1
|
Spindler J, Koller S, Graf U, Berger W, Gerth-Kahlert C, Blaser F. Macular Corneal Dystrophy - Molecular Genetics as the Key in Treatment-Refractory Keratopathy. Klin Monbl Augenheilkd 2024; 241:398-401. [PMID: 38653268 DOI: 10.1055/a-2219-8288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Jan Spindler
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
| | - Samuel Koller
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
| | - Urs Graf
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
- Aktuelle Adresse: Labordiagnostic St. Gallen West AG, 9015 St. Gallen
| | - Wolfgang Berger
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
- Zentrum für Neurowissenschaften (ZNZ), University and ETH Zurich, Zurich, Switzerland
| | | | - Frank Blaser
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Fuchs D, Bograd A, Pfister IB, Bächtiger J, Spindler J, Hoogewoud F, Gugleta K, Böni C, Guex-Crosier Y, Garweg JG, Tappeiner C. Efficacy of TNF-Alpha Inhibitors to Control Inflammation and Prevent Secondary Complications in Non-Infectious Uveitis: A Real-Life Experience from Switzerland. Ocul Immunol Inflamm 2023:1-6. [PMID: 37797183 DOI: 10.1080/09273948.2023.2263095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE To evaluate the efficacy of systemic tumor necrosis factor-alpha inhibitors (TNFi) in the treatment of non-infectious uveitis (NIU). METHODS This Swiss multicenter retrospective cohort study included patients with NIU requiring TNFi during the period from 2001 to 2018. Risk factors for the occurrence of new complications were identified using Cox regression analysis and hazard ratios (HR). RESULTS Seventy-one patients (126 eyes; mean age 40.6 ± 14.4 years, mean duration of uveitis 46.0 ± 61.8 months) were followed for 40.2 ± 17.3 months after addition of TNFi. Under TNFi, visual acuity improved from 0.2 ± 0.3 to 0.1 ± 0.3 logMAR (p < 0.001). The portion of patients under systemic corticosteroids decreased from 81.7% to 25.4% (p < 0.001), while that for conventional synthetic disease-modifying anti-rheumatic drugs insignificantly decreased from 63.4% to 50.7% (p > 0.05). In 80.2% of eyes, complications were present at baseline with epiretinal gliosis (39.7%), cataract (41.3%) and macular edema (ME; 27.8%) being the most common. New complications under TNFi were encountered in 49.2% of eyes, also including recurrence (5 eyes) or new onset of ME (14 eyes). The need for switching of TNFi was associated with further complications (HR 3.78, p = 0.012). CONCLUSION Although the efficacy and tolerability of TNFi in a real-life setting are favorable, treatment is often initiated late, i.e., after many eyes have already developed complications. Even with TNFi, new complications, particularly ME, cannot be completely avoided. Further research is needed to assess the impact of earlier initiation of TNFi therapy.
Collapse
Affiliation(s)
- Dominic Fuchs
- Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
| | - Alexandra Bograd
- Berner Augenklinik, Bern, Switzerland
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Department of Ophthalmology, Pallas Klink, Olten, Switzerland
| | | | | | - Jan Spindler
- Berner Augenklinik, Bern, Switzerland
- Department of Ophthalmology University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Florence Hoogewoud
- Eye Hospital, FAA, Department of Ophthalmology, University of Lausanne Jules-Gonin, Lausanne, Switzerland
| | | | - Christian Böni
- Department of Ophthalmology University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Augenarztpraxis Bremgarten, Bremgarten, Switzerland
| | - Yan Guex-Crosier
- Eye Hospital, FAA, Department of Ophthalmology, University of Lausanne Jules-Gonin, Lausanne, Switzerland
| | - Justus G Garweg
- Berner Augenklinik, Bern, Switzerland
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Christoph Tappeiner
- Department of Ophthalmology, Pallas Klink, Olten, Switzerland
- Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Ophthalmology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy
- Medical Faculty, University of Bern, Bern, Switzerland
| |
Collapse
|
3
|
Bograd A, Fuchs D, Bächtiger J, Pfister IB, Spindler J, Hoogewoud F, Gugleta K, Böni C, Guex-Crosier Y, Garweg JG, Tappeiner C. Long-term Efficacy of TNF-alpha Inhibitors on Persistent Uveitic Macular Edema: A Swiss Multicenter Cohort Study. Ocul Immunol Inflamm 2022:1-8. [PMID: 35588311 DOI: 10.1080/09273948.2022.2075761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the efficacy of tumor necrosis factor-alpha inhibitors (TNFi) on uveitic macular edema (ME) unresponsive to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). METHODS This multicenter retrospective study included patients with uveitic ME persisting despite csDMARDs. The effect of an additional TNFi on central retinal thickness (CRT), best corrected visual acuity (BCVA) and corticosteroid need was evaluated. RESULTS Thirty-five eyes (26 patients, mean age 42.9 ± 15.2 years) were included. CRT decreased from 425 ± 137 µm to 294 ± 66 µm (p < .001) and 280 ± 48 µm (p < .001) at 1 and 4 years of follow-up, respectively. BCVA improved from 0.28 ± 0.22 to 0.21 ± 0.48 (1 year, p = .013) and 0.08 ± 0.13 logMAR (4 years, p = .002). The proportion of patients requiring systemic corticosteroids decreased from 88.5% to 34.8% (1 year) and 15.4% (4 years). CONCLUSION The addition of a TNFi resulted in an improvement of CRT and BCVA for up to 4 years in uveitic ME but rescue treatments were needed for some patients.
