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Vogel-Claussen J, Lasch F, Bollmann AB, May K, Kuhlmann A, Schmid-Bindert G, Kaaks R, Barkhausen J, Bohnet S, Reck M. HANSE – Ganzheitliche Implementierungsstudie eines norddeutschen interdisziplinären Lungenkrebs Früherkennungs-Programms. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749896] [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: 11/05/2022]
Affiliation(s)
- J Vogel-Claussen
- Medizinische Hochschule Hannover, Institut für Radiologie, Hannover
| | - F Lasch
- European Medicines Agency, Amsterdam
| | - A B Bollmann
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover
| | - K May
- Klinik für Radiologie und Nuklearmedizin, UKSH Campus Lübeck, Lübeck
| | - A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Hannover
| | | | - R Kaaks
- Department of Cancer Epidemiology, German Cancer research Center (DKFZ), Heidelberg
| | - J Barkhausen
- Klinik für Radiologie und Nuklearmedizin, UKSH Campus Lübeck, Lübeck
| | - S Bohnet
- Medizinische Klinik III, UKSH Campus Lübeck, Lübeck
| | - M Reck
- LungenClinic Grosshansdorf GmbH, Großhansdorf
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Starrett J, Guernet A, Cuomo M, Poels K, van Alderwerelt van Rosenburgh I, Nagelberg A, Farnsworth D, Price K, Khan H, Ashtekar K, Gaefele M, Ayeni D, Stewart T, Kuhlmann A, Kaech S, Unni A, Homer R, Lockwood W, Michor F, Goldberg S, Lemmon M, Smith P, Cross D, Politi K. B32 Drug Sensitivity and Allele Specificity of First-Line Osimertinib Resistance EGFR Mutations. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kuhlmann A, Schmidt T, Treskova M, Golpon H, Welte T, Von Der Schulenburg J.G. P3.07-013 Cost-Effectiveness of Immune Checkpoint Inhibitors in the Treatment of Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kuhlmann A, Treskova M, Aumann I, Golpon H, Vogel-Claussen J, Welte T, Von Der Schulenburg J.G. OA 15.02 Benefits, Harms, and Economic Efficiency of Low-Dose CT Lung Cancer Screening Strategies in a Population-Based Setting. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Treskova M, Aumann I, Golpon H, Vogel-Claussen J, Welte T, Kuhlmann A. Kosteneffektivität des Lungenkarzinomscreenings mittels low-dose CT in Deutschland. Pneumologie 2017. [DOI: 10.1055/s-0037-1598334] [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: 10/20/2022]
Affiliation(s)
- M Treskova
- Center for Health Economics Research Hannover, Leibniz Universität Hannover
| | - I Aumann
- Center for Health Economics Research Hannover, Leibniz Universität Hannover
| | - H Golpon
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | | | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - A Kuhlmann
- Center for Health Economics Research Hannover, Leibniz Universität Hannover
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Kuhlmann A, Schmidt T, Treskova M, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Kanavos P, Taruscio D, Schieppati A, Iskrov G, Péntek M, Delgado C, von der Schulenburg JM, Persson U, Chevreul K, Fattore G. Social/economic costs and health-related quality of life in patients with juvenile idiopathic arthritis in Europe. Eur J Health Econ 2016; 17 Suppl 1:79-87. [PMID: 27086322 DOI: 10.1007/s10198-016-0786-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with juvenile idiopathic arthritis (JIA) in Europe. METHODS We conducted a cross-sectional study of patients with JIA from Germany, Italy, Spain, France, the United Kingdom, Bulgaria, and Sweden. Data on demographic characteristics, healthcare resource utilization, informal care, labor productivity losses, and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D-5L) questionnaire. RESULTS A total of 162 patients (67 Germany, 34 Sweden, 33 Italy, 23 United Kingdom, 4 France, and 1 Bulgaria) completed the questionnaire. Excluding Bulgarian results, due to small sample size, country-specific annual health care costs ranged from €18,913 to €36,396 (reference year: 2012). Estimated direct healthcare costs ranged from €11,068 to €22,138; direct non-healthcare costs ranged from €7837 to €14,155 and labor productivity losses ranged from €0 to €8715. Costs are also shown to differ between children and adults. The mean EQ-5D index score for JIA patients was estimated at between 0.44 and 0.88, and the mean EQ-5D visual analogue scale score was estimated at between 62 and 79. CONCLUSIONS JIA patients incur considerable societal costs and experience substantial deterioration in HRQOL in some countries. Compared with previous studies, our results show a remarkable increase in annual healthcare costs for JIA patients. Reasons for the increase are the inclusion of non-professional caregiver costs, a wider use of biologics, and longer hospital stays.
