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Siu L, Mckean M, Tolcher A, Victor A, Kitzing T, Pierre V, Gleicher S, Holland D, Richter E, Naing A. 750P Phase I study of TIGIT inhibitor M6223 as monotherapy or in combination with bintrafusp alfa (BA) in patients (pts) with metastatic/locally advanced solid unresectable tumours. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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2
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Affiliation(s)
- E Weber
- Ludwig-Maximilians-University, Munich, Germany
| | - E Richter
- Ludwig-Maximilians-University, Munich, Germany
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Krege S, Hess J, Güldenring A, Richter E, Lederbogen S, Mengel M, Seppel T, Hetkamp M, Küntscher M, Sollenböhmer K, Henkel UM, Möller B, Romer G, Löwenberg H, Riechardt S. Symposium Genderdysphorie. Urologe A 2020; 59:1320-1330. [DOI: 10.1007/s00120-020-01336-0] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Döhla M, Boesecke C, Schulte B, Diegmann C, Sib E, Richter E, Eschbach-Bludau M, Aldabbagh S, Marx B, Eis-Hübinger AM, Schmithausen RM, Streeck H. Rapid point-of-care testing for SARS-CoV-2 in a community screening setting shows low sensitivity. Public Health 2020; 182:170-172. [PMID: 32334183 PMCID: PMC7165286 DOI: 10.1016/j.puhe.2020.04.009] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE With the current SARS-CoV2 outbreak, countless tests need to be performed on potential symptomatic individuals, contacts and travellers. The gold standard is a quantitative polymerase chain reaction (qPCR)-based system taking several hours to confirm positivity. For effective public health containment measures, this time span is too long. We therefore evaluated a rapid test in a high-prevalence community setting. STUDY DESIGN Thirty-nine randomly selected individuals at a COVID-19 screening centre were simultaneously tested via qPCR and a rapid test. Ten previously diagnosed individuals with known SARS-CoV-2 infection were also analysed. METHODS The evaluated rapid test is an IgG/IgM-based test for SARS-CoV-2 with a time to result of 20 min. Two drops of blood are needed for the test performance. RESULTS Of 49 individuals, 22 tested positive by repeated qPCR. In contrast, the rapid test detected only eight of those positive correctly (sensitivity: 36.4%). Of the 27 qPCR-negative individuals, 24 were detected correctly (specificity: 88.9%). CONCLUSION Given the low sensitivity, we recommend not to rely on an antibody-based rapid test for public health measures such as community screenings.
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Affiliation(s)
- M Döhla
- Institute for Hygiene and Public Health, One Health Department, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - C Boesecke
- Clinic for Internal Medicine, Infectious Diseases Department, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - B Schulte
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - C Diegmann
- Institute for Hygiene and Public Health, One Health Department, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - E Sib
- Institute for Hygiene and Public Health, One Health Department, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - E Richter
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - M Eschbach-Bludau
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - S Aldabbagh
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - B Marx
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - A-M Eis-Hübinger
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - R M Schmithausen
- Institute for Hygiene and Public Health, One Health Department, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - H Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
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June GA, Sherrod PS, Hammack TS, Amaguaña RM, Andrews WH, Arling V, Ayers S, Ayotte E, Cirigliano M, Clifford DC, Cook D, Coles C, Dabney A, Davis T, Diaz B, Driggs RM, Eliasberg S, Fain A, Fung DYC, Hammers A, Hu E, Jirele K, Keating KJ, Kogan S, Kone K, Kuyyakamont B, Luebbert K, McDonagh S, McNally S, Mettler D, Milas J, Miller C, Nelson T, Nguyen P, Pfundheller R, Phebus RK, Redding R, Richardson S, Richter E, Robinson J, Romer J, Roo DW, Smoot L, Snow K, Tate C, Tompkins L, Vanderbilt K, Varney GW, Wagner D, Wang J, Wchienroj K. Relative Effectiveness of Selenite Cystine Broth, Tetrathionate Broth, and Rappaport-Vassiliadis Medium for Recovery of Salmonella spp. from Raw Flesh, Highly Contaminated Foods, and Poultry Feed: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/79.6.1307] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A collaborative study was performed in 18 laboratories to validate use of Rappaport-Vassiliadis (RV) medium in the standard culture method for recovery of Salmonella spp. from raw, highly contaminated foods and poultry feed. RV medium made from its individual ingredients and incubated at 42�C was compared with selenite cystine (SC) broth incubated at 35�C and tetrathionate (TT) broth incubated at 35� and 43�C for effectiveness in recovery of Salmonella spp. Four artificially contaminated foods (oysters, frog legs, mushrooms, and shrimp) and poultry feed and one naturally contaminated food (chicken) were analyzed. The artificially contaminated foods were inoculated with single serovars of Salmonella at target levels of 0.04 colony-forming units (CFU)/g for the low level and 0.4 CFU/g for the high level. For analysis of 1125 test portions, RV medium (42�C) recovered Salmonellairom 409 test portions; TT (43�C), from 368 test portions; TT (35�C), from 310 test portions; and SC (35�C), from 334 test portions. Overall, RV medium was comparable with or better than other selective enrichments for recovery of Salmonella from the foods in this study, except mushrooms. From mushrooms, SC broth (35�C) recovered more positive test portions than did RV medium (42�C) and TT broth (43�C). The method for detection of Salmonella in raw, highly contaminated foods and
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Affiliation(s)
- Geraldine A June
- U.S. Food and Drug Administration, Division of Microbiological Studies, Washington, DC 20204
| | - Patricia S Sherrod
- U.S. Food and Drug Administration, Division of Microbiological Studies, Washington, DC 20204
| | - Thomas S Hammack
- U.S. Food and Drug Administration, Division of Microbiological Studies, Washington, DC 20204
| | - R Miguel Amaguaña
- U.S. Food and Drug Administration, Division of Microbiological Studies, Washington, DC 20204
| | - Wallace H Andrews
- U.S. Food and Drug Administration, Division of Microbiological Studies, Washington, DC 20204
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Mozola MA, Peng X, Wendorf M, Alles S, Artiga L, Buchholz T, Camacho A, Charveron N, Clayborn J, Decker C, Deibel C, Donohue T, Draughon A, Ewings J, Feldworth M, Gane P, Goodwin J, Gunter T, Gutierrez M, Hovland R, Jechorek R, Jones W, Keskinen L, Lamproe B, Larson E, Manwarren H, Merkling A, Osing C, Pangloli P, Remes A, Richter E, Rogers A, Rose B, Ryser E, Secraw S, Slupik M, Wessinger A, Westmoreland R, Yan Z, Zahoor T, Zhang L. Evaluation of the GeneQuence® DNA Hybridization Method in Conjunction with 24-Hour Enrichment Protocols for Detection of Salmonella spp. in Select Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/90.3.738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare performance of the GeneQuence® DNA hybridization (DNAH) method incorporating new 24 h enrichment protocols and reference culture procedures for detection of Salmonella spp. in select foods. Six food types (raw ground turkey, raw ground beef, dried whole egg, milk chocolate, walnuts, and dry pet food) were tested by the DNAH method and by the culture methods of either the U.S. Department of Agriculture-Food Safety and Inspection Service (USDA-FSIS) or the U.S. Food and Drug Administration's Bacteriological Analytical Manual (FDA/BAM). Fifteen laboratories participated in the study. Four of the foods tested (raw ground turkey, dried whole egg, milk chocolate, and dry pet food), showed no statistically significant differences in performance between the DNAH method and the reference procedure as determined by Chi square analysis. Sensitivity rates for the DNAH method ranged from 92 to 100. The DNAH method, with the specific enrichment protocol evaluated, was found to be ineffective for detection of Salmonella spp. in walnuts. For raw ground beef, results from one trial showed a statistically significant difference in performance, with more positives obtained by the reference method. However, evidence suggests that the difference in the number of positives was likely due to lack of homogeneity of the test samples rather than to DNAH method performance.
