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Urquhart DS, Hebestreit H, Saynor Z, Radtke T. 'Gold-standard' field test is a non-sequitur. Pulmonology 2023; 29:173. [PMID: 36117100 DOI: 10.1016/j.pulmoe.2022.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- D S Urquhart
- Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, EH16 4TJ, United Kingdom; Department of Child Life and Health, University of Edinburgh, United Kingdom.
| | - H Hebestreit
- Paediatric Department, University Hospitals Würzburg, Germany
| | - Z Saynor
- School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, United Kingdom
| | - T Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
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Radtke T, Smith S, Nevitt SJ, Hebestreit H, Kriemler S. Physical activity and exercise training in cystic fibrosis. Paediatr Respir Rev 2022; 44:47-52. [PMID: 36402662 DOI: 10.1016/j.prrv.2022.08.001] [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] [Received: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 12/14/2022]
Affiliation(s)
- T Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - S Smith
- Division of Child Health, Obstetrics & Gynaecology (COG), School of Medicine, University of Nottingham, Nottingham, UK
| | - S J Nevitt
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - H Hebestreit
- Julius-Maximilians University, Würzburg, Germany
| | - S Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Schwartbeck B, Rumpf C, Hait R, Decker C, Janssen T, Romme K, Dübbers A, Küster P, Graepler-Mainka U, Hebestreit H, Van-Koningsbruggen-Rietschel S, Renner S, Wollschläger B, Naehrig S, Stehling F, Schlegtendahl A, Ballmann M, Junge S, Sutharsan S, Kahl B. 536 Not only 5–base pair deletions in the intergenic region of the intercellular adhesion operon, but also mutations in the repressor of the intercellular adhesion operon lead to a mucoid phenotype in Staphylococcus aureus residing in the airways of people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01226-7] [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: 11/05/2022]
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Heidenreich FJ, Kuhl JP, Metz C, Weng MA, Grunz PJ, Benkert T, Hebestreit H, Bley AT, Köstler H, Veldhoen S. Pulmonale 3D-UTE MRT bei Patienten mit Cystischer Fibrose zur Evaluation des Therapieansprechens unter CFTR-Modulator Therapie. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- F J Heidenreich
- Universtätsklinikum Würzburg, Institut f. Diagn. u. Intervent. Radiologie, Würzburg
| | - J P Kuhl
- Diagnostische und Interventionelle Radiologie, Uniklinikum Würzburg, Würzburg
| | - C Metz
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg
| | - M A Weng
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg
| | - P J Grunz
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg
| | - T Benkert
- Siemens Healthineers GmbH, -, Erlangen
| | - H Hebestreit
- Pädiatrie, Universitätsklinikum Würzburg, Würzburg
| | - A T Bley
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg
| | - H Köstler
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg
| | - S Veldhoen
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg
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Schippers C, Volk D, de Zwaan M, Deckert J, Dieris-Hirche J, Herpertz S, Schulz JB, Hebestreit H. [ZSE-DUO - dual guidance structure at the centre for rare diseases]. Inn Med (Heidelb) 2022; 63:791-797. [PMID: 35925266 DOI: 10.1007/s00108-022-01350-8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patients with an unclear diagnosis and suspected rare disease pose special challenges to physicians, among others. AIM OF THE STUDY (RESEARCH QUESTION) The ZSE-DUO project aims to establish whether patient care under the joint supervision of a somatic expert and a mental health expert can improve diagnostic efficacy and precision, as well as shorten the time to diagnosis. MATERIAL AND METHODS ZSE-DUO has successfully recruited more than 1000 patients at eleven national centres for rare diseases in a control and an intervention group. The findings are being analysed by three evaluating institutions. RESULTS AND DISCUSSION The study is currently in its final phase. The results will be published in further papers.
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Affiliation(s)
- C Schippers
- Zentrum für Seltene Erkrankungen, Universitätsklinikum, RWTH Aachen, Bahnhofstr. 18, 52064, Aachen, Deutschland.
| | - D Volk
- Zentrum für Seltene Erkrankungen, Universitätsklinikum, RWTH Aachen, Bahnhofstr. 18, 52064, Aachen, Deutschland
| | - M de Zwaan
- Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - J Deckert
- Zentrum für Seltene Erkrankungen - Referenzzentrum Nordbayern (ZESE), Universitätsklinikum Würzburg, Würzburg, Deutschland
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Zentrum für Psychische Gesundheit, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Dieris-Hirche
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum Bochum, Bochum, Deutschland
| | - S Herpertz
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum Bochum, Bochum, Deutschland
| | - J B Schulz
- Zentrum für Seltene Erkrankungen, Universitätsklinikum, RWTH Aachen, Bahnhofstr. 18, 52064, Aachen, Deutschland
- Neurologische Klinik, Universitätsklinikum, RWTH Aachen, Aachen, Deutschland
| | - H Hebestreit
- Zentrum für Seltene Erkrankungen - Referenzzentrum Nordbayern (ZESE), Universitätsklinikum Würzburg, Würzburg, Deutschland
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Radtke T, Kriemler S, Stein L, Karila C, Urquhart D, Orenstein D, Lands L, Schindler C, Eber E, Haile S, Hebestreit H. WS14.03 Cystic Fibrosis-Related Diabetes is not associated with maximal aerobic exercise capacity in cystic fibrosis (CF): a cross-sectional analysis of an international multicentre trial (ACTIVATE-CF). J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rumpf C, Schwartbeck B, Hait R, Deiwick S, Decker C, Romme K, Dübbers A, Küster P, Graepler-Mainka U, Hebestreit H, van Koningsbruggen-Rietschel S, Renner S, Wollschläger B, Naehrig S, Sterling F, Schlegtendal A, Sutharsan S, Ballmann M, Junge S, Kahl B. ePS3.01 Preliminary results of an ongoing study, which determines the prevalence and possible impact of mucoid Staphylococcus aureus on lung disease of people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00299-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hebestreit H, Ullrich M, Graeßner H, Rashid A, Ertl M, Maisch T. Digitale Systeme für Konsile und Fallkonferenzen bei Seltenen Erkrankungen. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01225-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hartmann M, Meyer M, Brudy L, Oberhoffer-Fritz R, Böhm R, Hebestreit H, Hansmann S. Bewegung und Sport bei chronischen Erkrankungen. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00935-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Schwarz C, Schulte-Hubbert B, Bend J, Abele-Horn M, Baumann I, Bremer W, Brunsmann F, Dieninghoff D, Eickmeier O, Ellemunter H, Fischer R, Grosse-Onnebrink J, Hammermann J, Hebestreit H, Hogardt M, Hügel C, Hug M, Illing S, Jung A, Kahl B, Koitschev A, Mahlberg R, Mainz JG, Mattner F, Mehl A, Möller A, Muche-Borowski C, Nüßlein T, Puderbach M, Renner S, Rietschel E, Ringshausen FC, Schmidt S, Sedlacek L, Sitter H, Smaczny C, Tümmler B, Vonberg R, Wielpütz MO, Wilkens H, Wollschläger B, Zerlik J, Düesberg U, van Koningsbruggen-Rietschel S. [CF Lung Disease - a German S3 Guideline: Module 2: Diagnostics and Treatment in Chronic Infection with Pseudomonas aeruginosa]. Pneumologie 2018; 72:347-392. [PMID: 29758578 DOI: 10.1055/s-0044-100191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Cystic Fibrosis (CF) is the most common autosomal-recessive genetic disease affecting approximately 8000 people in Germany. The disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to dysfunction of CFTR, a transmembrane chloride channel. This defect causes insufficient hydration of the epithelial lining fluid which leads to chronic inflammation of the airways. Recurrent infections of the airways as well as pulmonary exacerbations aggravate chronic inflammation, lead to pulmonary fibrosis and tissue destruction up to global respiratory insufficiency, which is responsible for the mortality in over 90 % of patients. The main aim of pulmonary treatment in CF is to reduce pulmonary inflammation and chronic infection. Pseudomonas aeruginosa (Pa) is the most relevant pathogen in the course of CF lung disease. Colonization and chronic infection are leading to additional loss of pulmonary function. There are many possibilities to treat Pa-infection. This is a S3-clinical guideline which implements a definition for chronic Pa-infection and demonstrates evidence-based diagnostic methods and medical treatment for Pa-infection in order to give guidance for individual treatment options.
