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Peelaerts W, Mercado G, George S, Villumsen M, Kasen A, Aguileta M, Linstow C, Sutter AB, Kuhn E, Stetzik L, Sheridan R, Bergkvist L, Meyerdirk L, Lindqvist A, Gavis MLE, Van den Haute C, Hultgren SJ, Baekelandt V, Pospisilik JA, Brudek T, Aznar S, Steiner JA, Henderson MX, Brundin L, Ivanova MI, Hannan TJ, Brundin P. Urinary tract infections trigger synucleinopathy via the innate immune response. Acta Neuropathol 2023; 145:541-559. [PMID: 36991261 PMCID: PMC10119259 DOI: 10.1007/s00401-023-02562-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 12/30/2022] [Revised: 02/28/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
Symptoms in the urogenital organs are common in multiple system atrophy (MSA), also in the years preceding the MSA diagnosis. It is unknown how MSA is triggered and these observations in prodromal MSA led us to hypothesize that synucleinopathy could be triggered by infection of the genitourinary tract causing ɑ-synuclein (ɑSyn) to aggregate in peripheral nerves innervating these organs. As a first proof that peripheral infections could act as a trigger in MSA, this study focused on lower urinary tract infections (UTIs), given the relevance and high frequency of UTIs in prodromal MSA, although other types of infection might also be important triggers of MSA. We performed an epidemiological nested-case control study in the Danish population showing that UTIs are associated with future diagnosis of MSA several years after infection and that it impacts risk in both men and women. Bacterial infection of the urinary bladder triggers synucleinopathy in mice and we propose a novel role of ɑSyn in the innate immune system response to bacteria. Urinary tract infection with uropathogenic E. coli results in the de novo aggregation of ɑSyn during neutrophil infiltration. During the infection, ɑSyn is released extracellularly from neutrophils as part of their extracellular traps. Injection of MSA aggregates into the urinary bladder leads to motor deficits and propagation of ɑSyn pathology to the central nervous system in mice overexpressing oligodendroglial ɑSyn. Repeated UTIs lead to progressive development of synucleinopathy with oligodendroglial involvement in vivo. Our results link bacterial infections with synucleinopathy and show that a host response to environmental triggers can result in ɑSyn pathology that bears semblance to MSA.
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Affiliation(s)
- Wouter Peelaerts
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
- Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Laboratory for Virology and Gene Therapy, Department of Pharmacy and Pharmaceutical Sciences, KU Leuven, Louvain, Belgium
| | - Gabriela Mercado
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Sonia George
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Marie Villumsen
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Alysa Kasen
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Miguel Aguileta
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Christian Linstow
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Alexandra B Sutter
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Neuroscience Graduate Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily Kuhn
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Lucas Stetzik
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Rachel Sheridan
- Flow Cytometry Core Facility, Van Andel Institute, Grand Rapids, MI, USA
| | - Liza Bergkvist
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Lindsay Meyerdirk
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Allison Lindqvist
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Martha L Escobar Gavis
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Chris Van den Haute
- Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Leuven Viral Vector Core, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | - Scott J Hultgren
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Veerle Baekelandt
- Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences, KU Leuven, Louvain, Belgium
- Leuven Viral Vector Core, Department of Neurosciences, KU Leuven, Louvain, Belgium
| | | | - Tomasz Brudek
- Centre for Neuroscience and Stereology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Susana Aznar
- Centre for Neuroscience and Stereology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jennifer A Steiner
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Michael X Henderson
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Lena Brundin
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA
| | - Magdalena I Ivanova
- Neuroscience Graduate Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Biophysics Program, University of Michigan, Ann Arbor, MI, USA
| | - Tom J Hannan
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Patrik Brundin
- Department of Neurodegenerative Science, Parkinson's Disease Center, Van Andel Institute, Grand Rapids, MI, USA.
- Pharma Research and Early Development (pRED), F. Hoffmann-La Roche, Basel, Switzerland.
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Ivanov B, Djordjevic I, Gerfer S, Gaisendrees C, Eghbalzadeh K, Risteski P, Kuhn E, Sabashnikov A, Wahlers T, Rahmanian P. Obesity-Associated Effect on In-Hospital Outcomes in Patients Receiving VA ECMO. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B. Ivanov
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - I. Djordjevic
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - S. Gerfer
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - C. Gaisendrees
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - K. Eghbalzadeh
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - P. Risteski
- Helios Klinikum Siegburg, Department of Cardiovascular Surgery, Siegburg, Deutschland
| | - E. Kuhn
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - A. Sabashnikov
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - T. Wahlers
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - P. Rahmanian
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
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Kuhn E, Eghbalzadeh K, Krasivskyi I, Djordjevic I, Adam M, Körber MI, Baldus S, Wahlers T. Early Clinical Results with the Tendyne Transcatheter Mitral Valve. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E. Kuhn
- University Hospital of Cologne, Köln, Deutschland
| | | | - I. Krasivskyi
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland, Köln, Deutschland
| | - I. Djordjevic
- University Hospital of Cologne, Cologne, Deutschland
| | - M. Adam
- Department of Internal Medicine III, Heart Center Cologne, Köln, Deutschland
| | - M. I. Körber
- Department of Internal Medicine III, Heart Center Cologne, Cologne, Deutschland
| | - S. Baldus
- Department of Internal Medicine III, Heart Center Cologne, Köln, Deutschland
| | - T. Wahlers
- University Hospital of Cologne, Köln, Deutschland
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Krasivskyi I, Eghbalzadeh K, Djordjevic I, Kuhn E, Gerfer S, Ivanov B, Rahmanian P, Wahlers T. Long-Term Pacemaker Dependency after Rapid Deployment Aortic Valve Replacement. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - I. Djordjevic
- University Hospital of Cologne, Cologne, Deutschland
| | - E. Kuhn
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - S. Gerfer
- University Hospital of Cologne, Cologne, Deutschland
| | - B. Ivanov
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - P. Rahmanian
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Deutschland
| | - T. Wahlers
- University Hospital of Cologne, Cologne, Deutschland
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Djordjevic I, Maier-Trauth J, Gerfer S, Elskamp M, Mühlbauer T, Maul A, Rademann P, Sabashnikov A, Eghbalzadeh K, Ivanov B, Kuhn E, Deppe AC, Liakopoulos O, Wahlers T. Fluid Management in ECMO Therapy: Analysis of an Experimental Pig Model. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - S. Gerfer