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Affiliation(s)
- A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany.
| | - T Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - M Treskova
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - J López-Bastida
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - R Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - J Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universidad de Castilla-La Mancha, Toledo, Spain
| | - P Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - M Posada-de-la-Paz
- Institute of Rare Diseases Research, ISCIII, SpainRDR & CIBERER, Madrid, Spain
| | - P Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, United Kingdom
| | - D Taruscio
- National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | - G Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - C Delgado
- Federación Española de Enfermedades Raras (FEDER), Madrid, Spain
| | - J M von der Schulenburg
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - U Persson
- Swedish Institute for Health Economics, Lund, Sweden
| | - K Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - G Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Ultsch B, Damm O, Beutels P, Bilcke J, Brüggenjürgen B, Gerber-Grote AU, Greiner W, Hanquet G, Harder T, Hutubessy R, Jit M, Knol M, Kuhlmann A, von Kries R, Levy-Bruhl D, Perleth M, Postma MJ, Salo H, Siebert U, Wasem J, Weidemann F, Wichmann O. Methods for Health Economic Evaluations of Vaccines - Results from an International Expert-Workshop. Value Health 2014; 17:A552. [PMID: 27201800 DOI: 10.1016/j.jval.2014.08.1803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- B Ultsch
- Robert Koch Institute / Charité University Medical Center, Berlin, Germany
| | - O Damm
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - P Beutels
- University of Antwerp, Antwerp, Belgium
| | - J Bilcke
- University of Antwerp, Antwerp, Belgium
| | | | - A U Gerber-Grote
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - W Greiner
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - G Hanquet
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - T Harder
- Robert Koch Institute, Berlin, Germany
| | - R Hutubessy
- World Health Organization, Geneva, Switzerland
| | - M Jit
- London School of Hygiene and Tropical Medicine / Public Health England (PHE), London, UK
| | - M Knol
- RIVM - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - A Kuhlmann
- Leibniz Universität Hannover, Hannover, Germany
| | - R von Kries
- Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - D Levy-Bruhl
- Institut de Veille Sanitaire, Saint-Maurice Cedex, France
| | - M Perleth
- Gemeinsamer Bundesausschuss (G-BA), Berlin, Germany
| | - M J Postma
- University of Groningen, Groningen, The Netherlands
| | - H Salo
- National Institute for Health and Welfare, Helsinki, Finland
| | - U Siebert
- Medical Informatics and Technology, and Director of the Division for Health Technology Assessment and Bioinformatics, ONCOTYROL, Hall i. T, Austria
| | - J Wasem
- University of Duisburg-Essen, Essen, Germany
| | - F Weidemann
- Robert Koch Institute / Charité Berlin, Berlin, Germany
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Gross M, Herr A, Kuhlmann A, Mahlich JC, Stoll M. What Drives Unemployment of HIV-Infected Patients in Germany? Value Health 2014; 17:A680. [PMID: 27202510 DOI: 10.1016/j.jval.2014.08.2533] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Gross
- University of Düsseldorf, Düsseldorf, Germany
| | - A Herr
- University of Düsseldorf, Düsseldorf, Germany
| | - A Kuhlmann
- Leibniz Universität Hannover, Hannover, Germany
| | - J C Mahlich
- Janssen-Pharmaceutical companies of Johnson & Johnson, Neuss, Germany
| | - M Stoll
- Medical University of Hanover (MHH), Hannover, Germany
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Kuhlmann A, Mittendorf T, Hower M, Heiken H, Gerschmann S, Klauke S, Lutz T, Bogner J, Degen O, van Lunzen J, Bachmann C, Stellbrink HJ, Schmidt W, Leistner I, Mahlich J, Ranneberg B, Stoll M. [Cost of Illness of HIV Patients under Anteretroviral Therapy in Germany - Results of the 48-Week Interim Analysis of the Prospective Multicentre Observational Study 'CORSAR']. Gesundheitswesen 2014; 77:e133-42. [PMID: 25247761 DOI: 10.1055/s-0034-1381993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the introduction of highly active combined antiretroviral therapy (c-ART) mortality and morbidity of HIV patients declined substantially. Earlier studies reported that c-ART was able to save health-care costs due to a reduction of other direct medical costs, particularly for inpatient treatments and concomitant medication. To date, analyses of costs and health-related quality of life (HRQOL) of patients under c-ART are lacking in Germany. Hence, this study aims