1
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Abstract
Let
X
=
(
X
t
)
t
≥
0
X=(X_t)_{t\geq 0}
be a one-dimensional Lévy process such that each
X
t
X_t
has a
C
b
1
C^1_b
-density w. r. t. Lebesgue measure and certain polynomial or exponential moments. We characterize all polynomially bounded functions
f
:
R
→
R
f\colon \mathbb {R}\to \mathbb {R}
, and exponentially bounded functions
g
:
R
→
(
0
,
∞
)
g\colon \mathbb {R}\to (0,\infty )
, such that
f
(
X
t
)
−
E
f
(
X
t
)
f(X_t)-\mathbb {E} f(X_t)
, resp.
g
(
X
t
)
/
E
g
(
X
t
)
g(X_t)/\mathbb {E} g(X_t)
, are martingales.
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2
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Karsten MM, Kühn F, Blohmer JU, Rose M, Fischer F, Kowalski C, Breidenbach C, Grittner U, Schilling R, Ferencz J, Pauler L, Matthesius G, Seemann J, Lenz J, Straubing L, Du Bois M. PRO B - PROM bei Brusterkrankungen – neue Wege in der Versorgung bei metastasiertem Brustkrebs. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717856] [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: 10/23/2022] Open
Affiliation(s)
- MM Karsten
- Charité Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
| | - F Kühn
- Charité Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
| | - JU Blohmer
- Charité Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
| | - M Rose
- Charité – Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Psychosomatik
| | - F Fischer
- Charité – Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Psychosomatik
| | | | | | - U Grittner
- Charité – Universitätsmedizin Berlin, Institut für Biometrie und Klinische Epidemiologie
| | - R Schilling
- Charité – Universitätsmedizin Berlin, Institut für Biometrie und Klinische Epidemiologie
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3
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Pross T, Kühn F, Karsten M, Kendel F, Feufel M, Speiser D. Fortbildung von Kooperationspartnern zur Stärkung der transsektoralen Versorgung am Zentrum Berlin des Deutschen Konsortiums Familiärer Brust- und Eierstockkrebs. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718084] [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: 10/23/2022] Open
Affiliation(s)
- T. Pross
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
| | - F. Kühn
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
| | - M.M. Karsten
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
| | - F. Kendel
- Charité – Universitätsmedizin Berlin, Institut für Geschlechterforschung in der Medizin
| | - M.A. Feufel
- Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft
| | - D. Speiser
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Brustzentrum
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4
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Kühn F, Philipp M, Klar E, Witte M. [Treatment of a subsequently detected, iatrogenic colonic perforation via minimal-invasive rendezvous procedure]. Z Gastroenterol 2014; 52:818-20. [PMID: 25111722 DOI: 10.1055/s-0034-1366615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Laparoscopic surgery as primary therapeutical option for iatrogenic colonic perforation after colonoscopy can be complemented by intraoparative colonoscopy in order to detect and treat even difficult accessible lesions. Via the presented method minimal invasisve detection and therapy of perforation can be conducted safely and can lead to reduction of morbidity.
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5
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Timper K, Fenske W, Katan M, Kühn F, Arici B, Schütz P, Frech N, Rutishauser J, Kopp P, Stettler C, Müller B, Christ Crain M. Copeptin in the Diagnosis and Differential Diagnosis of Diabetes Insipidus – The ‘CoSIP-Study’. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372046] [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: 10/25/2022]
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6
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Kühn F, Rau BM, Klar E, Schiffmann L. [Endoscopic vacuum therapy after iatrogenic oesophageal perforation--a case report]. Zentralbl Chir 2013; 139:98-100. [PMID: 23619772 DOI: 10.1055/s-0032-1328100] [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: 10/26/2022]
Affiliation(s)
- F Kühn
- Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Rostock, Deutschland
| | - B M Rau
- Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Rostock, Deutschland
| | - E Klar
- Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Rostock, Deutschland
| | - L Schiffmann
- Abteilung für Allgemeine, Thorax-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Rostock, Deutschland
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7
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Kühn F, Dieterich M, Klar E, Gerber B, Prinz C. Primary Malignant Vaginal Melanoma - Case Report and Review of the Literature. Geburtshilfe Frauenheilkd 2012; 72:740-743. [PMID: 25258467 DOI: 10.1055/s-0032-1315006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 04/02/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022] Open
Abstract
With fewer than 250 cases published worldwide, primary vaginal melanoma is an extremely rare malignant entity which is mostly diagnosed in advanced stages. The estimated incidence of vaginal melanoma is 0.026/100 000 women per year. The poor prognosis for advanced tumour stages and different therapies used in very limited numbers of patients require precise preoperative staging and a planned interdisciplinary therapeutic approach.
