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Saygin D, Glaubitz S, Zeng R, Bottai M, de Visser M, Dimachkie MM, Fiorentino D, Gerhardson I, Kuwana M, Miller FW, Needham M, Rider LG, Salem Y, Schlüter S, Shinjo SK, Wang G, Werth VP, Aggarwal R, Lundberg IE. Performance of the 2017 EULAR/ACR Classification Criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: a scoping review. Clin Exp Rheumatol 2024; 42:403-412. [PMID: 38436279 DOI: 10.55563/clinexprheumatol/vuc5py] [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: 10/30/2023] [Accepted: 01/22/2024] [Indexed: 03/05/2024]
Abstract
The 2017 EULAR/ACR classification criteria for adult/juvenile idiopathic inflammatory myopathies (IIM) were established using a data-driven approach by an international group of myositis experts to allow classification of IIM and its major subtypes. Since their publication, the performance of the criteria has been tested in multiple cohorts worldwide and significant limitations have been identified. Moreover, the understanding and classification of IIM have evolved since 2017. This scoping review was undertaken as part of a large international project to revise the EULAR/ACR criteria and aims to i) summarise the evidence from the current literature on the performance characteristics of the 2017 EULAR/ACR classification criteria in various cohorts and IIM subtypes, and ii) delineate the factors that need to be considered in the revision of the classification criteria. A systematic search of Medline (via PubMed), Cumulative Index to Nursing and Allied Health Literature, and conference abstract archives was conducted independently by three investigators for studies on the EULAR/ACR criteria published between October 2017 and January 2023. This scoping review of 19 articles and 13 abstracts revealed overall good performance characteristics of the EULAR/ACR criteria for IIM, yet deficiencies in lack of inclusion of certain IIM subtypes, such as immune mediated necrotising myopathy, amyopathic dermatomyositis, antisynthetase syndrome and overlap myositis. Published modifications that may improve the performance characteristics of the criteria for classification of IIM subtypes were also summarised. The results of this review suggest that a revision of the EULAR/ACR criteria is warranted.
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Affiliation(s)
- Didem Saygin
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, PA, USA
| | - Stefanie Glaubitz
- Department of Neurology, University Medical Center Göttingen, Germany
| | - Rachel Zeng
- Department of Neurology, University Medical Center Göttingen, Germany
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marianne de Visser
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Mazen M Dimachkie
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - David Fiorentino
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, USA
| | | | - Masataka Kuwana
- Department of Allergy and Rheumatology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Merrilee Needham
- Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Yasser Salem
- Physical Therapy Program, Hofstra University, Hemstead, NY, USA
| | - Silke Schlüter
- Diagnosegruppe Myositis, Deutsche Gesellschaft für Muskelkranke, Freiburg, Germany
| | - Samuel K Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Guochun Wang
- Department of Rheumatology, The Key Laboratory of Myositis, China-Japan Friendship Hospital, Beijing, China
| | - Victoria P Werth
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, and Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, PA, USA.