- University Hospital of Cologne, Köln, Deutschland
| | - M. Elskamp
- University Hospital of Cologne, Köln, Deutschland
| | - T. Mühlbauer
- University Hospital of Cologne, Köln, Deutschland
| | - A. Maul
- University Hospital of Cologne, Köln, Deutschland
| | - P. Rademann
- University Hospital of Cologne, Köln, Deutschland
| | | | | | - B. Ivanov
- University Hospital of Cologne, Köln, Deutschland
| | - E. Kuhn
- University Hospital of Cologne, Köln, Deutschland
| | - A. C. Deppe
- University Hospital of Cologne, Köln, Deutschland
| | - O. Liakopoulos
- Department of Cardiac Surgery, Kerhoff-Heart Center, Bad Nauheim, Deutschland
| | - T. Wahlers
- University Hospital of Cologne, Köln, Deutschland
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Ivanov B, Djordjevic I, Gerfer S, Risteski P, Kuhn E, Mader N, Rahmanian P, Wahlers T, Gaisendrees C. Results and Outcomes for Patients with Constrictive Pericarditis following Pericardiectomy. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B. Ivanov
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - I. Djordjevic
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - S. Gerfer
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - P. Risteski
- Helios Klinikum Siegburg, Department of Cardiovascular Surgery, Siegburg, Deutschland
| | - E. Kuhn
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - N. Mader
- Herzzentrum, Cologne, Deutschland
| | - P. Rahmanian
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - T. Wahlers
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
| | - C. Gaisendrees
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
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Elderia A, Gerfer S, Zeschky C, Eghbalzadeh K, Rustenbach C, Adam M, Rahmanian P, Mader N, Baldus S, Wahlers T, Kuhn E. Surgical Versus Interventional Treatment of Concomitant Aortic Valve Stenosis and Coronary Artery Disease. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A. Elderia
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - S. Gerfer
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - C. Zeschky
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - K. Eghbalzadeh
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - C. Rustenbach
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - M. Adam
- Department of Internal Medicine, Heart Center Cologne, Köln, Deutschland
| | - P. Rahmanian
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - N. Mader
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - S. Baldus
- Department of Internal Medicine, Heart Center Cologne, Köln, Deutschland
| | - T. Wahlers
- University Hospital of Cologne, Köln, Deutschland
| | - E. Kuhn
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
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Macherey S, Meertens M, Eichel S, Schipper J, Mauri V, Frerker C, Adam M, Kuhn E, Wahlers T, Lee S, Baldus S, Schmidt T. Stroke and mortality rates after valve-in-valve TAVR and comparison with data from redo SAVR. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2611] [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
Early registry data described a potentially increased risk for cerebrovascular events and mortality in patients undergoing transcatheter aortic valve replacement (TAVR) as valve-in-valve (viv) procedures. Further data of small patient cohorts described divergent results for cerebrovascular events and mortality in patients undergoing TAVR as viv procedures for failed surgical bioprotheses in comparison with patients on redo surgical aortic valve replacement (SAVR). We performed a meta-analysis of stroke rates and mortality for viv TAVR procedures basing on the current literature.
Methods
We included all case series (≥10 patients), case-control studies and randomized controlled trials comparing viv TAVR and redo SAVR procedures with respect to cerebrovascular events and mortality rates. Additionally, we included all case series and registries with patients undergoing viv TAVR. After a structured literature research, 17 studies were eligible. For statistical analysis risk ratios and confidence intervals using Mantel-Haenszel test and the I-statistic to quantify possible heterogeneity were calculated. A P-value <0.05 was defined as statistical significant difference.
Results
Eleven case series and registries reporting on stroke and mortality in 8,509 patients undergoing viv TAVR were eligible for analysis. The quantitative analysis of non-comparative studies showed a calculated 30-day stroke rate of 2.2% and 30-day mortality rate of 4.2% after viv TAVR. Data on the 1-year rates were sporadically reported, therefore meta analysis was not appropriately feasible.
Six studies reporting on 498 participants undergoing viv TAVR (N=254) and redo SAVR (N=244) were eligible. The median age ranged from 72.3 to 80.2 years for viv TAVR and from 66.2 to 78.8 years for redo SAVR patients. The STS score was 7.2–7.4% (viv TAVR) and 5.8–7.7% (redo SAVR), respectively. A total of 3/226 participants treated with viv TAVR and 4/214 patients undergoing redo SAVR experienced a stroke during the first 30 postoperative days (N=4 trials, RR 0.86, 95% CI 0.20 to 3.59, p=0.83, I2 = 0%). None of the studies reported sufficient data on the 1-year stroke incidence. The 30-day mortality was 4.3% for viv TAVR and 4.5% for redo SAVR patients. This difference was not significantly different (N=6 trials, RR 0.90, 95% CI 0.40 to 2.05, p=0.80, I2 = 0%). The 1-year mortality rates were 13.3% and 13.6%, respectively (N=2 trials, RR 0.98, 95% CI 0.49 to 1.94, p=0.94, I2 = 0%).
Conclusion
In the current literature favorable stroke and mortality rates at 30 days for patients undergoing viv TAVR are documented. Similar stroke and mortality rates comparing viv TAVR and redo SAVR patients at 30 days were found as well as similar 1-year mortality. A selection bias for the viv TAVR and redo SAVR patients may exist, but cannot be dissolved with this registry analysis, only showing a trend of younger and lower risk patients receiving a redo SAVR procedure.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Macherey
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - M Meertens
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - S Eichel
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - J Schipper
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - V Mauri
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - C Frerker
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - E Kuhn
- Cologne University Hospital - Heart Center, Department of Cardiothoracic Surgery, Cologne, Germany
| | - T Wahlers
- Cologne University Hospital - Heart Center, Department of Cardiothoracic Surgery, Cologne, Germany
| | - S Lee
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - T Schmidt
- Cologne University Hospital - Heart Center, Cologne, Germany
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Elderia A, Eghbalzadeh K, Zeschky C, Zeriouh M, Adam M, Baldus S, Mader N, Kuhn E, Wahlers T. Transcatheter Aortic Valve Implantation: Cardiologists versus Cardiac Surgeons. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kuhn E, Schalley S, Potthoff M, Weaver MS. The Arc of Generational Care: A Case Series Considering Grandparent Roles and Care Needs in Pediatric Palliative Care . J Soc Work End Life Palliat Care 2019; 15:99-110. [PMID: 31230584 DOI: 10.1080/15524256.2019.1629374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/09/2023]
Abstract
Children receiving palliative care services are held within the context of a family and often within multiple-generational arms. The purpose of this case series paper is to recognize grandparents' roles in their family system from a personal, cultural, and anthropological perspective; to explore emotions and experiences as applies to grandparents of children receiving palliative care; and to provide tangible insight into caring well for families across the generational arc.
