology, Cologne, Germany
| | - C Warnke
- University of Cologne, Department of Neurology, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - H Ten Freyhaus
- Cologne University Hospital - Heart Center, Cologne, Germany
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4
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Abstract
Recent advances in the medical oncological treatment options for cancer have led to a clear improvement in the survival rate worldwide; however, many of the recently developed new drugs are directly or indirectly associated with cardiovascular side effects. Cardiovascular diseases are already the most frequent non-cancerous cause of death in tumor patients. Prevention, early detection of these complications, correct management and timely initiation of specific cardiac medical treatment are the key for an improvement of the cardiovascular prognosis. This article provides an overview and comprehensive summary of the possible cardiotoxic side effects of important oncological therapies and offers possible practical strategies with respect to risk stratification, cardiological follow-up care and management approaches for chemotherapy-induced left ventricular dysfunction.
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Affiliation(s)
- C Hohmann
- Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S Baldus
- Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - R Pfister
- Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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5
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Avery EG, Balogh A, Bartolomaeus H, Löber U, Steckhan N, Markó L, Wilck N, Hamad I, Šušnjar U, Mähler A, Hohmann C, Lesker TR, Strowig T, Dechend R, Bzdok D, Kleinewietfeld M, Michalsen A, Müller DN, Forslund SK. Abstract P2072: Integrative Network Analysis Of Microbiome-Immune Axis In Metabolic Syndrome Patients During A Fasting Intervention. Hypertension 2019. [DOI: 10.1161/hyp.74.suppl_1.p2072] [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: 11/16/2022]
Abstract
Fasting can prolong survival and reduce disease burden in rodent models, and possibly in humans. The relationship between diet, gut microbiota, immune system and host (patho)physiology has only recently been explored, and information is lacking on how periodic fasting affects the gut microbiome in patients with metabolic syndrome (MetS). We show a 5-day fast (FAST) in humans, followed by a modified DASH diet is more effective than DASH alone (DASH) at reducing systolic blood pressure (SBP change measured by ABPM, 95% CI; FAST: [-7.053,-1.142], DASH: [-5.880,1.477]), need for antihypertensive medication (FAST: n=15 of n=35, DASH: n=6 of n=36 patients), and body-mass index at three months post intervention. Fasting altered the gut microbiome, impacting bacterial taxa and functional gene modules associated with the production of short-chain fatty acids (e.g.
Faecalibacterium prausnitzii
,
Eubacterium rectale, Coprococcus comes
), previously linked to vascular health and immunity. Immunophenotyping and cross-system analyses revealed that SBP changes correlated with circulating Il-2
+
TNFα
+
mucosa-associated invariant T (MAIT) cells (FDR-corr P(q) =0.044, Spearman’s rho=0.44), Il-17
-
IFNγ
+
MAITs (FDR-corr P(q) =0.022, Spearman’s rho=0.49), and effector CD4
+
T cells (FDR-corr P(q)=0.047, Spearman’s rho=0.43). By stratifying the fasting group into BP responders and non-responders, we identified a set of 76 microbial and 99 immune responder-specific features. Machine learning algorithms could predict long-term SBP responsiveness from baseline immunome data, identifying changes in effector CD8
+
T cells, Th17 cells and Tregs as discriminators (Single-subject prediction: 71%). This is the first high-resolution multi-omics characterization of fasting in MetS. Fasting induced long-term reduction in body weight and SBP, accompanied by changes in microbiome and immune homeostasis. Our data implicate fasting as a promising non-pharmacological intervention in MetS.
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Affiliation(s)
- Ellen G Avery
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - András Balogh
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Hendrik Bartolomaeus
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Ulrike Löber
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Nico Steckhan
- Charité Universitätsmedizin & Immanuel Krankenhaus, Berlin, Germany
| | - Lajos Markó
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Nicola Wilck
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Ibrahim Hamad
- VIB Cntr for Inflammation Rsch (IRC), UHasselt, Hasselt, Belgium
| | - Urša Šušnjar
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Anja Mähler
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | | | - Till R Lesker
- Helmholtz Cntr for Infection Rsch, Braunschweig, Germany
| | - Till Strowig
- Helmholtz Cntr for Infection Rsch, Braunschweig, Germany
| | - Ralf Dechend
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Danilo Bzdok
- Dept of Psychiatry, Psychotherapy, and Psychosomatics, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen Univ, Aachen, Germany
| | | | | | - Dominik N Müller
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
| | - Sofia K Forslund
- Experimental and Clinical Rsch Cntr (Max Delbrück Cntr for Molecular Medicine & Charité Universitätsmedizin), Berlin, Germany
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6
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Balogh A, Steckhan N, Forslund SK, Wilck N, Hamad I, Avery EG, Šušnjar U, Hohmann C, Strowig T, Dechend R, Kleinewietfeld M, Michalsen A, Mueller DN. Abstract P372: The Effect of Periodic Fasting on Patients With Hypertension and Metabolic Syndrome. Hypertension 2018. [DOI: 10.1161/hyp.72.suppl_1.p372] [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: 11/16/2022]
Abstract
Periodic fasting may serve as therapeutic strategy for the management of hypertension and metabolic syndrome. We hypothesize that fasting affects the gut microbiome and promotes immune cell homeostasis resulting in lower blood pressure. Patients suffering from metabolic syndrome and hypertension were randomized either to 7-day periodic fasting combined with lifestyle change or Dietary Approaches to Stop Hypertension (DASH) intervention. Data derived from clinical parameters, 16S sequencing of the gut microbiome and immunophenotyping were collected at baseline, at day 7 and 3 months post intervention. At baseline, 21 out 30 patients in the fasting and 23 out of 31 in the DASH group had elevated systolic office blood pressure (SBP >130 mmHg), which dropped significantly by 10 mmHg after fasting, and remained lower 3 months post intervention (7 mmHg). In the DASH group, SBP significantly decreased by 12 mmHg after 1 week and 8 mmHg after 3 months. At 3 months post intervention, 24-h ABPM confirmed the decrease in fasting, but not in DASH. Fasting, but not DASH significantly reduced body weight and BMI after 7 days compared to baseline, and this effect persisted for 3 months post-intervention. Furthermore, 50 % (15/30) of patients in fasting and 23 % (7/31) in DASH were able to decrease their use of medications for treatment of metabolic syndrome. Spearman correlation tests showed that fasting, but not DASH, altered the gut microbiome. After fasting
Bacteroides
,
Lachnoclostridium
,
Coprococcus
, and
Ruminococcus
Operational Taxonomic Units (OTUs) decreased, while the
Eubacterium rectale
OTU increased. In contrast to DASH, fasting significantly reduced the frequency of CD4+ Th17 cells, active CD69+ mucosa-associated invariant T cells (MAIT) and IFNg+IL-2+ or TNFa+ MAITs indicating the anti-inflammatory effect of fasting. While some of these changes reverted to baseline after 3 months, several persisted. Despite a similar decrease in office SBP in both study arms, the periodic fasting intervention is more beneficial in reducing body weight and BMI compared to baseline. Fasting altered the prevalence of certain gut microbes and influenced immune cell signatures whereas DASH did not, suggesting a distinct role of fasting for improving cardiometabolic health.
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Affiliation(s)
- Andras Balogh
- Experimental and Clinical Rsch Cntr & Charité Universitätsmedizin Berlin & DZHK, Berlin, Germany
| | - Nico Steckhan
- Charité Universitätsmedizin Berlin & Immanuel Hosp Berlin, Berlin, Germany
| | - Sofia K Forslund
- Experimental and Clinical Rsch Cntr & Charité Universitätsmedizin Berlin & Max Delbrück Cntr for Molecular Medicine & BIH, Berlin, Germany
| | - Nicola Wilck
- Experimental and Clinical Rsch Cntr & Charité Universitätsmedizin Berlin & DZHK, Berlin, Germany
| | - Ibrahim Hamad
- VIB Cntr for Inflammation Rsch (IRC), Hasselt Univ, Diepenbeek, Netherlands
| | - Ellen G Avery
- Experimental and Clinical Rsch Cntr & Max Delbrück Cntr for Molecular Medicine, Berlin, Germany
| | - Urša Šušnjar
- Experimental and Clinical Rsch Cntr & Max Delbrück Cntr for Molecular Medicine, Berlin, Germany
| | - Christoph Hohmann
- Charité Universitätsmedizin Berlin & Immanuel Hosp Berlin, Berlin, Germany
| | - Till Strowig
- Helmholtz Cntr for Infection Rsch, Braunschweig, Germany
| | - Ralf Dechend
- Experimental and Clinical Rsch Cntr & Charite Unviersitätsmedizin Berlin & DZHK & BIH & Helios Hosp, Berlin, Germany
| | | | - Andreas Michalsen
- Charité Universitätsmedizin Berlin & Immanuel Hosp Berlin, Berlin, Germany
| | - Dominik N Mueller
- Experimental and Clinical Rsch Cntr & Max Delbrück Cntr for Molecular Medicine, Charite Unviersitätsmedizin Berlin & DZHK & BIH, Berlin, Germany
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7
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Hohmann C, Hohnloser SH, Jacob J, Walker J, Baldus S, Pfister R. 4365Non-vitamin K oral anticoagulants in comparison to phenprocoumon in geriatric and non-geriatric patients: a retrospective, observational study on 71,000 patients with non-valvular atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4365] [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: 11/12/2022] Open
Affiliation(s)
- C Hohmann
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - S H Hohnloser
- JW Goethe University, Department of Cardiology, Frankfurt am Main, Germany
| | - J Jacob
- InGef- Institute for applied health research, Berlin, Germany
| | - J Walker
- InGef- Institute for applied health research, Berlin, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - R Pfister
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
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8
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Hohmann C, Pfister R, Michels G. Sind initialer pH- und Laktatwert nach kardiopulmonaler Wiederbelebung immer entscheidend? Med Klin Intensivmed Notfmed 2018; 114:561-566. [DOI: 10.1007/s00063-018-0432-z] [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] [Received: 01/05/2018] [Revised: 02/18/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
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9
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Krämer B, Pickert A, Hohmann C, Liebich H, Müller G, Hablitzel M, Risler T. In Vivo Clearance and Elimination of Nine Marker Substances during Hemofiltration with Different Membranes. Int J Artif Organs 2018. [DOI: 10.1177/039139889201500706] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The handling of low, middle and high molecular weight markers was examined in seven stable dialysis patients during hemofiltration with different membranes. Four membranes were examined in a randomized, crossover order (polysulfone, polyamide, AN69 polyacrylonitrile, Asahi polyacrylonitrile) by measuring plasma and dialysate concentrations of phosphate, creatinine, vitamin B12, β2-microglobulin, furanic acid, hippuric acid, retinolbinding protein, alpha-1-antitrypsin, and albumin. Sieving coefficients and plasma clearances of β-microglobulin or retinol-binding protein were markedly or slightly lower during hemofiltration with the Asahi polyacrylonitrile membrane than with the other membranes (highest removal with polysulfone/AN69 polyacrylonitrile membranes). No differences of obvious clinical relevance could be seen between the four membranes. A high β2-microglobulin removal rate might be important to prevent dialysis-associated amyloidosis.