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Affiliation(s)
- C Schwarz
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Christiane Herzog Zentrum, Berlin
| | - B Schulte-Hubbert
- Medizinische Klinik und Poliklinik I, Pneumologie, Universitätsklinikum Dresden
| | - J Bend
- Mukoviszidose Institut, Bonn
| | - M Abele-Horn
- Universität Würzburg, Institut für Hygiene und Mikrobiologie
| | - I Baumann
- Universität Heidelberg, Hals-Nasen-Ohrenklinik, Heidelberg
| | | | - F Brunsmann
- Charité Universitätsmedizin Berlin, Deutschland (Patientenvertreter)
| | - D Dieninghoff
- Kliniken der Stadt Köln, Lungenklinik, Lehrstuhl der Universität Witten Herdecke
| | - O Eickmeier
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Christiane Herzog CF-Zentrum, Frankfurt
| | - H Ellemunter
- Tirolkliniken GmbH, Department für Kinderheilkunde Pädiatrie III, Innsbruck, Österreich
| | - R Fischer
- Zentrum für erwachsene Mukoviszidose-Patienten München-West
| | - J Grosse-Onnebrink
- Universitätsklinikum Münster UKM; Klinik für Kinder- und Jugendmedizin; Allgemeine Pädiatrie Mukoviszidose-Ambulanz, Münster
| | - J Hammermann
- Universitäts-Mukoviszidose-Zentrum "Christiane Herzog", Dresden
| | | | - M Hogardt
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Frankfurt
| | - C Hügel
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Zentrum der Inneren Medizin, Frankfurt, Deutschland
| | - M Hug
- Universitätsklinikum Freiburg, Apotheke des Klinikums Freiburg
| | - S Illing
- Olgahospital - Kinderklinik - CF-Zentrum/Jugendliche/Erwachsene Stuttgart
| | - A Jung
- Kinderspital Zürich, Abteilung Pneumologie, Zürich, Schweiz
| | - B Kahl
- Universitätsklinikum Münster UKM, Institut für Medizinische Mikrobiologie, Münster
| | - A Koitschev
- Klinikum Stuttgart - Standort Olgahospital, Klinik für Hals-Nasen-Ohrenkrankheiten, Stuttgart
| | - R Mahlberg
- Klinikum Mutterhaus der Borromäerinnen, Abteilung Innere Medizin, Trier
| | - J G Mainz
- Universitätsklinikum Jena, Mukoviszidosezentrum/Pädiatrische Pneumologie, Jena
| | - F Mattner
- Kliniken der Stadt Köln, Institut für Hygiene, Köln
| | - A Mehl
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Christiane Herzog Zentrum, Berlin
| | - A Möller
- Pneumologie und CF Ambulanz der Universitäts-Kinderklinik Zürich, Schweiz
| | - C Muche-Borowski
- Philipps-Universität Marburg, AWMF-Institut für Medizinisches Wissensmanagement, Marburg und Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg
| | - T Nüßlein
- Gemeinschaftsklinikum Mittelrhein, Klinik für Kinder- und Jugendmedizin Koblenz und Mayen
| | - M Puderbach
- Hufeland Klinikum, Abteilung für Diagnostische und Interventionelle Radiologie, Bad Langensalza
| | - S Renner
- Allgemeines Universitätskrankenhaus, Klinik für Kinder- und Jugendheilkunde, CF Ambulanz, Wien, Österreich
| | - E Rietschel
- Mukoviszidose-Zentrum Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln
| | - F C Ringshausen
- Medizinische Hochschule Hannover, Klinik für Pneumologie und Deutsches Zentrum für Lungenforschung (DZL), Hannover
| | - S Schmidt
- Ernst-Moritz-Arndt Universität Greifswald, Zentrum für Kinder- und Jugendmedizin; Mukoviszidose Zentrum Mecklenburg/Vorpommern, Greifswald
| | - L Sedlacek
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover
| | - H Sitter
- Philipps-Universität Marburg, Institut für theoretische Medizin, Marburg
| | - C Smaczny
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Zentrum der Inneren Medizin, Frankfurt, Deutschland
| | - B Tümmler
- Medizinische Hochschule Hannover, Klinische Forschergruppe OE 6710, Klinik für Pädiatrische Pneumologie und Neonatologie
| | - R Vonberg
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover
| | - M O Wielpütz
- Diagnostische und Interventionelle Radiologie Universitätsklinikum Heidelberg, Heidelberg
| | - H Wilkens
- Universitätsklinikum des Saarlandes, Medizinische Klinik V, Pneumologie, Allergologie und Beatmungsmedizin, Homburg
| | - B Wollschläger
- Martin-Luther-Universität Halle, Universitätsklinik und Poliklinik für Innere Medizin I/Pneumologie, Halle
| | - J Zerlik
- Altonaer Kinderkrankenhaus gGmbH, Abteilung Physiotherapie, Hamburg
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Radtke T, Hebestreit H, Puhan M, Kriemler S. WS16.3 The 1-min sit-to-stand test in cystic fibrosis – insights into cardiorespiratory responses. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Kunz A, Weng A, Wirth C, Kestler C, Hebestreit H, Segerer F, Köstler H, Bley T, Veldhoen S. Funktionelle native Lungen-MRT (SENCEFUL) zur Ermittlung pulmonaler Perfusionsdefizite bei Cystischer Fibrose. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600447] [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 Kunz
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - A Weng
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - C Wirth
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - C Kestler
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - H Hebestreit
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg
| | - F Segerer
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg
| | - H Köstler
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - T Bley
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - S Veldhoen
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
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Veldhoen S, Weng A, Knapp J, Kunz A, Stab D, Wirth C, Segerer F, Hebestreit H, Malzahn U, Köstler H, Bley T. Die selbstnavigierte und kontrastmittelfreie funktionelle Lungen-MRT zur quantitativen Ventilationsanalyse bei Patienten mit cystischer Fibrose. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600453] [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 Veldhoen
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - A Weng