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Affiliation(s)
- Emily Kuhn
- Children's Hospital and Medical Center , Omaha , USA
| | | | - Meghan Potthoff
- CHI Health Creighton University Medical Center , Omaha , NE , United States
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Gasparini E, Bisagni A, Di Cicilia R, Kuhn E, Falco G, Ferrari G, Foroni M, Tamagnini I, Bassano C, Ragazzi M, Gardini G, Cecchi F, Hembrough T, Bisagni G. Abstract P3-10-24: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-24] [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
Abstract
This abstract was not presented at the conference.
Citation Format: Gasparini E, Bisagni A, Di Cicilia R, Kuhn E, Falco G, Ferrari G, Foroni M, Tamagnini I, Bassano C, Ragazzi M, Gardini G, Cecchi F, Hembrough T, Bisagni G. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-24.
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Affiliation(s)
- E Gasparini
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - A Bisagni
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - R Di Cicilia
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - E Kuhn
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - G Falco
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - G Ferrari
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - M Foroni
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - I Tamagnini
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - C Bassano
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - M Ragazzi
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - G Gardini
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - F Cecchi
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - T Hembrough
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
| | - G Bisagni
- Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Pathology Unit, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; Breast Surgery, Azienda USL Reggio Emilia – IRCCS, Reggio Emilia, Italy; NantOmics, Rockville
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Castinetti F, Albarel F, Archambeaud F, Bertherat J, Bouillet B, Buffier P, Briet C, Cariou B, Caron P, Chabre O, Chanson P, Cortet C, Do Cao C, Drui D, Haissaguerre M, Hescot S, Illouz F, Kuhn E, Lahlou N, Merlen E, Raverot V, Smati S, Verges B, Borson-Chazot F. French Endocrine Society Guidance on endocrine side effects of immunotherapy. Endocr Relat Cancer 2019; 26:G1-G18. [PMID: 30400055 PMCID: PMC6347286 DOI: 10.1530/erc-18-0320] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022]
Abstract
The management of cancer patients has changed due to the considerably more frequent use of immune checkpoint inhibitors (ICPIs). However, the use of ICPI has a risk of side effects, particularly endocrine toxicity. Since the indications for ICPI are constantly expanding due to their efficacy, it is important that endocrinologists and oncologists know how to look for this type of toxicity and how to treat it when it arises. In view of this, the French Endocrine Society initiated the formulation of a consensus document on ICPI-related endocrine toxicity. In this paper, we will introduce data on the general pathophysiology of endocrine toxicity, and we will then outline expert opinion focusing primarily on methods for screening, management and monitoring for endocrine side effects in patients treated by ICPI. We will then look in turn at endocrinopathies that are induced by ICPI including dysthyroidism, hypophysitis, primary adrenal insufficiency and fulminant diabetes. In each chapter, expert opinion will be given on the diagnosis, management and monitoring for each complication. These expert opinions will also discuss the methodology for categorizing these side effects in oncology using 'common terminology criteria for adverse events' (CTCAE) and the difficulties in applying this to endocrine side effects in the case of these anti-cancer therapies. This is shown in particular by certain recommendations that are used for other side effects (high-dose corticosteroids, contraindicated in ICPI for example) and that cannot be considered as appropriate in the management of endocrine toxicity, as it usually does not require ICPI withdrawal or high-dose glucocorticoid intake.
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Affiliation(s)
- F Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), and Department of Endocrinology, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Marseille, France
- Correspondence should be addressed to F Castinetti:
| | - F Albarel
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), and Department of Endocrinology, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Marseille, France
| | - F Archambeaud
- Service de Médecine Interne B – Endocrinologie, Limoges Cedex, France
| | - J Bertherat
- Hôpital Cochin, Service d’Endocrinologie et Maladies Métaboliques, Paris Cedex 14, France
| | - B Bouillet
- CHU Dijon, Hôpital François Mitterrand, Service d’Endocrinologie, Diabétologie, Maladies Métaboliques, Dijon Cedex, France
- Unité INSERM LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - P Buffier
- CHU Dijon, Hôpital François Mitterrand, Service d’Endocrinologie, Diabétologie, Maladies Métaboliques, Dijon Cedex, France
| | - C Briet
- Institut MITOVASC, INSERM U1083, Angers University, Department of Endocrinology, Diabetology and Nutrition, University Medical Center, Angers, France
| | - B Cariou
- Department of Endocrinology, L’Institut du Thorax, CHU Nantes, Nantes, France
| | - Ph Caron
- CHU de Toulouse – Hôpital Larrey – Service d’Endocrinologie – Maladies métaboliques – Nutrition, TSA 30030, Toulouse Cedex 9, France
| | - O Chabre
- CHU de Grenoble – Hôpital Albert Michallon, Service d’Endocrinologie-Diabétologie-Nutrition, Grenoble Cedex 9, France
| | - Ph Chanson
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, et UMR S-1185 Faculté de Médecine Paris-Sud, University of Paris-Saclay, Le Kremlin-Bicêtre, France
| | - C Cortet
- CHRU de Lille – Hopital Huriez, Service d’Endocrinologie, Lille Cedex, France
| | - C Do Cao
- CHRU de Lille – Hopital Huriez, Service d’Endocrinologie, Lille Cedex, France
| | - D Drui
- Department of Endocrinology, L’Institut du Thorax, CHU Nantes, Nantes, France
| | - M Haissaguerre
- CHU de Bordeaux – Hôpital du Haut Lévêque, Service d’Endocrinologie-Diabétologie et Maladies Métaboliques, Pessac Cedex, France
| | - S Hescot
- Institut Curie, Oncologie Endocrinienne, Saint Cloud, France
| | - F Illouz
