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Dobner S, Kulcsár A, Liptai Z, Vojnisek Z, Constantin T, Szabó L. Vaccination proposal for patients on onasemnogene abeparvovec therapy. Eur J Paediatr Neurol 2024; 49:95-99. [PMID: 38457958 DOI: 10.1016/j.ejpn.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/10/2024]
Abstract
The approval of disease-modifying treatment in spinal muscular atrophy made the condition less severe. The course of the disease changed, but some new concerns occurred with the different new therapies. The side effects of onasemnogene aboparvovec therapy can raise differential diagnostic challenges and necessitate immune therapy, leading to immunosuppression affecting response to vaccines. We provide a pretherapy screening proposal from an infectological point of view separately for newborns treated presymptomatically and children diagnosed with symptoms at any age. Furthermore, we summarise the guidelines on the vaccination before, during, and after immune therapy (steroids) in onasemnogene aboparvovec-treated patients.
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Affiliation(s)
- Sarolta Dobner
- Semmelweis University, Pediatric Center Tűzoltó Street Department, Hungary
| | - Andrea Kulcsár
- National Institute of Hematology and Infectious Diseases, Department of Special Immunization Services, Hungary
| | - Zoltán Liptai
- Semmelweis University, Pediatric Center Tűzoltó Street Department, Hungary
| | - Zsuzsanna Vojnisek
- Semmelweis University, Pediatric Center Tűzoltó Street Department, Hungary
| | - Tamás Constantin
- Semmelweis University, Pediatric Center Tűzoltó Street Department, Hungary
| | - Léna Szabó
- Semmelweis University, Pediatric Center Tűzoltó Street Department, Hungary.
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Schnegg B, Muster C, Wieser M, Pavlicek-Bahlo M, Wiedermann S, Dobner S, Bruno J, Capek L, Potratz P, Jenni H, Sidler D, Chanias I, Daskalakis M, Consiglio J, Schwitz F, Thomet C, Schwerzmann M, Immer F, Longnus S, Martinelli M, Hunziker L, Siepe M, Reineke D. From Vpra of 100% to Transplantation, Journey of the First Ocs-dbd Case in Switzerland. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.491] [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: 04/05/2023] Open
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Horváthy-Szőcs A, Liptai Z, Dobner S, Rudas G, Barsi P. A Closer Investigation of the Synchronous Bilateral Pattern of MRI Lesions in Acute Necrotizing Encephalopathy Type 1. AJNR Am J Neuroradiol 2021; 42:2251-2253. [PMID: 34593382 DOI: 10.3174/ajnr.a7305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/03/2021] [Indexed: 11/07/2022]
Abstract
We observed a lesion pattern in a series of 4 cases of RANBP2-mutation-linked acute necrotizing encephalopathy, which appears to be specific for this condition. The setting of synchronous bilateral mammillary, amygdaloid, and lateral geniculate lesions, along with claustro-parahippocampal lesions, can serve as a diagnostic tool in this condition. We add several further details to the MR imaging features of the typical brain lesions encountered in this disease.
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Affiliation(s)
- A Horváthy-Szőcs
- From the Department of Neuroradiology (A.H.-S., G.R., P.B.), Medical Imaging Centre
| | - Z Liptai
- Second Department of Pediatrics (Z.L., S.D.), Semmelweis University, Budapest, Hungary
- Department of Pediatric Infectology (Z.L., S.D.), St. Laszlo Hospital, Budapest, Hungary
| | - S Dobner
- Second Department of Pediatrics (Z.L., S.D.), Semmelweis University, Budapest, Hungary
- Department of Pediatric Infectology (Z.L., S.D.), St. Laszlo Hospital, Budapest, Hungary
| | - G Rudas
- From the Department of Neuroradiology (A.H.-S., G.R., P.B.), Medical Imaging Centre
| | - P Barsi
- From the Department of Neuroradiology (A.H.-S., G.R., P.B.), Medical Imaging Centre
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Mihalj M, Heinisch P, Schober P, Dobner S, Fuerholz M, Martinelli M, Hugi-Mayr B, De By T, Mohacsi P, Schefold J, Luedi M, Kadner A, Carrel T, Hunziker L, Reineke D. Third generation continuous flow left ventricular assist devices; a comparative outcome analysis by device type. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0946] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Continuous-flow left ventricular assist devices (CF-LVADs) have become a standard of care in end-stage heart failure (HF). Device-related complications remain high. Limited data exists comparing outcomes of the HeartMate 3 (HM3) and the HeartWare HVAD (HW). We aimed to analyze HM3 and HW devices implanted over the past 10 years with a focus on long-term clinical outcomes of respective patients.