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - J Knapp
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - A Kunz
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - D Stab
- University of Queensland, Centre of Advanced Imaging, Brisbane
| | - C Wirth
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - F Segerer
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg
| | - H Hebestreit
- Universitätsklinikum Würzburg, Kinderklinik und Poliklinik, Würzburg
| | - U Malzahn
- Universitätsklinikum Würzburg, Zentrale für Klinische Studien, Würzburg
| | - H Köstler
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
| | - T Bley
- Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Radiologie, Würzburg
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Leu T, Rauthe S, Wirth C, Simon HU, Kunzmann V, Hebestreit H, Kunzmann S. [The Lymphoid Variant of HES (L-HES) as Differential Diagnose of Severe Asthma in Childhood]. Klin Padiatr 2016; 228:319-324. [PMID: 27846662 DOI: 10.1055/s-0042-112593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Based on a case report an overview on the differential diagnostic considerations with respect to blood hypereosinophilia (HE) and hypereosinophilic syndromes (HES) in childhood is given. A 13-year-old boy was admitted for the clarification of an asthma. In the blood count an increased HE with 3 500/µl (30%) was found along with elevated total serum IgE and IL-5 level (2 000 IU/ml and 17 pg/ml). Lung function showed an obstruction (FEV1 38%). Radiologically the picture of bronchiectasis and mucus pluggine appeared. In the BAL a HE (76%) with raised IL-5 level was apparent. Histologically asthma was diagnosed with mucostasis, hypertrophy of the bronchial wall musculature and a lung HE. Differential-diagnostically an ABPA, a Churg-Strauss-Syndrome, a parasitosis, drug associated HE, allergies and malignant disease could be excluded. An aberrant T-cell clone in peripheral blood was detected by flow cytometry and T-cell receptor clonal rearrangements by PCR, leading to the diagnosis of a lymphoid variant of HES (L-HES). Failure to detect the FIP1L1-PDGFRA gene fusion and a normal bone marrow examination could exclude a neoplastic HES (HESN). After steroid initiation, prompt decrease of blood eosinophilia with resolution of symptoms was observed. Steroid discontinuation led to eosinophilia recurrence associated with disease symptoms. As steroid-sparing agent the immunosuppressive azathioprine was additionally given; steroid doses could be decreased and stopped in the course. This case demonstrated the range of HE evaluation in infancy. With asthma one should also consider the possibility of a L-HES.
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Affiliation(s)
- T Leu
- Children's Hospital, University of Würzburg, Würzburg
| | - S Rauthe
- Institute of Pathology, University of Würzburg, Würzburg
| | - C Wirth
- Institute of Radiology, University Hospital Würzburg, Würzburg
| | - H-U Simon
- Institute of pharmacology, University of Bern, Bern, Switzerland
| | - V Kunzmann
- Division of Medical Oncology, Department of Internal Medicine II, Würzburg
| | - H Hebestreit
- Children's Hospital, University of Würzburg, Würzburg
| | - S Kunzmann
- Children's Hospital, University of Würzburg, Würzburg
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Bradley J, O'Neill B, Kent L, Hulzebos EH, Arets B, Hebestreit H, Alison J, Arets B, Boas S, Bradley J, Button B, Bye P, Cerny F, Cooper D, Downs A, Dwyer T, Forster E, Gallagher C, Gruber W, Hebestreit A, Hebestreit H, Huber M, Hulzebos E, Johnstone Z, Lands L, Lannefors L, Lessine F, Lindblad A, Lowman J, Mandrusiak A, Martensson M, McIlwaine M, Möller A, Molloy M, Montgomery G, Morrison L, Murray J, Nippins M, Orenstein D, Prasaad A, Renner S, Salhberg M, Schneiderman J, Swisher A, Urquhart D, Zeitoun M. Physical activity assessment in cystic fibrosis: A position statement. J Cyst Fibros 2015. [DOI: 10.1016/j.jcf.2015.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Leu T, Simon HU, Hebestreit H, Kunzmann S. [The Hypereosinophilic Syndromes in Childhood]. Klin Padiatr 2015; 227:308-13. [PMID: 26267413 DOI: 10.1055/s-0035-1555792] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The hypereosinophilic syndromes are rare disorders in childhood and require extensive differential diagnostic considerations. In the last years the earlier "idiopathic HES" called syndromes could be differentiated into molecular biologically, immunophenotypically and clinically more characterized heterogeneous diseases with high therapeutic and prognostic relevance. Nowadays the term HES summarizes diseases, which go hand in hand with a local or systemic hypereosinophilia (HE) connected with an organ damage. Depending on the cause of the HE one differentiates primary/neoplastic HES (HESN) from secondary/reactive HES (HESR). The latter develops reactively in connection with allergies, parasitosis, medications, neoplasia or a clonal increase of T-lymphocytes among others. With HESN the HE results from a clonal increase of eosinophilic granulocytes. While for some subgroups of the HESN (among others FIP1L1-PDGFRA fusion gene) the administration of a tyrosine kinase inhibitor is a new and effective therapy option, glucocorticoids still represent the medication of first choice for many not PDGFRA associated variants. Different immunomodulatory drugs or cytostatic agents are necessary to allow dose reduction of glucocorticoids. The promising therapy with anti-IL-5 antibodies is still not approved in infancy, could however become a treatment option in the future. Due to the present lack of knowledge about the HES in infancy the establishment of a register should be aimed for the treatment of HES in infancy.