to estimate the current cost of illness and HRQOL of HIV-patients under c-ART in different treatment lines. METHODS A multicenter, prospective observational study was carried out in 12 specialised German centres for infectious diseases: 8 private practices/outpatient centres and 4 specialised hospitals offering both inpatient and outpatient services. Demographic, clinical and medication data were derived from patient records. Resource utilisation, information on productivity, out of pocket costs and HRQOL (EQ-5D) were collected every 12 weeks via a patient questionnaire. All costs were calculated based on price information from publicly accessible databases. RESULTS N=1,154 patients were included in the analysis. Mean direct disease-related costs of -patients under c-ART amounted to 22,563 Euro/year. Patients beyond the 3(rd) line of treatment -incurred considerably higher costs 24,654 Euro/year. In the 1(st) treatment line, c-ART accounted for 83.2% of the total direct costs, in the 2(nd)/3(rd) line for 80.8% and in >3(rd) line for 83.4%, respectively. Indirect costs due to impaired productivity were higher in the 2(nd)/3(rd) treatment line (2,843 Euro) compared to the 1(st) (1,604 Euro) and >3(rd) (1,752 Euro) treatment lines, respectively. The average HRQOL (EQ-5D) varied between 0.77 (self-assessment via visual analogue scale) and 0.91 (utility score based on the German time trade-off tariff). CONCLUSIONS Over the last decade, cost of illness of HIV patients under c-ART decreased slightly with average costs per year still being substantial. Main cost driver of overall costs is c-ART. There have been, however, noticeable shifts between different cost domains.
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Affiliation(s)
- A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz -Universität Hannover, Hannover
| | - T Mittendorf
- Health Economic Research & Consulting, Herescon GmbH, Hannover
| | - M Hower
- ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund
| | - H Heiken
- Innere Medizin, Praxis Georgstraße, Hannover
| | - S Gerschmann
- Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover
| | - S Klauke
- Infektiologie, Infektiologikum, Frankfurt
| | - T Lutz
- Infektiologie, Infektiologikum, Frankfurt
| | - J Bogner
- Infektionskrankheiten und klinische Immunologie, Ludwig-Maximilians-Universität München, München
| | - O Degen
- Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - J van Lunzen
- Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - C Bachmann
- ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund
| | - H J Stellbrink
- ICH Grindel, Infektionsmedizinisches Centrum Hamburg, Hamburg
| | - W Schmidt
- Innere Medizin, Ärzteforum Seestraße, Berlin
| | - I Leistner
- Innere Medizin, Ärzteforum Seestraße, Berlin
| | - J Mahlich
- Health Economics & Pricing, Janssen-Cilag GmbH, Neuss
| | - B Ranneberg
- Health Economics & Pricing, Janssen-Cilag GmbH, Neuss
| | - M Stoll
- Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover
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Kuhlmann A, Steckbeck JD, Sturgeon TJ, Craigo JK, Montelaro RC. The C-terminal tail of HIV-1 envelope: a unique role for conserved LLP arginines in Env functional properties. Retrovirology 2012. [PMCID: PMC3441709 DOI: 10.1186/1742-4690-9-s2-p325] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- A Kuhlmann
- Center for Vaccine Research, Pittsburgh, PA, USA
| | - JD Steckbeck
- Center for Vaccine Research, Pittsburgh, PA, USA
| | - TJ Sturgeon
- Center for Vaccine Research, Pittsburgh, PA, USA
| | - JK Craigo
- Center for Vaccine Research, Pittsburgh, PA, USA
| | - RC Montelaro
- Center for Vaccine Research, Pittsburgh, PA, USA
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Moerer O, Hinz J, Kuhlmann A, Knierim D, Dudykevych T, Neumann P. Die globale Lungenfunktion – gemessen mithilfe der Spirometrie, im Vergleich zur regionalen Lungenventilation – gemessen mithilfe der Elektrischen Impedanz Tomographie (EIT) bei Patienten mit chronisch obstruktiver Lungenerkrankung (COPD) und gesunden Probanden. Pneumologie 2005. [DOI: 10.1055/s-2005-864433] [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]
