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Peschke JC, Bergmann R, Mehnert M, Gonzalez Soto KE, Loureiro LR, Mitwasi N, Kegler A, Altmann H, Wobus M, Máthé D, Szigeti K, Feldmann A, Bornhäuser M, Bachmann M, Fasslrinner F, Arndt C. FLT3-directed UniCAR T-cell therapy of acute myeloid leukaemia. Br J Haematol 2023; 202:1137-1150. [PMID: 37460273 DOI: 10.1111/bjh.18971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 09/12/2023]
Abstract
Adaptor chimeric antigen receptor (CAR) T-cell therapy offers solutions for improved safety and antigen escape, which represent main obstacles for the clinical translation of CAR T-cell therapy in myeloid malignancies. The adaptor CAR T-cell platform 'UniCAR' is currently under early clinical investigation. Recently, the first proof of concept of a well-tolerated, rapidly switchable, CD123-directed UniCAR T-cell product treating patients with acute myeloid leukaemia (AML) was reported. Relapsed and refractory AML is prone to high plasticity under therapy pressure targeting one single tumour antigen. Thus, targeting of multiple tumour antigens seems to be required to achieve durable anti-tumour responses, underlining the need to further design alternative AML-specific target modules (TM) for the UniCAR platform. We here present the preclinical development of a novel FMS-like tyrosine kinase 3 (FLT3)-directed UniCAR T-cell therapy, which is highly effective for in vitro killing of both AML cell lines and primary AML samples. Furthermore, we show in vivo functionality in a murine xenograft model. PET analyses further demonstrate a short serum half-life of FLT3 TMs, which will enable a rapid on/off switch of UniCAR T cells. Overall, the presented preclinical data encourage the further development and clinical translation of FLT3-specific UniCAR T cells for the therapy of AML.
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Affiliation(s)
- J C Peschke
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
| | - R Bergmann
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - M Mehnert
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - K E Gonzalez Soto
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - L R Loureiro
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - N Mitwasi
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - A Kegler
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - H Altmann
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Wobus
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Máthé
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
- Hungarian Centre of Excellence for Molecular Medicine, In Vivo Imaging Advanced Core Facility, Szeged, Hungary
| | - K Szigeti
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - A Feldmann
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Bornhäuser
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- School of Cancer and Pharmaceutical Science, King's College, London, UK
| | - M Bachmann
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - F Fasslrinner
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Arndt
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
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Mitwasi N, Hassan H, Arndt C, Loureiro L, Neuber C, Kegler A, Kubeil M, Toussaint M, Deuther-Conrad W, Bachmann M, Feldmann A. 45P The RevCAR T cell platform: A switchable and combinatorial therapeutic strategy for glioblastoma. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100150] [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: 12/13/2022]
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Sellami S, Bachmann M, Brembilla N, Drukala J, Wehrle-Haller B, Boehncke W, Shutova M. 362 The role for epidermal αV integrin complexes in the pathogenesis of psoriatic inflammation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.375] [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: 11/19/2022]
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Bachmann M, Okon P, Blunk C, Kuhnitzsch C, Martens S, Steinhöfel O, Zeyner A. Ensiling and thermic treatment effects on nutrient content, protein solubility, and in vitro fermentation of partial crop faba beans. Anim Feed Sci Technol 2022. [DOI: 10.1016/j.anifeedsci.2022.115349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shiri T, Birungi J, Garrib AV, Kivuyo SL, Namakoola I, Mghamba J, Musinguzi J, Kimaro G, Mutungi G, Nyirenda MJ, Okebe J, Ramaiya K, Bachmann M, Sewankambo NK, Mfinanga S, Jaffar S, Niessen LW. Patient and health provider costs of integrated HIV, diabetes and hypertension ambulatory health services in low-income settings - an empirical socio-economic cohort study in Tanzania and Uganda. BMC Med 2021; 19:230. [PMID: 34503496 PMCID: PMC8431904 DOI: 10.1186/s12916-021-02094-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Integration of health services might be an efficient strategy for managing multiple chronic conditions in sub-Saharan Africa, considering the scope of treatments and synergies in service delivery. Proven to promote compliance, integration may lead to increased economies-of-scale. However, evidence on the socio-economic consequences of integration for providers and patients is lacking. We assessed the clinical resource use, staff time, relative service efficiency and overall societal costs associated with integrating HIV, diabetes and hypertension services in single one-stop clinics where persons with one or more of these conditions were managed. METHODS 2273 participants living with HIV infection, diabetes, or hypertension or combinations of these conditions were enrolled in 10 primary health facilities in Tanzania and Uganda and followed-up for up to 12 months. We collected data on resources used from all participants and on out-of-pocket costs in a sub-sample of 1531 participants, while a facility-level costing study was conducted at each facility. Health worker time per participant was assessed in a time-motion morbidity-stratified study among 228 participants. The mean health service cost per month and out-of-pocket costs per participant visit were calculated in 2020 US$ prices. Nested bootstrapping from these samples accounted for uncertainties. A data envelopment approach was used to benchmark the efficiency of the integrated services. Last, we estimated the budgetary consequences of integration, based on prevalence-based projections until 2025, for both country populations. RESULTS Their average retention after 1 year service follow-up was 1911/2273 (84.1%). Five hundred and eighty-two of 2273 (25.6%) participants had two or all three chronic conditions and 1691/2273 (74.4%) had a single condition. During the study, 84/2239 (3.8%) participants acquired a second or third condition. The mean service costs per month of managing two conditions in a single participant were $39.11 (95% CI 33.99, 44.33), $32.18 (95% CI 30.35, 34.07) and $22.65 (95% CI 21.86, 23.43) for the combinations of HIV and diabetes and of HIV and hypertension, diabetes and hypertension, respectively. These costs were 34.4% (95% CI 17.9%, 41.9%) lower as compared to managing any two conditions separately in two different participants. The cost of managing an individual with all three conditions was 48.8% (95% CI 42.1%, 55.3%) lower as compared to managing these conditions separately. Out-of-pocket healthcare expenditure per participant per visit was $7.33 (95% CI 3.70, 15.86). This constituted 23.4% (95% CI 9.9, 54.3) of the total monthly service expenditure per patient and 11.7% (95% CI 7.3, 22.1) of their individual total household income. The integrated clinics' mean efficiency benchmark score was 0.86 (range 0.30-1.00) suggesting undercapacity that could serve more participants without compromising quality of care. The estimated budgetary consequences of managing multi-morbidity in these types of integrated clinics is likely to increase by 21.5% (range 19.2-23.4%) in the next 5 years, including substantial savings of 21.6% on the provision of integrated care for vulnerable patients with multi-morbidities. CONCLUSION Integration of HIV services with diabetes and hypertension control reduces both health service and household costs, substantially. It is likely an efficient and equitable way to address the increasing burden of financially vulnerable households among Africa's ageing populations. Additional economic evidence is needed from longer-term larger-scale implementation studies to compare extended integrated care packages directly simultaneously with evidence on sustained clinical outcomes.