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Affiliation(s)
- T Leu
- Universitäts-Kinderklinik Würzburg, Würzburg
| | - H-U Simon
- Institut für Pharmakologie, Universität Bern, Bern
| | | | - S Kunzmann
- Universitäts-Kinderklinik Würzburg, Würzburg
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17
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Radtke T, Christen G, Huber MK, Hebestreit H, Kriemler S. WS14.2 Short-term effect of different physical exercise–physiotherapy combinations on sputum production, oxygen saturation and lung function in young patients with cystic fibrosis. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30085-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Ruf K, Hebestreit H. Körperliche Aktivität und Belastungsuntersuchungen bei Mukoviszidose. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-013-3013-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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19
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Wirbelauer J, Bauer J, Hebestreit H, Thomas W. Plastic bronchitis 3 years after Fontan palliation. Klin Padiatr 2011; 224:38-9. [PMID: 22161562 DOI: 10.1055/s-0031-1297263] [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] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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20
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Meyer U, Roth R, Zahner L, Gerber M, Puder JJ, Hebestreit H, Kriemler S. Contribution of physical education to overall physical activity. Scand J Med Sci Sports 2011; 23:600-6. [PMID: 22151355 DOI: 10.1111/j.1600-0838.2011.01425.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2011] [Indexed: 11/28/2022]
Abstract
For many children, physical activity (PA) during physical education (PE) lessons provides an important opportunity for being physically active. Although PA during PE has been shown to be low, little is known about the contribution of PA during PE to overall PA. The aim was therefore to assess children's PA during PE and to determine the contribution of PE to overall PA with special focus on overweight children. Accelerometer measurements were done in 676 children (9.3 ± 2.1 years) over 4-7 days in 59 randomly selected classes. Moderate-and-vigorous PA (MVPA; ≥ 2000 counts/min) during PE (MVPAPE), overall MVPA per day (MVPADAY), and a comparison of days with and without PE were calculated by a regression model with gender, grade, and weight status (normal vs overweight) as fixed factors and class as a random factor. Children spent 32.8 ± 15.1% of PE time in MVPA. Weight status was not associated to MVPAPE . MVPAPE accounted for 16.8 ± 8.5% of MVPADAY, and 17.5 ± 8.2% in overweight children. All children were more active on days with PE than on days without PE (differences: 16.1 ± 29.0 min of MVPADAY; P ≤ 0.001; 13.7 ± 28.0 min for overweight children). Although MVPAPE was low, PE played a considerable role in providing PA and was not compensated by reducing extracurricular MVPA.
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Affiliation(s)
- U Meyer
- Swiss Tropical and Public Health Institute, Basel, Switzerland
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21
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Neubauer H, Hebestreit H, Platek K, Weng AM, Hahn D, Köstler H, Beer M. Muskelarbeit live in der dynamischen 31P-MR-Spektroskopie. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286243] [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: 10/17/2022]
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22
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Bilton D, Aitken M, Flume P, Geller D, Lapey A, Zuckerman J, De Boeck K, Bellon G, Hebestreit H, Haarman E, Robinson P, Cooper P, Kolbe J, Gallagher C, Fox H, Charlton B. 78 Combined data from two phase III studies of Bronchitol (inhaled dry powder mannitol) in adult cystic fibrosis (CF) patients. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Verburg FA, Kirchgässner C, Hebestreit H, Steigerwald U, Lentjes EGWM, Ergezinger K, Grelle I, Reiners C, Luster M. Reference ranges for analytes of thyroid function in children. Horm Metab Res 2011; 43:422-6. [PMID: 21484669 DOI: 10.1055/s-0031-1275326] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Promptly detecting pediatric thyroid dysfunction requires age-appropriate reference ranges for serum thyroid-stimulating hormone (TSH), serum free thyroxine (FT4), and serum free triiodothyronine (FT3). We sought to establish such ranges, employing the widely-used Immulite® 2000 automated immunoluminometric assays in a large population. We assayed the analytes according to manufacturer's instructions in serum samples from 359 male and 297 female university hospital patients, aged between newborn to 18 years, without evidence of thyroid or pituitary dysfunction. As data were not normally distributed, the reference ranges were assumed to lie between the 2.5th and 97.5th percentiles. Curves for age-related changes in the reference ranges were calculated using the linearity, median and skewness method. TSH, FT4, and FT3 reference ranges showed a wide spread immediately after birth, rapidly decreasing within the first 2 years of life. Reference range width was fairly stable after about age 4 years. However, from that time, the ranges' lower and upper limits steadily declined, essentially reaching (FT3) or approximating (TSH, FT4) healthy adult values by age 18 years. Age-specific reference ranges should be used when measuring TSH, FT4, and FT3 in children. During very early life, values of these analytes range widely, making it challenging to interpret measurements in infants, and, especially, newborns.
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Affiliation(s)
- F A Verburg
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
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24
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Abstract
An increasing number of children and adolescents is diving with Self-Contained Underwater Breathing Apparatus (SCUBA). SCUBA diving is associated with health risks such as pulmonary barotrauma, especially in children and in individuals with airflow limitation. As no data has been published on the effects of open-water diving on pulmonary function in children, the objective of this study was to evaluate the effects of SCUBA dives on airflow in children. 16 healthy children aged 10-13 years underwent spirometry and a cycle-exercise challenge while breathing cold air. They subsequently performed dives to 1-m and 8-m depth in random order. Pulmonary function was measured before and after the exercise challenge and the dives. There were statistically significant decreases in FEV1, FVC, FEV1/FVC, MEF25 and MEF50 after the cold-air exercise challenge and the dives. Changes in lung function following the exercise challenge did not predict the responses to SCUBA diving. In 3 children the post-dive decrements in FEV1 exceeded 10%. These children had a lower body weight and BMI percentile. SCUBA diving in healthy children may be associated with relevant airflow limitation. A low body mass might contribute to diving-associated bronchoconstriction. In the majority of subjects, no clinically relevant airway obstruction could be observed.
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Affiliation(s)
- B E Winkler
- University of Wuerzburg, Department of Paediatrics, Wuerzburg, Germany.
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25
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Roth K, Ruf K, Obinger M, Mauer S, Ahnert J, Schneider W, Graf C, Hebestreit H. Is there a secular decline in motor skills in preschool children? Scand J Med Sci Sports 2010; 20:670-8. [DOI: 10.1111/j.1600-0838.2009.00982.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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26
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Radike K, Holl R, Molz K, Hebestreit H, Ballmann M. Prognostic relevance of hypoglycemia following an oral glucose challenge in cystic fibrosis. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60319-0] [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: 11/17/2022]
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27
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Wirth C, Brenner S, Oechsner M, Stäb D, Hebestreit H, Köstler H, Hahn D, Beer M. O2-unterstützte funktionelle Lungenuntersuchung am offenen Niederfeld-MRT bei Patienten mit zystischer Fibrose. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252787] [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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28
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Abstract
Current diagnostic tools for the assessment of lung function are limited by global measurements or the need for radioactive tracers. Ideally, these tools should allow quantitative, regional distinct analyses without exposure to radiation. The current paper presents oxygen-enhanced functional MRI for assessment of lung ventilation. First applied in humans in 1996, a considerable amount of experience is now available on 1.5T scanners. The generation of quantitative T1-maps shows a high clinical potential. Low-field MR scanners, which are mostly open-designed, are especially interesting for functional lung imaging. The open design has advantages in respect to patient comfort by lower noise production and easy access to the patients and the costs are lower (no need for helium cooling). Lower signal-to-noise ratios can be overcome by changing the relaxation times. New navigator techniques allow further compensations. This article focuses on the presentation of low-field scanners and the application of T1 and T2(*) maps is described for healthy volunteers and first patients.
