101
|
Abstract
We discuss the case of a 44-year-old man with a refractory left lower lobe pneumonia progressing to a pulmonary abscess caused by a colobronchial fistula, a rare complication of underlying Crohn's disease. The patient presented with weight loss and signs of a pulmonary consolidation, which responded incompletely to the targeted antibiotic treatment. The causative colobronchial fistula was demonstrated by CT-guided puncture and retrograde injection of contrast medium. After fistula excision, the patient recovered rapidly with a weight gain of 4 kg within a few weeks.
Collapse
Affiliation(s)
- Karim El-Hag
- Department of Internal Medicine/Pulmonology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Pietro Renzulli
- Department of Surgery, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Daniel Franzen
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
| |
Collapse
|
102
|
Crook S, Sievi NA, Bloch KE, Stradling JR, Frei A, Puhan MA, Kohler M. Minimum important difference of the Epworth Sleepiness Scale in obstructive sleep apnoea: estimation from three randomised controlled trials. Thorax 2018; 74:390-396. [PMID: 30100576 DOI: 10.1136/thoraxjnl-2018-211959] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/21/2018] [Accepted: 07/23/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND The Epworth Sleepiness Scale (ESS) is a widely used tool for assessing sleepiness in patients with obstructive sleep apnoea (OSA). We aimed to estimate the minimal important difference (MID) in patients with OSA. METHODS We used individual data from three randomised controlled trials (RCTs) in patients with OSA where the preintervention to postintervention change in ESS was used as a primary outcome. We used anchor-based linear regression and responder analysis approaches to estimate the MID. For anchors, we used the change in domains of the Functional Outcomes of Sleep Questionnaire and 36-Item Short Form Health Survey. We also used the distribution-based approaches Cohen's effect size, SE of measurement and empirical rule effect size to support the anchor-based estimates. The final MID was determined by triangulating all estimates to a single MID. FINDINGS A total of 639 patients with OSA were included in our analyses across the three RCTs with a median (IQR) baseline ESS score of 10 (6-13). The median (IQR) ESS change score overall was -2 (-5 to 1). The anchor-based estimates of the MID were between -1.74 and -4.21 points and estimates from the responder analysis were between -1 and -3 points. Distribution-based estimates were smaller, ranging from -1.46 to -2.36. INTERPRETATION We propose an MID for the ESS of 2 points in patients with OSA with a disease severity from mild to severe. This estimate provides the means to plan trials and interpret the clinical relevance of changes in ESS. TRIAL REGISTRATION NUMBER Provent, NCT01332175; autoCPAP trial, NCT00280800; MOSAIC,ISRCTN (3416388).
Collapse
Affiliation(s)
- Sarah Crook
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pneumology, University Hospital of Zurich, Zurich, Switzerland
| | - Konrad E Bloch
- Department of Pneumology, University Hospital of Zurich, Zurich, Switzerland.,Center of Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| | - John R Stradling
- Oxford Centre for Respiratory Medicine and Oxford NIHR Biomedical Research Centre, Churchill Campus, Oxford University, Oxford, UK
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pneumology, University Hospital of Zurich, Zurich, Switzerland.,Center of Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| |
Collapse
|
103
|
Kohler M, Strauß S, Horn U, Usichenko T, Langner I, Domin M, Lotze M. P54. Differences in neuronal representation of mental rotation in CRPS patients and healthy controls. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.691] [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: 11/24/2022]
|
104
|
Sievi NA, Brack T, Brutsche MH, Frey M, Irani S, Leuppi JD, Thurnheer R, Kohler M, Clarenbach CF. Physical activity declines in COPD while exercise capacity remains stable: A longitudinal study over 5 years. Respir Med 2018; 141:1-6. [DOI: 10.1016/j.rmed.2018.06.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 10/14/2022]
|
105
|
Sievi NA, Franzen D, Kohler M, Clarenbach CF. Lung volume reduction surgery does not increase daily physical activity in patients with severe chronic obstructive pulmonary disease. J Thorac Dis 2018; 10:2722-2730. [PMID: 29997934 DOI: 10.21037/jtd.2018.05.18] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Lung volume reduction surgery (LVRS) is a treatment option for selected patients with severe chronic obstructive pulmonary disease (COPD) and emphysema. The positive effects of LVRS on exercise capacity are well known. In contrast, the effect of LVRS on daily physical activity (PA) is less clear. Methods In a prospective case-control study we evaluated selected patients with severe COPD and emphysema who underwent LVRS and COPD patients following usual care. Controls were matched for age, severity of airflow obstruction (FEV1) and hyperinflation [residual volume to total lung capacity (RV/TLC)]. Treatment effect of LVRS on activity parameters was analysed using univariable regression model adjusting for treatment group. Results A total of 19 patients underwent LVRS and 16 COPD patients without a surgical intervention during the study period were included. The median (quartile) FEV1%pred was 28% (range, 21-33%), RV/TLC was 69% (range, 64-73%) in cases while controls had a median (quartile) FEV1%pred of 33% (range, 28.5-49.5%) and a RV/TLC of 58% (range, 49-61%). Age and body mass index (BMI) were comparable between both groups. Number of steps per day following LVRS was comparable to before the intervention (mean change: -115, 95% CI: -994.6 to 764.3, P=0.779) and was not significantly different to the change in control subjects (mean treatment effect: 931.4, 95% CI: -252.4 to 2,115.1, P=0.117). Conclusions The results from this study reveal that patients undergoing LVRS did not increase their daily level of PA despite improvement of exercise capacity and symptoms.
Collapse
Affiliation(s)
- Noriane A Sievi
- Division of Pulmonary, University Hospital of Zurich, Zurich, Switzerland
| | - Daniel Franzen
- Division of Pulmonary, University Hospital of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Division of Pulmonary, University Hospital of Zurich, Zurich, Switzerland.,Zurich Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | | |
Collapse
|
106
|
Hofmann P, Benden C, Kohler M, Schuurmans MM. Smoking resumption after heart or lung transplantation: a systematic review and suggestions for screening and management. J Thorac Dis 2018; 10:4609-4618. [PMID: 30174913 DOI: 10.21037/jtd.2018.07.16] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Smoking remains the leading cause of preventable disease and death in the developed world and kills half of all long-term users. Smoking resumption after heart or lung transplantation is associated with allograft dysfunction, higher incidence of cancer, and reduced overall survival. Although self-reporting is considered an unreliable method for tobacco use detection, implementing systematic cotinine-based screening has proven challenging. This review examines the prevalence of smoking resumption in thoracic transplant patients, explores the risk factors associated with a post-transplant smoking resumption and discusses the currently available smoking cessation interventions for transplant patients.
Collapse
Affiliation(s)
- Patrick Hofmann
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Benden
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Macé M Schuurmans
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| |
Collapse
|
107
|
Randerath W, Bassetti CL, Bonsignore MR, Farre R, Ferini-Strambi L, Grote L, Hedner J, Kohler M, Martinez-Garcia MA, Mihaicuta S, Montserrat J, Pepin JL, Pevernagie D, Pizza F, Polo O, Riha R, Ryan S, Verbraecken J, McNicholas WT. Challenges and perspectives in obstructive sleep apnoea. Eur Respir J 2018; 52:13993003.02616-2017. [DOI: 10.1183/13993003.02616-2017] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/25/2018] [Indexed: 12/21/2022]
Abstract
Obstructive sleep apnoea (OSA) is a major challenge for physicians and healthcare systems throughout the world. The high prevalence and the impact on daily life of OSA oblige clinicians to offer effective and acceptable treatment options. However, recent evidence has raised questions about the benefits of positive airway pressure therapy in ameliorating comorbidities.An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years, discussed the current challenges in the field, and proposed topics for future research on epidemiology, phenotyping, underlying mechanisms, prognostic implications and optimal treatment of patients with OSA.The group concluded that a revision to the diagnostic criteria for OSA is required to include factors that reflect different clinical and pathophysiological phenotypes and relevant comorbidities (e.g.nondipping nocturnal blood pressure). Furthermore, current severity thresholds require revision to reflect factors such as the disparity in the apnoea–hypopnoea index (AHI) between polysomnography and sleep studies that do not include sleep stage measurements, in addition to the poor correlation between AHI and daytime symptoms such as sleepiness. Management decisions should be linked to the underlying phenotype and consider outcomes beyond AHI.
