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Schmalz G, Garbade J, Sommerwerck U, Kollmar O, Ziebolz D. Oral health-related quality of life of patients after solid organ transplantation is not affected by oral conditions: results of a multicentre cross-sectional study. Med Oral Patol Oral Cir Bucal 2021; 26:e437-e444. [PMID: 33340076 PMCID: PMC8254886 DOI: 10.4317/medoral.24277] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background This multicentre cross-sectional study aimed in examination of oral health-related quality of life (OHRQoL) of patients after solid organ transplantation (SOT).
Material and Methods Patients after SOT (liver, lung and heart) at one out of three German centers (Goettingen, Essen, Leipzig) were included. For comparison, a healthy control (HC) was recruited. OHRQoL was assessed by German short form of oral health impact profile (OHIP G14). Oral examination comprised: decayed-, missing- and filled-teeth index (DMF-T), remaining teeth and periodontitis severity.
Results In total, 196 patients after SOT and 130 HC with comparable age, gender and smoking habits were included (p>0.05). DMF-T and number of remaining teeth was worse in SOT group (p<0.01). OHIP G14 sum score was significantly higher in SOT (3.49 ± 5.73 vs. 1.33 ± 2.63, p<0.01). In contrast to HC, in SOT no associations between OHIP G14 and oral health parameters were found (p>0.05). Number of remaining teeth was not an independent predictor of OHIP G14 sum score in SOT (β -0.082, CI95 -0.156 - 0.045, p=0.28).
Conclusions OHRQoL of SOT recipients is not affected by their oral condition, leading to the assumption that the individual perception of patients physical oral health is not in line with the clinical situation. Key words:Oral health, oral health-related quality of life, solid organ transplantation.
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Affiliation(s)
- G Schmalz
- University Leipzig Dept. of Cariology, Endodontology and Periodontology Liebigstr. 12, D 04103 Leipzig, Germany
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Schmalz G, Berisha L, Wendorff H, Widmer F, Marcinkowski A, Teschler H, Sommerwerck U, Haak R, Kollmar O, Ziebolz D. Association of time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected bacteria of patients after solid organ transplantation. Med Oral Patol Oral Cir Bucal 2018; 23:e326-e334. [PMID: 29680846 PMCID: PMC5945244 DOI: 10.4317/medoral.22238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/18/2017] [Indexed: 02/03/2023] Open
Abstract
Background Aim of this study was to investigate the association of the time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected periodontal pathogenic bacteria of immunosuppressed patients after solid organ transplantation (SOT). Material and Methods 169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs. combination). Periodontal probing depth (PPD) and clinical attachment loss (CAL) were assessed. Periodontal disease severity was classified as healthy/mild, moderate or severe periodontitis. Subgingival biofilm samples were investigated for eleven selected potentially periodontal pathogenic bacteria using polymerasechainreaction. Results The mean PPD and CAL as well as prevalence of Treponema denticola and Capnocytophaga species was shown to be different but heterogeneous depending on time under immunosuppression (p<0.05). Furthermore, only the medication with Cyclosporine was found to show worse periodontal condition compared to patients without Cyclosporine (p<0.05). Prevalence of Porphyromonas gingivalis, Tannerella forsythia and Fusobacterium nucleatum was reduced and prevalence of Parvimonas micra and Capnocytophaga species was increased in patients under immunosuppression with Glucocorticoids, Mycophenolate as well as combination therapy. Conclusions Time under and form of immunosuppression might have an impact on the clinical periodontal and microbiological parameters of patients after SOT. Patients under Cyclosporine medication should receive increased attention. Differences in subgingival biofilm, but not in clinical parameters were found for Glucocorticoids, Mycophenolate and combination therapy, making the clinical relevance of this finding unclear. Key words:Immunosuppression, organ transplantation, periodontitis, periodontal bacteria.