Collapse
Affiliation(s)
- Alexandra Bograd
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Dominic Fuchs
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | | | - Jan Spindler
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Florence Hoogewoud
- Eye Hospital, FAA, Department of Ophthalmology, University of LausanneJules-Gonin, Lausanne, Switzerland
| | | | - Christian Böni
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Yan Guex-Crosier
- Eye Hospital, FAA, Department of Ophthalmology, University of LausanneJules-Gonin, Lausanne, Switzerland
| | - Justus G Garweg
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.,Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Christoph Tappeiner
- Pallas Klinik, Olten, Switzerland.,Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,University of Bern, Bern, Switzerland
| |
Collapse
|
4
|
Pfister IB, Zandi S, Gerhardt C, Spindler J, Reichen N, Garweg JG. Risks and Challenges in Interpreting Simultaneous Analyses of Multiple Cytokines. Transl Vis Sci Technol 2020; 9:27. [PMID: 32832233 PMCID: PMC7414671 DOI: 10.1167/tvst.9.7.27] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/21/2020] [Indexed: 01/23/2023] Open
Abstract
Purpose To determine the inherent risks of handling results below the lowest detectable value in the analysis of multiple cytokines in the aqueous humor of patients with retinal diseases by comparing possible statistical strategies to lower the risk of mis interpretation or over interpretation of results. Furthermore, in analyzing multiple cytokines simultaneously, the challenge of multiple comparison arises. Methods The analyses were based on parallel testing of 43 cytokines in 58 aqueous humor samples from patients with macular hole or epiretinal membrane. Substitution of values below the detection limit with 0.1 ×, 0.5 ×, or 1.0× of the lowest level of quantitation was compared with handling as missing value. The impact of correction for multiple comparisons was assessed using the Holm correction. Results When comparing macular hole with epiretinal membrane, not substituting the missing data revealed a difference (P < 0.05) for five compared with wight cytokines after their substitution, indicating an increased risk for under-estimating group differences (type II error). Correcting for multiple comparisons revealed a relevant risk of over estimating group differences (type I error). Conclusions Physiologic cytokine concentrations in ocular fluids typically range at or below the lowest level of quantitation. Handling of results below this cutoff as missing leads to increased type II errors. Not correcting for multiple comparisons increases the risk of a type I error. Taken together, both harbor a systematic inherent risk of misinterpretation of the results. Translational Relevance Ignoring the inherent risks of data misinterpretation in analyses of ocular fluid samples may result in mis leading conclusions regarding their biological relevance.