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Affiliation(s)
- F Kühn
- Chirurgische Klinik und Poliklinik, Universität Rostock, Rostock, Germany
| | - M Dieterich
- Universitätsfrauenklinik und Poliklinik, Universität Rostock, Rostock, Germany
| | - E Klar
- Chirurgische Klinik und Poliklinik, Universität Rostock, Rostock, Germany
| | - B Gerber
- Universitätsfrauenklinik und Poliklinik, Universität Rostock, Rostock, Germany
| | - C Prinz
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, KMG Klinikum Güstrow, Güstrow, Germany
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8
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Dusemund F, Bucher B, Meyer S, Thomann R, Kühn F, Bassetti S, Sprenger M, Baechli E, Sigrist T, Schwietert M, Amin D, Hausfater P, Carre E, Schuetz P, Gaillat J, Regez K, Bossart R, Schild U, Müller B, Albrich WC. Influence of procalcitonin on decision to start antibiotic treatment in patients with a lower respiratory tract infection: insight from the observational multicentric ProREAL surveillance. Eur J Clin Microbiol Infect Dis 2012; 32:51-60. [PMID: 22886090 DOI: 10.1007/s10096-012-1713-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 07/23/2012] [Indexed: 01/27/2023]
Abstract
Procalcitonin (PCT)-guided antibiotic stewardship is a successful strategy to decrease antibiotic use. We assessed if clinical judgement affected compliance with a PCT-algorithm for antibiotic prescribing in a multicenter surveillance of patients with lower respiratory tract infections (LRTI). Initiation and duration of antibiotic therapy, adherence to a PCT algorithm and outcome were monitored in consecutive adults with LRTI who were enrolled in a prospective observational quality control. We correlated initial clinical judgment of the treating physician with algorithm compliance and assessed the influence of PCT on the final decision to initiate antibiotic therapy. PCT levels correlated with physicians' estimates of the likelihood of bacterial infection (p for trend <0.02). PCT influenced the post-test probability of antibiotic initiation with a greater effect in patients with non-pneumonia LRTI (e.g., for bronchitis: -23 % if PCT ≤ 0.25 μg/L and +31 % if PCT > 0.25 μg/L), in European centers (e.g., in France -22 % if PCT ≤ 0.25 μg/L and +13 % if PCT > 0.25 μg/L) and in centers, which had previous experience with the PCT-algorithm (-16 % if PCT ≤ 0.25 μg/L and +19 % if PCT > 0.25 μg/L). Algorithm non-compliance, i.e. antibiotic prescribing despite low PCT-levels, was independently predicted by the likelihood of a bacterial infection as judged by the treating physician. Compliance was significantly associated with identification of a bacterial etiology (p = 0.01). Compliance with PCT-guided antibiotic stewardship was affected by geographically and culturally-influenced subjective clinical judgment. Initiation of antibiotic therapy was altered by PCT levels. Differential compliance with antibiotic stewardship efforts contributes to geographical differences in antibiotic prescribing habits and potentially influences antibiotic resistance rates.