Collapse
|
108
|
Tomonaga Y, Ten Haaf K, Frauenfelder T, Kohler M, Kouyos RD, Shilaih M, Lorez M, de Koning HJ, Schwenkglenks M, Puhan MA. Cost-effectiveness of low-dose CT screening for lung cancer in a European country with high prevalence of smoking-A modelling study. Lung Cancer 2018; 121:61-69. [PMID: 29858029 DOI: 10.1016/j.lungcan.2018.05.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/01/2018] [Accepted: 05/11/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES In Europe, there is uncertainty about the potential effects and cost-effectiveness of low dose computed tomography screening for lung cancer and about the applicability of results of North American studies. We aimed to estimate the effects and cost-effectiveness of lung cancer screening in a population-based setting in Switzerland where the smoking prevalence is high. MATERIALS AND METHODS The MIcrosimulation Screening ANalysis-Lung (MISCAN) model was adapted using country specific input parameters regarding lung cancer epidemiology, smoking behaviours, and treatment costs. The effects and costs of 648 screening scenarios with different screening start and stop ages, smoking eligibility criteria, and screening intervals were examined from a public healthcare system perspective across a lifetime horizon in a cohort born between 1935 and 1965. RESULTS All screening scenarios showed an increase in the total number of detected lung cancer cases and a decrease in lung cancer mortality. On the efficiency frontier, 15 of 27 scenarios showed incremental cost-effectiveness ratios below € 50,000 per life year gained. These scenarios reduced lung cancer mortality by 6-15% while increasing incidence of lung cancer diagnoses by 2-6%. CONCLUSION These results suggest that lung cancer screening may be cost-effective in Switzerland, a high-income, European country with high smoking prevalence.
Collapse
Affiliation(s)
- Yuki Tomonaga
- Epidemiology, Biostatistics und Prevention Institute (EBPI), University of Zurich, 8001 Zurich, Switzerland
| | - Kevin Ten Haaf
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, 3015 CE Rotterdam, The Netherlands
| | - Thomas Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Malcolm Kohler
- Pulmonary Division, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
| | - Mohaned Shilaih
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
| | - Matthias Lorez
- National Institute for Cancer Epidemiology and Registration, 8001 Zurich, Switzerland
| | - Harry J de Koning
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, 3015 CE Rotterdam, The Netherlands
| | - Matthias Schwenkglenks
- Epidemiology, Biostatistics und Prevention Institute (EBPI), University of Zurich, 8001 Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics und Prevention Institute (EBPI), University of Zurich, 8001 Zurich, Switzerland.
| |
Collapse
|
109
|
McEvoy RD, Kohler M. Con: continuous positive airway pressure and cardiovascular prevention. Eur Respir J 2018; 51:51/5/1702721. [PMID: 29748242 DOI: 10.1183/13993003.02721-2017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 04/19/2018] [Indexed: 01/27/2023]
Affiliation(s)
- R Doug McEvoy
- Sleep Health Service, SALHN, Respiratory and Sleep Services, Adelaide, Australia.,Adelaide Institute for Sleep Health, Flinders University, Adelaide, Australia
| | - Malcolm Kohler
- Dept of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.,Center of Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| |
Collapse
|
110
|
Gaisl T, Bregy L, Stebler N, Gaugg MT, Bruderer T, García-Gómez D, Moeller A, Singer F, Schwarz EI, Benden C, M-L Sinues P, Zenobi R, Kohler M. Real-time exhaled breath analysis in patients with cystic fibrosis and controls. J Breath Res 2018; 12:036013. [DOI: 10.1088/1752-7163/aab7fd] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
111
|
Schwarz EI, Furian M, Schlatzer C, Stradling JR, Kohler M, Bloch KE. Nocturnal cerebral hypoxia in obstructive sleep apnoea: a randomised controlled trial. Eur Respir J 2018; 51:13993003.00032-2018. [DOI: 10.1183/13993003.00032-2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/06/2018] [Indexed: 01/15/2023]
Abstract
Cerebral hypoxia may promote cerebral damage in patients with obstructive sleep apnoea (OSA). We investigated whether OSA patients experience nocturnal cerebral hypoxia that is prevented by continuous positive airway pressure (CPAP).OSA patients using CPAP underwent sleep studies including pulse oximetry (arterial oxygen saturation (SpO2)) and near-infrared spectroscopy to monitor cerebral tissue oxygenation (CTO) at baseline and after 2 weeks on either subtherapeutic or therapeutic CPAP according to randomised allocation. Changes in oxygenation at end of the 2-week intervention were compared between groups.Among 21 patients (mean apnoea/hypopnoea index 50.3 events·h−1), OSA recurred in all nine patients using subtherapeutic CPAP and in none of the patients using therapeutic CPAP: mean (95% CI) between-group differences in changes of oxygen desaturation index from baseline to 2 weeks +40.7 (31.1–50.4) events·h−1 for SpO2 and +37.0 (25.3–48.7) events·h−1 for CTO (both p<0.001). Mean nocturnal SpO2 and CTO decreased more in patients using subtherapeutic versus therapeutic CPAP: −2.4 (−3.4–−1.1)% and −3.8 (−7.4–−0.1)%, respectively; both p<0.03. Severe CTO drops ≥13% associated with cerebral dysfunction in previous studies occurred in four out of nine patients using subtherapeutic CPAP, but in none out of 12 patients using therapeutic CPAP (p=0.01).In patients with OSA, CPAP withdrawal resulted in nocturnal cerebral deoxygenation, suggesting a role of cerebral hypoxia in predisposing untreated OSA patients to cerebral damage.