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Affiliation(s)
- B.K. Krämer
- Section of Nephrology and Hypertension, III Department of Medicine, University of Tübingen, Tübingen - Germany
| | - A. Pickert
- IV Department of Medicine and Clinical Chemistry, University of Tübingen, Tübingen - Germany
| | - C. Hohmann
- Section of Nephrology and Hypertension, III Department of Medicine, University of Tübingen, Tübingen - Germany
| | - H.M. Liebich
- IV Department of Medicine and Clinical Chemistry, University of Tübingen, Tübingen - Germany
| | - G.A. Müller
- Section of Nephrology and Hypertension, III Department of Medicine, University of Tübingen, Tübingen - Germany
| | - M. Hablitzel
- Section of Nephrology and Hypertension, III Department of Medicine, University of Tübingen, Tübingen - Germany
| | - T. Risler
- Section of Nephrology and Hypertension, III Department of Medicine, University of Tübingen, Tübingen - Germany
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Keller T, Hohmann C, Standl M, Wijga AH, Gehring U, Melén E, Almqvist C, Lau S, Eller E, Wahn U, Christiansen ES, von Berg A, Heinrich J, Lehmann I, Maier D, Postma DS, Antó JM, Bousquet J, Keil T, Roll S. The sex-shift in single disease and multimorbid asthma and rhinitis during puberty - a study by MeDALL. Allergy 2018; 73:602-614. [PMID: 28960325 PMCID: PMC5836860 DOI: 10.1111/all.13312] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cross-sectional studies suggested that allergy prevalence in childhood is higher in boys compared to girls, but it remains unclear whether this inequality changes after puberty. We examined the sex-specific prevalence of asthma and rhinitis as single and as multimorbid diseases before and after puberty onset in longitudinal cohort data. METHODS In six European population-based birth cohorts of MeDALL, we assessed the outcomes: current rhinitis, current asthma, current allergic multimorbidity (ie, concurrent asthma and rhinitis), puberty status and allergic sensitization by specific serum antibodies (immunoglobulin E) against aero-allergens. With generalized estimating equations, we analysed the effects of sex, age, puberty (yes/no) and possible confounders on the prevalence of asthma and rhinitis, and allergic multimorbidity in each cohort separately and performed individual participant data meta-analysis. FINDINGS We included data from 19 013 participants from birth to age 14-20 years. Current rhinitis only affected girls less often than boys before and after puberty onset: adjusted odds ratio for females vs males 0.79 (95%-confidence interval 0.73-0.86) and 0.86 (0.79-0.94), respectively (sex-puberty interaction P = .089). Similarly, for current asthma only, females were less often affected than boys both before and after puberty onset: 0.71, 0.63-0.81 and 0.81, 0.64-1.02, respectively (sex-puberty interaction P = .327). The prevalence of allergic multimorbidity showed the strongest sex effect before puberty onset (female-male-OR 0.55, 0.46-0.64) and a considerable shift towards a sex-balanced prevalence after puberty onset (0.89, 0.74-1.04); sex-puberty interaction: P < .001. INTERPRETATION The male predominance in prevalence before puberty and the "sex-shift" towards females after puberty onset were strongest in multimorbid patients who had asthma and rhinitis concurrently.
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Affiliation(s)
- T. Keller
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - C. Hohmann
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Standl
- Institute of Epidemiology I; Helmholtz Zentrum München - German Research Center for Environmental Health; Neuherberg Germany
| | - A. H. Wijga
- Center for Nutrition, Prevention, and Health Services; National Institute for Public Health and the Environment; Bilthoven The Netherlands
| | - U. Gehring
- Division of Environmental Epidemiology; Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
| | - E. Melén
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Solna Sweden
- Sachs’ Children's Hospital; Stockholm Sweden
| | - C. Almqvist
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Solna Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital; Karolinska University Hospital; Stockholm Sweden
| | - S. Lau
- Department of Paediatric Pneumology & Immunology; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - E. Eller
- Department of Dermatology and Allergy Center; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
| | - U. Wahn
- Department of Paediatric Pneumology & Immunology; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - E. S. Christiansen
- Department of Dermatology and Allergy Center; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
- Hans Christian Andersen Children Hospital; Odense Denmark
| | - A. von Berg
- Department of Pediatrics; Research Institute; Marien-Hospital Wesel; Wesel Germany
| | - J. Heinrich
- Institute of Epidemiology I; Helmholtz Zentrum München - German Research Center for Environmental Health; Neuherberg Germany
- Inner City Clinic; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine; University Hospital of Munich (LMU); Munich Germany
| | - I. Lehmann
- Department of Environmental Immunology/Core Facility Studies; Helmholtz Centre for Environmental Research - UFZ; Leipzig Germany
| | - D. Maier
- Biomax Informatics AG; Munich Germany
| | - D. S. Postma
- Department of Pulmonology; University Medical Center Groningen; University of Groningen; Groningen The Netherlands
| | - J. M. Antó
- Centre for Research in Environmental Epidemiology (CREAL); ISGlobal; Barcelona Spain
- Hospital del Mar Research Institute (IMIM); Barcelona Spain
- Universitat Popmpeu Fabra (UPF); Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP); Barcelona Spain
| | - J. Bousquet
- Universitat Popmpeu Fabra (UPF); Barcelona Spain
- University Hospital; Montpellier France
- MACVIA-LR; Contre les Maladies Chroniques pour un Vieillissement Actifen Languedoc Roussillon; European Innovation Partnership on Active and Healthy Ageing Reference Site, and INSERM; VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches; Paris France
- UVSQ; UMR-S 1168; Université Versailles; St-Quentin-en-Yvelines France
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Roll
- Institute of Social Medicine, Epidemiology and Health Economics; Charité - Universitätsmedizin Berlin; Berlin Germany
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11
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Fröhlich M, Pinart M, Keller T, Reich A, Cabieses B, Hohmann C, Postma DS, Bousquet J, Antó JM, Keil T, Roll S. Is there a sex-shift in prevalence of allergic rhinitis and comorbid asthma from childhood to adulthood? A meta-analysis. Clin Transl Allergy 2017; 7:44. [PMID: 29225773 PMCID: PMC5715620 DOI: 10.1186/s13601-017-0176-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/31/2017] [Indexed: 01/08/2023] Open
Abstract
Background Allergic rhinitis and asthma as single entities affect more boys than girls in childhood but more females in adulthood. However, it is unclear if this prevalence sex-shift also occurs in allergic rhinitis and concurrent asthma. Thus, our aim was to compare sex-specific differences in the prevalence of coexisting allergic rhinitis and asthma in childhood, adolescence and adulthood. Methods Post-hoc analysis of systematic review with meta-analysis concerning sex-specific prevalence of allergic rhinitis. Using random-effects meta-analysis, we assessed male–female ratios for coexisting allergic rhinitis and asthma in children (0–10 years), adolescents (11–17) and adults (> 17). Electronic searches were performed using MEDLINE and EMBASE for the time period 2000–2014. We included population-based observational studies, reporting coexisting allergic rhinitis and asthma as outcome stratified by sex. We excluded non-original or non-population-based studies, studies with only male or female participants or selective patient collectives. Results From a total of 6539 citations, 10 studies with a total of 93,483 participants met the inclusion criteria. The male–female ratios (95% CI) for coexisting allergic rhinitis and asthma were 1.65 (1.52; 1.78) in children (N = 6 studies), 0.61 (0.51; 0.72) in adolescents (N = 2) and 1.03 (0.79; 1.35) in adults (N = 2). Male–female ratios for allergic rhinitis only were 1.25 (1.19; 1.32, N = 5) in children, 0.80 (0.71; 0.89, N = 2) in adolescents and 0.98 (0.74; 1.30, N = 2) in adults, respectively. Conclusions The prevalence of coexisting allergic rhinitis and asthma shows a clear male predominance in childhood and seems to switch to a female predominance in adolescents. This switch was less pronounced for allergic rhinitis only. Electronic supplementary material The online version of this article (10.1186/s13601-017-0176-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Fröhlich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Clinic for Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Pinart
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Max-Delbrück-Centrum für Molekulare Medizin, Research Team Molecular Epidemiology, Berlin, Germany.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,Universitat Popmpeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - T Keller
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Reich
- Epidemiology, German Rheumatism Research Centre, Berlin, Germany
| | - B Cabieses
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - C Hohmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D S Postma
- Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J Bousquet
- University Hospital, Montpellier, France.,MACVIA-LR, Contre les Maladies Chroniques pour un Vieillissement Actifen Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, and INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France.,UVSQ, UMR-S 1168, Université Versailles, St-Quentin-en-Yvelines, France
| | - J M Antó
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,Universitat Popmpeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
| | - S Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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12
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Pfister R, Jacob J, Walker J, Baldus S, Hohmann C. 2874Non-vitamin K antagonist oral anticoagulants in comparison to phenprocoumon in a real-word setting of atrial fibrillation: an analysis of a large German health claims dataset. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.2874] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Hohmann C, Liehr K, Henning C, Fiedler R, Girndt M, Gebert M, Hulko M, Storr M, Glomb MA. Detection of Free Advanced Glycation End Products in Vivo during Hemodialysis. J Agric Food Chem 2017; 65:930-937. [PMID: 28112514 DOI: 10.1021/acs.jafc.6b05013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Advanced glycation end products (AGEs) are often regarded as glycotoxins, which are normally removed by the kidney. Patients with end-stage renal failure rely on hemodialysis (HD) treatment to eliminate these compounds. In the present work, a highly selective LC-MS/MS method was used for quantitation of AGE levels in plasma and in dialysis fluids of HD patients, with a focus on AGE-free adducts. A broad range of 19 amino acid modifications was identified and quantitated. It was expected that the AGE-free adducts are successfully eliminated by dialysis treatment. Indeed, with a mean elimination rate of 71%, this assumption proved to be valid for all target analytes with the exception of pyrraline, which showed an opposite behavior. Here, plasma and dialysate levels increased during the treatment by about 59%. The notions that pyrraline was formed in high amounts in the patient's bloodstream (I) after intake of the corresponding precursor compound 3-deoxyglucosone with the dialysis fluid or (II) by catalytic effects on the formation by the dialysis membrane were ruled out. In contrast, in a dietary study, the comparison of pyrraline concentrations in plasma before and after food consumption confirmed that the increase in pyrraline originates solely from digestion of glycated food proteins. Additionally, by detailed analyses of the food consumed during dialysis sessions, bread rolls with a pyrraline content of about 21.7 μmol per serving were identified as the main source.