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Affiliation(s)
| | - Xuan Peng
- Neogen Corp., 620 Lesher Pl, Lansing, MI 48912
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Haase A, Seyfarth M, Wenzel BE, Richter E, Baehre M, Meller B. Reduced radioiodine uptake at increased iodine intake and 131I-induced release of “cold” iodine stored in the thyroid. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim: The extent of urinary iodine excretion (UIE) provides information about iodine supply and release. In the present study we investigated correlations between UIE and radioiodine uptake (RIU) as well as effects of radioiodine therapy on UIE in patients with autonomous goitre. Patients, methods: In 197 consecutive patients with thyroid autonomy, UIE was measured twice during radioiodine test (RITe) and correlated with RIU. In 98 of these patients, thyroglobulin and thyroid volume (V) were determined prior to therapy. Individual changes in urinary iodine excretion (ΔUIE) and TG (ΔTG) could be investigated four weeks (4W) and six months (6M) after radioiodine therapy. Additionally, ΔV was determined 6M after therapy. ΔUIE, ΔTG and ΔV were correlated with target dose and target volume. Results: Patients with higher iodine excretion exhibited significantly lower thyroidal radioiodine uptake values. Twofold increased UIE prior to therapy decreased radioiodine uptake by 25%. Compared with pretherapeutic values, UIE and TG were significantly increased four weeks after radioiodine therapy (p <0.001). Median values of both parameters were found to be doubled. The product of target dose and target volume was not only correlated with a decrease of thyroid volume 6M after therapy, but also with an increase of UIE and TG in the early phase after therapy. Conclusions: It was confirmed that UIE during RITe is a measure for iodine intake and can be used to investigate the competition between stable iodine and radioiodine. The increase of UIE and TG four weeks after therapeutic administration of radioiodine can be explained by disintegrated thyroid follicles. The therapy-induced iodine release may be one important cause for the development of hyperthyroidism in some patients during the first weeks after radioiodine therapy. It may contribute to the known decrease of radioiodine uptake after preapplications of 131I in various thyroid diseases.
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von Hof K, Genina E, Deisting W, Meller J, Richter E, Baehre M, Meller B. Diagnostic 123I and 131I activities and radioiodine therapy. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryAim: Urinary iodine excretion (UIE) provides information about iodine supply and release. In the present study we investigated effects of the application of different radioiodine isotopes on UIE in patients with differentiated thyroid carcinoma (DTC). Patients, methods: In 91 consecutive patients with DTC UIE, measured as iodine/creatinine ratio, was determined before and after application of 123I and 131I for diagnostic or therapeutic purposes. Additionally, remnant volume (V) was determined prior to therapy. Group A consisted of 33 patients with supposed successful ablation of DTC. These patients received 370 MBq 131I for diagnostic use and served as controls. 58 patients (group B) with remnants, relapses and metastases received 370 MBq 123I for diagnostics prior to therapy with 1.5-22.2 GBq 131I. Factors influencing individual changes in urinary iodine excretion (ΔUIE) were investigated by using non-parametric tests. Results: In group A UIE did not change significantly after application of 131I. As well, UIE remained unchanged after diagnostic application of 123I in group B. In contrast, UIE increased significantly already 24 h after therapeutic application of 131I in this group. In patients with small remnants (V < 2.5 ml) a significant but only moderate increase of UIE could be observed (average increase: 47 μg I/g crea). In patients with larger remnants, with relapses or metastases increase of UIE values was significant and more pronounced. Conclusions: It was confirmed that UIE increased significantly during radioiodine therapy in patients with DTC and radioiodine-accumulating tissue. The increase of UIE after therapeutic administration of radioiodine can be explained by the disintegrated thyroid follicles in thyroid remnants. The radioiodine-induced iodine release may be one reason for thyroid “stunning” even after application of diagnostic amounts of 131I.
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Sommer K, Gerl J, Hof V, Surowiec A, Richter E, Wollenberg B, Baehre M, Meller B. High energy probe for detecting lymph node metastases with 18F-FDG in patients with head and neck cancer. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryAim of this study was to validate a newly developed high energy probe (positron emission probe, PEP) optimised for localising PET tracers in vivo. Patients and methods: Physical investigations included determination of full width at half maximum (FWHM) values at a distance of 1 cm and angular resolution using different point sources. Values obtained with the new probe were compared to those of a conventional gamma probe (CGP). Additionally, PET studies were performed in 36 patients (6 women, 30 men) with proven head and neck cancer and suspected lymph node metastases (Axis, Marconi/Philips) after administering 250–320 MBq 18F-FDG. Subsequent to PET investigations 18F-FDG uptake in cervical regions was measured using the PEP. PEP investigations were carried out bilaterally in 5 lymph node (LN) levels (Robbins’ classification of the neck). Results of probe studies were correlated with visual and semiquantitative PET evaluations, US and histological findings. Results: FWHM of the new probe was 7 mm (CGP 22 mm) at 662 keV (137Cs) and angular resolution resulted in 8° (CGP 60°). In 29 out of 36 patients LN metastases were suspected due to ultrasound investigations. After neck dissection, histology confirmed LN metastases in 21 patients. Sensitivity (sens.) of US amounted to 95% and specificity to 40%. In 18/21 patients LN metastases were detected by PET (sens. 86%). PET scans failed to diagnose the LN status correctly in 6/36 patients (accuracy 83%). Employing the PEP probe in 20/21 patients LN metastases were identified (sens. 95%), and LN status was determined accurately in 29/36 patients (accuracy 81%). Tumour/ background ratios of PEP measurement and results of semiquantitative PET analyses were comparable. Conclusions: PEP measurement is a promising method for preoperative planning of the extent of neck dissection in patients with head and neck cancer and further for radioguided localising PET tracer accumulation during surgery.
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Weiser T, Richter E, Hegewisch A, Muse DD, Lange R. Efficacy and safety of a fixed-dose combination of ibuprofen and caffeine in the management of moderate to severe dental pain after third molar extraction. Eur J Pain 2017; 22:28-38. [PMID: 28805281 PMCID: PMC5763370 DOI: 10.1002/ejp.1068] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 02/05/2023]
Abstract
Background Ibuprofen is an effective analgesic treatment with a ceiling effect at doses above 400 mg. This study compared the combination of ibuprofen 400 mg and caffeine 100 mg with ibuprofen 400 mg monotherapy, caffeine and placebo in the analgesic treatment of moderate to severe acute dental pain following third molar extraction. Methods Phase III, active‐/placebo‐controlled, double‐blind, single‐centre, two‐stage, parallel‐group study in adult patients with at least moderate baseline pain intensity. Primary endpoint was defined as the time‐weighted sum of pain relief and pain intensity difference over 8 h (SPRID0–8 h), secondary endpoints included duration of pain relief, time to meaningful pain relief and more. Results N = 748 patients were enrolled and N = 562 treated. Mean baseline pain intensity was 7.7 on a 0–10 numerical rating scale. Analysis of SPRID0–8 h demonstrated superior analgesic effects for a single dose of ibuprofen/caffeine versus ibuprofen, caffeine and placebo over 8 h, rescue medication in this stage was requested by more patients on ibuprofen (32.5%) than on ibuprofen/caffeine (16.0%). Median time to meaningful pain relief was shorter for ibuprofen/caffeine (1.13 h) compared with ibuprofen (1.78 h; p = 0.0001). More patients on ibuprofen/caffeine than on ibuprofen reported meaningful pain relief. Adverse events were infrequent and mostly mild or moderate across treatment groups. Tolerability was rated as ‘very good’ or ‘excellent’ by most patients in both treatment groups. Conclusion This study demonstrated clinically relevant superiority of ibuprofen/caffeine over monotherapy with ibuprofen in patients with acute dental pain. All treatments were well tolerated. Significance This trial showed superior efficacy of 400/100 mg ibuprofen/caffeine, compared to 400 mg ibuprofen alone, for treating acute pain, reflecting that caffeine is an effective analgesic adjuvant. Data on efficacy of 400 mg ibuprofen combined with caffeine for the treatment of acute pain were not available yet.