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Affiliation(s)
- G Schmalz
- University Leipzig, Dept. of Cariology, Endodontology and Periodontology, Liebigstr. 12, D 04103 Leipzig, Germany,
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Besa V, Cherneha M, Weinreich G, Slama A, Sommerwerck U, Taube C, Aigner C, Kamler M, Wilde B, Witzke O. Increased Phosphorylation of p70S6 Kinase is Associated With CMV Reactivation in Lung Transplant Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.517] [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: 11/25/2022] Open
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Alkhatib A, Mairose U, Sommerwerck U, Rasche K. Chronische eosinophile Pneumonie als Arzneimittelnebenwirkung von Nitrofurantoin. Pneumologie 2018. [DOI: 10.1055/s-0037-1619333] [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: 10/28/2022]
Affiliation(s)
- A Alkhatib
- Helios Universitätsklinikum Wuppertal; Universität Witten/Herdecke; Bergisches Lungenzentrum – Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
| | - U Mairose
- Helios Universitätsklinikum Wuppertal
| | - U Sommerwerck
- Helios Universitätsklinikum Wuppertal; Universität Witten/Herdecke; Bergisches Lungenzentrum – Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
| | - K Rasche
- Helios Universitätsklinikum Wuppertal; Universität Witten/Herdecke; Bergisches Lungenzentrum – Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
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Besa V, Bonella F, Ohshimo S, Weinreich G, Costabel U, Kamler M, Teschler H, Sommerwerck U. KL-6 Changes in Serum Can Be Predictive of Chronic Lung Allograft Dysfunction in Lung Transplant Recipients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.111] [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: 10/23/2022] Open
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Unger N, Simon A, Lahner H, Mellies U, Stehling F, Sutharsan S, Sommerwerck U, Teschler H, Kiewert C, Grasemann C, Hauffa BP, Führer D. Endocrine disorders in adolescents and young adults with cystic fibrosis. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Funke F, Fleimisch P, Kleibrink B, Firch V, Theegarten D, Weinreich G, Kamler M, Witzke O, Teschler H, Sommerwerck U. Bortezomibtherapie bei Bronchiolitis-Obliterans-Syndrom nach Lungentransplantation. Pneumologie 2015. [DOI: 10.1055/s-0035-1544821] [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: 10/24/2022]
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Besa V, Bonella F, Ohshimo S, Weinreich G, Costabel U, Kamler M, Teschler H, Sommerwerck U. Rolle von Serum KL-6 als Biomarker für die Entwicklung einer chronischen Dysfunktion des Lungentransplantates. Pneumologie 2015. [DOI: 10.1055/s-0035-1544820] [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: 10/24/2022]
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Marcinkowski A, Kleibrink B, Weinreich G, Kamler M, Teschler H, Ziebolz D, Sommerwerck U. Mundgesundheitszustand bei Patienten nach Lungentransplantation – erste Ergebnisse einer klinisch monozentrischen Querschnittsstudie. Pneumologie 2015. [DOI: 10.1055/s-0035-1544819] [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: 10/24/2022]
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Gottlieb J, Greer M, Sommerwerck U, Deuse T, Witt C, Schramm R, Hagl C, Strueber M, Smits JM. Introduction of the lung allocation score in Germany. Am J Transplant 2014; 14:1318-27. [PMID: 24854023 DOI: 10.1111/ajt.12752] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [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: 09/23/2013] [Revised: 02/03/2014] [Accepted: 02/03/2014] [Indexed: 01/25/2023]
Abstract
The aim of this study was to assess performance of the new lung allocation system in Germany based on lung allocation score (LAS). Retrospective analysis of waitlist (WL) outflow, lung transplantation (LTx) activity and 3-month outcomes comparing 1-year pre- and post-LAS introduction on December 10, 2011 was performed. Following LAS introduction, WL registrations remained constant, while WL mortality fell by 23% (p = 0.04). Reductions in WL mortality occurred in patients with cystic fibrosis (CF; -52%), emphysema (chronic obstructive pulmonary disease [COPD]; -49%) and pulmonary hypertension (PH; -67%), but not idiopathic pulmonary fibrosis (IPF; +48%). LTx activity increased by 9% (p = 0.146). Compared to pre-LAS, more patients with IPF (32% vs. 29%) and CF (20% vs. 18%) underwent transplantation and comparatively fewer with COPD (30% vs. 39%). Median LAS among transplant recipients was highest in PH (53) and IPF (49) and lowest in COPD (34). Transplantation under invasive respiratory support increased to 13% (in CF 28%, +85%, p = 0.017). Three-month survival remained unchanged (pre: 96.1% and post: 94.9%, p = 0.94). Following LAS implementation in Germany, reductions in waiting list size and WL mortality were observed. Composition of transplant recipients changed, with fewer COPD and more IPF recipients. Transplantation under invasive respiratory support increased. Reductions in WL mortality were most pronounced among CF and PH patients.