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Affiliation(s)
- Christoph Hohmann
- Institute of Chemistry, Food Chemistry, Martin-Luther-University Halle-Wittenberg , Halle/Salle, Germany
| | - Kristin Liehr
- Institute of Chemistry, Food Chemistry, Martin-Luther-University Halle-Wittenberg , Halle/Salle, Germany
| | - Christian Henning
- Institute of Chemistry, Food Chemistry, Martin-Luther-University Halle-Wittenberg , Halle/Salle, Germany
| | - Roman Fiedler
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg , Halle/Salle, Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg , Halle/Salle, Germany
| | - Michael Gebert
- Department of Research and Development, Gambro Dialysatoren GmbH , Hechingen, Germany
| | - Michael Hulko
- Department of Research and Development, Gambro Dialysatoren GmbH , Hechingen, Germany
| | - Markus Storr
- Department of Research and Development, Gambro Dialysatoren GmbH , Hechingen, Germany
| | - Marcus A Glomb
- Institute of Chemistry, Food Chemistry, Martin-Luther-University Halle-Wittenberg , Halle/Salle, Germany
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14
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Vardavas CI, Hohmann C, Patelarou E, Martinez D, Henderson AJ, Granell R, Sunyer J, Torrent M, Fantini MP, Gori D, Annesi-Maesano I, Slama R, Duijts L, de Jongste JC, Aurrekoetxea JJ, Basterrechea M, Morales E, Ballester F, Murcia M, Thijs C, Mommers M, Kuehni CE, Gaillard EA, Tischer C, Heinrich J, Pizzi C, Zugna D, Gehring U, Wijga A, Chatzi L, Vassilaki M, Bergström A, Eller E, Lau S, Keil T, Nieuwenhuijsen M, Kogevinas M. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children. Eur Respir J 2016; 48:115-24. [PMID: 26965294 DOI: 10.1183/13993003.01016-2015] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 01/27/2016] [Indexed: 11/05/2022]
Abstract
Maternal smoking during pregnancy increases childhood asthma risk, but health effects in children of nonsmoking mothers passively exposed to tobacco smoke during pregnancy are unclear. We examined the association of maternal passive smoking during pregnancy and wheeze in children aged ≤2 years.Individual data of 27 993 mother-child pairs from 15 European birth cohorts were combined in pooled analyses taking into consideration potential confounders.Children with maternal exposure to passive smoking during pregnancy and no other smoking exposure were more likely to develop wheeze up to the age of 2 years (OR 1.11, 95% CI 1.03-1.20) compared with unexposed children. Risk of wheeze was further increased by children's postnatal passive smoke exposure in addition to their mothers' passive exposure during pregnancy (OR 1.29, 95% CI 1.19-1.40) and highest in children with both sources of passive exposure and mothers who smoked actively during pregnancy (OR 1.73, 95% CI 1.59-1.88). Risk of wheeze associated with tobacco smoke exposure was higher in children with an allergic versus nonallergic family history.Maternal passive smoking exposure during pregnancy is an independent risk factor for wheeze in children up to the age of 2 years. Pregnant females should avoid active and passive exposure to tobacco smoke for the benefit of their children's health.
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Affiliation(s)
- C I Vardavas
- Dept of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece Center for Global Tobacco Control, Dept of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
| | - C Hohmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany University of Otago, Dunedin, New Zealand
| | - E Patelarou
- Dept of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - D Martinez
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | - A J Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - R Granell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - M Torrent
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain IB-Salut, Area de Salut de Menorca, Spain
| | - M P Fantini
- Dept of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Bologna, Italy
| | - D Gori
- Dept of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Bologna, Italy
| | - I Annesi-Maesano
- Inserm, Epidemiology of Allergic and Respiratory diseases (EPAR) Dept, U1136, Medical School Saint-Antoine, Univ6, Sorbonne Universités Paris, Paris, France UPMC, EPAR UMR-S 707, Medical School Saint-Antoine, Univ6, Sorbonne Universités Paris, Paris, France
| | - R Slama
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm and Univ Grenoble Alpes Joint Research Centre (IAB, U823), Grenoble, France
| | - L Duijts
- The Generation R Study Group, Dept of Paediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands Dept of Paediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands Dept of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J C de Jongste
- The Generation R Study Group, Dept of Paediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J J Aurrekoetxea
- Faculty of Medicine, University of the Basque Country (UPV/EHU), San Sebastian, Spain BIODONOSTIA Health Research Institute, San Sebastian, Spain Subdirección de Salud Pública de Gipuzkoa; Departamento de Sanidad del Gobierno Vasco, San Sebastian, Spain
| | - M Basterrechea
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain BIODONOSTIA Health Research Institute, San Sebastian, Spain Subdirección de Salud Pública de Gipuzkoa; Departamento de Sanidad del Gobierno Vasco, San Sebastian, Spain
| | - E Morales
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Virgen de la Arrixaca Universtiy Hospital, IMIB-Arrixaca Research Institute, Murcia, Spain
| | - F Ballester
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain FISABIO-Universitat de València-Universitat Jaume I Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - M Murcia
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain FISABIO-Universitat de València-Universitat Jaume I Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - C Thijs
- Dept of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - M Mommers
- Dept of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - C E Kuehni
- Paediatric Respiratory Epidemiology, Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - E A Gaillard
- Institute for Lung Health, Dept of Infection Immunity and Inflammation, NIHR Leicester Respiratory Biomedical Research Unit, University of Leicester, Leicester, UK
| | - C Tischer
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - J Heinrich
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig Maximilians University Munich, München, Germany
| | - C Pizzi
- Cancer Epidemiology Unit, Dept of Medical Sciences, University of Turin, CPO Piedmont, Turin, Italy
| | - D Zugna
- Cancer Epidemiology Unit, Dept of Medical Sciences, University of Turin, CPO Piedmont, Turin, Italy
| | - U Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - A Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - L Chatzi
- Dept of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - M Vassilaki
- Dept of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - A Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Eller
- Dept of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - S Lau
- Dept for Pediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - M Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | - M Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Dept of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain Hospital del Mar Research Institute (IMIM), Barcelona, Spain
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Fisch S, Klapp C, Bergmann R, Bergmann K, Hohmann C, Keil T. Psychosoziales Frühwarnsystem Babylotse Plus – Untersuchung der diagnostischen Genauigkeit des Babylotse Plus Screeningbogens. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Garcia-Aymerich J, Benet M, Saeys Y, Pinart M, Basagaña X, Smit HA, Siroux V, Just J, Momas I, Rancière F, Keil T, Hohmann C, Lau S, Wahn U, Heinrich J, Tischer CG, Fantini MP, Lenzi J, Porta D, Koppelman GH, Postma DS, Berdel D, Koletzko S, Kerkhof M, Gehring U, Wickman M, Melén E, Hallberg J, Bindslev-Jensen C, Eller E, Kull I, Lødrup Carlsen KC, Carlsen KH, Lambrecht BN, Kogevinas M, Sunyer J, Kauffmann F, Bousquet J, Antó JM. Phenotyping asthma, rhinitis and eczema in MeDALL population-based birth cohorts: an allergic comorbidity cluster. Allergy 2015; 70:973-84. [PMID: 25932997 DOI: 10.1111/all.12640] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND Asthma, rhinitis and eczema often co-occur in children, but their interrelationships at the population level have been poorly addressed. We assessed co-occurrence of childhood asthma, rhinitis and eczema using unsupervised statistical techniques. METHODS We included 17 209 children at 4 years and 14 585 at 8 years from seven European population-based birth cohorts (MeDALL project). At each age period, children were grouped, using partitioning cluster analysis, according to the distribution of 23 variables covering symptoms 'ever' and 'in the last 12 months', doctor diagnosis, age of onset and treatments of asthma, rhinitis and eczema; immunoglobulin E sensitization; weight; and height. We tested the sensitivity of our estimates to subject and variable selections, and to different statistical approaches, including latent class analysis and self-organizing maps. RESULTS Two groups were identified as the optimal way to cluster the data at both age periods and in all sensitivity analyses. The first (reference) group at 4 and 8 years (including 70% and 79% of children, respectively) was characterized by a low prevalence of symptoms and sensitization, whereas the second (symptomatic) group exhibited more frequent symptoms and sensitization. Ninety-nine percentage of children with comorbidities (co-occurrence of asthma, rhinitis and/or eczema) were included in the symptomatic group at both ages. The children's characteristics in both groups were consistent in all sensitivity analyses. CONCLUSION At 4 and 8 years, at the population level, asthma, rhinitis and eczema can be classified together as an allergic comorbidity cluster. Future research including time-repeated assessments and biological data will help understanding the interrelationships between these diseases.