Methods
Investigator-initiated comparative, retrospective observational analysis of all patients who underwent primary implantation of a centrifugal CF-LVAD at our tertiary care academic center between January 2010 and December 2020. Data derived from a prospective registry, and included all patients receiving a HM3 or HW device. Primary endpoint was overall (all-cause) mortality and heart transplantation. Secondary endpoints included device-related major adverse cardiac and cerebrovascular events (MACCE), as well right heart failure (RHF), gastrointestinal (GI) bleeding, driveline infections, and surgical re-interventions.
Results
Out of 106 primary CF-LVAD implantations, 36 (34%) received HM3 and 70 (66%) received HW. Median follow-up time was 1.48 years [interquartile range 0.67, 2.41] and did not differ between devices (p=0.739). HM3 was more often implanted in men (91.7% vs. 72.9%, p=0.024), patients were older (median 61 years [54, 66.5] vs. 52.5 years [43, 60], p<0.001), had a higher body mass index (BMI) (median 26.7 kg/m2 [23.4, 29.0] vs. 24.3 kg/m2 [20.7, 27.4], p=0.013), had more comorbidities and were more likely targeted for destination therapy (DT) (36.1% vs. 14.3%, p=0.010). Death occurred in 33.3% of HM3 patients, compared to 22.9% of HW patients, p=0.247 (probability of survival at 2 years 54.7% vs. 74.1%, p=0.296). After adjustment for confounders, we observed a significant 6-fold risk increase in device malfunctions for HW (hazard ratio (HR) 6.49, 95% CI [1.89, 22.32], p=0.003), but no significant differences between devices in pump thrombosis (p=0.173) or overall survival (p=0.801).
Conclusions
Comparing long-term outcomes between HeartMate 3 and HeartWare HVAD for LVAD support from a prospective registry, HeartWare HVAD patients had a significantly higher risk of device malfunctions. No significant differences were evident between devices in overall survival, and in respect to most clinical outcomes.
Funding Acknowledgement
Type of funding sources: None. KM Plot primary and secondary outcomesRisk analysis on all outcomes
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Affiliation(s)
- M Mihalj
- Bern University Hospital, Inselspital, Department of Cardiovascular Surgery, Bern, Switzerland
| | - P.P Heinisch
- Bern University Hospital, Inselspital, Department of Cardiovascular Surgery, Bern, Switzerland
| | - P Schober
- Vrije Universiteit Medical Center (VUMC), Department of Anaesthesiology, Amsterdam, Netherlands (The)
| | - S Dobner
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - M Fuerholz
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - M Martinelli
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - B Hugi-Mayr
- Bern University Hospital, Inselspital, Department of Cardiovascular Surgery, Bern, Switzerland
| | | | - P Mohacsi
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - J.C Schefold
- Bern University Hospital, Inselspital, Department of Intensive Care Medicine, Bern, Switzerland
| | - M.M Luedi
- Bern University Hospital, Inselspital, Department of Anesthesiology and Pain Medicine, Bern, Switzerland
| | - A Kadner
- Bern University Hospital, Inselspital, Department of Cardiovascular Surgery, Bern, Switzerland
| | - T Carrel
- Bern University Hospital, Inselspital, Department of Cardiovascular Surgery, Bern, Switzerland
| | - L Hunziker
- Bern University Hospital, Inselspital, Department of Cardiology, Bern, Switzerland
| | - D Reineke
- Bern University Hospital, Inselspital, Department of Cardiovascular Surgery, Bern, Switzerland
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Boros Á, Pankovics P, Kőmíves S, Liptai Z, Dobner S, Ujhelyi E, Várallyay G, Zsidegh P, Bolba N, Reuter G. Co-infection with coxsackievirus A5 and norovirus GII.4 could have been the trigger of the first episode of severe acute encephalopathy in a six-year-old child with the intermittent form of maple syrup urine disease (MSUD). Arch Virol 2017; 162:1757-1763. [PMID: 28243803 DOI: 10.1007/s00705-017-3299-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/10/2017] [Indexed: 11/27/2022]
Abstract
In this case study, a co-infection with coxsackievirus A5 (family Picornaviridae) and norovirus GII.4 (family Caliciviridae) was detected by RT-PCR in a faecal sample from a six-year-old girl with symptoms of severe acute encephalopathy subsequently diagnosed as the intermittent form of maple syrup urine disease (MSUD). The two co-infecting viruses, which had been detected previously, appeared to have triggered the underlying metabolic disorder. Here, we describe the genotyping of the viruses, as well as the chronological course, laboratory test results, and clinical presentation of this case, which included recurrent vomiting without diarrhoea, metabolic acidosis, unconsciousness, seizure and circulatory collapse, but with a positive final outcome.