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Affiliation(s)
- J Gottlieb
- Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany; Biomedical Research in End-Stage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
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Sommerwerck U, Virella-Lowell I, Angyalosi G, Viegas A, Iqbal A, Wan R, Debonnett L. 77 Long-term safety of tobramycin powder for inhalation in patients with cystic fibrosis: ETOILES study. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60213-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Besa V, Ohshimo S, Weinreich G, Bonella F, Costabel U, Kamler M, Teschler H, Sommerwerck U. Serum KL-6 Levels Are Associated With Long-Term Prognosis in Lung Transplant Recipients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Weidmann M, Kleibrink B, Rabis T, Weinreich G, Kamler M, Teschler H, Sommerwerck U. Hypercapnic Ventilatory Response Is Decreased in Long-Term Bilateral Lung Transplant Recipients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.507] [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] Open
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Bessa V, Ohshimo S, Weinreich G, Bonella F, Costabel U, Kamler M, Teschler H, Sommerwerck U. Serum KL-6 Ausgangskonzentration korreliert mit der Langzeitprognose von lungentransplantierten Patienten. Pneumologie 2014. [DOI: 10.1055/s-0034-1367945] [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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Kleibrink B, Rabis T, Weinreich G, Teschler H, Sommerwerck U. Unterschiede bei der klinischen Bestimmung der Nierenfunktion durch Kreatinin, Cystatin C und mittels 24-Stunden Sammelurins bei Lungentransplantierten. Pneumologie 2014. [DOI: 10.1055/s-0034-1367994] [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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Hartmann D, Theegarten D, Kamler M, Dührsen U, Teschler H, Sommerwerck U. Ist eine maligne Grunderkrankung immer eine absolute Kontraindikation für eine Lungentransplantationslistung? Eine Fallvorstellung. Pneumologie 2014. [DOI: 10.1055/s-0034-1368014] [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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Sommerwerck U, Kleibrink B, Kruse F, Wang Y, Kamler M, Teschler H, Weinreich G. Predictors of Sleep-Disordered Breathing in Lung Transplant Recipients. Pneumologie 2014. [DOI: 10.1055/s-0034-1367939] [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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Sommerwerck U, Rabis T, Fleimisch P, Carstens H, Teschler H, Kamler M. [Lung transplantation]. Herz 2014; 39:74-83. [PMID: 24477632 DOI: 10.1007/s00059-013-4044-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lung transplantation is a therapeutic option for patients with end-stage lung diseases. Selection of candidates requires careful consideration of the disease-specific indications and contraindications for transplantation. Advances have been made in candidate selection via the ability to prognosticate outcomes of various lung diseases and through the implementation of the lung allocation score (LAS) with specific consideration of the degree of urgency and good postoperative survival rate, after neglecting the waiting time. This system has resulted in decreased mortality on the waiting list for lung transplantation. The availability of donor organs can possibly be increased by implementation of ex vivo lung perfusion as an alternative to conventional organ preservation. Risk factors for poor outcomes post-lung transplantation have been identified and understanding of the physiological, cellular and molecular mechanisms responsible for lung and airway damage has been extensively expanded. Primary graft dysfunction, infectious diseases, acute rejection, antibody-mediated rejection, lymphocytic bronchiolitis, obliterative bronchiolitis, restrictive allograft syndrome, and chronic lung allograft dysfunction are well defined complications and continue to be common causes of morbidity and mortality. This article provides a comprehensive update on these topics for the non-transplantation clinician.
