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Knobloch C, Metzner M, Kehrein F, Schömers C, Scheloske S, Brons S, Hermann R, Peters A, Jäkel O, Martišíková M, Gehrke T. Experimental helium-beam radiography with a high-energy beam: Water-equivalent thickness calibration and first image-quality results. Med Phys 2022; 49:5347-5362. [PMID: 35670033 DOI: 10.1002/mp.15795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE A clinical implementation of ion-beam radiography (iRad) is envisaged to provide a method for on-couch verification of ion-beam treatment plans. The aim of this work is to introduce and evaluate a method for quantitative water-equivalent thickness (WET) measurements for a specific helium-ion imaging system for WETs that are relevant for imaging thicker body parts in the future. METHODS Helium-beam radiographs (αRads) are measured at the Heidelberg Ion-beam Therapy Center (HIT) with an initial beam energy of 239.5 MeV/ u. An imaging system based on three pairs of thin silicon pixel detectors is used for ion path reconstruction and measuring the energy deposition (dE) of each particle behind the object to be imaged. The dE behind homogeneous plastic blocks is related to their well-known WETs between 280.6mm and 312.6 mm with a calibration curve that is created by fitting the measured data points. The quality of the quantitative WET measurements is determined by the uncertainty of the measured WET of a single ion (single-ion WET precision) and the deviation of a measured WET value to the well-known WET (WET accuracy). Subsequently, the fitted calibration curve is applied to an energy deposition radiograph of a phantom with a complex geometry. The spatial resolution (modulation transfer function at 10% (MTF10% )) and WET accuracy (mean absolute percentage difference (MAPD)) of the WET map, are determined. RESULTS In the optimal imaging WET-range from ∼ 280 mm to 300 mm, the fitted calibration curve reached a mean single-ion WET precision of 1.55 ± 0.00%. Applying the calibration to an ion radiograph (iRad) of a more complex WET distribution, the spatial resolution was determined to be MTF10% = 0.49 ± 0.03 lp/mm and the WET accuracy was assessed as MAPD to 0.21%. CONCLUSIONS Using a beam energy of 239.5MeV/ u and the proposed calibration procedure, quantitative αRads of WETs between ∼ 280mm to 300 mm can be measured and show high potential for clinical use. The proposed approach with the resulting image qualities encourages further investigation towards the clinical application of helium-beam radiography. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- C Knobloch
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University, Department of Physics and Astronomy, Heidelberg, Germany
| | - M Metzner
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University, Department of Physics and Astronomy, Heidelberg, Germany
| | - F Kehrein
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University, Department of Physics and Astronomy, Heidelberg, Germany
| | - C Schömers
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - S Scheloske
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - S Brons
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - R Hermann
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany.,Goethe University Frankfurt, Institute of Applied Physics, Frankfurt, Germany
| | - A Peters
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - O Jäkel
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - M Martišíková
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - T Gehrke
- German Cancer Research Center (DKFZ), Department of Medical Physics in Radiation Oncology, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Heidelberg University Hospital, Department of Radiation Oncology, Heidelberg, Germany
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Hermann R, Acimov Z, Gavrilovs G, Klötzsch C. „Reversible splenial lesion syndrome“ (RESLES) nach einer mild verlaufenden SARS-CoV-2-Infektion. DGNeurologie 2021. [PMCID: PMC8475342 DOI: 10.1007/s42451-021-00378-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Daisley A, Hargreaves J, Hermann R, Poya Y, Wang Y. A comparison of the activities of various supported catalysts for ammonia synthesis. Catal Today 2020. [DOI: 10.1016/j.cattod.2019.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fieux M, Zaouche S, Philouze P, Truy E, Hermann R, Tringali S. Low-fidelity otoscopy simulation and anatomy training: A randomized controlled trial. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:231-234. [PMID: 33092986 DOI: 10.1016/j.anorl.2020.09.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate whether the use of low-fidelity otoscopy simulation improved medical students' theoretical knowledge of middle ear anatomy and pathologies compared to traditional teaching methods. METHODS This was a randomized controlled trial. Simulation workshops were conducted in April 2019 in the Lyon Sud University medical faculty, France. Students were randomly assigned to the simulation group (n=105) or to the control group (n=95). The students in the control group answered a questionnaire evaluating theoretical knowledge (25 true-false questions) before the simulation tutorial, while the students in the simulation group answered the same questions after the tutorial. Both groups also filled out a satisfaction questionnaire for feedback. RESULTS 196 of the 200 students who participated in the study completed the knowledge assessment questionnaire. Scores were 32.0% higher in the simulation group than in the control group (mean scores, 12.0/20 vs. 9.1/20; P<0.0001). 184 of the 191 students who completed the satisfaction questionnaire (96.3%) were satisfied or very satisfied with the workshop, and all but one (99.5%) recommended keeping it in the curriculum. In the free comments fields, students highlighted the educational value of learning without the stress of patient discomfort. CONCLUSION Otoscopy simulation is an effective training method, improving theoretical knowledge compared with conventional theoretical training.
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Affiliation(s)
- M Fieux
- Service d'otologie et otoneurologie, Hospices Civils de Lyon, centre hospitalier Lyon Sud, université de Lyon, université Claude Bernard Lyon 1, 69495 Pierre-Bénite, France.
| | - S Zaouche
- Service d'otologie et otoneurologie, Hospices Civils de Lyon, centre hospitalier Lyon Sud, université de Lyon, université Claude Bernard Lyon 1, 69495 Pierre-Bénite, France
| | - P Philouze
- Service d'ORL et chirurgie cervico faciale, Hospices Civils de Lyon, hôpital de la Croix Rousse, université de Lyon, université Claude Bernard Lyon 1, 69004 Lyon, France
| | - E Truy
- Service d'ORL, de chirurgie cervico faciale et d'audiophonologie, Hospices Civils de Lyon, hôpital Edouard Herriot, université de Lyon, université Claude Bernard Lyon 1, 69003 Lyon, France
| | - R Hermann
- Service d'ORL, de chirurgie cervico faciale et d'audiophonologie, Hospices Civils de Lyon, hôpital Edouard Herriot, université de Lyon, université Claude Bernard Lyon 1, 69003 Lyon, France
| | - S Tringali
- Service d'otologie et otoneurologie, Hospices Civils de Lyon, centre hospitalier Lyon Sud, université de Lyon, université Claude Bernard Lyon 1, 69495 Pierre-Bénite, France
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Hermann R, Coudert A, Aubry K, Bordure P, Bozorg-Grayeli A, Deguine O, Eyermann C, Franco-Vidal V, Godey B, Guevara N, Karkas A, Klopp N, Labrousse M, Lebreton JP, Lerosey Y, Lescanne E, Loundon N, Marianowski R, Merklen F, Mezouaghi K, Mom T, Moreau S, Mosnier I, Noël-Petroff N, Parietti-Winkler C, Piller P, Poncet C, Radafy E, Roman S, Roux-Vaillard S, Schmerber S, Tavernier L, Vincent C, Truy E. The French National Cochlear Implant Registry (EPIIC): Cochlear explantation and reimplantation. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137 Suppl 1:S45-S49. [PMID: 32826202 DOI: 10.1016/j.anorl.2020.07.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aims to determine the frequency and causes of cochlear explants with re-implantation (ERI) after 5 years' follow up of the patients included in the French national EPIIC (étude post-inscription des implants cochléaires) registry tracking patients with cochlear implantation. This multicenter, descriptive prospective study was conducted on 5051 patients enrolled in the EPIIC database between January 2012 and December 2016. Ninety-five patients (1.9%) received a primary implant and an ERI during the study. Of these, four benefitted from two ERIs. The number of ERIs was significantly higher in the pediatric population than among adults. The explantation and reimplantation were performed simultaneously in 86% of cases. The reasons for explantation were: in 46.4% of cases linked to a malfunction of the implant, and in 39.3% of cases for medical or surgical reasons. The number of electrodes inserted was significantly higher after the ERI than after the first implantation. There was just one post-ERI infection for these 95 explanted and re-implanted patients. As well as explantation with reimplantation rarely being necessary, it generally presents no major surgical difficulty and in most cases it allows a better integration than in the first implantation.
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Affiliation(s)
- R Hermann
- Otorhinolaryngology department and Head and Neck Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - A Coudert
- Otorhinolaryngology department and Head and Neck Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - K Aubry
- CHU de Limoges, Limoges, France
| | | | | | | | | | | | - B Godey
- CHU de Rennes, Rennes, France
| | | | - A Karkas
- CHU de St Etienne, Saint-Etienne, France
| | - N Klopp
- CHU d'Amiens, Amiens, France
| | | | | | | | | | | | | | - F Merklen
- CHU de Montpellier, Montpellier, France
| | | | - T Mom
- CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - I Mosnier
- Hôpital Pitié-Salpétrière, Paris, France
| | | | | | - P Piller
- CH de Nouméa, Nouméa, Nouvelle-Calédonie
| | - C Poncet
- Hôpital Rothschild, Paris, France
| | - E Radafy
- CH du Lamentin, Martinique, France
| | - S Roman
- CHU de Marseille, Marseille, France
| | | | | | | | | | - E Truy
- Otorhinolaryngology department and Head and Neck Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
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Fieux M, Mélan JB, Hermann R, Truy E, Tringali S. The medical uses of manosonic nebulizers (AMSA®) in 2018. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:73-76. [PMID: 32674996 DOI: 10.1016/j.anorl.2020.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIMS The purpose of repeated application of manosonic nebulizers (AMSA®) is to ensure active Eustachian tube rehabilitation and optimal middle-ear drug diffusion. In response to recent changes in marketing authorizations issued by the French National Drug Safety Agency (ANSM), the present study investigated how AMSA® is used in the Auvergne-Rhône-Alpes Region of France. MATERIAL AND METHODS A prospective non-interventional regional 1-year survey was conducted in 701 general practitioners and community and hospital ENT physicians in the Auvergne-Rhône-Alpes Region, using a questionnaire sent by mail with a reminder at 2 months. Percentage responses were compared on Chi2 test with alpha risk of 5%. Non-respondents were excluded. ENDPOINTS The main endpoints were rate of AMSA® prescription, and prescription modalities in a specific geographical territory (Auvergne-Rhône-Alpes Region) in 2018. RESULTS 93% of the 114 respondents prescribed AMSA®, with 4,000 prescriptions in 1 year. 66.7% prescribed this treatment to avoid recourse to myringotomy. Mean treatment duration was 2 weeks (50.9% of respondents). The most frequent nebulized substance was saline serum (68.4% of respondents), sometimes associated to corticosteroids or mucolytics. CONCLUSION The majority of physicians in the Auvergne-Rhône-Alpes Region, and notably the ENT physicians, were AMSA® prescribers for the treatment of Eustachian tube dysfunction and its consequences. However, the duration and modalities of use of AMSA® were very heterogeneous, and further studies are needed to standardize prescription.