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Affiliation(s)
- M Beer
- Institut für Röntgendiagnostik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg.
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29
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Hebestreit H, Asmar F, Lütgemeier J. Benigne Ösophagusstenosen bei Ektopie der Magenschleimhaut. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1229182] [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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30
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Böttger E, Träger F, Hebestreit H. Lymphographische Befunde bei verkalkender und verkäsender Lymphknotentuberkulose. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1229213] [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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31
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Hebestreit H, Kieser S, Junge S, Ballmann M, Hebestreit A, Schindler C, Schenk T, Posselt HG, Kriemler S. Long-term effects of a partially supervised conditioning programme in cystic fibrosis. Eur Respir J 2009; 35:578-83. [DOI: 10.1183/09031936.00062409] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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32
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Ruf K, Fehn S, Bachmann M, Möller A, Hebestreit H. Validierung von Fragebögen zur Erfassung der körperlichen Aktivität bei Mukoviszidoseerkrankten. Klin Padiatr 2009. [DOI: 10.1055/s-0029-1214285] [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: 10/21/2022]
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33
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Otto-Karg I, Jandl S, Müller T, Stirzel B, Vogel U, Frosch M, Hebestreit H, Abele-Horn M. P1719 Validation of VITEK 2 GN Cards and VITEK 2 Version 4.02 Software for identification and antimicrobial susceptibility testing of nonfermenting Gram-negative bacilli from cystic fibrosis patients. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71558-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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34
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Bernhardt J, Oechsner M, Jakob P, Koestler H, Hahn D, Darge K, Hebestreit H, Beer M. Etablierung und klinische Anwendung optimierter GRE-Sequenzen zum Nachweis Mukoviszidose-assoziierter pulmonaler Veränderungen bei Kindern und Jugendlichen an einem offenen 0,2T MR-Tomographen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976913] [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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35
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Hebestreit H, Kieser S, Rüdiger S, Schenk T, Junge S, Hebestreit A, Ballmann M, Posselt HG, Kriemler S. Physical activity is independently related to aerobic capacity in cystic fibrosis. Eur Respir J 2006; 28:734-9. [PMID: 16807261 DOI: 10.1183/09031936.06.00128605] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is unclear whether a relationship between physical activity (PA) and maximal oxygen uptake (V'(O2,max)) exists in cystic fibrosis (CF) and, if so, whether the relationship reflects a direct effect or is mediated by the effects of confounding variables, such as pulmonary or muscle function. The objective of the present study was to determine the relationship between PA and V'(O2,max) in CF while adjusting for possible influences of confounding factors. In total, 36 female and 35 male patients with CF from Germany and Switzerland (aged 12-40 yrs, forced expiratory volume in one second (FEV1) 25-107% predicted) were studied. A Wingate test was employed to measure muscle power. PA was monitored for 7 days and expressed in two ways: 1) average daily accelerometer count (ADAC) and 2) time spent in moderate-to-vigorous PA (MVPA). V'(O2,max) was determined during an incremental cycle exercise test to volitional fatigue. PA was positively related to V'(O2,max). In a multiple linear regression analysis, height, sex, FEV1, muscle power and ADAC (additionally explained variance 2.5%) or time spent in MVPA (additionally explained variance 3.7%) were identified as independent predictors of V'(O2,max). In conclusion, high levels of physical activity in addition to good muscular and pulmonary functions are associated with a high aerobic capacity in cystic fibrosis.
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Affiliation(s)
- H Hebestreit
- University Children's Hospital, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.
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36
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Unnithan VB, Nevill A, Lange G, Eppel J, Fischer M, Hebestreit H. Applicability of an allometric power equation to children, adolescents and young adults of extreme body size. J Sports Med Phys Fitness 2006; 46:202-8. [PMID: 16823348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
AIM The aim of this study was to assess the applicability of a regression model for peak power (PP) and total mechanical work (TMW) for healthy children, adolescents and young adults especially in the extreme ranges of stature, mass, and body mass index (BMI). METHODS A total of 454 children, adolescents and young adults aged 6-20 years volunteered for the study. Subjects, whose stature, mass and BMI were between the 10(th) and the 90(th) centile, were selected to calculate the prediction equation: 267 subjects fulfilled these criteria. Each subject performed two unilateral Wingate tests (ULWAnT), one with each leg. PP (Watts) and TMW (Joules) of the left and right leg were averaged for each individual. Ln(mass), in(stature), age, age(2), gender, and age x gender were used as predictors for in(PP) and ln(TMW). The applicability of the prediction equation was tested on individuals who were less than the 10(th) centile or greater than the 90(th) centile for stature, body mass and BMI. RESULTS All independent variables were statistically significant (P<0.05) predictors of in(PP), adjusted R(2)=0.93 and all but gender were significant predictors for in(TMW), adjusted R(2)=0.95. However, measured in(PP) and in(TMW) were significantly lower than predicted in(PP) and in(TMW) for subjects >90th centile for stature, body mass, or BMI. CONCLUSIONS the prediction equations overestimated PP and TMW in children, adolescents and young adults who were heavier than the reference subjects, as indicated by a relatively high body mass or high BMI for age or were taller than the reference subjects. The findings might reflect a deficit in anaerobic capacity in children, adolescents and young adults with relatively large body size for their age.
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Affiliation(s)
- V B Unnithan
- Department of Exercise Science, Syracuse University, NY, USA.
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37
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Abstract
UNLABELLED The aim of this pilot study was to obtain information on the value of MRI in the follow-up of atelectasis and pneumonic infiltrates in cystic fibrosis (CF). Six patients aged 5-15 y were initially examined using chest X-ray and magnetic resonance imaging (MRI). Both methods provided identical information. During follow-up, MRI proved suitable to monitor pulmonary complications. CONCLUSION MRI of the lung is feasible and valuable in the follow-up of atelectasis and pulmonary infiltrates in CF.
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Abstract
Necrotizing sarcoid granulomatosis (NSG) is characterized by pulmonary nodular infiltrates, a typical histology, and a benign clinical course. The etiology and pathogenesis of the disease are still unknown. In childhood, it is extremely rare, with only three reported cases so far. Here we report on an 8-year-old girl, who to our knowledge is the youngest reported patient with NSG. The girl presented with shortness of breath and a sore throat. Chest X-ray and computed tomography (CT) scan revealed multiple nodular opacities of the lung. The symptoms and radiological findings disappeared within 6 months without any treatment. The diagnosis was based on the typical signs and symptoms of NSG and on the exclusion of other diseases. As abnormal immunological findings such as the lack of specific diphtheria antibodies in spite of vaccination against diphtheria were present, we suggest that immunologic mechanisms could play an etiologic role in the pathogenesis of NSG. In addition, the ratio of CD4+/CD8+ T-cells in the peripheral blood was significantly reduced, whereas the CD4+/CD8+ T-cell ratio in the immunohistochemical staining of the lung tissue was elevated. Since this compartmentalization is a typical finding in sarcoidosis, it supports the theory that NSG may represent a variant of sarcoidosis. However, because some characteristics of NSG are uncommon in typical sarcoidosis, NSG may also be an entity in its own right.