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Affiliation(s)
- T Weiser
- Medical Affairs Consumer Health Care, Medical and Regulatory Affairs Germany, Boehringer Ingelheim Pharma GmbH & Co. KG, Germany
| | - E Richter
- Corporate Division Medicine, Global Department Biostatistics and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Germany
| | - A Hegewisch
- Marketing Self-Medication, Global Department Consumer Health Care Division Medical and Regulatory Affairs, Boehringer Ingelheim, Promeco S.A. de C.V, Germany
| | - D D Muse
- Jean Brown Research, Salt Lake City, USA
| | - R Lange
- Consumer Health Care Development, Medical and Regulatory Affairs, Boehringer Ingelheim Pharma GmbH & Co. KG, Germany
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Radloff J, Heyckendorf J, Reiling N, Richter E, Lange C, Kalsdorf B. M. bovis BCG-Impfung induziert eine Mykobakterien-spezifische T-Zell-Immunantwort, aber keinen Schutz vor der Infektion humaner Alveolarmakrophagen mit M. tuberculosis. Pneumologie 2017. [DOI: 10.1055/s-0037-1598435] [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)
- J Radloff
- Division Klinisch Infektiologie, Forschungszentrum Borstel
| | | | - N Reiling
- Division of Microbial Interface Biology, Research Center Borstel
| | - E Richter
- Tuberculosis, Labor Limbach, Heidelberg
| | - C Lange
- Medizinische Klinik, Klinische Infektiologie, Forschungszentrum Borstel
| | - B Kalsdorf
- Medizinische Klinik, Klinische Infektiologie, Forschungszentrum Borstel
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de Mey C, Koelsch S, Richter E, Pohlmann T, Sousa R. Efficacy and Safety of Ambroxol Lozenges in the Treatment of Acute Uncomplicated Sore Throat - a Pooled Analysis. Drug Res (Stuttg) 2016; 66:384-92. [PMID: 27281448 DOI: 10.1055/s-0042-107788] [Citation(s) in RCA: 7] [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: 10/21/2022]
Abstract
A pooled analysis is presented of 7 placebo-controlled RCT that investigated lozenges containing ambroxol for pain relief in acute sore throat.2 242 patients were treated with different ambroxol doses or control treatments, 2 183 were evaluable for efficacy. The present analysis is focused on the recommended dose of 20 mg (AXL20): 856 patients were treated with AXL20, 847 with matched placebo lozenges (PL).The average reduction in pain intensity over the first 3 h after the first AXL20 ranged from 38% to 52% of the maximum achievable effect (MAE). The overall treatment difference between AXL20 and PL was 11% (95% CI: 8-13%) of the MAE (post-hoc meta-analysis). The corresponding NNT was 6.0 (CI: 4.7-8.4) for an average pain reduction from baseline of 33% of the MAE over the first 3 h.71.9, 79.0, and 85.3% of the AXL20-patients scored the efficacy as "very good or good" at the end of the 1(st), 2(nd) and 3(rd) day, respectively, vs. 57.5, 64.4, and 70.4% of the PL-patients resulting in odds ratios of 1.9 (CI: 1.5-2.3) for the 1(st), 2.1 (CI: 1.7-2.6) for the 2(nd) and 2.43 (CI: 1.8-3.3) for the 3(rd) day.At the end of treatment 'no redness' or 'slightly red' was scored on pharyngeal inspection in 84.4% and 77.3% of AXL20- and PL-patients (OR: 1.6, CI: 1.3-1.9).AXL20-treatment was well tolerated and is safe and efficacious for acute uncomplicated sore throat of recent onset in adolescent and adult patients.
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Affiliation(s)
- C de Mey
- ACPS - Applied Clinical Pharmacology Services, Mainz-Kastel, Germany
| | - S Koelsch
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - E Richter
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - T Pohlmann
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - R Sousa
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
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Schoenfeld N, Haas W, Richter E, Bauer T, Boes L, Castell S, Hauer B, Magdorf K, Matthiessen W, Mauch H, Reuss A, Schenkel K, Ruesch-Gerdes S, Zabel P, Dalhoff K, Schaberg T, Loddenkemper R. Recommendations of the German Central Committee against Tuberculosis (DZK) and the German Respiratory Society (DGP) for the Diagnosis and Treatment of Non-tuberculous Mycobacterioses. Pneumologie 2016; 70:250-76. [PMID: 27064418 DOI: 10.1055/s-0041-111494] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Non-tuberculous mycobacterioses comprise a group of diseases caused by mycobacteria which do not belong to the Mycobacterium (M.) tuberculosis-complex and are not ascribed to M. leprae. These mycobacteria are characterized by a broad variety as to environmental distribution and adaptation. Some of the species may cause specific diseases, especially in patients with underlying immunosuppressive diseases, chronic pulmonary diseases or genetic predisposition, respectively. Worldwide, a rising prevalence and significance of non-tuberculous mycobacterioses is recognized. The present recommendations summarise current aspects of epidemiology, pathogenesis, clinical aspects, diagnostics - especially microbiological methods including susceptibility testing -, and specific treatment for the most relevant species. Diagnosis and treatment of non-tuberculous mycobacterioses during childhood and in HIV-infected individuals are described in separate chapters.
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Affiliation(s)
- N Schoenfeld
- Department of Pneumology, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | - W Haas
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin
| | - E Richter
- Head of TB laboratory; MVZ Labor Dr. Limbach & Kollegen GbR
| | - T Bauer
- Department of Pneumology, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | - L Boes
- German Central Committee against Tuberculosis, Berlin
| | - S Castell
- German Central Committee against Tuberculosis, Berlin
| | - B Hauer
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin
| | - K Magdorf
- Department of Pediatrics, Subspecialty Pneumology and Immunology, Charité Universitäts-Medizin Berlin, Stiftung Oskar-Helene-Heim, Berlin
| | - W Matthiessen
- Coswig Specialist Hospital, Center for Pneumology and Thoracic Surgery
| | - H Mauch
- Department of Microbiology, Immunology and Laboratory Medicine, Helios Klinikum Emil von Behring, Berlin
| | - A Reuss
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin
| | - K Schenkel
- German Central Committee against Tuberculosis, Berlin
| | - S Ruesch-Gerdes
- Microbiologist consultant, Reinbek, member of the WHO GLI Europe
| | - P Zabel
- Research Center Borstel, Medical Clinic, Borstel
| | - K Dalhoff
- Department of Medicine III (Pulmonology), University Hospital of Schleswig-Holstein, Luebeck Campus
| | - T Schaberg
- Center for Pneumology, Agaplesion Diakonie Hospital, Rotenburg
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Abstract
The rapid and reliable detection of tuberculosis is the main goal of microbiological analyses. This is not only of great value for an early diagnosis and early start of an adequate therapy, but also helps to stop transmission and spread of the disease. Prerequisites for successful detection of mycobacteria are careful selection of patient specimens, proper sampling and appropriate shipping. In addition to the classical microbiological methods such as staining for acid-fast bacteria and culture procedures, newer molecular methods are gaining greater importance (PCR; NAT). TB bacteria and resistance-associated mutations can be detected from the specimens directly, providing an early hint about resistant strains. In positive cultures, M. tuberculosis complex and nontuberculous mycobacteria must be discriminated from each other. Drug susceptibility testing (DST) of all first-line drugs has to be performed from one isolate of each patient and repeated if TB bacteria are still isolated after 2 months of therapy. DST of second-line drugs should follow in case of drug resistance or drug intolerance.