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Kleeberg UR, Tews JT, Ruprecht T, Höing M, Kuhlmann A, Runge C. Patient satisfaction and quality of life in cancer outpatients: results of the PASQOC study. Support Care Cancer 2005; 13:303-10. [PMID: 15729552 DOI: 10.1007/s00520-004-0727-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2004] [Accepted: 10/05/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Satisfaction with care and quality of life (QoL) are indicative of the quality of care of cancer patients. The purpose of this study was to lay a cornerstone for patient-centred quality management by assessing the current status of satisfaction with care and QoL among oncological outpatients in Germany, and by identifying the key factors that determine a patient's willingness to recommend a medical facility. PATIENTS AND METHODS A self-constructed and validated patient satisfaction questionnaire plus the SF-36 were distributed to a random sample of 3384 cancer patients who presented at 24 investigators' offices nationwide within a defined recruiting period and who met the inclusion criteria. The return rate was 81.9% (n=2772). A total of 2659 (78.6%) questionnaires were evaluable. The most common cancer types were breast (22.9%) and intestine (19.8%). RESULTS Overall satisfaction was high, but specific reporting questions revealed many areas for improvement such as shared decision making, doctor-patient communication and organization of care. QoL was significantly impaired in many domains. Patient-provider relationship, facility setting and information on diagnosis and treatment options are major determinants of a patient's willingness to recommend a facility to a friend or relative if needed. CONCLUSIONS This multicentre study focusing on patient perspectives highlights that, although the overall degree of satisfaction was quite high, there are numerous areas for improvement.
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Affiliation(s)
- U R Kleeberg
- Hämatologisch-onkologische Praxis Altona, 22765 Hamburg, Germany
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Câmpean V, Haas C, Kuhlmann A, Peters H, Acker T, Plate K, Amann K. Glomerular gene and protein expression of angiogenic factors in mesangioproliferative glomerulonephritis in the rat. Pathol Res Pract 2004. [DOI: 10.1016/s0344-0338(04)80543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Buchta M, Kiesswetter E, Otto A, Schaller KH, Seeber A, Hilla W, Windorfer K, Stork J, Kuhlmann A, Gefeller O, Letzel S. Longitudinal study examining the neurotoxicity of occupational exposure to aluminium-containing welding fumes. Int Arch Occup Environ Health 2003; 76:539-48. [PMID: 12838425 DOI: 10.1007/s00420-003-0450-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2002] [Accepted: 04/16/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The neurotoxicity of occupational exposure to aluminium (Al)-containing welding fumes has been discussed with controversial results. The aim of the longitudinal study was to examine a group of Al welders for significant central nervous changes in comparison with a non-exposed cohort. METHODS A group of 98 Al welders (mean age 37 years) in the car-body construction industry, with a median of 6 years of occupational exposure to Al welding fumes, and an education-matched, gender-matched, age-matched control group of 50 car-production workers (mean age 36 years) at the same plant, were included in this longitudinal study. Two cross-sectional studies were done in 1999 and 2001. In the second cross-sectional study 97 welders and 50 controls could be examined. The examination programme consisted, for example, of a standardised anamnesis, focussing on occupational history, education, illnesses, medication, accidents and current alcohol consumption, a physical examination that included neurological status, and the assessment of Al concentration in plasma and urine. The neurobehavioral methods included a symptom questionnaire, modified Q16, and computerised and non-computerised tests: psychomotor performance (steadiness, line tracing, aiming, tapping), verbal intelligence (WST), simple reaction time, digit span, block design (HAWIE), symbol-digit substitution, digit span, switching attention (European neurobehavioral evaluation system, EURO-NES), and standard progressive matrices. The data were analysed by multivariate analysis of covariance (MANCOVA) for repeated measurements with covariates age, education, and carbohydrate-deficient transferrin in plasma (CDT). RESULTS. The median Al urine concentration (mean preshift/postshift) was 52.4 microg/g creatinine (2001) and 57.6 microg/g creatinine (1999). Median respirable air dust was 0.67 mg/m(3) (2001) and 0.47 mg/m(3) (1999). Welders and controls did not report significantly more symptoms in the modified Q16. Furthermore, no significant differences in psychomotor performance and other neurobehavioral tasks, except for reaction time, were seen between welders and non-welders. Regression analyses reveal a significant relationship between reaction time and Al excretion in urine that was confounded by other factors. CONCLUSIONS At present the outcome for reaction time has to be interpreted as a single result. However, as the modified Q16 questionnaire and the rest of the psychomotor performance showed no significant changes, the next cross-sectional study, in 2003, will provide further information on which a final conclusion can be based.
