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Radtke T, Kriemler S, Stein L, Karila C, Urquhart D, Orenstein D, Lands L, Schindler C, Eber E, Haile S, Hebestreit H. WS14.03 Cystic Fibrosis-Related Diabetes is not associated with maximal aerobic exercise capacity in cystic fibrosis (CF): a cross-sectional analysis of an international multicentre trial (ACTIVATE-CF). J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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2
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Lavoie JA, Schindler C, Garnier-Villareal M, Bagli S, McCarthy DL, Goday PS. Nasogastric Bridles are Associated with Improved Tube-Related Outcomes in Children. JPEN J Parenter Enteral Nutr 2022; 46:1568-1577. [PMID: 35589402 DOI: 10.1002/jpen.2409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/29/2022] [Accepted: 04/27/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare tube-related outcomes in children with standard tape versus nasal bridle securement of nasogastric tubes (NGTs). STUDY DESIGN Single-center, retrospective, correlational study of outcomes from the time of NGT placement until full oral feeds or durable-tube placement. Outcomes of interest included NGT dislodgements, length of stay, emergency department (ED) encounters, radiographic exposures, and adverse skin outcomes. Negative binomial regression and logistic regression were used to analyze differences between groups. RESULTS 582 children had NGTs secured traditionally [43% female; age at therapy initiation 2.6 months (SD 8.1)] and 173 received nasal bridles [55.5% female; age at therapy initiation 8.4 months (SD 11.8)]. Children with bridled NGTs were 16.67 times less likely to experience ≥1 dislodgement (OR=0.06, 95% CI 0.04, 0.09); 2.5 times less likely to have one more ED visit (OR=0.4, 95% CI 0.19, 0.82), and 4.76 times less likely to require one more radiographic exposure (OR=0.21, 95% CI 0.14, 0.33) than their non-bridled NGT counterparts (all p values <0.02). The mean initial hospital length of stay was 28 and 54 days in the bridled and standard care group respectively (p<0.001). Overall, 62.4% children with bridled NGTs and 77.1% children with unbridled NGTs progressed to full oral feedings and required no further therapy (p<0.001). Adverse skin outcomes were rare in both groups. CONCLUSION Children with bridled NGTs experienced fewer dislodgements, days in the hospital, ED encounters, and radiographic exposures than children with traditionally secured NGTs. The majority of children in both groups progressed to full oral feedings. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Julie Ann Lavoie
- Pediatric Gastroenterology and Nutrition, Children's Hospital of Wisconsin, Milwaukee, WI
| | - Christine Schindler
- Marquette University, College of Nursing, Milwaukee, WI.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | | | - Sravya Bagli
- Herma Heart Institute, Cardiology, Children's Hospital of Wisconsin, Milwaukee, WI
| | | | - Praveen S Goday
- Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin Milwaukee WI
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Schindler C, Barrette R, Sandcock A, Kuhn E. Medical Device-related Pressure Injuries Associated With Electroencephalogram Leads in a Tertiary Care Children’s Hospital: A Retrospective Chart Review. Wound Manag Prev 2021. [DOI: 10.25270/wmp.2021.9.2532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: Medical device-related pressure injuries (MDRPIs) present a substantial safety risk for children who are hospitalized. PURPOSE: This study aimed to describe patient and clinical characteristics of children who develop MDRPIs related to electroencephalogram (EEG) leads, determine risk factors associated with their development, and determine if there are common risk factors that can lead to actionable strategies to reduce MDRPIs related to EEG leads. METHODS: A retrospective review was completed of the electronic health records of all 3136 children who had EEG lead placements between January 1, 2014, and April 16, 2018, at a large tertiary care children’s hospital. Data abstracted included demographic variables, patient and pressure injury characteristics, as well as length of stay. RESULTS: Twenty-four (24) of the 3136 children (0.8%) developed an MDRPI. Most were stage 2 pressure injuries. Patients who developed a pressure injury were significantly younger than patients who did not (median age, 0.9 and 5.2 years, respectively; P = .005). Fifty percent (50%) of all patients who developed pressure injuries were younger than 1 year of age compared with 27% of patients who did not develop pressure injuries. The median length of stay for patients in whom MDRPI developed was 84.5 days (interquartile range, 45–137) versus 3.0 days (interquartile range, 2–8) for those who did not develop an MDRPI (P < .001). The mortality rate during the hospital stay was 21% (n = 5) for those who developed MDPRIs versus 4% (n = 19) for those who did not (P = .002). All patients received standard preventive strategies. CONCLUSION: The incidence of MDRPIs in this patient population was significantly higher in younger and longer-stay patients, and their mortality rate was significantly higher. This suggests that the patients who developed an MDRPI were more critically ill than those who did not. Vigilant assessment and more research are needed to determine if there are appropriate strategies to reduce MDRPIs related to EEG lead placement.
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Voth M, Sommer K, Schindler C, Frank J, Marzi I. Rise of extremity fractures and sport accidents in children at 8-12 years and increase of admittance via the resuscitation room over a decade. Eur J Trauma Emerg Surg 2021; 48:3439-3448. [PMID: 34519864 PMCID: PMC9532303 DOI: 10.1007/s00068-021-01785-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022]
Abstract
Introduction In an emergency department, the majority of pediatric trauma patients present because of minor injuries. The aim of this study was to evaluate temporal changes in age-related injury pattern, trauma mechanism, and surgeries in pediatric patients. Methods This retrospective study included patients < 18 years of age following trauma from 01/2009 to 12/2018 at a level I trauma center. They were divided into two groups: group A (A: 01/2009 to 12/2013) and group B (B: 01/2014 to 12/2018). Injury mechanism, injury pattern, and surgeries were analyzed. As major injuries fractures, dislocations, and organ injuries and as minor injuries contusions and superficial wounds were defined. Results 23,582 patients were included (58% male, median age 8.2 years). There was a slight increase in patients comparing A (n = 11,557) and B (n = 12,025) with no difference concerning demographic characteristics. Significant more patients (A: 1.9%; B: 2.4%) were admitted to resuscitation room, though the number of multiple injured patients was not significantly different. In A (25.5%), major injuries occurred significantly less frequently than in B (27.0%), minor injuries occurred equally. Extremity fractures were significantly more frequent in B (21.5%) than in A (20.2%), peaking at 8–12 years. Most trauma mechanisms of both groups were constant, with a rising of sport injuries at 8–12 years. Conclusion Although number of patients increases only slightly over a decade, there was a clear increase in major injuries, particularly extremity fractures, peaking at 8–12 years. At this age also sport accidents significantly increased. At least, admittance to resuscitation room rose but without an increase of multiple injured patients.
