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Lochbaum R, Trainotti S, Hoffmann TK, Greve J, Hahn J. A clinical evaluation of patients with known mutations (plasminogen and factor XII) with a focus on prophylactic treatment. J DERMATOL TREAT 2024; 35:2290362. [PMID: 38086754 DOI: 10.1080/09546634.2023.2290362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Hereditary angioedema with normal C1-inhibitor (HAE-nC1-INH) is a rare genetic disease. The symptoms can resemble other forms of hereditary angioedema (HAE), but the specific laboratory values are inconspicuous. The knowledge about treatment strategies in HAE-nC1-INH remains insufficient; most of the drugs are only licensed and approved for other types of HAE. METHODS An analysis of all patients with HAE-nC1-INH was carried out in a certified angioedema treatment center in southern Germany. Only patients with a confirmed HAE-nC1-INH mutation were included. The impact of disease was monitored with validated questionnaires. RESULTS Eighteen patients were included: two families with a factor XII mutation and seven families with a plasminogen mutation. All individuals received icatibant for on-demand therapy-efficient treatment response was reported. Three patients were severely affected, and prophylaxis was initiated with lanadelumab. According to the questionnaires, the clinical course and symptoms improved significantly under this prophylactic regime. CONCLUSION This is one of the first descriptions of the clinical outcomes as a response to prophylactic treatment with lanadelumab in HAE-nC1-INH patients with a known mutation. The therapeutic management of HAE-1 and HAE-2 should also be the basis of HAE-nC1-INH, including prophylaxis.
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Affiliation(s)
- Robin Lochbaum
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Susanne Trainotti
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Müller H, Hahn J, Gierke A, Stark R, Brunner C, Hoffmann TK, Greve J, Wittekindt O, Lochbaum R. Establishment of the deuterium oxide dilution method as a new possibility for determining the transendothelial water permeability. Pflugers Arch 2024:10.1007/s00424-024-02934-z. [PMID: 38438679 DOI: 10.1007/s00424-024-02934-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/01/2024] [Accepted: 02/25/2024] [Indexed: 03/06/2024]
Abstract
Increase in transendothelial water permeability is an essential etiological factor in a variety of diseases like edema and shock. Despite the high clinical relevance, there has been no precise method to detect transendothelial water flow until now. The deuterium oxide (D2O) dilution method, already established for measuring transepithelial water transport, was used to precisely determine the transendothelial water permeability. It detected appropriate transendothelial water flow induced by different hydrostatic forces. This was shown in four different endothelial cell types. The general experimental setup was verified by gravimetry and absorbance spectroscopy. Determination of transendothelial electrical resistance (TEER) and immunocytochemical staining for proteins of the cell-cell contacts were performed to ensure that no damage to the endothelium occurred because of the measurements. Furthermore, endothelial barrier function was modulated. Measurement of transendothelial water flux was verified by measuring the TEER, the apparent permeability coefficient and the electrical capacity. The barrier-promoting substances cyclic adenosine monophosphate and iloprost reduced TEER and electrical capacity and increased permeability. This was accompanied by a reduced transendothelial water flux. In contrast, the barrier-damaging substances thrombin, histamine and bradykinin reduced TEER and electrical capacity, but increased permeability. Here, an increased water flow was shown. This newly established in vitro method for direct measurement of transendothelial water permeability was verified as a highly precise technique in various assays. The use of patient-specific endothelial cells enables individualized precision medicine in the context of basic edema research, for example regarding the development of barrier-protective pharmaceuticals.
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Affiliation(s)
- Hannes Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Angelina Gierke
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Robert Stark
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Cornelia Brunner
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Oliver Wittekindt
- Department of General Physiology, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Robin Lochbaum
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany.
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Reuthner K, Aubele P, Menhart K, Rath P, Harrer DC, Herr W, Hahn J, Vogelhuber M, Heudobler D, Lueke F, Reichle A, Grube M. Case report: Sustained complete remission with all-oral MEPED therapy in a patient with Hodgkin's disease developing resistance to pembrolizumab. Front Pharmacol 2024; 15:1334233. [PMID: 38444946 PMCID: PMC10912635 DOI: 10.3389/fphar.2024.1334233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/26/2024] [Indexed: 03/07/2024] Open
Abstract
Targeted chemotherapy and immune checkpoint inhibitors (ICPi) have expanded the spectrum of therapies for patients with relapsed/refractory (r/r) Hodgkin's disease and significantly improved the proportion of patients with long-term disease control. However, there is no standardized therapeutic option in case of further progression. Recently, we demonstrated that therapy with MEPED (metronomic chemotherapy, everolimus, pioglitazone, etoricoxib, dexamethasone) is highly effective in patients with r/r Hodgkin's disease. The benefit after pre-treatment with ICPi has not been studied, yet. Here, we report a patient with progressive Hodgkin's disease on Pembrolizumab for the first time who achieved sustained complete remission (CR) after initiation of MEPED therapy. A 57-year-old patient was pre-treated with brentuximab vedotin for relapsed advanced Hodgkin's disease and had received Pembrolizumab for progression from November 2020 to July 2022. Due to further progression, MEPED therapy was started in August 2022 and continued until May 2023. It consisted of a strictly oral daily (28-day cycle) application of low-dose treosulfan 250 mg, everolimus 15 mg, pioglitazone 45 mg, etoricoxib 60 mg, and dexamethasone 0.5 mg. Treatment response was evaluated by F-18 FDG-PET/CT (PET/CT). CR was defined by a negative Deauville score (DS) of 1-3. Already 3 months after starting MEPED, a CR (DS: 3) was confirmed by PET/CT in November 2022. The next follow-up in May 2023 continued to show CR (DS: 3). The therapy was very well tolerated. No hematological or other organ toxicity was observed. However, in May 2023 the patient presented with leg edema and weight gain, most likely due to pioglitazone and the PET/CT revealed suspected everolimus-induced pneumonitis, so MEPED was discontinued and diuretic therapy and treatment with prednisolone was started with gradual dose reduction. This resulted in a rapid complete resolution of the symptoms. The next PET-CT in July 2023 continued to show CR (DS: 3) without evidence of pneumonitis. Currently, therapy with MEPED has not been resumed. In conclusion, we demonstrate for the first time that MEPED therapy is highly effective in a patient with Hodgkin's disease who has been refractory to ICPi. Sustained CR was achieved over 11 months after initiation of MEPED therapy. Further studies on a larger patient cohort should be performed.
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Affiliation(s)
- K. Reuthner
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - P. Aubele
- Medical Care Center (MVZ), Oncology, Hospital of Straubing, Straubing, Germany
| | - K. Menhart
- Department of Nuclear Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - P. Rath
- Department of Nuclear Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - D. C. Harrer
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - W. Herr
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - J. Hahn
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - M. Vogelhuber
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - D. Heudobler
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), University Hospital Regensburg, Regensburg, Germany
| | - F. Lueke
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
- Division of Personalized Tumor Therapy, Fraunhofer Institute for Toxicology and Experimental Medicine, Regensburg, Germany
| | - A. Reichle
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - M. Grube
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
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Trainotti S, Johnson F, Hahn J, Hofauer B, Greve J, Wollenberg B, Hoffmann TK, Lochbaum R. Acquired Angioedema Due to C1-Inhibitor Deficiency (AAE-C1-INH)-A Bicenter Retrospective Study on Diagnosis, Course, and Therapy. J Allergy Clin Immunol Pract 2023; 11:3772-3779. [PMID: 37716525 DOI: 10.1016/j.jaip.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 08/06/2023] [Accepted: 09/01/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Acquired angioedema with C1-inhibitor deficiency (AAE-C1-INH) is a rare condition resembling hereditary angioedema (HAE), but with late onset and low C1-inhibitor (C1-INH) due to consumption potentially caused by autoimmune diseases and mainly lymphatic malignancies. Being about 10-fold rarer than HAE, there is limited knowledge and no licensed therapy. OBJECTIVE To report clinical and biological data from a newly described population of 20 patients with AAE-C1-INH assessing diagnostic delay, AAE-C1-INH:HAE-ratio, underlying conditions, and therapeutic management in Germany. METHODS Retrospective data analysis of 20 patients from 2 angioedema centers in southern Germany. RESULTS Median age at symptoms' onset was 64 years (60% females), with predominant swellings of the face (85%) and low levels for C1-INH in almost all patients. The ratio AAE-C1-INH:HAE was 1:9.7. From symptoms' onset to diagnosis of AAE-C1-INH, the median delay was 7.5 months, and between AAE-C1-INH symptoms' onset and diagnosis of the underlying hematological condition (n = 9) it was 4 months (median). Four patients had a history of solid neoplasm, 1 had a papillary thyroid carcinoma as the only potential cause for AAE-C1-INH, with treatment of the malignancy resulting in resolution of AAE-C1-INH. All the symptomatic patients were treated with off-label on-demand icatibant subcutaneously or C1-INH concentrate intravenously, and 6 severely affected patients needed off-label long-term prophylaxis with good symptom control. CONCLUSIONS AAE-C1-INH is characterized by late-onset swellings mainly involving the face and low C1-INH levels. Diagnostic delay for AAE-C1-INH is further decreasing despite being about 10-fold rarer than HAE. Patients severely affected without underlying condition or no indication for treatment could benefit from off-label therapy.