Collapse
Affiliation(s)
- Isabel B Pfister
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Souska Zandi
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland.,Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christin Gerhardt
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Jan Spindler
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Natalie Reichen
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Justus G Garweg
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland.,Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
5
|
Traine PG, Pfister IB, Zandi S, Spindler J, Garweg JG. Long-term Outcome of Intravitreal Aflibercept Treatment for Neovascular Age-Related Macular Degeneration Using a "Treat-and-Extend" Regimen. Ophthalmol Retina 2019; 3:393-399. [PMID: 31044729 DOI: 10.1016/j.oret.2019.01.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To report outcomes in patients with neovascular age-related macular degeneration (nAMD) after treatment with aflibercept for up to 4 years using a treat-and-extend (T&E) regimen. DESIGN Observational study. PARTICIPANTS Patients with newly diagnosed nAMD treated with aflibercept in a T&E protocol. METHODS Subjects received 3 injections of aflibercept at monthly intervals followed by a T&E protocol for at least 12 months. At each clinical visit after the loading phase, OCT and best-corrected visual acuity (BCVA) testing were performed to monitor disease activity. MAIN OUTCOME MEASURES Change in BCVA over time, number of injections and visits per year, and percentage of patients reaching a treatment interval of ≥12 weeks. RESULTS Of 231 consecutive eyes (231 patients) with a mean follow-up time of 2.9 (1-5.5) years, 173 were followed up for ≥2 years, 112 were followed up for ≥3 years, and 62 were followed up for ≥4 years. Mean BCVA increased from 59.8 letters (20/60) at diagnosis to 65.8 letters (20/50) after the loading phase (+6.0 letters; standard deviation [SD], 11.1) and to 65.5 letters at 12 months (+5.7 letters; [SD], 17). After 4 years of treatment, mean BCVA was maintained insignificantly better than baseline (63.4 letters, +3.6 letters gain, SD, 20.6; P > 0.05). To achieve this, a mean of 7.7 (±1.2) injections and 4.4 (±1.6) clinic visits in the first year and 4.4 (±1.9) injections and 4.3 (±1.3) clinical visits per year thereafter were required. By 2 years of follow-up, 46.9% of patients reached a treatment interval of ≥12 weeks. CONCLUSIONS By using a T&E regimen, patients with nAMD maintained stable visual function over 4 years in a real-world setting with a reasonable treatment burden.
Collapse
Affiliation(s)
- Peter G Traine
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Isabel B Pfister
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland; University of Bern, Bern, Switzerland
| | - Souska Zandi
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Jan Spindler
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland; University of Bern, Bern, Switzerland
| | - Justus G Garweg
- Swiss Eye Institute, Rotkreuz, and Berner Augenklinik am Lindenhofspital, Bern, Switzerland; University of Bern, Bern, Switzerland.
| |
Collapse
|
6
|
Spindler J, Zandi S, Pfister IB, Gerhardt C, Garweg JG. Cytokine profiles in the aqueous humor and serum of patients with dry and treated wet age-related macular degeneration. PLoS One 2018; 13:e0203337. [PMID: 30157273 PMCID: PMC6114931 DOI: 10.1371/journal.pone.0203337] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/17/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To identify disease-specific cytokine profile differences in the aqueous humor (AH) (other than the vascular endothelial growth factor) between patients with dry and treated wet age-related macular degeneration (AMD) and healthy controls. METHODS This retrospective study drew on a case-series of patients diagnosed with dry AMD (n = 25) and treated wet AMD (n = 19), as well as on healthy controls (no systemic therapy; n = 20) undergoing phacoemulsification or vitrectomy. Samples of AH and serum were collected in parallel at the beginning of surgery. The levels of 43 cytokines were simultaneously determined using the Bio-Plex® multiplex beads system. Differences between the three groups were statistically compared using the Kruskal-Wallis H-Test after applying the Bonferroni correction for multiple comparisons (p<0.0012). RESULTS The concentrations of three cytokines were elevated in the AH of patients with dry AMD (CXCL6; p = 0.00067) and treated wet AMD (CXCL5, CXCL6, MIG/XCXL; all p<0.001) relative to those in the healthy controls. No other differences between the three groups were identified. The AH levels of seven cytokines (16%), including CXCL6, ranged below the lower limit of quantitation of the assay. Without the correction for multiple comparisons (p<0.05), the levels of 31 of the 43 cytokines in the AH of patients with AMD would have differed significantly from those in the control. The systemic cytokine profiles (serum) were similar in all three groups. CONCLUSIONS No systematic differences in the AH cytokine environment were identified between patients with dry AMD and those with treated wet AMD. This finding might indicate that AMD is either the result of a persistent imbalance in the physiological tissue milieu, or that the localized process induces no significant change in the cytokine environment of the anterior ocular segment.