- Department of Endocrinology, Diabetes and Nutrition, Reference Centre of Rare Thyroid Disease, Hospital of Angers, Angers Cedex 09, France
| | - E Kuhn
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, et UMR S-1185 Faculté de Médecine Paris-Sud, University of Paris-Saclay, Le Kremlin-Bicêtre, France
| | - N Lahlou
- Département d’Hormonologie Spécialisée, BPR-AS, Pannes, France
| | - E Merlen
- CHRU de Lille – Hopital Huriez, Service d’Endocrinologie, Lille Cedex, France
| | - V Raverot
- Hospices Civils de Lyon, Laboratoire d’Hormonologie, Service de Biochimie et Biologie Moléculaire, Groupement Hospitalier Est, Lyon, France
| | - S Smati
- Department of Endocrinology, L’Institut du Thorax, CHU Nantes, Nantes, France
| | - B Verges
- CHU Dijon, Hôpital François Mitterrand, Service d’Endocrinologie, Diabétologie, Maladies Métaboliques, Dijon Cedex, France
- Unité INSERM LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - F Borson-Chazot
- Hospices Civils de Lyon, Fédération d’Endocrinologie, Université Claude Bernard Lyon 1, Lyon, France
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Djordjevic I, Sabashnikov A, Deppe AC, Kuhn E, Eghbalzadeh K, Merkle J, Maier J, Weber C, Azizov F, Sindhu D, Wahlers T. Risk factors associated with 30-day mortality for out-of-center ECMO support: experience from the newly launched ECMO retrieval service. J Artif Organs 2019; 22:110-117. [DOI: 10.1007/s10047-019-01092-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022]
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14
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Mauri V, Frohn T, Deuschl FG, Reimann A, Koerber MI, Kuhn E, Baldus S, Wahlers T, Rudolph V, Madershahian N, Schaefer U, Rudolph TK. P6310Impact of device landing zone calcification on paravalvular regurgitation after transcatheter aortic valve replacement with different next generation devices. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V Mauri
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - T Frohn
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - F G Deuschl
- University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany
| | - A Reimann
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - M I Koerber
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - E Kuhn
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - T Wahlers
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - V Rudolph
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - N Madershahian
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - U Schaefer
- University Heart Center Hamburg, Department of General and Interventional Cardiology, Hamburg, Germany
| | - T K Rudolph
- Cologne University Hospital - Heart Center, Cologne, Germany
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Hescot S, Haissaguerre M, Pautier P, Kuhn E, Schlumberger M, Berdelou A. Immunotherapy-induced Addison's disease: A rare, persistent and potentially lethal side-effect. Eur J Cancer 2018; 97:57-58. [PMID: 29731229 DOI: 10.1016/j.ejca.2018.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 04/02/2018] [Indexed: 11/17/2022]
Affiliation(s)
- S Hescot
- Department of Medical Oncology, Institut Curie, Paris, France; Department of Endocrine Oncology, Gustave Roussy, Villejuif, France.
| | - M Haissaguerre
- Department of Endocrinology, CHU Bordeaux, Bordeaux, France
| | - P Pautier
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - E Kuhn
- Department of Endocrinology, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - M Schlumberger
- Department of Endocrine Oncology, Gustave Roussy, Villejuif, France
| | - A Berdelou
- Department of Endocrine Oncology, Gustave Roussy, Villejuif, France
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16
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Kerckhove N, Pereira B, Soriot-Thomas S, Alchaar H, Deleens R, Hieng VS, Serra E, Lanteri-Minet M, Arcagni P, Picard P, Lefebvre-Kuntz D, Maindet C, Mick G, Balp L, Lucas C, Creach C, Letellier M, Martinez V, Navez M, Delbrouck D, Kuhn E, Piquet E, Bozzolo E, Brosse C, Lietar B, Marcaillou F, Hamdani A, Leroux-Bromberg N, Perier Y, Vergne-Salle P, Gov C, Delage N, Gillet D, Romettino S, Richard D, Mallet C, Bernard L, Lambert C, Dubray C, Duale C, Eschalier A. Efficacy and safety of a T-type calcium channel blocker in patients with neuropathic pain: A proof-of-concept, randomized, double-blind and controlled trial. Eur J Pain 2018; 22:1321-1330. [PMID: 29577519 DOI: 10.1002/ejp.1221] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND T-type calcium channels have been shown to play an important role in the initiation and maintenance of neuropathic pain and represent a promising therapeutic target for new analgesic treatments. Ethosuximide (ETX), an anticonvulsant and a T-type channel blocker has shown analgesic effect in several chronic pain models but has not yet been evaluated in patients with neuropathic pain. METHODS This proof-of-concept, multicentre, double-blind, controlled and randomized trial compared the efficacy and safety of ETX (given as add-on therapy) to an inactive control (IC) in 114 patients with non-diabetic peripheral neuropathic pain. After a 7-day run-in period, eligible patients aged over 18 years were randomly assigned (1:1) to ETX or IC for 6 weeks. The primary outcome was the difference between groups in the pain intensity (% of change from the baseline to end of treatment) assessed in the intention-to-treat population. This study is registered with EudraCT (2013-004801-26) and ClinicalTrials.gov (NCT02100046). RESULTS The study was stopped during the interim analysis due to the high number of adverse events in the active treatment group. ETX failed to reduce total pain and showed a poor tolerance in comparison to IC. In the per-protocol analysis, ETX significantly reduced pain intensity by 15.6% (95% CI -25.8; -5.4) from baseline compared to IC (-7.8%, 95% CI -14.3; -1.3; p = 0.033), but this result must be interpreted with caution because of a small subgroup of patients. CONCLUSION Ethosuximide did not reduce the severity of neuropathic pain and induces, at the doses used, many adverse events. SIGNIFICANCE This article shows that ETX is not effective to treat neuropathic pain. Nevertheless, per-protocol analysis suggests a possible analgesic effect of ETX. Thus, our work adds significant knowledge to preclinical and clinical data on the benefits of T-type calcium channel inhibition for the treatment of neuropathic pain.