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Langebrake C, Ihbe-Heffinger A, Leichenberg K, Kaden S, Kunkel M, Lueb M, Hilgarth H, Hohmann C. PS-110 Extent and diversity of day-to-day clinical pharmacists’ interventions in hospitals. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.433] [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: 11/04/2022] Open
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Schorr SG, Eickhoff C, Feldt S, Hohmann C, Schulz M. Exploring the potential impact of hospital ward-based pharmacy interns on drug safety. Pharmazie 2014; 69:316-320. [PMID: 24791599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Clinical pharmacists play an important role in improving drug safety on hospital wards. However, little is known about the impact of pharmacy interns. The objective of our study was, therefore, to investigate the impact of hospital ward-based pharmacy interns on drug safety. This study was conducted as part of the project "P-STAT 2: Pharmacy interns on the ward" on 14 surgical wards in seven hospitals in Germany and a total of 27 pharmacy interns participated. All patients admitted to the participating wards from 1st June 2008 until 31st October 2008 and from 1st December 2008 till 30th April 2009 were included. The pharmacy interns were involved in medication reconciliation, and identifying, resolving, and preventing drug-related problems (DRPs) using the classification system APS-Doc. A total of 6,551 patients were included. Patients received on average (+/- SD) 4.4 +/- 3.9 drugs. The pharmacy interns detected a total of 4,085 DRPs and on average 0.6 +/- 1.2 DRPs per patient. Most frequently detected DRPs were potential drug-drug interactions (n = 591, 14%), missing drug strength, when different strengths were available (n = 373, 9%), and incomplete medication record (n = 296, 7%). The pharmacy interns conducted an intervention for 98% (n = 4,011) of all DRPs. According to their documentation, 74% of the DRPs (n = 3,038) were solved. Drugs which were most often related with DRPs were simvastatin, diclofenac, and ibuprofen. This is the very first study exploring the potential impact of pharmacy interns on drug safety on surgical wards in Europe. Pharmacy interns can play an important role to improve drug safety on hospital wards.
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Alter P, Luetteken L, Nell C, Haid D, Kehr K, Greulich T, Apelt S, Langenhan K, Hohmann C, Vogelmeier CF, Koczulla AR. Exercise training leads to physiological left ventricular hypertrophy in COPD. Int J Cardiol 2014; 174:156-7. [PMID: 24726167 DOI: 10.1016/j.ijcard.2014.03.160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- P Alter
- University of Marburg, Internal Medicine, Cardiology, Germany.
| | - L Luetteken
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C Nell
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - D Haid
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - K Kehr
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - T Greulich
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - S Apelt
- University of Marburg, Physiotherapy, Germany
| | - K Langenhan
- University of Marburg, Physiotherapy, Germany
| | - C Hohmann
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - C F Vogelmeier
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany
| | - A R Koczulla
- University of Marburg, Internal Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Reserach (DZL), Germany.
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Ihbe-Heffinger A, Langebrake C, Leichenberg K, Hilgarth H, Hohmann C, Kunkel M, Lueb M, Schuster T. PS-039 DokuPIK – Pharmaceutical interventions: Do ward pharmacists know how to document? Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.390] [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: 11/04/2022] Open
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Hohmann C, Neumann-Haefelin T, Klotz JM, Freidank A, Radziwill R. Providing systematic detailed information on medication upon hospital discharge as an important step towards improved transitional care. J Clin Pharm Ther 2014; 39:286-91. [PMID: 24877212 DOI: 10.1111/jcpt.12140] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Good communication between hospital and primary care physicians (PCPs) is important for the continuity of patient care in the transition phase following hospital treatment. Drug-related problems and medication errors may occur at that interface. Discharge letters often lack a structured medication report at the end and therefore may not provide the reasons for medication changes, resulting in low adherence rates. The objectives were to develop a structured medication report as part of the discharge letter, to evaluate the impact of the medication report in ischaemic stroke patients and to identify the most important issues in the transitional care process of stroke patients. METHODS First, a structured medication report was developed. Thereafter, the impact of this new medication report on clinical practice was evaluated with an open, prospective, interventional two-phase study conducted at the Klinikum Fulda gAG (Germany), which included patients with ischaemic stroke and >2 drugs in the discharge medication. In the control group (CG), the neurologist included the current medication in the discharge letter. In the intervention group (IG), the clinical pharmacist added the detailed information to a medication report. To evaluate adherence to discharge medication, the PCP was interviewed 3 months after hospital discharge about the medication. Adherence was measured with respect to the entire medication regimen, antithrombotic and cholesterol-lowering drugs and discontinued medication. The most important issues in the transitional care for patients with ischaemic stroke were identified on the basis of the secondary stroke prevention and cardiovascular risk factors. RESULTS AND DISCUSSION Overall, 312 patients were enrolled in the study with 156 patients in each group. By providing detailed information in the newly developed discharge letter, adherence increased significantly from 83·3% (CG) to 90·9% (IG; P = 0·01). Significant differences between the CG and IG were found with regard to adherence to both antithrombotic drugs [83·8% CG vs. 91·9% IG (P = 0·033)] and statin therapy [69·8% CG vs. 87·7% IG (P < 0·001)]. WHAT IS NEW AND CONCLUSION The use of a structured medication report as part of the discharge letter leads to improved adherence to hospital discharge medication.
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Fisch S, Tonn R, Bergmann R, Hohmann C, Klapp C. Babylotse plus – ein psychosoziales Screening- und Unterstützungsprogramm (nicht nur) für belastete Eltern von der Geburt bis zum 1. Geburtstag. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Koustenis E, Pfitzer C, Balcerek M, Reinmuth S, Zynda A, Stromberger C, Hohmann C, Keil T, Borgmann-Staudt A. Impact of Cranial Irradiation and Brain Tumor Location on Fertility: a Survey. Klin Padiatr 2013; 225:320-4. [DOI: 10.1055/s-0033-1353206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- E. Koustenis
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - C. Pfitzer
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - M. Balcerek
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - S. Reinmuth
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - A. Zynda
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - C. Stromberger
- Department of Radiooncology and Radiotherapy, Charité – Universitätsmedizin Berlin, Germany
| | - C. Hohmann
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Germany
| | - T. Keil
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - A. Borgmann-Staudt
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
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Messer MP, Kellermann P, Weber SJ, Hohmann C, Denk S, Klohs B, Schultze A, Braumüller S, Huber-Lang MS, Perl M. Silencing of fas, fas-associated via death domain, or caspase 3 differentially affects lung inflammation, apoptosis, and development of trauma-induced septic acute lung injury. Shock 2013; 39:19-27. [PMID: 23247118 DOI: 10.1097/shk.0b013e318277d856] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Activation of Fas signaling is a potentially important pathophysiological mechanism in the development of septic acute lung injury (ALI). However, so far the optimal targets within this signaling cascade remain elusive. Thus, we tested the hypothesis that in vivo gene silencing of Fas, Fas-associated via death domain (FADD), or caspase 3 by intratracheal administration of small interfering RNA would ameliorate ALI in a clinically relevant double-hit mouse model of trauma induced septic lung injury. Male C57Bl/6 mice received small interfering (Fas, FADD, caspase 3) or control RNA 24 h before and 12 h after blunt chest trauma or sham procedures. Polymicrobial sepsis was induced by cecal ligation and puncture 24 h after chest trauma. Twelve or 24 h later, lung tissue, plasma, and bronchoalveolar lavage fluid were harvested. During ALI, lung apoptosis (active caspase 3 Western blotting, TUNEL staining) was substantially increased when compared with sham. Silencing of caspase 3 or FADD both markedly reduced pulmonary apoptosis. Fas- and FADD-small interfering RNA administration substantially decreased lung cytokine concentration, whereas caspase 3 silencing did not reduce lung inflammation. In addition, Fas silencing markedly decreased lung neutrophil infiltration. Interestingly, only in response to caspase 3 silencing, ALI-induced lung epithelial barrier dysfunction was substantially improved, and histological appearance was beneficially affected. Taken together, downstream inhibition of lung apoptosis via caspase 3 silencing proved to be superior in mitigating ALI when compared with upstream inhibition of apoptosis via Fas or FADD silencing, even in the presence of additional anti-inflammatory effects. This indicates a major pathophysiological role of lung apoptosis and suggests the importance of other than Fas-driven apoptotic pathways in trauma-induced septic ALI.