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Affiliation(s)
- M Fieux
- Service d'Otologie et Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France.
| | - J-B Mélan
- Service d'Otologie et Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
| | - R Hermann
- Service ORL et Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon, Hôpital Edouard Herriot, Lyon, France
| | - E Truy
- Service ORL et Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon, Hôpital Edouard Herriot, Lyon, France
| | - S Tringali
- Service d'Otologie et Otoneurologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
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Hermann R, Farr B, Ji S, Schlieve T. A Novel Approach to Nerve Preservation during Segmental Resection of Mandible Utilizing Virtual Surgical Planning (VSP): A Case Series. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The vestibulo-ocular reflex maintains gaze stabilization during angular or linear head accelerations, allowing adequate dynamic visual acuity. In case of bilateral vestibular hypofunction, patients use saccades to compensate for the reduced vestibulo-ocular reflex function, with covert saccades occurring even during the head displacement. In this study, we questioned whether covert saccades help maintain dynamic visual acuity, and evaluated which characteristic of these saccades are the most relevant to improve visual function. We prospectively included 18 patients with chronic bilateral vestibular hypofunction. Subjects underwent evaluation of dynamic visual acuity in the horizontal plane as well as video recording of their head and eye positions during horizontal head impulse tests in both directions (36 ears tested). Frequency, latency, consistency of covert saccade initiation, and gain of covert saccades as well as residual vestibulo-ocular reflex gain were calculated. We found no correlation between residual vestibulo-ocular reflex gain and dynamic visual acuity. Dynamic visual acuity performance was however positively correlated with the frequency and gain of covert saccades and negatively correlated with covert saccade latency. There was no correlation between consistency of covert saccade initiation and dynamic visual acuity. Even though gaze stabilization in space during covert saccades might be of very short duration, these refixation saccades seem to improve vision in patients with bilateral vestibular hypofunction during angular head impulses. These findings emphasize the need for specific rehabilitation technics that favor the triggering of covert saccades. The physiological origin of covert saccades is discussed.
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Affiliation(s)
- R Hermann
- Hospices Civils de Lyon, ENT, Cervico-Facial Surgery and Audiophonology, Hôpital Edouard Herriot, Lyon, France
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, IMPACT Team, Lyon, France
- Lyon I University, Lyon, France
| | - D Pelisson
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, IMPACT Team, Lyon, France
- Lyon I University, Lyon, France
| | - O Dumas
- French Vestibular Rehabilitation Society, Lyon, France
| | - Ch Urquizar
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, IMPACT Team, Lyon, France
| | - E Truy
- Hospices Civils de Lyon, ENT, Cervico-Facial Surgery and Audiophonology, Hôpital Edouard Herriot, Lyon, France
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, IMPACT Team, Lyon, France
- Lyon I University, Lyon, France
| | - C Tilikete
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, IMPACT Team, Lyon, France.
- Lyon I University, Lyon, France.
- Hospices Civils de Lyon, Neuro-Ophthalmology Unit, Hopital Neurologique et Neurochirurgical P Wertheimer, Lyon, France.
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Rouault M, Coudert A, Hermann R, Gillet Y, Truy E, Ayari-Khalfallah S. Otorhinolaryngological manifestations and delayed diagnosis in Kawasaki disease. Int J Pediatr Otorhinolaryngol 2019; 121:137-142. [PMID: 30903929 DOI: 10.1016/j.ijporl.2019.02.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Kawasaki disease (KD) is a febrile multisystemic vasculitis of unknown etiology whose coronary prognosis is improved by early diagnosis and management. The objective of this study was to describe ENT manifestations encountered and to look for a delayed diagnosis associated with these manifestations. METHODS A retrospective descriptive single-center study was conducted in Lyon between January 2009 and December 2017. All children treated for Kawasaki disease were included in the study. Clinical, biological and cardiac ultrasound data were collected. According to the diagnosis made at the first medical visit, children were classified into two groups: diagnosis of ENT spectrum or non-ENT diagnosis. The diagnostic times were compared by a Student test. RESULTS 142 patients were included: 64 in the ENT diagnostic group, 78 in the non-ENT diagnostic group. When the initial diagnosis was of ENT spectrum, the diagnostic time of KD was significantly longer: 8.51 days vs 5.77 days - (p < 0.01). The total duration of fever was also longer - 10.92 vs 8.32 days - (p = 0.013) - and the frequency of antibiotics intake more important - 92.2% vs 46.2% - (p < 0.01). Four children underwent surgery in the ENT diagnostic group: two retro-pharyngeal abscesses, one paracentesis and one cervicectomy. CONCLUSIONS ENT manifestations are frequently at the forefront of KD and constitute a misleading clinical picture responsible for delayed diagnosis and potentially inappropriate medico-surgical management. It is necessary to provide more education to practitioners for earlier recognition of Kawasaki disease.
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Affiliation(s)
- M Rouault
- Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Centre Hospitalier et Universitaire, Lyon, France; Université de Lyon, Lyon, France.
| | - A Coudert
- Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Centre Hospitalier et Universitaire, Lyon, France; Université de Lyon, Lyon, France
| | - R Hermann
- Service d'ORL, Hôpital Edouard Herriot, Centre Hospitalier et Universitaire, Lyon, France; Université de Lyon, Lyon, France
| | - Y Gillet
- Service d'urgences Pédiatriques, Hôpital Femme Mère Enfants, Centre Hospitalier et Universitaire, Lyon, France
| | - E Truy
- Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Centre Hospitalier et Universitaire, Lyon, France; Service d'ORL, Hôpital Edouard Herriot, Centre Hospitalier et Universitaire, Lyon, France; Université de Lyon, Lyon, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, IMPACT Team, Lyon, France
| | - S Ayari-Khalfallah
- Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Centre Hospitalier et Universitaire, Lyon, France; Service d'ORL, Hôpital Edouard Herriot, Centre Hospitalier et Universitaire, Lyon, France
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Hermann R, Lescanne E, Loundon N, Barone P, Belmin J, Blanchet C, Borel S, Charpiot A, Coez A, Deguine O, Farinetti A, Godey B, Lazard D, Marx M, Mosnier I, Nguyen Y, Teissier N, Virole M, Roman S, Truy E. French Society of ENT (SFORL) guidelines. Indications for cochlear implantation in adults. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:193-197. [DOI: 10.1016/j.anorl.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Misra N, Wines TF, Knopp CL, Hermann R, Bond L, Mitchell B, McGuire MA, Tinker JK. Immunogenicity of a Staphylococcus aureus-cholera toxin A 2/B vaccine for bovine mastitis. Vaccine 2018; 36:3513-3521. [PMID: 29739718 DOI: 10.1016/j.vaccine.2018.04.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 04/09/2018] [Accepted: 04/22/2018] [Indexed: 01/10/2023]
Abstract
Staphylococcus aureus causes a chronic, contagious disease of the udder, or mastitis, in dairy cows. This infection is often refractory to antibiotic treatment, and has a significant economic impact on milk production worldwide. An effective vaccine to prevent S. aureus mastitis would improve animal health, reduce antibiotic dependence and inform human vaccine approaches. The iron-regulated surface determinant A (IsdA) and clumping factor A (ClfA) are conserved S. aureus extracellular-matrix adhesins and target vaccine antigens. Here we report the results of two bovine immunogenicity trials using purified IsdA and ClfA-cholera toxin A2/B chimeras (IsdA-CTA2/B and ClfA-CTA2/B). Cows were intranasally inoculated with IsdA-CTA2/B + ClfA-CTA2/B at dry off and followed for 70 days. Trial 1 utilized three groups with one or two booster doses at a total concentration of 600 or 900 μg. Trial 2 utilized two groups with one booster at a total concentration of 1200 μg. Humoral immune responses in serum and milk were examined by ELISA. Responses in serum were significant between groups and provide evidence of antigen-specific IgG induction after vaccination in both trials. Cellular proliferation was detected by flow cytometry using antigen-stimulated PBMCs from day 60 of Trial 2 and revealed an increase in CD4+ T cells from vaccinated cows. IsdA and ClfA stimulation induced IL-4 expression, but not IFN-γ or IL-17, in PBMCs from day 60 as determined by cytokine expression analysis. Opsonophagocytosis of S. aureus confirmed the functional in vitro activity of anti-IsdA antibodies from Trial 2 serum and milk. The vaccine was well tolerated and safe, and results support the potential of mucosally-delivered CTA2/B chimeras to protect cows from mastitis caused by S. aureus.