| | - Ingrid E Lundberg
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm; and Department of Gastroenterology, Dermatology and Rheumatology, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
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Weiss M, Holzer MT, Muehlensiepen F, Ignatyev Y, Fiehn C, Bauhammer J, Schmidt J, Schlüter S, Dihkan A, Scheibner D, Schneider U, Valor-Mendez L, Corte G, Gupta L, Chinoy H, Lundberg I, Cavagna L, Distler JHW, Schett G, Knitza J. Healthcare utilization and unmet needs of patients with antisynthetase syndrome: An international patient survey. Rheumatol Int 2023; 43:1925-1934. [PMID: 37452880 PMCID: PMC10435645 DOI: 10.1007/s00296-023-05372-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023]
Abstract
Antisynthease syndrome (ASSD) is a rare, complex and understudied autoimmune disease. Internet-based studies can overcome barriers of traditional on-site research and are therefore very appealing for rare diseases. The aim of this study was to investigate patient-reported symptoms, diagnostic delay, symptoms, medical care, health status, working status, disease knowledge and willingness to participate in research of ASSD patients by conducting an international web-based survey. The multilingual questionnaire was created by an international group of rheumatologists and patients and distributed online. 236 participants from 22 countries completed the survey. 184/236 (78.0%) were female, mean age (SD) was 49.6 years (11.3) and most common antisynthetase antibody was Jo-1 (169/236, 71.6%). 79/236 (33.5%) reported to work full-time. Median diagnostic delay was one year. The most common symptom at disease onset was fatigue 159/236 (67.4%), followed by myalgia 130/236 (55.1%). The complete triad of myositis, arthritis and lung involvement verified by a clinician was present in 42/236 (17.8%) at disease onset and in 88/236 (37.3%) during the disease course. 36/236 (15.3%) reported to have been diagnosed with fibromyalgia and 40/236 (16.3%) with depression. The most reported immunosuppressive treatments were oral corticosteroids 179/236 (75.9%), followed by rituximab 85/236 (36.0%). 73/236 (30.9%) had received physiotherapy treatment. 71/236 (30.1%) reported to know useful online information sources related to ASSD. 223/236 (94.5%) were willing to share health data for research purposes once a year. Our results reiterate that internet-based research is invaluable for cooperating with patients to foster knowledge in rare diseases.
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Affiliation(s)
- M Weiss
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University, Erlangen, Germany
| | - M T Holzer
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - F Muehlensiepen
- Faculty of Health Sciences, Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Y Ignatyev
- Faculty of Health Sciences, Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - C Fiehn
- Praxis für Rheumatologie, Klinische Immunologie, Medical Center, Baden-Baden, Germany
| | - J Bauhammer
- Praxis für Rheumatologie, Klinische Immunologie, Medical Center, Baden-Baden, Germany
| | - J Schmidt
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany
- Department of Neurology and Pain Treatment, Center for Translational Medicine, Neuromuscular Center, Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany
- Department of Neurology, Neuromuscular Center, University Medical Center, Göttingen, Germany
| | - S Schlüter
- Myositis-Gruppe, Deutsche Gesellschaft Für Muskelkranke, Freiburg, Germany
| | - A Dihkan
- The Swedish Working Group for Myositis, The Swedish Rheumatism Association, Stockholm, Sweden
| | - D Scheibner
- Myositis-Gruppe, Deutsche Gesellschaft Für Muskelkranke, Freiburg, Germany
| | - U Schneider
- Department of Rheumatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - L Valor-Mendez
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University, Erlangen, Germany
| | - G Corte
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University, Erlangen, Germany
| | - L Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
- Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - H Chinoy
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - I Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - L Cavagna
- Rheumatology Division, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - J H W Distler
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University, Erlangen, Germany
| | - G Schett
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University, Erlangen, Germany
| | - J Knitza
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University, Erlangen, Germany
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Schlüter S, de Groot I, Lubinus M, Dihkan A, Johnsson J, Drápalová O, Oakley I. Working towards a patient-centred Global Myositis Alliance: call for partnership. Clin Exp Rheumatol 2023; 41:214-216. [PMID: 36700650 DOI: 10.55563/clinexprheumatol/u1pdqm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 11/18/2022] [Indexed: 01/24/2023]
Affiliation(s)
- Silke Schlüter
- Diagnosegruppe Myositis, Deutsche Gesellschaft für Muskelkranke, Freiburg, Germany.
| | - Ingrid de Groot
- Dutch Myositis Working Group, Spierziekten Nederland, Baarn, The Netherlands
| | - Manuel Lubinus
- Myositis Support and Understanding Association, Lincoln, DE, USA
| | - Anneli Dihkan
- The Swedish Working Group for Myositis, The Swedish Rheumatism Association, Stockholm, Sweden
| | - Jan Johnsson
- The Swedish Working Group for Myositis, The Swedish Rheumatism Association, Stockholm, Sweden
| | - Olga Drápalová
- Czech Myositis Working Group, Czech League against Rheumatism, Prague, Czech Republic
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Deike-Hofmann K, von Lampe P, Eerikaeinen M, Ting S, Schlüter S, Schlemmer PH, Bechrakis N, Forsting M, Radbruch A. Enhancement der Vorderen Augenkammer ist ein Prediktor für die Optikusinfiltration bei Retinoblastomen. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | - S Ting
- Pathologie, Uniklinik Essen, Essen
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Schmidt J, Korsten P, Zechel S, Schlüter S. Introducing the international Myositis Society (iMyoS): a novel multiprofessional society to foster the care, education, and research on myositis. Clin Exp Rheumatol 2022; 40:210-213. [DOI: 10.55563/clinexprheumatol/1a7tkf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Jens Schmidt
- Muscle Immunobiology Group, Department of Neurology, Neuromuscular Center, University Medical Center Göttingen; Department of Neurology and Pain Treatment, University Hospital of the Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf bei Berlin; and Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany.