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Affiliation(s)
- Mirko Philipp Messer
- Department of Trauma, Hand, Plastic, and Reconstructive Surgery, University of Ulm, Ulm, Germany.
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Pfitzer C, Zynda A, Hohmann C, Keil T, Borgmann-Staudt A. Educational Level of Childhood Brain Tumor Survivors: Results from a German Survey. Klin Padiatr 2013; 225:138-44. [DOI: 10.1055/s-0033-1341488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- C. Pfitzer
- Paediatric Oncology/Haematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A. Zynda
- Paediatric Oncology/Haematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C. Hohmann
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T. Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A. Borgmann-Staudt
- Paediatric Oncology/Haematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Naumann M, Hohmann C, Happe A, Beuer F, Frankenberger R, Seemann R, Rosentritt M. Are implants more reliable than severely compromised endodontically treated teeth as abutments for zirconia-based FPDs? : In vitro results of long-term preclinical load simulation. Clin Oral Investig 2012; 17:1685-92. [PMID: 23103959 DOI: 10.1007/s00784-012-0866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim was to study the impact of the defect size of endodontically treated incisors compared to dental implants as abutments on the survival of zirconia two-unit anterior cantilever-fixed partial dentures (2U-FPDs) during 10-year simulation. MATERIALS AND METHODS Human maxillary central incisors were endodontically treated and divided into three groups (n = 24): I, access cavities rebuilt with composite core; II, teeth decoronated and restored with composite; and III as II supported by fiber posts. In group IV, implants with individual zirconia abutments were used. Specimens were restored with zirconia 2U-FPDs and exposed to two sequences of thermal cycling and mechanical loading. STATISTICS Kaplan-Meier; log-rank tests. RESULTS During TCML in group I two tooth fractures and two debondings with chipping were found. Solely chippings occurred in groups II (2×), IV (2×), and III (1×). No significant different survival was found for the different abutments (p = 0.085) or FPDs (p = 0.526). Load capability differed significantly between groups I (176 N) and III (670 N), and III and IV (324 N) (p < 0.024). CONCLUSION Within the limitations of an in vitro study, it can be concluded that zirconia-framework 2U-FPDs on decoronated teeth with/without post showed comparable in vitro reliability as restorations on implants. The results indicated that restorations on teeth with only access cavity perform worse in survival and linear loading. CLINICAL RELEVANCE Even severe defects do not justify per se a replacement of this particular tooth by a dental implant from load capability point of view.
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Affiliation(s)
- M Naumann
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
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Bousquet J, Anto JM, Demoly P, Schünemann HJ, Togias A, Akdis M, Auffray C, Bachert C, Bieber T, Bousquet PJ, Carlsen KH, Casale TB, Cruz AA, Keil T, Lodrup Carlsen KC, Maurer M, Ohta K, Papadopoulos NG, Roman Rodriguez M, Samolinski B, Agache I, Andrianarisoa A, Ang CS, Annesi-Maesano I, Ballester F, Baena-Cagnani CE, Basagaña X, Bateman ED, Bel EH, Bedbrook A, Beghé B, Beji M, Ben Kheder A, Benet M, Bennoor KS, Bergmann KC, Berrissoul F, Bindslev Jensen C, Bleecker ER, Bonini S, Boner AL, Boulet LP, Brightling CE, Brozek JL, Bush A, Busse WW, Camargos PAM, Canonica GW, Carr W, Cesario A, Chen YZ, Chiriac AM, Costa DJ, Cox L, Custovic A, Dahl R, Darsow U, Didi T, Dolen WK, Douagui H, Dubakiene R, El-Meziane A, Fonseca JA, Fokkens WJ, Fthenou E, Gamkrelidze A, Garcia-Aymerich J, Gerth van Wijk R, Gimeno-Santos E, Guerra S, Haahtela T, Haddad H, Hellings PW, Hellquist-Dahl B, Hohmann C, Howarth P, Hourihane JO, Humbert M, Jacquemin B, Just J, Kalayci O, Kaliner MA, Kauffmann F, Kerkhof M, Khayat G, Koffi N'Goran B, Kogevinas M, Koppelman GH, Kowalski ML, Kull I, Kuna P, Larenas D, Lavi I, Le LT, Lieberman P, Lipworth B, Mahboub B, Makela MJ, Martin F, Martinez FD, Marshall GD, Mazon A, Melen E, Meltzer EO, Mihaltan F, Mohammad Y, Mohammadi A, Momas I, Morais-Almeida M, Mullol J, Muraro A, Naclerio R, Nafti S, Namazova-Baranova L, Nawijn MC, Nyembue TD, Oddie S, O'Hehir RE, Okamoto Y, Orru MP, Ozdemir C, Ouedraogo GS, Palkonen S, Panzner P, Passalacqua G, Pawankar R, Pigearias B, Pin I, Pinart M, Pison C, Popov TA, Porta D, Postma DS, Price D, Rabe KF, Ratomaharo J, Reitamo S, Rezagui D, Ring J, Roberts R, Roca J, Rogala B, Romano A, Rosado-Pinto J, Ryan D, Sanchez-Borges M, Scadding GK, Sheikh A, Simons FER, Siroux V, Schmid-Grendelmeier PD, Smit HA, Sooronbaev T, Stein RT, Sterk PJ, Sunyer J, Terreehorst I, Toskala E, Tremblay Y, Valenta R, Valeyre D, Vandenplas O, van Weel C, Vassilaki M, Varraso R, Viegi G, Wang DY, Wickman M, Williams D, Wöhrl S, Wright J, Yorgancioglu A, Yusuf OM, Zar HJ, Zernotti ME, Zidarn M, Zhong N, Zuberbier T. Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper. Int Arch Allergy Immunol 2012; 158:216-31. [PMID: 22382913 DOI: 10.1159/000332924] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.
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Affiliation(s)
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- Centre Hospitalier Universitaire Montpellier, Montpellier Cedex 05, France.
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Schumann S, Lauche R, Irmisch G, Hohmann C, Rolke R, Saha J, Cramer H, Choi K, Langhorst J, Rampp T, Dobos G, Musial F. P02.164. The effects of five sessions of cupping massage on chronic non-specific neck pain: a randomized controlled pilot study. Altern Ther Health Med 2012. [PMCID: PMC3373387 DOI: 10.1186/1472-6882-12-s1-p220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rendtorff R, Beyer M, Müller A, Dittrich R, Hohmann C, Keil T, Henze G, Borgmann A. Low inhibin B levels alone are not a reliable marker of dysfunctional spermatogenesis in childhood cancer survivors. Andrologia 2012; 44 Suppl 1:219-25. [DOI: 10.1111/j.1439-0272.2011.01167.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tischer CG, Hohmann C, Thiering E, Herbarth O, Müller A, Henderson J, Granell R, Fantini MP, Luciano L, Bergström A, Kull I, Link E, von Berg A, Kuehni CE, Strippoli MPF, Gehring U, Wijga A, Eller E, Bindslev-Jensen C, Keil T, Heinrich J. Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative. Allergy 2011; 66:1570-9. [PMID: 21923669 DOI: 10.1111/j.1398-9995.2011.02712.x] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several cross-sectional studies during the past 10 years have observed an increased risk of allergic outcomes for children living in damp or mouldy environments. OBJECTIVE The objective of this study was to investigate whether reported mould or dampness exposure in early life is associated with the development of allergic disorders in children from eight European birth cohorts. METHODS We analysed data from 31 742 children from eight ongoing European birth cohorts. Exposure to mould and allergic health outcomes were assessed by parental questionnaires at different time points. Meta-analyses with fixed- and random-effect models were applied. The number of the studies included in each analysis varied based on the outcome data available for each cohort. RESULTS Exposure to visible mould and/or dampness during first 2 years of life was associated with an increased risk of developing asthma: there was a significant association with early asthma symptoms in meta-analyses of four cohorts [0-2 years: adjusted odds ratios (aOR), 1.39 (95% CI, 1.05-1.84)] and with asthma later in childhood in six cohorts [6-8 years: aOR, 1.09 (95% CI, 0.90-1.32) and 3-10 years: aOR, 1.10 (95% CI, 0.90-1.34)]. A statistically significant association was observed in six cohorts with symptoms of allergic rhinitis at school age [6-8 years: aOR, 1.12 (1.02-1.23)] and at any time point between 3 and 10 years [aOR, 1.18 (1.09-1.28)]. CONCLUSION These findings suggest that a mouldy home environment in early life is associated with an increased risk of asthma particularly in young children and allergic rhinitis symptoms in school-age children.