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Affiliation(s)
- Susanne Trainotti
- Department of Otorhinolaryngology, Technical University of Munich, Munich, Germany.
| | - Felix Johnson
- University Hospital for Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Benedikt Hofauer
- University Hospital for Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology, Technical University of Munich, Munich, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Robin Lochbaum
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Johnson F, Stenzl A, Hofauer B, Heppt H, Ebert EV, Wollenberg B, Lochbaum R, Hahn J, Greve J, Trainotti S. A Retrospective Analysis of Long-Term Prophylaxis with Berotralstat in Patients with Hereditary Angioedema and Acquired C1-Inhibitor Deficiency-Real-World Data. Clin Rev Allergy Immunol 2023; 65:354-364. [PMID: 37914894 PMCID: PMC10847220 DOI: 10.1007/s12016-023-08972-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 11/03/2023]
Abstract
Hereditary angioedema (HAE) and acquired C1-inhibitor deficiency (AAE-C1-INH) are orphan diseases. Berotralstat is a recently licensed long-term prophylaxis (LTP) and the first oral therapy for HAE patients. No approved therapies exist for AAE-C1-INH patients. This study is the first to report real-world clinical data of patients with AAE-C1-INH and HAE who received Berotralstat. All patients treated with Berotralstat were included in this retrospective, bi-centric study. Data was collected from patients' attack calendars and the angioedema quality of life (AE-QoL) and angioedema control test (AECT) questionnaires before treatment, and at 3, 6, and 12 months after treatment and was then analyzed. Twelve patients were included, 3 patients with AAE-C1-INH, 7 patients with HAE type I, and 2 patients with HAE-nC1-INH. One patient (HAE I) quit treatment. Berotralstat was associated with fewer attacks in all groups. After 6 months of treatment, a median decrease of attacks per month was noted for HAE type I patients (3.3 to 1.5) and AAE-C1-INH patients (2.3 to 1.0). No aerodigestive attacks were noted for AAE-C1-INH patients. For HAE-nC1-INH patients, a mean decrease from 3.8 to 1.0 was noted (3 months). For HAE I patients, the total AE-QoL lowered a mean of 24.1 points after 6 months, for HAE-nC1-HAE patients 8.0 points, and for AAE-C1-INH patients 13.7 points. AECT scores increased for HAE I patients (mean: 7.1), HAE-nC1-INH patients (9.0), and AAE-C1-INH patients (4.2) after 6 months. Patients with HAE, HAE-nC1-INH, and AAE-C1-INH treated with Berotralstat showed reduced angioedema attacks and improved AE-QoL and AECT scores.
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Affiliation(s)
- Felix Johnson
- University Hospital for Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Anna Stenzl
- University Hospital for Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria.
| | - Benedikt Hofauer
- University Hospital for Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Helen Heppt
- University Hospital for Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Eva-Vanessa Ebert
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum rechts der Isar, TUM School of Medicine and Health, Department Clinical Medicine, Munich, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum rechts der Isar, TUM School of Medicine and Health, Department Clinical Medicine, Munich, Germany
| | - Robin Lochbaum
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Susanne Trainotti
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum rechts der Isar, TUM School of Medicine and Health, Department Clinical Medicine, Munich, Germany
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Lochbaum R, Hoffmann TK, Greve J, Hahn J. Concomitant medication in patients with bradykinin-mediated angioedema - there's more than ACE inhibitors. J Dtsch Dermatol Ges 2023; 21:1283-1289. [PMID: 37483139 DOI: 10.1111/ddg.15154] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/20/2023] [Indexed: 07/25/2023]
Abstract
Bradykinin-mediated angioedema is a rare, non-allergic, potentially life-threatening disease. ACE inhibitor-induced angioedema and hereditary angioedema (HAE) are the two most common presentations. Therapeutic options, pathophysiology and diagnosis continue to be investigated, with considerable progress in HAE over the last few decades. For all patients with bradykinin-mediated angioedema, there are several medications that should be avoided or administered with caution. Some of the triggering medications are well known, while others are suspected or of unknown significance. A common denominator is that there is no approved therapy for bradykinin-mediated angioedema as a drug side effect. Some medications, such as tissue plasminogen activator, have a higher incidence of angioedema with potential airway compromise than ACE inhibitors, although this fact is widely underappreciated. In this review, we aim to summarize what is currently known and recommended about concomitant medication in HAE patients and the interaction of other bradykinin-influencing drugs.
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Affiliation(s)
- Robin Lochbaum
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Janina Hahn
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Lochbaum R, Hoffmann TK, Greve J, Hahn J. Medikamente als Auslöser Bradykinin-vermittelter Angioödeme - mehr als ACE-Hemmer. J Dtsch Dermatol Ges 2023; 21:1283-1290. [PMID: 37946655 DOI: 10.1111/ddg.15154_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/20/2023] [Indexed: 11/12/2023]
Abstract
ZusammenfassungBradykinin‐vermittelte Angioödeme sind seltene, nichtallergische und potenziell lebensbedrohliche Krankheiten. Die beiden bekanntesten Formen sind das ACE‐Hemmer‐induzierte Angioödem und das hereditäre Angioödem (HAE). Die therapeutischen Möglichkeiten, die Pathophysiologie und die Diagnostik werden weiter erforscht, wobei beim HAE in den letzten Jahrzehnten erhebliche Fortschritte erzielt wurden. Für alle Patienten mit Bradykinin‐vermittelten Angioödemen gibt es Medikamente, die vermieden oder mit Vorsicht verabreicht werden sollten. Einige dieser auslösenden Medikamente sind gut bekannt, bei anderen wird ein Zusammenhang vermutet oder ihre Bedeutung ist unbekannt. Ein gemeinsamer Nenner ist, dass es keine zugelassene Therapie für das Bradykinin‐vermittelte Angioödem als Arzneimittelnebenwirkung gibt. Bei einigen Medikamenten, wie dem gewebespezifischen Plasminogenaktivator, ist die Inzidenz von Angioödemen mit möglicher Beeinträchtigung der Atemwege höher als bei ACE‐Hemmern, wobei diese Tatsache weitgehend unterschätzt wird. In dieser Übersichtsarbeit fassen wir zusammen, was derzeit über die Begleitmedikation bei HAE‐Patienten und die Interaktion mit anderen Bradykinin‐beeinflussenden Medikamenten bekannt ist und empfohlen wird.
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Affiliation(s)
- Robin Lochbaum
- Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - Thomas K Hoffmann
- Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - Jens Greve
- Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| | - Janina Hahn
- Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
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Werz J, Greve J, Hoffmann TK, Hahn J. New Year's Eve in otorhinolaryngology: a 16-year retrospective evaluation. Eur Arch Otorhinolaryngol 2023; 280:3453-3459. [PMID: 37062783 PMCID: PMC10106316 DOI: 10.1007/s00405-023-07966-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/04/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Pyrotechnics are a long-standing tradition at the turn of the year. There are little data available on New Year's Eve-associated ORL injuries. Due to restrictions during the Corona pandemic, the handling of fireworks and meetings on New Year's Eve 2020-2022 had been significantly changed. Our aim was to analyze first data about New Year's Eve-associated ORL injuries. METHODS A retrospective analysis of 16 turns of the year (2006-2022) at a University ORL department was performed. The 2 recent years were influenced by the changes and restrictions of the COVID-19 pandemic. RESULTS Of 343 emergency presentations, 69 presented with New Year's Eve-associated reasons (20%). 72% were male, 15.9% were underage. 74% presented for fireworks-related injuries, 19% due to violent altercations. Noise trauma was present in 71%. The average number of New Year's Eve-associated emergency patients per year and the average total number of patients were reduced by more than half under COVID-19 pandemic conditions. CONCLUSIONS New Year's Eve-associated ORL injuries range from inner ear trauma to midface fractures. Long-term damage may include hearing loss and tinnitus. These results shall support the responsible use of fireworks even after the end of the special regulations of the COVID-19 pandemic.
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Affiliation(s)
- Julia Werz
- Division of Phoniatrics and Paediatric Audiology, Waldstr. 1, Erlangen, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ulm, Frauensteige 12, 89075, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ulm, Frauensteige 12, 89075, Ulm, Germany
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ulm, Frauensteige 12, 89075, Ulm, Germany.
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Hahn J, Beule A, Lindemann J. [Functional disorders of the nose - definition, diagnostics and treatment options]. Laryngorhinootologie 2023; 102:305-313. [PMID: 37040753 DOI: 10.1055/a-1994-5382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The surgical spectrum of functional rhinosurgery includes nasal septum surgery, septorhinoplasty and nasal concha surgery. Based on the German guideline "Disorders of the inner and/or external nose (with functional and/or aesthetic impairment)" published in April 2022, which was prepared on behalf of the German Society of Otorhinolaryngology, Head and Neck Surgery, we discuss the indications, diagnostic approaches, the planning of the surgery and postoperative care. The most common findings of the external nose with a functional impairment include crooked nose, saddle nose, and tension nose. Combined pathologies occur. Well-documented in-depth consultation is essential for rhinosurgical procedures. In the case of revision surgery, the possible necessity of autologous ear or rib cartilage should be considered. Despite correct surgical performance, no "guarantee" can be given for the surgical (long-term) result in rhinosurgery.