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Affiliation(s)
- N Kerckhove
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
| | - B Pereira
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | | | - H Alchaar
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | | | | | - E Serra
- CHU Amiens Picardie, CETD, CRC, Amiens, France
| | - M Lanteri-Minet
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - P Arcagni
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | - P Picard
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | | | - C Maindet
- CHU Grenoble Alpes, CETD, Grenoble, France
| | - G Mick
- CH Voiron, UETD, Voiron, France
| | - L Balp
- CH Lons-le-Saunier, CETD, Lons-le-Saunier, France
| | - C Lucas
- Université Lille Nord de France, CHRU Lille, CETD, Lille, France
| | - C Creach
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | | | - V Martinez
- AP-HP - Hôpital Raymond Poincaré, CETD, Paris, France
| | - M Navez
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | | | - E Kuhn
- CHU Nantes, CETD, Nantes, France
| | - E Piquet
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - E Bozzolo
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - C Brosse
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | - B Lietar
- CHU Saint-Etienne, CETD, Saint-Etienne, France
| | - F Marcaillou
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - A Hamdani
- Cancer Centre Oscar-Lambret, Lille, France
| | | | - Y Perier
- CH Avranches, CETD, Avranches, France
| | | | - C Gov
- HCL - Hôpital Neurologique, CETD, Lyon, France
| | - N Delage
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | | | - S Romettino
- Université Nice Côte-d'Azur, CHU Nice - Hôpital de Cimiez, Fédération Hospitalo-Universitaire INOVPAIN, CETD, Nice, France
| | - D Richard
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - C Mallet
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - L Bernard
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - C Lambert
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France
| | - C Dubray
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
| | - C Duale
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
| | - A Eschalier
- Service de Pharmacologie Médicale, Direction de la Recherche Clinique et de l'Innovation, CETD, CIC, CNRS, SIGMA Clermont, ICCF, Service de Pharmacie, Université Clermont Auvergne, CHU Clermont-Ferrand, INSERM - NEURO-DOL, Clermont-Ferrand, France.,Analgesia Institute, Université Clermont Auvergne, Clermont-Ferrand, France
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17
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Kuhn E, Morbini P, Cancellieri A, Damiani S, Cavazza A, Comin CE. Adenocarcinoma classification: patterns and prognosis. Pathologica 2018; 110:5-11. [PMID: 30259909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Lung cancer is the most frequent human malignancy and the principal cause of cancer-related death worldwide. Adenocarcinoma is now the main histologic type, accounting for almost half of all the cases. The 2015 World Health Organization has adopted the classification recently developed by the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society. This new adenocarcinoma classification has incorporated up-to-date advances in radiological, molecular and oncological knowledge, providing univocal diagnostic criteria and terminology. For resection specimens, new entities have been defined such as adenocarcinoma in situ and minimally invasive adenocarcinoma to designate adenocarcinomas, mostly nonmucinous and ≤ 3 cm in size, with either pure lepidic growth or predominant lepidic growth with ≤ 5 mm invasion, respectively. For invasive adenocarcinoma, the new classification has introduced histological subtyping according to the predominant pattern of growth of the neoplastic cells: lepidic (formerly non mucinous brochioloalveolar adenocarcinoma), acinar, papillary, micropapillary, and solid. Of note, micropapillary pattern is a brand new histologic subtype. In addition, four variants of invasive adenocarcinoma are recognized, namely invasive mucinous (formerly mucinous brochioloalveolar adenocarcinoma), colloid, fetal, and enteric. Importantly, three variants that were considered in the previous classification have been eliminated, specifically mucinous cystadenocarcinoma, signet ring cell, and clear cell adenocarcinoma. This review presents the changes introduced by the current histological classification of lung adenocarcinoma and its prognostic implications.
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Affiliation(s)
- E Kuhn
- Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy; Department of Morphology, Surgery and Experimental Medicine and Laboratory of Technology for Advanced Therapies (LTTA), University of Ferrara, Italy
| | - P Morbini
- Pathology Unit, Policlinico S. Matteo, Pavia, Italy
| | | | - S Damiani
- Pathology Unit, Ospedale Bellaria, Bologna, Italy
| | - A Cavazza
- Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - C E Comin
- Department of Experimental and Clinical Medicine, University of Florence, Italy
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18
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Weber C, Deppe A, Esser M, Eghbalzadeh K, Djordjevic I, Braun I, Gassa A, Sabashnikov A, Kuhn E, Choi Y, Madershahian N, Liakopoulos O, Wahlers T. Levosimendan Reduces Mortality and Postoperative Acute Kidney Injury in High-Risk Cardiac Surgery Patients: A Meta-analysis of 3,130 Patients. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - E. Kuhn
- Uniklinik Köln, Köln, Germany
| | - Y. Choi
- Uniklinik Köln, Köln, Germany
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19
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Eghbalzadeh K, Gablac H, Kuhn E, Sabashnikov A, Zeriouh M, Weber C, Rudolph T, Baldus S, Mader N, Wahlers T. Low Ejection Fraction Is a Predictor of Intraprocedural Cardiopulmonary Resuscitation in Patients Undergoing TAVI. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K. Eghbalzadeh
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - H. Gablac
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - E. Kuhn
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - A. Sabashnikov
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - M. Zeriouh
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - C. Weber
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - T. Rudolph
- Department of Cardiology, University Herzzentrum Köln, Cologne, Germany
| | - S. Baldus
- Department of Cardiology, University Herzzentrum Köln, Cologne, Germany
| | - N. Mader
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
| | - T. Wahlers
- Department of Cardiothoracic Surgery, University Herzzentrum Köln, Cologne, Germany
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20
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Maier J, Liakopoulos O, Auth D, Kuhn E, Choi Y, Wahlers T. Outcomes and Indication-Based Risk Stratification in Redo Cardiac Surgery. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J. Maier
- Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany
| | - O. Liakopoulos
- Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany
| | - D. Auth
- Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany
| | - E. Kuhn
- Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany
| | - Y. Choi
- Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany
| | - T. Wahlers
- Department of Cardiothoracic Surgery, Heart Center of the University Hospital of Cologne, Cologne, Germany
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21
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Marraccini C, Merolle L, Berni P, Boito K, Tamagnini I, Kuhn E, Ragazzi M, Baricchi R, Pertinhez TA. Safety of leucodepleted salvaged blood in oncological surgery: an in vitro
model. Vox Sang 2017; 112:803-805. [DOI: 10.1111/vox.12565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 01/28/2023]
Affiliation(s)
- C. Marraccini
- Transfusion Medicine Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - L. Merolle
- Transfusion Medicine Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - P. Berni
- Transfusion Medicine Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - K. Boito
- Transfusion Medicine Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - I. Tamagnini
- Pathological Anatomy Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - E. Kuhn
- Pathological Anatomy Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - M. Ragazzi
- Pathological Anatomy Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - R. Baricchi
- Transfusion Medicine Unit; AUSL-IRCCS; Reggio Emilia Italy
| | - T. A. Pertinhez
- Transfusion Medicine Unit; AUSL-IRCCS; Reggio Emilia Italy
- Department of Medicine and Surgery; University of Parma; Parma Italy
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Ragazzi M, Bisagni A, Gasparini E, Kuhn E, Bassano C, Tamagnini I, Foroni M, Bortesi M, Falco G, Ferrari G, Braglia L, Savoldi L, Bologna A, Di Cicilia R, Bisagni G, Gardini G. Impact of 2013 ASCO/CAP guidelines on HER2 determination of invasive breast cancer: A single institution experience using frontline dual-color FISH. Breast 2017; 34:65-72. [DOI: 10.1016/j.breast.2017.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/20/2017] [Accepted: 05/04/2017] [Indexed: 11/24/2022] Open
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23
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Rincent R, Kuhn E, Monod H, Oury FX, Rousset M, Allard V, Le Gouis J. Optimization of multi-environment trials for genomic selection based on crop models. Theor Appl Genet 2017; 130:1735-1752. [PMID: 28540573 PMCID: PMC5511605 DOI: 10.1007/s00122-017-2922-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/11/2017] [Indexed: 05/20/2023]
Abstract
We propose a statistical criterion to optimize multi-environment trials to predict genotype × environment interactions more efficiently, by combining crop growth models and genomic selection models. Genotype × environment interactions (GEI) are common in plant multi-environment trials (METs). In this context, models developed for genomic selection (GS) that refers to the use of genome-wide information for predicting breeding values of selection candidates need to be adapted. One promising way to increase prediction accuracy in various environments is to combine ecophysiological and genetic modelling thanks to crop growth models (CGM) incorporating genetic parameters. The efficiency of this approach relies on the quality of the parameter estimates, which depends on the environments composing this MET used for calibration. The objective of this study was to determine a method to optimize the set of environments composing the MET for estimating genetic parameters in this context. A criterion called OptiMET was defined to this aim, and was evaluated on simulated and real data, with the example of wheat phenology. The MET defined with OptiMET allowed estimating the genetic parameters with lower error, leading to higher QTL detection power and higher prediction accuracies. MET defined with OptiMET was on average more efficient than random MET composed of twice as many environments, in terms of quality of the parameter estimates. OptiMET is thus a valuable tool to determine optimal experimental conditions to best exploit MET and the phenotyping tools that are currently developed.