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Affiliation(s)
- F Dusemund
- Medical University Department, Kantonsspital Aarau, Tellstrasse, CH-5001 Aarau, Switzerland
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9
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Articus K, Baier M, Tracik F, Kühn F, Preuss UW, Kurz A. A 24-week, multicentre, open evaluation of the clinical effectiveness of the rivastigmine patch in patients with probable Alzheimer's disease. Int J Clin Pract 2011; 65:790-6. [PMID: 21645184 DOI: 10.1111/j.1742-1241.2011.02713.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [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: 11/29/2022] Open
Abstract
BACKGROUND Cholinesterase inhibitors form the mainstay of treatment for persons with mild-to-moderate Alzheimer's disease (AD). The rivastigmine patch may increase compliance and the proportion of patients maintaining an efficacious dose compared with oral cholinesterase inhibitors. OBJECTIVE To investigate the proportion of patients who reached and maintained the target rivastigmine patch dose compared with the target rivastigmine capsule dose reported in clinical trials. METHODS This was a multicentre, 24-week, open-label study in persons with probable AD and a Mini-Mental State Examination (MMSE) score of ≥ 10 and ≤ 26. The primary outcome was the proportion of patients (ITT population) treated with 9.5 mg/24 h rivastigmine patch for at least 8 weeks at week 24. Secondary outcomes included week 24 MMSE, Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC), Trail Making Test Part A (TMT-A) and Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scores. RESULTS Overall, 208 participants received treatment and 155 (74.5%) completed the study. Within the ITT population, 147/182 patients (80.8%; 95% CI 75.0-86.5%) were treated for at least 8 weeks with the 9.5 mg/24 h rivastigmine patch; 135/182 patients (74.2%; 95% CI 67.8-80.5%) were treated for at least 8 weeks and completed the study. The most common adverse events were nausea (10.1% of patients), erythema (8.7%), pruritus (8.2%) and vomiting (7.2%). At week 24, patients treated with the rivastigmine patch showed improvements on MMSE, ADCS-ADL, ADCS-CGIC and TMT-A scores. Caregivers reported acceptance, preference and satisfaction with the patch. CONCLUSION Transdermal delivery may allow more patients to reach and maintain therapeutic doses of rivastigmine compared with oral rivastigmine.
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Affiliation(s)
- K Articus
- Novartis Pharma GmbH, Nuremberg, Germany.
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10
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Donndorf P, Kaminski A, Kühn F, Rösner J, Alms A, Vollmar B, Steinhoff G, Liebold A. Comparing microvascular alterations during CABG under minimal extracoporal circulation or conventional cardiopulmonary bypass using Orthogonal Polarization Spectral Imaging and the O2C® system: A prospective, randomized study. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269095] [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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11
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Ibach B, Kühn F, Gerwe M, Diekamp B. Galantamine improves non-cognitive symptoms as compared to nootropics in outpatients with mild to moderate Alzheimer's disease. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Ibach B, Kühn F, Gerwe M, Diekamp B. Galantamine improves behavioural disturbances in outpatients with mild to moderate Alzheimer's disease. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238382] [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: 10/20/2022]
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13
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Diekamp B, Helfrich S, Kaltofen J, Kühn F, Müller HJ, Schäuble B. Effectiveness, tolerability and changes in quality of life in patients with epilepsy treated with topiramate – results from a 28 weeks naturalistic study. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238601] [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: 10/20/2022]
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14
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Kowalik A, Rimpau W, Adam H, Kühn F, van Oene J, Schreiner A, Bogdanow M, Schauble B. Conversion from carbamazepine or oxcarbazepine to topiramate in adolescents and adults with epilepsy. Acta Neurol Scand 2008; 117:159-66. [PMID: 18218062 DOI: 10.1111/j.1600-0404.2007.00977.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore effectiveness, tolerability and changes in quality of life in patients with epilepsy converting to topiramate (TPM) from carbamazepine (CBZ) or oxcarbazepine (OXC) due to insufficient effectiveness and/or tolerability. METHODS A multicenter, open-label, non-interventional trial was used to examine patients (> or = 12 years) with epilepsy, changing to TPM monotherapy from baseline mono- or combination therapy with CBZ or OXC. TPM was added to the existing antiepileptic drug (AED) treatment and started at a dose of 25 mg once daily. The dose was titrated up with 25 mg/day increments, once every 1-2 weeks, until a final dose between 50 and 200 mg/day was reached. On the basis of clinical judgment, the treating physician decided whether or not the existing AED treatment with CBZ or OXC could then be withdrawn. Type and number of seizures, preferred TPM dose, quality of life (QOLIE-10 questionnaire), subjective perception of improvement and adverse events (AE) were documented. RESULTS 140 patients (53.5% women, mean age 47 years) decided to switch to TPM due to insufficient effectiveness (75% of patients) and/or poor tolerability (80%) of the CBZ/OXC treatment. Average duration of follow-up was 24 weeks with an overall discontinuation rate of 19.3%, mainly due to AEs (12.1%). At study endpoint, the intended shift to TPM monotherapy was achieved in 73% of patients at a median TPM dose of 100 mg/day. A seizure reduction of > or = 50% was achieved in 91% of patients in the last scheduled period (weeks 12-26); 62% of patients entering that period remained seizure free. Quality of life at endpoint improved significantly when compared with baseline for all domains of QOLIE-10 (P < 0.001). Most frequent AEs (reported by > or = 5% of patients) were paresthesia (9.3%), weight loss (7.9%), convulsions (5.7%) and memory disorders (5.0%). CONCLUSION In patients with epilepsy, previously not satisfactorily treated with CBZ or OXC, conversion to TPM may result in an improvement in seizure control as well as in quality of life.