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Strassen U, Bas M, Wirth M, Wirth M, Gröger M, Stelter K, Volkenstein S, Kehl V, Kojda G, Hoffmann TK, Hahn J, Trainotti S, Greve J. Efficacy of human C1 esterase inhibitor concentrate for treatment of ACE-inhibitor induced angioedema. Am J Emerg Med 2023; 64:121-128. [PMID: 36516670 DOI: 10.1016/j.ajem.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/21/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND ACE inhibitor (ACEi) induced angioedema predominantly affects the upper aerodigestive tract. As ACEi induced angioedema is mediated by bradykinin, therapeutic response to antihistamines and glucocorticoids remains unsatisfactory. In bradykinin mediated hereditary angioedema, C1-esterase inhibitor (C1INH) is an effective and approved treatment since many years. Our aim was to evaluate the therapeutic effect of C1INH in ACEi induced angioedema. METHODS We performed a double-blind, parallel-group, multicentre randomised placebo-controlled trial between December 2013 and September 2018. Eligible were adults with ACEi induced angioedema with airway obstruction. Participants were randomised 1:1 to single doses of either C1INH (20 IU/kg) or placebo (0.9% NaCl) i.v in addition to standard care (i.v. 500 mg prednisolone and 2.68 mg clemastine) i.v. Composite symptom scores were assessed at baseline and up to 48 h, at discharge and 1 week after discharge. Physician assessed time to complete oedema resolution (TCER) and time to onset of relief (TOR). RESULTS 30 patients (16 C1INH, 14 placebo) were randomised and dosed. 25 (9 C1INH, 12 placebo) completed the study. TCER was 29.63 h ± 15.56 h in the C1INH and 17.29 h ± 10.40 h in the placebo arm (p = 0.0457). TORs were 4.13 h ± 3.38 h and 2.86 h ± 1.29 h for C1INH and placebo, respectively (p = 0.4443). There were no adverse events related to study medication. CONCLUSIONS In the context of baseline application of steroids and antihistamines C1INH was inferior in the treatment of ACEi induced angioedema when compared to placebo with respect to time to complete resolution of symptoms. Eudra-CT Number: 2012-001670-28.
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Affiliation(s)
- Ulrich Strassen
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Germany.
| | - Murat Bas
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Magdalena Wirth
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Markus Wirth
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Germany
| | - Moritz Gröger
- Department of Otorhinolaryngology, Grosshadern Medical Center of the University of Munich, Germany
| | - Klaus Stelter
- Department of Otorhinolaryngology, Grosshadern Medical Center of the University of Munich, Germany
| | - Stefan Volkenstein
- Department of Otorhinolaryngology, Ruhr-University of Bochum, St. Elisabeth-Hospital Bochum, Germany
| | - Victoria Kehl
- Munich Study Center, Faculty of Medicine, Technical University Munich, Germany; Institute for AI and Informatics in Medicine, Faculty of Medicine, Technical University Munich, Germany
| | - Georg Kojda
- Institute of Pharmacology and Clinical Pharmacology, University Hospital Düsseldorf, Düsseldorf (G.K.), Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University, Medical Center, Ulm, Germany
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University, Medical Center, Ulm, Germany
| | - Susanne Trainotti
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technische Universität München, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University, Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University, Medical Center, Ulm, Germany
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11
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Lochbaum R, Tewes S, Hoffmann TK, Greve J, Hahn J. [Typical emergencies in otorhinolaryngology-a monocentric analysis of the seasonal course]. HNO 2022; 70:601-608. [PMID: 35657418 PMCID: PMC9164187 DOI: 10.1007/s00106-022-01185-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
Hintergrund Die Inzidenz der Akutdiagnosen im Hals-Nasen-Ohren(HNO)-Bereich wird durch multiple Parameter beeinflusst, unter anderem meteorologische und saisonale Einflüsse. Durch ein besseres Verständnis dieser Faktoren könnten prophylaktische Ansätze entwickelt werden. Material und Methoden Über 6 Jahre erfolgte eine retrospektive Analyse aller Patienten, die sich aufgrund von typischen und weniger komplexen HNO-ärztlichen Krankheitsbildern wie Cerumen obturans, akuter Otitis externa und media, Nasenpyramidenfraktur, Epistaxis nasi, akuter Tonsillitis, akuter Rhinosinusitis oder eines Peritonsillarabszess in einer südwestdeutschen Universitätsklinik vorgestellt haben. Ergebnisse 32.968 Fälle wurden ausgewertet. Mit 24,5 % (8082 Fälle) war die Epistaxis nasi die häufigste Notfalldiagnose. Diese, wie auch die akute Otitis media und die akute Rhinosinusitis, traten signifikant häufiger in der kälteren Jahreshälfte auf. Es bestand keine signifikante Korrelation der Diagnose Nasenpyramidenfraktur mit besonderen Zeiten wie Feiertagen. Die akute Otitis externa korrelierte signifikant mit dem Zeitraum der Sommerferien. In Kalenderwoche 38 gab es die wenigsten und in der Kalenderwoche 52 die meisten Notfallvorstellungen. Schlussfolgerung Saisonale und meteorologische Faktoren spielen eine Rolle in der Krankheitsentstehung verschiedener HNO-ärztlicher Notfalldiagnosen.
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Affiliation(s)
- R Lochbaum
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - S Tewes
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Greve
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Hahn
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
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12
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Costenbader K, Cook N, Lee IM, Hahn J, Walter J, Bubes V, Kotler G, Yang N, Friedman S, Alexander E, Manson J. OP0038 VITAMIN D AND MARINE n-3 FATTY ACID SUPPLEMENTATION FOR PREVENTION OF AUTOIMMUNE DISEASE IN THE VITAL RANDOMIZED CONTROLLED TRIAL: OUTCOMES OVER 7 YEARS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundStrong biologic rationale supports both vitamin D and marine omega-3 (n-3) fatty acids for prevention of autoimmune disease (AD). Within the randomized, double-blind, placebo-controlled VITamin D and OmegA-3 TriaL (VITAL), we tested the effects of these supplements on AD incidence. We previously reported results after 5.3 years of randomized follow-up showing overall protective effects for vitamin D on AD incidence (HR 0.78, 95% CI 0.61-0.99) and suggestive results for n-3 fatty acids (HR 0.85, 95%CI 0.67-1.08)1.ObjectivesWe aimed to test effects of these supplements with two more years of post-intervention follow-up in VITAL.MethodsVITAL enrolled and randomized men and women (age ≥50 and ≥55 years, respectively) in a 2-by-2 factorial design to vitamin D3 (2000 IU/d) and/or n-3 fatty acids (1000 mg/d) or placebo and followed for median 5.3 years. Here, we followed participants for another 2 years of observation to assess for sustained effects. Incident AD diagnoses were reported by participants annually and confirmed by medical record review by expert physicians using existing classification criteria. The primary endpoint was total incident AD, including rheumatoid arthritis (RA), polymyalgia rheumatica (PMR), autoimmune thyroid disease (AITD), psoriasis, and all others. Pre-specified secondary endpoints included individual common AD; and probable AD. Cox models calcuated hazard ratios (HR) for incident ADs.ResultsOf 25,871 participants randomized, 71% self-reported non-Hispanic Whites, 20% Black, 9% other racial/ethnic groups, 51% women, mean age was 67.1 years. During 7.5 years median follow-up, confirmed AD was diagnosed in 156 participants in vitamin D arm vs 198 in vitamin D placebo arm, HR 0.79 (0.64-0.97). Incident AD was confirmed in 167 participants in n-3 fatty acid arm and 187 in n-3 fatty acid placebo arm, HR 0.89 (0.72-1.10). For vitamin D, HRs trended toward reduction for RA 0.67 (0.37- 1.21), PMR 0.69 (0.46-1.03) and psoriasis 0.57 (0.33-0.99). For n-3 fatty acids, HRs trended toward reduction for RA 0.55 (0.30-1.10) and AITD 0.61 (0.33-1.12). Vitamin D’s effect on AD incidence was stronger in those with body mass index (BMI) < 25 (HR 0.65, 0.44-0.96) than ≥ 25 kg/m2 (p interaction 0.01).ConclusionSupplementation for 5.3 years with 2000 IU/day vitamin D (compared to placebo), followed by 2 years of observational follow-up, significantly reduced overall incident AD by 21% in older adults. HRs for RA, PMR and psoriasis trended toward reduction with vitamin D, with stronger effect in those with normal BMI. Supplementation with 1000 mg/day n-3 fatty acids did not significantly reduce total AD.References[1]Hahn J et al, BMJ, 2022 Jan 26;376: e066452.Table 1.Hazard Ratios for Primary and Secondary Endpoints, by Randomized Assignment to Vitamin D/Placebo (Left), N-3 Fatty Acids/Placebo (Right)aEndpointVitamin D3(N=12,927)Placebo (N=12,944)Hazard Ratio (95% CI)pN-3 Fatty Acids (N=12,933)Placebo (N=12,938)Hazard Ratio (95% CI)pPrimary: Confirmed AD1561980.79 (0.64-0.97)0.031671870.89 (0.72-1.10)0.27Secondary:Confirmed + probable AD2653210.83 (0.70-0.97)0.022713150.86 (0.73-1.01)0.06Excluding subjects with any pre-randomization AD Confirmed AD1271620. 79 (0.62-0.99)0.041411480.95 (0.75-1.20)0.66 Confirmed + probable AD2112700. 78 (0.65-0.94)0.0072322490.93 (0.78-1.11)0.41Excluding first 2 years follow-up Confirmed AD861300.66 (0.50-0.87)0.0031041120.92 (0.71-1.21)0.56 Confirmed + probable AD1472050.72 (0.58-0.89)0.0021721800.95 (0.77-1.17)0.63Individual ADb RA18270.67 (0.37-1.21)0.1816290.55 (0.30-1.01)0.06 PMR39570.69 (0.46-1.03)0.0746500.92 (0.61-1.37)0.67 AITD27181.50 (0.82-2.71)0.1917280.61 (0.33-1.12)0.11 Psoriasis20350.57 (0.33-0.99)0.0534211.62 (0.94-2.79)0.08aAnalyses from Cox regression models controlled for age, sex, race, and other (n-3 fatty acid or vitamin D) randomization group bConfirmed AD.Figure 1.Disclosure of InterestsKaren Costenbader Consultant of: Astra Zeneca, Glaxo Smith Kline, Neutrolis, Grant/research support from: Merck, Exagen, Gilead, Nancy Cook: None declared, I-min Lee: None declared, Jill Hahn: None declared, Joseph Walter: None declared, Vadim Bubes: None declared, Gregory Kotler: None declared, Nicole Yang: None declared, Sonia Friedman: None declared, Erik Alexander: None declared, JoAnn Manson: None declared.