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Affiliation(s)
- M Voth
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - K Sommer
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - C Schindler
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - J Frank
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - I Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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5
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Mhimbira F, Hiza H, Mbuba E, Hella J, Kamwela L, Sasamalo M, Ticlla M, Said K, Mhalu G, Chiryamkubi M, Schindler C, Reither K, Gagneux S, Fenner L. Prevalence and clinical significance of respiratory viruses and bacteria detected in tuberculosis patients compared to household contact controls in Tanzania: a cohort study. Clin Microbiol Infect 2018; 25:107.e1-107.e7. [PMID: 29581053 PMCID: PMC7128396 DOI: 10.1016/j.cmi.2018.03.019] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/04/2018] [Accepted: 03/13/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To describe the prevalence of respiratory pathogens in tuberculosis (TB) patients and in their household contact controls, and to determine the clinical significance of respiratory pathogens in TB patients. METHODS We studied 489 smear-positive adult TB patients and 305 household contact controls without TB with nasopharyngeal swab samples within an ongoing prospective cohort study in Dar es Salaam, Tanzania, between 2013 and 2015. We used multiplex real-time PCR to detect 16 respiratory viruses and seven bacterial pathogens from nasopharyngeal swabs. RESULTS The median age of the study participants was 33 years; 61% (484/794) were men, and 21% (168/794) were HIV-positive. TB patients had a higher prevalence of HIV (28.6%; 140/489) than controls (9.2%; 28/305). Overall prevalence of respiratory viral pathogens was 20.4% (160/794; 95%CI 17.7-23.3%) and of bacterial pathogens 38.2% (303/794; 95%CI 34.9-41.6%). TB patients and controls did not differ in the prevalence of respiratory viruses (Odds Ratio [OR] 1.00, 95%CI 0.71-1.44), but respiratory bacteria were less frequently detected in TB patients (OR 0.70, 95%CI 0.53-0.94). TB patients with both respiratory viruses and respiratory bacteria were likely to have more severe disease (adjusted OR [aOR] 1.6, 95%CI 1.1-2.4; p 0.011). TB patients with respiratory viruses tended to have more frequent lung cavitations (aOR 1.6, 95%CI 0.93-2.7; p 0.089). CONCLUSIONS Respiratory viruses are common for both TB patients and household controls. TB patients may present with more severe TB disease, particularly when they are co-infected with both bacteria and viruses.
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Affiliation(s)
- F Mhimbira
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - H Hiza
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - E Mbuba
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - J Hella
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - L Kamwela
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - M Sasamalo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - M Ticlla
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - K Said
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - G Mhalu
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Dar es Salaam, Tanzania; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - M Chiryamkubi
- Department of Curative Services, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - C Schindler
- University of Basel, Basel, Switzerland; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - K Reither
- University of Basel, Basel, Switzerland; Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - S Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - L Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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6
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Stinkens R, van der Kolk BW, Jordan J, Jax T, Engeli S, Heise T, Jocken JW, May M, Schindler C, Havekes B, Schaper N, Albrecht D, Kaiser S, Hartmann N, Letzkus M, Langenickel TH, Goossens GH, Blaak EE. The effects of angiotensin receptor neprilysin inhibition by sacubitril/valsartan on adipose tissue transcriptome and protein expression in obese hypertensive patients. Sci Rep 2018; 8:3933. [PMID: 29500454 PMCID: PMC5834447 DOI: 10.1038/s41598-018-22194-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 02/19/2018] [Indexed: 01/30/2023] Open
Abstract
Increased activation of the renin-angiotensin system is involved in the onset and progression of cardiometabolic diseases, while natriuretic peptides (NP) may exert protective effects. We have recently demonstrated that sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, which blocks the angiotensin II type-1 receptor and augments natriuretic peptide levels, improved peripheral insulin sensitivity in obese hypertensive patients. Here, we investigated the effects of sacubitril/valsartan (400 mg QD) treatment for 8 weeks on the abdominal subcutaneous adipose tissue (AT) phenotype compared to the metabolically neutral comparator amlodipine (10 mg QD) in 70 obese hypertensive patients. Abdominal subcutaneous AT biopsies were collected before and after intervention to determine the AT transcriptome and expression of proteins involved in lipolysis, NP signaling and mitochondrial oxidative metabolism. Both sacubitril/valsartan and amlodipine treatment did not significantly induce AT transcriptional changes in pathways related to lipolysis, NP signaling and oxidative metabolism. Furthermore, protein expression of adipose triglyceride lipase (ATGL) (Ptime*group = 0.195), hormone-sensitive lipase (HSL) (Ptime*group = 0.458), HSL-ser660 phosphorylation (Ptime*group = 0.340), NP receptor-A (NPRA) (Ptime*group = 0.829) and OXPHOS complexes (Ptime*group = 0.964) remained unchanged. In conclusion, sacubitril/valsartan treatment for 8 weeks did not alter the abdominal subcutaneous AT transcriptome and expression of proteins involved in lipolysis, NP signaling and oxidative metabolism in obese hypertensive patients.
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Affiliation(s)
- R Stinkens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - B W van der Kolk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - J Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.,Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - T Jax
- Profil GmbH, Neuss, Germany
| | - S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | | | - J W Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M May
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - C Schindler
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - B Havekes
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - N Schaper
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - D Albrecht
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - S Kaiser
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - N Hartmann
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - M Letzkus
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - T H Langenickel
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - G H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - E E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
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Abstract
SummaryBesides more classical aetiologies for oedema such as heart failure, liver cirrhosis, nephrotic syndrome and chronic venous insufficiency, in practice we increasingly observe iatrogenic or drug-induced oedema as adverse events. Many drugs have the potential to cause oedema or to worsen pre-existing oedema prior to the initiation of drug therapy. Drug-induced oedema is frequently caused by calciumchannel-blockers of the dihydropyridine-type but can also be caused by dihydralazine and minoxidil which are less frequently prescribed. Other drugs which may support the formation of oedema are diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), ACE-inhibitors or AT1-receptor-antagonists (angioedema) and thiazolidinediones/glitazones which are used as oral anti-diabetics.This review focuses on drug-induced oedema, pathophysiological considerations and potential treatment and management strategies from a clinical-pharmacological perspective.
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8
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Getzin T, May M, Schmidbauer M, Gutberlet M, Wacker F, Schindler C, Hueper K. Funktionelle MRT zur Quantifizierung des pharmakotherapeutischen Effektes eines ACE-Hemmers auf die Nierenperfusion und die T1-Relaxationszeit. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600190] [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: 10/19/2022]
Affiliation(s)
- T Getzin
- Medizinische Hochschule Hannover, Radiologie, Hannover
| | - M May
- Medizinische Hochschule Hannover, CRC Core Facility, Hannover
| | - M Schmidbauer
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - M Gutberlet
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - F Wacker
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - C Schindler
- Medizinische Hochschule Hannover, CRC Core Facility, Hannover
| | - K Hueper
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
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Schneeweiss A, Park-Simon TW, Albanell J, Lassen U, Cortes J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Abstract P6-11-13: Phase Ib study evaluating the safety and clinical activity of lumretuzumab combined with pertuzumab and paclitaxel in HER2-low metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-11-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inhibition of HER2 and HER3 heterodimerisation is a novel treatment concept in HER2-”low” expressing breast cancer (BC). Lumretuzumab, a glycoengineered monoclonal anti-HER3 antibody, in combination with pertuzumab has demonstrated synergistic anti-tumor activity in preclinical HER2–low expressing preclinical BC models.