| | - Peter Korsten
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Germany
| | - Sabrina Zechel
- Department of Neuropathology, University Medical Center Göttingen, Germany
| | - Silke Schlüter
- Diagnosegruppe Myositis, Deutsche Gesellschaft für Muskelkranke, Freiburg, Germany
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Girod K, Schlüter S, Hennig T, Lohmann H, Kaluza S. Methanol synthesis with real steel mill gases: Performance investigations in a new on‐site technical center. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- K. Girod
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - S. Schlüter
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - T. Hennig
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - H. Lohmann
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - S. Kaluza
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
- Hochschule Düsseldorf, University of Applied Sciences Faculty of Mechanical and Process Engineering Münsterstr. 156 40476 Düsseldorf Germany
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Lohse M, Blaser SRGA, Vetterlein D, Schlüter S, Oburger E, Reemtsma T, Lechtenfeld OJ. Online Nano Solid Phase Extraction Fourier-Transform Ion Cyclotron Resonance Mass Spectrometry Workflow to Analyze Small Scale Gradients of Soil Solution Organic Matter in the Rhizosphere. Anal Chem 2020; 92:10442-10449. [PMID: 32628457 DOI: 10.1021/acs.analchem.0c00946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A new method combining online nano solid phase extraction coupled with Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR-MS) was developed to extract and analyze organic matter (OM) from microliter volumes of salt containing soil solution samples. This approach allows the reproducible analysis of only minute amounts of organic carbon (down to 10 ng C) without the need of further sample preparation. The new method was applied to unravel developing small-scale patterns of dissolved organic matter (DOM) in soil solutions of a soil column experiment in which Zea mays plants were grown for 3 weeks. Soil solution was sampled by micro suction cups from the undisturbed soil-root system once a week. Growth of the root system and, hence, position of individual roots relative to the suction cups was followed by X-ray computed tomography (X-ray CT). Our method makes it possible to resolve the chemical complexity of soil solution OM (up to 4300 molecular formulas from 2.5 μL sample). This allows to observe chemical gradients in the rhizosphere on a molecular level over time. The increasing influence of roots on soil solution OM is visible from higher molecular masses, an increasing degree of oxygenation and a higher fraction of formulas containing heteroatoms. The online nano solid phase extraction-FT-ICR-MS method provides novel insight into the processes affecting DOM in the rhizosphere, such as root exudation, microbial processes, and soil organic matter stabilization.