Collapse
Affiliation(s)
- Jan Spindler
- Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Souska Zandi
- Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
| | - Isabel B. Pfister
- Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Christin Gerhardt
- Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Justus G. Garweg
- Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bern, Switzerland
- University of Bern, Bern, Switzerland
| |
Collapse
|
7
|
Eichhorn S, Mendoza Garcia A, Polski M, Spindler J, Stroh A, Heller M, Lange R, Krane M. Corpuls cpr resuscitation device generates superior emulated flows and pressures than LUCAS II in a mechanical thorax model. Australas Phys Eng Sci Med 2017; 40:441-447. [PMID: 28258484 DOI: 10.1007/s13246-017-0537-3] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/11/2017] [Indexed: 11/24/2022]
Abstract
The provision of sufficient chest compression is among the most important factors influencing patient survival during cardiopulmonary resuscitation (CPR). One approach to optimize the quality of chest compressions is to use mechanical-resuscitation devices. The aim of this study was to compare a new device for chest compression (corpuls cpr) with an established device (LUCAS II). We used a mechanical thorax model consisting of a chest with variable stiffness and an integrated heart chamber which generated blood flow dependent on the compression depth and waveform. The method of blood-flow generation could be changed between direct cardiac-compression mode and thoracic-pump mode. Different chest-stiffness settings and compression modes were tested to generate various blood-flow profiles. Additionally, an endurance test at high stiffness was performed to measure overall performance and compression consistency. Both resuscitation machines were able to compress the model thorax with a frequency of 100/min and a depth of 5 cm, independent of the chosen chest stiffness. Both devices passed the endurance test without difficulty. The corpuls cpr device was able to generate about 10-40% more blood flow than the LUCAS II device, depending on the model settings. In most scenarios, the corpuls cpr device also generated a higher blood pressure than the LUCAS II. The peak compression forces during CPR were about 30% higher using the corpuls cpr device than with the LUCAS II. In this study, the corpuls cpr device had improved blood flow and pressure outcomes than the LUCAS II device. Further examination in an animal model is required to prove the findings of this preliminary study.
Collapse
Affiliation(s)
- S Eichhorn
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Munich Heart Alliance, Lazarettstrasse 36, 80636, Munich, Germany.
| | - A Mendoza Garcia
- Fakultät für Informatik, Robotics and Embedded Systems, Technische Universität München, Munich, Germany
| | - M Polski
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Munich Heart Alliance, Lazarettstrasse 36, 80636, Munich, Germany
| | - J Spindler
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Munich Heart Alliance, Lazarettstrasse 36, 80636, Munich, Germany
| | - A Stroh
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Munich Heart Alliance, Lazarettstrasse 36, 80636, Munich, Germany
| | - M Heller
- GS Elektromedizinische Geräte G. Stemple GmbH, Kaufering, Germany
| | - R Lange
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Munich Heart Alliance, Lazarettstrasse 36, 80636, Munich, Germany.,DZHK (German Center for Cardiovascular Research) - Partner Site Munich Heart Alliance, Munich, Germany
| | - M Krane
- Department of Cardiovascular Surgery, Division of Experimental Surgery, German Heart Center Munich, Munich Heart Alliance, Lazarettstrasse 36, 80636, Munich, Germany.,DZHK (German Center for Cardiovascular Research) - Partner Site Munich Heart Alliance, Munich, Germany
| |
Collapse
|
8
|
Simonetti F, Spindler J, Wu X, Maldarelli F, Coffin J. Diverse proviral structure of HIV integrants in clonally expanded cells. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)31377-7] [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: 10/23/2022] Open
|
9
|
Affiliation(s)
- J Spindler
- Scripps Memorial Hospital, La Jolla, Calif
| | | |
Collapse
|
10
|
Maldarelli F, Wu X, Su L, Simonetti FR, Shao W, Hill S, Spindler J, Ferris AL, Mellors JW, Kearney MF, Coffin JM, Hughes SH. HIV latency. Specific HIV integration sites are linked to clonal expansion and persistence of infected cells. Science 2014; 345:179-83. [PMID: 24968937 DOI: 10.1126/science.1254194] [Citation(s) in RCA: 637] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The persistence of HIV-infected cells in individuals on suppressive combination antiretroviral therapy (cART) presents a major barrier for curing HIV infections. HIV integrates its DNA into many sites in the host genome; we identified 2410 integration sites in peripheral blood lymphocytes of five infected individuals on cART. About 40% of the integrations were in clonally expanded cells. Approximately 50% of the infected cells in one patient were from a single clone, and some clones persisted for many years. There were multiple independent integrations in several genes, including MKL2 and BACH2; many of these integrations were in clonally expanded cells. Our findings show that HIV integration sites can play a critical role in expansion and persistence of HIV-infected cells.