Collapse
|
112
|
Kofler L, Schweinzer K, Heister M, Kohler M, Breuninger H, Häfner HM. Surgical treatment of hidradenitis suppurativa: an analysis of postoperative outcome, cosmetic results and quality of life in 255 patients. J Eur Acad Dermatol Venereol 2018; 32:1570-1574. [DOI: 10.1111/jdv.14892] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/29/2018] [Indexed: 12/30/2022]
Affiliation(s)
- L. Kofler
- Department of Dermatology; University Medical Center; Eberhard Karls University; Tübingen Germany
| | - K. Schweinzer
- Department of Dermatology; University Medical Center; Eberhard Karls University; Tübingen Germany
| | - M. Heister
- Department of Dermatology; University Medical Center; Eberhard Karls University; Tübingen Germany
| | - M. Kohler
- Department of Dermatology; University Medical Center; Eberhard Karls University; Tübingen Germany
| | - H. Breuninger
- Department of Dermatology; University Medical Center; Eberhard Karls University; Tübingen Germany
| | - H.-M. Häfner
- Department of Dermatology; University Medical Center; Eberhard Karls University; Tübingen Germany
| |
Collapse
|
113
|
Watson EJ, Coates AM, Banks S, Kohler M. Reply to letter to the editor on: "is there a relationship between excessive sugar consumption and sleep quality in children?"<sup/>. Int J Food Sci Nutr 2018; 69:902-903. [PMID: 29508653 DOI: 10.1080/09637486.2018.1445203] [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: 10/17/2022]
Affiliation(s)
- E J Watson
- a Centre for Sleep Research, School of Psychology , University of South Australia , Adelaide , South Australia , Australia
| | - A M Coates
- b Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences , University of South Australia , Adelaide , South Australia , Australia
| | - S Banks
- a Centre for Sleep Research, School of Psychology , University of South Australia , Adelaide , South Australia , Australia
| | - M Kohler
- a Centre for Sleep Research, School of Psychology , University of South Australia , Adelaide , South Australia , Australia
| |
Collapse
|
114
|
Furian M, Hartmann SE, Latshang TD, Flueck D, Murer C, Scheiwiller PM, Osmonov B, Ulrich S, Kohler M, Poulin MJ, Bloch KE. Exercise Performance of Lowlanders with COPD at 2,590 m: Data from a Randomized Trial. Respiration 2018; 95:422-432. [PMID: 29502125 DOI: 10.1159/000486450] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 12/20/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Effects of hypobaric hypoxia at altitude on exercise performance of lowlanders with chronic obstructive pulmonary disease (COPD) have not been studied in detail. OBJECTIVES To quantify changes in exercise performance and associated physiologic responses in lowlanders with COPD travelling to moderate altitude. METHODS A total of 31 COPD patients with a median age (quartiles) of 66 years (59; 69) and FEV1 of 56% predicted (49; 69) living below 800 m performed a constant-load bicycle exercise to exhaustion at 60% of the maximal work rate at 490 m (Zurich) and at an identical work rate at 2,590 m (Davos) in randomized order. Pulmonary gas exchange, pulse oximetry (SpO2), cerebral tissue oxygenation (CTO; near-infrared spectroscopy), and middle cerebral artery peak blood flow velocity (MCAv) by Doppler ultrasound during 30 s at end exercise were compared between altitudes. RESULTS With ascent from 490 to 2,590 m, the median endurance time (quartiles) was reduced from 500 s (256; 795) to 205 s (139; 297) by a median (95% CI) of 303 s (150-420) (p < 0.001). End exercise SpO2 decreased from 92% (89; 94) to 81% (77; 84) and CTO from 62% (56; 66) to 55% (50; 60); end exercise minute ventilation increased from 40.6 L/min (35.5; 47.8) to 47.2 L/min (39.6; 58.7) (p < 0.05; all comparisons 2,590 vs. 490 m). MCAv increased similarly from rest to end exercise at 490 m (+25% [17; 36]) and at 2,590 m (+21% [14; 30]). However, the ratio of MCAv increase to SpO2 drop during exercise decreased from +6%/% (3; 12) at 490 m to +3%/% (2; 5) at 2,590 m (p < 0.05). CONCLUSIONS In lowlanders with COPD travelling to 2,590 m, exercise endurance is reduced by more than half compared to 490 m in association with reductions in systemic and cerebral oxygen availability.
Collapse
Affiliation(s)
- Michael Furian
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland.,Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Sara E Hartmann
- Department of Physiology and Pharmacology and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tsogyal D Latshang
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Deborah Flueck
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Christian Murer
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | | | - Batyr Osmonov
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Silvia Ulrich
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Marc J Poulin
- Department of Physiology and Pharmacology and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Konrad E Bloch
- Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
115
|
McNicholas WT, Bassetti CL, Ferini-Strambi L, Pépin JL, Pevernagie D, Verbraecken J, Randerath W, McNicholas WT, Bassetti CL, Ferini-Strambi L, Pépin JL, Pevernagie D, Verbraecken J, Bonsignore MR, Farre R, Grote L, Hedner J, Kohler M, Martinez-Garcia MA, Mihaicuta S, Montserrat J, Pizza F, Polo O, Riha RL, Ryan S, Randerath W. Challenges in obstructive sleep apnoea. The Lancet Respiratory Medicine 2018; 6:170-172. [DOI: 10.1016/s2213-2600(18)30059-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 01/09/2018] [Indexed: 12/29/2022]
|
116
|
Singh KD, Del Miguel GV, Gaugg MT, Ibañez AJ, Zenobi R, Kohler M, Frey U, Sinues PML. Translating secondary electrospray ionization-high-resolution mass spectrometry to the clinical environment. J Breath Res 2018; 12:027113. [PMID: 29411710 DOI: 10.1088/1752-7163/aa9ee3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While there has been progress in making use of breath tests to guide clinical decision making, the full potential of exhaled breath analysis still remains to be exploited. Here we summarize some of the reasons why this is the case, what we have done so far to overcome some of the existing obstacles, and our vision of how we think breath analysis will play a more prominent role in the coming years. In particular, we envision that real-time high-resolution mass spectrometry will provide valuable information in biomarker discovery studies. However, this can only be achieved by a coordinated effort, using standardized equipment and methods in multi-center studies to eventually deliver tangible advances in the field of breath analysis in a clinical setting. Concrete aspects such as sample integrity, compound identification, quantification and standardization are discussed. Novel secondary electrospray ionization developments with the aim of facilitating inter-groups comparisons and biomarker validation studies are also presented.
Collapse
Affiliation(s)
- Kapil Dev Singh
- University of Basel Children's Hospital, Basel, Switzerland. Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
117
|
Kim JH, Gellatly KJ, Lueke B, Kohler M, Nauen R, Murenzi E, Yoon KS, Clark JM. Detoxification of ivermectin by ATP binding cassette transporter C4 and cytochrome P450 monooxygenase 6CJ1 in the human body louse, Pediculus humanus humanus. Insect Mol Biol 2018; 27:73-82. [PMID: 28960749 DOI: 10.1111/imb.12348] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We previously observed that ivermectin-induced detoxification genes, including ATP binding cassette transporter C4 (PhABCC4) and cytochrome P450 6CJ1 (CYP6CJ1) were identified from body lice following a brief exposure to a sublethal dose of ivermectin using a non-invasive induction assay. In this current study, the functional properties of PhABCC4 and CYP6CJ1 were investigated after expression in either X. laevis oocytes or using a baculovirus expression system, respectively. Efflux of [3 H]-9-(2-phosphonomethoxyethyl) adenine ([3 H]-PMEA), a known ABCC4 substrate in humans, was detected from PhABCC4 cRNA-injected oocytes by liquid scintillation spectrophotometric analysis and PhABCC4 expression in oocytes was confirmed using ABC transporter inhibitors. Efflux was also determined to be ATP-dependent. Using a variety of insecticides in a competition assay, only co-injection of ivermectin and dichlorodiphenyltrichloroethane led to decreased efflux of [3 H]-PMEA. PhABCC4-expressing oocytes also directly effluxed [3 H]-ivermectin, which increased over time. In addition, ivermectin appeared to be oxidatively metabolized and/or sequestered, although at low levels, following functional expression of CYP6CJ1 along with cytochrome P450 reductase in Sf9 cells. Our study suggests that PhABCC4 and perhaps CYP6CJ1 are involved in the Phase III and Phase I xenobiotic metabolism of ivermectin, respectively, and may play an important role in the evolution of ivermectin resistance in lice and other insects as field selection occurs.
Collapse
Affiliation(s)
- J H Kim
- Department of Veterinary and Animal Science, University of Massachusetts, Amherst, MA, USA
| | - K J Gellatly
- Department of Veterinary and Animal Science, University of Massachusetts, Amherst, MA, USA
| | - B Lueke
- Crop Science Division, R&D, Bayer AG, Monheim, Germany
| | - M Kohler
- Crop Science Division, R&D, Bayer AG, Monheim, Germany
| | - R Nauen
- Crop Science Division, R&D, Bayer AG, Monheim, Germany
| | - E Murenzi
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, MA, USA
| | - K S Yoon
- Department of Biological Sciences and Environmental Sciences Program, Southern Illinois University, Edwardsville, IL, USA
| | - J M Clark
- Department of Veterinary and Animal Science, University of Massachusetts, Amherst, MA, USA
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, MA, USA
| |
Collapse
|
118
|
Franzen D, Schad K, Kowalski B, Clarenbach CF, Stupp R, Dummer R, Kohler M. Ipilimumab and early signs of pulmonary toxicity in patients with metastastic melanoma: a prospective observational study. Cancer Immunol Immunother 2018; 67:127-134. [PMID: 28983773 PMCID: PMC11028167 DOI: 10.1007/s00262-017-2071-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/26/2017] [Indexed: 11/28/2022]
Abstract
Ipilimumab, an immune checkpoint inhibitor, is approved for treatment metastastic melanoma and is a promising agent against other malignancies. There is some preliminary evidence from case reports that ipilimumab treatment may be associated with pulmonary side effects. However, data from prospective studies on ipilimumab-related pulmonary toxicity are still scarce. Serial spirometries and measurements of CO-diffusion capacity (DLCO) in patients with metastatic melanoma before and during treatment with ipilimumab were performed. A reduction from baseline of forced vital capacity (FVC) of ≥ 10%, or ≥ 15% of DLCO was defined as clinically meaningful and indicative for pulmonary toxicity. Of 71 patients included in this study, a clinically meaningful lung function decline was registered in 6/65 (9%), 5/44 (11%), and 9/38 (24%) patients after 3, 6, and 9 weeks of treatment initiation, respectively. Even after adjusting for age, concomitant melanoma treatment, progressive pulmonary metastases, and baseline pulmonary function values, mean ± SD DLCO decreased significantly during follow-up (-4.3% ± 13.6% from baseline, p = 0.033). Only 7% of patients reported respiratory symptoms. Clinically manifest ipilimumab-related pneumonitis was diagnosed only in one patient (1.4%). DLCO decline maybe an early indicator of subclinical pulmonary drug toxicity. Therefore, routine pulmonary function testing including DLCO measurement during treatment might help for risk stratification to screen for ipilimumab-related pneumonitis.