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Affiliation(s)
- C G Tischer
- Helmholtz Centre Munich, German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
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Gong L, Ye Z, Zeng Z, Xia M, Zhong Y, Yao Y, Lee E, Ionescu A, Dwivedi G, Mahadevan G, Jiminez D, Frenneaux M, Steeds R, Moore C, Samad Z, Jackson K, Castellucci J, Kisslo J, Von Ramm O, D'ascenzi F, Zaca' V, Cameli M, Lisi M, Natali B, Malandrino A, Mondillo S, Barbier P, Guerrini U, Franzosi M, Castiglioni L, Nobili E, Colazzo F, Li Causi T, Sironi L, Tremoli E, Clausen H, Macdonald S, Basaggianis C, Newton J, Cameli M, Lisi M, Bennati E, Reccia R, Malandrino A, Bigio E, Maccherini M, Chiavarelli M, Henein M, Mondillo S, Floria M, Jamart J, Arsenescu Georgescu C, Mantovani F, Barbieri A, Bursi F, Valenti C, Quaglia M, Modena M, Kutty S, Gribben P, Padiyath A, Polak A, Scott C, Waiss M, Danford D, Bech-Hanssen O, Selimovic N, Rundqvist B, Schmiedel L, Hohmann C, Katzke S, Haacke K, Rauwolf T, Strasser R, Tumasyan LR, Adamyan K, Kosmala W, Derzhko R, Przewlocka-Kosmala M, Mysiak A, Stachowska B, Jedrzejuk D, Bednarek-Tupikowska G, Chrzanowski L, Kasprzak J, Wojciechowska C, Wita K, Busz-Papiez B, Gasior Z, Mizia-Stec K, Kukulski T, Gosciniak P, Sinkiewicz W, Moelmen H, Stoylen A, Thorstensen A, Torp H, Dalen H, Groves A, Nicholson G, Lopez L, Goh CW, Ahn H, Byun Y, Kim J, Park J, Lee J, Park J, Kim B, Rhee K, Kim K, Park J, Yoon H, Hong Y, Park H, Kim J, Ahn Y, Jeong M, Cho J, Kang J, Grapsa J, Dawson D, Karfopoulos K, Jakaj G, Punjabi P, Nihoyannopoulos P, Ruisanchez Villar C, Lerena Saenz P, Gonzalez Vilchez F, Gonzalez Fernandez C, Zurbano Goni F, Cifrian Martinez J, Mons Lera R, Ruano Calvo J, Martin Duran R, Vazquez De Prada Tiffe J, Pietrzak R, Werner B, Voillot D, Huttin O, Zinzius P, Schwartz J, Sellal J, Lemoine S, Christophe C, Popovic B, Juilliere Y, Selton-Suty C, Ishii K, Furukawa A, Nagai T, Kataoka K, Seino Y, Shimada K, Yoshikawa J, Tekkesin A, Yildirimturk O, Tayyareci Y, Yurdakul S, Aytekin S, Jaroch J, Loboz-Grudzien K, Bociaga Z, Kowalska A, Kruszynska E, Wilczynska M, Dudek K, Kakihara R, Naruse C, Hironaka H, Tsuzuku T, Cucchini U, Muraru D, Badano L, Solda' E, Tuveri M, Al Nono O, Sarais C, Iliceto S, Santos L, Cortez-Dias N, Ribeiro S, Goncalves S, Jorge C, Carrilho-Ferreira P, Silva D, Silva-Marques J, Lopes M, Diogo A, Hristova K, Vassilev D, Pavlov P, Katova T, Simova I, Kostova V, Esposito R, Santoro A, Schiano Lomoriello V, Raia R, De Palma D, Dores E, De Simone G, Galderisi M, Zaborska B, Makowska E, Pilichowska E, Maciejewski P, Bednarz B, Wasek W, Stec S, Budaj A, Spinelli L, Morisco C, Assante Di Panzillo E, Crispo S, Di Marino S, Trimarco B, Santoro A, Schiano Lomoriello V, Esposito R, Farina F, Innelli P, Rapacciuolo A, Galderisi M, Polgar B, Banyai F, Rokusz L, Tomcsanyi I, Vaszily M, Nieszner E, Borsanyi T, Kerecsen G, Preda I, Kiss RG, Bull S, Suttie J, Augustine D, Francis J, Karamitsos T, Becher H, Prendergast B, Neubauer S, Myerson S, Lodge F, Broyd C, Milton P, Mikhail G, Mayet J, Davies J, Francis D, Clavel MA, Ennezat PV, Marechaux S, Dumesnil J, Bellouin A, Bergeron S, Meimoun P, Le Tourneau T, Pasquet A, Pibarot P, Herrmann S, Stoerk S, Niemann M, Hu K, Voelker W, Ertl G, Weidemann F, Tayyareci Y, Yurdakul S, Yildirimturk O, Aytekin V, Aytekin S, Kogoj P, Ambrozic J, Bunc M, Di Salvo G, Rea A, Castaldi B, Gala S, D'aiello A, Mormile A, Pisacane F, Pacileo G, Russo M, Calabro R, Nguyen L, Ricksten SE, Jeppsson A, Schersten H, Bech-Hanssen O, Boerlage-Van Dijk K, Yong Z, Bouma B, Koch K, Vis M, Piek J, Baan J, Scandura S, Ussia G, Caggegi A, Cammalleri V, Sarkar K, Mangiafico S, Chiaranda' M, Imme' S, Pistritto A, Tamburino C, Ring L, Nair S, Wells F, Shapiro L, Rusk R, Rana B, Madrid Marcano G, Solis Martin J, Gonzalez Mansilla A, Bravo L, Menarguez Palanca C, Munoz P, Bouza E, Yotti R, Bermejo Thomas J, Fernandez Aviles F, Tamayo T, Denes M, Balint O, Csepregi A, Csillik A, Erdei T, Temesvari A, Fernandez-Pastor J, Linde-Estrella A, Cabrera-Bueno F, Pena-Hernandez J, Barrera-Cordero A, Alzueta-Rodriguez F, De Teresa-Galvan E, Merlo M, Pinamonti M, Finocchiaro G, Pyxaras S, Barbati G, Buiatti A, Dilenarda A, Sinagra G, Kuperstein R, Freimark D, Hirsch S, Feinberg M, Arad M, Mitroi C, Garcia Lunar I, Monivas Palomero V, Mingo Santos S, Beltran Correas P, Gonzalez Lopez E, Garcia Pavia P, Gonzalez Mirelis J, Cavero Gibanel M, Alonso Pulpon L, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Dilenarda A, Sinagra G, Zaidi A, Ghani S, Sheikh N, Gati S, Howes R, Sharma R, Sharma S, Calcagnino M, O'mahony C, Coats C, Cardona M, Garcia A, Murphy E, Lachmann R, Mehta A, Hughes D, Elliott P, Di Bella G, Madaffari A, Donato R, Mazzeo A, Casale M, Zito C, Vita G, Carerj S, Marek D, Indrakova J, Rusinakova Z, Skala T, Kocianova E, Taborsky M, Musca F, De Chiara B, Belli O, Cataldo S, Brunati C, Colussi G, Quattrocchi G, Santambrogio G, Spano F, Moreo A, Rustad L, Nytroen K, Gullestad L, Amundsen B, Aakhus S, Maroz-Vadalazhskaya N, Shumavetc V, Kurganovich S, Seljun Y, Ostrovskiy A, Ostrovskiy Y, Rustad L, Nytroen K, Segers P, Amundsen B, Aakhus S, Przewlocka-Kosmala M, Orda A, Karolko B, Mysiak A, Driessen MMP, Eising JB, Uiterwaal C, Van Der Ent CK, Meijboom FJ, Shang Q, Tam L, Sun J, Sanderson J, Zhang Q, Li E, Yu C, Arroyo Ucar E, De La Rosa Hernandez A, Hernandez Garcia C, Jorge Perez P, Lacalzada Almeida J, Jimenez Rivera J, Duque Garcia A, Barragan Acea A, Laynez Cerdena I, Kaldararova M, Simkova I, Pacak J, Tittel P, Masura J, Tadic M, Ivanovic B, Zlatanovic M, Damjanov N, Maggiolini S, Gentile G, Bozzano A, Suraci S, Meles E, Carbone C, Tempesta A, Malafronte C, Piatti L, Achilli F, Luijendijk P, Stevens A, De Bruin-Bon H, Vriend J, Van Den Brink R, Vliegen H, Mulder B, Bouma B, Chow V, Ng A, Chung T, Kritharides L, Iancu M, Serban M, Craciunescu I, Hodo A, Ghiorghiu I, Popescu B, Ginghina C, Styczynski G, Szmigielski CA, Kaczynska A, Leszczynski J, Rosinski G, Kuch-Wocial A, Slavich M, Ancona M, Fisicaro A, Oppizzi M, Marone E, Bertoglio L, Melissano G, Margonato A, Chiesa R, Agricola E, Zito C, Mohammed M, Cusma-Piccione M, Piluso S, Arcidiaco S, Nava R, Giuffre R, Ciraci L, Ferro M, Carerj S, Uusitalo V, Luotolahti M, Pietila M, Wendelin-Saarenhovi M, Hartiala J, Saraste M, Knuuti J, Saraste A, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Bartko PE, Graf S, Khorsand A, Rosenhek R, Burwash I, Beanlands R, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kudrnova S, Apor A, Huttl H, Kudrnova S, Apor A, Huttl H, Mori F, Santoro G, Oddo A, Rosso G, Meucci F, Pieri F, Squillantini G, Gensini G, Scislo P, Kochanowski J, Piatkowski R, Roik M, Postula M, Opolski G, Park DG, Hong JY, Kim SE, Lee JH, Han KR, Oh DJ, Muraru D, Dal Bianco L, Beraldo M, Solda' E, Cucchini U, Peluso D, Tuveri M, Al Mamary A, Badano L, Iliceto S, Aggeli C, Felekos I, Poulidakis E, Pietri P, Roussakis G, Siasos G, Stefanadis C, Furukawa A, Hoshiba H, Miyasaka C, Sato H, Nagai T, Yamanaka A, Kataoka K, Seino Y, Ishii K, Lilli A, Baratto M, Magnacca M, Comella A, Poddighe R, Talini E, Canale M, Chioccioli M, Del Meglio J, Casolo G, Kuznetsov VA, Melnikov NN, Krinochkin DV, Calin A, Enache R, Popescu B, Beladan C, Rosca M, Lupascu L, Purcarea F, Calin C, Gurzun M, Ginghina C, Dulgheru R, Ciobanu A, Magda S, Mihaila S, Rimbas R, Margulescu A, Cinteza M, Vinereanu D, Sumin AN, Arhipov O, Yoon J, Moon J, Rim S, Nyktari E, Patrianakos A, Solidakis G, Psathakis E, Parthenakis F, Vardas P, Kordybach M, Kowalski M, Kowalik E, Hoffman P, Nagy KV, Kutyifa V, Edes E, Apor A, Merkely B, Gerlach A, Rost C, Schmid M, Rost M, Flachskampf F, Daniel W, Breithardt O, Altekin E, Karakas S, Yanikoglu A, Er A, Baktir A, Demir I, Deger N, Klitsie L, Hazekamp M, Roest A, Van Der Hulst A, Gesink- Van Der Veer B, Kuipers I, Blom N, Ten Harkel A, Farsalinos K, Tsiapras D, Kyrzopoulos S, Avramidou E, Vasilopoulou D, Voudris V, Werner B, Florianczyk T, Ivanovic B, Tadic M, Kalinowski M, Szulik M, Streb W, Rybus-Kalinowska B, Sliwinska A, Stabryla J, Kukla