Collapse
Affiliation(s)
- F Maldarelli
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA
| | - X Wu
- Leidos Biomedical Research, Frederick, MD 21702, USA
| | - L Su
- Leidos Biomedical Research, Frederick, MD 21702, USA
| | - F R Simonetti
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA. Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20122 Milan, Italy
| | - W Shao
- Leidos Biomedical Research, Frederick, MD 21702, USA
| | - S Hill
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA
| | - J Spindler
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA
| | - A L Ferris
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA
| | - J W Mellors
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - M F Kearney
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA
| | - J M Coffin
- Department of Molecular Biology and Microbiology, Tufts University, Boston, MA 02111, USA
| | - S H Hughes
- HIV Drug Resistance Program, National Cancer Institute, Frederick, MD 21702, USA.
| |
Collapse
|
11
|
Vonau W, Gerlach F, Enseleit U, Spindler J, Bachmann T. New solid-state glass electrodes by using zinc oxide thin films as interface layer. J Solid State Electrochem 2008. [DOI: 10.1007/s10008-008-0573-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
12
|
Vaselaney J, Spindler J. Be cautious about collection actions. J Mich Dent Assoc 2000; 82:24. [PMID: 11324034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
13
|
Benassi R, Bertarini C, Hilfert L, Kempter G, Kleinpeter E, Spindler J, Taddei F, Thomas S. Exocyclic push–pull conjugated compounds. Part 3. An experimental NMR and theoretical MO ab initio study of the structure, the electronic properties and barriers to rotation about the exocyclic partial double bond in 2-exo-methylene- and 2-cyanoimino-quinazolines and -benzodiazepines. J Mol Struct 2000. [DOI: 10.1016/s0022-2860(99)00346-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Spindler J. Endorsed plan offers superior service. J Mich Dent Assoc 1999; 81:18, 37. [PMID: 11816092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
|
15
|
Caldwell J, Gendreau RM, Furst D, Wiesenhutter C, Quagliata F, Spindler J, Bertram J. A pilot study using a staph protein A column (Prosorba) to treat refractory rheumatoid arthritis. J Rheumatol 1999; 26:1657-62. [PMID: 10451058] [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: 02/13/2023]
Abstract
OBJECTIVE To assess the safety and effectiveness of extracorporeal treatments with protein A (Prosorba) columns in the treatment of patients with severe refractory rheumatoid arthritis (RA) in an open label pilot study. METHODS Fifteen patients with RA who had failed to respond to 2 or more disease modifying antirheumatic drugs were "washed out" for 1-3 months before enrollment into this 6 month pilot study. The treatment schedule called for patients to receive apheresis treatments across staphylococcal protein A columns once a week for 12 weeks. Clinical evaluations of RA activity, defined by Paulus criteria, were conducted at study enrollment (baseline) and monthly throughout the treatment phase. In addition, examinations were conducted at 2, 4, 8, and 12 weeks after the last treatment. Fourteen patients received all 12 scheduled treatments, while one patient received only 10 treatments due to complications secondary to pneumonia. RESULTS Using Paulus 50% criteria, 9 of 15 (60%) patients were improved at the 4th month, and one more fulfilled >20% Paulus criteria (7%) in the 5th month after starting therapy. The study group reported an average of 2.47 adverse effects per treatment, of which the most common were joint pain and swelling and fatigue of short duration (arthritic flare). CONCLUSION The adverse effects associated with this apheresis based treatment proved to be manageable and of short duration and resolved without sequelae. The results suggest that extracorporeal protein A therapy may have a role in the management of refractory RA, and encouraged the initiation of a larger, blinded, controlled clinical trial.
Collapse
Affiliation(s)
- J Caldwell
- Virginia Mason Research Center, University of Washington, Seattle, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
The importance of moist wound healing was clearly established by Winter in the 1960s1, but the introduction of changes in medical and nursing practice in support of this principle is slow. In The Netherlands, many practitioners still use traditional cotton gauze dressings, with three dressing changes a day, and topical antibacterial agents without due attention to wound presentation. Doctors who prescribe dressings and treatments often have less knowledge than nurses about wound care and there is insufficient consideration of the impact of these materials on wound healing.