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Affiliation(s)
- M Lohse
- Department of Analytical Chemistry, Helmholtz Centre for Environmental Research - UFZ, 04318, Leipzig, Germany
| | - S R G A Blaser
- Department of Soil System Science, Helmholtz Centre for Environmental Research - UFZ, 06120, Halle, Germany
| | - D Vetterlein
- Department of Soil System Science, Helmholtz Centre for Environmental Research - UFZ, 06120, Halle, Germany.,Institute of Agricultural and Nutritional Sciences, Martin-Luther-University Halle-Wittenberg, Von-Seckendorff-Platz 3, 06120 Halle (Saale), Germany
| | - S Schlüter
- Department of Soil System Science, Helmholtz Centre for Environmental Research - UFZ, 06120, Halle, Germany
| | - E Oburger
- Institute of Soil Research, University of Natural Resources and Life Sciences, Vienna - BOKU, 3430 Tulln an der Donau Austria
| | - T Reemtsma
- Department of Analytical Chemistry, Helmholtz Centre for Environmental Research - UFZ, 04318, Leipzig, Germany.,Institute of Analytical Chemistry, University of Leipzig, 04103, Leipzig, Germany
| | - O J Lechtenfeld
- Department of Analytical Chemistry, Helmholtz Centre for Environmental Research - UFZ, 04318, Leipzig, Germany.,ProVIS - Centre for Chemical Microscopy, Helmholtz Centre for Environmental Research - UFZ, 04318, Leipzig, Germany
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Harder B, Schulzke T, Schlüter S, Deerberg G. Simulation eines Reaktors zur ablativen Flash-Pyrolyse mit COMSOL Multiphysics. CHEM-ING-TECH 2015. [DOI: 10.1002/cite.201550050] [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: 11/12/2022]
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Niemeyer H, Sengespeick A, Meller K, Schlüter S, Schieferstein E, Deerberg G. Adsorbenskomposit mit gesteigerter Wärmeleitfähigkeit zur Verbesserung der Effizienz mobiler Methanadsorptionsspeicher. CHEM-ING-TECH 2013. [DOI: 10.1002/cite.201250645] [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: 11/10/2022]
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Janicki G, Egenolf-Jonkmanns B, Schlüter S, Hennig T, Bruzzano S, Deerberg G. Untersuchungen zu Gashydraten. CHEM-ING-TECH 2013. [DOI: 10.1002/cite.201250654] [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: 11/07/2022]
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Janicki G, Schlüter S, Hennig T, Deerberg G. Simulation der Gewinnung von Erdgas aus maritimen Hydratlagerstätten und der CO2-Speicherung. CHEM-ING-TECH 2010. [DOI: 10.1002/cite.201050369] [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: 11/12/2022]
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Fassbender WJ, Schlüter S, Stracke H, Bretzel RG, Waas W, Tillmanns H. [Thyroid function after iodine-containing contrast agent administration in coronary angiography: a prospective study of euthyroid patients]. Z Kardiol 2001; 90:751-9. [PMID: 11757471 DOI: 10.1007/s003920170095] [Citation(s) in RCA: 21] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In a prospective study, thyroid metabolism in 102 patients undergoing diagnostic coronary angiography was investigated, stratified for thyroid morphology. The thyroid function serum parameters "TT3, rT3, TT4, fT4 and TSH" and the urinary iodine excretion were measured before and three weeks after diagnostic intraarterial administration of the iodine-containing contrast agent. Only patients with euthyroid function were included in order to answer the questions whether or not the administration of non-ionic iodine containing contrast medium leads to significant thyroid function changes in euthyroid patients and whether thyroid morphology is a prognostic factor for the risk of developing hyperthroidism. Serum concentrations of thyroid autoantibodies (TPO-Ab, Tg-Ab, TSH-receptor-Ab) were measured and thyroid ultrasound was performed. According to the ultrasound findings, 4 morphologic groups were formed: normal thyroid glands (n = 37), normal sized but nodular glands (n = 16), diffuse goiter (n = 15) and nodular goiter (n = 34). Twenty-five patients were positive for Tg-Ab; TPO-Ab were found in 13 patients. TSH-receptor-Abs were not detected in all patients. TT3 levels did not significantly change after iodine application (p = 0.30). TT4 and fT4 levels showed significantly different alterations in the 4 groups (fT4 p < 0.001). The amount of iodine given did not influence alteration of serum concentrations of TSH (p = 0.67), TT3 (p = 0.68), TT4 (p = 0.37), fT4 (p = 0.92) and rT3 (p = 0.81). Elevated levels of urinary iodine excretion correlated with the amount of contrast medium given (p = 0.087). Albeit there was a high number of nodular transformed glands and goitrous patients included, and our cohort was recruited in an iodine deficient area, we did not observe hyperthyroidism in any patient. However, thyroid function parameters are significantly altered after coronary angiography independent of antibody status and the amount of contrast agent given, but dependent on thyroid morphology.