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Affiliation(s)
- U Sommerwerck
- Abt. f. Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Deutschland,
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Kruse F, Rabis T, Kleibrink B, Wang Y, Langguth N, Broecker-Preuss M, Jäger A, Weinreich G, Kamler M, Teschler H, Sommerwerck U. Entzündungsparameter, Lipide und metabolische Hormone bei lungentransplantierten Patienten mit obstruktiver Schlafapnoe. Pneumologie 2013. [DOI: 10.1055/s-0033-1334787] [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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Weidmann M, Kleibrink B, Rabis T, Weinreich G, Kamler M, Teschler H, Sommerwerck U. Niedrige hyperkapnische Atemantwort bei Langzeit-Lungentransplantierten ist mit einer Beeinträchtigung der körperlichen Leistung assoziiert. Pneumologie 2013. [DOI: 10.1055/s-0033-1334512] [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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Chan O, Rabis T, Kleibrink B, Wang Y, Moraidis I, Weinreich G, Kamler M, Teschler H, Sommerwerck U. Der Berlin-Fragebogen und der STOP-BANG-Fragebogen sind nicht geeignet zur Ermittlung von schlafbezogenen Atemstörungen bei Patienten nach Lungentransplantation. Pneumologie 2013. [DOI: 10.1055/s-0033-1334671] [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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Kleibrink B, Rabis T, Nagy P, Weinreich G, Sommerwerck U, Kamler M, Teschler H. Diffusionskapazität nach Lungentransplantation. Pneumologie 2013. [DOI: 10.1055/s-0033-1334513] [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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Weidmann M, Kruse F, Kleibrink B, Rabis T, Weinreich G, Colsmann I, Kamler M, Teschler H, Sommerwerck U. Analyse der gesundheitsbezogenen Lebensqualität bei Patienten mit beidseitiger Lungentransplantation mit dem SF-36 Fragebogen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334785] [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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Haasler I, Weinreich G, Kamler M, Teschler H, Sommerwerck U. Pneumothorax und einschmelzende Pneumonie als Komplikation nach interventioneller Lungenvolumenreduktion bei schwerem Lungenemphysem. Pneumologie 2013. [DOI: 10.1055/s-0033-1334546] [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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25
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Nagy P, Rabis T, Wang Y, Kleibrink B, Zimmer L, Moraidis I, Werther S, Kamler M, Teschler H, Weinreich G, Sommerwerck U. Einfluss schlafbezogener Atmungsstörungen auf die Belastbarkeit von Patienten nach Lungentransplantation. Pneumologie 2013. [DOI: 10.1055/s-0033-1334789] [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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Fleimisch P, Theegarten D, Weinreich G, Kamler M, Rath PM, Teschler H, Sommerwerck U. Nach Lungentransplantation Infektion der Lunge durch Trichosporon asahii. Pneumologie 2013. [DOI: 10.1055/s-0033-1334632] [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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Weinreich G, Rabis T, Kleibrink B, Wang Y, Werther S, Kamler M, Teschler H, Sommerwerck U. Diagnostische Güte von ApneaLink zur Bestimmung von schlafbezogenen Atmungsstörungen bei Patienten nach Lungentransplantation. Pneumologie 2013. [DOI: 10.1055/s-0033-1334788] [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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Bessa V, Kleibrink B, Weinreich G, Kamler M, Teschler H, Sommerwerck U. Restriktives Allograft Syndrom bei lungentransplantierten Patienten. Pneumologie 2013. [DOI: 10.1055/s-0033-1334514] [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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Brokalaki E, Sommerwerck U, von Heinegg E, Hillen U. Ochroconis Gallopavum Infection in a Lung Transplant Recipient: Report of a Case. Transplant Proc 2012; 44:2778-80. [DOI: 10.1016/j.transproceed.2012.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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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Sommerwerck U, Weinreich G, Anhenn O, Moraidis I, Kreuseler D, Wende W, Kamler M, Teschler H. Schlafbezogene Atmungsstörungen und Schlafcharakteristik nach Lungentransplantation. Pneumologie 2012. [DOI: 10.1055/s-0032-1302589] [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: 10/28/2022]
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Wende W, Wang YM, Wang Y, Sommerwerck U, Teschler H, Weinreich G. Evaluierung des vom S9-Auto-CPAP-Gerät ermittelten Apnoe-Hypopnoe-Index bei Patienten mit obstruktivem Schlafapnoe-Syndrom (OSAS). Pneumologie 2012. [DOI: 10.1055/s-0032-1302786] [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: 10/28/2022]
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Anhenn O, Rabis T, Sommerwerck U, Baumbach JI, Theegarten D, Darwiche K, Freitag L, Teschler H, Costabel U. Detektion volatiler organischer Komponenten in der Ausatemluft von Patienten mit Aspergillus-Besiedlung oder -Infektion und Exogen Allergischer Alveolitis. Pneumologie 2012. [DOI: 10.1055/s-0032-1302632] [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: 10/28/2022]