Collapse
|
17
|
Ruckenstein MJ, Spindler J, Harris JP. Benign positional vertigo. West J Med 1995; 163:153-4. [PMID: 7571564 PMCID: PMC1303012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
18
|
Spindler J, Kerowgan M, Goldmann SF. Development of a batch-processed, passive latex agglutination test for cytomegalovirus. Transfusion 1994; 34:995-8. [PMID: 7974709 DOI: 10.1046/j.1537-2995.1994.341195065039.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The passive latex agglutination test is commonly used for the identification of cytomegalovirus IgG and IgM antibodies. This test is used because of its sensitivity, specificity, speed, and ease of performance, but it is unsuitable for large numbers of samples or for batch processing. STUDY DESIGN AND METHODS To solve this problem, comparative studies to assess the cytomegalovirus passive latex agglutination test on microtiter plates were done with a new photometric particle agglutination method (PPAM) and an enzyme-linked immunosorbent assay as a control. RESULTS A total of 3430 sera were tested using both the PPAM and enzyme-linked immunosorbent assay. A high degree (97.6%) of correspondence between the results of the tests was observed. The new PPAM was easier and faster to use (96 wells in 25 min). CONCLUSION These results, as well as the possibility of adapting this method to a fully automated system, suggest that the PPAM could be an important contribution to the field of infection serology.
Collapse
|
19
|
Schauberger CW, Rooney BL, Beguin EA, Schaper AM, Spindler J. Evaluating the thirty minute interval in emergency cesarean sections. J Am Coll Surg 1994; 179:151-5. [PMID: 8044383] [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: 01/28/2023]
Abstract
BACKGROUND This study was done to evaluate what percent of emergency cesarean sections are begun within the 30 minute interval between decision and incision time and to evaluate morbidity associated with this time interval. STUDY DESIGN A retrospective patient-control study of records from 75 patients undergoing emergency cesarean sections and two different control groups was undertaken. RESULTS Sixty-three percent of emergency cesarean sections were begun in less than 30 minutes. A significantly greater number of infants in the group that delivered in less than 30 minutes experienced five minute Apgar scores less than six. There was no significant differences in maternal morbidity associated with emergency cesarean sections. CONCLUSIONS The 30 minute interval is obtainable in a large number of patients but did not have a beneficial effect on neonatal morbidity. There was no significant morbidity seen in the patients who underwent emergency cesarean section. Other measurements of emergency preparedness should be considered other than the 30 minute rule.
Collapse
Affiliation(s)
- C W Schauberger
- Department of Obstetrics and Gynecology, Gundersen Clinic, Limited, La Crosse, WI 54601
| | | | | | | | | |
Collapse
|
20
|
Abstract
The doll's eye reflex represents the vestibulo-ocular reflex (VOR) elicited by high-acceleration head rotation. After complete unilateral vestibular lesions, the ipsilateral, horizontal doll's eye reflex is replaced by a series of "catch-up" saccades. These cause permanent symptoms of blurred vision and dizziness during ipsilateral turns. We compared normal controls and patients with complete surgical lesions or canal paresis of up to 9 years duration via electronystagmography (ENG) to determine the usefulness of the doll's eye test as a diagnostic test for complete vestibular lesions. This test was found to be more sensitive in diagnosis of such lesions than head-shaking nystagmus, rotatory directional preponderance, and spontaneous nystagmus. It is also useful to document VOR function in patients in whom caloric irrigation is contraindicated.
Collapse
Affiliation(s)
- C A Foster
- Division of Head and Neck Surgery, University of California San Diego, La Jolla
| | | | | | | |
Collapse
|
21
|
Affiliation(s)
- J Spindler
- Otolaryngology/Head and Neck Surgery, Division of General Surgery, University of California Medical Group, La Jolla 92092-06271
| |
Collapse
|
22
|
Spindler J, Neppert J. Improved alanine aminotransferase assay using the microtiter plate. Transfusion 1991; 31:527-30. [PMID: 1853448 DOI: 10.1046/j.1537-2995.1991.31691306251.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
New procedures and new devices have been developed to improve the alanine aminotransferase (ALT) assay by using microtiter plates with 96 wells. Sera for ALT determination and reagents are distributed with a computer-controlled multiple syringe for simultaneous filling of the 96 wells. The volumes simultaneously distributed by this new multiple syringe show very little variation. The coefficient of variation (CV) is 0.6 percent (n = 96). Repeated filling of the wells with this syringe results in good reproducibility of distributed volumes (CV = 0.5%, n = 10). The temperature of sera, reagents, and mixtures, even during photometry, is actively regulated (down or up) to 25 degrees C in special chambers. Thus, the temperature varies minimally +/- 0.05 degrees C. ALT values in the low normal range as well as the high pathologic range show little variation (CV less than 2.3%) in aliquots of the same sample simultaneously or subsequently examined by the new procedure and with new devices. There is good correlation between the improved method using microtiter plates and the conventional methods (r greater than 0.9900, ALT values from 1-154 U/L). False-low and false-high values are excluded by computerized evaluation of many single determinations during the kinetic reactions in each sample. The new method is precise as well as simple, saves time, and may become important for the determination of other serum constituents on the basis of kinetics.