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Affiliation(s)
- W J Fassbender
- Medizinische Klinik I Klinikum der Johann-Wolfgang-Goethe-Universität Theodor-Stern-Kai 7 60590 Frankfurt am Main, Germany
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Boltersdorf U, Deerberg G, Schlüter S, Weinspach PM. Stirred Tank Reactors in Multiphase Operation-Simulation of Catalytic Reactions and Crystallisation Processes. CHEM-ING-TECH 2001. [DOI: 10.1002/1522-2640(200106)73:6<740::aid-cite7401111>3.0.co;2-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Prasser HM, Dudlik A, Schönfeld S, Fahlenkamp H, Schlüter S. Prevention of Water Hammer in Pipelines in Case of Emergency Shut-Off by Fast Acting Valves. CHEM-ING-TECH 2001. [DOI: 10.1002/1522-2640(200106)73:6<611::aid-cite6114444>3.0.co;2-s] [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: 11/10/2022]
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zur Stadt U, Harms DO, Schlüter S, Schrappe M, Goebel U, Spaar H, Janka G, Kabisch H. MRD at the end of induction therapy in childhood acute lymphoblastic leukemia: outcome prediction strongly depends on the therapeutic regimen. Leukemia 2001; 15:283-5. [PMID: 11236947 DOI: 10.1038/sj.leu.2402019] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- U zur Stadt
- Department of Pediatric Hematology and Oncology, University of Hamburg, Germany
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Boltersdorf U, Deerberg G, Schlüter S. Modellierung und Simulation von mehrphasigen Rührreaktoren mit Zellnetz-Modellen: Ergänzung oder Alternative zur CFD-Simulation? CHEM-ING-TECH 2000. [DOI: 10.1002/1522-2640(200009)72:9<1068::aid-cite10680>3.0.co;2-1] [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: 11/06/2022]
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zur Stadt U, Harms DO, Schlüter S, Jorch N, Spaar HJ, Nürnberger W, Völpel S, Gutjahr P, Schrappe M, Janka G, Kabisch H. [Minimal residual disease analysis in acute lymphoblastic leukemia of childhood within the framework of COALL Study: results of an induction therapy without asparaginase]. Klin Padiatr 2000; 212:169-73. [PMID: 10994545 DOI: 10.1055/s-2000-9672] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
UNLABELLED The detection of minimal residual disease (MRD) is a major prognostic factor for treatment in acute lymphoblastic leukemia (ALL) of childhood. Several groups showed the predictive value of MRD after 5 weeks of chemotherapy (at the end of induction therapy). Patients with more than 1 leukemic cells in 100 cells (> or = 10(-2)) at this time-point have a significantly higher relapse rate. The MRD measurement has been shown to be an independent prognostic factor at several time points in the BFM study (ALL-BFM 90) as well as in the EORTC study. The aim of our investigations was the detection of MRD at the end of induction therapy within the COALL studies which is different from the above studies. In the COALL studies, therapy starts with a 1 week DNR prephase (24 h infusion on day one) and i.th. MTX. Induction therapy consisted of 3 drugs over a period of 4 weeks (Prednisolone, Vincristine and Daunorubicin), asparaginase is given later in consolidation. At the end of induction therapy, bone marrow was obtained for cytomorphologic and molecular analysis. PATIENTS AND METHODS We investigated bone marrow samples from 76 patients. All patients were in morphologic remission at the end. of induction therapy. For MRD analysis, DNA was isolated from bone marrow mononuclear cells. Clonal T-cell-receptor (TCR) or immunoglobulin gene (IgH) rearrangements were identified by PCR. Monoclonal products were either sequenced directly (TCR) or after excision from high resolution agarose gels. Subsequently patient-specific oligonucleotides for allele-specific PCR were generated. PCR analysis was performed with 1 microgram DNA for each reaction within a semiquantitative matter. This method reached sensitivities down to 10(-5). RESULTS Eighty-four percent of the analysed samples were MRD positive at the end of induction therapy. 20 out of 76 patient samples (26%) were highly positive (> or = 10(-2)), 28 patients had levels of about 10(-3) (37%), 16 had levels around 10(-4) (21%) and 12 patients had no detectable residual cells (16%). All analysed 15 T-ALL patients had detectable residual disease at this timepoint. Until now, 5/20 patients with very high MRD level at the end of induction therapy suffered a relapse. DISCUSSION Patients with very high MRD level at the end of induction therapy showed an elevated risk of relapse, but the predictive value is much poorer than for example in the BFM 90 MRD-study. We suggest, that a high MRD level at this timepoint results from a different induction therapy compared to the BFM 90 study. In the COALL studies asparaginase is given only after induction therapy to decrease the risk of thrombosis. We would like to conclude that this differences were compensated later during therapy as the event free survival of both studies is similar. In conclusion, an optimal information from MRD studies is strongly associated with the given therapy. Therefore we initiated an additional MRD time-point after the first chemotherapy block in consolidation.