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Affiliation(s)
- Ákos Boros
- Regional Laboratory of Virology, National Reference Laboratory of Gastroenteric Viruses, ÁNTSZ Regional Institute of State Public Health Service, Pecs, Hungary
- Department of Medical Microbiology and Immunology, University of Pécs, Szigeti út 12, Pecs, 7624, Hungary
| | - Péter Pankovics
- Regional Laboratory of Virology, National Reference Laboratory of Gastroenteric Viruses, ÁNTSZ Regional Institute of State Public Health Service, Pecs, Hungary
- Department of Medical Microbiology and Immunology, University of Pécs, Szigeti út 12, Pecs, 7624, Hungary
| | - Sándor Kőmíves
- Szent István and Szent László Hospital, Budapest, Hungary
| | - Zoltán Liptai
- Szent István and Szent László Hospital, Budapest, Hungary
| | - Sarolta Dobner
- Szent István and Szent László Hospital, Budapest, Hungary
| | - Enikő Ujhelyi
- Szent István and Szent László Hospital, Budapest, Hungary
| | | | - Petra Zsidegh
- 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Nóra Bolba
- Regional Laboratory of Virology, National Reference Laboratory of Gastroenteric Viruses, ÁNTSZ Regional Institute of State Public Health Service, Pecs, Hungary
- Department of Medical Microbiology and Immunology, University of Pécs, Szigeti út 12, Pecs, 7624, Hungary
| | - Gábor Reuter
- Regional Laboratory of Virology, National Reference Laboratory of Gastroenteric Viruses, ÁNTSZ Regional Institute of State Public Health Service, Pecs, Hungary.
- Department of Medical Microbiology and Immunology, University of Pécs, Szigeti út 12, Pecs, 7624, Hungary.
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Kocher F, Dobner S, Föger B, Fiegl M, Fridrik M, Hubalek M, Lang A, Pall G, Petzer A, Wöll E, Hilbe W. Cardiovascular complications of cancer treatment: update CACOCA trial. Pneumologie 2015. [DOI: 10.1055/s-0035-1551918] [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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Subbotina I, Hakmi S, Dobner S, Bernhardt A, Oelschner C, Reichenspurner H, Deuse T. HeartWare® Assist Device - Infections, bleedings, and thrombosis dominate morbidity and mortality. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367367] [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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Kakkar R, Hei H, Dobner S, Reichenspurner H, Lee R. Interleukin 33 as a mechanically responsive cytokine secreted by living cells. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367392] [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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Kadner K, Dobner S, Franz T, Bezuidenhout D, Sirry M, Reichenspurner H, Zilla P, Davies N. The beneficial effects of deferred delivery on the efficiency of hydrogel therapy post myocardial infarction. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367271] [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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Dobner S, Davies NH, Bezuidenhout D, Schmidt C, Beck M, Reichenspurner H, Zisch AH, Zilla P. The dosage dependence of VEGF stimulation on scaffold neovascularisation. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332581] [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: 10/27/2022]
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Abstract
Flash heating of Illinois coal (to 700 degrees C in 1 second) in flowing hydrogen at 100 atmospheres, limiting the vapor residence time at 700 degrees C to 3 seconds, converts 14 percent of the coal's carbon to methane, 7 percent to ethane, and 10 percent to benzene, toluene, and xylenes. The remainder is coke; the carbon balance shows that heavy tar, if any exists, is less than 3 percent.
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