Collapse
Affiliation(s)
- Daniel Franzen
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
| | - Karin Schad
- Department of Dermatology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Benedikt Kowalski
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Christian F Clarenbach
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Roger Stupp
- Department of Medical Oncology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| |
Collapse
|
119
|
Schwarz EI, Stradling JR, Kohler M. Physiological consequences of CPAP therapy withdrawal in patients with obstructive sleep apnoea-an opportunity for an efficient experimental model. J Thorac Dis 2018; 10:S24-S32. [PMID: 29445525 PMCID: PMC5803046 DOI: 10.21037/jtd.2017.12.142] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/11/2017] [Indexed: 12/20/2022]
Abstract
Randomised controlled trials (RCTs) of continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) are time consuming, and their findings often inconclusive or limited due to suboptimal CPAP adherence in CPAP-naïve patients with OSA. Short-term CPAP withdrawal in patients with prior optimal CPAP adherence results in recurrence of OSA and its consequences. Thus, this experimental model serves as an efficient tool to investigate both the consequences of untreated OSA, and potential treatment alternatives to CPAP. The CPAP withdrawal protocol has been thoroughly validated, and applied in several RCTs focusing on cardiovascular and metabolic consequences of untreated OSA, as well as the assessment of treatment alternatives to CPAP.
Collapse
Affiliation(s)
- Esther I. Schwarz
- Sleep Disorders Center and Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
| | - John R. Stradling
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and University of Oxford, Oxford, UK
| | - Malcolm Kohler
- Sleep Disorders Center and Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Interdisciplinary Center for Sleep Research, University of Zurich, Zurich, Switzerland
| |
Collapse
|
120
|
Diebold M, Soltermann A, Hottinger S, Haile SR, Bubendorf L, Komminoth P, Jochum W, Grobholz R, Theegarten D, Berezowska S, Darwiche K, Oezkan F, Kohler M, Franzen DP. Prognostic value of MIB-1 proliferation index in solitary fibrous tumors of the pleura implemented in a new score - a multicenter study. Respir Res 2017; 18:210. [PMID: 29246159 PMCID: PMC5732426 DOI: 10.1186/s12931-017-0693-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 08/23/2017] [Accepted: 12/04/2017] [Indexed: 01/01/2023] Open
Abstract
Background Although the majority of solitary fibrous tumors of the pleura (SFTP) follow a benign course, 10–25% of patients suffer from recurrence or metastatic disease. Several scoring models have been proposed to predict the outcome. However, none of these included immunohistochemical (IHC) markers as possible prognosticators. Methods In this multicenter study, we collected clinical data and formalin-fixed and paraffin-embedded (FFPE) tissue blocks of patients with histologically proven SFTP which had been surgically resected between 2000 und 2015. After systematic and extensive IHC staining on tissue microarrays, the results were analyzed and compared to histomorphological and clinical data for their possible prognostic value. Results In total, 78 patients (mean age 61 ± 11 years) were included. Of these, 9 patients (11%) had an adverse outcome including SFTP recurrence (n = 6) or SFTP-related death (n = 3). Mean overall survival was 172 ± 13 months. 1 and 10-year event-free survival rates were 99% and 93%. In the multivariable analysis only MIB-1 proliferation index (Ki-67) ≥10% (HR 12.3, CI 1.1–139.5, p = 0.043), ≥4 mitoses per 10 high power fields (HR 36.5, CI 1.2–1103.7, p = 0.039) and tumor size larger than 10 cm (HR 81.8, CI 1.7–4016.8, p = 0.027) were independently associated with adverse outcome. Conclusion A high proliferation rate by MIB-1 IHC was associated with impaired outcome. Upon this, we established a new score using mitosis, necrosis, size of the tumor and MIB-1, which performed better than the traditional scores in our data set. This prognostic score could help to better evaluate outcome of SFTP, but requires external validation.
Collapse
Affiliation(s)
- Matthias Diebold
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
| | - Alex Soltermann
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Selma Hottinger
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Sarah R Haile
- Institute of Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
| | - Lukas Bubendorf
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Paul Komminoth
- Institute of Pathology, Triemli City Hospital, Zurich, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Rainer Grobholz
- Department of Pathology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Dirk Theegarten
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Kaid Darwiche
- Department of Interventional Pulmonology, Ruhrlandklinik, University Hospital Essen, Essen, Germany
| | - Filiz Oezkan
- Department of Interventional Pulmonology, Ruhrlandklinik, University Hospital Essen, Essen, Germany.,James Thoracic Oncology Center, Ohio State University, Columbus, OH, USA
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Daniel P Franzen
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| |
Collapse
|
121
|
Carron T, Bridevaux PO, Lörvall K, Parmentier R, Moix JB, Beytrison V, Pernet R, Rey C, Roberfroid PY, Chhajed PN, Dieterle T, Joos Zellweger L, Kohler M, Maier S, Miedinger D, Thurnheer R, Urwyler P, Tschopp JM, Zuercher E, Leuppi JD, Burnand B, Peytremann-Bridevaux I. Feasibility, acceptability and effectiveness of integrated care for COPD patients: a mixed methods evaluation of a pilot community-based programme. Swiss Med Wkly 2017; 147:w14567. [PMID: 29231234 DOI: 10.4414/smw.2017.14567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
QUESTION UNDER STUDY The aim of this study was to assess the feasibility, acceptability and effectiveness of a pilot COPD integrated care programme implemented in Valais, Switzerland. METHODS The programme was adapted from the self-management programme Living Well with COPD, and included the following elements: self-management patient-education group sessions, telephone and medical follow-ups, multidisciplinary teams, training of healthcare professionals, and evidence-based COPD care. A process and outcome evaluation of the pilot phase of the programme was conducted by means of qualitative and quantitative methods. Reach (coverage, participation rates), dosage (interventions carried out), fidelity (delivered as intended) and stakeholders' acceptance of the programme were evaluated through data monitoring and conduct of focus groups with patients and healthcare professionals. Effectiveness was assessed with pre-post analyses (before and after the intervention). The primary outcome measures were; (1) generic and disease-specific quality of life (36-Item Short Form Health Survey, Chronic Respiratory Questionnaire); and (2) hospitalisations (all-cause and for acute exacerbations) in the past 12 months. Secondary outcomes included self-efficacy, number of exacerbations and exercise capacity. Finally, controlled pre-post comparisons were also made with patients from the Swiss COPD Cohort for three common outcome measures (dyspnoea [mMRC score], number of exacerbations and smoking status). RESULTS During the first 2 years of the programme, eight series of group-based education sessions were delivered to 57 patients with COPD in three different locations of the canton of Valais. Coverage objectives were achieved and attendance rate at the education sessions was high (83.6%). Patients' and healthcare professionals' reported a high degree of satisfaction, except for multidisciplinarity and transfer of information. Exploration of the effectiveness of this pilot programme suggested positive pre-post results at 12 months, with improvements in terms of health-related quality of life, self-efficacy, exercise capacity, immunisation coverage and Patient Assessment of Chronic Illness Care score. No other outcome, including the number of hospital admissions, differed significantly after 12 months. We observed no differences from the control group. CONCLUSIONS The evaluation demonstrated the feasibility and acceptability of the programme and confirmed the relevance of mixed method process evaluation to adjust and improve programme implementation. The introduction of multidisciplinary teams in a context characterised by fragmentation of care was identified as the main challenge in the programme implementation and could not be achieved as expected. Despite this area for improvement, patients' feedback and early effectiveness results confirmed the benefits of COPD integrated care programmes emphasising self-management education.