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Kleibrink B, Rabis T, Anhenn O, Kamler M, Erbel R, Teschler H, Sommerwerck U. Pulmonale Hypertonie vor Lungentransplantation und mittleres Überleben bei COPD, Alpha-1-Antitrypsin-Mangel und Lungenfibrose. Pneumologie 2012. [DOI: 10.1055/s-0032-1302871] [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: 10/28/2022]
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Besa V, Darwiche K, Teschler H, Sommerwerck U, Kurth I, Rabis T, Baumbach JI, Freitag L. Volatile organische Komponenten bei Patienten mit COPD Exazerbation. Pneumologie 2012. [DOI: 10.1055/s-0032-1302718] [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: 10/28/2022]
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35
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Besa V, Theegarten D, Anhenn O, Kamler M, Teschler H, Sommerwerck U. Pulmonale kapilläre Hämangiomatose – Case report. Pneumologie 2012. [DOI: 10.1055/s-0032-1302750] [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: 10/28/2022]
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Theegarten D, Kikhney J, Petrich A, Anhenn O, Sommerwerck U, Welter S, Moter A. Bakterielle Biofilme in Bronchiektasen bei der primären ziliären Dyskinesie (PCD) im Vergleich zur cystischen Fibrose (CF). Pneumologie 2012. [DOI: 10.1055/s-0032-1302528] [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: 10/28/2022]
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Baumbach JI, Maddula S, Sommerwerck U, Besa V, Kurth I, Bödeker B, Teschler H, Freitag L, Darwiche K. Significant different volatile biomarker during bronchoscopic ion mobility spectrometry investigation of patients suffering lung carcinoma. ACTA ACUST UNITED AC 2011. [DOI: 10.1007/s12127-011-0078-5] [Citation(s) in RCA: 14] [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: 10/17/2022]
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Wohlschläger J, Sommerwerck U, Jonigk D, Rische J, Baba HA, Müller KM. [Lung transplantation and rejection. Basic principles, clinical aspects and histomorphology]. Pathologe 2011; 32:104-12. [PMID: 21424408 DOI: 10.1007/s00292-010-1403-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Lung transplantation is the ultimate therapeutical approach for the treatment of both children and adults with terminal congenital or acquired lung disease. In contrast to survival rates during the first year following transplantation, the long-term survival for patients after lung transplantation has not significantly improved in the past. In addition to other complications, acute cellular rejection constitutes a major cause for diminished function of pulmonary grafts, and can, among other factors, be causative for chronic rejection (bronchiolitis obliterans syndrome, BOS). In 2006, the International Society for Heart and Lung Transplantation (ISHLT) provided a revised version of the grading system for acute and chronic rejection of pulmonary grafts.
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Affiliation(s)
- J Wohlschläger
- Institut für Pathologie und Neuropathologie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
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Besa V, Darwiche K, Bödeker B, Sommerwerck U, Anhenn O, Baumbach J, Freitag L. Flüchtige organische Verbindungen in COPD. Pneumologie 2011. [DOI: 10.1055/s-0031-1272145] [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: 10/18/2022]
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Sommerwerck U, Anhenn O, Rabis T, Darwiche K, Freitag L, Kamler M, Jakob H, Baumbach J, Bödeker B, Teschler H. Ionenmobilitätsspektrometrie - ist eine nichtinvasive Diagnose des Bronchiolitis-obliterans-Syndroms möglich? Pneumologie 2011. [DOI: 10.1055/s-0031-1272247] [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: 10/18/2022]
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Rabis T, Sommerwerck U, Anhenn O, Bödeker B, Baumbach J, Kamler M, Jakob H, Teschler H. Ionenmobilitätsspektrometrie vor und nach Lungentransplantation. Pneumologie 2011. [DOI: 10.1055/s-0031-1272246] [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: 10/18/2022]
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42
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Anhenn O, Sommerwerck U, Rabis T, Baumbach J, Bödeker B, Darwiche K, Freitag L, Teschler H. Nicht-invasive Identifikation verschiedener Erreger in der Atemluft durch Ionen-Mobilitäts-Spektrometrie. Pneumologie 2011. [DOI: 10.1055/s-0031-1272167] [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: 10/18/2022]
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Theegarten D, Worm K, Anhenn O, Kamler M, Sommerwerck U, Tötsch M. Primäres pulmonales Adenokarzinom nach bilateraler Lungentransplantation. Pneumologie 2009. [DOI: 10.1055/s-0029-1214026] [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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Bauer PC, Sommerwerck U, Hagmeyer J, Bonella F, Costabel U. Lokale Applikation von Mitomycin C bei Atemwegsstenosen. Pneumologie 2009. [DOI: 10.1055/s-0029-1213906] [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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Theegarten D, Costabel U, Werther S, Sommerwerck U, Teschler H, Tötsch M. Rezidiv einer exogen-allergischen Alveolitis im Lungentransplantat. Pneumologie 2007. [DOI: 10.1055/s-2007-973194] [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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Sommerwerck U, Konietzko N. [Is there a classification of degrees of severity for a restrictive respiratory disorder?]. Dtsch Med Wochenschr 2002; 127:817. [PMID: 11951142 DOI: 10.1055/s-2002-25016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- U Sommerwerck