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Affiliation(s)
- Tinevimbo Shiri
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Josephine Birungi
- The AIDS Support Organisation, Mulago Hospital Complex, Kampala, Uganda
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Anupam V Garrib
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Sokoine L Kivuyo
- National Institutes for Medical Research, Dar es Salaam, Tanzania
| | - Ivan Namakoola
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Janneth Mghamba
- Directors Office, Ministry of Health, Community Development, Gender, Elderly and Children, Kampala, Uganda
| | - Joshua Musinguzi
- Directors Office, Ministry of Health, Community Development, Gender, Elderly and Children, Kampala, Uganda
| | - Godfather Kimaro
- School of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gerald Mutungi
- Non-Communicable Diseases Control Programme, Ministry of Health, Kampala, Uganda
| | - Moffat J Nyirenda
- The AIDS Support Organisation, Mulago Hospital Complex, Kampala, Uganda
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Joseph Okebe
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Kaushik Ramaiya
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
- Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | - M Bachmann
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Sayoki Mfinanga
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
- National Institutes for Medical Research, Dar es Salaam, Tanzania
- School of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Shabbar Jaffar
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Louis W Niessen
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Abstract
The logistical and infectious peculiarities and requirements challenge the intensive care treatment teams aiming at a successful liberation of patients from long-term mechanical ventilation. Especially in the pandemic, it is therefore important to use all potentials for weaning and decannulation, respectively, in patients with prolonged weaning.Weaning centers represent units of intensive medical care with a particular specialization in prolonged weaning. They are an integral part of a continuous care concept for these patients. A systematic weaning concept in the pandemic includes structural, personnel, equipment, infectiological and hygienic issues. In addition to the S2k guideline "Prolonged weaning" this position paper hightlights a new classification in prolonged weaning and organizational structures required in the future for the challenging pandemic situation. Category A patients with high weaning potential require a structured respiratory weaning in specialized weaning units, so as to get the greatest possible chance to realize successful weaning. Patients in category B with low or currently nonexistent weaning potential should receive a weaning attempt after an intermediate phase of further stabilization in an out-of-hospital ventilator unit. Category C patients with no weaning potential require a permanent out-of-hospital care, alternatively finishing mechanical ventilation with palliative support.Finally, under perspective in the position paper the following conceivable networks and registers in the future are presented: 1. locally organized regional networks of certified weaning centers, 2. a central, nationwide register of weaning capacities accordingly the already existing DIVI register and 3. registration of patients in difficult or prolonged weaning.
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Affiliation(s)
- M Westhoff
- Klinik für Pneumologie, Schlaf- und Beatmungsmedizin, Lungenklinik Hemer, Zentrum für Pneumologie und Thoraxchirurgie, Hemer
- Universität Witten-Herdecke, Witten
| | - J Geiseler
- Medizinische Klinik IV: Klinik für Pneumologie, Beatmungs- und Schlafmedizin, Klinikum Vest GmbH, Paracelsus-Klinik, Marl
| | - B Schönhofer
- Pneumologische Praxis und pneumologischer Konsildienst im Klinikum Agnes Karll Laatzen, Klinikum Region Hannover, Laatzen, Germany
| | - M Pfeifer
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinik Regensburg, Regensburg
- Abteilung für Pneumologie, Fachklinik für Lungenerkrankungen Donaustauf, Donaustauf
- Krankenhaus Barmherzige Brüder, Klinik für Pneumologie und konservative Intensivmedizin, Regensburg
| | - D Dellweg
- Fachkrankenhaus Kloster Grafschaft GmbH, Akademisches Lehrkrankenhaus der Philipps-Universität Marburg, Schmallenberg
| | - M Bachmann
- Klinik für Intensiv- und Beatmungsmedizin, Asklepios-Klinik Harburg, Hamburg
| | - W Randerath
- Institut für Pneumologie an der Universität zu Köln, Köln
- Klinik für Pneumologie, Krankenhaus Bethanien, Solingen
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Hoegen P, Lang C, Akbaba S, Häring P, Splinter M, Miltner A, Bachmann M, Stahl-Arnsberger C, Brechter T, Bernhardt D, Klüter S, Syed M, Weykamp F, König L, Debus J, Hörner-Rieber J. PO-1652: In silico trial of cone-beam-CT guided adaptive planning for radiotherapy of locally advanced NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01670-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vdovenko D, Wijnen W, Zarak Crnkovic M, Blyszczuk P, Bachmann M, Costantino S, Paneni F, Camici G, Luescher T, Eriksson U. IL-23 promotes T-cell mediated cardiac inflammation but protects the heart from fibrosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cardiac inflammation varies widely and, in some cases, triggers autoimmune myocarditis and further inflammatory dilated cardiomyopathy (iDCM) and heart failure. In children, myocarditis leads to cardiomyopathy in almost half of affected individuals and up to 20% of sudden death cases in young adults have been reported to be due to myocarditis. IL-12 and IL-23 belong to the same family of cytokines known to mediate inflammatory conditions. Both regulate the differentiation of T cells: IL-12 promotes towards IFN-gamma-producing Th-1 cells, while IL-23 induces IL-17-producing Th-17 cells. Heart-reactive CD4+Th17 cells play a leading role in the development of myocarditis, however, literature reports excessiveness of IL-23 in Th17-derived IL-17 production. Therapeutic strategies blocking IL-23 were suggested as a promising approach, though the specific role of IL-23 in pathogenesis is unclear and the long-term perspectives stay elusive.
Purpose
We aim to explore the role IL-23 compared to IL-12 in the manifestation of cardiac autoimmune myocarditis.
Methodology
We use dendritic cell (DC) model of experimental autoimmune myocarditis in IL-12 and IL-23-deficient mice. Mice were injected with bone marrow-derived in vitro activated and loaded with cardiac-specific peptide DCs. This model mimics natural processes taking place during heart inflammation and provides a unique method to address the role of DCs-derived cytokines. Cardiac inflammation, as well as remodeling and heart function, were analysed at the acute and chronic stages of the disease.
Results
Surprisingly, all mice developed acute myocarditis, though wt receiving IL-23−/−bmDCs showed a twofold decrease in heart-infiltrating T cells and lower numbers of Th17 population. Further decrease of heart-infiltrating T cells appeared upon total systemic IL-23 deficiency. In comparison to IL-12, directly inducing differentiation of IFN-gamma–producing Th1, IL-23 cannot induce Th17 differentiation. None of the two cytokines affect proliferation, though, IL-23 activates T cell migratory potential and increases T cell migration by twofold. At the same time, deficiency of IL-23-production by bmDCs leads to lower migration of T cells. We also show an involvement of RhoA, and the other Rho GTPases, in the mechanism of migration as blocking revoke the IL-23 effect on T cells. Moreover, we further observed more fibrosis and worse heart functioning in IL-23−/−, but not IL-12−/− mice at the chronic stage what underlines the importance of IL-23-dependent T cell trafficking in the resolution of the acute stage of autoimmune myocarditis.
Conclusion
Our observations underline IL-23 as an important cytokine responsible for T cell trafficking and resolution of the inflammation in autoimmune myocarditis. Therapeutic approaches involving inflammatory cytokine targeting are a promising clinical perspective though IL-23 deficiency might lead to increased cardiac remodeling and iDCM progression.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Swiss National Science Foundation
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Affiliation(s)
- D Vdovenko
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - W.J Wijnen
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - M Zarak Crnkovic
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - P Blyszczuk
- University Hospital Zurich, Department of Rheumatology, Zurich, Switzerland
| | - M Bachmann
- GZO Zurich Regional Health Center, Department of Medicine, Wetzikon, Switzerland
| | - S Costantino
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - F Paneni
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - G.G Camici
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - T.F Luescher
- University of Zurich, Center for Molecular Cardiology, Zurich, Switzerland
| | - U Eriksson
- GZO Zurich Regional Health Center, Department of Medicine, Wetzikon, Switzerland
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Zani B, Fairall L, Petersen I, Folb N, Bhana A, Thornicroft G, Hanass-Hancock J, Lund C, Bachmann M. Predictors of receiving a diagnosis, referral and treatment of depression in people on antiretroviral therapy in South African primary care: a secondary analysis of data from a randomised trial. Trop Med Int Health 2020; 25:1450-1466. [PMID: 32985080 PMCID: PMC7756779 DOI: 10.1111/tmi.13495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/30/2022]
Abstract
Objective To describe the receipt of a diagnosis, referral and treatment for depression in people receiving antiretroviral therapy (ART), with depressive symptoms and attending primary care clinics in South Africa, and investigate factors associated with receiving these components of care. Methods This is a secondary analysis of data from a randomised controlled trial of an intervention intended to improve detection and treatment of depression in primary care patients receiving ART. In this analysis, we combined cross‐sectional and longitudinal data from the intervention and control arms. Using regression models and adjusting for intra‐cluster correlation of outcomes, we investigated associations between socioeconomic characteristics, depressive symptoms, stress, disability and stigma, and receipt of a diagnosis, referral and treatment for depression. Results Of 2002 participants enrolled, 18% reported a previous diagnosis of depression by a healthcare worker and 10% reported having received counselling from a specialist mental health worker. Diagnosis, referral and counselling during the follow‐up period were appropriately targeted, being independently more frequent in participants with higher enrolment scores for depressive symptoms, stress or disability. Participants with higher stigma scores at enrolment were independently less likely to receive counselling. Severe socio‐economic deprivation was common but was not associated with treatment. Conclusion While the receipt of a diagnosis, referral and treatment for depression were uncommon, they seemed to be appropriately targeted. Socio‐economic deprivation was not associated with treatment.