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Affiliation(s)
- N Misra
- Biomolecular Ph.D. Program, Boise State University, Boise, ID, USA
| | - T F Wines
- Department of Biological Sciences, Boise State University, Boise, ID, USA
| | - C L Knopp
- Department of Biological Sciences, Boise State University, Boise, ID, USA
| | - R Hermann
- Department of Biological Sciences, Boise State University, Boise, ID, USA; Biomolecular Ph.D. Program, Boise State University, Boise, ID, USA
| | - L Bond
- Biomolecular Research Center, Boise State University, Boise, ID, USA
| | - B Mitchell
- DairyTeam Nutrition and Veterinary Consulting, Boise, ID, USA
| | - M A McGuire
- Department of Animal and Veterinary Science, University of Idaho, Moscow, ID, USA
| | - J K Tinker
- Department of Biological Sciences, Boise State University, Boise, ID, USA; Biomolecular Ph.D. Program, Boise State University, Boise, ID, USA.
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Jouan R, Picot E, Hermann R, Faure F, Marchal F. Sialendoscopy for sialolithiasis in children: 4-8 years follow up. Br J Oral Maxillofac Surg 2018; 56:120-123. [PMID: 29373144 DOI: 10.1016/j.bjoms.2017.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/08/2017] [Indexed: 01/22/2023]
Abstract
Sialolithiasis is rare in children, there are no guidelines for its treatment, and there are few, if any, long term follow-up studies. We report a retrospective review of medical records of children who were treated for sialolithiasis by sialendoscopy between 1 January 2007 and 31 December 2011, and who have been followed up for 4-8 years. Personal and clinical details, including age, sex, symptoms, whether the lithiasis was parotid or submandibular, the technique of sialendoscopy and complications, were recorded. Twenty-six children (30 sides) were successfully treated by sialendoscopy between 2007 and 2011 (mean (range) age 12 (3-17) years). Stones were removed from the parotid gland in four patients and the submandibular gland in 22. The main indication for sialendoscopy was swelling of the salivary gland during meals. Twenty-six procedures were done endoscopically. Twelve were treated with a wire basket alone, 10 by the combined approach, and laser was used in eight. Four patients developed complications, but without long-term effects. During follow-up of 4-8 years there were no recurrent swellings. We conclude that endoscopic treatment of stones in childhood is an efficient and conservative option for salivary glands, has few complications and no clinical recurrence at medium to long-term follow-up.
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Affiliation(s)
- R Jouan
- Oral and Maxillofacial Surgery Department, Hospices Civils de Lyon, France.
| | - E Picot
- Oral and Maxillofacial Surgery Department, Hospices Civils de Lyon, France
| | - R Hermann
- Otorhinolaryngology, Head and Neck Surgery Department, Hospices Civils de Lyon, France
| | - F Faure
- Otorhinolaryngology, Head and Neck Surgery Department, Hospices Civils de Lyon, France; ENT Department, Infirmerie Protestante, Caluire, France
| | - F Marchal
- Department of Otolaryngology, Head and Neck Surgery, University Hospital, Geneva, Switzerland
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Coudert A, Van HT, Ayari-Khalfallah S, Hermann R, Lina-Granade G, Truy E, Ionescu E. Vestibular Assessment in Cochlear Implanted Children: How to Do? When to Do? A Review of Literature. Curr Otorhinolaryngol Rep 2017. [DOI: 10.1007/s40136-017-0172-2] [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: 10/18/2022]
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15
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Brinkmann C, Hermann R, Rühl E, Kerzel H, Reinhardt L, Grau M, Latsch J, Kohl-Bareis M, Bloch W, Brixius K. Effects of Wearing Compression Stockings on the Physical Performance of T2DM Men with MetS. Int J Sports Med 2016; 37:347-53. [PMID: 26859644 DOI: 10.1055/s-0035-1565202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are associated with macro- and microcirculatory complications that reduce physical performance. Wearing compression garments to potentially optimize hemodynamics has been discussed. This study investigates the effects of wearing compression stockings on physical performance-related variables in type 2 diabetic men with metabolic syndrome (n=9, 57±12 years, BMI: 36±4 kg/m(2)). Participants served as their own controls in a randomized 3*3 crossover study wearing below-knee stockings with either compression (24 or 30 mmHg ankle pressure) or no compression. Venous pooling and lower limb oxygenation profiles were determined with near-infrared spectroscopy and arterial oxygen saturation was determined using a pulse oxymeter. Measurements were performed in the supine lying position, during standing, following 10 tiptoe exercises and after submaximal intensity cycling. In addition, lactate and erythrocyte deformability were analyzed in capillary blood pre- and post-exercise. Erythrocyte deformability was analyzed using a laser-assisted optical rotational red cell analyzer. No significant differences in any variables when wearing different compression or regular stockings were evident at any point of measurement. This study did not reveal any beneficial effects of wearing compression stockings at rest and during acute bouts of moderately intense exercise in this particular patient group.
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Affiliation(s)
- C Brinkmann
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - R Hermann
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - E Rühl
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - H Kerzel
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - L Reinhardt
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - M Grau
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - J Latsch
- Department of Preventive and Rehabilitative Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - M Kohl-Bareis
- RheinAhrCampus, University of Applied Sciences Koblenz, Remagen, Germany
| | - W Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - K Brixius
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
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Kahnt A, Flyunt R, Naumov S, Knolle W, Eigler S, Hermann R, Abel B. Shedding light on the soft and efficient free radical induced reduction of graphene oxide: hidden mechanisms and energetics. RSC Adv 2016. [DOI: 10.1039/c6ra13085b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Reduction of graphene oxide in aqueous dispersions by strongly reducing free radicals has been found to be a very powerful approach – functional groups are removed softly but efficiently, and non-volatile impurities as well as defects are avoided.
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Affiliation(s)
- A. Kahnt
- Department of Chemistry and Pharmacy
- Chair of Physical Chemistry I
- Friedrich-Alexander-Universität Erlangen-Nürnberg
- 91058 Erlangen
- Germany
| | - R. Flyunt
- Leibniz Institute of Surface Modification (IOM)
- Chemical Department
- 04303 Leipzig
- Germany
| | - S. Naumov
- Leibniz Institute of Surface Modification (IOM)
- Chemical Department
- 04303 Leipzig
- Germany
| | - W. Knolle
- Leibniz Institute of Surface Modification (IOM)
- Chemical Department
- 04303 Leipzig
- Germany
| | - S. Eigler
- Department of Chemistry and Pharmacy
- Institute of Advanced Materials and Processes (ZMP)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
- 91054 Erlangen
- Germany
| | - R. Hermann
- Wilhelm-Ostwald-Institute for Physical and Theoretical Chemistry
- Universität Leipzig
- 04103 Leipzig
- Germany
| | - B. Abel
- Leibniz Institute of Surface Modification (IOM)
- Chemical Department
- 04303 Leipzig
- Germany
- Wilhelm-Ostwald-Institute for Physical and Theoretical Chemistry
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Aydin M, Schmitz C, Hermann R, Wingels C, Miao Y, Brixius K. Über den Einfluss von Exergames auf die Herz-Kreislauffunktion bei übergewichtigen insulinpflichtigen Typ-2-Diabetikern. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chalmers ZR, Ali SM, Ohgami RS, Campregher PV, Frampton GM, Yelensky R, Elvin JA, Palma NA, Erlich R, Vergilio JA, Chmielecki J, Ross JS, Stephens PJ, Hermann R, Miller VA, Miles CR. Comprehensive genomic profiling identifies a novel TNKS2-PDGFRA fusion that defines a myeloid neoplasm with eosinophilia that responded dramatically to imatinib therapy. Blood Cancer J 2015; 5:e278. [PMID: 25658984 PMCID: PMC4349257 DOI: 10.1038/bcj.2014.95] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
| | - S M Ali
- Foundation Medicine Inc., Cambridge, MA, USA
| | - R S Ohgami
- Department of Pathology, Stanford School of Medicine, Stanford, CA, USA
| | - P V Campregher
- 1] Foundation Medicine Inc., Cambridge, MA, USA [2] Clinical Laboratory, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | | | - R Yelensky
- Foundation Medicine Inc., Cambridge, MA, USA
| | - J A Elvin
- Foundation Medicine Inc., Cambridge, MA, USA
| | - N A Palma
- Foundation Medicine Inc., Cambridge, MA, USA
| | - R Erlich
- Foundation Medicine Inc., Cambridge, MA, USA
| | - J-A Vergilio
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | | | - J S Ross
- 1] Foundation Medicine Inc., Cambridge, MA, USA [2] Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | | | - R Hermann
- Northwest Georgia Oncology Centers, Jasper Cancer Center, Jasper, GA, USA
| | - V A Miller
- Foundation Medicine Inc., Cambridge, MA, USA
| | - C R Miles
- Northwest Georgia Oncology Centers, Jasper Cancer Center, Jasper, GA, USA
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Opitz D, Lenzen E, Schiffer T, Hermann R, Hellmich M, Bloch W, Brixius K, Brinkmann C. Endurance training alters skeletal muscle MCT contents in T2DM men. Int J Sports Med 2014; 35:1065-71. [PMID: 25009968 DOI: 10.1055/s-0034-1371838] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Patients suffering from type 2 diabetes mellitus (T2DM) often exhibit chronic elevated lactate levels which can promote peripheral insulin resistance by disturbing skeletal muscle insulin-signaling. Monocarboxylate transporter (MCT) proteins transfer lactate molecules through cellular membranes. MCT-1 and MCT-4 are the main protein isoforms expressed in human skeletal muscle, with MCT-1 showing a higher affinity (lower Km) for lactate than MCT-4. T2DM patients have reduced membranous MCT-1 proteins. Consequently, the lactate transport between muscle cells and the circulation as well as within an intracellular lactate shuttle, involving mitochondria (where lactate can be further metabolized), can be negatively affected. This study investigates whether moderate cycling endurance training (3 times per week for 3 months) can change skele-tal muscle MCT contents in T2DM men (n=8, years=56±9, body mass index (BMI)=32±4 kg/m(2)). Protein content analyses (immuno-histochemical stainings) were performed in bio-psies taken from the vastus lateralis muscle. Intracellular MCT-1 proteins were up-regulated (relative increase+89%), while intracellular MCT-4 contents were down-regulated (relative decrease - 41%) following endurance training. Sarcolemmal MCT-1 and MCT-4 did not change. The question of whether the training-induced up-regulation of intracellular MCT-1 leads to an improved lactate transport (and clearance) in T2DM patients requires further research.