Collapse
Affiliation(s)
- Tania Carron
- Institute of social and preventive medicine (IUMSP), Lausanne University Hospital, Switzerland
| | - Pierre-Olivier Bridevaux
- Division of Pneumology, Hospital of Valais, Sion, Switzerland / Division of Pneumology, University Hospitals of Geneva, Switzerland / Faculty of Medicine, University of Geneva, Switzerland
| | - Karin Lörvall
- Institute of social and preventive medicine (IUMSP), Lausanne University Hospital, Switzerland / Division of Pneumology, Hospital of Valais, Sion, Switzerland / Ligue pulmonaire Valaisanne - Promotion Santé Valais, Sion, Switzerland
| | - Rachel Parmentier
- Ligue pulmonaire Valaisanne - Promotion Santé Valais, Sion, Switzerland
| | - Jean-Bernard Moix
- Ligue pulmonaire Valaisanne - Promotion Santé Valais, Sion, Switzerland
| | | | | | | | | | - Prashant N Chhajed
- University Clinic of Medicine, Kantonsspital Baselland, Liestal, and Medical Faculty of Medicine, University of Basel, Switzerland
| | - Thomas Dieterle
- University Clinic of Medicine, Kantonsspital Baselland, Liestal, and Medical Faculty of Medicine, University of Basel, Switzerland
| | | | - Malcolm Kohler
- Division of Pneumology, University Hospital Zürich, Switzerland
| | - Sabrina Maier
- University Clinic of Medicine, Kantonsspital Baselland, Liestal, and Medical Faculty of Medicine, University of Basel, Switzerland
| | - David Miedinger
- University Clinic of Medicine, Kantonsspital Baselland, Liestal, and Medical Faculty of Medicine, University of Basel, Switzerland
| | - Robert Thurnheer
- Division of Pneumology, Kantonsspital Münsterlingen, Switzerland
| | - Pascal Urwyler
- University Clinic of Medicine, Kantonsspital Baselland, Liestal, and Medical Faculty of Medicine, University of Basel, Switzerland
| | - Jean-Marie Tschopp
- Centre Valaisan de Pneumologie, Department of Internal Medicine, Montana, Switzerland
| | - Emilie Zuercher
- Institute of social and preventive medicine (IUMSP), Lausanne University Hospital, Switzerland
| | - Jörg Daniel Leuppi
- University Clinic of Medicine, Kantonsspital Baselland, Liestal, and Medical Faculty of Medicine, University of Basel, Switzerland
| | - Bernard Burnand
- Institute of social and preventive medicine (IUMSP), Lausanne University Hospital, Switzerland
| | | |
Collapse
|
122
|
Kontos A, Baumert M, Lushington K, Martin J, Kohler M, Ciccone D, Pamula Y, Kennedy D. Cardiac modulation in healthy children during sleep. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.493] [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: 11/25/2022]
|
123
|
Turnbull CD, Petousi N, Sen D, Stradling JR, Kohler M. P218 The effects of supplemental oxygen on blood pressure in obstructive sleep apnoea during cpap withdrawal. Sleep Breath 2017. [DOI: 10.1136/thoraxjnl-2017-210983.360] [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]
|
124
|
Koch A, Favre R, Viville B, Fritz G, Kohler M, Guerra F, Lecointre L, Gaudineau A, Langer B, Weingertner AS, Sananès N. Expectant management and laser photocoagulation in isolated selective intra-uterine growth restriction: A single-center series. J Gynecol Obstet Hum Reprod 2017; 46:731-736. [DOI: 10.1016/j.jogoh.2017.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/07/2017] [Accepted: 09/19/2017] [Indexed: 11/15/2022]
|
125
|
Franzen DP, Lang C, Agorastos N, Freitag L, Kohler M, Schmid-Grendelmeier P. Evaluation of Nickel Release from Endobronchial Valves as a Possible Cause of Hypersensitivity Pneumonitis in a Patient Treated with Bronchoscopic Lung Volume Reduction. Int Arch Allergy Immunol 2017; 174:144-150. [PMID: 29136621 DOI: 10.1159/000481986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 06/19/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Endobronchial valve (EBV) placement is an established lung volume reduction procedure aiming to improve lung function and exercise capacity in patients with severe emphysema. As EBVs consist of silicone and nitinol (a metal alloy of nickel and titanium), there are concerns that nickel ions might be released and could have a clinical impact in patients with a contact allergy to nickel. Based on a case with hypersensitivity pneumonitis (HP) after treatment with EBVs, we aimed to evaluate the in vitro nickel release from EBVs using inductively coupled plasma mass spectrometry (ICP-MS) and scanning electron microscopy (SEM). METHODS Six EBVs were immersed in artificial saliva for a period of 7 days. At 24-h intervals, the nickel ion concentration was measured using ICP-MS. RESULTS There was evidence of a significant nickel release from EBV during the first 48 h, which is possibly due to an incomplete silicone layer detected by SEM. The concentration of released nickel was below the toxic limit. CONCLUSIONS To the best of our knowledge, we report the first case of HP after EBV treatment. Our finding of in vitro release of nickel ions from EBVs may contribute to the current understanding on hypersensitivity reactions after nitinol implants in patients with nickel contact allergy. However, it did not confirm a causative relationship.
Collapse
Affiliation(s)
- Daniel P Franzen
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | | |
Collapse
|
126
|
Kohler M, Schwarz EI. Response. Chest 2017; 152:1090-1091. [PMID: 29126524 DOI: 10.1016/j.chest.2017.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 07/12/2017] [Indexed: 11/15/2022] Open
Affiliation(s)
- Malcolm Kohler
- Department of Pulmonology, University Hospital of Zurich; and the Clinical Research Priority Programme Sleep and Health, University of Zurich, Zurich, Switzerland.