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Affiliation(s)
- B Zani
- Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - L Fairall
- Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa.,King's Global Health Institute, King's College London, London, UK.,Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - I Petersen
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - N Folb
- Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - A Bhana
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa.,Health Systems Research Unit, South African Medical Research Council, Durban, South Africa
| | - G Thornicroft
- Centre for Global Mental Health, King's College London, London, UK
| | - J Hanass-Hancock
- HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa.,School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - C Lund
- Centre for Global Mental Health, King's College London, London, UK.,Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - M Bachmann
- Norwich Medical School, University of East Anglia, Norwich, UK
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Mukhtyar C, Steel L, Jones C, Bachmann M. THU0553 A HEALTH ECONOMIC ANALYSIS OF THE USE OF COLOUR DOPPLER ULTRASONOGRAPHY AS THE PRIMARY DIAGNOSTIC MODALITY IN PATIENTS WITH SUSPECTED GIANT CELL ARTERITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:EULAR has recommended ultrasonography (US) as first imaging modality for diagnosis of Giant Cell Arteritis (GCA)1. For patients with a high pre-test probability who have a negative scan, the recommendation is to use another diagnostic modality like temporal artery biopsy (TAB) to make a diagnosis1. We know that a fast-track pathway incorporating US, results in better clinical outcomes2; but there are little data on the health-economics of this approach. Since 2017, we have used ultrasonography as the primary diagnostic modality for suspected GCA. In patients with a high pre-test probability with a negative ultrasonography, we perform a temporal artery biopsy.Objectives:To compare the cost of investigating GCA using first-line US and second-line TAB the use of TAB only. To compare the cost per definite diagnosis of GCA.Methods:Number of cases from 2007-2009 and 2017-2019 were calculated by the number of TAB performed and number of referrals to hospital GCA clinic, respectively. Costs of the procedure were calculated as per the nationally agreed tariff by the United Kingdom National Health Service. For ease of comparison, we used the 2018/19 tariff (£1284/TAB; £51 for US)Results:In 2007-2009, 162 cases were referred to clinic and had a TAB, of which 86 were positive. No cases had US. The 2018/19 corrected cost was £208008; the cost per positive diagnosis was £2418.70 (Table 1).In 2017-2019, 419 patients were referred to the GCA clinic, 416 of whom had US for diagnosis. 3 individuals had a TAB as the first diagnostic modality and 66 others were referred for a TAB because of a high pre-test probability and negative US. The 2018/19 corrected cost of this pathway was £109812 and the cost per positive diagnosis was £773.32 (Table 1).Table 1.Numbers of cases investigated for suspected GCA by TAB or US and the costs corrected to 2018/19 UK NHS tariff.YearsNo of referralsNo of TABNo of USNo of patients with GCATotal costCost of making 1 positive diagnosis2007-09162162086£208008£2418.702017-1941969416142£109812£773.32If all cases in 2017-2019 had a TAB for suspected GCA, the 2018/19 corrected cost would have been £537996. The estimated 2018/19 corrected savings in our center was £142728/year. The estimated 2018/19 corrected savings per definite diagnosis of GCA has dropped by £1645.37 (Table 1).Conclusion:The EULAR recommendation of using first-line US for diagnosis of GCA followed by a TAB in cases with uncertain diagnosis after US, is highly cost-effective in the UK, resulting in cost savings of >£140K per year.References:[1]Dejaco C, et al. Ann Rheum Dis. 2018 May;77(5):636-643.[2]Diamantopoulos AP, et al. Rheumatology (Oxford). 2016 Jan;55(1):66-70.Disclosure of Interests:None declared
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Wiesner B, Bachmann M, Blum TG, Forchheim S, Geiseler J, Kassin A, Kretzschmar E, Weber-Carstens S, Westhoff M, Witzenrath M, Grohé C. [Responsibilities of Weaning Centers during the COVID-19 Pandemic Outbreak - Recommendations for the Assignment of ICU Capacities in COVID-19 Patients as shown by the Berlin-Brandenburg POST-SAVE-Model]. Pneumologie 2020; 74:358-365. [PMID: 32294763 PMCID: PMC7356087 DOI: 10.1055/a-1153-9710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Die enorme Zunahme von Patienten mit schwerer respiratorischer Insuffizienz aufgrund der COVID19-Pandemie erfordert einen systematischen Ansatz zur Optimierung der Betreuung von beatmeten Patienten. Ein standardisierter Algorithmus namens „SAVE“ wurde in Berlin entwickelt, um Patienten mit COVID-19-Infektion, die eine invasive Beatmung benötigen, zu lenken. Um Bettenkapazitäten auf den Intensivstationen sicherzustellen, muss eine konstante Patientenentlassung gewährleistet sein. Ein strukturierter Entlassungsprozess der Patienten nach der Akutbehandlung ist dringend erforderlich. In einem nächsten Schritt haben wir einen Triage-Algorithmus entwickelt, um Patienten auf SAVE-Intensivstationen zu identifizieren, die das Potenzial haben, von der Beatmung entwöhnt zu werden und in dafür spezialisierte Einrichtungen zu verlegen. Dieser Prozess ist das POST-SAVE-Konzept. In der vorliegenden Arbeit werden die Algorithmen dargestellt, einschließlich der Verwendung einer standardisierten digitalen Datenbank, der Verwendung geschulter Lotsen zur Erleichterung der Kommunikation zwischen SAVE-Intensivstationen und Weaningeinheiten und der Etablierung eines prospektiven Datenregisters, um Patienten dauerhaft hinsichtlich ihres Weaningpotenzials reevaluieren zu können.
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Affiliation(s)
| | - M Bachmann
- Asklepios Klinikum Harburg, Zentrum für Atemwegs- und Thoraxmedizin
| | - T-G Blum
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | | | | | - A Kassin
- Evangelische Lungenklinik, Berlin
| | | | - S Weber-Carstens
- Charité-Universitätsmedizin Berlin, Klinik für Anästhesiologie m.S. operative Intensivmedizin
| | - M Westhoff
- Lungenklinik Hemer, Klinik für Pneumologie, Schlaf- und Beatmungsmedizin; Universität Witten-Herdecke
| | - M Witzenrath
- Charité-Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie
| | - C Grohé
- Evangelische Lungenklinik, Berlin
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Bachmann M, Kuhnitzsch C, Thierbach A, Michel S, Bochnia M, Greef J, Martens S, Steinhöfel O, Zeyner A. Effects of toasting temperature and duration on in vitro ruminal gas production kinetics and post-ruminal crude protein from field pea (Pisum sativum) legume grain silages. Livest Sci 2020. [DOI: 10.1016/j.livsci.2020.103944] [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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13
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Bachmann M, Kuhnitzsch C, Martens S, Steinhöfel O, Zeyner A. Estimation of gas production and post-ruminal crude protein from native or ensiled Pisum sativum and Vicia faba grains. Journal of Applied Animal Research 2020. [DOI: 10.1080/09712119.2020.1733581] [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: 10/24/2022]
Affiliation(s)
- M. Bachmann
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - C. Kuhnitzsch
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Saxon State Office for Environment, Agriculture and Geology, Köllitsch, Germany
| | - S.D. Martens
- Saxon State Office for Environment, Agriculture and Geology, Köllitsch, Germany
| | - O. Steinhöfel
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Saxon State Office for Environment, Agriculture and Geology, Köllitsch, Germany
| | - A. Zeyner
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Acar A, Niemeyer D, Groß-Fengels W, Bachmann M, Wiest G. [Nocardiosis as a Differential Diagnosis of Pulmonary Epitheloid Cell Granulomas]. Pneumologie 2019; 73:538-543. [PMID: 31533175 DOI: 10.1055/a-0980-9028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 47-year-old man presented with fever, weight loss and pulmonary consolidations and cavitation in the x-ray of the thorax. The comprehensive diagnostics resulted pulmonary epitholoid cell granulomas, therefore an immunosuppressive therapy was applied on suspicion of sarcoidosis. Progressivly the pulmonary infiltration increased and cerebral and abdominal abscesses were determined with microbiological detection of Nocardia farcinica. Despite antibiotic therapy, the patient died in a septic shock with multiple organ failure.Nocardiosis is a rare granulomatous bacterial infectious disease. Risk factors include immunosuppression and structural lung diseases. Characteristic is an abscess formation that can occur in any organ, while pulmonary onset is common.The case demonstrates the importance of considering rare differential diagnoses in the detection of pulmonary epithelioid granulomas.