Methods: This open-label, multicenter phase I study selectively enrolled metastatic BC patients (pts) expressing HER3 protein and low levels of HER2 (defined as IHC 1+ and 2+ and ISH-negative) in a formalin-fixed paraffin-embedded pretreatment tumor biopsy sample. Eligible pts were treated with a combination of paclitaxel (PA) qw plus lumretuzumab (L) and pertuzumab (P) q3w in three dose cohorts. The safety, antitumor activity and tumor biomarkers including protein expression (IHC, MS) and mutational data (NGS) in association with clinical activity were evaluated.
Results: Overall, 35 pts were included in this study. The median age was 60 (range: 33 to 77) years. The median number of prior treatments for metastatic disease ranged from 0 to 5 with 23 pts (65.7%) without prior chemotherapy for metastatic disease. Cohort 1 was treated with PA at 80 mg/m2, L at 1000 mg and P at 840 mg for Cycle 1 followed by 420 mg for the following cycles. This cohort was stopped after two pts both experienced grade 3 diarrhea within the first treatment cycle which was considered a dose-limiting toxicity (DLT). For Cohort 2 the dose of L was reduced to 500 mg based on PK modelling and simulation data. No DLTs were seen for the first 6 pts. A total of 20 pts were recruited with an objective response rate (ORR) and disease control rate (DCR) of 30% and 75%, respectively, and 56% and 78%, respectively, for 1st-line pts (n=9) in this cohort. Diarrhea (≥G3) and hypokalemia (≥G3) occurred in 50% and 55% of pts, respectively, and all pts experienced chronic diarrhea throughout the course of treatment. For Cohort 3 the dose of L was maintained at 500 mg, PA at 80 mg/m2, and P was administered at 420 mg at all cycles. In addition, a prophylactic loperamide regimen was introduced. Altogether, 13 pts - all 1st-line for metastatic disease - were treated. No DLTs were seen for the first 6 pts. Diarrhea (≥G3) and hypokalemia (≥G3) were reduced to 31% and 15%, respectively, but chronic diarrhea was still observed throughout the treatment in all pts. The ORR and DCR were 31% and 77%, respectively. Preliminary mechanistic safety experiments revealed HER2/HER3-dependent chloride channels in the intestine as likely cause of diarrhea. Biomarker data will be presented along with updated clinical and safety data.
Conclusions: The combination of L, P and PA was associated with high rates of persistent diarrhea. Dose modifications and prophylactic anti-diarrheal medication led to significantly reduced diarrhea intensity but did not change the incidence and persistence of diarrhea overall. Despite encouraging clinical activity especially in 1st line pts, the therapeutic window of this combination is too low to warrant further clinical development.
Citation Format: Schneeweiss A, Park-Simon T-W, Albanell J, Lassen U, Cortes J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Phase Ib study evaluating the safety and clinical activity of lumretuzumab combined with pertuzumab and paclitaxel in HER2-low metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-11-13.
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Affiliation(s)
- A Schneeweiss
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - T-W Park-Simon
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Albanell
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - U Lassen
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Cortes
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - V Dieras
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M May
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - C Schindler
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Marmé
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - JM Cejalvo
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Martinez-Garcia
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - I Gonzalez
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Lopez-Martin
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Welt
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Joly
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Michielin
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - W Jacob
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - C Adessi
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Moisan
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - G Meneses-Lorente
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - I James
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Ceppi
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Hasmann
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Weisser
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Cervantes
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
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Jordan J, Stinkens R, Jax T, Engeli S, Blaak EE, May M, Havekes B, Schindler C, Albrecht D, Pal P, Heise T, Goossens GH, Langenickel TH. Improved Insulin Sensitivity With Angiotensin Receptor Neprilysin Inhibition in Individuals With Obesity and Hypertension. Clin Pharmacol Ther 2016; 101:254-263. [DOI: 10.1002/cpt.455] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/27/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
Affiliation(s)
- J Jordan
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - R Stinkens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | | | - S Engeli
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - EE Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | - M May
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - B Havekes
- Department of Internal Medicine, Division of Endocrinology; Maastricht University Medical Center; Maastricht The Netherlands
| | - C Schindler
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - D Albrecht
- Translational Medicine, Novartis Pharma AG; Basel Switzerland
| | - P Pal
- Biostatistical Sciences, Integrated Development Functions and Regions; Novartis Healthcare Pvt. Ltd; Hyderabad India
| | | | - GH Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | - TH Langenickel
- Translational Medicine, Novartis Pharma AG; Basel Switzerland
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Sperling R, Schindler C, Hofmann C, Löb P. Continuous Synthesis of Nanoparticles and Online Process Analytics. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650391] [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: 11/09/2022]
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Chaturvedi M, Bousleiman H, Cozac V, Gschwandtner U, Hatz F, Meyer A, Schindler C, Zimmermann R, Fuhr P. Quantitative EEG in patients with Parkinson’s Disease (PD) with and without Mild Cognitive Impairment (MCI) – Power analysis. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.092] [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: 11/26/2022]
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Hardmeier M, Hatz F, Penner I, Naegelin Y, Schindler C, Kappos L, Fuhr P. Graph measures to characterize resting state connectomes in MS patients: An EEG-study over two years. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lanfermann H, Schindler C, Jordan J, Krug N, Raab P. Pharmacological MRI (phMRI) of the Human Central Nervous System. Clin Neuroradiol 2015; 25 Suppl 2:259-66. [DOI: 10.1007/s00062-015-0457-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/12/2015] [Indexed: 01/09/2023]
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Hardmeier M, Hatz F, Penner I, Naegelin Y, Bousleiman H, Schindler C, Kappos L, Fuhr P. P126. Functional connectivity of resting state EEG in MS patients: Follow-up over two years. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.253] [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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Hatz F, Nina B, Hardmeier M, Bousleiman H, Ehrensperger M, Gschwandtner U, Schindler C, Monsch A, Fuhr P. P132. Microstates connectivity alterations in patients with early Alzheimer’s disease. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.257] [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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Bousleiman H, Chaturvedi M, Gschwandtner U, Hatz F, Schindler C, Zimmermann R, Fuhr P. P122. Alpha1/theta ratio from quantitative EEG (qEEG) as a reliable marker for mild cognitive impairment (MCI) in patients with Parkinson’s disease (PD). Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.249] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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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Norberg M, Belgrand L, Schindler C, Norberg M. AB0958 Prognostics of Chronic Low Back Pain and Association Between COMI and Fear Avoidance. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3318] [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: 11/03/2022]
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Hatz F, Hardmeier M, Bousleiman H, Rüegg S, Schindler C, Fuhr P. Reliability of fully automated versus visually controlled pre- and post-processing of resting-state EEG. Clin Neurophysiol 2015; 126:268-74. [DOI: 10.1016/j.clinph.2014.05.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/11/2014] [Accepted: 05/05/2014] [Indexed: 10/25/2022]
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Zimmermann R, Gschwandtner U, Hatz F, Schindler C, Bousleiman H, Ahmed S, Hardmeier M, Calabrese P, Fuhr P. LP15: EEG slowing and cognitive domains in non-demented patients with Parkinson’s disease. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50345-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schlaeger R, D'Souza M, Schindler C, Grize L, Kappos L, Fuhr P. Prediction of MS disability by multimodal evoked potentials: investigation during relapse or in the relapse-free interval? Clin Neurophysiol 2014; 125:1889-92. [PMID: 24555924 DOI: 10.1016/j.clinph.2013.12.117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/19/2013] [Accepted: 12/07/2013] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Little is known about optimal timing of multimodal evoked potential (EP)-investigations regarding prediction of MS disability. The aim of this study was to investigate whether timing of EP-investigations during a relapse or in the relapse-free interval influences prediction of MS disability. METHODS Two groups of MS patients with similar age and gender distributions received visual, motor and somatosensory EPs either during a relapse (Group 1) or in the relapse-free interval (Group 2). Expanded Disability Status Score (EDSS) was obtained at baseline (T0) and year 3 (T2). Linear regression analysis was performed to examine the association between EDSS(T2) and a baseline EP compound measure (s-EP-Q(T0)) for each group. RESULTS Median EDSS(T0) was 3.0 for Group 1 and 1.5 for Group 2. Mean disease durations were 2.0 and 2.8 years, respectively. Median EDSS(T2) was 2.0 for both groups. The s-EP-Q(T0) significantly predicted EDSS(T2) (R(2)=0.47) for patients in Group 2, but not for patients in Group 1 (R(2)=0.07). CONCLUSION In early MS the functional remnants of relapses are a better predictor for development of medium-term disability than is the extent of impulse propagation impairment measured during relapse. SIGNIFICANCE This suggests a role of multimodal EPs in prediction of MS disability if performed in the relapse-free interval.