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Affiliation(s)
- E Richter
- Forschungszentrum Borstel, Leibniz-Zentrum für Medizin und Biowissenschaften, Nationales Referenzzentrum für Mykobakterien
| | - S Andres
- Forschungszentrum Borstel, Leibniz-Zentrum für Medizin und Biowissenschaften, Nationales Referenzzentrum für Mykobakterien
| | - D Hillemann
- Forschungszentrum Borstel, Leibniz-Zentrum für Medizin und Biowissenschaften, Nationales Referenzzentrum für Mykobakterien
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Braguglia CM, Coors A, Gallipoli A, Gianico A, Guillon E, Kunkel U, Mascolo G, Richter E, Ternes TA, Tomei MC, Mininni G. Erratum to: Quality assessment of digested sludges produced by advanced stabilization processes. Environ Sci Pollut Res Int 2015; 22:7236. [PMID: 25655750 DOI: 10.1007/s11356-015-4127-1] [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: 06/04/2023]
Affiliation(s)
- C M Braguglia
- Istituto di Ricerca sulle Acque-CNR, Area della Ricerca RM1, Monterotondo, Rome, Italy,
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Braguglia CM, Coors A, Gallipoli A, Gianico A, Guillon E, Kunkel U, Mascolo G, Richter E, Ternes TA, Tomei MC, Mininni G. Quality assessment of digested sludges produced by advanced stabilization processes. Environ Sci Pollut Res Int 2015; 22:7216-7235. [PMID: 24903249 DOI: 10.1007/s11356-014-3090-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 05/23/2014] [Indexed: 06/03/2023]
Abstract
The European Union (EU) Project Routes aimed to discover new routes in sludge stabilization treatments leading to high-quality digested sludge, suitable for land application. In order to investigate the impact of different enhanced sludge stabilization processes such as (a) thermophilic digestion integrated with thermal hydrolysis pretreatment (TT), (b) sonication before mesophilic/thermophilic digestion (UMT), and (c) sequential anaerobic/aerobic digestion (AA) on digested sludge quality, a broad class of conventional and emerging organic micropollutants as well as ecotoxicity was analyzed, extending the assessment beyond the parameters typically considered (i.e., stability index and heavy metals). The stability index was improved by adding aerobic posttreatment or by operating dual-stage process but not by pretreatment integration. Filterability was worsened by thermophilic digestion, either alone (TT) or coupled with mesophilic digestion (UMT). The concentrations of heavy metals, present in ranking order Zn > Cu > Pb > Cr ~ Ni > Cd > Hg, were always below the current legal requirements for use on land and were not removed during the processes. Removals of conventional and emerging organic pollutants were greatly enhanced by performing double-stage digestion (UMT and AA treatment) compared to a single-stage process as TT; the same trend was found as regards toxicity reduction. Overall, all the digested sludges exhibited toxicity to the soil bacterium Arthrobacter globiformis at concentrations about factor 100 higher than the usual application rate of sludge to soil in Europe. For earthworms, a safety margin of factor 30 was generally achieved for all the digested samples.
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Affiliation(s)
- C M Braguglia
- Istituto di Ricerca sulle Acque-CNR, Area della Ricerca RM1, Monterotondo, Rome, Italy,
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Gaubitz M, Schiffer T, Holm C, Richter E, Pisternick-Ruf W, Weiser T. Efficacy and safety of nicoboxil/nonivamide ointment for the treatment of acute pain in the low back - A randomized, controlled trial. Eur J Pain 2015; 20:263-73. [PMID: 25929250 PMCID: PMC5029595 DOI: 10.1002/ejp.719] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2015] [Indexed: 11/22/2022]
Abstract
Background Until now, nonivamide/nicoboxil ointment has not been tested in a randomized trial for the treatment of acute non‐specific low back pain. Methods This phase III randomized, double‐blind, active‐ and placebo‐controlled, multi‐centre trial investigated efficacy, safety and tolerability of topical nicoboxil 2.5%/nonivamide 0.4% for treatment of acute non‐specific low back pain [primary endpoint: pain intensity (PI) difference between pre‐dose baseline and 8 h after the first application]. Results Patients (n = 805), 18–74 years of age were treated for up to 4 days with nicoboxil 2.5%/nonivamide 0.4%, nicoboxil 2.5%, nonivamide 0.4% or placebo ointment. Pre‐dose baseline pain intensity (6.6 on a 0‐ to 10‐point numerical rating scale) was reduced by 1.049 points with placebo, by 1.428 points with nicoboxil, by 2.252 points with nonivamide and by 2.410 points with nicoboxil/nonivamide after 8 h (p < 0.0001 for nicoboxil/nonivamide vs. placebo, nicoboxil; p = 0.4171 for nicoboxil/nonivamide vs. nonivamide). At the end of treatment, the combination provided more pronounced PI reduction (3.540 points) compared with nicoboxil (2.371, p < 0.0001), nonivamide (3.074, p = 0.0259) and placebo (1.884, p < 0.0001). Low back mobility scores on Day 1 were better for the combination compared with all other treatments (p < 0.044); on Day 2–4, scores were better than for placebo and nicoboxil (p < 0.003). Patients assessed efficacy of the combination as greater than of the comparators (p ≤ 0.0129). All treatments were tolerated well. No treatment‐related serious adverse events were reported. Conclusion Nicoboxil/nonivamide ointment is an effective, well‐tolerated medication for the treatment of acute non‐specific low back pain.
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Affiliation(s)
- M Gaubitz
- Interdisciplinary Diagnostics and Therapy in the Academy for Manual Medicine, University Münster, Germany
| | - T Schiffer
- Outpatient Clinic for Sports Traumatology and Public Health Consultation, German Sport University Cologne, Germany
| | - C Holm
- Boehringer Ingelheim RCV GmbH & Co KG, Vienna, Austria
| | - E Richter
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
| | | | - T Weiser
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
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19
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Joeres R, Richter E. Viral hepatitis. Curr Probl Dermatol 2015; 24:57-66. [PMID: 8743254 DOI: 10.1159/000424884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- R Joeres
- St.-Josefs-Hospital, Troisdorf, Deutschland
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Affiliation(s)
- E. A. Scharberg
- Institute for Transfusion Medicine and Immunohematology; Red Cross Blood Service of Baden-Wuerttemberg-Hessen; Baden-Baden Germany
| | - E. Richter
- Institute for Transfusion Medicine and Immunohematology; Red Cross Blood Service of Baden-Wuerttemberg-Hessen; Baden-Baden Germany
| | - P. Bugert
- Institute for Transfusion Medicine and Immunology; Medical Faculty Mannheim; Heidelberg University; Red Cross Blood Service of Baden-Wuerttemberg-Hessen; Mannheim Germany
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de Mey C, Patel J, Lakha D, Richter E, Koelsch S. Efficacy and Safety of an Oral Ambroxol Spray in the Treatment of Acute Uncomplicated Sore Throat. Drug Res (Stuttg) 2015; 65:658-67. [DOI: 10.1055/s-0035-1547229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. de Mey
- ACPS – Applied Clinical Pharmacology Services, Mainz-Kastel, Germany
| | - J. Patel
- Boehringer Ingelheim (Pty) Ltd, Randburg, South Africa
| | - D. Lakha
- 1644 Starling Street, Lenasia South, Johannesburg, South Africa
| | - E. Richter
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - S. Koelsch
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
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22
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Hammer P, Richter E, Rüsch-Gerdes S, Walte HGC, Matzen S, Kiesner C. Inactivation of Mycobacterium bovis ssp. caprae in high-temperature, short-term pasteurized pilot-plant milk. J Dairy Sci 2015; 98:1634-9. [DOI: 10.3168/jds.2014-8939] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/25/2014] [Indexed: 11/19/2022]
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Egenlauf B, Schuhmann M, Giese T, Junghanss T, Kapaun A, Tintelnot K, de Hoog S, Greil J, Richter E, Vehresschild M, Heußel CP, Herth FJF, Kreuter M. Disseminierte Mykose mit Arthrocladium Species gefährdet Patientin mit GATA-2 Defekt. Pneumologie 2015. [DOI: 10.1055/s-0035-1544842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Napiórkowska A, Rüsch-Gerdes S, Hillemann D, Richter E, Augustynowicz-Kopeć E. Characterisation of pyrazinamide-resistant Mycobacterium tuberculosis strains isolated in Poland and Germany. Int J Tuberc Lung Dis 2014; 18:454-60. [PMID: 24670702 DOI: 10.5588/ijtld.13.0457] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pyrazinamide (PZA) is an important first-line anti-tuberculosis drug that is generally administered with isoniazid, rifampicin, ethambutol and streptomycin. OBJECTIVE To analyse the correlation between phenotypic resistance to PZA and genotype to find out whether the great diversity in pncA mutations is epidemiologically useful in tracing the transmission of PZA-resistant Mycobacterium tuberculosis strains among patients. MATERIALS AND METHODS The study included 71 PZA-resistant M. tuberculosis strains isolated from 62 Polish and 9 German patients. All strains were analysed using minimal inhibitory concentration value determination, pncA mutation analysis, spoligotyping, 24-loci mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) and insertion sequence (IS) 6110 restriction fragment length polymorphism (RFLP) fingerprinting. RESULTS In 63 isolates, 37 (88.7%) different mutations in the pncA gene were observed, 13 of which had not been previously reported; 11 molecular families with the same MIRU-VNTR and IS6110-RFLP pattern were found. The same mutation was identified in three families, while different ones were identified in the remaining families. CONCLUSION Mutations in the pncA gene are a major cause of PZA resistance in M. tuberculosis. pncA mutation analysis can be used to obtain valuable additional information, but should be applied with caution for epidemiological analysis.