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Affiliation(s)
- A Acar
- Asklepios Klinikum Hamburg-Harburg, Klinik für Atemwegs-, Lungen- und Thoraxmedizin
| | - D Niemeyer
- Asklepios Klinikum Hamburg-Harburg, Klinik für Atemwegs-, Lungen- und Thoraxmedizin
| | - W Groß-Fengels
- Asklepios Klinikum Hamburg-Harburg, Abteilung für Radiologie und Nuklearmedizin
| | - M Bachmann
- Asklepios Klinikum Hamburg-Harburg, Klinik für Atemwegs-, Lungen- und Thoraxmedizin
| | - G Wiest
- Asklepios Klinikum Hamburg-Harburg, Klinik für Atemwegs-, Lungen- und Thoraxmedizin
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Glatter M, Borewicz K, van den Bogert B, Wensch-Dorendorf M, Bochnia M, Greef JM, Bachmann M, Smidt H, Breves G, Zeyner A. Modification of the equine gastrointestinal microbiota by Jerusalem artichoke meal supplementation. PLoS One 2019; 14:e0220553. [PMID: 31393892 PMCID: PMC6687111 DOI: 10.1371/journal.pone.0220553] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/18/2019] [Indexed: 01/21/2023] Open
Abstract
The objective of this study was to investigate the impact of natural prebiotic active compounds on the microbial composition in different regions of the equine gastrointestinal tract. Twelve adult horses (body weight [bwt] 534 ± 64.5 kg; age 14 ± 7.5 years) were randomly divided into two feeding groups. Six horses received a basal diet consisting of 1.5 kg hay/100 kg bwt x d-1 and oat grains equal to 1.19 g starch/kg bwt x d-1, supplemented with Jerusalem artichoke meal providing prebiotic fructooligosaccharides + inulin in a quantity of 0.15 g/kg bwt x d-1. The remaining horses received a placebo added to the basal diet. The horses were fed for 21 d and euthanized at the end of the feeding period. Digesta samples from different parts of the gastrointestinal tract were taken, DNA extracted and the V1-V2 region of the 16S rRNA gene amplified. Supplementation with the prebiotic increased the relative abundance of Lactobacillus (P < 0.05), with a concurrent reduction of the relative abundance of Streptococcus mainly in the stomach (P < 0.05). In the hindgut, the supplemental prebiotic also increased the relative abundance of Lactobacillus but further reduced the relative abundance of fibrolytic bacteria, specifically the unclassified members of the families Lachnospiraceae (P < 0.05) and Ruminococcaceae. The relative abundance of the genus Ruminococcus increased solely in the caecum and colon transversum. Overall, the addition of the prebiotic significantly increased the diversity in nearly all parts of the gastrointestinal tract (P < 0.05). The feeding of this natural prebiotic compound to horses had an impact on the microbial community in the entire gastrointestinal tract. Furthermore, the effect on the bacterial community in the foregut (especially the stomach) was more pronounced in comparison to the effect in the hindgut. Therefore, the impact on stomach health should be carefully considered.
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Affiliation(s)
- M. Glatter
- Institute of Agricultural and Nutritional Sciences, Group Animal Nutrition, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- * E-mail:
| | - K. Borewicz
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - B. van den Bogert
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - M. Wensch-Dorendorf
- Institute of Agricultural and Nutritional Sciences, Biometrics and Informatics in Agriculture Group, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - M. Bochnia
- Institute of Agricultural and Nutritional Sciences, Group Animal Nutrition, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - J. M. Greef
- Julius Kuehn Institute, Federal Research Center for Cultivated Plants, Crop and Soil Science, Braunschweig, Germany
| | - M. Bachmann
- Institute of Agricultural and Nutritional Sciences, Group Animal Nutrition, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - H. Smidt
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - G. Breves
- Institute for Physiology and Cell Biology, University of Veterinary Medicine, Foundation, Hannover, Germany
| | - A. Zeyner
- Institute of Agricultural and Nutritional Sciences, Group Animal Nutrition, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Zarschler K, Bachmann M, Ddungu J, De Cola L, Stephan S, Bergmann R, Singh G. Ultrasmall silicon nanoparticles as promising platform for targeted multimodal imaging. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30352-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Striese F, Bergmann R, Weißflog S, Arndt C, Feldmann A, Steinbach J, Bachmann M, Pietzsch HJ. Development and characterization of a 177Lu-labeled anti-prostate stem cell antigen (PSCA) monoclonal antibody for metastatic prostate cancer. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30244-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Loureiro LR, Feldmann A, Bergmann R, Koristka S, Berndt N, Arndt C, Pietzsch J, Novo C, Videira P, Bachmann M. Development of a novel target module redirecting UniCAR T cells to Sialyl Tn-expressing tumor cells. Blood Cancer J 2018; 8:81. [PMID: 30190468 PMCID: PMC6127150 DOI: 10.1038/s41408-018-0113-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/08/2018] [Accepted: 07/10/2018] [Indexed: 01/21/2023] Open
Affiliation(s)
- L R Loureiro
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,UniversityCancerCenter (UCC) Dresden, Tumor Immunology, 'Carl Gustav Carus' Technische Universität Dresden, Dresden, Germany
| | - A Feldmann
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - R Bergmann
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - S Koristka
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - N Berndt
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), partner site Dresden, Heidelberg, Germany
| | - C Arndt
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - J Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,Faculty of Chemistry and Food Chemistry, School of Science, Technische Universität Dresden, Dresden, Germany
| | - C Novo
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal.,UEIPM, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisboa, Portugal.,CDG & Allies, Professional and Patient Association International Network (PPAIN), Caparica, Portugal
| | - P Videira
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal.,UEIPM, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisboa, Portugal.,CDG & Allies, Professional and Patient Association International Network (PPAIN), Caparica, Portugal
| | - M Bachmann
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany. .,UniversityCancerCenter (UCC) Dresden, Tumor Immunology, 'Carl Gustav Carus' Technische Universität Dresden, Dresden, Germany. .,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), partner site Dresden, Heidelberg, Germany. .,National Center of Tumor Diseases (NCT), partner site Dresden, Dresden, Germany.