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Affiliation(s)
- R Rincent
- INRA, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 5 chemin de Beaulieu, 63100, Clermont-Ferrand, France.
- Université Blaise Pascal, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 63178, Aubière Cedex, France.
| | - E Kuhn
- INRA, MaIAGE, INRA, Université Paris-Saclay, 78350, Jouy-en-Josas, France
| | - H Monod
- INRA, MaIAGE, INRA, Université Paris-Saclay, 78350, Jouy-en-Josas, France
| | - F-X Oury
- INRA, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 5 chemin de Beaulieu, 63100, Clermont-Ferrand, France
- Université Blaise Pascal, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 63178, Aubière Cedex, France
| | - M Rousset
- INRA, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 5 chemin de Beaulieu, 63100, Clermont-Ferrand, France
- Université Blaise Pascal, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 63178, Aubière Cedex, France
| | - V Allard
- INRA, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 5 chemin de Beaulieu, 63100, Clermont-Ferrand, France
- Université Blaise Pascal, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 63178, Aubière Cedex, France
| | - J Le Gouis
- INRA, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 5 chemin de Beaulieu, 63100, Clermont-Ferrand, France
- Université Blaise Pascal, UMR 1095 Génétique, Diversité et Ecophysiologie des Céréales, 63178, Aubière Cedex, France
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Miller KE, Kuhn E, Weiss B, Owen J, Crowley JJ, Yu J, Taylor KL, Trockel M. 0356 CLINICIAN PERCEPTIONS RELATED TO THE USE OF CBT-I COACH MOBILE APP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.355] [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: 11/13/2022] Open
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25
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Deppe A, Weber C, Liakopoulos O, Zeriouh M, Slottosch I, Scherner M, Kuhn E, Choi Y, Wahlers T. Intra-aortic Balloon Pump Therapy before Cardiac Surgery: A Systematic Review and Meta-analysis of 9,212 Patients. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A.C. Deppe
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - C. Weber
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - O.J. Liakopoulos
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - M. Zeriouh
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - I. Slottosch
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - M. Scherner
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - E. Kuhn
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - Y.H. Choi
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
| | - T. Wahlers
- Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universitätsklinikum Köln, Köln, Germany
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Sabashnikov A, Djordjevic I, Deppe A, Kuhn E, Slottosch I, Eghbalzadeh K, Zeriouh M, Rahmanian P, Mader N, Choi Y, Kuhn-Régnier F, Wippermann J, Wahlers T. Managing Traps and Pitfalls during Initial Steps of ECMO Retrieval Program Using Miniaturized Portable ECMO System: What Have We Learned from the First Year? Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Sabashnikov
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - I. Djordjevic
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - A.C. Deppe
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - E. Kuhn
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - I. Slottosch
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - K. Eghbalzadeh
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - M. Zeriouh
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - P. Rahmanian
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - N. Mader
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Y.H. Choi
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - F. Kuhn-Régnier
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - J. Wippermann
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - T. Wahlers
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
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Weber C, Madershahian N, Scherner M, Rudolph T, Kuhn E, Choi Y, Eghbalzadeh K, Willkomm L, Deppe A, Rudolph V, Sahyoun C, Wahlers T. “Persistent Contrast”-Guided Transcatheter Aortic Valve Implantation: Feasibility and Safety of a Vessel Projection Roadmap Technology. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- C. Weber
- University Hospital of Cologne, Koeln, Germany
| | | | - M. Scherner
- University Hospital of Cologne, Koeln, Germany
| | - T. Rudolph
- University Hospital of Cologne, Koeln, Germany
| | - E. Kuhn
- University Hospital of Cologne, Koeln, Germany
| | - Y.H. Choi
- University Hospital of Cologne, Koeln, Germany
| | | | | | - A.C. Deppe
- University Hospital of Cologne, Koeln, Germany
| | - V. Rudolph
- University Hospital of Cologne, Koeln, Germany
| | - C. Sahyoun
- Philips Healthcare, Best, The Netherlands
| | - T. Wahlers
- University Hospital of Cologne, Koeln, Germany
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Maier J, Mader N, Rudolf T, Kuhn E, Scherner M, Baldus S, Wahlers T. Multimodality Imaging in TAVI Procedure: A Comparison of C-Arm Angulation Forecast using HeartNavigator and 3Mensio. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J. Maier
- Department of Cardiothoracic Surgery, Cologne University Heart Centre, Cologne, Germany
| | - N. Mader
- Department of Cardiothoracic Surgery, Cologne University Heart Centre, Cologne, Germany
| | - T. Rudolf
- Department of Internal Medicine III, Cologne University Heart Centre, Cologne, Germany
| | - E. Kuhn
- Department of Cardiothoracic Surgery, Cologne University Heart Centre, Cologne, Germany
| | - M. Scherner
- Department of Cardiothoracic Surgery, Cologne University Heart Centre, Cologne, Germany
| | - S. Baldus
- Department of Internal Medicine III, Cologne University Heart Centre, Cologne, Germany
| | - T. Wahlers
- Department of Cardiothoracic Surgery, Cologne University Heart Centre, Cologne, Germany
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Kuhn E, Waite-Cusic J, Goddik L. 0531 Hauling and receiving practices at dairy processing facilities. J Anim Sci 2016. [DOI: 10.2527/jam2016-0531] [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: 11/13/2022] Open
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31
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Kuhn E, Schindler P. Advances in the Understanding of the Effects of Various Blowing Agents on Rigid Polyurethane Appliance Foam Properties. J CELL PLAST 2016. [DOI: 10.1177/0021955x9302900506] [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: 11/16/2022]
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Gruenbauer H, Brands G, Van Duin K, Kuhn E, Swartzmiller S, Cooper L. Novel Polyurethane/Plastic Liner Technologies for Hcfc-Blown Appliance Foam. J CELL PLAST 2016. [DOI: 10.1177/0021955x9102700196] [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: 11/16/2022]
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Kuhn E, Schindler P. Advances in the Understanding of the Effects of Various Blowing Agents on Rigid Polyurethane Appliance Foam Properties. J CELL PLAST 2016. [DOI: 10.1177/0021955x9403000607] [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)