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Affiliation(s)
- R Schlaeger
- Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland
| | - M D'Souza
- Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland
| | - C Schindler
- Swiss Tropical and Public Health Institute, Switzerland; University of Basel, Switzerland
| | - L Grize
- Swiss Tropical and Public Health Institute, Switzerland; University of Basel, Switzerland
| | - L Kappos
- Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland
| | - P Fuhr
- Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland.
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Barthel A, Schwarz P, Schindler C, Bornstein S. Personalisierte Medizin und Typ-2-Diabetes: Pharmakogenetische Aspekte bei der Therapie. Dtsch Med Wochenschr 2014; 139:234-6. [DOI: 10.1055/s-0033-1360060] [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: 10/25/2022]
Affiliation(s)
- A. Barthel
- Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden
| | - P. Schwarz
- Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden
| | - C. Schindler
- Klinisches Forschungszentrum – CRC Hannover, Medizinische Hochschule Hannover
| | - S. Bornstein
- Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden
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Dall P, Lenzen G, Göhler T, Feisel-Schwickeradi G, Koch T, Heilmann V, Schindler C, Wilke J, Tesch H, Selbach J, Eggert J, Hinke A. Abstract P2-15-02: Trastuzumab treatment of early breast cancer: Long-term results from a prospective observation study, including a large cohort of elderly patients. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-15-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Trastuzumab (T; Roche) is part of the standard treatment in patients (pts) of any age with early stage, HER2+ breast cancer, in addition to (neo)adjuvant chemotherapy (CT) and locoregional treatment. After its registration in Germany in 2006, this prospective observation study was started in order to assess the generalizability of the results from the randomized studies, specifically with respect to elderly age cohorts.
Methods: 4027 pts were enrolled between 2006 and 2012. 87 were non-eligible due to M1 and/or negative HER2 status. There were no restrictions for recruitment with respect to age or concomitant/sequential adjuvant medication. The long-term relapse/survival status of pts was retrieved by fax forms collected once a year. Safety assessment was limited to the treatment period. Data base cut-off was May 2013.
Results: Among the 3940 evaluable pts, there were 1013 elderly pts (EP) ≥ 65 years (y) of age (26%). This contrasts to the pivotal studies, e.g. with a proportion of only 6% beyond 65 y in the NSABP B-31 and NCCTG N9831 studies. The rate of EP steadily increased during the period from 2006 to 2009, remaining stable thereafter. More than half of the pts had pT≥2, with EP more often presenting with a larger tumor (56% vs. 48%,p<.0001). 52% had a grade 3 tumor. Hormone receptor positivity was recorded in 63%. As to be expected, performance status was more impaired in elderly compared to younger pts (ECOG 0: 53 vs 65%,p<.0001). 94% received CT, 78% as adjuvant, 14% as neoadjuvant treatment (in EP only 8%), while 2% received both modalities. In the vast majority (87%), T was administered sequentially to CT, with no differences among the age cohorts. The proportion without any adjuvant CT was higher in EP (8 vs. 5%). 56% of pts were treated with adjuvant endocrine medication, 78% with irradiation. T treatment was stopped prematurely in only 9% of pts, but more often in EP (11% vs 8%, p = .014).
After a follow-up period of up to a maximum of 8 y, 370 relapses were reported so far. The estimated recurrence-free survival is 94.7% (95% CI: 94-96%), 89.8% (89-91%), and 82.9% (81-85%) after 2, 3 and 5 y, respectively. Numeric results in EP are only slightly lower with 93.9 (92-96%), 89.3% (87-92%), and 81.6% (78-85%), not statistically significant (p = 0.18, HR = 1.17 [95% CI: 0.93 - 1.47]). Adverse effects with respect to cardiac function were reported in overall 153 pts (3.9%), with the majority of these cases of NCI grade 1 (39%) or 2 (38%). 23% of these events were of grade 3/4, but life-threatening in only 2 pts. Thus, the overall incidence of acute grade 3/4 cardiac function toxicity was 0.9%. In the EP subgroup the incidence across all NCI grades was only slightly increased (4.6%), but grade 3/4 cases were more common (1.6%).
Conclusion: Overall, the maturing follow-up data of this observational study confirm the beneficial results from the randomized studies. In addition, the data from more than thousand pts ≥ 65 y of age show that a similar anti-tumor efficiency can be achieved in elderly pts, and suggest that minor age-related differences detected with respect to adjuvant treatment duration, aggressiveness and toxicity do not impair the long-term clinical outcome.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-15-02.