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Hahn J, Hassan Virk H, Greason K, Al-Azza F, Krittanawong C. Outcomes of transctheter mitral valve repair in a large urban US health system. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Transcatheter mitral valve repair (TMVR) has become an important minimally invasive alternative to open surgical repair in patients with severe mitral regurgitation. As TMVR develops as an established practice, real-world outcome data is needed to guide clinical decision making as the body of literature on this topic is limited. In our study, we investigate TMVR outcomes in a large urban health system.
Methods
We retrospectively analyzed clinical data from the electronic health records of the extensive urban health system Mount Sinai Data Warehouse and analyzed all individuals who underwent TMVR. Baseline demographics were obtained as well as significant morbidity and mortality outcomes. Finally, multivariable analysis was used to determine associated characteristics with mortality.
Results
We identified 3533 patients who underwent TMVR from 2008 to 2018. The overall mortality was 3.7%. The most common comorbidities observed were heart failure (56%), pulmonary hypertension (26%), atrial fibrillation (26%) and CKD or ESRD (16%). After multivariable analyses, ischemic stroke (adjusted OR 3.46; 95% CI 1.93–5.97, p = <0.001), CKD or ESRD (3.95; 2.72–5.75, p 0.01), aortic stenosis (2.23; 1.12–4.15, p<0.001), and heart failure (8.18; 4.16–18.5, p<0.001) were independently associated with mortality.
Conclusion
In all patients who underwent TMVR at a large urban health system, ischemic stroke, aortic stenosis, heart failure, CKD and ESRD were independently associated with mortality. Future prospective studies will be needed to further define these observed associations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Hahn
- Baylor College of Medicine, Houston, United States of America
| | - H Hassan Virk
- University Hospitals Case Medical Center, Cleveland, United States of America
| | - K Greason
- Mayo Clinic, Rochester, United States of America
| | - F Al-Azza
- Mayo Clinic, Rochester, United States of America
| | - C Krittanawong
- Baylor College of Medicine, Houston, United States of America
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Chen TX, Pinharanda A, Steinemann NA, Yasuma-Mitobe K, Lee E, Hahn J, Wu L, Fanourakis S, Peterka DS, Hillman EMC. Evaluation of at-home methods for N95 filtering facepiece respirator decontamination. Sci Rep 2021; 11:19750. [PMID: 34611228 PMCID: PMC8492771 DOI: 10.1038/s41598-021-99129-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
N95 filtering facepiece respirators (FFRs) are essential for the protection of healthcare professionals and other high-risk groups against Coronavirus Disease of 2019 (COVID-19). In response to shortages in FFRs during the ongoing COVID-19 pandemic, the Food and Drug Administration issued an Emergency Use Authorization permitting FFR decontamination and reuse. However, although industrial decontamination services are available at some large institutions, FFR decontamination is not widely accessible. To be effective, FFR decontamination must (1) inactivate the virus; (2) preserve FFR integrity, specifically fit and filtering capability; and (3) be non-toxic and safe. Here we identify and test at-home heat-based methods for FFR decontamination that meet these requirements using common household appliances. Our results identify potential protocols for simple and accessible FFR decontamination, while also highlighting unsuitable methods that may jeopardize FFR integrity.
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Affiliation(s)
- T X Chen
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA
| | - A Pinharanda
- Department of Biological Sciences, Columbia University, New York, NY, 10027, USA
| | - N A Steinemann
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA
| | - K Yasuma-Mitobe
- Department of Microbiology and Immunology, Columbia University, New York, NY, 10032, USA
| | - E Lee
- Columbia College, Columbia University, New York, NY, 10032, USA
| | - J Hahn
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - L Wu
- Columbia College, Columbia University, New York, NY, 10032, USA
| | - S Fanourakis
- Environmental Health and Safety, Columbia University, New York, NY, 10032, USA
| | - D S Peterka
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA.
| | - E M C Hillman
- Mortimer B. Zuckerman Mind Brain Behavior Institute, New York, NY, 10027, USA.
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA.
- Department of Radiology, Columbia University, New York, NY, 10027, USA.
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Martin M, Greve J, Hoffmann TK, Hahn J. [Epistaxis Requiring Intervention After Swab for SARS-CoV-2]. Gesundheitswesen 2021; 84:27-30. [PMID: 34555854 DOI: 10.1055/a-1537-9562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Since May 2020, the first nasopharyngeal POC tests for SARS-CoV-2 diagnostic have been available. Due to the long passage through the nasal cavity, there is a risk of injury with subsequent epistaxis. METHODS We describe the course of disease of two female patients who suffered from massive epistaxis requiring intervention after an externally performed nasopharyngeal swab. RESULTS After nasal tamponade, one patient underwent clipping of the sphenopalatine artery under general anesthesia. The other patient suffered from nasal bleeding with hemorrhagic shock requiring transfusion. She was intubated and admitted to our hospital. CONCLUSION The nasopharyngeal swab for diagnosis of SARS-CoV-2 can lead to life-threatening complications in rare cases. Considering that daily more than 5 million corona tests are being carried out worldwide as part of the current pandemic, complications should not be neglected. It is necessary that the person performing the swab has a detailed understanding of the anatomy involved. Alternative test methods were further assessed with regard to their sensitivity. With regard to the future need for SARS-CoV-2 tests, alternative and lower-risk test procedures must be investigated and established.
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Affiliation(s)
- Melanie Martin
- Klinik für Hals-Nasen-Ohren-Heilkunde und Kopf-Hals-Chirurgie, University Ulm Medical Centre, Ulm, Deutschland
| | - Jens Greve
- Klinik für Hals-Nasen-Ohren-Heilkunde und Kopf-Hals-Chirurgie, University Ulm Medical Centre, Ulm, Deutschland
| | - Thomas K Hoffmann
- Klinik für Hals-Nasen-Ohren-Heilkunde und Kopf-Hals-Chirurgie, University Ulm Medical Centre, Ulm, Deutschland
| | - Janina Hahn
- Klinik für Hals-Nasen-Ohren-Heilkunde und Kopf-Hals-Chirurgie, University Ulm Medical Centre, Ulm, Deutschland
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Johnson FA, Wirth M, Zhu Z, Hahn J, Greve J, Ebert E, Strassen UG. Etiology and predictors of cluster attacks of hereditary angioedema that recur despite pharmaceutical treatment. Allergy Asthma Proc 2021; 42:317-324. [PMID: 34187623 DOI: 10.2500/aap.2021.42.210015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: Hereditary angioedema (HAE) is a disease that leads to recurrent swelling of the skin and mucous membranes, including the upper airway tract. Apart from being deadly, these attacks can be debilitating, which leads to a poor quality of life in patients. Clinicians are occasionally confronted with patients who have recurrent attacks despite treatment with C1 esterase inhibitor concentrate or β₂-receptor antagonists. The goal of this study was to investigate repeated attacks that occur 48 hours to 7 days ("cluster attacks") after treatment, to determine why they occur and the factors that may be associated with them, and thus to prevent their occurrence. Methods: We conducted a multicenter mixed retrospective-prospective study with data acquired from all documented attacks in our patients with collective (n = 132) between 2015 and 2018. Results: Eighty-five percent (n = 132) of our total patient collective (N = 156) agreed to participate in the study. Nine percent of these patients (n = 12) had cluster attacks, with a total of 48 cluster attacks. The data procured from the patients were mixed retrospective-prospective. Approximately 72% of all the cluster attacks were caused by exogenous stimuli (41% due to psychological stress, 29% due to physical stimuli, and 2% due to menstruation). Cluster attacks occurred in 7% of the patients who received prophylactic therapy in comparison with 12.5% of patients who received on-demand therapy. Cluster attacks comprised 48.4% of all the attacks that patients with cluster-attacks (n= 9) experienced. In addition, the patients who were underdosing their C1 esterase inhibitor treatment had cluster attacks more often. A lower "time to repeated attack" was seen in the patients who received on-demand therapy compared with those who received prophylactic therapy. Discussion: The percentage of the patients who had attacks as a result of exogenous triggers was higher in the cluster-attack group (70.5%) compared with the general HAE population (30-42%). Repeated attacks, therefore, were strongly associated with external triggers. The patients who received prophylactic treatment and who experienced cluster attacks were highly likely to have been underdosing, which may explain the repeated attacks despite treatment. In the patients prone to cluster attacks, prophylaxis should be considered.