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Affiliation(s)
- D Opitz
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - E Lenzen
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - T Schiffer
- Outpatient Clinic for Sports Traumatology and Public Health Consultation, German Sport University Cologne, Cologne, Germany
| | - R Hermann
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - M Hellmich
- University of Cologne, Institute of Medical Statistics, Informatics and Epidemiology, Cologne, Germany
| | - W Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - K Brixius
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - C Brinkmann
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
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Hermann R, Wingels C, Bloch W, Brixius K, Brinkmann C. Computerspielkonsolen-unterstütztes Training verbessert die Gleichgewichtsfähigkeit bei Diabetes-Patienten. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375080] [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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Brinkmann C, Hermann R, Bloch W, Brixius K. Antioxidative Kapazität und Typ-2-Diabetes – Einfluss körperlicher Aktivität auf Peroxiredoxine. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374960] [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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22
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Derendorf H, Meltzer EO, Hermann R, Canonica GW. Clinical development of an advanced intranasal delivery system of azelastine hydrochloride and fluticasone propionate. Drugs Today (Barc) 2014; 50:15-31. [PMID: 24524103 DOI: 10.1358/dot.2014.50.1.2094806] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is no shortage of pharmacologic treatments available for the management of allergic rhinitis (AR), but none regularly provide full relief from all symptoms. MP29-02 (Dymista®) is a novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP), benefiting from an enhanced formulation and improved device characteristics compared to marketed intranasal corticosteroid (INS) formulations. Results from large, randomized, double-blind, placebo-controlled, head-to-head trials versus first-line therapies, confirmed MP29-02 as the evidence-based drug-of-choice for AR treatment. MP29-02 was twice as effective as AZE or FP for nasal and ocular symptom relief in moderate to severe seasonal AR patients, with superiority documented regardless of season, and in more severe patients. More MP29-02-treated patients experienced clinically relevant responses (i.e., halving of nasal symptom burden and complete/near-to-complete relief) days faster than those on INS or intranasal antihistamine monotherapy. MP29-02's efficacy was sustained long-term versus FP (up to 52 weeks) in chronic rhinitis patients (perennial AR or nonallergic rhinitis), with 7 out of 10 patients first becoming symptom-free following 1 month's treatment with MP29-02, and days faster than with the INS. These results confirm MP29-02's superiority over the historical gold-standard therapy for AR (i.e., INS), and position it now as first-line treatment for moderate to severe AR patients, the majority of whom are uncontrolled on existing medications.
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Affiliation(s)
- H Derendorf
- College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, California, USA
| | - R Hermann
- Clinical Research Appliance, Gelnhausen, Germany
| | - G W Canonica
- University of Genova, IRCCS AOU S. Martino, Genoa, Italy.
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Hermann R, Rau M, Marx C, Wolf G. [Arterial hypertension: guideline acceptance and implementation in workaday life of internists and general practitioners in Thuringia]. Dtsch Med Wochenschr 2013; 138:1347-52. [PMID: 23761056 DOI: 10.1055/s-0033-1343227] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Although evidence-based medical guidelines are widely accepted it is not clear how they are implemented in daily clinical work. The aim of this study was a Thuringia-wide analysis of hypertension diagnosis and treatment in clinical practice of internists and general practitioners, combined with the evaluation of guideline implementation. METHODS 1884 Thuringian internists and general practitioners were interviewed using a postally delivered, validated questionnaire to assess knowledge and implementation of the hypertension guidelines. RESULTS 33,4 % of the physicians participated in our survey (433 general practitioners, 197 internists). 98 % of the participants routinely treat hypertension. Internists reported significantly more frequently to treat patients with resistance to antihypertensive therapy. Compared with older physicians and general practitioners, internists were significantly more likely to initiate diagnostic procedures for secondary hypertension according to the guidelines. Long-term measurement of arterial blood pressure in patients with more than three antihypertensive drugs and in cases of suspected endorgan damage or sleep apnea syndrome was more frequently applied by internists. 82,1 % of the participants reported to prescribe nonpharmacological therapies because of their efficacy. ACE-inhibitors (41,6 %) and beta-blockers (34,6 %) were preferred for monotherapy of hypertension without risk factors. ACE-inhibitors (80,1 %), followed by angiotensin receptor antagonists (12,1 %), were primarily selected in hypertensive patients with diabetic nephropathy. In left-ventricular hypertrophy, ACE inhibitors were favoured, too (67%). CONCLUSION This survey indicates that in clinical practice doctors treat hypertensives according to official guidelines. However, there is a need for further education especially regarding indication of long-term measurement of arterial blood pressure. Continued education related to diagnosis and treatment of arterial hypertension and implementation of guidelines remains a permanent challenge for doctors.
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Affiliation(s)
- R Hermann
- Klinik für Innere Medizin III, Universitätsklinikum Jena
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Hermann R, Eghbalzadeh K, Wiesehöfer M, Brinkmann C, Bloch W, Schiffer T, Ladage D, Brixius K. Influence of exercise training on eNOS amount and phosphorylation in skeletal muscle of non-insulin dependent typ-2-diabetic men. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341748] [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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Stegemann S, Kopp S, Borchard G, Shah V, Senel S, Dubey R, Urbanetz N, Cittero M, Schoubben A, Hippchen C, Cade D, Fuglsang A, Morais J, Borgström L, Farshi F, Seyfang KH, Hermann R, van de Putte A, Klebovich I, Hincal A. Developing and advancing dry powder inhalation towards enhanced therapeutics. Eur J Pharm Sci 2013; 48:181-94. [DOI: 10.1016/j.ejps.2012.10.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 10/22/2012] [Accepted: 10/26/2012] [Indexed: 01/04/2023]
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Schwartzberg LS, Tauer KW, Schnell FM, Hermann R, Rubin P, Christianson D, Weinstein P, Epperson A, Walker M. Abstract P5-20-08: Phase II trial of ixabepilone (Ixa) and dasatinib (D) for treatment of metastatic breast cancer (MBC). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p5-20-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Ixa is a novel semi-synthetic epothilone microtubule blocking agent with activity in taxane and anthracycline-resistant MBC. D is a potent small molecule tyrosine kinase inhibitor with substantial activity against SRC family non-receptor kinases, known to play multiple roles in promoting tumor growth and metastases. D inhibits cellular SRC autophosphorylation in cell lines that highly express SRC and inhibits in vivo activation in a broad array of tumors in nude mice. Ixa and D have synergistic effects in preclinical models suggesting this strategy would be of clinical benefit as combination therapy. A phase I trial of the combination determined the maximally tolerated doses of ixabepilone at 20 mg/m2 weekly and dasatinib 100 mg po daily with objective responses seen. Neutropenia was the dose limiting toxicity.
Methods: Multicenter single arm phase II trial. Eligibility: Measurable or evaluable disease by RECIST 1.0, ECOG PS 0–2, HER2− or HER2 refractory, no CYP 3A4 inducers or inhibitors, no H2 blockers or PPIs, no pleural/pericardial effusion, exposure to 1 or 2 prior lines of chemotherapy in the metastatic setting, peripheral neuropathy ≤ grade 1. The primary endpoint was progression-free survival (PFS). Assessment for response was performed every 8 weeks. The treatment schedule was D at 100 mg po daily starting day 1, and Ixa 20 mg/m2 Day 1, 8, 15 every 28 days (1 cycle).
Results: The study met its accrual goal with 50 patients (pts) enrolled on the phase II dosing, including six from the phase I portion. As of May 21, 2012, 47 pts are evaluable. The median age was 55 (range, 34–70), 19 African-American, 46 ECOG PS 0–1, median number of metastatic sites, three. Forty pts had prior taxanes, 24 prior anthracyclines. Median PFS was 6.0 months (95% CI, 2.9–8.0), achieving pre-specified value of interest for further study of the combination. The overall unconfirmed response rate was 14.9% with a clinical benefit rate (CR+PR + stable at 24 weeks) of 25.5%. Six pts continued D monotherapy after eight cycles of Ixa + D. All-grade adverse events (AEs) occurring in >15% of pts included anemia (45%), neutropenia (32%), nausea (51%), vomiting (32%) diarrhea (51%), fatigue (53%), anorexia (25%) dysgeusia (32%), headache (28%), peripheral neuropathy (34%) cough (28%) alopecia (21%) and hypokalemia (19%). Grade 3/4 adverse events occurred in 30 patients, with only four experiencing grade 4 AEs, three neutropenia and one chest pain. No grade 3/4 febrile neutropenia occurred. Grade 3 AEs of interest included two pts with peripheral neuropathy and 1 with pleural effusion.
Conclusions: The combination of Ixabepilone weekly + Dasatinib orally daily is an active and well tolerated regimen in pretreated MBC with manageable toxicity. Updated results will be reported.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-20-08.