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Martins PHL, Plascak JA, Bachmann M. Adsorption of flexible polymer chains on a surface: Effects of different solvent conditions. J Chem Phys 2018; 148:204901. [DOI: 10.1063/1.5027270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- P. H. L. Martins
- Instituto de Física, Universidade Federal de Mato Grosso, 78060-900 Cuiabá, MT, Brazil
| | - J. A. Plascak
- Departamento de Física, Centro de Ciências Exatas e da Natureza, CCEN, Universidade Federal da Paraíba, Cidade Universitária, 58051-970 João Pessoa, PB, Brazil
- Center for Simulational Physics, University of Georgia, Athens, Georgia 30602, USA
| | - M. Bachmann
- Instituto de Física, Universidade Federal de Mato Grosso, 78060-900 Cuiabá, MT, Brazil
- Center for Simulational Physics, University of Georgia, Athens, Georgia 30602, USA
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Dietrich J, Riewaldt J, Loff S, Meyer J, Schallenberg S, Spehr J, Gründer C, Franke K, Kreissig C, Ehninger G, Bachmann M, Ehninger A, Cartellieri M. Clinical-grade manufacturing of switchable CAR-T cells in an automated closed system for phase I/II trials. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.302] [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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Kalev K, Bachmann M, Orgo L, Lass J, Hinrikus H. Lempel-Ziv and multiscale Lempel-Ziv complexity in depression. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:4158-61. [PMID: 26737210 DOI: 10.1109/embc.2015.7319310] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There is a high demand for objective indicators in diagnosis of depression as diagnosis of depression is still based on psychiatrist's subjective judgment. A nonlinear method Lempel Ziv Complexity (LZC) has been previously successfully used for detection of neuronal or mental disorders based on electroencephalographic (EEG) signals. However, the method overlooks the high frequency content of EEG signals. Therefore, this study is aimed to find out whether the use of Multiscale Lempel Ziv Complexity (MLZC), considering also high frequencies, could overcome the limitations of LZC and better differentiate depression. In current study the EEG recordings were carried out on the groups of depressive and healthy subjects of 11 volunteers each. The LZC and MLZC were calculated on resting EEG signals in eyes open condition from 30 channels at a length of 2 minutes. The results revealed the incapability of traditional LZC to differentiate depressive subjects from healthy controls in eyes open condition, while MLZC differentiated two groups in numerous channels at different frequencies, giving the highest classification accuracy in channel F3 (86 %) at frequencies 9 and 15.5 Hz. The results indicate that the high frequency information, which is lost in calculation of traditional LZC, has a great value in differentiating between depressive and control groups.
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Orgo L, Bachmann M, Lass J, Hinrikus H. Effect of negative and positive emotions on EEG spectral asymmetry. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:8107-10. [PMID: 26738175 DOI: 10.1109/embc.2015.7320275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of the study was to evaluate the applicability of electroencephalogram (EEG) spectral asymmetry index (SASI) for discrimination of the effect of negative and positive emotions on human brain bioelectrical activity. SASI has been previously proposed as a method to detect depression based on the balance of EEG theta and beta frequency band powers. Emotions were evoked on 22 healthy subjects using emotional pictures portraying humans from International Affective Picture System (IAPS) and late response to stimuli was examined (1700-2200 ms). Electroencephalogram (EEG) was recorded in 30 channels divided into 10 brain regions: left frontal, right frontal, left temporal, right temporal, frontal, frontocentral, central, centroparietal, parietal and occipital. Negative stimuli, compared to neutral stimuli, significantly increased SASI in frontocentral, central, centroparietal, parietal and occipital areas. Positive stimuli, compared to neutral stimuli, significantly decreased SASI in left temporal, centroparietal, parietal and occipital areas. The results indicate that SASI provides a good discrimination between the effects of negative, neutral and positive emotions on human EEG.
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Glatter M, Wiedner K, Hirche F, Mielenz N, Hillegeist D, Bochnia M, Cehak A, Bachmann M, Greef JM, Glaser B, Wolf P, Breves G, Zeyner A. Fermentation Characteristics along the Gastrointestinal Tract after Feeding of Jerusalem Artichoke Meal to Adult Healthy Warmblood Horses. ACTA ACUST UNITED AC 2016. [DOI: 10.21767/2572-5459.100016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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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Frensing T, Heldt S, Bachmann M, Genzel Y, Jordan I, Reichl U. Continuous Influenza Vaccine Production. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450656] [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: 11/11/2022]
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Gattinoni L, Carlesso E, Brazzi L, Cressoni M, Rosseau S, Kluge S, Kalenka A, Bachmann M, Toepfer L, Wrigge H, Redaelli F, Vetter C, Wysocki M. Friday night ventilation: a safety starting tool kit for mechanically ventilated patients. Minerva Anestesiol 2014; 80:1046-1057. [PMID: 24847737] [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: 06/03/2023]
Abstract
We wish to report here a practical approach to an acute respiratory distress syndrome (ARDS) patient as devised by a group of intensivists with different expertise. The referral scenario is an intensive care unit of a Community Hospital with limited technology, where a young doctor, alone, must deal with this complicate syndrome during the night. The knowledge of pulse oximetry at room air and at 100% oxygen allows to estimate the PaO2 and the cause of hypoxemia, shunt vs. VA/Q maldistribution. The ARDS severity (mild [200<PaO2/FiO2≤300], moderate [100<PaO2/FiO2≤200] and severe [PaO2/FiO2≤100]) must be immediately assessed. Noninvasive ventilation should be attempted in mild ARDS only. Possible errors due to inappropriate premature intubation are preferable to a delayed intubation. In moderate and severe ARDS tracheal intubation associated with heavy sedation/muscle relaxation allows to fully characterize the patient. A tidal volume of 6 mL/kg predicted body weight is recommended, either in pressure or volume control ventilation. Tailoring tidal volume on residual functional capacity, however, is preferable. Plateau pressure greater than 30 cmH2O is acceptable only if chest wall compliance is decreased. In this case maximal attention must be devoted to the hemodynamics. PEEP from 5 to 10, from 10 to 15 and greater than 15 cmH2O should be set in mild, moderate and severe ARDS, respectively. Prone position should be applied in severe ARDS, if experience is available. In case of unchanged conditions or increased ARDS severity a referral center should be contacted.
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Affiliation(s)
- L Gattinoni
- Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano, Italia -
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Bachmann M, Rutz E, Brunner R, Gaston MS, Hirschmann MT, Camathias C. Temporary hemiepiphysiodesis of the distal medial femur: MPFL in danger. Arch Orthop Trauma Surg 2014; 134:1059-64. [PMID: 24916364 DOI: 10.1007/s00402-014-2032-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Temporary hemiepiphysiodesis (TH) with plate fixation is a well-accepted and common treatment for correcting leg malalignment in skeletally immature patients. The purpose of this study was to investigate any soft tissue damage caused during TH at the distal medial femur with a plate and two screws. We hypothesized that correct plate placement can affect the integrity of the medial stabilizing structures of the knee, especially the medial patellofemoral ligament (MPFL), the medial collateral ligament (MCL) or result in arthrotomy of the knee joint itself. MATERIALS AND METHODS In eight cadaveric knees of five adult humans a TH was performed with a plate and two cancellous screws at the distal medial femur using a standardized surgical technique. Subsequently the medial capsular and ligamentous structures were systematically exposed and assessed. Capsular and synovial tissue was also inspected for impingement by the plate or screws. RESULTS In all knees the MPFL was present. In two specimens the MPFL was intact and the plate was lying over the dorsal part of the MPFL close to the MCL. The MPFL was completely cut in two cases in the central part of the ligament. In four cases the MPFL was partially dissected or perforated by a screw and fixed to the femur by the plate. The MCL was intact and not impinged by the implant in any case. In total four of eight knees the capsule was transected or perforated by a screw or by a part of the plate, resulting in intraarticular implant placement. CONCLUSIONS Standard plate placement during TH on the distal medial femur frequently leads to damage to the MPFL, impingement of the MPFL, the capsular and synovial tissues or exposure of the knee joint.
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Affiliation(s)
- M Bachmann
- Orthopaedics and Sport Traumatology, Sportclinic Villa Linde, 2503, Biel/Bienne, Switzerland,
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Ehninger A, Kramer M, Röllig C, Thiede C, Bornhäuser M, von Bonin M, Wermke M, Feldmann A, Bachmann M, Ehninger G, Oelschlägel U. Distribution and levels of cell surface expression of CD33 and CD123 in acute myeloid leukemia. Blood Cancer J 2014; 4:e218. [PMID: 24927407 PMCID: PMC4080210 DOI: 10.1038/bcj.2014.39] [Citation(s) in RCA: 218] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/25/2014] [Indexed: 11/24/2022] Open
Abstract
Owing to the more recent positive results with the anti-CD33 immunotoxin gemtuzumab ozogamicin, therapy against acute myeloid leukemias (AMLs) targeting CD33 holds many promises. Here, CD33 and CD123 expression on AML blasts was studied by flow cytometry in a cohort of 319 patients with detailed information on French–American–British/World Health Organization (FAB/WHO) classification, cytogenetics and molecular aberrations. AMLs of 87.8% express CD33 and would therefore be targetable with anti-CD33 therapies. Additionally, 9.4% of AMLs express CD123 without concomitant CD33 expression. Thus, nearly all AMLs could be either targeted via CD33 or CD123. Simultaneous presence of both antigens was observed in 69.5% of patients. Most importantly, even AMLs with adverse cytogenetics express CD33 and CD123 levels comparable to those with favorable and intermediate subtypes. Some patient groups with unfavorable alterations, such as FMS-related tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations, high FLT3-ITD mutant/wild-type ratios and monosomy 5 are even characterized by high expression of CD33 and CD123. In addition, blasts of patients with mutant nucleophosmin (NPM1) revealed significantly higher CD33 and CD123 expression pointing toward the possibility of minimal residual disease-guided interventions in mutated NPM1-positive AMLs. These results stimulate the development of novel concepts to redirect immune effector cells toward CD33- and CD123-expressing blasts using bi-specific antibodies or engineered T cells expressing chimeric antigen receptors.