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Affiliation(s)
- P Dall
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - G Lenzen
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - T Göhler
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - G Feisel-Schwickeradi
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - T Koch
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - V Heilmann
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - C Schindler
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - J Wilke
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - H Tesch
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - J Selbach
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - J Eggert
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
| | - A Hinke
- Städtisches Klinikum, Frauenklinik, Lüneburg, Germany; Practice, Osnabrück, Germany; Practice, Dresden, Germany; Klinikum Kassel, Kassel, Germany; Klinikum Nürnberg Nord, Frauenklinik, Nürnberg, Germany; Practice, Günzburg, Germany; Practice, Leipzig, Germany; Practice, Fürth, Germany; Onkologie Bethanien, Frankfurt, Germany; Practice, Duisburg, Germany; Practice, Moers, Germany; WiSP Research Institute, Langenfeld, Germany
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Mehta AJ, Thun GA, Imboden M, Ferrarotti I, Keidel D, Künzli N, Kromhout H, Miedinger D, Phuleria H, Rochat T, Russi EW, Schindler C, Schwartz J, Vermeulen R, Luisetti M, Probst-Hensch N. Interactions betweenSERPINA1PiMZ genotype, occupational exposure and lung function decline. Occup Environ Med 2013; 71:234-40. [DOI: 10.1136/oemed-2013-101592] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Endes S, Schindler C, Schaffner E, Caviezel S, Dratva J, Kuenzli N, Gaspoz JM, Rochat T, Probst-Hensch N, Schmidt-Trucksaess A. Reproducibility of the Cardio-Ankle Vascular Index (CAVI) in Caucasians (SAPALDIA 3). Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Singeisen H, Hodel D, Schindler C, Frey K, Eichenberger U, Hausmann ON. [Significantly shorter anesthesia time for surgery of the lumbar spine : process analytical comparison of spinal anesthesia and intubation narcosis]. Anaesthesist 2013; 62:632-8. [PMID: 23925461 DOI: 10.1007/s00101-013-2204-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/28/2013] [Accepted: 06/06/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Most surgery of the lumbar spine is performed with the patient under general anesthesia (GA); however, qualitative benefits of spinal anesthesia (SA) have been reported. The goal of this study was to compare time efficiency between these two anesthesia methods in lumbar spine surgery. To test the hypothesis that the use of SA leads to significant time saving compared to GA for lumbar spine surgery, key points in the preoperative, intraoperative and postoperative anesthesiology care times were analyzed. The focus was on anesthesia time excluding surgery time. MATERIALS AND METHODS Electronically based data of 473 anesthesia procedures (368 SA, 105 GA) for lumbar spine interventions performed in the prone position (i. e. decompression, discectomy and transpedicular instrumentation) were analyzed retrospectively. Patient population data including gender, age, American Society of Anesthesiologists (ASA) classification and body mass index (BMI) were analyzed. The focus was on the documented perioperative key time points which are defined as follows: (1) induction, (2) positioning (turning into prone position), (3) scrubbing and covering, (4) surgery time (knife to skin closure), (5) closing (end of surgery until leaving operating room) and (6) handing over to recovery. Differences in the amount of time for each perioperative period were calculated for SA and GA. RESULTS In 7 out of the 368 SA patients SA failed and had to be converted to GA. There were no significant differences in BMI, ASA prevalence and gender between SA and GA patients but SA patients were significantly older (median 61.7 ± 15.4 years) than GA patients (median 56.1 ± 14.6 years). However, SA required significantly less time for induction (SA: 17.7 ± 7.0 min, GA: 21.6 ± 7.2 min), preoperative preparation (SA: 9.7 ± 3.6 min, GA: 13.3 ± 5.4 min) and closing period (SA: 4.9 ± 1.1 min, GA: 15.3 ± 5.7 min) compared to GA. Total anesthesia time with exclusion of the surgery time revealed a significant time reduction using SA of 19 min (95 % confidence interval: range 13.6-24.4 min, median in SA: 56.7 min, median in GA: 75.7 min, p < 0.0001). CONCLUSIONS This study showed that in lumbar spine surgery 19 min of anesthesia time can be saved using SA compared to GA which could have an impact on economic aspects. Gender, BMI and ASA had no statistically detectable influence on the choice between the two anesthesia methods. The fact that time-intensive complex instrumentation is mainly performed in younger patients may explain why GA patients were younger than SA patients.
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Affiliation(s)
- H Singeisen
- Medizinische Fakultät, Universität Basel, Basel, Schweiz
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Caviezel S, Dratva J, Schaffner E, Schindler C, Kuenzli N, Gaspoz JM, Rochat T, Probst-Hensch N, Schmidt-Trucksaess A. Association of current carotid elastic modulus and prior body mass index in elderly people - results from the SAPALDIA cohort study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Norberg M, Schindler C. SAT0426 Decreased Apprehension in Chronic Lumbar Pain : Accelerates Return to Work. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2150] [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: 11/03/2022]
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Norberg M, Schindler C. AB0672 Articular hyper mobility in chronic lumbar pain : touching 10% of the patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Norberg M, Schindler C. AB1103 Multidisciplinary rehabilitation in chronic lumbar pain: Long-term effect on work status. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1101] [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: 11/03/2022]
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Gerbase M, Dupuis-Lozeron E, Schindler C, Keidel D, Bridevaux P, Kriemler S, Probst-Hensch N, Rochat T, Künzli N. Agreement between Spirometers: A Challenge in the Follow-Up of Patients and Populations? Respiration 2013; 85:505-14. [DOI: 10.1159/000346649] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 12/13/2012] [Indexed: 11/19/2022] Open
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Niederer I, Bürgi F, Ebenegger V, Marques-Vidal P, Schindler C, Nydegger A, Kriemler S, Puder JJ. Effects of a lifestyle intervention on adiposity and fitness in overweight or low fit preschoolers (Ballabeina). Obesity (Silver Spring) 2013; 21:E287-93. [PMID: 23592683 DOI: 10.1002/oby.20119] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 09/07/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Overweight (OW) and low fit children represent cardiovascular high-risk groups. A multidimensional school-based lifestyle intervention performed in 652 preschoolers reduced skinfold thickness and waist circumference, and improved fitness, but did not affect BMI. The objective of this study is to examine whether the intervention was equally effective in OW (≥90th national percentile) and/or low fit (lowest sex- and age-adjusted quartile of aerobic fitness) children compared to their normal weight and normal fit counterparts. DESIGN AND METHODS Cluster randomized controlled single blinded trial, conducted in 2008/09 in 40 randomly selected preschool classes in Switzerland. The intervention included a playful physical activity program and lessons on nutrition, media use and sleeps. Primary outcomes were BMI and aerobic fitness; secondary outcomes included sum of four skinfolds, waist circumference and motor agility. Modification of intervention effects by BMI-group and fitness-group was tested by interaction terms. RESULTS Compared to their counterparts, OW children (n = 130) had more beneficial effects on waist circumference (p for interaction = 0.001) and low fit children (n = 154) more beneficial effects on all adiposity outcomes (p for interaction ≤0.03). The intervention effects on both fitness outcomes were not modified by BMI- or fitness-group (all p for interaction ≥0.2). Average intervention effect sizes for BMI were -0.12, -0.05, -0.26 and -0.02 kg/m(2) and for aerobic fitness were 0.40, 0.30, 0.12 and 0.36 stages for OW, normal weight, low fit and normal fit children, respectively. CONCLUSIONS This multidimensional intervention was equally and for some adiposity measures even more effective in high-risk preschoolers and represents a promising option for these children.