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Affiliation(s)
- LS Schwartzberg
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - KW Tauer
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - FM Schnell
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - R Hermann
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - P Rubin
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - D Christianson
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - P Weinstein
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - A Epperson
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
| | - M Walker
- The West Clinic, Memphis, TN; Central Georgia Cancer Care, Macon, GA; Northwest Georgia Oncology Centers, Marietta, GA; Cone Health Cancer Center, Greensboro, NC; Hematology Oncology Centers of the Northern Rockies, Billings, MT; Hematology Oncology PC, Stamford, CT; ACORN Research, LLC, Memphis, TN
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Hermann R, Marina Prendes MG, Torresin ME, Vélez D, Savino EA, Varela A. Effects of the AMP-activated protein kinase inhibitor compound C on the postconditioned rat heart. J Physiol Sci 2012; 62:333-41. [PMID: 22614393 PMCID: PMC10717064 DOI: 10.1007/s12576-012-0209-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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: 02/27/2012] [Accepted: 05/03/2012] [Indexed: 12/27/2022]
Abstract
Ischemic postconditioning (IPOC) protects the myocardium from ischemic-reperfusion injury, improving functional recovery and cell viability. This protection is concurrent with stimulation of glycogen breakdown, increased mitochondrial ATP synthesis and content, maintenance of reduced-to-oxidized glutathione ratio (GSH/GSSG), and decreased oxidative damage. The present study's objective was to assess whether these effects are associated with increased resistance to mitochondrial permeability transition pore (MPTP) opening. The effects of the AMP-activated protein kinase (AMPK) inhibitor, compound C (CC), were measured to investigate association with AMPK. Mitochondria removed from postconditioned hearts required higher calcium levels to induce MPTP opening. Improved functional recovery, increased glycogen mobilization, maintenance of the GSH/GSSG ratio, decreased oxidative damage, and increased resistance to MPTP opening were abrogated when the hearts were postconditioned in the presence of CC, without affecting preservation of cell viability. Although AMPK appears to play a role in IPOC, it would not be the major cellular mediator.
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Affiliation(s)
- R. Hermann
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, Universidad de Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - M. G. Marina Prendes
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, Universidad de Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - M. E. Torresin
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, Universidad de Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - D. Vélez
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, Universidad de Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - E. A. Savino
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, Universidad de Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - A. Varela
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, Universidad de Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
- Cátedra de Fisiología, Facultad de Farmacia y Bioquímica, School of Pharmacy and Biochemistry, Universidad de Buenos Aires, Junín 956, C1113AAD Buenos Aires, Argentina
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Marina Prendes MG, Hermann R, Torresin ME, Souto P, Tallis S, Savino EA, Varela A. Involvement of energetic metabolism in the effects of ischemic postconditioning on the ischemic-reperfused heart of fed and fasted rats. J Physiol Sci 2011; 61:303-12. [PMID: 21547611 PMCID: PMC10717561 DOI: 10.1007/s12576-011-0152-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/26/2010] [Accepted: 04/08/2011] [Indexed: 01/20/2023]
Abstract
The effects of ischemic-postconditioning (IPOC) on functional recovery and cell viability of ischemic-reperfused hearts from fed and fasted rats were studied in relation to triacylglycerol and glycogen mobilization, ATP content, glucose-6-phosphate dehydrogenase activity and reduced/oxidized glutathione (GSH/GSSG). Oxidative damage was estimated by measuring thiobarbituric acid reactive substances (TBARS). IPOC improved contractile recovery and cell viability in the fed but attenuated them in the fasted hearts. In both groups ischemia lowered glycogen. IPOC further reduced it. Triacylglycerol remained unchanged during ischemia-reperfusion in both groups, but triacylglycerol mobilization was activated by IPOC in the fasted group. ATP was increased by IPOC in the fed hearts, but lowered in the fasted ones, which appeared to be associated with the rates of ATP synthesis in isolated mitochondria. In the fed hearts IPOC raised glucose-6-phosphate dehydrogenase activity and GSH/GSSG, and lowered TBARS. These results suggest that IPOC effects are associated with changes in the ATP supply, mobilization of energy sources and glutathione antioxidant ratio.
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Affiliation(s)
- M. G. Marina Prendes
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - R. Hermann
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - M. E. Torresin
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - P. Souto
- Physiopathology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - S. Tallis
- Physiopathology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - E. A. Savino
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - A. Varela
- Physiology Unit, Department of Biological Sciences, School of Pharmacy and Biochemistry, University of Buenos Aires and IQUIMEFA-CONICET, Buenos Aires, Argentina
- Cátedra de Fisiología, Facultad de Farmacia y Bioquímica, University of Buenos Aires, Junín 956, 1113 Buenos Aires, Argentina
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Zervou S, Wang YF, Laiho A, Gyenesei A, Kytömäki L, Hermann R, Abouna S, Epstein D, Pelengaris S, Khan M. Short-term hyperglycaemia causes non-reversible changes in arterial gene expression in a fully 'switchable' in vivo mouse model of diabetes. Diabetologia 2010; 53:2676-87. [PMID: 20844862 DOI: 10.1007/s00125-010-1887-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 08/02/2010] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Irreversible arterial damage due to early effects of hypo- or hyperglycaemia could account for the limited success of glucose-lowering treatments in preventing cardiovascular disease (CVD) events. We hypothesised that even brief hypo- or hyperglycaemia could adversely affect arterial gene expression and that these changes, moreover, might not be fully reversible. METHODS By controlled activation of a 'switchable' c-Myc transgene in beta cells, adult pIns-c-MycER(TAM) mice were rendered transiently hypo- and then hyperglycaemic, after which they were allowed to recover for up to 3 months. Immediate and sequential changes in aortic global gene expression from normal glycaemia through hypo- and hyperglycaemia to recovery were assessed. RESULTS Gene expression was compared with that of normoglycaemic transgenic and tamoxifen-treated wild-type controls. Overall, expression of 95 genes was significantly affected by moderate hypoglycaemia (glucose down to 2.5 mmol/l), whereas over 769 genes were affected by hyperglycaemia. Genes and pathways activated included several involved in atherogenic processes, such as inflammation and arterial calcification. Although expression of many genes recovered to initial pre-exposure levels when hyperglycaemia was corrected (74.9%), in one in four genes this did not occur. Quantitative reverse transcriptase PCR and immunohistochemistry verified the gene expression patterns of key molecules, as shown by global gene arrays. CONCLUSIONS/INTERPRETATION Short-term exposure to hyperglycaemia can cause deleterious and persistent changes in arterial gene expression in vivo. Brief hypoglycaemia also adversely affects gene expression, although less substantially. Together, these results suggest that early correction of hyperglycaemia and avoidance of hypoglycaemia may both be necessary to avoid excess CVD risk in diabetes.
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MESH Headings
- Animals
- Arteries/metabolism
- Arteries/pathology
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Disease Models, Animal
- Female
- Gene Expression/drug effects
- Genes, myc/genetics
- Genes, myc/physiology
- Glucose/pharmacology
- Hyperglycemia/etiology
- Hyperglycemia/genetics
- Hyperglycemia/metabolism
- Hyperglycemia/pathology
- Insulin/genetics
- Mice
- Mice, Inbred C57BL
- Mice, Inbred CBA
- Mice, Transgenic
- Recovery of Function/genetics
- Time Factors
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Affiliation(s)
- S Zervou
- Department of Cardiovascular Medicine, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
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Alekseev MG, Alexakhin VY, Alexandrov Y, Alexeev GD, Amoroso A, Austregesilo A, Badełek B, Balestra F, Ball J, Barth J, Baum G, Bedfer Y, Bernhard J, Bertini R, Bettinelli M, Birsa R, Bisplinghoff J, Bordalo P, Bradamante F, Bravar A, Bressan A, Brona G, Burtin E, Bussa MP, Chapiro A, Chiosso M, Chung SU, Cicuttin A, Colantoni M, Crespo ML, Dalla Torre S, Dafni T, Das S, Dasgupta SS, Denisov OY, Dhara L, Diaz V, Dinkelbach AM, Donskov SV, Doshita N, Duic V, Dünnweber W, Efremov A, El Alaoui A, Eversheim PD, Eyrich W, Faessler M, Ferrero A, Finger M, Finger M, Fischer H, Franco C, Friedrich JM, Garfagnini R, Gautheron F, Gavrichtchouk OP, Gazda R, Gerassimov S, Geyer R, Giorgi M, Gobbo B, Goertz S, Grabmüller S, Grajek OA, Grasso A, Grube B, Gushterski R, Guskov A, Haas F, von Harrach D, Hasegawa T, Heckmann J, Heinsius FH, Hermann R, Herrmann F, Hess C, Hinterberger F, Horikawa N, Höppner C, d'Hose N, Ilgner C, Ishimoto S, Ivanov O, Ivanshin Y, Iwata T, Jahn R, Jasinski P, Jegou G, Joosten R, Kabuss E, Kang D, Ketzer B, Khaustov GV, Khokhlov YA, Kisselev Y, Klein F, Klimaszewski K, Koblitz S, Koivuniemi JH, Kolosov VN, Komissarov EV, Kondo K, Königsmann K, Konopka R, Konorov I, Konstantinov VF, Korzenev A, Kotzinian AM, Kouznetsov O, Kowalik K, Krämer M, Kral A, Kroumchtein ZV, Kuhn R, Kunne F, Kurek K, Lauser L, Le Goff JM, Lednev AA, Lehmann A, Levorato S, Lichtenstadt J, Liska T, Maggiora A, Maggiora M, Magnon A, Mallot GK, Mann A, Marchand C, Marroncle J, Martin A, Marzec J, Massmann F, Matsuda T, Maximov AN, Meyer W, Michigami T, Mikhailov YV, Moinester MA, Mutter A, Nagaytsev A, Nagel T, Nassalski J, Negrini T, Nerling F, Neubert S, Neyret D, Nikolaenko VI, Olshevsky AG, Ostrick M, Padee A, Panknin R, Panzieri D, Parsamyan B, Paul S, Pawlukiewicz-Kaminska B, Perevalova E, Pesaro G, Peshekhonov DV, Piragino G, Platchkov S, Pochodzalla J, Polak J, Polyakov VA, Pontecorvo G, Pretz J, Quintans C, Rajotte JF, Ramos S, Rapatsky V, Reicherz G, Reggiani D, Richter A, Robinet F, Rocco E, Rondio E, Ryabchikov DI, Samoylenko VD, Sandacz A, Santos H, Sapozhnikov MG, Sarkar S, Savin IA, Sbrizzai G, Schiavon P, Schill C, Schlüter T, Schmitt L, Schopferer S, Schröder W, Shevchenko OY, Siebert HW, Silva L, Sinha L, Sissakian AN, Slunecka M, Smirnov GI, Sosio S, Sozzi F, Srnka A, Stolarski M, Sulc M, Sulej R, Takekawa S, Tessaro S, Tessarotto F, Teufel A, Tkatchev LG, Uhl S, Uman I, Venugopal G, Virius M, Vlassov NV, Vossen A, Weitzel Q, Windmolders R, Wiślicki W, Wollny H, Zaremba K, Zavertyaev M, Zemlyanichkina E, Ziembicki M, Zhao J, Zhuravlev N, Zvyagin A. Observation of a J(PC)=1-+ exotic resonance in diffractive dissociation of 190 GeV/c π- into π- π- π+. Phys Rev Lett 2010; 104:241803. [PMID: 20867295 DOI: 10.1103/physrevlett.104.241803] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Indexed: 05/29/2023]
Abstract
The COMPASS experiment at the CERN SPS has studied the diffractive dissociation of negative pions into the π- π- π+ final state using a 190 GeV/c pion beam hitting a lead target. A partial wave analysis has been performed on a sample of 420,000 events taken at values of the squared 4-momentum transfer t' between 0.1 and 1 GeV2/c2. The well-known resonances a1(1260), a2(1320), and π2(1670) are clearly observed. In addition, the data show a significant natural-parity exchange production of a resonance with spin-exotic quantum numbers J(PC)=1-+ at 1.66 GeV/c2 decaying to ρπ. The resonant nature of this wave is evident from the mass-dependent phase differences to the J(PC)=2-+ and 1++ waves. From a mass-dependent fit a resonance mass of (1660±10(-64)(+0)) MeV/c2 and a width of (269±21(-64)(+42)) MeV/c2 are deduced, with an intensity of (1.7±0.2)% of the total intensity.