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Affiliation(s)
- A Ehninger
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Kramer
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - C Röllig
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - C Thiede
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M von Bonin
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Wermke
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - A Feldmann
- Institute of Immunology, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Bachmann
- Institute of Immunology, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - U Oelschlägel
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
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Bachmann M, Lass J, Suhhova A, Hinrikus H. Spectral asymmetry index and Higuchi’s fractal dimension for detecting microwave radiation effect on electroencephalographic signal. Proc Estonian Acad Sci 2014. [DOI: 10.3176/proc.2014.3.05] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Olukoga A, Bachmann M, Harris G, Olukoga T, Oluwadiya K. Analysis of the perception of institutional function for health sector reform in Nigeria. Int Health 2013; 2:150-5. [PMID: 24037474 DOI: 10.1016/j.inhe.2009.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Institutional function reflects the institution's understanding of the world around it, its ability to locate itself within that world and to make decisions in relation to it. Three dimensions of institutional function were identified as management, environmental mastery and service delivery. This study analysed the perception of institutional function of four hospitals in Nigeria by 507 healthcare professionals and managers and its influence on the implementation of the health sector reform programme in the country. The respondents were doctors and dentists (30%), nurses (27.2%), pharmacists (8.9%), managers (15.5%) and other allied healthcare workers (18.4%). The overall perception of institutional function was 56.3%. The perceptions of the three dimensions of institutional function were management 52.7%, environmental mastery 50.8% and service delivery 62.6%. Three out of 12 statements on institutional function had levels of perception that were lower than 50%. These were adequacy of management skills (49.7%), functioning management information systems that are used in management decision-making (47.9%) and degree of autonomy for the hospitals (42.4%). There is the need to strengthen the institutional function of Nigerian hospitals, especially the acquisition of management skills by the healthcare professionals and managers, management information systems and autonomy for the hospitals.
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Affiliation(s)
- A Olukoga
- School of Medicine, Health Policy & Practice, University of East Anglia, Norwich NR4 7TU, UK
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Abstract
We systematically investigate how the range of interaction between non-bonded monomers influences the formation of structural phases of elastic, flexible polymers. Massively parallel replica-exchange simulations of a generic, coarse-grained model, performed partly on graphics processing units and in multiple-gaussian modified ensembles, pave the way for the construction of the structural phase diagram, parametrized by interaction range and temperature. Conformational transitions between gas-like, liquid, and diverse solid (pseudo) phases are identified by microcanonical statistical inflection-point analysis. We find evidence for finite-size effects that cause the crossover of "collapse" and "freezing" transitions for very short interaction ranges.
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Affiliation(s)
- J Gross
- Center for Simulational Physics, The University of Georgia, Athens, Georgia 30602, USA.
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Zaman MJ, Shepstone L, Stirling S, Bachmann M, Myint PK. The effect of older age on receipt and outcomes of care in patients with acute coronary syndromes: a cohort study of 68,025 patients from the national acute coronary syndrome register of England/Wales. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arndt C, von Bonin M, Cartellieri M, Feldmann A, Koristka S, Michalk I, Stamova S, Bornhäuser M, Schmitz M, Ehninger G, Bachmann M. Redirection of T cells with a first fully humanized bispecific CD33-CD3 antibody efficiently eliminates AML blasts without harming hematopoietic stem cells. Leukemia 2013; 27:964-7. [PMID: 23325142 DOI: 10.1038/leu.2013.18] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Umar NA, Abubakar I, Fordham R, Bachmann M. Direct costs of pulmonary tuberculosis among patients receiving treatment in Bauchi State, Nigeria. Int J Tuberc Lung Dis 2012; 16:835-40. [PMID: 22613686 DOI: 10.5588/ijtld.10.0774] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To access tuberculosis (TB) services, patients have to bear the costs of out-of-pocket expenditures or direct costs for transport, drugs and other services that are not provided free-of-charge. These costs could represent a barrier to care, especially in a country such as Nigeria, where per capita gross national income is only US$1160 and 46% of the urban population live below the poverty line. OBJECTIVE To describe the direct costs of TB diagnosis and treatment in Bauchi State, Nigeria, from the patient's perspective. METHODS A cross-sectional study. A sample size of 255 patients was randomly selected from 27 of 67 facilities in Bauchi State, Nigeria. RESULTS The median out-of-pocket cost for hospitalised patients was estimated at US$166.11, while ambulatory patients paid an estimated median cost of US$94.16, equivalent to about 9-38% of their average annual income. Female patients spent a higher proportion of their income on diagnosis and treatment than males (P < 0.0001). The median out-of-pocket costs borne by patients before, during and after diagnosis were estimated at respectively US$35.23, US$27.12 and US$23.43 for ambulatory patients, and additional average out-of-pocket spending of US$66.44 for patients hospitalised during their illness. Pre-diagnosis, diagnosis and post-diagnosis out-of-pocket spending did not vary significantly by human immunodeficiency virus status (P > 0.05) and sex (P > 0.05). CONCLUSION The costs of anti-tuberculosis treatment found in this study are expensive and potentially catastrophic for many patients and their families.
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Affiliation(s)
- N A Umar
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.
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Cross J, Elender F, Barton G, Clark A, Shepstone L, Blyth A, Bachmann M, Harvey I. A randomised controlled equivalence trial to determine the effectiveness and cost-utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX). Health Technol Assess 2010; 14:1-147, iii-iv. [PMID: 20487638 DOI: 10.3310/hta14230] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To estimate the effect, if any, of manual chest physiotherapy (MCP) administered to patients hospitalised with chronic obstructive pulmonary disease (COPD) exacerbation on both disease-specific and generic health-related quality of life. To compare the health service costs for those receiving and not receiving MCP. DESIGN A pragmatic, randomised controlled trial powered for equivalence. It was not possible to blind participants, clinicians or research staff to study arm allocation during the intervention. SETTING Four UK hospitals in Norwich, Great Yarmouth, King's Lynn and Liverpool. PARTICIPANTS 526 participants aged 34-91 years were recruited between November 2005 and April 2008; of these, 372 provided evaluable data for the primary outcome. All persons hospitalised with COPD exacerbation and evidence of sputum production on examination were eligible for the trial providing there were no contraindications to performing MCP. INTERVENTIONS Participants were allocated to either MCP or no MCP on an intention-to-treat (ITT) basis. However, active cycle of breathing techniques (ACBT) was used in both arms. Participants allocated to the intervention were guided to perform ACBT while the physiotherapist delivered MCP. Participants allocated to the control arm received instruction on ACBT only. MAIN OUTCOME MEASURES The primary outcome was COPD-specific quality of life, measured using the St George's Respiratory Questionnaire (SGRQ) at 6 months post randomisation. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to calculate the quality-adjusted life-year (QALY) gain associated with MCP compared with no MCP. Secondary physiological outcome measures were also used. RESULTS Of the 526 participants, 261 were allocated to MCP and 264 to control, with 186 participants evaluable in each arm. ITT analyses indicated no significant difference at 6 months post randomisation in total SGRQ score [adjusted effect size (no MCP - MCP) 0.03 (95% confidence interval, CI -0.14 to 0.19)], SGRQ symptom score [adjusted effect size 0.04 (95% CI -0.15 to 0.23)], SGRQ activity score [adjusted effect size -0.02 (95% CI -0.20 to 0.16)] or SGRQ impact score [adjusted effect size 0.02 (95% CI -0.15 to 0.18)]. The imputed ITT and per-protocol results were similar. No significant differences were observed in any of the outcome measures or subgroup analyses. Compared with no MCP, employing MCP was associated with a slight loss in quality of life (0.001 QALY loss) but lower health service costs (cost saving of 410.79 pounds). Based on these estimates, at a cost-effectiveness threshold of lambda = 20,000 pounds per QALY, MCP would constitute a cost-effective use of resources (net benefit = 376.14 pounds). There was, however, a high level of uncertainty associated with these results and it is possible that the lower health service costs could have been due to other factors. CONCLUSIONS In terms of longer-term quality of life the use of MCP did not appear to affect outcome. However, this does not mean that MCP is of no therapeutic value to patients with COPD in specific circumstances. Although the cost-effectiveness analysis suggested that its use was cost-effective, much uncertainty was associated with this finding and it would be difficult to justify providing MCP therapy on the basis of cost-effectiveness alone. Future research should include evaluation of MCP for patients with COPD producing high volumes of sputum, and an evaluation of the effectiveness of ACBT in COPD exacerbation. TRIAL REGISTRATION Current Controlled Trials ISRCTN13825248.