| | - Esther I Schwarz
- Department of Pulmonology, University Hospital of Zurich; and the Clinical Research Priority Programme Sleep and Health, University of Zurich, Zurich, Switzerland
| |
Collapse
|
127
|
Schnitzer S, Deutschbein S, Nolte C, Kohler M, Kuhlmey A, Schenk L. How does sex affect the care dependency risk one year after stroke? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Schnitzer
- Charité, Department of Medical Sociology, Berlin, Germany
| | - S Deutschbein
- Charité, Department of Medical Sociology, Berlin, Germany
| | - C Nolte
- Charité, Center for Stroke Research, Berlin, Germany
| | - M Kohler
- Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - A Kuhlmey
- Charité, Department of Medical Sociology, Berlin, Germany
| | - L Schenk
- Charité, Department of Medical Sociology, Berlin, Germany
| |
Collapse
|
128
|
Rodriguez‐Perez N, Schiavi E, Frei R, Ferstl R, Wawrzyniak P, Smolinska S, Sokolowska M, Sievi N, Kohler M, Schmid‐Grendelmeier P, Michalovich D, Simpson K, Hessel E, Jutel M, Martin‐Fontecha M, Palomares O, Akdis C, O'Mahony L. Altered fatty acid metabolism and reduced stearoyl-coenzyme a desaturase activity in asthma. Allergy 2017; 72:1744-1752. [PMID: 28397284 DOI: 10.1111/all.13180] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Fatty acids and lipid mediator signaling play an important role in the pathogenesis of asthma, yet this area remains largely underexplored. The aims of this study were (i) to examine fatty acid levels and their metabolism in obese and nonobese asthma patients and (ii) to determine the functional effects of altered fatty acid metabolism in experimental models. METHODS Medium- and long-chain fatty acid levels were quantified in serum from 161 human volunteers by LC/MS. Changes in stearoyl-coenzyme A desaturase (SCD) expression and activity were evaluated in the ovalbumin (OVA) and house dust mite (HDM) murine models. Primary human bronchial epithelial cells from asthma patients and controls were evaluated for SCD expression and activity. RESULTS The serum desaturation index (an indirect measure of SCD) was significantly reduced in nonobese asthma patients and in the OVA murine model. SCD1 gene expression was significantly reduced within the lungs following OVA or HDM challenge. Inhibition of SCD in mice promoted airway hyper-responsiveness. SCD1 expression was suppressed in bronchial epithelial cells from asthma patients. IL-4 and IL-13 reduced epithelial cell SCD1 expression. Inhibition of SCD reduced surfactant protein C expression and suppressed rhinovirus-induced IP-10 secretion, which was associated with increased viral titers. CONCLUSIONS This is the first study to demonstrate decreased fatty acid desaturase activity in humans with asthma. Experimental models in mice and human epithelial cells suggest that inhibition of desaturase activity leads to airway hyper-responsiveness and reduced antiviral defense. SCD may represent a new target for therapeutic intervention in asthma patients.
Collapse
Affiliation(s)
- N. Rodriguez‐Perez
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - E. Schiavi
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - R. Frei
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - R. Ferstl
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - P. Wawrzyniak
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - S. Smolinska
- Department of Clinical ImmunologyWroclaw Medical University Wroclaw Poland
- ”ALL‐MED” Medical Research Institute Wroclaw Poland
| | - M. Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - N.A. Sievi
- Pulmonary Division University Hospital of Zürich Zürich Switzerland
| | - M. Kohler
- Pulmonary Division University Hospital of Zürich Zürich Switzerland
| | - P. Schmid‐Grendelmeier
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Allergy Unit Department of Dermatology University Hospital of Zürich Zürich Switzerland
| | - D. Michalovich
- Refractory Respiratory Inflammation Discovery Performance Unit GlaxoSmithKlineStevenage UK
| | - K.D. Simpson
- Refractory Respiratory Inflammation Discovery Performance Unit GlaxoSmithKlineStevenage UK
| | - E.M. Hessel
- Refractory Respiratory Inflammation Discovery Performance Unit GlaxoSmithKlineStevenage UK
| | - M. Jutel
- Department of Clinical ImmunologyWroclaw Medical University Wroclaw Poland
- ”ALL‐MED” Medical Research Institute Wroclaw Poland
| | - M. Martin‐Fontecha
- Departamento de Química Orgánica I Facultad de Ciencias Químicas Universidad Complutense de Madrid Madrid Spain
| | - O. Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - C.A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - L. O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| |
Collapse
|
129
|
Markun S, Franzen DP, Dalla Lana K, Beyer S, Wieser S, Hess T, Kohler M, Rosemann T, Senn O, Steurer-Stey C. Acute exacerbated COPD: room for improvement in key elements of care. Int J Chron Obstruct Pulmon Dis 2017; 12:2969-2975. [PMID: 29066878 PMCID: PMC5644547 DOI: 10.2147/copd.s145496] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Indexed: 12/30/2022] Open
Abstract
Introduction Hospitalizations because of acute exacerbated COPD (AECOPD) are a major burden to patients and the health care system. Interventions during acute and post-acute hospital care exist not only to improve short-term outcomes but also to prevent future exacerbations and disease progression. We aimed at measuring the implementation rates of acute and post-acute hospital care interventions for AECOPD. Methods We performed 24 months (January 1, 2012, to December 31, 2013) retrospective medical chart review of consecutive cases hospitalized to one of three public hospitals in the canton of Zurich due to AECOPD. Implementation rates of five acute care and seven post-acute care interventions were assessed. Results Data from 263 hospitalizations (61% male, mean age 68.5 years, 47% active smokers) were analyzed. The median length of stay was 9 days (interquartile range [IQR] 6–12 days). In all, 32% of hospitalizations were caused by individuals with previous hospitalizations because of AECOPD. Implementation rates of four acute care interventions were >75% (lowest was appropriate antibiotic therapy with 56%). Compared to this, implementation rates of five post-acute care interventions were <25% (lowest was patient education and self-management advice with 2%). Conclusion The results of this audit revealed room for improvement mainly in post-acute care interventions for AECOPD.
Collapse
Affiliation(s)
| | - Daniel P Franzen
- Department of Pneumology, University Hospital Zurich, University of Zurich, Zurich
| | | | - Swantje Beyer
- Department of Pneumology, Cantonal Hospital of Winterthur, Winterthur
| | | | - Thomas Hess
- Department of Pneumology, Cantonal Hospital of Winterthur, Winterthur
| | - Malcolm Kohler
- Department of Pneumology, University Hospital Zurich, University of Zurich, Zurich
| | | | | | | |
Collapse
|
130
|
Bloch KE, Huber F, Furian M, Latshang TD, Lo Cascio CM, Nussbaumer-Ochsner Y, Senn O, Russi EW, Kohler M, Schoch OD, Turk A, Imhof E, Laube I, Matthews F, Thurnheer R. Autoadjusted versus fixed CPAP for obstructive sleep apnoea: a multicentre, randomised equivalence trial. Thorax 2017; 73:174-184. [DOI: 10.1136/thoraxjnl-2016-209699] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 08/13/2017] [Accepted: 08/29/2017] [Indexed: 11/03/2022]
Abstract
BackgroundThe obstructive sleep apnoea syndrome (OSAS) is conventionally treated by continuous positive airway pressure set at a fixed level (fCPAP). Automatic mask pressure adjustment (autoCPAP) is increasingly used during home therapy. We investigated whether autoCPAP is equivalent to fCPAP in improving sleepiness in patients with OSAS in the long-term.MethodsIn this multicentre equivalence trial, 208 patients with OSAS, with median Epworth sleepiness score (ESS) 13, apnoea/hypopnoea index 48.4/hour, were randomised to treatment with autoCPAP (5–15 mbar) or fCPAP (pressure set at the 90th percentile applied by autoCPAP during 2–4 weeks adaptation). Coprimary outcomes were changes in subjective and objective sleepiness from baseline to 2 years after treatment. Equivalence ranges were ±2 points in ESS and ±3 min sleep resistance time evaluated by recording responses to light signals.ResultsAt 2 years, in the intention to treat analysis, the reduction in sleepiness versus pretreatment baseline was similar in patients using autoCPAP (n=113, mean ESS-change −6.3, 95% CI −7.1 to −5.5; sleep resistance time +8.3 min, +6.9 to +9.7) and fCPAP (n=95, mean ESS-change −6.2, 95% CI −7.0 to −5.3; sleep resistance time +6.3 min, +4.7 to +7.8). The 95% CI of difference in ESS-reduction between autoCPAP and fCPAP was −0.9 to +1.4 and the 95% CI of difference in increase in sleep resistance time was −2.6 to +1.0 min. Blood pressure reduction and OSAS-related costs were similar between groups.ConclusionsAutoCPAP and fCPAP are equivalent within prespecified ranges in improving subjective and objective sleepiness in patients with OSAS over the course of 2 years. Costs of these treatments are similar.Trial registration numberClinicalTrials.gov NCT00280800.