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Affiliation(s)
- Felix. A. Johnson
- From the Department of Otorhinolaryngology, Technische Universität München, München, Germany; and
| | - Magdalena Wirth
- From the Department of Otorhinolaryngology, Technische Universität München, München, Germany; and
| | - Zhaojun Zhu
- From the Department of Otorhinolaryngology, Technische Universität München, München, Germany; and
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Eva Ebert
- From the Department of Otorhinolaryngology, Technische Universität München, München, Germany; and
| | - Ulrich G. Strassen
- From the Department of Otorhinolaryngology, Technische Universität München, München, Germany; and
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Abdalla H, Aharonian F, Ait Benkhali F, Angüner EO, Arcaro C, Armand C, Armstrong T, Ashkar H, Backes M, Baghmanyan V, Barbosa Martins V, Barnacka A, Barnard M, Becherini Y, Berge D, Bernlöhr K, Bi B, Bissaldi E, Böttcher M, Boisson C, Bolmont J, de Bony de Lavergne M, Breuhaus M, Brun F, Brun P, Bryan M, Büchele M, Bulik T, Bylund T, Caroff S, Carosi A, Casanova S, Chand T, Chandra S, Chen A, Cotter G, Curyło M, Damascene Mbarubucyeye J, Davids ID, Davies J, Deil C, Devin J, Dirson L, Djannati-Ataï A, Dmytriiev A, Donath A, Doroshenko V, Dreyer L, Duffy C, Dyks J, Egberts K, Eichhorn F, Einecke S, Emery G, Ernenwein JP, Feijen K, Fegan S, Fiasson A, Fichet de Clairfontaine G, Fontaine G, Funk S, Füßling M, Gabici S, Gallant YA, Giavitto G, Giunti L, Glawion D, Glicenstein JF, Grondin MH, Hahn J, Haupt M, Hermann G, Hinton JA, Hofmann W, Hoischen C, Holch TL, Holler M, Hörbe M, Horns D, Huber D, Jamrozy M, Jankowsky D, Jankowsky F, Jardin-Blicq A, Joshi V, Jung-Richardt I, Kasai E, Kastendieck MA, Katarzyński K, Katz U, Khangulyan D, Khélifi B, Klepser S, Kluźniak W, Komin N, Konno R, Kosack K, Kostunin D, Kreter M, Lamanna G, Lemière A, Lemoine-Goumard M, Lenain JP, Leuschner F, Levy C, Lohse T, Lypova I, Mackey J, Majumdar J, Malyshev D, Malyshev D, Marandon V, Marchegiani P, Marcowith A, Mares A, Martí-Devesa G, Marx R, Maurin G, Meintjes PJ, Meyer M, Mitchell A, Moderski R, Mohrmann L, Montanari A, Moore C, Morris P, Moulin E, Muller J, Murach T, Nakashima K, Nayerhoda A, de Naurois M, Ndiyavala H, Niemiec J, Oakes L, O'Brien P, Odaka H, Ohm S, Olivera-Nieto L, de Ona Wilhelmi E, Ostrowski M, Panny S, Panter M, Parsons RD, Peron G, Peyaud B, Piel Q, Pita S, Poireau V, Priyana Noel A, Prokhorov DA, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Raab S, Rauth R, Reichherzer P, Reimer A, Reimer O, Remy Q, Renaud M, Rieger F, Rinchiuso L, Romoli C, Rowell G, Rudak B, Ruiz-Velasco E, Sahakian V, Sailer S, Salzmann H, Sanchez DA, Santangelo A, Sasaki M, Scalici M, Schäfer J, Schüssler F, Schutte HM, Schwanke U, Seglar-Arroyo M, Senniappan M, Seyffert AS, Shafi N, Shapopi JNS, Shiningayamwe K, Simoni R, Sinha A, Sol H, Specovius A, Spencer S, Spir-Jacob M, Stawarz Ł, Sun L, Steenkamp R, Stegmann C, Steinmassl S, Steppa C, Takahashi T, Tam T, Tavernier T, Taylor AM, Terrier R, Thiersen JHE, Tiziani D, Tluczykont M, Tomankova L, Tsirou M, Tuffs R, Uchiyama Y, van der Walt DJ, van Eldik C, van Rensburg C, van Soelen B, Vasileiadis G, Veh J, Venter C, Vincent P, Vink J, Völk HJ, Wadiasingh Z, Wagner SJ, Watson J, Werner F, White R, Wierzcholska A, Wong YW, Yusafzai A, Zacharias M, Zanin R, Zargaryan D, Zdziarski AA, Zech A, Zhu SJ, Zorn J, Zouari S, Żywucka N, Evans P, Page K. Revealing x-ray and gamma ray temporal and spectral similarities in the GRB 190829A afterglow. Science 2021; 372:1081-1085. [PMID: 34083487 DOI: 10.1126/science.abe8560] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/07/2021] [Indexed: 11/02/2022]
Abstract
Gamma-ray bursts (GRBs), which are bright flashes of gamma rays from extragalactic sources followed by fading afterglow emission, are associated with stellar core collapse events. We report the detection of very-high-energy (VHE) gamma rays from the afterglow of GRB 190829A, between 4 and 56 hours after the trigger, using the High Energy Stereoscopic System (H.E.S.S.). The low luminosity and redshift of GRB 190829A reduce both internal and external absorption, allowing determination of its intrinsic energy spectrum. Between energies of 0.18 and 3.3 tera-electron volts, this spectrum is described by a power law with photon index of 2.07 ± 0.09, similar to the x-ray spectrum. The x-ray and VHE gamma-ray light curves also show similar decay profiles. These similar characteristics in the x-ray and gamma-ray bands challenge GRB afterglow emission scenarios.
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Affiliation(s)
| | - H Abdalla
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - F Aharonian
- Dublin Institute for Advanced Studies, Dublin 2, Ireland. .,Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.,High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), Yerevan 0051, Armenia
| | - F Ait Benkhali
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - E O Angüner
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - C Arcaro
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Armand
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - T Armstrong
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - H Ashkar
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Backes
- University of Namibia, Department of Physics, Windhoek 10005, Namibia.,Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - V Baghmanyan
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | | | - A Barnacka
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - M Barnard
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - Y Becherini
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - D Berge
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - B Bi
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - E Bissaldi
- Dipartimento Interateneo di Fisica, Politecnico di Bari, 70125 Bari, Italy.,Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125 Bari, Italy
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - J Bolmont
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - M de Bony de Lavergne
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - M Breuhaus
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - F Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - P Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Bryan
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - M Büchele
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - T Bulik
- Astronomical Observatory, The University of Warsaw, 00-478 Warsaw, Poland
| | - T Bylund
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - S Caroff
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Carosi
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - S Casanova
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.,Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - T Chand
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S Chandra
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Chen
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - G Cotter
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - M Curyło
- Astronomical Observatory, The University of Warsaw, 00-478 Warsaw, Poland
| | | | - I D Davids
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - J Davies
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - C Deil
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - J Devin
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - L Dirson
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - A Djannati-Ataï
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Dmytriiev
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Donath
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - V Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - L Dreyer
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Duffy
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - J Dyks
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - F Eichhorn
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - S Einecke
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - G Emery
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - J-P Ernenwein
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - K Feijen
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - S Fegan
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - A Fiasson
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - G Fichet de Clairfontaine
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - S Funk
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Füßling
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Gabici
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Y A Gallant
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - G Giavitto
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - L Giunti
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.,Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - D Glawion
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - J F Glicenstein
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M-H Grondin
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J Hahn
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - M Haupt
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - G Hermann
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - C Hoischen
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - T L Holch
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Hörbe
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - D Huber
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - D Jankowsky
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - A Jardin-Blicq
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - V Joshi
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - I Jung-Richardt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - E Kasai
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - M A Kastendieck
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - K Katarzyński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, 87-100 Torun, Poland
| | - U Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - D Khangulyan
- Department of Physics, Rikkyo University, Toshima-ku, Tokyo 171-8501, Japan.
| | - B Khélifi
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S Klepser
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - R Konno
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Kosack
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Kostunin
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - M Kreter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - G Lamanna
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Lemière
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - M Lemoine-Goumard
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J-P Lenain
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - F Leuschner
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - C Levy
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - I Lypova
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - J Mackey
- Dublin Institute for Advanced Studies, Dublin 2, Ireland
| | - J Majumdar
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - D Malyshev
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - V Marandon
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - P Marchegiani
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - A Mares
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - G Martí-Devesa
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - R Marx
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany.,Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - G Maurin
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - P J Meintjes
- Department of Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - M Meyer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Mitchell
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - L Mohrmann
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Montanari
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Moore
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - P Morris
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - E Moulin
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Muller
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - T Murach
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Nakashima
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Nayerhoda
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - M de Naurois
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - H Ndiyavala
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - J Niemiec
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - L Oakes
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - P O'Brien
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - H Odaka
- Department of Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - S Ohm
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - L Olivera-Nieto
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | | | - M Ostrowski
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - S Panny
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Panter
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R D Parsons
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - G Peron
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - B Peyaud
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Q Piel
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - S Pita
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - V Poireau
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Priyana Noel
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - D A Prokhorov
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - H Prokoph
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - M Punch
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden.,Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Quirrenbach
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - S Raab
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - R Rauth
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - P Reichherzer
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - Q Remy
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - F Rieger
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - L Rinchiuso
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Romoli
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.
| | - G Rowell
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - E Ruiz-Velasco
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.
| | - V Sahakian
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - S Sailer
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - H Salzmann
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - D A Sanchez
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - M Sasaki
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Scalici
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - J Schäfer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - F Schüssler
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.
| | - H M Schutte
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - M Seglar-Arroyo
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Senniappan
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - A S Seyffert
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - N Shafi
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - J N S Shapopi
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - K Shiningayamwe
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - R Simoni
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - A Sinha
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - H Sol
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Specovius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - S Spencer
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - M Spir-Jacob
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Ł Stawarz
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - L Sun
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - R Steenkamp
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - C Stegmann
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany.,Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Steinmassl
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - C Steppa
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe (World Premier International Research Center Initiative (WPI)), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Kashiwa, Chiba, 277-8583, Japan
| | - T Tam
- School of Physics and Astronomy, Sun Yat Sen University, Guangzhou 510275, People's Republic of China
| | - T Tavernier
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A M Taylor
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany.
| | - R Terrier
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - J H E Thiersen
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - D Tiziani
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Tluczykont
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - L Tomankova
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Tsirou
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R Tuffs
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - Y Uchiyama
- Department of Physics, Rikkyo University, Toshima-ku, Tokyo 171-8501, Japan
| | - D J van der Walt
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C van Eldik
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - C van Rensburg
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - B van Soelen
- Department of Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - G Vasileiadis
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - J Veh
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - C Venter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - P Vincent
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - J Vink
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - H J Völk
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - Z Wadiasingh
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S J Wagner
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - J Watson
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - F Werner
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R White
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - A Wierzcholska
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland.,Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - Yu Wun Wong
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Yusafzai
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Zacharias
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa.,Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - R Zanin
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - D Zargaryan
- Dublin Institute for Advanced Studies, Dublin 2, Ireland.,High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), Yerevan 0051, Armenia
| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - A Zech
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - S J Zhu
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany.