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Affiliation(s)
- D Heinrich
- Children's Hospital, University of Würzburg, Würzburg, Germany.
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39
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Abstract
With the increase in survival rates of children born prematurely, issues related to their active pursuits and responses to exercise have been gaining increasing attention. In some preterm children with an extremely low birthweight, bronchopulmonary dysplasia or cerebral palsy exercise capacity may be limited, especially in tasks requiring good neuromotor coordination. Deficiencies in aerobic and anaerobic performance, strength and coordination may even occur in children without overt manifestations of a neuromuscular or pulmonary disease. However, as a rule, children born prematurely may engage in physical activities and competitive sports without limitations. Exercise is safe in almost all such children as long as precautions are taken to avoid exercise-induced bronchoconstriction. However, to date there are no studies that have determined the efficacy of training. A wide variety of activities should be encouraged in all children born prematurely at an early age, to support the development of skills and to compensate for the possible effects of their premature birth on coordination.
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Affiliation(s)
- H Hebestreit
- Children's Hospital, Julius-Maximilians University, Würzburg, Germany.
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40
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Hebestreit A, Kersting U, Basler B, Jeschke R, Hebestreit H. Exercise inhibits epithelial sodium channels in patients with cystic fibrosis. Am J Respir Crit Care Med 2001; 164:443-6. [PMID: 11500347 DOI: 10.1164/ajrccm.164.3.2007168] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to determine the effects of a single exercise bout on luminal Cl(-) and Na(+) conductance in the respiratory epithelium of patients with cystic fibrosis (CF). In nine patients with CF and nine healthy control subjects, the transepithelial electrical potential difference (PD) of the nasal respiratory epithelium was recorded, first at rest and then during moderate-intensity exercise. Under both conditions, PD was first measured while superfusing the epithelium with isotonic saline. Then, the effects of amiloride and amiloride plus low chloride plus isoproterenol were determined. Exercise resulted in a significant lower PD compared with rest in patients with CF (-6.6 +/- 16.6 mV versus -33.6 +/- 10.0 mV, p < 0.0001) and control subjects (0.1 +/- 8.7 mV versus -7.1 +/- 5.1 mV, p < 0.01). The effects of amiloride on PD were reduced during exercise compared with rest in patients with CF (+15.8 +/- 9.5 mV versus +26.1 +/- 11.0 mV, p < 0.01) and control subjects (+5.8 +/- 4.8 mV versus +10.0 +/- 3.1 mV, p < 0.01). There was no effect of exercise on chloride conductance in patients with CF and control subjects. We conclude that moderate-intensity exercise partially blocks the amiloride-sensitive sodium conductance in the respiratory epithelium. The inhibition of luminal sodium conductance could increase water content of the mucus in the CF lung during exercise and may, in part, explain the beneficial effects of exercise in patients with CF.
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Affiliation(s)
- A Hebestreit
- Kinderklinik und Institut für Klinische Biochemie und Pathobiochemie, Universität Würzburg, Würzburg, Germany.
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41
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Dunstheimer D, Hebestreit H, Staschen B, Strassburg HM, Jeschke R. Bilateral deficit during short-term, high-intensity cycle ergometry in girls and boys. Eur J Appl Physiol 2001; 84:557-61. [PMID: 11482551 DOI: 10.1007/s004210100406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Peak torque during an isokinetic bilateral knee extension or flexion is usually lower than the summed peak torque of two unilateral contractions, and this phenomenon is designated as bilateral deficit (BD). The objectives of this study were to determine whether a BD also exists for more complex, alternating movements (e.g., short-term, high-intensity cycling), and to assess the possible effects of gender and maturity. Forty children and adolescents performed two unilateral (ULWAnT) and one bilateral Wingate anaerobic test (BLWAnT). The highest power reached in any 3-s interval (peak power; PP), and the total mechanical work (TMW) performed during the test was determined. Individual BD for PP (BDpp, %) was calculated by dividing the PP in the BLWAnT by the sum of the PP values of both ULWAnTs. The BD for TMW (BDTMw) was calculated in the same way. The sum of PP generated during the two ULWAnTs was larger than the PP measured in the BLWAnT (P<0.000001). The same difference was observed for TMW (P<0.0001). Maturity did not affect the BDpp or BDTMW (P=0.34). However, the BD was more pronounced in females compared to males (P= 0.03). In conclusion, a BD is evident during cycling exercise.
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Abstract
PURPOSE The objective of this study was to assess intra- and inter-evaluator reliability and validity of ventilatory threshold (VT) determination in children. METHODS At the age of 6-12 yr, 35 children born prematurely and 20 controls born at term performed an incremental continuous cycling task until volitional fatigue. Fifteen-second averages of VE/VO2, VE/VCO2, and respiratory exchange ratio were plotted 1) over time (X-time) and 2) over VO2 (X-VO2). VCO2 was plotted over VO2 only (X-VO2). Two experienced evaluators, blind to the identity of plots, independently assessed VT from X-time and X-VO2 plots on two occasions, 6 wk apart. Thus, for each of the 55 subjects, four VT values were expected from X-time plots and four from X-VO2 plots (2 evaluators, 2 occasions). RESULTS VT expressed as VO2 in mL x min(-1) could be determined by both evaluators on both occasions in 40/55 children from X-time and in 45/55 children from X-VO2. VT was significantly different between evaluators for X-time plots. Using X-time plots, intraevaluator ICC were 0.88 and 0.98 and interevaluator ICC were 0.82 and 0.79. The respective values for X-VO2 plots were 0.94 and 0.95, and 0.96 and 0.92. Intra- and inter-evaluator reliability of VT determinations tended to be slightly lower in children born prematurely compared with those born at term. There was a close association between VT and VO2peak (r = 0.92). CONCLUSION Plotting gas exchange data over VO2 is likely to be the method of choice for determining VT. Although a minority of children have uninterpretable X-VO, plots, VT can be reliably interpreted in the remainder. Furthermore, VT is a valid marker of aerobic capacity. Thus, VT is a useful measure of aerobic fitness in children.