Collapse
|
131
|
Güntner AT, Sievi NA, Theodore SJ, Gulich T, Kohler M, Pratsinis SE. Noninvasive Body Fat Burn Monitoring from Exhaled Acetone with Si-doped WO 3-sensing Nanoparticles. Anal Chem 2017; 89:10578-10584. [PMID: 28891296 DOI: 10.1021/acs.analchem.7b02843] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Obesity is a global health threat on the rise, and its prevalence continues to grow. Yet suitable biomedical sensors to monitor body fat burn rates in situ, to guide physical activity or dietary interventions toward efficient weight loss, are missing. Here, we introduce a compact and inexpensive breath acetone sensor based on Si-doped WO3 nanoparticles that can accurately follow body fat burn rates in real time. We tested this sensor on 20 volunteers during exercise and rest and measured their individual breath acetone concentrations in good agreement with benchtop proton transfer reaction time-of-flight mass spectrometry (PTR-TOF-MS). During exercise, this sensor reveals clearly the onset and progression of increasing breath acetone levels that indicate intensified body fat metabolism, as validated by parallel venous blood β-hydroxybutyrate (BOHB) measurements. Most importantly, we found that the body fat metabolism was especially pronounced for most volunteers during fasting for 3 h after exercise, with strong variation between subjects, and this was displayed correctly by the sensor in real-time. As a result, this simple breath acetone sensor enables easily applicable and hand-held body fat burn monitoring for personalized and immediate feedback on workout effectiveness that can guide dieting as well.
Collapse
Affiliation(s)
- A T Güntner
- Particle Technology Laboratory, Department of Mechanical and Process Engineering, Eidgenössische Technische Hochschule Zürich , CH-8092 Zürich, Switzerland
| | - N A Sievi
- Department of Pulmonology, University Hospital Zürich , CH-8091 Zürich, Switzerland
| | - S J Theodore
- Particle Technology Laboratory, Department of Mechanical and Process Engineering, Eidgenössische Technische Hochschule Zürich , CH-8092 Zürich, Switzerland
| | - T Gulich
- Particle Technology Laboratory, Department of Mechanical and Process Engineering, Eidgenössische Technische Hochschule Zürich , CH-8092 Zürich, Switzerland
| | - M Kohler
- Department of Pulmonology, University Hospital Zürich , CH-8091 Zürich, Switzerland
| | - S E Pratsinis
- Particle Technology Laboratory, Department of Mechanical and Process Engineering, Eidgenössische Technische Hochschule Zürich , CH-8092 Zürich, Switzerland
| |
Collapse
|
132
|
Clarenbach CF, Sievi NA, Kohler M. Annual progression of endothelial dysfunction in patients with COPD. Respir Med 2017; 132:15-20. [PMID: 29229089 DOI: 10.1016/j.rmed.2017.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/16/2017] [Accepted: 09/15/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The risk to die from cardiovascular disease is particularly high in patients with COPD. This longitudinal study aims to evaluate changes of endothelial function over time and identify underlying mechanisms in COPD patients. METHODS In stable COPD patients we performed annual assessments of endothelial function by flow-mediated dilatation (FMD), lung function, systemic inflammation and cholesterol, sympathetic activation, oxygenation, physical activity and exercise capacity. Associations between annual changes of potential predictors and FMD were investigated in mixed analysis. RESULTS 76 patients (41% GOLD stage 1/2, 30% 3, 29% 4) were included. Endothelial function significantly decreased annually by -0.14% (95%CI -0.25/-0.04), equal to a relative decrease of -5.6%. Yearly change in 6-min walking distance was significantly associated with FMD in univariable analysis (Coef. -0.00, p = 0.045). Progressive airway obstruction and increase in level of total cholesterol were borderline significant with a greater decrease in FMD (Coeff. -0.02, p = 0.097 and Coeff. -0.16, p = 0.080, respectively). In multivariable analysis a greater annual decline in FEV1 tends to be independently associated with a decrease in FMD (p = 0.085). CONCLUSION The findings of this study demonstrated that COPD patients experience a significant decrease in endothelial function over time. A greater annual decline in lung function tends to be associated with greater decrease in FMD. However, no other independent predictors for endothelial dysfunction could be identified. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, NCT01527773.
Collapse
Affiliation(s)
| | - Noriane A Sievi
- Pulmonary Division, University Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Pulmonary Division, University Hospital Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Switzerland
| |
Collapse
|
133
|
Gaugg MT, Bruderer T, Nowak N, Eiffert L, Martinez-Lozano Sinues P, Kohler M, Zenobi R. Mass-Spectrometric Detection of Omega-Oxidation Products of Aliphatic Fatty Acids in Exhaled Breath. Anal Chem 2017; 89:10329-10334. [DOI: 10.1021/acs.analchem.7b02092] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Martin Thomas Gaugg
- Department
of Chemistry and Applied Biosciences, Federal Institute of Technology, Zurich, Switzerland
| | - Tobias Bruderer
- Department
of Chemistry and Applied Biosciences, Federal Institute of Technology, Zurich, Switzerland
- Division
of Respiratory Medicine, University Children’s Hospital Zurich and Children’s Research Center Zurich, Zurich, Switzerland
| | - Nora Nowak
- Department
of Chemistry and Applied Biosciences, Federal Institute of Technology, Zurich, Switzerland
| | - Lara Eiffert
- Department
of Chemistry and Applied Biosciences, Federal Institute of Technology, Zurich, Switzerland
| | | | - Malcolm Kohler
- Department
of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- Center
for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Zurich
Center for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| | - Renato Zenobi
- Department
of Chemistry and Applied Biosciences, Federal Institute of Technology, Zurich, Switzerland
| |
Collapse
|
134
|
Gaugg MT, Engler A, Nussbaumer-Ochsner Y, Bregy L, Stöberl AS, Gaisl T, Bruderer T, Zenobi R, Kohler M, Martinez-Lozano Sinues P. Metabolic effects of inhaled salbutamol determined by exhaled breath analysis. J Breath Res 2017; 11:046004. [DOI: 10.1088/1752-7163/aa7caa] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
135
|
Isenring B, Robinson C, Buergi U, Schuurmans MM, Kohler M, Huber LC, Benden C. Lung transplant recipients on long-term extracorporeal photopheresis. Clin Transplant 2017; 31. [PMID: 28653398 DOI: 10.1111/ctr.13041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2017] [Indexed: 11/28/2022]
Abstract
Extracorporeal photophoresis (ECP) is an increasingly used therapy to address chronic lung allograft dysfunction (CLAD) following lung transplantation. In 2008, we reported the first single-center experience showing that ECP not only reduces lung function decline in patients with bronchiolitis obliterans syndrome (BOS) but results in stabilization of patients with recurrent acute cellular rejection (ACR). In this study, the original cohort was followed up further 5 years. In addition, patients with CLAD were retrospectively classified according to recently published phenotypes. The current cohort included 21 of the original 24 patients, of which nine were initially treated for CLAD, 12 were initially treated for recurrent ACR. Our results show that survival of patients treated with ECP for CLAD was inferior to patients treated for recurrent ACR (66% vs. 82% survival rate). Long-term survivors in the CLAD subgroup were mostly classified as BOS 1 at time of ECP initiation. These long-term data show that patients started on ECP at early BOS stages have better long-term outcome. The subgroup of ECP patients with recurrent ACR has an overall superior survival. To assist prediction of therapy response, we agree with other authors that patients with CLAD should be aimed to be phenotyped and evaluated for an early treatment with ECP.