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Affiliation(s)
- A Napiórkowska
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - S Rüsch-Gerdes
- The National Reference Centre for Mycobacteria, Forschungszentrim Borstel, Germany
| | - D Hillemann
- The National Reference Centre for Mycobacteria, Forschungszentrim Borstel, Germany
| | - E Richter
- The National Reference Centre for Mycobacteria, Forschungszentrim Borstel, Germany
| | - E Augustynowicz-Kopeć
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
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25
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Cambau E, Viveiros M, Machado D, Raskine L, Ritter C, Tortoli E, Matthys V, Hoffner S, Richter E, Perez Del Molino ML, Cirillo DM, van Soolingen D, Böttger EC. Revisiting susceptibility testing in MDR-TB by a standardized quantitative phenotypic assessment in a European multicentre study. J Antimicrob Chemother 2014; 70:686-96. [PMID: 25587993 DOI: 10.1093/jac/dku438] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [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: 11/13/2022] Open
Abstract
OBJECTIVES Treatment outcome of MDR-TB is critically dependent on the proper use of second-line drugs as per the result of in vitro drug susceptibility testing (DST). We aimed to establish a standardized DST procedure based on quantitative determination of drug resistance and compared the results with those of genotypes associated with drug resistance. METHODS The protocol, based on MGIT 960 and the TB eXiST software, was evaluated in nine European reference laboratories. Resistance detection at a screening drug concentration was followed by determination of resistance levels and estimation of the resistance proportion. Mutations in 14 gene regions were investigated using established techniques. RESULTS A total of 139 Mycobacterium tuberculosis isolates from patients with MDR-TB and resistance beyond MDR-TB were tested for 13 antituberculous drugs: isoniazid, rifampicin, rifabutin, ethambutol, pyrazinamide, streptomycin, para-aminosalicylic acid, ethionamide, amikacin, capreomycin, ofloxacin, moxifloxacin and linezolid. Concordance between phenotypic and genotypic resistance was >80%, except for ethambutol. Time to results was short (median 10 days). High-level resistance, which precludes the therapeutic use of an antituberculous drug, was observed in 49% of the isolates. The finding of a low or intermediate resistance level in 16% and 35% of the isolates, respectively, may help in designing an efficient personalized regimen for the treatment of MDR-TB patients. CONCLUSIONS The automated DST procedure permits accurate and rapid quantitative resistance profiling of first- and second-line antituberculous drugs. Prospective validation is warranted to determine the impact on patient care.
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Affiliation(s)
- E Cambau
- AP-HP, Hôpital Lariboisière, Service de Bactériologie, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux; IAME UMR1137, INSERM, Université Paris Diderot, 75010 Paris, France
| | - M Viveiros
- Grupo de Micobactérias, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa (IHMT/UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal
| | - D Machado
- Grupo de Micobactérias, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa (IHMT/UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal
| | - L Raskine
- AP-HP, Hôpital Lariboisière, Service de Bactériologie, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux; IAME UMR1137, INSERM, Université Paris Diderot, 75010 Paris, France
| | - C Ritter
- Institut für Medizinische Mikrobiologie, Nationales Zentrum für Mykobakterien, Universität Zürich, Zürich, Switzerland
| | - E Tortoli
- IRCCS San Raffaele Scientific Institute, Emerging Bacterial Pathogens Unit Supranational Reference Laboratory, via Olgettina 60, 20132 Milan, Italy
| | - V Matthys
- National Reference Centre of Tuberculosis and Mycobacteria, Communicable and Infectious Diseases, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - S Hoffner
- Department of Microbiology, Public Health Agency of Sweden and Department of Microbiology, Cell and Tumor Biology, Karolinska Institute, Stockholm, Sweden
| | - E Richter
- National Reference Center for Mycobacteria, Forschungszentrum Borstel, Borstel, Germany
| | - M L Perez Del Molino
- Servicio de Microbiología, CH Universitario de Santiago, Centro de Referencia de Micobacterias de Galicia, Choupana S/N, 15705 Santiago de Compostela, Spain
| | - D M Cirillo
- IRCCS San Raffaele Scientific Institute, Emerging Bacterial Pathogens Unit Supranational Reference Laboratory, via Olgettina 60, 20132 Milan, Italy
| | - D van Soolingen
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands Department of Pulmonary Diseases/Department of Clinical Microbiology, Radboud University Medical Centre, PO Box 9101, Nijmegen, The Netherlands
| | - E C Böttger
- Institut für Medizinische Mikrobiologie, Nationales Zentrum für Mykobakterien, Universität Zürich, Zürich, Switzerland
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Diel R, Nienhaus A, Lampenius N, Rüsch-Gerdes S, Richter E. Cost of multi drug resistance tuberculosis in Germany. Respir Med 2014; 108:1677-87. [PMID: 25443398 DOI: 10.1016/j.rmed.2014.09.021] [Citation(s) in RCA: 20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 09/25/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES 4220 new cases of tuberculosis (TB) were reported in Germany in 2012; of those, 65 cases were multidrug-resistant TB (MDR-TB) or extensively multidrug-resistant TB (XDR-TB) cases. However, there is only limited information on the economic consequences of drug resistance patterns on the treatment costs of MDR-and XDR-TB patients. METHODS On the basis of drug susceptibility of the single MDR-TB/XDR-TB strains the direct medical costs of suitable therapies were calculated according to the current guidelines of the World Health Organization (WHO) and those of the German Central Committee against Tuberculosis. These costs were combined with hospital and outpatients monitoring costs and followed the most recent German invoicing system and health statistics. Total drug and monitoring costs and were determined by Monte-Carlo simulation comprising all different options. RESULTS According to this, the mean drug costs were €51,113.22 (range €19,586.14 to €94,767.90). The weighted costs for hospitalization were €26,000.76 per patient compared to only €2,192.13 for primary outpatients; the total treatment costs of MDR-TB amounted to €64,429.23. These are joined by the costs due to loss of productivity, varying between €17,721.60 and €44,304. From a societal perspective, the total cost per MDR-TB/XDR-TB case reach an amount between €82,150 and €108,733 per case, respectively. CONCLUSION Cost analyses based on strain resistance patterns allow more reliable estimates of the real costs of treating MDR-TB/XDR-TB than do methods that ignore this factor. Advantageously, they demonstrate the economic impact of drug-resistant TB in low-incidence countries. Costs of productivity loss is of new importance because of the length of MDR-XDR therapy, but its true share of total costs has still to be determined.
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Affiliation(s)
- R Diel
- Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, Kiel, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Germany.
| | - A Nienhaus
- Institute for Health Service Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Lampenius
- Department of Accounting and Finance, University of Hohenheim, Stuttgart, Germany
| | - S Rüsch-Gerdes
- National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - E Richter
- National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
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Farkas MK, Mak E, Richter E, Farkas V. EHMTI-0336. Metabolic diet therapy in the prophylactic treatment of migraine headache in adolescents by using ketogenic diet. J Headache Pain 2014. [PMCID: PMC4182204 DOI: 10.1186/1129-2377-15-s1-g9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Für einen elektronischen Digitalrechner wird ein Rechenverfahren beschrieben, das es gestattet, für homogene und feldfreie, aber sonst beliebige Halbleiter aus der Neutralitätsgleichung die Lage des FERMi-Niveaus für einen beliebig weiten Temperaturbereich (auch unter 1°K) mit großer Genauigkeit zu berechnen. Dabei wird die Temperaturabhängigkeit des Bandabstandes und der Störstellenniveaus berücksichtigt. Als Beispiel wird der Verlauf des FERMi-Niveaus für Silicium verschiedener Dotierung und für Wismut-Tellurid in einigen speziellen Fällen angegeben.