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Lahu G, Hermann R, Zech K, Siegmund W, de Mey C, Bethke T. Pharmakokinetik des oralen PDE4-Inhibitors Roflumilast bei gleichzeitiger Gabe der Inhalativa Salbutamol, Formoterol oder Budesonid bei gesunden Probanden. Pneumologie 2010. [DOI: 10.1055/s-0030-1251407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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33
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Bethke T, Hünnemeyer A, de Mey C, Haverkamp W, Hermann R, Lahu G. Untersuchungen zur kardiovaskulären Sicherheit von Roflumilast. Pneumologie 2010. [DOI: 10.1055/s-0030-1251408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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34
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Lommel M, Cirak S, Willer T, Hermann R, Uyanik G, van Bokhoven H, Korner C, Voit T, Baric I, Hehr U, Strahl S. Correlation of enzyme activity and clinical phenotype in POMT1-associated dystroglycanopathies. Neurology 2010; 74:157-64. [DOI: 10.1212/wnl.0b013e3181c919d6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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35
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Jermendy A, Szatmári I, Laine AP, Lukács K, Horváth KH, Körner A, Madácsy L, Veijola R, Simell O, Knip M, Ilonen J, Hermann R. The interferon-induced helicase IFIH1 Ala946Thr polymorphism is associated with type 1 diabetes in both the high-incidence Finnish and the medium-incidence Hungarian populations. Diabetologia 2010; 53:98-102. [PMID: 19841890 DOI: 10.1007/s00125-009-1561-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Accepted: 09/02/2009] [Indexed: 11/27/2022]
Abstract
AIMS/HYPOTHESIS The rs1990760 polymorphism (Ala946Thr) of interferon induced with helicase C domain 1 (IFIH1) has been proposed to associate with type 1 diabetes. In this study, association between IFIH1 Ala946Thr and type 1 diabetes was investigated in two distinct white populations, the Hungarians and Finns. METHODS The rs1990760 polymorphism was genotyped in 757/509 Hungarian/Finnish childhood-onset cases, 499/250 Hungarian/Finnish control individuals and in 529/924 Hungarian/Finnish nuclear family trios. Disease association was tested using case-control and family-based approaches. A meta-analysis of data from 9,546 cases and 11,000 controls was also performed. RESULTS In the Hungarian dataset, the A allele was significantly more frequent among cases than among controls (OR 1.29, 95% CI 1.10-1.52; p = 0.002). Combined analysis of Hungarian and Finnish datasets revealed a strong disease association (OR 1.235, 95% CI 1.083-1.408; p = 0.002). Furthermore, the A allele was significantly overtransmitted in both family trio datasets (p = 0.017 in Hungarians; p = 0.007 in Finns). The A allele was increased in Hungarian vs Finnish cases (64.9% vs 60.8% in Finns; p = 0.003). The meta-analysis yielded a significant effect for IFIH1 rs1990760 A allele on type 1 diabetes risk (OR 1.176, 95% CI 1.130-1.225; p = 5.3 x 10(-15)) with significant heterogeneity between effect sizes across the studied populations (p = 0.023). CONCLUSIONS/INTERPRETATION This study represents the first independent confirmation of the association between type 1 diabetes and the IFIH1 gene in Hungarian and Finnish populations. Summarising the data published so far, a clear association between the Ala946Thr polymorphism and type 1 diabetes was detected, with an apparent difference in the contribution to disease susceptibility in different populations of European ancestry.
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Affiliation(s)
- A Jermendy
- CellScreen Applied Biomedical Research Center, Semmelweis University, Budapest, Hungary.
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Blakely L, Somer B, Keaton M, Hermann R, Schnell F, Cobb P, Johns A, Walker M, Schwartzberg L. Neoadjuvant dose-dense sequential biweekly epirubicin and cyclophosphamide followed by docetaxel and trastuzumab for HER2+ operable breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.595] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
595 Background: Neoadjuvant (Neo) chemotherapy (CT) with trastuzumab (H) improves pathologic complete response (pCR) rate for HER2+ breast cancer. Dose-dense regimens improve outcome in the adjuvant setting but have not been fully evaluated as preoperative therapy. We designed this regimen to utilize full doses of active agents including docetaxel (T) and H in a novel biweekly schedule to explore efficacy and safety. Methods: Patients (pts) with biopsy proven, clinical stage IIA-IIIC, noninflammatory breast cancer were eligible. HER2+ by FISH was determined locally. CT consisted of epirubicin (E) 100 mg/m2 and cyclophosphamide (C) 600 mg/m2 Q 14 days x 4 followed by T 75 mg/m2 and H 6 mg/kg loading dose, then 4 mg/kg Q 14 days x 4, all with pegfilgrastim support. Surgery was scheduled 20–24 weeks from start after a fifth cycle of H 4mg/kg. EF was measured prior to CT, after EC, after TH and at 6, 12 and 24 months after surgery. Additional adjuvant H to complete 1 year of therapy by conventional schedule was recommended after surgery. The primary endpoint was pCR for invasive cancer in breast and lymph nodes. Results: 30 pts were enrolled at 5 centers: median age was 50.1 (range, 31–72); ethnicity African-American 14, Caucasian 14, other 2; clinical stage IIA, 14, IIB, 4, IIIA, 7, IIIB/C, 5; ER+ 18, PR+ 14; grade 3, 21 and grade 2, 8. Twenty eight pts were evaluable for pathologic response- 2 withdrew before completing treatment, 1 for toxicity. Dose delivery on schedule was >95% for all drugs. Clinical response prior to surgery was cCR 20; cPR 5; and stable 2 pts. Pathologic response: pCR 16 (57%) including 4 with residual DCIS only; 9 pPR, and 2 stable. Mean EF was 63.1 (range, 51–81) before treatment, 62.4 (49–75) after EC and 58.3 (35–74) after TH. Two pts had EF <50% during Neo, one with clinical CHF and 1 additional pt developed CHF during adjuvant single agent H. Both pts had symptomatic improvement with cessation of H. Adverse events were generally mild with 14 grade 3 AEs including 3 episodes of dyspnea and no grade 3 skin toxicity or any grade 4 toxicity noted. Conclusions: Sequential Neo dose-dense Q 14 day EC followed by Q 14 day TH yields a high pCR rate in HER2+ breast cancer with acceptable toxicity profile and no new safety signals noted. No significant financial relationships to disclose.
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Affiliation(s)
- L. Blakely
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - B. Somer
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - M. Keaton
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - R. Hermann
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - F. Schnell
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - P. Cobb
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - A. Johns
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - M. Walker
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
| | - L. Schwartzberg
- The West Clinic, Memphis, TN; Accelerated Community Oncology Research Network, Memphis, TN
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Laine AP, Turpeinen H, Veijola R, Hermann R, Simell O, Knip M, Ilonen J. Evidence for linkage to and association with type 1 diabetes at the 3q21 region in the Finnish population. Genes Immun 2009; 7:69-72. [PMID: 16292340 DOI: 10.1038/sj.gene.6364269] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
IDDM9-region on chromosome 3q has shown suggestive evidence for linkage to type 1 diabetes in some but not all genome scans. We analyzed 22 microsatellite markers in 121 Finnish type 1 diabetes multiplex families across the IDDM9-region. Two-point maximum LOD scores of 3.4 and 2.5 were detected with markers D3S1589 and D3S3606, respectively. Two markers were further tested for association using the transmission disequilibrium test in 384 Finnish type 1 diabetes simplex families. Marker AFM203wd10 showed association with type 1 diabetes (P = 0.0002 for allele R16). Association was present in families with children carrying the HphI-23 AA risk genotype at IDDM2 but not in families with children carrying protective AT or TT genotypes implying interaction between the two loci. Our data gives credence to earlier findings of linkage in this region and suggests a location for a polymorphism affecting type 1 diabetes susceptibility in the area surrounding AFM203wd10.