| | - J Zorn
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - S Zouari
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - N Żywucka
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - P Evans
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - K Page
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
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Hahn J, Barth I, Wigand MC, Mayer B, Hoffmann TK, Greve J. The Surgical Treatment of Peritonsillar Abscess: A Retrospective Analysis in 584 Patients. Laryngoscope 2021; 131:2706-2712. [PMID: 34111309 DOI: 10.1002/lary.29677] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/10/2021] [Accepted: 05/28/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES There are three surgical treatment options for patients with peritonsillar abscess (PTA): needle aspiration, incision and drainage (ID), and abscess tonsillectomy (ATE). The updated German national guideline (2015) included changes in the treatment of PTA. The indication for tonsillectomy (TE) in patients became more stringent and preference was given to ID in certain cases. STUDY DESIGN Retrospective analysis. METHODS We performed a retrospective systematic analysis of patient data using the in-house electronic patient records and considered a 4-year period from 2014 to 2017. About 584 patients were identified. Our aim was to analyze the influence of the updated guideline on clinical practice. RESULTS 236 of 584 patients (40.4%) underwent ATE with contralateral TE. In 225 patients (38.5%), unilateral ATE was performed. Mean surgery time was significantly shortened when only unilateral ATE was performed. Concerning postoperative bleeding, we noted a tendency toward a lower incidence after ATE in comparison to ATE with contralateral TE. Less than 1% of patients who underwent ATE had to be revised surgically due to postoperative hemorrhage. After the revision of the guideline, unilateral ATE and ID were conducted more frequently. CONCLUSION These results support that ATE in an inpatient setting is a considerably safe and effective primary therapeutic option. ID represents a favorable treatment option for patients with PTA and comorbidities, nevertheless, patient compliance is required and insufficient drainage or recurrence of PTA may occur. The revision of the guideline had a significant impact on the choice of interventions (P < .001), which is reflected by the increased number of unilateral ATE. LEVEL OF EVIDENCE IV Laryngoscope, 2021.
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Affiliation(s)
- Janina Hahn
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Ina Barth
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Marlene C Wigand
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Krittanawong C, Narasimhan B, Hahn J, Wang Z, Johnson K, Tang W, Baber U, Amos C. A genome-wide association study identifies novel genetic loci associated with pulmonary embolism. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary embolism (PE) is a life-threatening cardiovascular condition. Studies showed that PE patients were associated with disorders of lipid metabolism and had higher triglyceride and lower HDL-C levels compared with healthy. We conducted the genome-wide association study to identify novel loci contributing to PE.
Methods
We conducted a large-scale GWAS of PE in 5,466 PE cases and 461,219 controls of European ancestry from the UK Biobank (466,685 participants total). We used genome-wide summary statistics to test for enrichment of functional annotations using ENRICHR. Example pathways included in Enrichr for testing include membership of genes in pathway databases such as the Kyoto Encyclopedia of Genes and Genomes (KEGG), Wikipathway, PANTHER, BioCarta or NCI-Nature pathways. We analyzed the pathways using combined score and p-values which were well validated by comparing to several methods. For pathway analyses, we considered a nominal P-value threshold of 0.05.
Results
We identified genome-wide significant genetic associations in 63 independent genetic loci for PE (P<5.0x10–7). Our findings for top pathways highlight that lipid metabolism (LIPC, LCAT, NPC2), caffeine metabolism (NAT2), and sudden cardiac death (ABCG8) related genetic loci play an important role in PE alongside genes already associated with coagulation-thrombosis pathway (VWF, THPO, PTPN11, INPP5D, UROS, HMBS) (all p-values p-values <0.05).
Conclusion
Our findings uncovered unexpected novel factors of PE etiology, suggesting novel mechanistic concepts of PE pathophysiology.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Krittanawong
- Baylor College of Medicine, Houston, United States of America
| | - B Narasimhan
- Mount Sinai School of Medicine, New York, United States of America
| | - J Hahn
- Baylor College of Medicine, Houston, United States of America
| | - Z Wang
- Mayo Clinic, Rochester, United States of America
| | - K Johnson
- Mount Sinai School of Medicine, New York, United States of America
| | - W Tang
- Baylor College of Medicine, Houston, United States of America
| | - U Baber
- Mount Sinai School of Medicine, New York, United States of America
| | - C Amos
- Baylor College of Medicine, Houston, United States of America
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20
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Scheithauer M, Hahn J, Wigand MC. [Surgery of the Nasal Septum]. Laryngorhinootologie 2020; 99:733-740. [PMID: 32987416 DOI: 10.1055/a-1021-2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Dimension, position and stability of the cartilaginous nasal septum are crucial for successful surgery of the nasal septum. The objective of septoplasty is to create sufficient space in the anterior parts of the nose, particularly in the region of the nasal valves. Therefore, the cartilaginous nasal septum should obtain a state of "balanced tension". Essential steps of septoplasty include the hemitransfixion incision, the dissection of subperichondrial/subperiosteal tunnels, the mobilization via chondrotomy/osteotomy, the resection of cartilage/bone, the replantation of extracorporeally straightened material/reconstruction of the caudal nasal septum, closure by suture and fixation with nasal splints. Firmness of the caudal nasal septum is essential for sustainable septal surgery. It ensures the stability of the entire cartilaginous nose over decades.
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Abstract
Until the 1990s, radical sinus surgery was considered a standard procedure for maxillary sinus diseases, but it is no longer favored due to the high morbidity. Today, functional endoscopic sinus surgery (FESS) is considered the gold standard in sinus surgery. Modifications of surgical approaches also allow access to regions of the maxillary sinus that were previously difficult to reach. Depending on anatomy and pathology, different methods for widening the maxillary ostium can be selected. In type I sinusotomy, the natural ostium is widened dorsally by a maximum of 1 cm. Sinusotomy type II involves widening the natural ostium up to a maximum diameter of 2 cm. In sinusotomy type III, the natural ostium is widened dorsally to the posterior wall of the maxillary sinus and caudally to the base of the inferior turbinate. Beside the prelacrimal approach, more invasive approaches are the medial maxillectomy, in which the dorsal part of the inferior turbinate and the adjacent medial wall of the maxillary sinus is resected, as well as its modifications "mega antrostomy" and "extended maxillary antrostomy." Correct selection of the size of the maxillary sinus window is prerequisite for successful treatment and long-term postoperative success. Isolated purulent maxillary sinusitis can usually be treated by a type I sinusotomy. Sinusotomy type II addresses nasal polyps with involvement of the mucosa of the ostium, recurrent stenosis after previous surgery, chronic maxillary sinusitis due to cystic fibrosis, and purulent maxillary sinusitis with involvement of other adjacent sinuses. Sinusotomy type III is required for choanal polyps with attachment to the floor of the maxillary sinus, for extensive polyposis and fungal sinusitis, and for inverted papilloma. Particularly for (recurrent) disease and extensive interventions in the maxillary sinus, medial maxillectomy or a modification thereof may be required.
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Affiliation(s)
- F Sommer
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
| | - T Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Lindemann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Hahn
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - M-N Theodoraki
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
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Hahn J, Trainotti S, Wigand M, Schuler P, Hoffmann T, Greve J. Prospective Analysis in Patients With HAE Under Prophylaxis With Lanadelumab: A Real-life Experience. J Drugs Dermatol 2020; 19:978-983. [DOI: 10.36849/jdd.2020.5269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Schenker N, van der Schalk H, Bohné M, Hahn J, Waddell D, Moschner A, Alexy H, Willems S, Kivelitz D, Bahlmann E. Hirninfarkt als Erstsymptom – seltene kardiogene Ursache. Med Klin Intensivmed Notfmed 2020; 115:343-347. [DOI: 10.1007/s00063-020-00666-3] [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] [Received: 10/01/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/24/2022]
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Hahn J, Appel H, Scheithauer MO, Petereit F, Greve J, Lindemann J, Hoffmann TK, Veit JA, Sommer F. Symptom Control of Patients With Chronic Rhinosinusitis With Nasal Polyps Under Maintenance Therapy With Daily Acetylsalicylic Acid. Am J Rhinol Allergy 2020; 34:554-563. [PMID: 32208749 DOI: 10.1177/1945892420912362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Nonsteroidal anti-inflammatory drugs (NSAID)-exacerbated respiratory disease (NERD) is defined by intolerance to cyclooxygenase 1 inhibitors, chronic rhinosinusitis with recurrent nasal polyps, and/or intrinsic bronchial asthma. Long-term administration of acetylsalicylic acid (ASA) after desensitization has been used to mitigate these sequelae, but the optimal dose and balancing symptom relief and side effects remain unsettled. METHODS Retrospective data analysis of 85 patients with NERD receiving maintenance therapy of 300 mg ASA was followed by questionnaires (our own, not validated and the Sino-Nasal Outcome Test-20). We received responses from 55 patients and examined 30 of them clinically. RESULTS Patients with no ASA-associated side effects were 56.4% (56 of 85 patients) of the cohort. In this study, 60% (33 of 55 patients) continued prophylaxis of 300 mg ASA daily for an average of 34.7 months. Elective surgery was the most frequent cause of discontinuation of ASA (21.8%; 12 of 55 patients). Rhinomanometry values were significantly improved with ASA (P < .05; Wilcoxon), but there was no significant reduction in nasal polyposis or improvement in olfaction at the time of follow-up examination. CONCLUSIONS Minor clinical improvements were identified. Side effects were well tolerated by most patients, and no serious sequelae occurred. The indications for long-term ASA therapy in NERD patients remain unsettled.