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Affiliation(s)
- I Niederer
- Institute of Exercise and Health Sciences, University of Basel, 4052 Basel, Switzerland
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Caviezel S, Dratva J, Schaffner E, Schindler C, Zemp Stutz E, Künzli N, Gaspoz JM, Rochat T, Probst-Hensch N, Schmidt-Trucksäss A. P3.24 SEX-SPECIFIC ASSOCIATIONS BETWEEN CAROTID DISTENSIBILITY AND PRIOR BLOOD PRESSURE CATEGORIES – RESULTS FROM THE SAPALDIA COHORT. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Benninghoff J, Grunze H, Schindler C, Genius J, Schloesser RJ, van der Ven A, Dehning S, Wiltfang J, Möller HJ, Rujescu D. Ziprasidone--not haloperidol--induces more de-novo neurogenesis of adult neural stem cells derived from murine hippocampus. Pharmacopsychiatry 2013; 46:10-5. [PMID: 22592505 DOI: 10.1055/s-0032-1311607] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Here, we present a stem-cell based study on the de-novo generation of beta-III-tubulin-positive neurons after treatment with the classic antipsychotic drug haloperidol or after treatment with the second-generation antipsychotic (SGA) ziprasidone. METHODS Adult neural stem cells (ANSC) dissociated from the adult mouse hippocampus were expanded in cell culture with basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF). ANSC differentiated upon withdrawal of EGF and bFGF. RESULTS AND DISCUSSION Ziprasidone generated significantly more beta-III-tubulin-positive neurons than haloperidol during the differentiation of adult neural stem cells isolated from murine hippocampus (ANSC). We assume that this net increase in neurogenesis by ziprasidone relies on this drug's 5-HT1A receptor affinity, which is not present in the haloperidol molecule, since the inactivation by WAY100621 impeded this process. These data could possibly suggest a clinical relevance for studying antipsychotic drugs in the stem cell paradigm employed in this study.
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Affiliation(s)
- J Benninghoff
- Department of Psychiatry, LMU-University of Munich, Munich, Germany. jens.benninghoff @lvr.de
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Mehta AJ, Schindler C, Perez L, Probst-Hensch N, Schwartz J, Brändl O, Karrer W, Tschopp JM, Rochat T, Künzli N. Acute respiratory health effects of urban air pollutants in adults with different patterns of underlying respiratory disease. Swiss Med Wkly 2012; 142:w13681. [PMID: 23076649 DOI: 10.4414/smw.2012.13681] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Whether underlying chronic respiratory diseases are susceptible factors for symptomatic episodes, which lead to primary-level care, in association with air pollutant exposures is unknown. We evaluated and compared association lag structures between daily ambient levels of nitrogen dioxide (NO(2)) and total suspended particulates (TSP) and respiratory symptom-related doctor visits in adults with different patterns of underlying chronic respiratory disease. METHODS In a time-stratified case-crossover analysis nested within a diary panel study, 459 Swiss adult participants with asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD) and healthy participants recorded occurrence of respiratory-symptom related doctor visits (n = 1,048) in one to six four-week intervals over two years. For each disease subgroup, odds ratios (ORs) for doctor visit were estimated as a function of NO(2) or TSP concentrations (per 10 micrograms per cubic meter [µg/m(3)]) lagged between 0-13 days in a polynomial distributed lag model. RESULTS Higher ORs for NO(2) in participants with COPD (OR: 1.17, 95%CI: 1.02-1.35) and asthma (OR: 1.15, 95%CI: 1.02-1.30) occurred at exposure lags of two and five days, respectively. Doctor visits increased by 9.1% (95%CI: 3.2-15.4%) and 4.2% (95%CI: 1.2-7.2%) over the first week following a 10 µg/m(3) increase in NO(2) concentration in the COPD and chronic bronchitis subgroups, respectively. The percent increase in the COPD subgroup was significantly greater (p <0.05) when compared with the healthy subgroup. Observed findings were similar for TSP. CONCLUSIONS Respiratory problems leading to a doctor visit, associated with an increase in exposure to NO(2) and TSP, may have a faster dynamic in individuals with COPD.
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Affiliation(s)
- A J Mehta
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
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Degenhardt G, Goltz L, Maywald U, Kirch W, Schindler C. Osteoproaktiv – eine pharmakoepidemiologische Studie zur Versorgungsqualität von Osteoporosepatienten in Sachsen und Thüringen. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323213] [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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Zemp E, Schikowski T, Dratva J, Schindler C, Probst-Hensch N. Asthma and the menopause: a systematic review and meta-analysis. Maturitas 2012; 73:212-7. [PMID: 22964072 DOI: 10.1016/j.maturitas.2012.08.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 08/12/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To review the available literature to determine whether the menopausal transition is associated with asthma incidence. METHODS We performed a systematic review and meta-analysis of cohort and cross-sectional studies providing a definition/assessment of menopausal status, incidence or prevalence of a defined diagnosis of asthma, and providing a measure of the association or of menopausal state and asthma or enough data for a calculation of this association. Where possible these meta-analytic estimates were also stratified by intake of menopausal hormone therapy (MHT). RESULTS Of 76 potentially relevant articles, 8 studies met the inclusion criteria and were included in the review, and 6 in the meta-analysis. There was heterogeneity across studies: four studies reported slightly increased prevalence rates of asthma in post-menopause, one large cohort yielded a lower asthma incidence and one cross-sectional study a lower prevalence in post-menopause. Overall, the meta-analysis showed no significant association between menopause and asthma rates. When stratifying by use of MHT, the association between menopause and asthma rates was increased in women reporting use of MHT (RR 1.32, 95%CI 1.01-1.74), but not in women not using MHT. CONCLUSION We found no significant association of menopause with asthma prevalence or incidence except for women reporting use of MHT. However, these findings result from a small number of studies, including only 1 large cohort with incidence rates for pre- as well as post-menopause. Further studies are needed addressing more closely subgroup analyses and a possible modification of the association of menopause and asthma by MHT.
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Affiliation(s)
- E Zemp
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.
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Gensicke H, Datta AN, Dill P, Schindler C, Fischer D. Increased incidence of Guillain-Barré syndrome after surgery. Eur J Neurol 2012; 19:1239-44. [PMID: 22519650 DOI: 10.1111/j.1468-1331.2012.03730.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 03/13/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Antecedent surgery has been described to trigger Guillain-Barré syndrome (GBS), but its evidence is poor and based on case reports only. METHODS We performed a retrospective analysis of 63 patients with GBS admitted to the University Hospital Basel and University Children's Hospital Basel from January 2005 to December 2010. We calculated and compared the incidences of post-surgical and non-exposed patients with GBS in the study population and those reported previously in literature. RESULTS Six of 63 (9.5%) GBS cases had had a surgery within 6 weeks prior to GBS. The relative risk of developing GBS during the 6-week period after surgery is 13.1 times higher than the normal incidence in the study population (95% confidence interval: 5.68, 30.3; P ≤ 0.0001), suggesting an attributable risk of 4.1 cases per 100, 000 surgeries. In addition, the incidence of post-surgical GBS is significantly higher than influenza vaccine-associated GBS in the study population (P = 0.01) as well as in comparison with previous reported vaccine-associated GBS (P ≤ 0.0001) and background incidences (P ≤ 0.0001). CONCLUSION Surgery must be considered to be a potential risk factor for developing GBS.