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Affiliation(s)
- A-P Laine
- JDRF Centre for Prevention of Type 1 Diabetes in Finland and Department of Virology, University of Turku, MediCity, Turku, Finland.
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Cobb PW, Hermann R, Lebos H, Tamim H, Walker MS, Stepanski EJ, Schwartzberg LS. Evidence-based treatment protocol (ETP) usage in community oncology clinics. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6621] [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: 11/20/2022] Open
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Machtens S, Kuczyk M, Serth J, Bokemeyer C, Macheel I, Jetscho I, Hradil K, Hermann R, Hartmann J, Thon W, Jonas U. Prognostische Bedeutung der zellzyklusassoziierten Genep27Kip 1undp21WAF/Cipfür das muskelinvasive Harnblasenkarzinom. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1065313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schastak S, Gitter B, Handzel R, Hermann R, Wiedemann P. Improved photoinactivation of Gram-negative and Gram-positive methicillin-resistant bacterial strains using a new near-infrared absorbing meso-tetrahydroporphyrin: A comparative study with a chlorine e6 photosensitizer "Photolon". ACTA ACUST UNITED AC 2008; 30:129-33. [DOI: 10.1358/mf.2008.30.2.1165448] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gombos Z, Hermann R, Kiviniemi M, Nejentsev S, Reimand K, Fadeyev V, Peterson P, Uibo R, Ilonen J. Analysis of extended human leukocyte antigen haplotype association with Addison's disease in three populations. Eur J Endocrinol 2007; 157:757-61. [PMID: 18057383 DOI: 10.1530/eje-07-0290] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Addison's disease is an organ-specific autoimmune disorder with a polygenic background. The aim of the study was to identify non-class II human leukocyte antigen (HLA) susceptibility genes for Addison's disease. DESIGN AND METHODS Addison's disease patients from three European populations were analysed for selected HLA-DR-DQ alleles and for 11 microsatellite markers covering approximately 4 Mb over the HLA region. Subjects were 69 patients with Addison's disease from Estonia (24), Finland (14) and Russia (31). Consecutively recruited healthy newborns from the same geographical regions were used as controls (269 Estonian, 1000 Finnish and 413 Russian). Association measures for HLA-DRB1, DQB1, DQA1 and 11 microsatellites between D6S273 and D6S2223 were taken. A low-resolution full-house typing was used for HLA class II genes, while microsatellite markers were studied using fluorescence-based DNA fragment sizing technology. RESULTS We confirmed that the HLA-DR3-DQ2 and the DQB1*0302-DRB1*0404 haplotypes confer disease susceptibility. In Russian patients, we also found an increase of DRB1*0403 allele, combined with DQB1*0305 allele in three out of six cases (P<0.0001). Analysis of 11 microsatellite markers including STR MICA confirmed the strong linkage in DR3-DQ2 haplotypes but DRB1*0404-DQB1*0302 haplotypes were diverse. MICA5.1 allele was found in 22 out of 24 Estonian patients, but results from Finnish and Russian patients did not support its independent role in disease susceptibility. CONCLUSION HLA-DRB1*0403 was identified as a novel susceptibility allele for Addison's disease. Additionally, we found no evidence of a non-class II HLA disease susceptibility locus; however, the HLA-DR3-DQ2 haplotype appeared more conserved in patient groups with high DR-DQ2 frequencies.
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Affiliation(s)
- Z Gombos
- Immunogenetics Laboratory, University of Turku, Medicity, Tykistökatu 6 A 4th, 20520 Turku, Finland.
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Thomson G, Valdes AM, Noble JA, Kockum I, Grote MN, Najman J, Erlich HA, Cucca F, Pugliese A, Steenkiste A, Dorman JS, Caillat-Zucman S, Hermann R, Ilonen J, Lambert AP, Bingley PJ, Gillespie KM, Lernmark A, Sanjeevi CB, Rønningen KS, Undlien DE, Thorsby E, Petrone A, Buzzetti R, Koeleman BPC, Roep BO, Saruhan-Direskeneli G, Uyar FA, Günoz H, Gorodezky C, Alaez C, Boehm BO, Mlynarski W, Ikegami H, Berrino M, Fasano ME, Dametto E, Israel S, Brautbar C, Santiago-Cortes A, Frazer de Llado T, She JX, Bugawan TL, Rotter JI, Raffel L, Zeidler A, Leyva-Cobian F, Hawkins BR, Chan SH, Castano L, Pociot F, Nerup J. Relative predispositional effects of HLA class II DRB1-DQB1 haplotypes and genotypes on type 1 diabetes: a meta-analysis. ACTA ACUST UNITED AC 2007; 70:110-27. [PMID: 17610416 DOI: 10.1111/j.1399-0039.2007.00867.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The direct involvement of the human leukocyte antigen class II DR-DQ genes in type 1 diabetes (T1D) is well established, and these genes display a complex hierarchy of risk effects at the genotype and haplotype levels. We investigated, using data from 38 studies, whether the DR-DQ haplotypes and genotypes show the same relative predispositional effects across populations and ethnic groups. Significant differences in risk within a population were considered, as well as comparisons across populations using the patient/control (P/C) ratio. Within a population, the ratio of the P/C ratios for two different genotypes or haplotypes is a function only of the absolute penetrance values, allowing ranking of risk effects. Categories of consistent predisposing, intermediate ('neutral'), and protective haplotypes were identified and found to correlate with disease prevalence and the marked ethnic differences in DRB1-DQB1 frequencies. Specific effects were identified, for example for predisposing haplotypes, there was a statistically significant and consistent hierarchy for DR4 DQB1*0302s: DRB1*0405 =*0401 =*0402 > *0404 > *0403, with DRB1*0301 DQB1*0200 (DR3) being significantly less predisposing than DRB1*0402 and more than DRB1*0404. The predisposing DRB1*0401 DQB1*0302 haplotype was relatively increased compared with the protective haplotype DRB1*0401 DQB1*0301 in heterozygotes with DR3 compared with heterozygotes with DRB1*0101 DQB1*0501 (DR1). Our results show that meta-analyses and use of the P/C ratio and rankings thereof can be valuable in determining T1D risk factors at the haplotype and amino acid residue levels.
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Affiliation(s)
- G Thomson
- Department of Integrative Biology, University of California, Berkeley, CA 94720-3140, USA.
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Abstract
Some commercial photoresists have been examined to assess their suitability for use with the moiré method of surface-strain measurement. As most of these materials do not produce a pattern of high contrast directly, some etching and plating procedures are also described. Combined with correct illumination, these processes will produce grids of sufficient contrast for most applications.
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Affiliation(s)
- A Luxmoore
- School of Engineering, University College of Swansea, Glam
| | - R Hermann
- School of Engineering, University College of Swansea, Glam
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Häupl T, Zimmermann T, Hermann R, Brede O. On the Photochromism of Spiro[cyclohexadiene-dihydroacridines]. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2000)0710294otposc2.0.co2] [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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Bethke TD, Giessmann T, Westphal K, Weinbrenner A, Hauns B, Hauschke D, David M, Lahu G, Zech K, Hermann R, Siegmund W. Roflumilast, a once-daily oral phosphodiesterase 4 inhibitor, lacks relevant pharmacokinetic interactions with inhaled salbutamol when co-administered in healthy subjects. Int J Clin Pharmacol Ther 2007; 44:572-9. [PMID: 17176624 DOI: 10.5414/cpp44572] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Roflumilast is an oral, once-daily phosphodiesterase 4 inhibitor under investigation for the treatment of chronic obstructive pulmonary disease and asthma. In clinical practice, the drug is likely to be co-administered with inhaled bronchodilating beta2-adrenoceptor agonists. Therefore, this study investigated the pharmacokinetic characteristics of roflumilast and its pharmacodynamically active metabolite roflumilast N-oxide when co-administered with orally inhaled salbutamol in healthy subjects. METHODS In this open, randomized clinical study, 12 healthy male subjects received repeated doses of oral roflumilast 500 microg once daily, orally inhaled salbutamol 200 microg 3 times daily, and a combination of both drugs over 7 days according to a 3-period, changeover design with 14 days washout between treatments. RESULTS Co-administration of roflumilast and salbutamol did not markedly change roflumilast or roflumilast N-oxide disposition. Point estimates (90% confidence intervals) of area under the curve from 0-24 h (AUC 0-24) and maximum plasma concentration in steady state (Cmax,ss) for roflumilast with salbutamol versus roflumilast alone were 1.05 (0.94, 1.17) and 0.97 (0.84, 1.10); the respective point estimates (90% confidence intervals) for AUC 0-24 and Cmax,ss of roflumilast N-oxide were 0.98 (0.91, 1.06) and 0.98 (0.92, 1.03). Roflumilast co-administration did not alter the pharmacokinetics of steady state salbutamol. The respective point estimates (90% confidence intervals) for AUC 0-6 and Cmax,ss of salbutamol with roflumilast versus salbutamol alone were 1.10 (0.99, 1.21), 1.08 (0.91, 1.28). The combination of both drugs was well tolerated. CONCLUSION There were no relevant pharmacokinetic interactions between roflumilast and salbutamol at therapeutically effective doses.