Collapse
Affiliation(s)
- J Spindler
- Mannheim Blood Center, Blood Transfusion Service, German Red Cross Baden-Württemberg, Mannheim
| | | |
Collapse
|
23
|
Spindler J. Seeing through the mask of cancer. Nursing 1991; 21:36-40. [PMID: 2027566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
24
|
Abstract
The dopamine receptor blocker pimozide attenuated lever-pressing and running for food reward in hungry rats. In each case the characteristic behavior of pimozide-treated rats was the same as that of undrugged rats when reward was simply withheld. Drug-induced performance difficulties were ruled out by the presence of periods of normal responding in drug-treated animals. Pimozide appears to selectively blunt the rewarding impact of food and other hedonic stimuli.
Collapse
|
25
|
Wise RA, Spindler J, Legault L. Major attenuation of food reward with performance-sparing doses of pimozide in the rat. Can J Psychol 1978; 32:77-85. [PMID: 737579 DOI: 10.1037/h0081678] [Citation(s) in RCA: 141] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
26
|
Abstract
Benjamin, Ivy, Taylor, Herbert, and Spindler, James: Orbital and conjuctival involvement in multiple myeloma. Report of a case. Am J Clin Pathol 63: 811-817, 1975. Orbital and conjunctival involvement in multiple myeloma are rare. In most reported cases of multiple myeloma with orbital involvement proptosis has been the initial manifestation that has led to diagnosis of the disease. Our case represents and example of terminal involvement of the orbit and conjunctiva, causing proptosis. The minimal conjunctival changes were the first indication of neoplastic proliferation of plasma cells in this location and, presumably, the orbit.
Collapse
|
27
|
Corrigan TP, Fossard DP, Spindler J, Armstrong P, Strachan CJ, Johnston KW, Kakkar VV. Phlebography in the management of pulmonary embolism. Br J Surg 1974; 61:484-8. [PMID: 4835203 DOI: 10.1002/bjs.1800610617] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
The value of phlebography in the management of 102 patients presenting with clinical features suggestive of pulmonary embolism was assessed. Ascending phlebograms, chest x-rays and pulmonary perfusion scans were performed in all the cases. Of 33 patients with a high probability of pulmonary embolism, 29 (87 per cent) had thrombi in the peripheral veins shown by phlebography. Of 45 patients with no evidence of pulmonary emboli on lung scan, the deep veins were normal in 30, while in the remaining 15 (33 per cent), phlebograms showed the presence of thrombi. In all 7 patients where pulmonary angiography confirmed the presence of extensive emboli, phlebograms showed thrombi in the peripheral veins. Phlebography was of considerable help in deciding whether to give anticoagulant therapy.
Collapse
|
28
|
Kakkar VV, Corrigan T, Spindler J, Fossard DP, Flute PT, Crellin RQ, Wessler S, Yin ET. Efficacy of low doses of heparin in prevention of deep-vein thrombosis after major surgery. A double-blind, randomised trial. Lancet 1972; 2:101-6. [PMID: 4113891 DOI: 10.1016/s0140-6736(72)91595-4] [Citation(s) in RCA: 246] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
29
|
Nicolaides AN, Kakkar VV, Field ES, Spindler J. Soleal veins and stasis during operation. Br J Surg 1972; 59:304. [PMID: 5020752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
30
|
Nicolaides AN, Kakkar VV, Field ES, Spindler J. Antibiotics, postoperative infection, and deep-vein thrombosis. Br J Surg 1972; 59:303. [PMID: 5020748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
31
|
Kempter G, Spindler J, Fiebig HJ, Sarodnick G. Darstellung von heterocyclisch substituierten Imidazolen und Imidazo[2.1-b] thiazolen. ACTA ACUST UNITED AC 1971. [DOI: 10.1002/prac.19713130525] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
32
|
|