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Affiliation(s)
- J Cross
- School of Allied Health Professions, University of East Anglia, Norwich, UK
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Wehner R, Schumacher P, Bornhäuser M, Ehninger G, Schäkel K, Bachmann M, Schmitz M. Acute myeloid leukemia cells fail to activate native human dendritic cells: a potential mechanism of immune evasion. Leukemia 2010; 24:1965-7. [DOI: 10.1038/leu.2010.189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ighomereho A, Steel N, Bachmann M. P68 The prevalence of eye disease in Norfolk and Waveney. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120477.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Olukoga A, Bachmann M, Harris G, Olukoga T, Olasinde A. Analysis of the perception of institutional culture for health sector reform in Nigeria. Leadersh Health Serv (Bradf Engl) 2010. [DOI: 10.1108/17511871011013788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to analyse the perception of institutional culture in four hospitals in Nigeria and its influence on the implementation of the health sector reform programme in the country.Design/methodology/approachA cross‐sectional study of 507 healthcare professionals and managers using a self‐administered questionnaire was carried our.FindingsThe overall perception of institutional culture was above average at 56.4 per cent. The perceptions of the two dimensions of institutional culture were: leadership 59.3 per cent and character 54.0 per cent. Two out of the 11 statements on institutional culture had levels of perception that were lower than 50 per cent. These were: “staff morale and job satisfaction are high at all levels, and regularly evaluated by the institution” (41.6 per cent) and “information is shared openly in the institution” (44.3 per cent).Originality/valueThere is a need to strengthen the character dimension of the institutional culture of Nigerian hospitals, especially staff morale and job satisfaction as well as the sharing of information in the hospitals.
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Vogel T, Neuhaus T, Bachmann M, Janke W. Ground-state properties of tubelike flexible polymers. Eur Phys J E Soft Matter 2009; 30:7-18. [PMID: 19777280 DOI: 10.1140/epje/i2009-10497-3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2009] [Accepted: 07/15/2009] [Indexed: 05/28/2023]
Abstract
In this work we investigate the structural properties of native states of a simple model for short flexible homopolymers, where the steric influence of monomeric side chains is effectively introduced by a thickness constraint. This geometric constraint is implemented through the concept of the global radius of curvature and affects the conformational topology of ground-state structures. A systematic analysis allows for a thickness-dependent classification of the dominant ground-state topologies. It turns out that helical structures, strands, rings, and coils are natural, intrinsic geometries of such tubelike objects.
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Affiliation(s)
- T Vogel
- Institut für Theoretische Physik and Centre for Theoretical Sciences (NTZ), Universität Leipzig, Postfach 100 920, 04009 Leipzig, Germany.
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Ziesché E, Scheiermann P, Bachmann M, Sadik CD, Hofstetter C, Zwissler B, Pfeilschifter J, Mühl H. Dexamethasone suppresses interleukin-22 associated with bacterial infection in vitro and in vivo. Clin Exp Immunol 2009; 157:370-6. [PMID: 19664145 PMCID: PMC2745031 DOI: 10.1111/j.1365-2249.2009.03969.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2009] [Indexed: 01/24/2023] Open
Abstract
Interleukin (IL)-22 production triggered by innate immune mechanisms has been identified as key to efficient intestinal anti-bacterial host defence and preservation of homeostasis. We hypothesized that glucocorticoid therapy may impair IL-22 expression, which should promote intestinal epithelial damage with the potential of subsequent bacterial translocation. High-dose corticosteroid therapy in Crohn's disease has been associated with an increased rate of abscess formation and ultimately with a higher risk of developing postoperative infectious complications, including abdominal sepsis. Thus, we sought to investigate effects of the prototypic glucocorticoid dexamethasone on IL-22 production in the context of bacterial infection. Enhanced IL-22 plasma levels were detectable in rat sepsis. Moreover, heat-inactivated Staphylococcus epidermidis, used as a prototypic activator of innate immunity, induced robust production of IL-22 by human peripheral blood mononuclear cells (PBMC). Here, we report for the first time that dexamethasone mediates remarkable suppression of IL-22 as detected in S. epidermidis-activated PBMC and rat sepsis, respectively. The data presented herein suggest that insufficient IL-22 function may contribute to impaired intestinal host defence in the context of corticosteroid therapy.
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Affiliation(s)
- E Ziesché
- Pharmazentrum Frankfurt/ZAFES, Intensive Care Medicine and Pain Therapy, University Hospital Goethe University, 60590 Frankfurt am Main, Germany
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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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Bachmann M, Pere P, Kairaluoma P, Rosenberg P, Kallio H. Comparison of hyperbaric and plain articaine in spinal anaesthesia for open inguinal hernia repair. Br J Anaesth 2008; 101:848-54. [DOI: 10.1093/bja/aen294] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kallio H, Bachmann M, Pere P, Kairaluoma P, Rosenberg PH. 96. Hyperbaric vs. Plain Articaine for Spinal Anaesthesia. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND Pain after laparoscopic cholecystectomy (LCC) is multifactorial. Effective post-operative pain control is necessary in LCC performed as day-case surgery. We studied the efficacy of paracetamol or valdecoxib with or without dexamethasone after LCC. METHODS One hundred sixty patients were randomized to four groups of 40 patients. Groups 1 and 3 received parecoxib 40 mg intravenously (IV) during surgery and valdecoxib 40 mg x 1 per os (PO) for 7 post-operative days. Groups 2 and 4 received paracetamol 1 g x 4 IV during surgery and 1 g x 4 PO for 7 days. In addition, Groups 3 and 4 were given dexamethasone 10 mg IV intra-operatively. Propofol and remifentanil were used during surgery. The patients were given oxycodone 0.05 mg/kg IV in phase 1 post-anaesthesia care unit (PACU 1) or 0.15 mg/kg PO in phase 2 post-anaesthesia care unit (PACU 2) as needed to keep visual analogue scale <3/10. The patients were supplied with the study drugs for 7 post-operative days. RESULTS Pain intensity, nausea and the need of oxycodone in phase 1 PACU were similar in all groups. Dexamethasone reduced the need of oral oxycodone in phase 2 PACU (7.0 +/- 1.0 mg vs. 9.1 +/- 1.0 mg, P<0.05). Pain intensity was similar in all groups at home. More patients in the parecoxib/valdecoxib groups needed rescue medication on the 1st post-operative day (P<0.001) than paracetamol-treated patients. CONCLUSION Paracetamol was as effective as parecoxib/valdecoxib for pain after LCC. Dexamethasone decreased the need of oxycodone in phase 2 PACU. The effect of dexamethasone was similar in paracetamol and parecoxib/valdecoxib patients.
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Affiliation(s)
- E Tiippana
- Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Helsinki University Hospital, Helsinki, Finland.