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Grentzmann G, Heinzerling H, Wollin SL, Hauns B, Schoenfeld K, Hesslinger C, Sanjar S, Elmlinger M, Melchers K, Beume R, Hermann R. Integrative COPD Biomarker Studie. Pneumologie 2006. [DOI: 10.1055/s-2006-958885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mayfield W, Bordoni R, Holder R, Waldman M, Muster A, McLaughlin M, Hermann R. Objective improvement in lung cancer patient care by the development of a multidisciplinary clinic (MDC) in the community. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17086 Background: Medical resources allocated to lung cancer management are limited, scattered and uncoordinated, resulting in sub-optimal care. The MDC offers patients access to multi-disciplinary care (Pulmonary Medicine, Thoracic Surgery, Medical and Radiation Oncology) to operate in an efficient, cost effective way. Methods: 2004 Cancer Registry data on time to treatment (TTT) for lung cancer was 53 days. A project with the primary endpoint of reducing the TTT from 53 to 30 days was designed. Secondary endpoints were improvement in treatment planning; enhancement in clinical trials referral, and patient satisfaction. On 9/15/05 the MDC open its doors. The project was assigned to this clinic including patients with solitary lung nodules, lung, esophageal, and mediastinal cancers, mesothelioma, and other thoracic malignancies. Results: 54 pts were seen in the first 90 days; median age 60 (range 41–82), 29 males; 32 (59%) lung cancer (94% NSCLC), 8 (15%) esophageal cancer, 6 other diagnosis, and 6 abnormal radiological findings without diagnosis. The TTT of 30 evaluable patients is 26.36 days. Of the 30 NSCLC the TNM stage was: 4 IA, 5 IB, 2 each IIA/IIB, 8 (27%) IIIA, 3 (10%) IIIB, and 6 (20%) IV. Fifteen of the cases had pathologic staging. Out of 9 pts with cstage I, 7 (78%) had definitive surgery; 4 pts confirmed to have pstage IB, were evaluated for adjuvant chemo. Four pts with cstage II had surgery, 2 of them adjuvant chemo. Of the 11 pts with cstage III, 5 (46%) received concurrent CHRT, 1 (stage IIIA) underwent surgery f/b chemo, 2 received chemo alone and 2 refused therapy. Out of 6 pts with stage IV, 5 (83%) received systemic therapy. Conclusions: The TTT of 26.36 days represents a 50.26% improvement from our institutional benchmark of 53 days. Updated and expanded data on our project primary and secondary endpoints will be presented at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- W. Mayfield
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
| | - R. Bordoni
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
| | - R. Holder
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
| | - M. Waldman
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
| | - A. Muster
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
| | - M. McLaughlin
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
| | - R. Hermann
- Wellstar, Marietta, GA; Georgia Cancer Specialists, Marietta, GA
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Hermann R, Lipponen K, Kiviniemi M, Kakko T, Veijola R, Simell O, Knip M, Ilonen J. Lymphoid tyrosine phosphatase (LYP/PTPN22) Arg620Trp variant regulates insulin autoimmunity and progression to type 1 diabetes. Diabetologia 2006; 49:1198-208. [PMID: 16614815 DOI: 10.1007/s00125-006-0225-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2005] [Accepted: 02/13/2006] [Indexed: 10/24/2022]
Abstract
AIMS/HYPOTHESIS We analysed the contribution of the lymphoid protein tyrosine phosphatase (LYP) Arg620Trp variant (which corresponds to the PTPN22 C1858T polymorphism) to the emergence of beta-cell-specific humoral autoimmunity and progression to type 1 diabetes in man. We also explored the heterogeneity in the disease-predisposing effect of this polymorphism in relation to known disease loci, sex and age at disease onset. SUBJECTS AND METHODS A population-derived Finnish birth cohort with increased disease susceptibility conferred by HLA-DQB1 was monitored for the appearance of islet cell autoantibodies, and individuals found to be positive were tested for autoantibodies against insulin (IAA), glutamic acid decarboxylase and islet antigen-2 (n = 574; mean follow-up time 4.9 years). Gene interaction effects on disease susceptibility were analysed in case-control and family series (546 patients, 538 controls, 245 nuclear families). All subjects were typed for HLA DR-DQ, insulin gene (INS), CTLA4 and PTPN22 C1858T polymorphisms. RESULTS The PTPN22 1858TT genotype was associated with the appearance of IAA (adjusted hazard ratio = 4.6, 95% CI 2.4-9.0; p = 0.000013). PTPN22, INS and HLA-DRB1 had an additive effect on the emergence of IAA. The 1858TT and CT genotypes conferred an increased risk of developing additional autoantibodies or clinical disease (hazard ratio=4.1, 95% CI 1.5-11.6; and 1.6, 95% CI 1.1-2.4, respectively; p = 0.003). The strong effect of PTPN22 on disease susceptibility (p = 2.1 x 10(-8)) was more pronounced in males (p = 0.021) and in subjects with non-DR4-DQ8/low-risk HLA genotypes (p = 0.0004). CONCLUSIONS/INTERPRETATION In the pathogenesis of type 1 diabetes the underlying mechanism of the PTPN22 C1858T polymorphism appears to involve regulation of insulin-specific autoimmunity. Importantly, it strongly affects progression from prediabetes to clinical disease.
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Affiliation(s)
- R Hermann
- JDRF Centre for Prevention of Type 1 Diabetes in Finland, Turku, Finland.
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Hermann R, Wildgrube HJ, Ruus P, Niebch G, Nowak H, Gleiter CH. Gastric emptying in patients with insulin dependent diabetes mellitus and bioavailability of thioctic acid-enantiomers. Eur J Pharm Sci 2006; 6:27-37. [PMID: 16256705 DOI: 10.1016/s0928-0987(97)00065-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/1996] [Accepted: 05/29/1997] [Indexed: 11/29/2022]
Abstract
The objective of this study was to determine the impact of prolonged gastric emptying in patients with insulin dependent diabetes mellitus (IDDM) on the bioavailability of the R(+)- and S(-)-thioctic acid (TA) enantiomers. Gastric emptying time (GET) was assessed in 30 healthy volunteers and 22 patients with IDDM using sequential ultrasonography after a standardized solid-liquid test meal. Pharmacokinetics and absolute bioavailability (F) of the TA-enantiomers were studied using a randomized, open two-way crossover design with administrations of oral and intravenous single doses of 200 mg rac-TA. GET in healthy subjects was 134.7+/-21.6 min, the normal range was calculated from 88.3 to 181.1 min. The mean GET in all IDDM patients was significantly prolonged (178.2+/-28.1 min; P<0.001). Only 50% of the patients (n=11) were found to have normal GET (group A), the other half of the population (n=11) were considered to have delayed GET (group B). Mean GET values were 156.9+/-21.5 in group A (P=0.028) and 199.4+/-13.9 min in group B, respectively, suggesting that gastric motility is significantly different from non-diabetic controls even in patients with apparently normal gastric emptying. Times to peak plasma concentrations (t(max)) of both TA-enantiomers were similar in both groups and thus, unrelated to measures of gastric emptying. In contrast, maximum concentrations (C(max)) and area-under-the-curve values (AUC) of both enantiomers were reduced by about 30% in patients with delayed GET. Although these differences resulted in statistical significance for the AUC of both enantiomers (P<0.05), linear regression analysis showed only modest correlation between GET and the extent of TA-enantiomer absorption (r2=0.31 and 0.22 for R(+)-/S(-)-TA, respectively). The study suggests that prolonged gastric emptying is frequently present in IDDM. Delayed gastric emptying, however, does not substantially affect the rate and extent of absorption of both TA-enantiomers.
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Affiliation(s)
- R Hermann
- Department of Clinical Pharmacology, Medical Research, ASTA Medica AG, 60314 Frankfurt/Main, Weismüllerstr. 45, Germany
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Hermann R, Borlak J, Munzel U, Niebch G, Fuhr U, Maus J, Erb K. The role of Gilbert's syndrome and frequent NAT2 slow acetylation polymorphisms in the pharmacokinetics of retigabine. Pharmacogenomics J 2006; 6:211-9. [PMID: 16402080 DOI: 10.1038/sj.tpj.6500359] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Retigabine (RGB) is an investigational antiepileptic drug, which undergoes extensive UGT1A1, 1A9 and 1A4-mediated N-glucuronidation and N-acetylation. The mono-acetylated metabolite of RGB has some pharmacological activity and is denoted AWD21-360. We investigated whether the pharmacokinetics (PK) of RGB and AWD21-360 are altered in subjects with Gilbert's syndrome (GS) and/or with frequent N-acetyltransferase 2 (NAT2) slow acetylator (SA) polymorphisms. Based on consistent genotyping and phenotyping screening results, 37 Caucasian subjects (21-46 years; 31 men, six women) were assigned to one of the following groups: (1) absence of GS (non-GS)/rapid acetylator (RA) (N=11); (2) GS/RA (N=8); (3) non-GS/SA (N=11); (4) GS/SA (N=7). Subjects received single and multiple (b.i.d.) 200-mg oral RGB doses over 5 days. Blood samples were collected up to 60 h after dosing for plasma PK of RGB and AWD21-360. Group comparisons were performed by ANOVA. Single-dose PK of RGB and AWD21-360 and multiple-dose PK of RGB did not differ significantly between groups. After multiple dose treatment, RA subjects showed a significantly higher total exposure to AWD21-360 of about 32% (95% CI 101.9-172.5) relative to SA subjects (P=0.0362). The UGT1A1 metabolic capacity (i.e. presence or absence of GS), however, did not significantly affect the overall exposure to AWD21-360. The results indicate that the PK of RGB is unaltered in individuals with GS, in subjects with NAT2 SA status, and in carriers of both variants, whereas the total exposure to AWD21-360 is significantly related to the RA or SA status of subjects. Results further suggest that metabolic switching to the mono-acetylated metabolite AWD21-360 may partially compensate for the impaired glucuronidation capacity in GS subjects. RGB treatment showed no significant differences in tolerability and safety between groups.
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Affiliation(s)
- R Hermann
- Department of Clinical Pharmacology, ALTANA Pharma AG, Konstanz, Germany.
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