M, Nowak J, Kukulski T, Kalarus Z, Florescu M, Mihalcea D, Magda L, Suran B, Enescu O, Mincu R, Cinteza M, Vinereanu D, Salerno G, Scognamiglio G, D'andrea A, Dinardo G, Gravino R, Sarubbi B, Disalvo G, Pacileo G, Russo M, Calabro R, Liao JN, Sung S, Chen C, Park S, Shin S, Kim M, Shim S, Yildirimturk O, Helvacioglu F, Ulusoy O, Duran C, Tayyareci Y, Yurdakul S, Aytekin S, Kirschner R, Simor T, Moreo A, Ambrosio G, De Chiara B, Tran T, Raman S, Vidal Perez RC, Carreras F, Leta R, Pujadas S, Barros A, Hidalgo A, Alomar X, Pons-Llado G, Olofsson M, Boman K, Ledakowicz-Polak A, Polak L, Zielinska M, Fontana A, Schirone V, Mauro A, Zambon A, Giannattasio C, Trocino G, Dekleva M, Dungen H, Inkrot S, Gelbrich G, Suzic Lazic J, Kleut M, Markovic Nikolic N, Waagstein F, Khoor S, Balogh N, Simon I, Fugedi K, Kovacs I, Khoor M, Florian G, Kocsis A, Szuszai T, O'driscoll J, Saha A, Smith R, Gupta S, Sharma R, Lenkey Z, Gaszner B, Illyes M, Sarszegi Z, Horvath IG, Magyari B, Molnar F, Cziraki A, Elnoamany MF, Badran H, Ebraheem H, Reda A, Elsheekh N. Poster Session 5: Saturday 10 December 2011, 08:30-12:30 * Location: Poster Area. European Journal of Echocardiography 2011. [DOI: 10.1093/ejechocard/jer218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hohmann C, Eickhoff C, Radziwill R, Schulz M. Adherence to guidelines for antibiotic prophylaxis in surgery patients in German hospitals: a multicentre evaluation involving pharmacy interns. Infection 2011; 40:131-7. [PMID: 22002734 DOI: 10.1007/s15010-011-0204-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Accepted: 09/27/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Surgical site infections (SSIs) are associated with a high morbidity, mortality and healthcare costs. The prevention of SSIs is based on a combination of preoperative preparation, surgical techniques, perioperative antibiotic prophylaxis (PAP) and postoperative wound care. Despite an abundance of evidence demonstrating the effectiveness of antimicrobials to prevent SSIs, the use of antimicrobial prophylaxis in this clinical setting is associated with inappropriate timing and selection and excessive duration of administration. To date, pharmacy interns (PIs) have not been involved in this process. The aim of this study was to evaluate feasibility of involving PIs in monitoring adherence to the guidelines for antibiotic prophylaxis in surgery patients. METHODS The study was conducted in seven hospitals in Germany within the framework of the project "Pharmacy interns on the ward" (P-STAT2). Twenty-seven PIs participated, either from either May to October 2008 or from November 2008 to April 2009. Each patient admitted to the participating wards was consecutively monitored. PIs documented the antibiotic prophylaxis and checked the adherence with the hospital ward's PAP guidelines taking both the choice of antibiotic drug and the duration of PAP into account. The costs of antibiotics, personnel and material were calculated in cases of non-adherence with guidelines. RESULTS This is the first time that PIs were involved in monitoring antibiotic prophylaxis guidelines. A total of 6,167 patients were enrolled (mean age 58.3 ± 19.6 years; 47.1% male); of these, 5,064 patients underwent surgery and were ultimately available for evaluation. Guidelines for antibiotic prophylaxis were followed in 70.7% of the cases. CONCLUSIONS The study revealed that many patients do not receive the appropriate antibiotic prophylaxis despite the fact that guidelines are in place. Based on these results, we conclude that PIs may play an important role in antibiotic prophylaxis management.
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Affiliation(s)
- C Hohmann
- Department of Medicine, Federal Union of German Associations of Pharmacists, Jaegerstraße 49-50, Berlin, Germany.
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Hohmann C, Eickhoff C, Klotz JM, Schulz M, Radziwill R. Development of a classification system for drug-related problems in the hospital setting (APS-Doc) and assessment of the inter-rater reliability. J Clin Pharm Ther 2011; 37:276-81. [PMID: 21790687 DOI: 10.1111/j.1365-2710.2011.01281.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Identifying, preventing and resolving drug-related problems (DRP) is an important issue in the pharmaceutical care process. Because DRPs have been detected in a more systematic way, the need for a classification system to document, classify and evaluate the collected data has become necessary. The objective was to develop a classification system for DRPs within the hospital setting, to evaluate the practicality and to assess the inter-rater reliability. METHODS All DRPs defined in PI-Doc and PCNE, which are relevant in the hospital setting, were included. Further relevant DRPs identified in other projects in a hospital setting as well as DRPs from the daily work on the ward were collected, and a short description of each DRP was written. A prospective study was conducted at Klinikum Fulda, Germany, in both a non-surgical and a surgical setting to explore whether the new classification system is suitable to classify DRPs in clinics with different specifications. For assessing the inter-rater reliability, 24 standardized case reports were provided. All participants classified them independently. The inter-rater reliability was analysed using Kappa coefficient. RESULTS AND DISCUSSION A classification system for DRPs in the hospital setting (APS-Doc) was established with 10 main categories and 48 subcategories. Practicality was assessed in 250 patients in a non-surgical ward as well as in 100 patients in a surgical ward. The inter-rater agreement was 0·68 (95% CI, 0·66-0·69) for main categories, which comprises substantial agreement. Moderate agreement (κ = 0·58; 95% CI, 0·58-0·59) was demonstrated for the subcategories. WHAT IS NEW AND CONCLUSION A new hierarchical classification system for DRPs in the hospital setting has been developed. APS-Doc seems suitable for various parts of the medication process such as medication reconciliation and drug therapy within both non-surgical and surgical wards. Inter-rater reliability was found to be substantial in the main categories and moderate in the subcategories.
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Affiliation(s)
- C Hohmann
- Department of Pharmacy, Klinikum Fulda gAG, Fulda, Germany.
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Haense C, Kalbe E, Herholz K, Hohmann C, Neumaier B, Krais R, Heiss WD. Cholinergic system function and cognition in mild cognitive impairment. Neurobiol Aging 2010; 33:867-77. [PMID: 20961662 DOI: 10.1016/j.neurobiolaging.2010.08.015] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 08/09/2010] [Accepted: 08/31/2010] [Indexed: 01/01/2023]
Abstract
Evidence for cholinergic dysfunction in very early stages of neurodegeneration like mild cognitive impairment (MCI) is inconclusive. Previous positron emission tomography (PET) studies based on small samples investigated if it is related to memory impairment. We examined whether cortical acetylcholine esterase (AChE) activity is reduced at this stage and correlated with cognitive function. N-[(11)C]-methyl-4-piperidyl acetate ([11C]MP4A), a positron emission tomography tracer for measuring cerebral AChE activity in vivo, was applied in 21 controls and 17 MCI patients. Parametric images of AChE activity were analyzed using standard atlas regions. Principal components analysis (PCA) of regional values of AChE activity and correlation analysis with neuropsychological test results was performed. Cortical AChE activity showed a significant decline in MCI patients compared with controls which was most pronounced in temporal regions. They formed the main part of a principal component that was related significantly to verbal and nonverbal memory, language comprehension and executive function. Cholinergic dysfunction is an early hallmark even before onset of dementia at the clinical stage of MCI. Its impact especially on temporal neocortex is associated with impaired neuropsychological function.