- E. Kuhn
- Dow Europe S.A. Bachtobelstr. 3, CH-8810 Horgen Switzerland
| | - P. Schindler
- Dow Europe S.A. Bachtobelstr. 3, CH-8810 Horgen Switzerland
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Affiliation(s)
- X. Fanichet
- Dow Europe S.A. Polyurethanes R&D CH-8810 Horgen, Switzerland
| | - E. Kuhn
- Dow Europe S.A. Polyurethanes R&D CH-8810 Horgen, Switzerland
| | - P. Schindler
- Dow Europe S.A. Polyurethanes R&D CH-8810 Horgen, Switzerland
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Fanichet X, Kuhn E, Schindler P. Rapid Technology Evaluation To Hcfc-22/142b Blowing Agent for Refrigerator Insulation Foam. J CELL PLAST 2016. [DOI: 10.1177/0021955x9403000401] [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: 11/17/2022]
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36
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Kuhn E, Potthoff A, Dirks H, Borgmann R, Esser S, Scherbaum N, Brockmeyer NH, Skaletz-Rorowski A. Viral load strategy: impact on risk behaviour and serocommunication of men who have sex with men in specialized care. J Eur Acad Dermatol Venereol 2016; 30:1561-6. [PMID: 27393373 DOI: 10.1111/jdv.13672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 02/15/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Incidence and prevalence of HIV are continuously high in German men, who have sex with men (MSM). Different transmission risk minimizing strategies have been observed. The viral load strategy rates patients unlikely to be sexually infectious if their viral load under effective therapy is stably suppressed during 6 months and no other sexually transmitted infections are present. OBJECTIVES We aim to objectify the current popularity of the viral load strategy, the adherence to basic conditions and its impact on risk behaviour and serocommunication. Until now, no data on a German sample of HIV-positive MSM in regular specialized outpatient care are available. METHODS Cross-sectional study with group comparisons between user group and non-user-group of the viral load strategy. Self-report questionnaires were conducted with 269 sexually active German HIV+MSM under effective treatment in specialized outpatient care. Structured interviews gathered additional information about approach to and realization of definite action levels concerning sexual risk behaviour and transmission risk minimizing strategies. RESULTS Twenty-seven of 269 participants (10%) affirmed knowledge of having an undetectable viral load and stated this to be criteria for unprotected sexual behaviour. This subgroup reported more unprotected insertive (P = 0.018) and receptive anal intercourse (P = 0.042), more anonymous sex partners (P = 0.008) and less consistent safer sex. Analysing serocommunication, less addressing HIV/AIDS in general (P = 0.043) and less disclosing to sex partners (P = 0.023) was found, especially in anonymous settings. Differentiating serocommunication characteristics, a focus on seroguessing was depicted. CONCLUSIONS The user group of the viral load strategy is small. But a less frequent, more reactive and assumptive serocommunication leads to an imprecise information exchange paired with higher frequency of risky behaviour, especially in anonymous settings, where frank serocommunication is often avoided. The targeted group of the viral load strategy diverges greatly from the user group.
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Affiliation(s)
- E Kuhn
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany
| | - A Potthoff
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany.,Competence Network for HIV/AIDS, Ruhr-Universität Bochum, Bochum, Germany
| | - H Dirks
- Department of Addiction Medicine and Addictive Behaviour, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - R Borgmann
- Department of Addiction Medicine and Addictive Behaviour, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - S Esser
- Department of Dermatology and Venerology, University Hospital Duisburg-Essen, Essen, Germany
| | - N Scherbaum
- Department of Addiction Medicine and Addictive Behaviour, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Essen, Germany
| | - N H Brockmeyer
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany.,Competence Network for HIV/AIDS, Ruhr-Universität Bochum, Bochum, Germany
| | - A Skaletz-Rorowski
- Department of Dermatology, Venerology and Allergology, Center for Sexual Health and Medicine, Ruhr-Universität Bochum, Bochum, Germany.,Competence Network for HIV/AIDS, Ruhr-Universität Bochum, Bochum, Germany
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Scherner M, Ney S, Madershahian N, Kuhn E, Rudolph T, Weber C, Slottosch I, Baldus S, Wahlers T. Remote Ischemic Preconditioning for Prevention of Acute Kidney Injury after Transcatheter Aortic Valve Implantation: A Matched Cohort Study. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571564] [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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38
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Slottosch I, Liakopoulos O, Kuhn E, Deppe A, Scherner M, Mader N, Choi Y, Wahlers T. Value of Lactate Levels during ECMO Support for Refractory Cardiogenic Shock. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571787] [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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39
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Slottosch I, Liakopoulos O, Kuhn E, Deppe A, Scherner M, Mader N, Choi YH, Wahlers T. Relevance of Cardiac Enzymes on Outcome after Urgent CABG for Acute Coronary Syndrome. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571782] [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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40
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Weber C, Deppe AC, Kuhn E, Scherner M, Slottosch I, Liakopoulos O, Choi YH, Wahlers T. Point-of-care TEG/ROTEM Based Coagulation Management in Cardiac Surgery: A Meta-analysis of 8,321 Patients. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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41
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Neef K, Zeriouh M, Kuhn E, Deppe AC, Slottosch I, Stamm C, Wittwer T, Wahlers T, Choi YH. The Dysregulation of Pro-angiogeneic Factors in Pressure-overload Left Ventricular Hypertrophy Results in Inadequate Myocardial Capillarization. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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42