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Affiliation(s)
- E. Richter
- Aus dem AEG-Forschungsinstitut, Frankfurt/Main
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Böttger O, Richter E. Über Versetzungsdichte und Lebensdauer zonengezogener Silicium-Einkristalle in Abhängigkeit von Ziehgeschwindigkeit und Temperbehandlungen. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/zna-1962-0612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Der Zusammenhang zwischen Ziehgeschwindigkeit, Krümmung der Wachstumsfront, Versetzungsdichte und Lebensdauer der Minoritätsträger an zonengezogenen Silicium-Einkristallen wurde untersucht. Der Einfluß einer Temperung auf die Volumenlebensdauer nach vorangegangenen verschiedenen Oberflächenbehandlungen des Kristalles konnte als Eindiffusion von Rekombinationszentren bildenden Verunreinigungen bzw. als Erhöhung der Versetzungsdichte nachgewiesen werden.
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Affiliation(s)
- O. Böttger
- Aus dem AEG-Forschungsinstitut, Frankfurt/Main
| | - E. Richter
- Aus dem AEG-Forschungsinstitut, Frankfurt/Main
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Sanchini A, Fiebig L, Drobniewski F, Haas W, Richter E, Katalinic-Jankovic V, Pimkina E, Skenders G, Cirillo DM, Balabanova Y. Laboratory diagnosis of paediatric tuberculosis in the European Union/European Economic Area: analysis of routine laboratory data, 2007 to 2011. ACTA ACUST UNITED AC 2014; 19. [PMID: 24679723 DOI: 10.2807/1560-7917.es2014.19.11.20744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Laboratory confirmation of paediatric tuberculosis (TB) is frequently lacking. We reviewed the range of routine laboratory tests and their performance in different biological samples used to diagnose active TB in children. A questionnaire-based survey was conducted among the European Reference Laboratory Network for TB followed by collection of routine laboratory data on 10,549 paediatric samples tested in 2007 to 2011 at six reference laboratories (in Croatia, Germany, Italy, Latvia, Lithuania and the United Kingdom (UK)). The questionnaire showed that all laboratories used rapid assays. Non-respiratory samples were collected more often in Germany (135/275, 49.1%) and the UK (490/2,140, 22.9%) compared with Croatia (138/2,792, 4.9%), Latvia (222/2,401, 9.2%) and Lithuania (76/1,549, 4.9%). Overall laboratory positivity rates (isolation of Mycobacterium tuberculosis complex and/or identification of its nucleic acids in a sample) were higher in lymph node and gastric aspirate samples (14/203 (6.9%) and 43/1,231 (3.5%)) than in sputum samples (89/4,684 (1.9%)). Pooled sensitivity, specificity, positive and negative predictive values and accuracy of molecular assays assessed against solid or liquid culture were 79.2%, 93.6%, 67.1%, 96.5% and 91.6%, respectively. A more intensive approach in obtaining gastric aspirate and non-respiratory samples may increase laboratory confirmation of paediatric TB. Major effort is needed in optimisation and validation of molecular tests in these samples.
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Affiliation(s)
- A Sanchini
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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Schönfeld N, Haas W, Richter E, Bauer T, Bös L, Castell S, Hauer B, Magdorf K, Matthiessen W, Mauch H, Reuß A, Rüsch-Gerdes S, Zabel P, Dalhoff K, Schaberg T, Loddenkemper R. Empfehlungen zur Diagnostik und Therapie nichttuberkulöser Mykobakteriosen des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose (DZK) und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP). Pneumologie 2013; 67:605-33. [DOI: 10.1055/s-0033-1344790] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- N. Schönfeld
- Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin
| | - W. Haas
- Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut, Berlin
| | - E. Richter
- Forschungszentrum Borstel, Nationales Referenzzentrum für Mykobakterien
| | - T. Bauer
- Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin
| | - L. Bös
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
| | - S. Castell
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
| | - B. Hauer
- Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut, Berlin
| | - K. Magdorf
- Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Charité Universitätsmedizin Berlin
| | - W. Matthiessen
- Fachkrankenhaus Coswig, Zentrum für Pneumologie und Thoraxchirurgie
| | - H. Mauch
- Institut für Mikrobiologie, Immunologie und Laboratoriumsmedizin, HELIOS Klinikum Emil von Behring, Berlin
| | - A. Reuß
- Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut, Berlin
| | - S. Rüsch-Gerdes
- Forschungszentrum Borstel, Nationales Referenzzentrum für Mykobakterien
| | - P. Zabel
- Forschungszentrum Borstel, Medizinische Klinik
| | - K. Dalhoff
- Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - T. Schaberg
- Zentrum für Pneumologie, Agaplesion Diakonieklinikum Rotenburg
| | - R. Loddenkemper
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
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Krüger O, Kalbe U, Richter E, Egeler P, Römbke J, Berger W. New approach to the ecotoxicological risk assessment of artificial outdoor sporting grounds. Environ Pollut 2013; 175:69-74. [PMID: 23337354 DOI: 10.1016/j.envpol.2012.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/11/2012] [Accepted: 12/20/2012] [Indexed: 05/21/2023]
Abstract
Artificial surfaces for outdoor sporting grounds may pose environmental and health hazards that are difficult to assess due to their complex chemical composition. Ecotoxicity tests can indicate general hazardous impacts. We conducted growth inhibition (Pseudokirchneriella subcapitata) and acute toxicity tests (Daphnia magna) with leachates obtained from batch tests of granular infill material and column tests of complete sporting ground assemblies. Ethylene propylene diene monomer rubber (EPDM) leachate showed the highest effect on Daphnia magna (EC(50) < 0.4% leachate) and the leachate of scrap tires made of styrene butadiene rubber (SBR) had the highest effect on P. subcapitata (EC(10) = 4.2% leachate; EC(50) = 15.6% leachate). We found no correlations between ecotoxicity potential of leachates and zinc and PAH concentrations. Leachates obtained from column tests revealed lower ecotoxicological potential. Leachates of column tests of complete assemblies may be used for a reliable risk assessment of artificial sporting grounds.
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Affiliation(s)
- O Krüger
- BAM Federal Institute for Materials Research and Testing, Division 4.4 Thermochemical Residues Treatment and Resource Recovery, Unter den Eichen 87, 12205 Berlin, Germany.
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Feyerabend T, Steeves R, Jager B, Wiedemann G, Sommer K, Richter E, Katschinski D, Robins H. Local hyperthermia, hyperfractionated radiation, and cisplatin in preirradiated recurrent lymph node metastases of recurrent head and neck cancer. Int J Oncol 2012; 10:591-5. [PMID: 21533418 DOI: 10.3892/ijo.10.3.591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Large tumor size is a negative prognostic variable for attaining complete regression (CR) with local hyperthermia (HT) and radiotherapy (RT). Such poor prognosis lesions (i.e., >7 cm(2) or >14 cm(3)) have an expected CR rate of similar to 30+/-8%. To improve on this result we added cisplatin to HT and RT with standard fractionation (std Fx) in an earlier study, and observed a 19% CR rate in head and neck (H&N) patients. We now report the results of a second generation trial combining HT, cisplatin (40 mg/m(2)) and hyperfractionated RT in a series of 13 pretreated poor prognosis H&N patients. Therapy encompassed 44 triple modality sessions and was well tolerated: toxicity included one episode of grade-3 skin reaction and one grade 1 leukopenia. Although the overall remission rate was 92%, the CR rate was only 8%; this resulted in early closure of this trial concluding that hyperfractionated RT had no (over std Fx RT) benefit in this combined modality approach.