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Affiliation(s)
- M Buchta
- Institute for Occupational, Social, and Environmental Medicine, University of Mainz, Germany.
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Gross ML, El-Shakmak A, Szábó A, Koch A, Kuhlmann A, Münter K, Ritz E, Amann K. ACE-inhibitors but not endothelin receptor blockers prevent podocyte loss in early diabetic nephropathy. Diabetologia 2003; 46:856-68. [PMID: 12802493 DOI: 10.1007/s00125-003-1106-8] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [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: 10/11/2002] [Revised: 02/17/2003] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS It was the aim of our study to investigate the influence of a selective ET-A receptor antagonist LU 135252 alone and in combination with the ACE-inhibitor, trandolapril on podocyte number and morphology in streptozotocin diabetic rats. METHODS Male Sprague-Dawley rats were injected with 65 mg streptozotocin i.v. and subsequently developed diabetes. Animals were left untreated or received daily either trandolapril (0.3 mg/kg body weight), LU 135252 (50 mg/kg body weight) or a combination of both. After 6 months the experiment was terminated. Glomerular geometry and cellularity were assessed by stereological techniques. Protein expression of TGF-beta, ET-1, PDGF-AB, fibronectin, desmin and alpha-smooth muscle cell actin was investigated by immunohistochemistry. RESULTS The mean number of podocytes per glomerulus was lower (86+/-17 vs. 138+/-25; p<0.05) and mean podocyte volume was higher in untreated diabetic animals than in non-diabetic controls. Only ACE-i alone and in combination, but not ET(A)-RB alone prevented loss of podocytes and podocyte hypertrophy. In diabetic rats, increased numbers of PCNA positive and p27(kip1) positive cells (mainly podocytes) were reduced by all treatments, but only ACE-i decreased numbers of desmin positive podocytes and tubulointerstitial expression of TGF-beta. Albuminuria was increased in untreated diabetes and was prevented only by ACE-i and combination treatment. CONCLUSION/INTERPRETATION Podocyte hypertrophy and degeneration is an early event in diabetic nephropathy leading to a loss of podocytes. Treatment with an ACE-i, but not with an ET(A)-RB, prevented the development of albuminuria as well as damage and loss of podocytes. The well known anti-proteinuric effect of ACE-i is presumably due at least in part to conservation of podocyte structure. Increased plasma endothelin-1 (ET-1) concentrations and urine excretion of ET-1 have been documented in patients with diabetes and proteinuria [1]. It has been shown that experimental diabetes mellitus increases renal ET-1 gene transcription [2]. To assess the relevance of the ET-system in the pathogenesis of renal structural changes in the model of the STZ-induced diabetic rat we compared the effect of an ET(A)-receptor specific antagonist with the well known beneficial effect of an ACE-i, especially on podocyte cell number and morphology.
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Affiliation(s)
- M-L Gross
- Department of Pathology, University of Heidelberg, Im Neuenheimer Feld, 69120 Heidelberg, Germany.
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Job V, Kuhlmann A, Gross M, Gaumann A, Gaumann A, Grobholz R, Krump-Konvalinkova V, Müller A. Vessels and Angiogenesis, Abstract 38–45, Posters. Pathol Res Pract 2003. [DOI: 10.1078/0344-0338-00376] [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: 11/18/2022]
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Barillà D, Lucet I, Kuhlmann A, Yudkin MD. Genotype, phenotype, and protein structure in a regulator of sporulation: effects of mutations in the spoIIAA gene of Bacillus subtilis. J Bacteriol 1999; 181:3860-3. [PMID: 10368168 PMCID: PMC93871 DOI: 10.1128/jb.181.12.3860-3863.1999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
SpoIIAA, a phosphorylatable protein, is essential to the regulation of sigmaF, the first sporulation-specific transcription factor of Bacillus subtilis. The solution structure of SpoIIAA has recently been published. Here we examine four mutant SpoIIAA proteins and correlate their properties with the phenotypes of the corresponding B. subtilis mutant strains. Two of the mutations severely disrupted the structure of the protein, a third greatly diminished the rate of its phosphorylation and abolished dephosphorylation, and the fourth left phosphorylation unaffected but reduced the rate of dephosphorylation about 10-fold.