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Affiliation(s)
- H Gensicke
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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Schindler C, Barthel A, Fischer S, Bornstein SR, Kirch W. [Benefits and risks of current pharmacotherapy in the treatment of type 2 diabetes]. Internist (Berl) 2012; 53:478, 480-5, 487. [PMID: 22388922 DOI: 10.1007/s00108-012-3014-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of new drugs for the treatment of type 2 diabetes (T2DM) and metabolic disorders is currently one of the most innovative areas of drug development. However, a considerable number of newly developed drugs have either not reached the market and were stopped late in development or have been withdrawn after initial approval soon after market authorization due to serious safety concerns. How can drug safety problems be anticipated and, even more important, how can adverse events definitely caused by a drug be differentiated from incidences of naturally occurring diseases? This review article will provide an update about the state of the art treatment of type 2 diabetes and reflect on the newest available study evidence on glitazones, incretin mimetics (GLP-1 agonists and DPP-4 inhibitors), SGLT-2 inhibitors (gliflocines) and pan-PPAR agonists (glitazars). Furthermore, new and still experimental approaches for the treatment of T2DM, such as bardoxolone, salsalate and anakinra will be briefly reviewed.
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Affiliation(s)
- C Schindler
- Institut für Klinische Pharmakologie, Medizinische Fakultät, TU Dresden.
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Puder JJ, Marques-Vidal P, Schindler C, Zahner L, Niederer I, Burgi F, Ebenegger V, Nydegger A, Kriemler S. Authors' reply to Metcalf and Wilkin. West J Med 2012. [DOI: 10.1136/bmj.e717] [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: 11/03/2022]
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Endes S, Dratva J, Caviezel S, Schindler C, Künzli N, Probst-Hensch N, Gaspoz JM, Rochat T, Schmidt-Trucksäss A. P1.20 ASSOCIATION OF THE CARDIO-ANKLE VASCULAR INDEX WITH AGE AND SEX IN THE SAPALDIA 3 COHORT STUDY. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.057] [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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Puder JJ, Marques-Vidal P, Schindler C, Zahner L, Niederer I, Bürgi F, Ebenegger V, Nydegger A, Kriemler S. Effect of multidimensional lifestyle intervention on fitness and adiposity in predominantly migrant preschool children (Ballabeina): cluster randomised controlled trial. BMJ 2011; 343:d6195. [PMID: 21998346 PMCID: PMC3192456 DOI: 10.1136/bmj.d6195] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2011] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To test the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children. DESIGN Cluster randomised controlled single blinded trial (Ballabeina study) over one school year; randomisation was performed after stratification for linguistic region. SETTING 40 preschool classes in areas with a high migrant population in the German and French speaking regions of Switzerland. PARTICIPANTS 652 of the 727 preschool children had informed consent and were present for baseline measures (mean age 5.1 years (SD 0.7), 72% migrants of multicultural origins). No children withdrew, but 26 moved away. INTERVENTION The multidimensional culturally tailored lifestyle intervention included a physical activity programme, lessons on nutrition, media use (use of television and computers), and sleep and adaptation of the built environment of the preschool class. It lasted from August 2008 to June 2009. MAIN OUTCOME MEASURES Primary outcomes were aerobic fitness (20 m shuttle run test) and body mass index (BMI). Secondary outcomes included motor agility, balance, percentage body fat, waist circumference, physical activity, eating habits, media use, sleep, psychological health, and cognitive abilities. RESULTS Compared with controls, children in the intervention group had an increase in aerobic fitness at the end of the intervention (adjusted mean difference: 0.32 stages (95% confidence interval 0.07 to 0.57; P=0.01) but no difference in BMI (-0.07 kg/m(2), -0.19 to 0.06; P=0.31). Relative to controls, children in the intervention group had beneficial effects in motor agility (-0.54 s, -0.90 to -0.17; P=0.004), percentage body fat (-1.1%, -2.0 to -0.2; P=0.02), and waist circumference (-1.0 cm, -1.6 to -0.4; P=0.001). There were also significant benefits in the intervention group in reported physical activity, media use, and eating habits, but not in the remaining secondary outcomes. CONCLUSIONS A multidimensional intervention increased aerobic fitness and reduced body fat but not BMI in predominantly migrant preschool children. Trial registration Clinical Trials NCT00674544.
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Affiliation(s)
- J J Puder
- Service of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
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Abstract
BACKGROUND Little is known about the predictive value of neurophysiological measures for the long-term course of multiple sclerosis (MS). OBJECTIVE To prospectively investigate whether combined visual (VEP) and motor evoked potentials (MEP) allow prediction of disability over 14 years. METHODS A total of 30 patients with relapsing-remitting and secondary progressive MS were prospectively investigated with VEPs, MEPs and the Expanded Disability Status Scale (EDSS) at entry (T0) and after 6, 12 and 24 months, and with cranial MRI scans at entry (T2-weighted and gadolinium-enhanced T1-weighted images). EDSS was again assessed at year 14 (T4). The association between evoked potential (EP), magnetic resonance (MR) data and EDSS was measured using Spearman's rank correlation. Multivariable linear regression was performed to predict EDSS(T4) as a function of z-transformed EP-latencies(T0). The model was validated using a jack-knife procedure and the potential for improving it by inclusion of additional baseline variables was examined. RESULTS EDSS values(T4) correlated with the sum of z-transformed EP-latencies(T0) (rho = 0.68, p < 0.0001), but not with MR-parameters(T0). EDSS(T4) as predicted by the formula EDSS(T4) = 4.194 + 0.088 * z-score P100(T0) + 0.071 * z-score CMCT(UE, T0) correlated with the observed values (rho = 0.69, p < 0.0001). CONCLUSION Combined EPs allow prediction of long-term disability in small groups of patients with MS. This may have implications for the choice of monitoring methods in clinical trials and for daily practice decisions.
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Affiliation(s)
- R Schlaeger
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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Schindler C, Chavakis T, Lamounier-Zepter V, Bornstein SR. [Pharmacological concepts for the treatment of obesity - a therapeutic meander?]. Dtsch Med Wochenschr 2011; 136:1570-3. [PMID: 21809243 DOI: 10.1055/s-0031-1281554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- C Schindler
- Institut für Klinische Pharmakologie, Medizinische Fakultät der TU Dresden.