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Abstract
We tested the hypothesis that kinetics of O(2) uptake (VO(2)) measured in the transition to exercise near or above peak VO(2) (VO(2 peak)) would be slower than those for subventilatory threshold exercise. Eight healthy young men exercised at approximately 57, approximately 96, and approximately 125% VO(2 peak). Data were fit by a two- or three-component exponential model and with a semilogarithmic transformation that tested the difference between required VO(2) and measured VO(2). With the exponential model, phase 2 kinetics appeared to be faster at 125% VO(2 peak) [time constant (tau(2)) = 16.3 +/- 8.8 (SE) s] than at 57% VO(2 peak) (tau(2) = 29. 4 +/- 4.0 s) but were not different from that at 96% VO(2 peak) exercise (tau(2) = 22.1 +/- 2.1 s). VO(2) at the completion of phase 2 was 77 and 80% VO(2 peak) in tests predicted to require 96 and 125% VO(2 peak). When VO(2) kinetics were calculated with the semilogarithmic model, the estimated tau(2) at 96% VO(2 peak) (49.7 +/- 5.1 s) and 125% VO(2 peak) (40.2 +/- 5.1 s) were slower than with the exponential model. These results are consistent with our hypothesis and with a model in which the cardiovascular system is compromised during very heavy exercise.
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Affiliation(s)
- R L Hughson
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada N2L 3G1.
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44
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Abstract
PURPOSE Single-leg cycle ergometry employing the protocol of the Wingate Test (WAnT) has been used to assess unilateral muscle power and leg-dominance. The objectives of this study were to determine the reliability of the single-leg WAnT (SLWAnT) and to establish optimal braking force for the SLWAnT. METHODS Twenty female and 19 male subjects (prepubertals: 6.0-9.9 yr, 7 female and 6 male; midpubertals: 11.0-14.9 yr, 7 female and 7 male; and postpubertals: 17.0-20.9 yr, 6 female and 6 male) came to the laboratory on three occasions. On each visit, they first performed two SLWAnT after a standardized warm-up, one with each leg. Braking force for these tests was kept constant throughout all visits. On each of the following visits, subjects performed four additional SLWAnT, two with each leg, with braking force varying from test to test to determine the braking force associated with the highest performance over 30 s. RESULTS Although a significant increase in performance was observed from visit to visit in some groups, intraclass correlation coefficients (which included trial-to-trial differences) of peak power and total work generated during the first two SLWAnT of each visit ranged from 0.89 to 0.98. Optimal braking force (J x rev(-1)) could be estimated from 0.4052 x body mass(1.4662) for all subjects irrespective of gender or maturity. The standard error of estimate was lowest in the prepubertals and highest in postpubertals (8.3-31.4 J x rev(-1)). CONCLUSIONS SLWAnT is a highly reliable method to measure single-leg power. The above equation provides good estimates of optimal braking force. The SLWAnT can, therefore, be used to monitor changes in single-leg power and to assess leg-dominance.
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45
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Abstract
The main objective of the present study was to determine whether a structured, laboratory-based exercise task would modify the energy expenditure (EE) and the pattern of spontaneous physical activity (PA) of obese boys on the day of an exercise laboratory visit and on the following day. Fourteen 10- to 15-y-old moderately obese (36.6+/-3.3% fat) boys volunteered. They each had three laboratory visits, I wk apart. In one visit, they performed a strenuous 50-min cycling task; in another, a 30-min medium-intensity cycling task; and in another (which served as placebo), they did not exercise. PA was monitored the day before (d 1), during (d 2), and after (d 3) each laboratory visit by use of a heart rate monitor and a 12-h recall interview. EE was calculated from minute-by-minute heart rate and each child's predetermined relationship between oxygen uptake and heart rate. EE and PA were analyzed from 1300 to 1900 h each day using 15-min intervals. EE tended to decrease (p < 0.087) in the afternoon of all d 2 compared with d 1, and it increased on d 3 after the medium-intensity exercise (p < 0.0005). EE during d 2 and 3 combined, compared with d 1, decreased after the high-intensity exercise (534.2 versus 564.3 kJ/h, p < 0.05). It increased after the medium-intensity exercise (561.8 versus 526.7 kJ/h, p = 0.052) and was not affected after the placebo visit (589.4 versus 574.3 kJ/h). Time spent outdoors was consistently reduced on the day of laboratory visit compared with the day before and after the visit, regardless of the contents of intervention. In conclusion, a single laboratory visit is followed by a reduction in EE and PA on the day of intervention. However, its effect on EE the following day may be dose dependent: medium-intensity exercise induces an increase in EE, but high-intensity exercise causes a decrease in EE. One implication is that intervention by physical training should employ medium-intensity exercise to enhance the EE of obese boys.
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Affiliation(s)
- S Kriemler
- Children's Exercise and Nutrition Centre, McMaster University, Hamilton, Canada
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46
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Abstract
The objective of this study was to compare the O2 uptake (VO2) kinetics at the onset of heavy exercise in boys and men. Nine boys, aged 9-12 yr, and 8 men, aged 19-27 yr, performed a continuous incremental cycling task to determine peak VO2 (VO2 peak). On 2 other days, subjects performed each day four cycling tasks at 80 rpm, each consisting of 2 min of unloaded cycling followed twice by cycling at 50% VO2 peak for 3.5 min, once by cycling at 100% VO2 peak for 2 min, and once by cycling at 130% VO2 peak for 75 s. O2 deficit was not significantly different between boys and men (respectively, 50% VO2 peak task: 6.6 +/- 11.1 vs. 5.5 +/- 7.3 ml . min-1 . kg-1; 100% VO2 peak task: 28.5 +/- 8.1 vs. 31.8 +/- 6.3 ml . min-1 . kg-1; and 130% VO2 peak task: 30.1 +/- 5.7 vs. 35.8 +/- 5.3 ml . min-1 . kg-1). To assess the kinetics, phase I was excluded from analysis. Phase II VO2 kinetics could be described in all cases by a monoexponential function. ANOVA revealed no differences in time constants between boys and men (respectively, 50% VO2 peak task: 22. 8 +/- 5.1 vs. 26.4 +/- 4.1 s; 100% VO2 peak task: 28.0 +/- 6.0 vs. 28.1 +/- 4.4 s; and 130% VO2 peak task: 19.8 +/- 4.1 vs. 20.7 +/- 5. 7 s). In conclusion, O2 deficit and fast-component VO2 on-transients are similar in boys and men, even at high exercise intensities, which is in contrast to the findings of other studies employing simpler methods of analysis. The previous interpretation that children rely less on nonoxidative energy pathways at the onset of heavy exercise is not supported by our findings.
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Affiliation(s)
- H Hebestreit
- Universitäts-Kinderklinik, 97080 Würzburg, Germany.