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Affiliation(s)
- U zur Stadt
- Abt. für pädiatrische Hämatologie und Onkologie, Universitätskinderklinik Eppendorf, Hamburg.
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Schlüter S, Steinhart H, Schwarz FJ, Kirchgessner M. Changes in the odorants of boiled carp fillet (Cyprinus carpio L.) as affected by increasing methionine levels in feed. J Agric Food Chem 1999; 47:5146-5150. [PMID: 10606586 DOI: 10.1021/jf9902604] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Sixty common carp in groups of five in four tanks per treatment were given three diets containing different increasing amounts of methionine. The aroma extract dilution analysis (AEDA) of the boiled carp fillets resulted in 32 odorants, of which 26 were identified. Ten compounds were quantified using an internal standard (IS), and the very low concentrations of 2-acetyl-1-pyrroline, (Z)-1, 5-octadien-3-one, and methional were calculated by the nasally determined detection limit. The concentration of methional seemed to increase with increasing methionine in the diet. Because the unstable methional could be converted by beta-elimination into methanethiol, the impact resulting in an off-flavor was investigated by headspace analysis. The investigation revealed no difference in the methanethiol contents between the treatments with the lowest and highest methionine supplies.
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Affiliation(s)
- S Schlüter
- Institute of Physiology of Nutrition, Technical University of Munich, 85356 Freising-Weihenstephan, Germany
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Abstract
We used immunocytochemical staining of peripheral (trigeminal) nerve to screen sera of patients with Guillain-Barré syndrome (GBS) for the presence of autoantibodies, using sera from patients with other neurological diseases and healthy volunteers as controls. Most sera mildly reacted with axons, myelin sheaths, or sensory neurons without correlation to a specific disease. A characteristic staining, however, was found in 23 demyelinating cases (89%) out of 26 investigated GBS sera. With these sera, dark, oval and often paired small blobs were observed throughout the sections. A similar picture was rarely observed with sera from patients with other disorders or healthy controls. Using immunocytochemical marker proteins and high light microscopic resolution, the blobs were identified as Schmidt-Lanterman's incisures (SLIs). Further investigations will be necessary to identify the corresponding antigen and to answer the question, whether these antibodies represent an epiphenomenon or play a role in the causative mechanism of the disease.
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Affiliation(s)
- A Görtzen
- Neurologische Klinik, St. Josef-Hospital, Oberhausen, Germany.