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Affiliation(s)
- T Feyerabend
- UNIV WISCONSIN,CTR COMPREHENS CANC,MADISON,WI 53792. UNIV LUBECK,D-23538 LUBECK,GERMANY
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Kurbatova EV, Cavanaugh JS, Shah NS, Wright A, Kim H, Metchock B, Van Deun A, Barrera L, Boulahbal F, Richter E, Martín-Casabona N, Arias F, Zemanova I, Drobniewski F, Santos Silva A, Coulter C, Lumb R, Cegielski JP. Rifampicin-resistant Mycobacterium tuberculosis: susceptibility to isoniazid and other anti-tuberculosis drugs. Int J Tuberc Lung Dis 2012; 16:355-7. [PMID: 22640449 DOI: 10.5588/ijtld.11.0542] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Based on data from 14 Supranational Tuberculosis (TB) Reference Laboratories worldwide, the proportion of rifampicin (RMP) resistant isolates that were isoniazid (INH) susceptible by phenotypic drug susceptibility testing varied widely (0.5-11.6%). RMP-resistant isolates that were INH-susceptible had significantly lower rates of resistance to other first- and second-line anti-tuberculosis drugs (except rifabutin) compared to multidrug-resistant isolates. RMP resistance is not always a good proxy for a presumptive diagnosis of multidrug-resistant TB, which has implications for use of molecular assays that identify only RMP resistance-associated DNA mutations.
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Affiliation(s)
- E V Kurbatova
- Kurbatova, International Research and Programs Branch, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Ziegler R, Just HM, Castell S, Diel R, Gastmeier P, Haas W, Hauer B, Loytved G, Mielke M, Moser I, Nienhaus A, Richter E, Rüden H, Rüsch-Gerdes S, Schaberg T, Wischnewski N, Loddenkemper R. [Tuberculosis infection control - recommendations of the DZK]. Gesundheitswesen 2012; 74:337-50. [PMID: 22723258 DOI: 10.1055/s-0032-1306680] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.
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Affiliation(s)
- R Ziegler
- Institut für Klinikhygiene, Med. Mikrobiologie u. Klin. Infektiologie, Klinikum Nürnberg
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36
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Klapdor S, Richter E, Klapdor R. Vitamin D status and per-oral vitamin D supplementation in patients suffering from chronic pancreatitis and pancreatic cancer disease. Anticancer Res 2012; 32:1991-1998. [PMID: 22593477] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Exocrine pancreatic insufficiency due to chronic pancreatitis may result--depending on the degree of insufficiency--, in a decrease in serum 25-hydroxyvitamin D (25(OH)D) level. However, the data in the literature concerning the rate and extent of vitamin D deficiency in pancreatic cancer with or without previous pancreas resection, are very rare, in particular regarding the question how to supplement these patients with vitamin D. In recent years, vitamin D is increasingly being discussed as one factor involved not only in musculo-skeletal diseases but also in cardiovascular and autoimmune diseases, cancer development, diabetes mellitus and overall mortality. PATIENTS AND METHODS In all, 248 ambulatory patients (n=140 patients suffering from exocrine pancreatic insufficiency due to chronic pancreatitis, pancreatic cancer with/without previous resections of the pancreas n=108 patients without pancreatic disease), we measured the serum 25(OH)D concentrations by the chemoluminescence method. In addition, in 91 of these patients (n=65 pancreatic patients, n=26 controls), we started supplementation with oral vitamin D in combination with dietary advice and adequate substitution with pancreatic enzyme preparations, followed by subsequent serum 25(OH)D determinations. The oral vitamin D doses varied from 1000 IU per day over 1× 20,000 IU per week, or 2-3 times 20,000 IU per week up to 20,000 IU per day in single patients, depending on the underlying disease and the estimated degree of maldigestion/malassimilation. In addition, in a pilot trial vitamins A and E were measured in the serum from 121 and 105 of these patients respectively (resp.) (HPLC method). RESULTS Serum 25(OH)D concentrations were <30 ng/ml in 93% of the patients with pancreatic diseases,<20 ng/ml in 77.9%, <10 ng/ml in 32.1% and <4 ng/ml in 9.3%. The results were comparable to those in patients suffering from chronic pancreatitis and those with pancreatic tumor disease, with or without a previous tumor resection (n=51 Whipple procedure, n=11 left resection, n=9 total duodeno-pancreatectomy). Similar data were also found in the controls, only slightly higher. In contrast to the vitamin D data, however, determination of vitamins A and E in the serum resulted in values within the normal range for the majority of the patients of both groups, suggesting a diminished vitamin D uptake as being at least one reason to explain the low serum vitamin D concentrations in the patients with pancreatic diseases. Individual supplementation with oral vitamin D in all patients studied (n=91) resulted in an increase of the serum 25(OH)D concentrations into the normal range (14.2±5.8 up to 42.3±12 in controls, 11.9±7.4 up to 46.6±15.7 in patients with pancreatic diseases). The data of a subgroup of patients with continuous long-term supplementation, however, suggest that some patients with pancreatic diseases may need a significantly higher vitamin D supplementation, up to 20000 IU per day in single patients, compared to the controls. CONCLUSION The results demonstrate that vitamin D deficiency is a common problem in patients suffering from exocrine pancreatic insufficiency from various reasons as well as in our controls. Apart from insufficient sun exposure, exocrine pancreatic insufficiency, as well as a too low vitamin D uptake with food seem to represent the main causes of low serum 25(OH)D. In nearly all patients, the serum 25(OH)D concentrations could be normalized by oral supplementation of vitamin D in the case of individual therapy based on routine serum controls.
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Affiliation(s)
- S Klapdor
- Internal Medicine, ZeTDT GmbH, Hamburg, Germany.
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Ziegler R, Just HM, Castell S, Diel R, Gastmeier P, Haas W, Hauer B, Loytved G, Mielke M, Moser I, Nienhaus A, Richter E, Rüden H, Rüsch-Gerdes S, Schaberg T, Wischnewski N, Loddenkemper R. [Tuberculosis infection control--recommendations of the DZK]. Pneumologie 2012; 66:269-82. [PMID: 22294284 DOI: 10.1055/s-0031-1291582] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.
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Affiliation(s)
- R Ziegler
- Institut für Klinikhygiene, Med. Mikrobiologie u. Klin. Infektiologie, Klinikum Nürnberg, Germany
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Kaynak S, Bauer C, Richter V, Richter E, Niemann S. [Tuberculosis outbreak in 13 people in Saxony-Anhalt: indications of an infection chain by spoligotyping]. Gesundheitswesen 2011; 74:351-7. [PMID: 21866495 DOI: 10.1055/s-0031-1285862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In Germany the number of new tuberculosis incidents continues to decline slightly. Cases of illnesses are often diagnosed late, due to the uncharacteristic course of tuberculosis. The success in environment investigations by health authorities in finding incidents within one infection chain depends on the compliance of patients among other factors. Tuberculosis occurs especially in groups with social disadvantages. In this population segment the identification of contact persons of a patient with infectious tuberculosis presents difficulties. Moreover, identifying the source of infection is frequently not successful. For these reasons, additional infections and sicknesses are caused. The cultural pathogen proof, including type differentiation and resistance testing, continues to be the "gold standard" in tuberculosis diagnostics and is required for the examination of outbreaks. Molecular methods for fine typification of isolated bacterial strains and their subsequent comparison constitute an important tool in the infection epidemiology investigation of incident clustering. OBJECTIVE AND METHOD The objective of this work is the description of a tuberculosis infection chain in Saxony-Anhalt, which was discovered by means of a molecular biological method. The conservative method represents the environment investigations for the expedient selection of contact persons. The investigations always take 2 directions in the process. On the one hand, it is searched for the still unknown source of infection. On the other hand, persons are to be identified, who have been infected before the diagnosis became known. The diagnostics for contact persons includes besides the lung X-ray checkup exam, the Mendel Mantoux tuberculin skin test (THT), sputum tests and the Interferon Gamma (INF-γ) tests (IGRA). In described case, the molecular biological method of spoliogotyping was employed as additional instrument. Therein, fingerprint maps of the patients' tuberculosis strings were created and compared. Infection chains resulting from the environment investigations were thereby secured. RESULTS We report on a tuberculosis outbreak in a district of the state of Saxony-Anhalt, which occurred in the time from June 2007 to May 2010. As result of the environment investigations, an infection chain of 13 ill patients (77% ♂, 23% ♀) was identified. In 11 cases the correlation of the infection chain was proven by spoligotyping (9 ♂, 2 ♀). 2 cases (1 ♂, 1 ♀) without verification of the pathogen cannot be attributed on basis of the epidemiological correlations.