Collapse
Affiliation(s)
- Bruno Isenring
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Cécile Robinson
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Urs Buergi
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Macé M Schuurmans
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Lars C Huber
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Benden
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
136
|
Schindel D, Kuhlmey A, Kohler M, Schenk L. Lebensqualität nach dem Schlaganfall – Entwicklung von gesundheitlicher Ungleichheit in der nachstationären Versorgungsrealität. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1606047] [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: 10/18/2022]
Affiliation(s)
- D Schindel
- Charité – Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin
| | - A Kuhlmey
- Charité – Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin
| | - M Kohler
- Charité – Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin
| | - L Schenk
- Charité – Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin
| |
Collapse
|
137
|
Franzen DP, Nowak A, Haile SR, Mottet D, Bonani M, Dormond O, Kohler M, Krayenbuehl PA, Barbey F. Long-term follow-up of pulmonary function in Fabry disease: A bi-center observational study. PLoS One 2017; 12:e0180437. [PMID: 28742806 PMCID: PMC5526574 DOI: 10.1371/journal.pone.0180437] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/18/2017] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Fabry disease (FD) is a lysosomal storage disorder leading to decreased α-galactosidase A enzyme activity and subsequent abnormal accumulation of glycosphingolipids in various organs. Although histological evidence of lung involvement has been demonstrated, the functional impact of these changes is less clear. MATERIALS AND METHODS Adult patients with FD who had yearly pulmonary function tests (PFT) at two centers from 1999 thru 2015 were eligible for this observational study. Primary outcome measures were the change in forced expiratory volume in the first second (FEV1) and FEV1/FVC over time. As secondary outcome we investigated sex, smoking, enzyme replacement therapy (ERT), residual enzyme activity, and Mainz Severity Score Index as possible predictors. RESULTS 95 patients (41% male, 38.2 ± 14.5 years) were included. The overall prevalence of bronchial obstruction (BO, (FEV1/FVC < 70%)) was 46%, with male sex, age and smoking as significant predictors. FEV1 decreased 29 ml per year (95% CI -36, -22 ml, p<0.0001). FEV1 decline was significantly higher in males (p = 0.009) and in patients on ERT (p = 0.004). Conclusion: Pulmonary involvement seems to be a relevant manifestation of Fabry disease, and routine PFTs should therefore be included in the multidisciplinary follow-up of these patients.
Collapse
Affiliation(s)
- Daniel P. Franzen
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- * E-mail:
| | - Albina Nowak
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Sarah R. Haile
- Epidemiology, Biostatistics and Prevention Institute, Epidemiology Department, University of Zurich, Zurich, Switzerland
| | - Dominique Mottet
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Marco Bonani
- Department of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Olivier Dormond
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | | | - Frederic Barbey
- Transplantation Centre, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
138
|
Spoelstra S, Kohler M, Roth J, Evelyn-Gustave A, Schueller M, Szanton S. IMPLEMENTING CAPABLE (COMMUNITY AGING IN PLACE FOR BETTER ELDERLY LIVING) AS MICAPABLE IN A WAIVER. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Spoelstra
- Grand Valley State University, Grand Rapids, Michigan,
| | - M. Kohler
- Grand Valley State University, Grand Rapids, Michigan,
| | - J. Roth
- Johns Hopkins University, Baltimore, Maryland
| | | | - M. Schueller
- Grand Valley State University, Grand Rapids, Michigan,
| | | |
Collapse
|
139
|
Affiliation(s)
- S. Schnitzer
- Department of Medical Sociology, Charité Berlin, Berlin, Germany,
| | - J. Deutschbein
- Department of Medical Sociology, Charité Berlin, Berlin, Germany,
| | - C. Nolte
- Center for Stroke Research, Charité Berlin, Berlin, Germany,
| | - M. Kohler
- Central Research Institute of Ambulatory Health Care in Germany, Berlin, Berlin, Germany
| | - A. Kuhlmey
- Department of Medical Sociology, Charité Berlin, Berlin, Germany,
| | - L. Schenk
- Department of Medical Sociology, Charité Berlin, Berlin, Germany,
| |
Collapse
|
140
|
Affiliation(s)
- Esther I Schwarz
- Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Anna Engler
- Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Sleep Disorders Center and Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
- Center for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
| |
Collapse
|
141
|
Stöberl AS, Schwarz EI, Haile SR, Turnbull CD, Rossi VA, Stradling JR, Kohler M. Night-to-night variability of obstructive sleep apnea. J Sleep Res 2017; 26:782-788. [DOI: 10.1111/jsr.12558] [Citation(s) in RCA: 60] [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: 11/23/2016] [Accepted: 04/11/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Anna S. Stöberl
- Sleep Disorders Center and Pulmonary Division; University Hospital of Zurich; Zurich Switzerland
| | - Esther I. Schwarz
- Sleep Disorders Center and Pulmonary Division; University Hospital of Zurich; Zurich Switzerland
| | - Sarah R. Haile
- Epidemiology, Biostatistics and Prevention Institute; University of Zurich; Zurich Switzerland
| | - Christopher D. Turnbull
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at Oxford University Hospitals NHS Foundation Trust and University of Oxford; Oxford UK
| | - Valentina A. Rossi
- Sleep Disorders Center and Pulmonary Division; University Hospital of Zurich; Zurich Switzerland
| | - John R. Stradling
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at Oxford University Hospitals NHS Foundation Trust and University of Oxford; Oxford UK
| | - Malcolm Kohler
- Sleep Disorders Center and Pulmonary Division; University Hospital of Zurich; Zurich Switzerland
- Center for Interdisciplinary Sleep Research; University of Zurich; Zurich Switzerland
| |
Collapse
|
142
|
Schwarz E, Haile S, Scherff F, Puhan M, Kohler M. P162 Effect of treatment of central sleep apnoea/cheyne stokes respiration on left ventricular ejection fraction in heart failure - a network meta-analysis. Chest 2017. [DOI: 10.1016/j.chest.2017.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
143
|
Rejmer P, Kohler M. 113 Is obstructive sleep apnea (OSA) a risk factor for the progression of thoracic aortic aneurysm (TAA)? Chest 2017. [DOI: 10.1016/j.chest.2017.04.010] [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: 11/30/2022] Open
|
144
|
Gaugg M, Nussbaumer-Ochsner Y, Bregy L, Engler A, Stebler N, Bruderer T, Martinez-Lozano Sinues P, Zenobi R, Kohler M. 110 On-line breath analysis with secondary electrospray ionization discriminates between COPD patients with and without frequent exacerbations. Chest 2017. [DOI: 10.1016/j.chest.2017.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
145
|
Nussbaumer-Ochsner Y, Gaugg M, Bregy L, Engler A, Anna Sophie S, Gaisl T, Martinez-Lozano Sinues P, Kohler M, Zenobi R. P149 Targeted on-line breath analysis discriminates COPD patients vs. healthy controls and subjects suffering from asthma. Chest 2017. [DOI: 10.1016/j.chest.2017.04.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
146
|
Bisang M, Latshang T, Furian M, Aeschbacher S, Huber F, Lichtblau M, Ulrich S, Scheiwiller P, Hasler E, Ulrich S, Kohler M, Bloch K. P156 Risk of cardiac arrhythmias in lowlanders with COPD travelling to high altitude. Randomized trial of nocturnal oxygen therapy. Chest 2017. [DOI: 10.1016/j.chest.2017.04.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
147
|
Gaisl T, Bregy L, Stebler N, Gaugg M, Bruderer T, García-Gómez D, Möller A, Singer F, Schwarz E, Benden C, M-L Sinues P, Zenobi R, Kohler M. P205 Real-time exhaled breath analysis identifies altered metabolic signature in cystic fibrosis. Chest 2017. [DOI: 10.1016/j.chest.2017.04.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
148
|
Clarenbach C, Sievi N, Brack T, Brutsche M, Frey M, Irani S, Leuppi J, Thurnheer R, Kohler M. P147 Is a questionnaire suitable to assess physical activity and its changes in COPD? Chest 2017. [DOI: 10.1016/j.chest.2017.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
149
|
Bruderer T, Baghdasaryan A, Wyler J, Kohler M, Zenobi R, Möller A. P246 Exhalomics SESI-MS feasibility study with infants and young children for early detection of cystic fibrosis inflammation and infection. Chest 2017. [DOI: 10.1016/j.chest.2017.04.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
150
|
Fisser C, Marcinek A, Hetzenecker A, Debl K, Luchner A, Sterz U, Priefert J, Zeman F, Kohler M, Maier LS, Buchner S, Arzt M. Association of sleep-disordered breathing and disturbed cardiac repolarization in patients with ST-segment elevation myocardial infarction. Sleep Med 2017; 33:61-67. [DOI: 10.1016/j.sleep.2017.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/30/2016] [Accepted: 01/04/2017] [Indexed: 11/28/2022]
|