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Dudlik A, Schlüter S, Weinspach PM. 104. Transiente Strömungen in Rohrleitungen - Diagnose von Druckstößen und Kavitationsschlägen. CHEM-ING-TECH 1998. [DOI: 10.1002/cite.3307009106] [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: 11/06/2022]
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Anderegg B, Schlüter S, Kabisch H. Highly efficient and non-toxic DNA isolation from very old bone marrow smears. Leukemia 1998; 12:774-5. [PMID: 9593279 DOI: 10.1038/sj.leu.2401008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Kammel U, Körner HJ, Schlüter S, Weinspach PM. Kontrolle durchgehender Reaktionen durch den Einsatz von Reaktions-stoppern. CHEM-ING-TECH 1997. [DOI: 10.1002/cite.3306909100] [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: 11/08/2022]
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Albrecht S, le Blond R, Köhler V, Cordis R, Gill C, Kleihues H, Schlüter S, Noack W. [Cryotherapy as analgesic technique in direct, postoperative treatment following elective joint replacement]. Z Orthop Ihre Grenzgeb 1997; 135:45-51. [PMID: 9199073 DOI: 10.1055/s-2008-1039554] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The application of crushed ice or hydrogenated silicate, a micro-crystalline substitute has been used as a method to treat posttraumatic and postoperative irritations of the locomotor system for a long time. Closed systems using pumps can be viewed as further development as they enable continuous, water-free cooling of operating areas. The analgetic effect of postoperative cold therapy was evaluated in a prospective clinical trial, including 312 patients after total knee or hip arthroplasty. Conventional cold packs, consisting of microcrystalline silicate were compared to a continuous applicable closed system. Continuous cryotherapy resulted in a depression of skin temperature to 12 degrees C, whereas intermittent cooling only caused a mean temperature decrease of 1 degree C. Clinically continuous cold application leads to a more than 50% decrease of analgetic demands in both, systemic and regional application (p < 0.001). This observation was found in a significant correlation with patient's pain sensation as well as primary range of motion. Intermittent cryotherapy was found to be ineffective in postoperative pain relieve in hip- and adequate in knee arthroplasty patients. We could not report an influence on postoperative blood loss, as discussed in previous reports.
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Affiliation(s)
- S Albrecht
- Abteilung für Orthopädie, Ev. Waldkrankenhaus Spandau, Akademisches Lehrkrankenhaus, Klinikum Rudolf Virchow Medizinische Fakultät, Humboldt-Universität Berlin
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Heintzen MP, Michel CJ, Schlüter S, Leschke M, Schwartzkopff B, Vester EG, Kelm M, Schiele TM, Strauer BE. [Interventional therapy in acute myocardial infarct]. Internist (Berl) 1997; 38:44-52. [PMID: 9119658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M P Heintzen
- Medizinische Klinik und Poliklinik B, Kardiologie, Pneumologie, Angiologie, Heinrich-Heine-Universität Düsseldorf
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Niehues R, Schlüter S, Kramer A, Klein RM, Strauer BE, Schaal KP, Horstkotte D. [Systemic Nocardia asteroides infection with endocardial involvement in a patient undergoing immunosuppressive therapy]. Dtsch Med Wochenschr 1996; 121:1390-5. [PMID: 8964228 DOI: 10.1055/s-2008-1043158] [Citation(s) in RCA: 9] [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] [Indexed: 02/03/2023]
Abstract
HISTORY A 62 year-old male patient developed malaise, unproductive cough and high temperature (39.5 degrees C) during immunosuppressive therapy with methylprednisolon and cyclosporin A six months after kidney transplantation for glomerulonephritis. INVESTIGATIONS Clinical examination revealed an endophthalmitis and chest X ray a left-sided lobar pulmonic infiltration. Computed tomography and magnetic resonance imaging examination performed because of recurrent petit-mal-convulsions demonstrated multiple intracranial infiltrations. Transoesophageal echocardiography revealed floating vegetations up to 8 mm in diameter predominantly attached to the aortic valve. A total of 39 consecutive blood cultures drawn during several days remained sterile. However, Nocardia asteroides (Biovar A1) was isolated from a small cutaneous tumor excised from the right thigh. TREATMENT AND COURSE After initiation of a specific antibiotic treatment with imipenem/cilastatin (each 1 g three times daily), and doxycyclin (100 mg twice daily), computed tomography and magnetic resonance imaging showed a reduction in size and number of the intracranial infiltrations. Neurological symptoms were progressive despite maximal anticonvulsant therapy. The patient died 83 days after hospital admission from an epileptic state resistant to therapy. CONCLUSION Though nocardiosis is still rare, it should early be included in the differential diagnosis of infections in immunocompromised patients to allow timely diagnosis and therapy.