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Affiliation(s)
- S Kaynak
- Kreisverwaltung Wittenberg, Fachdienst Gesundheit.
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Hepple P, Novoa-Cain J, Cheruiyot C, Richter E, Ritmeijer K. Implementation of liquid culture for tuberculosis diagnosis in a remote setting: lessons learned. Int J Tuberc Lung Dis 2011; 15:405-407. [PMID: 21333111] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Although sputum smear microscopy is the primary method for tuberculosis (TB) diagnosis in low-resource settings, it has low sensitivity. The World Health Organization recommends the use of liquid culture techniques for TB diagnosis and drug susceptibility testing in low- and middle-income countries. An evaluation of samples from southern Sudan found that culture was able to detect cases of active pulmonary TB and extra-pulmonary TB missed by conventional smear microscopy. However, the long delays involved in obtaining culture results meant that they were usually not clinically useful, and high rates of non-tuberculous mycobacteria isolation made interpretation of results difficult. Improvements in diagnostic capacity and rapid speciation facilities, either on-site or through a local reference laboratory, are crucial.
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Affiliation(s)
- P Hepple
- Médecins Sans Frontières, Manson Unit, London, UK.
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Raval JS, Waters JH, Seltsam A, Scharberg EA, Richter E, Kameneva MV, Yazer MH. Menopausal status affects the susceptibility of stored RBCs to mechanical stress. Vox Sang 2010; 100:418-21. [PMID: 21488881 DOI: 10.1111/j.1423-0410.2010.01439.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The mechanical fragility index (MFI) is an in vitro measure of sublethal injury to RBCs. In our previous experiments, we demonstrated that an increase in sublethal injury (increasing MFI) was a component of the RBC storage lesion, and that the MFI was significantly higher amongst the RBC units from male donors compared to pre-menopausal female donors during storage. It was hypothesized that hormonal or menstrual factors contributed to this difference. In this study, we found that RBC units donated by post-menopausal women demonstrated an MFI that was significantly higher than those donated by pre-menopausal women throughout storage.
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Affiliation(s)
- J S Raval
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Theuß T, Aupperle H, Eulenberger K, Schoon HA, Richter E. Disseminated Infection with Mycobacterium genavense in a Grizzled Giant Squirrel (Ratufa macroura) Associated with the Isolation of an Unknown Mycobacterium. J Comp Pathol 2010; 143:195-8. [DOI: 10.1016/j.jcpa.2010.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 12/08/2009] [Accepted: 01/05/2010] [Indexed: 11/26/2022]
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Raval JS, Waters JH, Seltsam A, Scharberg EA, Richter E, Daly AR, Kameneva MV, Yazer MH. The use of the mechanical fragility test in evaluating sublethal RBC injury during storage. Vox Sang 2010; 99:325-31. [DOI: 10.1111/j.1423-0410.2010.01365.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
The microstructure of nonpolar m-plane (1100) oriented GaN layers deposited on (100)gamma-LiAlO(2) was analysed by transmission electron microscopy. This study shows that the films contain a large number of defects. The most dominant defects in the m-plane GaN are intrinsic I(1) basal plane stacking faults (approximately 10(4) cm(-1)), threading dislocations (approximately 10(9) cm(-2)) as well as a complex defect network consisting of planar defects located on prismatic {1010} GaN and differently inclined pyramidal planes. A large number of the stacking faults nucleate at the GaN/LiAlO(2) interface. Furthermore, the inclined planar defects act as additional nucleation sites for the basal plane stacking faults. A decreasing crystal quality with an increasing layer thickness can be explained by this defect formation mechanism.
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Affiliation(s)
- W Neumann
- Institut für Physik, Humboldt Universität zu Berlin, Berlin, Germany.
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Wald A, Mueller-Lissner S, Kamm MA, Hinkel U, Richter E, Schuijt C, Mandel KG. Survey of laxative use by adults with self-defined constipation in South America and Asia: a comparison of six countries. Aliment Pharmacol Ther 2010; 31:274-84. [PMID: 19832728 DOI: 10.1111/j.1365-2036.2009.04169.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND In contrast to the US and Europe, prevalence and laxative use for self-defined constipation among adults was previously reported to be unassociated with age among adults in South Korea and Brazil. AIM To determine whether observations in South Korea and Brazil are reflective of other Asian and South American countries. METHODS A total of 8100 adults from Argentina, Colombia, Indonesia and China completed a questionnaire identical to that previously used in South Korea and Brazil. RESULTS Prevalence of constipation was similar to that reported for Brazil and South Korea and was 2.17-fold (95% CI: 1.71-2.64) higher amongst women than amongst men. Prevalence increased with age amongst all adults in Argentina and China and only among men in Colombia and Brazil. With the exception of Indonesia, the majority of those with constipation had symptoms at least once weekly, and for < or =3 years. Less than one-third of adults reported using laxatives to treat constipation. Laxative use was not associated with gender and increased with age in Argentina and Colombia. CONCLUSIONS No clear geographical or cultural tendencies were observed in the prevalence of constipation and laxative use among the South American and Asian countries studied in this survey.
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Affiliation(s)
- A Wald
- University of Wisconsin School of Medicine and Public Health, Madison, 53792, USA.
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Richter E. Zum Kontraluesin: Erwiderung auf die Kehrmannsche Arbeit. Dermatology 2009. [DOI: 10.1159/000245837] [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: 11/19/2022] Open
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Hüttner J, Dallüge KH, Eichhorn HJ, Jacob R, Kriedemann E, Lessel A, Mateev B, Richter E, Rotte KH, Schröder H. Untersuchung zur Treffsicherheit der Mammographie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1229855] [Citation(s) in RCA: 2] [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: 10/20/2022]
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Ozkucur N, Richter E, Wetzel C, Funk RHW, Monsees TK. Biological relevance of ion energy in performance of human endothelial cells on ion-implanted flexible polyurethane surfaces. J Biomed Mater Res A 2009; 93:258-68. [PMID: 19557788 DOI: 10.1002/jbm.a.32541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To improve the biocompatibility of polyurethane (PUR), we modified the surface by irradiation with different ions (Carbon; C, Oxygen; O, Nitrogen; N, or Argon; Ar) at 0.3-50 keV energy and doses of 1,00E+13 - 1,00E+15 ions/cm(2). The effects of ion implantation using different ion energies and densities were observed on adhesion, proliferation, and viability of human umbilical vein endothelial cells (HUVECs). The long-term in vitro stability of ion-implanted PUR was also investigated. Ion irradiation moderately affected the surface roughness (R(a)), but strongly enhanced the work of adhesion (W(a)). Cell adhesion was markedly improved on O-, N-, and Ar-, but not on C-implanted PUR surfaces. Medium ion energies and lower ion doses produced the best HUVEC attachment and proliferation, indicating the importance of choosing the proper range of energy applied during ion irradiation. In addition, apoptosis rates were significantly reduced when compared with unmodified PUR (uPUR). N implantation significantly protected the surface, although C implantation led to stronger surface erosions than on uPUR. In total, ion implantation on flexible PUR surfaces strongly improved the material surface characteristics and biocompatibility. Electron beam ion implantation within an appropriate energy window is thus a key to improving flexible PUR surfaces for clinical use to support endothelial cell performance. Thus, it can contribute to designing small-diameter grafts, which are in great demand, towards vascular tissue engineering applications.
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Affiliation(s)
- Nurdan Ozkucur
- Department of Anatomy, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.
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Hiltunen LH, Ojanperä T, Kortemaa H, Richter E, Lehtonen MJ, Valkonen JPT. Interactions and biocontrol of pathogenicStreptomycesstrains co-occurring in potato scab lesions. J Appl Microbiol 2009; 106:199-212. [PMID: 19054229 DOI: 10.1111/j.1365-2672.2008.03992.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L H Hiltunen
- Department of Applied Biology, University of Helsinki, Helsinki, Finland
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