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Affiliation(s)
- A Kowalik
- Section of Neurology, Bürgerspital Stuttgart, Stuttgart, Germany
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15
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Kühn F, Fehr S, Stoll T. [Back pain and acne conglobata: SAPHO syndrome]. Praxis (Bern 1994) 2007; 96:591-5. [PMID: 17506389 DOI: 10.1024/1661-8157.96.15.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We report on a young woman suffering from SAPHO syndrome with back pain and arthritis of the sternoclavicular joints. This inflammatory disorder of the osteoarticular system (synovitis, osteitis, and hyperostosis) is associated with severe acne or palmoplantar pustulosis. The patient was treated with pamidronate, NSAID and physiotherapy which improved the musculoskeletal symptoms completely. The acne was treated with isotretinoin.
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Affiliation(s)
- F Kühn
- Abteilung Rheumatologie, Kantonsspital Schaffhausen
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Pédaillès S, Kühn F, Grollier G, Thielly P. [Secondary prevention of myocardial infarction in the Basse-Normandie region]. Arch Mal Coeur Vaiss 2005; 98:960-5. [PMID: 16294540] [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: 05/05/2023]
Abstract
The objectives of this study were to determine post-infarction drug therapy at discharge from hospital and at one year in the Basse Normandie region (France) and the management of risk factors, to compare them with the practice recommended by the French Society of Cardiology and other recent references. Patients whose medical expenses were exonerated by the Social Security for primary myocardial infarction without a history of angioplasty or of coronary bypass grafting between February and September 2002 were reviewed. The data was researched from the hospital, the patient, the attending physician and the data bases of the Social Security. Four hundred and fifteen patients were included. At discharge from hospital the percentages of prescriptions of recommended drugs were as follows: betablockers 85%, antithrombotics 99%, ACE inhibitors 75%, lipid lowering drugs 90%; the four drug families were associated in 63% of cases. There was no significant difference in prescription between hospital discharge and the twelfth months except with regards to ACE inhibitors (68%) and the association of the four drug groups (54%). The prevalence of smoking, hypertension, diabetes, overweight, obesity and dyslipidaemia were respectively 40, 39, 9, 44, 20 and 81% at the time of infarction. At one year, the prevalence of smoking had fallen significantly to 16%; only 10.3% of patients had uncontrolled hypertension and only 29% had not obtained the recommended therapeutic target for LDL-cholesterol. The authors conclude that this analysis shows an adequation of drug prescription to current recommendations and an improvement in risk factor management which should, however, be pursued.
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Affiliation(s)
- S Pédaillès
- CNAMTS, service médical de Normandie, Alençon.
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17
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Petroianu G, Kühn F, Arafat K, Zuleger K, Missler A. In vitro protection of plasma cholinesterases by metoclopramide from inhibition by mipafox. J Appl Toxicol 2004; 24:143-6. [PMID: 15052610 DOI: 10.1002/jat.964] [Citation(s) in RCA: 3] [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: 11/08/2022]
Abstract
Metoclopramide (MCP) is a dopamine receptor antagonist and serotonin receptor agonist widely used as an antiemetic and gastric prokinetic drug. In addition MCP is a reversible inhibitor of cholinesterases from human central nervous system and blood. Metoclopramide may have a cholinesterase protective effect against inhibition by organophosphates. The purpose of the study was to quantify in vitro, by means of the IC(50) shift, the extent of MCP conferred protection, using mipafox (MPFX) as an inhibitor. Mipafox is a neuropathic organophosphate. Cholinesterase activities (with acetylthiocholine [ChE-A] and butyrylthiocholine [ChE-B] as substrates) in human plasma were measured photometrically in the presence of different MPFX concentrations and the IC(50) was calculated. Determinations were repeated in the presence of increasing MCP concentrations. It appears that the shift induced by the presence of MCP increases with the MCP concentration in a linear manner. In the presence of a clinically easily achievable plasma concentration of 1 micro M MCP, the IC(50) of MPFX for cholinesterase 'shifts' by a factor of ca. 3-6. The protective effect of MCP on cholinesterase could be of practical relevance in the treatment of organophosphate poisoning. We conclude that in vivo testing of MCP as an organophosphate protective agent is warranted.