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Affiliation(s)
- R Niehues
- Klinik für Kardiologie, Pneumologie und Angiologie, Universität Düsseldorf
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Tofern B, Simat T, Schulz H, von Wachtendonk D, Wischmann H, Schlüter S, Beil D, Eulitz K, Miethke, Herrmann K, Rehbein H, Wittmann R, Wegner-Hambloch S, van Wickern B, Besler M, Steinhart H, Fritsche J, Täufel A, Hener U, Pabel B, Reiners W, Hein W, Schwerdtfeger E, Spiegel H, Männlein E, Haselein I, Oehlenschläger J, Griffig J, Stumm I, Karl H, Krause E, Reinders G, Täubert T, Heimhuber B, Fretzdorff B, Hartmann S, Bezkorovainy S, Hübner D, Renger A, Schindler M, Feldheim W, Broschard T, Rathjen T, von Rymon Lipinski G, Jager M, Honikel M, Reiß J, Lück E, Vogelgesang J, Timm M, Möller M, Armbruster W, Gasser U, Kettrup PA, Bauer U, Food JJ, Kotoucek J, Köhnlein M, Wettach J, van Lishaut H, Majerus P, Brauckhoff S, Hees C, Otteneder H, Rudolph T, Lederer M, Breithaupt D, Wölwer-Rieck U, Petridis KD, Brockmann R, Luckas B. W, Rohrdanz A, Endres O, Schubring R, Engelhardt U, Krings U, Schulz C, Wedekind R, Bohnenstengel F, Kohl-Himmelseher M, Bartsch A, Marx F, Schrödter R, Stauff D, Paschke A, Martin N, Hahn H, Hagenauer-Hener U, Mätzel U, Stephani A, Gutmacher B, Schwack W, Ehlermann D, Öehlenschläger J, Seulen P. Abstracts. Eur Food Res Technol 1996. [DOI: 10.1007/bf01193339] [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: 11/29/2022]
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Grän-Heedfeld J, Schlüter S, Steiff A, Weinspach PM. 34. Beitrag zur Modellierung von Airliftschlaufenreaktoren unter besonderer Berücksichtigung der Gaszirkulation. CHEM-ING-TECH 1996. [DOI: 10.1002/cite.330680936] [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: 11/06/2022]
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Deerberg G, Schlüter S, Steiff A. 127. Methoden zur sicherheitstechnischen Beurteilung zweiphasiger Semi-Batch-Prozesse. CHEM-ING-TECH 1996. [DOI: 10.1002/cite.3306809129] [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: 11/06/2022]
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Deerberg G, Schlüter S, Steiff A, Witt W. Maßnahmen zum sicheren Betrieb zweiphasiger Semibatch-Prozesse. CHEM-ING-TECH 1995. [DOI: 10.1002/cite.3306709161] [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: 11/07/2022]
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Grän-Heedfeld J, Schlüter S, Steiff A, Daun M. 110. Mathematische Modellierung eines Tiefschachtreaktors für die Naßoxidation von Klärschlämmen. CHEM-ING-TECH 1994. [DOI: 10.1002/cite.3306609111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Schlüter S, Erkrath KD. [Dealing with AIDS in a North Rhine Westphalia large city: Bottrop]. Offentl Gesundheitswes 1989; 51:688-91. [PMID: 2532721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The various Public Health offices in North Rhine Westphalia are making a substantial contribution towards AIDS prevention means of their relevant concepts. Regional and political individualities as well as local structures can exercise a positive or a negative effect on concrete AIDS prevention work. Cities like Düsseldorf, Köln, Essen etc., enjoy material and personal advantages. Smaller communities (like Bottrop) must rely entirely on creative working concepts. The AIDS prevention concept of Bottrop (a city situated in the northern Ruhr area with a population of 120,000), consisting of sexual education and paedagogical approaches, is presented. The information aims at specific groups, but has no ideological strings attached. The report refers to five main points of working: 1. AIDS prevention with special attention to adolescents in school and out-of-school contexts. 2. Medical advice by institutions. 3. Daily AIDS consulting hours in the Public Health office. 4. Planning and realisation of an action day 'Health Day'. 5. Working with drug addicts. In addition, there is an epidemiological approach. The overall aims are the prevention or infection and a human psychosocial spectrum of advice without excluding anyone.
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