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Affiliation(s)
- Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Heike Appel
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Marc O Scheithauer
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Florian Petereit
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jörg Lindemann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Johannes A Veit
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Mannheim, Mannheim, Germany
| | - Fabian Sommer
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Hahn J, Nordmann-Kleiner M, Bönner C, Kojda G, Hoffmann TK, Greve J. The Influence of ACE Inhibition on C1-Inhibitor: A Biomarker for ACE Inhibitor-Induced Angioedema? Biomed Hub 2020; 4:1-9. [PMID: 31993426 PMCID: PMC6985889 DOI: 10.1159/000499075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/03/2019] [Indexed: 11/24/2022] Open
Abstract
Aims Angioedema is a rare side effect of angiotensin-converting enzyme (ACE) inhibitors. It remains unclear why it is only induced in a few patients taking ACE inhibitors, often after a long period of uneventful treatment. The aim of this study was to analyze the influence of ACE inhibitor treatment on C1-inhibitor (C1-INH) levels. Methods Captopril (5 mg/25 mg) was added to blood samples of 5 healthy subjects. C1-INH levels were measured before and after incubation for 180 min. The second section of the study was done with 17 patients who received therapy with an ACE inhibitor for the first time. C1-INH levels were measured before ACE inhibitor treatment, 24 h after first drug administration, and 4 weeks later. Results After incubation of blood samples with 5 mg captopril, there was no detectable change in C1-INH levels. After incubation with 25 mg, C1-INH activity was decreased by an average of 29% and the C1-INH concentration was decreased by an average of 0.06 g/L. In the second study section, inconsistent effects on C1-INH levels were detected. In the majority of patients, 24 h after the first ACE inhibitor administration C1-INH activity was tending to be increased. Conclusions A dose-dependent effect on C1-INH levels in captopril-incubated blood samples of healthy test persons was shown. In patients with new ACE inhibitor treatment, heterogeneous reactions of C1-INH values were detected. Larger studies are needed over a longer period of time to find correlations between the effect of ACE inhibitor therapy on C1-INH levels and the clinical course/development of side effects.
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Affiliation(s)
- Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Melanie Nordmann-Kleiner
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Christoph Bönner
- Department of Cardiology, Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Georg Kojda
- Institute of Pharmacology and Clinical Pharmacology, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Gholamreza-Fahimi E, Bisha M, Hahn J, Straßen U, Krybus M, Khosravani F, Hoffmann TK, Hohlfeld T, Greve J, Bas M, Twarock S, Kojda G. Cyclooxygenase activity in bradykinin-induced dermal extravasation. A study in mice and humans. Biomed Pharmacother 2019; 123:109797. [PMID: 31874445 DOI: 10.1016/j.biopha.2019.109797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Non-allergic angioedema is largely driven by increased plasma levels of bradykinin and over-activation of bradykinin receptor type II (B2), but the specific downstream signalling pathways remain unclear. The aim of this study was to identify signal transduction events involved in bradykinin-induced dermal extravasation. METHODS Quantification of dermal extravasation was accomplished following intradermal (i.d.) injection of bradykinin or the B2 agonist labradimil in mice with endothelial NO-synthase (eNOS) deficiency and in C57BL/6J mice pre-treated with vehicle, NO-synthase or cyclooxygenase (COX) inhibitors. In the multicentre clinical study ABRASE, 38 healthy volunteers received i.d. bradykinin injections into the ventral forearm before and after oral treatment with the COX inhibitor ibuprofen (600 mg). The primary endpoint of ABRASE was the mean time to complete resolution of wheals (TTCR) and the secondary endpoint was the change of maximal wheal size. RESULTS Neither NOS inhibitors nor eNOS deficiency altered bradykinin-induced extravasation. In striking contrast, the COX inhibitors ibuprofen, diclofenac, SC560 and celecoxib significantly diminished this extravasation when given before injection. As for diclofenac, a similar but significantly lower effect was observed when given after i.d. injection of bradykinin. Similar results were obtained when bradykinin was replaced by labradimil. In volunteers, ibuprofen significantly reduced TTCR (P < 0.001) and maximal wheal size (P = 0.0044). CONCLUSION These data suggest that COX activity contributes to bradykinin-induced dermal extravasation in mice and humans. In addition, our findings may open new treatment options and point to a potential activity of drugs interfering with the release of the COX substrate arachidonic acid, e.g. glucocorticoids.
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Affiliation(s)
- Ehsan Gholamreza-Fahimi
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Marion Bisha
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Janina Hahn
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Ulrich Straßen
- Otorhinolaryngology Department, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Michael Krybus
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Farbod Khosravani
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany; Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany; Otorhinolaryngology Department, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Thomas Hohlfeld
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Jens Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Murat Bas
- Otorhinolaryngology Department, University Hospital Rechts der Isar, Munich Technical University, Munich, Germany
| | - Sören Twarock
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Georg Kojda
- Institute of Pharmacology andClinical Pharmacology, University Hospital, Heinrich Heine University, Düsseldorf, Germany.
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Pfaue A, Schuler PJ, Mayer B, Hoffmann TK, Greve J, Hahn J. Clinical features of angioedema induced by renin-angiotensin-aldosterone system inhibition: a retrospective analysis of 84 patients. J Community Hosp Intern Med Perspect 2019; 9:453-459. [PMID: 32002148 PMCID: PMC6968333 DOI: 10.1080/20009666.2019.1698259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/08/2019] [Indexed: 01/09/2023] Open
Abstract
Background and objectives: Bradykinin-mediated angioedema (AE) induced by antihypertensive drugs primarily affect the head and neck region and may occur even after several years of uneventful treatment. Many facts about the clinical course remain unknown. Diagnosis is not easy, as the clinical appearance resembles allergic AE. No specific diagnostic markers are known and no officially approved treatment is currently available. Methods: All patients who presented to the ORL department between 2010 and 2016 with acute AE were included. Those with a history of renin-angiotensin-aldosterone system (RAAS) blocker intake were defined as RAE and their pathophysiological characteristics and clinical course of the disease were analyzed. Results: A total of 84 patients (median age of 71 years) with RAE was identified. The majority (80%) was on ACE inhibition. The oral cavity was most often affected. Nearly 60% were medicated for more than 1 year before AE occurred. RAE occurred more often during the morning hours. The necessity for emergency intubation and/or tracheostomy was nine times higher in patients with acute RAE compared to patients with AE due to other reasons. Conclusions: Event-free, long-term therapy with an RAAS blocker before the first development of edema does not exclude RAE. RAE is associated with an increased risk for emergency airway management. Abbreviations ACE: Angiotensin Converting Enzyme; ACEi AE: ACE inhibitor-induced angioedema; AE: Angioedema; ARB: Angiotensin II receptor 1 blocker; C1 INH: C1 Inhibitor; CI: Confidence Interval; CRP: C-reactive protein; DPP IV: Dipeptidyl peptidase IV; ENT: Ear, Nose and Throat; HAE: Hereditary Angioedema; ICD 10: International Statistical Classification of Diseases and Related Health Problems, 10th Edition; OR: Odds Ratio; ORL: Otorhinolaryngology; RAAS: Renin-Angiotensin-Aldosterone System; RAE: RAAS-blocker-induced angioedema
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Affiliation(s)
- Anja Pfaue
- Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany
| | - Patrick J Schuler
- Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany
| | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Thomas K Hoffmann
- Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany
| | - Jens Greve
- Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany
| | - Janina Hahn
- Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany
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Kempe S, Fois G, Brunner C, Hoffmann TK, Hahn J, Greve J. Bradykinin signaling regulates solute permeability and cellular junction organization in lymphatic endothelial cells. Microcirculation 2019; 27:e12592. [PMID: 31550055 DOI: 10.1111/micc.12592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Determine the effect of bradykinin on solute permeability and cellular junctional proteins in human dermis microvascular endothelial cells. METHODS Cells were characterized by immunofluorescence and fluorescence-activated cell sorting. Macromolecular transport of dextran and albumin was monitored. Junctional protein expression and phosphorylation were determined by immunoblot analyses. Intracellular calcium and cAMP levels were evaluated. Target gene expression at mRNA and protein levels was determined. RESULTS Human dermis microvascular endothelial cells comprised 97% lymphatic endothelial cells. Bradykinin increased the permeability to dextran in a concentration-dependent manner, while reduced the permeability to albumin. Bradykinin treatment down-regulated VE-cadherin expression and affected its phosphorylation status at Tyr731. It also down-regulated claudin-5 expression at the transcriptional level through bradykinin-2-receptor signaling. An increase in the intracellular calcium levels and a reduction in the cAMP concentration were associated effects. Finally, bradykinin induced the up-regulation of vascular endothelial growth factor-C protein which was found increased in BK-induced human dermis microvascular endothelial cells culture supernates. CONCLUSIONS Human dermis microvascular endothelial cells represent a model of lymphatic endothelial cells, in which bradykinin-2-receptor is expressed. Bradykinin-induced bradykinin-2-receptor signaling through intracellular calcium mobilization and reduction in cAMP levels, triggered changes in solute permeability and cellular junction expression. It further up-regulated vascular endothelial growth factors-C protein expression, which is a key modulator of lymphatic vessels function and lymphangiogenesis.