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Affiliation(s)
- G Petroianu
- United Arab Emirates University, Department of Pharmacology and Therapeutics, PO Box 17666, Al Ain, United Arab Emirates.
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18
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Flatz L, Cottagnoud M, Kühn F, Entenza J, Stucki A, Cottagnoud P. Ceftriaxone acts synergistically with levofloxacin in experimental meningitis and reduces levofloxacin-induced resistance in penicillin-resistant pneumococci. J Antimicrob Chemother 2004; 53:305-10. [PMID: 14729741 DOI: 10.1093/jac/dkh082] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [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: 11/13/2022] Open
Abstract
Ceftriaxone acted synergistically with levofloxacin in time-killing assays in vitro over 8 h against two penicillin-resistant pneumococcal strains (WB4 and KR4; MIC of penicillin: 4 mg/L). Synergy was confirmed with the chequerboard method, showing FIC indices of 0.25. In the experimental rabbit meningitis model, ceftriaxone (1x 125 mg/kg) was slightly less bactericidal (-0.30 Deltalog(10) cfu/mL(.)h) compared with levofloxacin (-0.45 Deltalog(10) cfu/mL(.)h) against the penicillin-resistant strain WB4. The combination therapy (levofloxacin and ceftriaxone) was significantly superior (-0.64 Deltalog(10) cfu/mL(.)h) to either monotherapy. In cycling experiments in vitro, the addition of ceftriaxone at a sub-MIC concentration (1/16 MIC) reduced levofloxacin-induced resistance in the two strains KR4 and WB4. After 12 cycles with levofloxacin monotherapy, the MIC increased 64-fold in both strains versus a 16-fold increase with the combination (levofloxacin + ceftriaxone 1/16 MIC). In both strains, levofloxacin-induced resistance was confirmed by mutations detected in the genes parC and gyrA, encoding for subunits of topoisomerase IV and gyrase, respectively. The addition of ceftriaxone suppressed mutations in parC but led to a new mutation in parE in both strains.
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Affiliation(s)
- L Flatz
- Department of Internal Medicine, Spital Bern-Ziegler, Bern, Switzerland.
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19
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Cottagnoud P, Cottagnoud M, Acosta F, Flatz L, Kühn F, Stucki A, Entenza J. Meropenem prevents levofloxacin-induced resistance in penicillin-resistant pneumococci and acts synergistically with levofloxacin in experimental meningitis. Eur J Clin Microbiol Infect Dis 2003; 22:656-62. [PMID: 14557920 DOI: 10.1007/s10096-003-1016-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [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: 11/25/2022]
Abstract
The aim of the present study was to investigate the potential synergy between meropenem and levofloxacin in vitro and in experimental meningitis and to determine the effect of meropenem on levofloxacin-induced resistance in vitro. Meropenem increased the efficacy of levofloxacin against the penicillin-resistant pneumococcal strain KR4 in time-killing assays in vitro and acted synergistically against a second penicillin-resistant strain WB4. In the checkerboard, only an additive effect (FIC indices: 1.0) was observed for both strains. In cycling experiments in vitro, levofloxacin alone led to a 64-fold increase in the MIC for both strains after 12 cycles. Addition of meropenem in sub-MIC concentrations (0.25 x MIC) completely inhibited the selection of levofloxacin-resistant mutants in WB4 after 12 cycles. In KR4, the addition of meropenem led to just a twofold increase in the MIC for levofloxacin after 12 cycles. Mutations detected in the genes encoding for topoisomerase IV (parC) and gyrase (gyrA) confirmed the levofloxacin-induced resistance in both strains. Addition of meropenem was able to completely suppress levofloxacin-induced mutations in WB4 and led to only one mutation in parE in KR4. In experimental meningitis, meropenem, given in two doses (2 x 125 mg/kg), produced a good bactericidal activity (-0.45 Deltalog10 cfu/ml.h) comparable to one dose (1 x 10 mg/kg) of levofloxacin (-0.44 Deltalog10 cfu/ml.h) against the penicillin-resistant strain WB4. Meropenem combined with levofloxacin acted synergistically (-0.93 Deltalog10 cfu/ml.h), sterilizing the CSF of all rabbits.