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Affiliation(s)
- D Barillà
- Microbiology Unit, Department of Biochemistry, University of Oxford, Oxford OX1 3QU, United Kingdom
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21
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Kuhlmann A. [Psychology of the physically handicapped patient--an outline of development in Germany]. Rehabilitation (Stuttg) 1987; 26:119-26. [PMID: 2958912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The present article is directed at giving a broad account of the emergence and subsequent differentiation of a specific "psychology of the physically disabled" in Germany, based on articles by selected authors, that appeared in "Zeitschrift für Krüppelfürsorge" (1909-1943) and "Jahrbücher der Fürsorge für Körperbehinderte" (1951-1962). With the cripple care sector just beginning to organize itself around the turn of the century, a historical-chronologically oriented overview is given of those psychological currents that have made decisive contributions toward shaping today's understanding of rehabilitation. Essential positions are brought out, with core ideas presented by original quotations. It turns out in this process that many of our contemporary ideas, which are deemed so modern and novel, have in fact originated already in the first half of the century.
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Affiliation(s)
- A Kuhlmann
- Lehramtsanwärter am Studienseminar für das Lehramt der Sonderpädagogik, Rhede
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Rübesamen M, Grossmann K, Reissmann HC, Gleiser W, Regel R, Giegler I, Kassel G, Kuhlmann A. [Comparison of the values of automatic ECG analysis according to the Smith and the Pipberger diagnostic programs by means of a serial study in a large industry]. Z Gesamte Inn Med 1978; 33:304-8. [PMID: 685324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
It could be shown that an ECG-screening could be integrated into the routine work of a factory outpatient department. As a result of the automatical analysis of the ECG we got an exact knowledge of the efficiency of Smith's and Pipberger's diagnostic programmes. The suitability of the two programmes for screening examinations resulted from the 91% and 97% certain separation of normal and pathological findings and the small proportion of falsely negative results (Smith, Pipberger). Concerning the exact differentiation of pathological ECG the frequency of recognition of Pipberger's programme still surpassed that one of Smith's programme. However, the two programmes show a diagnostic security which lies above the visual diagnosing. The establishment of findings performed off line per week ascertained a rapid disposal of results. In comparison to former examinations newly detected cases could be established only in a small percentage. The importance for health polities of such examinations results from the necessity of the prophylaxis of cardio-vascular diseases, the numbers of morbidity and mortality of which are permanently increasing.
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Rübesamen M, Gleiser W, Kuhlmann A, Rolka H, Giegler I, Grossmann K. [Experience in the use of Smith's ECG evaluation program]. Z Gesamte Inn Med 1977; 32:suppl 284-6. [PMID: 339568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
After the experiences with the use of the programme of Pipberger concerning the automatised ECG-analysis in clinic, outpatient department and factory public health, which were made at the Medical Academy Erfurt during the last years, at this time comparative examinations with the ECG-analysis programme of Smith were performed. The intake of data (3 orthogonal leads) is done by means of a data establishing unit developed by us. For the analog-digital-changing, the pretreatment of data and the transmission of the ECG-data on the digital magnet tape a process-calculator TPA-i is used. The analysis is performed by the computer Robotron 21. The evaluation of the results shows that, when a great number of patients is examined, normal curves are correctly estimated at 100%. The recognition rate of pathological curves has with 79.5% about the same size as the visual judgment. The deficiencies of the diagnostic programme of Smith must be essentially found in the relatively high proportion of falsely negative findings, the insufficient differentiation of the changes of the chamber variation, in the sometimes incorrect formation, why the classification of the curves in individual groups was performed. On account of the certain centage of falsely negative ones the programme is well recognition of normal findings and the tolerable pernotion of the diagnosis and the sometimes lacking insuited for screening examinations.
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