- Ruhrlandklinik, Zentrum für Pneumologie und Thoraxchirurgie, Essen, Germany
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Sommerwerck U, Konietzko N. [Singing in asthma--does budesonide harm the voice box?]. Dtsch Med Wochenschr 2002; 127:523. [PMID: 11884998 DOI: 10.1055/s-2002-20935] [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: 10/17/2022]
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Abstract
OBJECTIVE To test the hypothesis that latencies of evoked potentials in IDDM patients are delayed compared with healthy control subjects during euglycemia, and that insulin-induced hypoglycemia causes further latency delays of evoked potentials to occur. RESEARCH DESIGN AND METHODS We recruited 23 IDDM patients (27.9 +/- 1.6 yr of age, HbA1c 6.7 +/- 0.3%, without sensory or autonomic neuropathy) and 26 unequivocally healthy subjects who were carefully matched for sex, age, and body mass index to serve as the control group (18 men and 8 women, 28.4 +/- 1.6 yr of age, 22.6 +/- 0.7 kg/m2), for a controlled, prospective study. Sequential euglycemic-hypoglycemic clamps were performed with stable glycemic plateaus of 5.6, 3.3, 2.2, and 1.7 mM, at which the patients' and healthy control subjects' neurophysiological functions were evaluated. The methodological armamentarium included the measurement of brainstem auditory, middle-latency auditory, and somatosensory evoked potentials that assessed conduction velocity in corresponding neural structures and information processing in the midbrain and auditory cortex. RESULTS Multiple analysis of variance revealed a significant overall difference of brainstem auditory evoked potential latencies during euglycemia between the study group and healthy control group (F = 3.41, P < 0.03), which was mainly attributable to latency delays of wave III (F = 6.60, P < 0.02), V (F = 9.19, P < 0.01), and interpeak latency I-V (F = 2.82, P < 0.07). Repeated analysis of variance measures detected a significant latency delay of the major wave Pa of the middle-latency auditory evoked potentials during hypoglycemia (F = 4.4, P < 0.02), which rapidly returned to normal after reinstitution of euglycemia. CONCLUSIONS In IDDM patients, chronic, structural CNS changes already appear at the brainstem level during euglycemia. Functional, reversible CNS changes, however, seem to emerge during acute deviation from glucose homeostasis in more rostral brain regions.
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Affiliation(s)
- T Lingenfelser
- Department of Medicine, Eberhard-Karls University Tuebingen, Germany
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Lingenfelser T, Renn W, Sommerwerck U, Jung MF, Buettner UW, Zaiser-Kaschel H, Kaschel R, Eggstein M, Jakober B. Compromised hormonal counterregulation, symptom awareness, and neurophysiological function after recurrent short-term episodes of insulin-induced hypoglycemia in IDDM patients. Diabetes 1993; 42:610-8. [PMID: 8384134 DOI: 10.2337/diab.42.4.610] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [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: 01/30/2023]
Abstract
To test the hypothesis that recurrent short-term hypoglycemic episodes may impair hormonal counterregulation, symptom awareness, and neurophysiological function during subsequent hypoglycemia, we examined two groups of IDDM patients (n = 18), neither of whom exhibited signs of autonomic neuropathy. Two sequential euglycemic-hypoglycemic clamp studies were performed three days apart with stable glycemic plateaus of 5.6, 3.3, 2.2, and 1.7 mM, at which the patients' awareness of and response to hypoglycemia was evaluated. In the intervention group (n = 11), three short-term hypoglycemic episodes preceded the second clamp study. Counterregulatory hormones increased significantly during hypoglycemia, but adrenaline (P < 0.03), cortisol (P < 0.01), and ACTH (albeit not significant) showed a blunted response after repetitive hypoglycemic events. In this group, the perception of hypoglycemic symptoms was significantly reduced and was most evident for the autonomic symptoms of sweating (P < 0.05), heart pounding (P < 0.01), and warmness (P < 0.03). The deterioration of neurophysiological function, as assessed from the middle latency auditory evoked potentials, was more pronounced in the intervention group (latency shift of the Pa component, P < 0.05). These data suggest that alterations of neuroendocrine counterregulation, symptom perception, and certain aspects of cerebral function may occur as a consequence of recurrent short-term hypoglycemic episodes. These adaptation phenomena may contribute to the increased incidence of severe hypoglycemia in IDDM patients on intensive insulin therapy.
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Affiliation(s)
- T Lingenfelser
- Department of Medicine, Eberhard-Karls University Tuebingen, Germany
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