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Keogh-Brown M, Bachmann M, Shepstone L, Hewitt C, Howe A, Ramsay C, Song F, Miles J, Torgerson D, Miles S, Elbourne D, Harvey I, Campbell M. Contamination in trials of educational interventions. Health Technol Assess 2007; 11:iii, ix-107. [PMID: 17935683 DOI: 10.3310/hta11430] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - M Campbell
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
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Straube C, Wehner R, Wendisch M, Bornhäuser M, Bachmann M, Rieber EP, Schmitz M. Bortezomib significantly impairs the immunostimulatory capacity of human myeloid blood dendritic cells. Leukemia 2007; 21:1464-71. [PMID: 17495970 DOI: 10.1038/sj.leu.2404734] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [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: 12/22/2022]
Abstract
Bortezomib is a potent drug for the treatment of multiple myeloma. Its anti-tumor activity is mediated by proteasome inhibition leading to decreased cell proliferation and induction of apoptosis. However, an unimpaired proteasomal function plays a crucial role for the induction of anti-tumor immunity by dendritic cells (DCs), which are currently used for therapeutic vaccination against various tumors including myeloma. In the present study, we investigated the impact of bortezomib on the immunostimulatory capacity of 6-sulfo LacNAc (slan) DCs, which represent a major subset of human blood DCs. We demonstrated that this proteasome inhibitor efficiently impairs the spontaneous in vitro maturation of slanDCs and the release of tumor necrosis factor (TNF)-alpha as well as interleukin (IL)-12 upon lipopolysaccharide (LPS) stimulation. Functional data revealed that bortezomib profoundly inhibits slanDC-induced proliferation and differentiation of CD4(+) T cells. In addition, the capacity of slanDCs to promote interferon-gamma secretion and tumor-directed cytotoxicity of natural killer (NK) cells is markedly impaired by bortezomib. These results provide evidence that bortezomib significantly reduces the ability of native human blood DCs to regulate innate and adaptive anti-tumor immunity and may have implications for the design of therapeutic strategies combining DC vaccination and bortezomib treatment.
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Affiliation(s)
- C Straube
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
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Bheekie A, Buskens I, Allen S, English R, Mayers P, Fairall L, Majara B, Bateman ED, Zwarenstein M, Bachmann M. The Practical Approach to Lung Health in South Africa (PALSA) intervention: respiratory guideline implementation for nurse trainers. Int Nurs Rev 2007; 53:261-8. [PMID: 17083414 DOI: 10.1111/j.1466-7657.2006.00520.x] [Citation(s) in RCA: 25] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper describes the design, facilitation and preliminary assessment of a 1-week cascade training programme for nurse trainers in preparation for implementation of the Practical Approach to Lung Health in South Africa (PALSA) intervention, tested within the context of a pragmatic cluster randomized controlled trial in the Free State province. PALSA combines evidence-based syndromic guidelines on the management of respiratory disease in adults with group educational outreach to nurse practitioners. BACKGROUND Evidence-based strategies to facilitate the implementation of primary care guidelines in low- to middle-income countries are limited. In South Africa, where the burden of respiratory diseases is high and growing, documentation and evaluation of training programmes in chronic conditions for health professionals is limited. METHOD The PALSA training design aimed for coherence between the content of the guidelines and the facilitation process that underpins adult learning. Content facilitation involved the use of key management principles (key messages) highlighted in nurse-centred guidelines manual and supplemented by illustrated material and reminders. Process facilitation entailed reflective and experiential learning, role-playing and non-judgemental feedback. DISCUSSION AND RESULTS Preliminary feedback showed an increase in trainers' self-awareness and self-confidence. Process and content facilitators agreed that the integrated training approach was balanced. All participants found that the training was motivational, minimally prescriptive, highly nurse-centred and offered personal growth. CONCLUSION In addition to tailored guideline recommendations, training programmes should consider individual learning styles and adult learning processes.
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Affiliation(s)
- A Bheekie
- School of Pharmacy, Discipline of Pharmacology, University of the Western Cape, Cape Town, South Africa
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Schmitz M, Temme A, Senner V, Ebner R, Schwind S, Stevanovic S, Wehner R, Schackert G, Schackert HK, Fussel M, Bachmann M, Rieber EP, Weigle B. Identification of SOX2 as a novel glioma-associated antigen and potential target for T cell-based immunotherapy. Br J Cancer 2007; 96:1293-301. [PMID: 17375044 PMCID: PMC2360145 DOI: 10.1038/sj.bjc.6603696] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.6] [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] [Indexed: 12/19/2022] Open
Abstract
Prognosis for patients suffering from malignant glioma has not substantially improved. Specific immunotherapy as a novel treatment concept critically depends on target antigens, which are highly overexpressed in the majority of gliomas, but the number of such antigens is still very limited. SOX2 was identified by screening an expression database for transcripts that are overexpressed in malignant glioma, but display minimal expression in normal tissues. Expression of SOX2 mRNA was further investigated in tumour and normal tissues by real-time PCR. Compared to cDNA from pooled normal brain, SOX2 was overexpressed in almost all (9 out of 10) malignant glioma samples, whereas expression in other, non-malignant tissues was almost negligible. SOX2 protein expression in glioma cell lines and tumour tissues was verified by Western blot and immunofluorescence. Immunohistochemistry demonstrated SOX2 protein expression in all malignant glioma tissues investigated ranging from 6 to 66% stained tumour cells. Human leucocyte antigen-A*0201-restricted SOX2-derived peptides were tested for the activation of glioma-reactive CD8+ cytotoxic T lymphocytes (CTLs). Specific CTLs were raised against the peptide TLMKKDKYTL and were capable of lysing glioma cells. The abundant and glioma-restricted overexpression of SOX2 and the generation of SOX2-specific and tumour-reactive CTLs may recommend this antigen as target for T-cell-based immunotherapy of glioma.
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Affiliation(s)
- M Schmitz
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | - A Temme
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
- Medical Faculty, Department of Neurosurgery, Technical University of Dresden, Dresden, Germany
| | - V Senner
- Institute of Neuropathology, University Hospital Muenster, Muenster, Germany
| | - R Ebner
- Avalon Pharmaceuticals, Germantown, MD, USA
| | - S Schwind
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | - S Stevanovic
- Department of Immunology, Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | - R Wehner
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | - G Schackert
- Medical Faculty, Department of Neurosurgery, Technical University of Dresden, Dresden, Germany
| | - H K Schackert
- Medical Faculty, Department of Surgical Research, Technical University of Dresden, Dresden, Germany
| | - M Fussel
- DKMS, Life Science Lab GmbH, Dresden, Germany
| | - M Bachmann
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | - E P Rieber
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
| | - B Weigle
- Medical Faculty, Institute of Immunology, Technical University of Dresden, Dresden, Germany
- Eucodis GmbH, Vienna, Austria
- Eucodis GmbH, Brunner Strasse 59, 1230 Vienna, Austria; E-mail:
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Lass J, Hinrikus H, Bachmann M, Tuulik V. Microwave radiation has modulation frequency dependent stimulating effect on human EEG rhythms. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:4225-8. [PMID: 17271236 DOI: 10.1109/iembs.2004.1404178] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study is focused on low-level modulated microwave field effects on human EEG theta, alpha and beta rhythms at different modulation frequencies. During the experiment 13 healthy volunteers were exposed to a microwave (450 MHz) with 7 Hz, 14 Hz and 21 Hz frequency on-off modulation. The field power density at the scalp was 0.16 mW/cm(2). The experimental protocol consisted of five cycles of the repetitive microwave stimulation at fixed modulation frequencies. Changes in the EEG rhythms energy became evident in the case of modulation frequencies higher than the EEG rhythms frequencies. The changes varied strongly from subject to subject. Microwave exposure caused statistically significant changes in the EEG theta rhythm energy and for occipital channels in the alpha rhythm energy.
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Affiliation(s)
- J Lass
- Biomedical Engineering Centre, Tallinn University of Technology, Tallinn, Estonia
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Minocchieri S, Bachmann M, Burren J, Kaeser R, Wildhaber JH, Nelle M. In vitro determination of the optimal aerosol particle size for inhalation therapy in preterm infants. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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