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Affiliation(s)
- P Cottagnoud
- Department of Internal Medicine, Inselspital, Freiburgstrasse, 3010 Bern, Switzerland.
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Kühn F, Cottagnoud M, Acosta F, Flatz L, Entenza J, Cottagnoud P. Cefotaxime acts synergistically with levofloxacin in experimental meningitis due to penicillin-resistant pneumococci and prevents selection of levofloxacin-resistant mutants in vitro. Antimicrob Agents Chemother 2003; 47:2487-91. [PMID: 12878509 PMCID: PMC166100 DOI: 10.1128/aac.47.8.2487-2491.2003] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [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
Cefotaxime, given in two doses (each 100 mg/kg of body weight), produced a good bactericidal activity (-0.47 Deltalog(10) CFU/ml. h) which was comparable to that of levofloxacin (-0.49 Deltalog(10) CFU/ml. h) against a penicillin-resistant pneumococcal strain WB4 in experimental meningitis. Cefotaxime combined with levofloxacin acted synergistically (-1.04 Deltalog(10) CFU/ml. h). Synergy between cefotaxime and levofloxacin was also demonstrated in vitro in time killing assays and with the checkerboard method for two penicillin-resistant strains (WB4 and KR4). Using in vitro cycling experiments, the addition of cefotaxime in sub-MIC concentrations (one-eighth of the MIC) drastically reduced levofloxacin-induced resistance in the same two strains (64-fold increase of the MIC of levofloxacin after 12 cycles versus 2-fold increase of the MIC of levofloxacin combined with cefotaxime). Mutations detected in the genes encoding topoisomerase IV (parC and parE) and gyrase (gyrA and gyrB) confirmed the levofloxacin-induced resistance in both strains. Addition of cefotaxime in low doses was able to suppress levofloxacin-induced resistance.
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Affiliation(s)
- F Kühn
- Department of Internal Medicine, Spital Bern-Ziegler, Inselspital, Bern, Switzerland
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21
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Strauss U, Lugauer HJ, Weimar A, Baur J, Brüderl G, Eisert D, Kühn F, Zehnder U, Härle V. Progress of InGaN Light Emitting Diodes on SiC. ACTA ACUST UNITED AC 2003. [DOI: 10.1002/pssc.200390042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Petroianu G, Kühn F, Thyes C, Ewald V, Missler A. In vitro protection of plasma cholinesterases by metoclopramide from inhibition by paraoxon. J Appl Toxicol 2003; 23:75-9. [PMID: 12518340 DOI: 10.1002/jat.891] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/10/2022]
Abstract
Metoclopramide (MCP) is a dopamine receptor antagonist and serotonine receptor agonist widely used as an antiemetic and gastric prokinetic drug. In addition MCP is a reversible inhibitor of cholinesterases from human central nervous system and blood. MCP may have a cholinesterase protective effect against inhibition by organophosphates. The purpose of the study was to quantify "in vitro" by means of the IC(50)-shift the extent of MCP conferred protection, using paraoxon (POX) as an inhibitor. POX is a widely used organophospate responsible for a large number of accidental or suicidal exposures. Cholinesteratic activities (ChE) (with acetyl-thiocholine (A) and butyryl-thiocholine (B) as substrates) in human plasma were measured photometrically in the presence of different POX concentrations and IC(50) was calculated. Determinations were repeated in the presence of increasing MCP concentrations. It appears that the shift induced by the presence of MCP increases with the MCP concentration in a linear manner. In the presence of a clinically easily achievable plasma concentration of 1 micro M MCP the IC(50) of POX for ChE 'shifts' by a factor of approximately 2-3. The protective effect of metoclopramide on cholinesterases could be of practical relevance in the treatment of paraoxon poisoning. We conclude that in vivo testing of MCP as an organophosphate protective agent is warranted.