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Ney S, Scherner M, Madershahian N, Kuhr K, Rosenkranz S, Choi YH, Rudolph T, Kuhn E, Baldus S, Wahlers T. TAVI - Focus on the Surgical Approach: Complications, Outcome and Preoperative Risk Adjustment. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544577] [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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Kuhn E, Madershahian N, Abel J, Scherner M, Deppe AC, Choi YH, Wahlers T. Better Prediction of Fluoroscopic C-arm Position for TAVI Procedures by Manual CT Assessment Compared to Automatic Determination Using HeartNavigator Software. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Scherner M, Ney S, Madershahian N, Kuhr K, Kuhn E, Rudolph T, Slottosch I, Wippermann J, Baldus S, Wahlers T. Further Insights in Acute Kidney Injury after Transcatheter Aortic Valve Implantation: Time of Onset of Kidney Injury is Crucial for Severity and Mortality Risk. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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45
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Deppe AC, Weber C, Kuhn E, Scherner M, Slottosch I, Liakopoulos L, Choi YH, Wahlers T. Prophylactic Intra-Aortic Balloon Pump Therapy before Cardiac Revascularization Surgery - A Systematic Review and Meta-Analysis of 3,247 Patients. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ose J, Fortner RT, Schock H, Peeters PH, Onland-Moret NC, Bueno-de-Mesquita HB, Weiderpass E, Gram IT, Overvad K, Tjonneland A, Dossus L, Fournier A, Baglietto L, Trichopoulou A, Benetou V, Trichopoulos D, Boeing H, Masala G, Krogh V, Matiello A, Tumino R, Popovic M, Obón-Santacana M, Larrañaga N, Ardanaz E, Sánchez MJ, Menéndez V, Chirlaque MD, Travis RC, Khaw KT, Brändstedt J, Idahl A, Lundin E, Rinaldi S, Kuhn E, Romieu I, Gunter MJ, Merritt MA, Riboli E, Kaaks R. Insulin-like growth factor I and risk of epithelial invasive ovarian cancer by tumour characteristics: results from the EPIC cohort. Br J Cancer 2015; 112:162-6. [PMID: 25349976 PMCID: PMC4453611 DOI: 10.1038/bjc.2014.566] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/24/2014] [Accepted: 10/08/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Prospective studies on insulin-like growth factor I (IGF-I) and epithelial ovarian cancer (EOC) risk are inconclusive. Data suggest risk associations vary by tumour characteristics. METHODS We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate IGF-I concentrations and EOC risk by tumour characteristics (n=565 cases). Multivariable conditional logistic regression models were used to estimate associations. RESULTS We observed no association between IGF-I and EOC overall or by tumour characteristics. CONCLUSIONS In the largest prospective study to date was no association between IGF-I and EOC risk. Pre-diagnostic serum IGF-I concentrations may not influence EOC risk.
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Affiliation(s)
- J Ose
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - H Schock
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - P H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - N C Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, 3542 Utrecht, The Netherlands
- Department of Epidemiology and Statistics, the School of Public Health, Imperial College London, SW72AZ London, UK
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, 90109 Tromsø, Norway
- Cancer Registry of Norway, 0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Genetic Epidemiology, Folkhälsan Research Center, 00014 Helsinki, Finland
| | - I T Gram
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - K Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, 8000 Aarhus, Denmark
| | - A Tjonneland
- Institute of Cancer Epidemiology, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | - L Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France
- IGR, F-94805 Villejuif, France
| | - A Fournier
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France
- IGR, F-94805 Villejuif, France
| | - L Baglietto
- Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, 3004 Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, 3004 Victoria, Australia
| | - A Trichopoulou
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - V Benetou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75M Asias Street, Goudi, Athens GR-115 27, Greece
| | - D Trichopoulos
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition (DIfE) 14558 Potsdam-Rehbrücke, Nuthetal, Germany
| | - G Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, 50139 Florence, Italy
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Instituto Nazionale dei Tumori, Via Veneziani 1, 20133 Milano, Italy
| | - A Matiello
- Department of Clinical and Experimental Medicine, Federico II University, 80131 Naples, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, ‘Civic - M.P. Arezzo' Hospita, ASP 97100 Ragusa, Italy
| | - M Popovic
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, Department of Medical Sciences, University of Turin and Center for Cancer Prevention (CPO-Piemonte), 10126 Turin, Italy
| | - M Obón-Santacana
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), 08908 Barcelona, Spain
| | - N Larrañaga
- Public Health Division of Gipuzkoa-BIODonostia Research Institute, Basque Regional Health Department, 20013 San Sebastian, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
| | - E Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
- Navarre Public Health Institute, 31006 Pamplona, Spain
| | - M-J Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
- Andalusian School of Public Health, 18011 Granada, Spain
| | - V Menéndez
- Public Health Directorate, 33006 Asturias, Spain
| | - M-D Chirlaque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Authority, 30008 Murcia, Spain
| | - R C Travis
- Cancer Epidemiology Unit, University of Oxford, OX30NR Oxford, UK
| | - K-T Khaw
- Department of Public Health and Primary Care, University of Cambridge, CB22QQ Cambridge, UK
| | - J Brändstedt
- Medical Department of Surgery, Malmö University Hospital, 20502 Malmö, Sweden
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology and Department of Public Health and Clinical Medicine, Nutritional Research Umeå University, 90185 Umeå, Sweden
| | - E Lundin
- Department of Medical Biosciences, Pathology Umeå University, 90185 Umeå, Sweden
| | - S Rinaldi
- International Agency for Research on Cancer, 69372 Lyon, France
| | - E Kuhn
- International Agency for Research on Cancer, 69372 Lyon, France
| | - I Romieu
- International Agency for Research on Cancer, 69372 Lyon, France
| | - M J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, SW72AZ London, UK
| | - M A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, SW72AZ London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, SW72AZ London, UK
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
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Slottosch I, Liakopoulos O, Kuhn E, Deppe A, Choi YH, Madershahian N, Wahlers T. Predictors of mortality in patients requiring IABP support after urgent CABG. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Scherner M, Madershahian N, Kuhn E, Slottosch I, Deppe A, Choi Y, Strauch J, Wippermann J, Wahlers T. Impact of gender on frequency of contrast-induced nephropathy following transcatheter aortic valve implantation. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Slottosch I, Liakopoulos O, Kuhn E, Deppe A, Choi YH, Wahlers T. Clinical outcomes after emergency CABG for coronary complications following PCI. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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