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Affiliation(s)
- Cathleen Haense
- Max Planck Institute for Neurological Research, Cologne, Germany
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Bockelbrink A, Hohmann C, Lau S, Willich S, Wahn U, Keil T. Schwierigkeiten in der Familie während der frühen Kindheit und die Entwicklung allergischer Erkrankungen im Vor- und Grundschulalter. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hohmann C, Keil T, Reinmuth S, Rendtorff R, Willich S, Henze G, Borgmann-Staudt A. Infertilität bei Erwachsenen nach Chemo- und Strahlentherapie im Kindes- und Jugendalter: Eine nationale Registerstudie. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rendtorff R, Hohmann C, Reinmuth S, Müller A, Dittrich R, Beyer M, Wickmann L, Keil T, Henze G, Borgmann-Staudt A. Hormone and Sperm Analyses after Chemo- and Radiotherapy in Childhood and Adolescence. Klin Padiatr 2010; 222:145-9. [PMID: 20514617 DOI: 10.1055/s-0030-1249658] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Since prevalence of and reasons for infertility were unclear in survivors of childhood cancer we conducted a two centre survey in 2006 and nationwide in 2008. In 2008/2009 we undertook a study entitled "Hormone and Sperm Analyses after Chemo- and Radiotherapy in Childhood and Adolescence". PATIENTS AND METHODS Letters were sent to 748 former paediatric oncological patients who were at least 18 years of age at the time of the survey. Serum and sperm samples were analysed. RESULTS We obtained 159 blood samples (86 women, 73 men). 42 men took part in the sperm analyses. The average participants' age at the time of the survey was 25 years. The anti-Mullerian hormone levels (AMH) in 14/86 female participants (16 %) were < 0.1 ng/ml. The follicular reserve of these women seemed manifestly impaired, which is consistent with suspected infertility. The AMH levels in 21/86 women (24 %) were 0.1 - 1.0 ng/ml indicating limited follicular reserve and therefore suspected early ovarian failure. Inhibin B levels of < 80 pg/ml and FSH levels of > 10 IU/L were found in 23/73 male participants (32 %), which may indicate impaired spermiogenesis with increased risk of infertility. 13/42 sperm analyses (31 %) revealed azoospermia. DISCUSSION Paediatric oncological therapy seems to have led to fertility impairment in about 1/3 of the participants. Considering this serious impairment, patients and their families should be given comprehensive counselling ahead of therapy to enable fertility-preserving measures. For persons who wish to have children after undergoing therapy we recommend a hormone and sperm analysis. An early analysis may enable a more successful family planning.
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Affiliation(s)
- R Rendtorff
- Charite-Universitätsmedizin Berlin, Paediatric Oncology/Haematology, Berlin, Germany
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Klein JC, Eggers C, Kalbe E, Weisenbach S, Hohmann C, Vollmar S, Baudrexel S, Diederich NJ, Heiss WD, Hilker R. Neurotransmitter changes in dementia with Lewy bodies and Parkinson disease dementia in vivo. Neurology 2010; 74:885-92. [PMID: 20181924 DOI: 10.1212/wnl.0b013e3181d55f61] [Citation(s) in RCA: 249] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Although Parkinson disease with dementia (PDD) and dementia with Lewy bodies (DLB) show a wide clinical and neuropathologic overlap, they are differentiated according to the order and latency of cognitive and motor symptom appearance. Whether both are distinct disease entities is an ongoing controversy. Therefore, we directly compared patients with DLB and PDD with multitracer PET. METHODS PET with (18)fluorodopa (FDOPA), N-(11)C-methyl-4-piperidyl acetate (MP4A), and (18)fluorodeoxyglucose (FDG) was performed in 8 patients with PDD, 6 patients with DLB, and 9 patients with PD without dementia vs age-matched controls. Data were analyzed with voxel-based statistical parametric mapping and region of interest-based statistics. RESULTS We found a reduced FDOPA uptake in the striatum and in limbic and associative prefrontal areas in all patient groups. Patients with PDD and patients with DLB showed a severe MP4A and FDG binding reduction in the neocortex with increasing signal diminution from frontal to occipital regions. Significant differences between PDD and DLB were not found in any of the radioligands used. Patients with PD without dementia had a mild cholinergic deficit and no FDG reductions vs controls. CONCLUSIONS Patients with dementia with Lewy bodies and Parkinson disease dementia share the same dopaminergic and cholinergic deficit profile in the brain and seem to represent 2 sides of the same coin in a continuum of Lewy body diseases. Cholinergic deficits seem to be crucial for the development of dementia in addition to motor symptoms. The spatial congruence of cholinergic deficits and energy hypometabolism argues for cortical deafferentation due to the degeneration of projection fibers from the basal forebrain.
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Affiliation(s)
- J C Klein
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
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Hohmann C, Lauche R, Choi KE, Saha F, Rampp T, Dobos G, Musial F. Quantitative sensory testing in patients with chronic neck pain before and after the application of the acupressure pad—A randomized, controlled pilot study. Eur J Integr Med 2009. [DOI: 10.1016/j.eujim.2009.08.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hohmann C, Hein O, Walter A, Fabricius J, Stock A, Klotz JM, Hofmann E, Jacobs AH. Sichere und effiziente Thrombolyse und/oder mechanische Thrombektomie bei Patienten mit zerebraler Ischämie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Herholz K, Hohmann C, Florea I, Varrone A, Haense C, Krais R, Garibotto V, Kalbe E, Bertoldo A, Perani D, Vollmar S, Heiss W. IC‐P‐043: Reduction of cortical acetylcholine esterase in mild cognitive impairment: Consistency across centers and PET methods. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.05.063] [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: 11/15/2022]
Affiliation(s)
- Karl Herholz
- University of ManchesterManchesterUnited Kingdom
| | | | | | | | - Cathleen Haense
- Max‐Planck‐Institute for Neurological ResearchCologneGermany
| | - Roman Krais
- Max‐Planck‐Institute for Neurological ResearchCologneGermany
| | | | | | | | | | - Stefan Vollmar
- Max‐Planck‐Institute for Neurological ResearchCologneGermany
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Herholz K, Hohmann C, Florea I, Varrone A, Haense C, Krais R, Garibotto V, Kalbe E, Bertoldo A, Perani D, Vollmar S, Heiss W. P3‐081: Reduction of cortical acetylcholine esterase in mild cognitive impairment: Consistency across centers and PET methods. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.1157] [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: 11/25/2022]
Affiliation(s)
- Karl Herholz
- University of ManchesterManchesterUnited Kingdom
| | | | | | | | - Cathleen Haense
- Max‐Planck‐ Institute for Neurological ResearchCologneGermany
| | - Roman Krais
- Max‐Planck‐ Institute for Neurological ResearchCologneGermany
| | | | | | | | | | - Stefan Vollmar
- Max‐Planck‐ Institute for Neurological ResearchCologneGermany
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Fabricius J, Hohmann C, Vogt E, Hofmann E, Janka M, Behr R, Jacobs A. Zerebrale Abszesse als Differentialdiagnose von Metastasen bei Bronchialkarzinom. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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44
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Stock A, Hofmann E, Demeke T, Kirsch M, Hohmann C, Jacobs A. Status epilepticus bei Tacrolimus-induzierter Enzephalopathie mit subkortikalen Hirnblutungen und Hirninfarkt. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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45
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Radziwill R, Hohmann C, Klotz J, Jacobs A. Einfluss der pharmazeutischen Betreuung auf die Versorgungsqualität von Patienten mit Schlaganfall: schnittstellenübergreifenden Nachbeobachtung zwischen Krankenhaus, Reha und ambulantem Bereich (EPASKA-Studie). Akt Neurol 2008. [DOI: 10.1055/s-0028-1086912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kramer L, Hohmann C, Stock A, Kaufmann M, Jacobs A. Frühe Carotisendarteriektomie bei Patienten mit symptomatischer hochgradiger A. carotis interna Stenose. Akt Neurol 2008. [DOI: 10.1055/s-0028-1087032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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47
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Hohmann C, Hein O, Meißner L, Walter A, Stock A, Klotz J, Hofmann E, Jacobs A. Follow-up Beobachtung von Patienten mit zerebraler Ischämie nach Lysetherapie. Akt Neurol 2008. [DOI: 10.1055/s-0028-1087024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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48
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Meißner L, Vogt E, Stock A, Hohmann C, Hofmann E, Jacobs A. Ballondilatation einer intrazerebralen Stenose bei amphetaminassoziierter zerebraler Vaskulitis. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hofmann E, Stock A, Hohmann C, Jacobs A. Erfolgreiche Kombination einer systemischen Lysetherapie mit mechanischer Thrombusextraktion bei A. basilaris Thrombose. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Wilke T, Kulle M, Gotal G, Hohmann C. Tablette versus Spritze - eine betriebswirtschaftlich-pharmakoökonomische Analyse von Antikoagulanzien in sechs Krankenhäusern. Gesundh ökon Qual manag 2006. [DOI: 10.1055/s-2005-858924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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