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47
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Hebestreit H, Müller-Scholden J, Huppertz HI. Aerobic fitness and physical activity in patients with HLA-B27 positive juvenile spondyloarthropathy that is inactive or in remission. J Rheumatol 1998; 25:1626-33. [PMID: 9712111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess aerobic fitness (AF) and physical activity (PA) in patients with HLA-B27 positive juvenile spondyloarthropathy (JSpA) in remission at the time of testing. METHODS Twenty-one previous patients (12 male, 9 female), age 6-26 years (median age 17.8), and 21 healthy controls matched for age, sex, height, and weight participated. AF was determined by measuring maximal power and peak oxygen uptake (VO2 peak) during a continuous incremental cycling task. PA was assessed by Seven-Day Recall and Lipid Research Clinic questionnaire. RESULTS There was only a tendency for a lower maximal power and O2 peak in the 21 patients compared to controls for the total group (median/range: 191/49-306 W vs 219/41-337 W; 2385/998-3962 ml x min(-1) vs 2761/10434221 ml x min(-1); both p < 0.10). However, patients who were older than 18 years had a significantly lower maximal power and VO2 peak than their controls (median/range: 199/126-306 W vs 255/194-337 W; 2785/1570-3962 ml x min(-1) vs 3308/2049-4221 ml x min(-1); both p < 0.05). Many of the older patients had also had arthritis for longer than 2 years and felt limited in their AF or PA. PA was not significantly different between patients and controls. CONCLUSION These data suggest that some patients have an impairment of their AF long after arthritis has ceased, which is likely attributable to psychological factors. Changes in the heart and skeletal muscle might also contribute to the lower AF. Participation in physical exercise is encouraged especially in older or "anxious" patients with inactive JSpA.
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Affiliation(s)
- H Hebestreit
- Children's Hospital, Julius-Maximilians-University, Würzburg, Germany.
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48
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Simon HU, Yousefi S, Dibbert B, Hebestreit H, Weber M, Branch DR, Blaser K, Levi-Schaffer F, Anderson GP. Role for tyrosine phosphorylation and Lyn tyrosine kinase in fas receptor-mediated apoptosis in eosinophils. Blood 1998; 92:547-57. [PMID: 9657755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Fas ligand/Fas receptor molecular interactions have been implicated as having an important function for the regulation of eosinophil apoptosis. The purpose of the present study was to investigate biochemical events triggered by the engagement of the Fas receptor in freshly isolated human and mouse eosinophils. Activation of the Fas receptor on eosinophils with the agonistic anti-Fas monoclonal antibody (MoAb) resulted in increased tyrosine phosphorylation of several intracellular proteins. The tyrosine kinase inhibitors lavendustin A and genistein inhibited Fas receptor-induced cell death in both human and mouse eosinophils in vitro and prevented, at least partially, Fas receptor-mediated resolution of eosinophilic inflammation in a mouse in vivo model of lung eosinophilia. In addition, in freshly purified human eosinophils, lavendustin A prevented anti-Fas MoAb-induced proteolytic cleavage of lamin B, suggesting that tyrosine kinases may amplify the proteolytic signaling cascade within interleukin-1beta converting enzyme (ICE) family proteases. Moreover, the tyrosine kinase Lyn was identified as being involved in Fas receptor-mediated cell death. Collectively, these results demonstrate that tyrosine phosphorylation is an important step in the generation of the Fas receptor-linked transmembrane death signal in eosinophils and that Lyn participates in this pathway.
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Affiliation(s)
- H U Simon
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
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49
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Hebestreit H, Bar-Or O. Influence of climate on heart rate in children: comparison between intermittent and continuous exercise. Eur J Appl Physiol Occup Physiol 1998; 78:7-12. [PMID: 9660150 DOI: 10.1007/s004210050380] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Heart rate (HR) monitoring is commonly used to assess 24-h energy expenditure (EE) in children but it has been found to overestimate the true values. One reason for this may be the effect of climatic heat stress on HR. An equation has been previously developed to adjust HR measured during continuous exercise for the influence of climate. Since play in children is rarely of a continuous pattern, one objective of this study was to compare the effects of climatic heat stress on the HR response to intermittent and to continuous exercise. A second objective was to determine whether the previously developed equation is suitable for intermittent exercise. A group of 12 boys and 8 girls (aged 8-11 years) cycled in a climatic chamber. The exercise consisted of continuous cycling for 5 min at 35%, 55%, and 75% of peak oxygen up take (random order) followed by alternating cycling at the same resistance and cadence (30 s) and rest (30 s) for 3 additional min. The oxygen uptake (VO2) and HR were determined for 2 min at the end of continuous cycling and for 2 min during intermittent cycling. Climatic conditions (randomly assigned) were dry bulb temperature T(db) 22 degrees C, 50% relative humidity (rh); T(db) 28 degrees C, 55% rh; T(db) 32 degrees C, 52% rh; or T(db) 35 degrees C, 58% rh. The difference between HR measured at a given T(db) (HR(meas)) and HR at 22 degrees C and at the same VO2 was then calculated (deltaHR). The deltaHR increased linearly with increasing temperature but was not related to VO2 or to exercise type. However, a small but significant difference was found if the published equation was used with data from intermittent exercise. The accuracy of the existing equation adjusting HR(meas) for the influence of T(db) (HR(corr)) could be improved to HR(corr) = HR(meas) x (1.18308-(0.0083218 x T(db))). In conclusion, the effects of climatic heat stress on HR were similar in continuous and intermittent exercise, and HR can be adjusted for the influence of climate in groups of pre- and early pubertal children during rest, intermittent and continuous exercise at ambient temperatures between 22 degrees C and 35 degrees C, thereby reducing the error in predicting EE from HR.
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50
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Abstract
It has been suggested that Fas ligand-Fas receptor interactions are involved in the regulation of eosinophil apoptosis and that dysfunctions in this system could contribute to the accumulation of these cells in allergic and asthmatic diseases. Here, we demonstrate that nitric oxide (NO) specifically prevents Fas receptor-mediated apoptosis in freshly isolated human eosinophils. In contrast, rapid acceleration of eosinophil apoptosis by activation of the Fas receptor occurs in the presence of eosinophil hematopoietins. Analysis of the intracellular mechanisms revealed that NO disrupts Fas receptor-mediated signaling events at the level of, or proximal to, Jun kinase (JNK), but distal to sphingomyelinase (SMase) activation and ceramide generation. In addition, activation of SMase occurs downstream of an interleukin 1 converting enzyme-like (ICE-like) protease(s) that is not blocked by NO. However, NO prevents activation of a protease that targets lamin B1. These findings suggest a role for an additional NO-sensitive apoptotic signaling pathway that amplifies the proteolytic cascade initialized by activation of the Fas receptor. Therefore, NO concentrations within allergic inflammatory sites may be important in determining whether an eosinophil survives or undergoes apoptosis upon Fas ligand stimulation.
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Affiliation(s)
- H Hebestreit
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, CH-7270 Davos, Switzerland
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