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Gerbase MW, Keidel D, Imboden M, Gemperli A, Bircher A, Schmid-Grendelmeier P, Bridevaux PO, Berger W, Schindler C, Rochat T, Probst-Hensch N. Effect modification of immunoglobulin E-mediated atopy and rhinitis by glutathione S-transferase genotypes in passive smokers. Clin Exp Allergy 2011; 41:1579-86. [PMID: 21729179 DOI: 10.1111/j.1365-2222.2011.03807.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Experimental studies suggest that glutathione S-transferase (GST) genotypes modify nasal allergen responses induced by secondhand smoke (SHS) exposure. OBJECTIVE We aimed to investigate whether GSTs affected systemic IgE and allergic rhinitis (AR) in SHS-exposed individuals from a population-based cohort. METHODS Analyses comprised 2309 never-smokers from the Swiss study on air pollution and health in adults cohort, reporting SHS status at baseline and 11 years later. Outcomes were defined by total serum IgE≥100 kU/L, specific serum IgE determined by Phadiatop® ≥0.35 kU/L and self-reported AR. GSTP1 Ile105Val, GSTM1 and GSTT1 gene deletion genotypes were identified at the follow-up survey. RESULTS After adjustment for relevant covariates, the homozygous GSTP1 105-Val genotype was negatively associated with high total IgE and high-specific IgE by Phadiatop®, notably in subjects persistently exposed to SHS (OR: 0.20, 95% CI 0.05-0.75; P=0.02, for high total IgE and OR: 0.29, 95% CI 0.10-0.89; P=0.03, for high specific IgE by Phadiatop®). Carrying at least one copy of the GSTM1 gene (non-null) showed a similar association for high specific IgE by Phadiatop® (OR: 0.41, 95% CI 0.22-0.76; P=0.004). No significant associations were found between GSTs and rhinitis. CONCLUSION AND CLINICAL RELEVANCE In this large cohort, homozygosity for GSTP1 105-Val or carrying the GSTM1 non-null genotype decreased the risk of high total IgE or high specific IgE using Phadiatop® by nearly half in subjects exposed to SHS, as compared with subjects carrying opposite alleles. These findings underline the value of genetic susceptibility when evaluating the effects of environmental exposure on allergic illness. The potential long-term effects of persistent SHS exposure in genetically vulnerable individuals may be of public health relevance.
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Affiliation(s)
- M W Gerbase
- Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland.
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Bürgi F, Meyer U, Granacher U, Schindler C, Marques-Vidal P, Kriemler S, Puder JJ. Relationship of physical activity with motor skills, aerobic fitness and body fat in preschool children: a cross-sectional and longitudinal study (Ballabeina). Int J Obes (Lond) 2011; 35:937-44. [PMID: 21448128 DOI: 10.1038/ijo.2011.54] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [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: 11/09/2022]
Abstract
BACKGROUND Adiposity, low aerobic fitness and low levels of activity are all associated with clustered cardiovascular disease risk in children and their high prevalence represents a major public health concern. OBJECTIVE The aim of this study is to investigate the relationship of objectively measured physical activity (PA) with motor skills (agility and balance), aerobic fitness and %body fat in young children. DESIGN This study is a cross-sectional and longitudinal analyses using mixed linear models. Longitudinal data were adjusted for baseline outcome parameters. SUBJECTS In all, 217 healthy preschool children (age 4-6 years, 48% boys) participated in this study. MEASUREMENTS PA (accelerometers), agility (obstacle course), dynamic balance (balance beam), aerobic fitness (20-m shuttle run) and %body fat (bioelectric impedance) at baseline and 9 months later. RESULTS PA was positively associated with both motor skills and aerobic fitness at baseline as well as with their longitudinal changes. Specifically, only vigorous, but not total or moderate PA, was related to changes in aerobic fitness. Higher PA was associated with less %body fat at baseline, but not with its change. Conversely, baseline motor skills, aerobic fitness or %body fat were not related to changes in PA. CONCLUSION In young children, baseline PA was associated with improvements in motor skills and in aerobic fitness, an important determinant of cardiovascular risk.
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Affiliation(s)
- F Bürgi
- Institute of Exercise and Health Science, University of Basel, Basel, Switzerland
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Probst-Hensch NM, Curjuric I, Bridevaux PO, Kunzli N, Schindler C, Rochat T. Authors' response. Thorax 2011. [DOI: 10.1136/thx.2010.148213] [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: 11/03/2022]
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Kuhle J, Leppert D, Petzold A, Regeniter A, Schindler C, Mehling M, Anthony DC, Kappos L, Lindberg RLP. Neurofilament heavy chain in CSF correlates with relapses and disability in multiple sclerosis. Neurology 2011; 76:1206-13. [PMID: 21346223 DOI: 10.1212/wnl.0b013e31821432ff] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Neurodegeneration is now accepted as a pathologic hallmark of multiple sclerosis (MS). We sought to discover whether CSF levels of neurofilament heavy chain protein (NfH(SMI35)) correlate with disability, disease activity, or specific stages of MS. METHODS An electrochemiluminescence immunoassay was used to retrospectively measure NfH(SMI35) in CSF of patients with clinically isolated syndrome (CIS) (n = 63), relapsing-remitting multiple sclerosis (RRMS) (n = 39), secondary progressive multiple sclerosis (SPMS) (n = 25), primary progressive multiple sclerosis (PPMS) (n = 23), or controls (n = 73). Cell count and CSF levels of immunoglobulin and albumin were also measured. RESULTS CSF levels of NfH(SMI35) increased with age in controls (r(s) = 0.50, p < 0.0001) and CIS (r(s) = 0.50, p < 0.0001); this effect was less pronounced in RRMS (r(s) = 0.35, p = 0.027) and absent in SPMS/PPMS. After age correction, NfH(SMI35) levels were found to be higher in all disease stages compared to control. Relapses were associated with higher CSF NfH(SMI35) values compared with stable disease. NfH(SMI35) levels correlated with EDSS scores in patients with CIS and RRMS (r(s) = 0.33, p = 0.001), and during relapse (r(s) = 0.35, p = 0.01); the correlation was most prominent in RRMS during relapse (r(s) = 0.54, p = 0.01). This was not the case for any of the other CSF markers examined. CONCLUSIONS Neuronal loss is a feature of aging, and the age-dependent increase of CSF NfH(SMI35) suggests that this loss accelerates over time. For MS, increased NfH(SMI35) levels reflect the superimposed presence of further neurodegenerative processes. Evaluation of NfH(SMI35) levels is likely to provide a useful surrogate for measuring the rate of neurodegeneration in MS. Furthermore, the dissociation of NfH(SMI35) levels with biomarkers of inflammation suggests that the mechanisms responsible for their production are at least partly independent.
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Affiliation(s)
- J Kuhle
- Department of Biomedicine and Neurology, University Hospital Basel, CH-4031 Basel, Switzerland.
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Kofler M, Kumru H, Stetkarova I, Schindler C, Vidal J. P23-19 Relationship between reduction of muscle hypertonia and suppression of blink reflex by intrathecal baclofen. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)60994-7] [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: 11/29/2022]
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