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Affiliation(s)
- G Petroianu
- United Arab Emirates University, Faculty of Medicine and Health Sciences Department of Pharmacology, Al Ain, United Arab Emirates.
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23
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Rückert JC, Kühn F, Wacks JH, Settmacher U, Zanow J, Wolff H, von Baer R, Krause KP. Clinical transplantation of cryopreserved fetal pancreas tissue. Transplant Proc 1992; 24:2967-8. [PMID: 1466017] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- J C Rückert
- Surgical Clinic, Medical Faculty, Humboldt University, Berlin (Charité), Germany
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24
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Raude H, Löhde E, Lück M, Kühn F, Abri O, Kraas E. Influence of human donor operation and isolation techniques on the viability of islets of Langerhans. Transplant Proc 1991; 23:2450. [PMID: 1926427] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- H Raude
- Department of Surgery, Academic Hospital Maobit, Berlin, Germany
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25
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Löhde E, Lück M, Raude H, Kühn F, Abri O, Kraas E. Influence of Iloprost on insulin synthesis in isolated human islets of Langerhans. Transplant Proc 1991; 23:2432-4. [PMID: 1718074] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- E Löhde
- Department of Surgery, Academic Hospital Moabit, Berlin, Germany
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26
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Elias J, Dauth J, Senekal JC, van der Walt P, Joubert HF, Kühn F, Greenacre M. Serum beta-2-microglobulin in the differential diagnosis of monoclonal gammopathies. S Afr Med J 1991; 79:650-3. [PMID: 2047946] [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: 12/30/2022] Open
Abstract
Serum beta-2-microglobulin (B2m) concentrations were determined in 43 southern African black patients with multiple myeloma (MM), in 130 black patients with monoclonal gammopathy of undetermined significance (MGUS) and in 70 control subjects. The results showed median values for serum B2m in patients with MM, MGUS and the control group to be 8.10 mg/l, 3.05 mg/l, and 2.35 mg/l, respectively; these values differed significantly from one another (P less than 0.01), even when patients with normal renal function (serum creatinine value less than 110 mumol/l) were considered separately. The median serum B2m concentration for IgG MM (22 cases) was 4.3 mg/l, for IgA MM (8 cases) 7.3 mg/l, and 24.2 mg/l for Bence Jones MM (12 cases). These differences were also significant (P = 0.001), but not in the restricted group of MM patients with normal renal function. In the 43 MM patients serum B2m concentrations had a significant positive correlation with serum creatinine (r = 0.706; P less than 0.005) and a significant negative correlation with haemoglobin values (r = -0.459; P = 0.006). In 28 MM patients with normal renal function, serum B2m values had a significant negative correlation with serum albumin (r = -0.602, P = 0.003). Sixty-five per cent of the 43 MM patients and 18.5% of the MGUS patients had raised serum B2m values (greater than 4.7 mg/l). An optimum cut-off value for serum B2m of 6.9 mg/l for differentiating MM from MGUS was determined using a classification rule. Despite lacking specificity, serum B2m measurement was useful in differentiating MM from MGUS, and was the best second choice variable in relation to serum albumin and haemoglobin in patients with normal renal function.
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Affiliation(s)
- J Elias
- Department of Chemical Pathology, Medical University of Southern Africa, Pretoria
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27
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Löhde E, Abri O, Lepple-Wienhus A, Kühn F, Kraas E. Prostacyclin--protective effects on human islets of Langerhans in vitro. Transplant Proc 1990; 22:2048-9. [PMID: 1697123] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- E Löhde
- Surgical Department, Academic Hospital Moabit, West Berlin, FRG
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28
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Kühn F, Wachs JH, Rückert J, Settmacher U, Schulz HJ, Matthes G, Bollmann R, Hahn HJ, Ratzmann KP, Wolff H. Tissue bank of human fetal pancreas. Transplant Proc 1990; 22:683-4. [PMID: 2183441] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- F Kühn
- Surgical Clinic of Charité Hospital, Humboldt University Berlin, GDR
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29
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Abri O, Kühn F, Lippert H, Löhde E, Gütte N, Kraas E, Wolff H. The effect of multiple-organ donation on the degree of preservation of isolated pancreas islets. Transplant Proc 1987; 19:99-102. [PMID: 3113016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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