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Affiliation(s)
- Sybille Kempe
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Giorgio Fois
- Institute of General Physiology, Ulm University, Ulm, Germany
| | - Cornelia Brunner
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Janina Hahn
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Heudobler D, Schulz C, Fischer J, Staib P, Wehler T, Südhoff T, Schichtl T, Wilke J, Hahn J, Lüke F, Vogelhuber M, Klobuch S, Pukrop T, Herr W, Held S, Beckers K, Bouche G, Reichle A. Pioglitazone and clarithromycin combined with metronomic low-dose chemotherapy versus nivolumab in patients with advanced non-small cell lung cancer treated in 2nd-line and beyond: Outcomes from a randomized phase II trial (ModuLung). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hahn J, Nordmann-Kleiner M, Trainotti S, Hoffmann TK, Greve J. Successful Long-Term Prophylactic Treatment With Subcutaneous C1 Esterase Inhibitor in a Patient With Hereditary Angioedema. J Pharm Pract 2019; 33:907-911. [PMID: 31234699 DOI: 10.1177/0897190019857407] [Citation(s) in RCA: 2] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hereditary angioedema (HAE) patients suffer from recurrent swellings. Current standard therapy consists of C1 esterase inhibitor (C1-INH) and bradykinin receptor B2 antagonists. Severe courses require prophylactic treatment. For such patients, it has been demonstrated that the intravenous (IV) administration of C1-INH [C1-INH(IV)] is safe and effective. A new prophylactic option is subcutaneous (SC) treatment with C1-INH. METHODS AND CASE We present the case of an HAE patient placed on prophylactic C1-INH(IV) therapy due to frequent attacks when managed with on-demand therapy. An implanted port allowed the periodical and safe application of medication until the device was explanted due to an infection. Due to the poor venous access, repeated IV application failed. Therefore, we began a SC treatment with 1500 IU C1-INH [C1-INH(SC)] as long-term prophylaxis and analyzed the clinical course over 16 months. RESULTS Under the SC prophylaxis, the number of attacks were reduced to 1/month in comparison to 4.33/month with no prophylactic treatment and 1.83/month with C1-INH(IV). No severe attacks and no attack within the upper airway occurred over the 16 months of C1-INH(SC) treatment. As a result, quality of life improved, as measured by the Angioedema quality of life questionaire (AE-QoL). CONCLUSION Self-administered SC prophylactic use of C1-INH over a period of 16 months seems to be a well tolerated and efficient. The patient's quality of life improved, and by learning self-application, the patient gained independence.
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Affiliation(s)
- Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, 27197University Medical Center Ulm, Ulm, Germany
| | - Melanie Nordmann-Kleiner
- Department of Otorhinolaryngology, Head and Neck Surgery, 27197University Medical Center Ulm, Ulm, Germany
| | - Susanne Trainotti
- Department of Otorhinolaryngology, Head and Neck Surgery, 27197University Medical Center Ulm, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, 27197University Medical Center Ulm, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, 27197University Medical Center Ulm, Ulm, Germany
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Hahn J, Hoess A, Friedrich DT, Mayer B, Schauf L, Hoffmann TK, Greve J. Unnötige abdominelle Eingriffe bei Patienten mit hereditärem Angioödem. J Dtsch Dermatol Ges 2018; 16:1443-1450. [PMID: 30537315 DOI: 10.1111/ddg.13698_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/15/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Janina Hahn
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Germany (Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Deutschland)
| | - Alisa Hoess
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Germany (Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Deutschland)
| | - Daniel Thomas Friedrich
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Germany (Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Deutschland)
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry, Ulm University, Germany (Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm)
| | - Lucia Schauf
- HAE Support Group Organization, Germany (HAE-Vereinigung e.V., Deutschland)
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Germany (Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Deutschland)
| | - Jens Greve
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Ulm University Medical Center, Germany (Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Deutschland)
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Hahn J, Nordmann-Kleiner M, Hoffmann TK, Greve J. Thrombosis of the internal jugular vein in the ENT-department - Prevalence, causes and therapy: A retrospective analysis. Auris Nasus Larynx 2018; 46:624-629. [PMID: 30545728 DOI: 10.1016/j.anl.2018.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/03/2018] [Accepted: 11/15/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Less than 5% of deep vein thrombosis is due to thrombosis of the internal jugular vein. Genetic, malignant or inflammatory underlying diseases as well as insertion of venous catheters can be responsible for this pathology. Due to its rare occurrence, it is difficult to find systematic research about thrombosis of the internal jugular vein. METHODS We performed a systematic analysis of present patient data from our ENT department with the electronic patient record considering the period from 2012-2017. Search terms were "thrombosis" and "jugular internal vein". We identified 41 patients with the requested diagnosis and performed further analysis of the cases. Internal jugular vein thrombosis was diagnosed in all patients using Duplex sonography and/or CT/MR angiography. RESULTS Paraneoplastic thrombosis was found in 22/41 patients (54%), in 15 of the 22 (68%), the tumor was located in the ENT region. Two out of seven (29%) of the patients with tumor entities outside the head and neck region had thrombosis of the internal jugular vein as the first symptom of the disease. Another 14/41 patients (34%) had underlying inflammatory diseases - mostly streptococci-associated - for example a cervical abscess. In two patients, insertion of a central-venous catheter was causal, in three patients we could not find any reason for the development of thrombosis. CONCLUSION To diagnose the rare and often asymptomatic thrombosis of the internal jugular vein, ultrasound of the cervical region should always include vascular imaging. Thrombosis of the internal jugular vein results mostly paraneoplastic or due to inflammation/abscess. It can be the first symptom of a malignant primary disease and always requires detailed diagnostic clarification. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Janina Hahn
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany.
| | - Melanie Nordmann-Kleiner
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Jens Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
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Hahn J, Hoess A, Friedrich DT, Mayer B, Schauf L, Hoffmann TK, Greve J. Unnecessary abdominal interventions in patients with hereditary angioedema. J Dtsch Dermatol Ges 2018; 16:1443-1449. [DOI: 10.1111/ddg.13698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Janina Hahn
- Department of Oto‐Rhino‐Laryngology Head and Neck Surgery Ulm University Medical Center Germany
| | - Alisa Hoess
- Department of Oto‐Rhino‐Laryngology Head and Neck Surgery Ulm University Medical Center Germany
| | - Daniel Thomas Friedrich
- Department of Oto‐Rhino‐Laryngology Head and Neck Surgery Ulm University Medical Center Germany
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry Ulm University Germany
| | - Lucia Schauf
- HAE Vereinigung e.V. (HAE Support Group Organization) Germany
| | - Thomas K. Hoffmann
- Department of Oto‐Rhino‐Laryngology Head and Neck Surgery Ulm University Medical Center Germany
| | - Jens Greve
- Department of Oto‐Rhino‐Laryngology Head and Neck Surgery Ulm University Medical Center Germany
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Sterns H, Hahn J, Schafer D, Maiden R. ACCREDITING THE FIRST GERONTOLOGY DEGREE PROGRAMS: PROCEDURES REFINED AND LESSONS LEARNED. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - J Hahn
- Western Michigan University
| | - D Schafer
- National Ass. for Professional Gerontologists
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Hahn J, Bock B, Muth CM, Pfaue A, Friedrich D, Hoffmann TK, Greve J. [The ulm emergency algorithm for the acute treatment of drug-induced, bradykinin-mediated angioedema]. Med Klin Intensivmed Notfmed 2018; 114:708-716. [PMID: 30232503 DOI: 10.1007/s00063-018-0483-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/16/2018] [Accepted: 08/05/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bradykinin-mediated, drug-induced edema like ACE-inhibitor-induced angioedema (ACEi AE) is almost exclusively located in the head and neck region and is potentially life threatening. To date, there are no guidelines or officially-approved treatments available for this pathology. OBJECTIVES We sought to provide a structured therapeutic algorithm for the acute treatment of drug-induced bradykinin-mediated angioedema. MATERIALS AND METHODS We analyzed data (especially the course of disease and therapy) of all patients with acute angioedema, who presented to the Department of Otorhinolaryngology, Head and Neck Surgery at the University of Ulm (2010-2015). We also conducted a literature review on PubMed with the terms "acute angioedema", "angioedema emergency", "ACE angioedema", "bradykinin angioedema" and "angioedema therapy". Other fundamental references were the recent German guidelines "hereditary angioedema", "anaphylaxis" and "airway management". RESULTS An emergency algorithm was generated as a flowchart for the acute therapy of bradykinin-mediated drug-induced angioedema was generated. We focused on the decision criteria for intubation/airway management and pharmacological therapy: antihistamines and glucocorticoids versus anti-bradykinin treatment. Furthermore, recommendations for inpatient monitoring have been derived. CONCLUSION/DISCUSSION To date, therapy of drug-induced bradykinin-mediated angioedema is performed according to an "off-label" use and without officially-approved guidelines. The presented emergency algorithm provides a first approach for a structured therapeutic concept for a potentially life-threatening pathology.
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Affiliation(s)
- J Hahn
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
| | - B Bock
- Klinik für Anästhesiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - C-M Muth
- Klinik für Anästhesiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - A Pfaue
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - D Friedrich
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - T K Hoffmann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Greve
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
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Abdallah H, Abramowski A, Aharonian F, Ait Benkhali F, Angüner EO, Arakawa M, Arrieta M, Aubert P, Backes M, Balzer A, Barnard M, Becherini Y, Becker Tjus J, Berge D, Bernhard S, Bernlöhr K, Blackwell R, Böttcher M, Boisson C, Bolmont J, Bonnefoy S, Bordas P, Bregeon J, Brun F, Brun P, Bryan M, Büchele M, Bulik T, Capasso M, Caroff S, Carosi A, Carr J, Casanova S, Cerruti M, Chakraborty N, Chaves RCG, Chen A, Chevalier J, Colafrancesco S, Condon B, Conrad J, Davids ID, Decock J, Deil C, Devin J, deWilt P, Dirson L, Djannati-Ataï A, Domainko W, Donath A, Drury LO, Dutson K, Dyks J, Edwards T, Egberts K, Eger P, Emery G, Ernenwein JP, Eschbach S, Farnier C, Fegan S, Fernandes MV, Fiasson A, Fontaine G, Förster A, Funk S, Füßling M, Gabici S, Gallant YA, Garrigoux T, Gaté F, Giavitto G, Giebels B, Glawion D, Glicenstein JF, Gottschall D, Grondin MH, Hahn J, Haupt M, Hawkes J, Heinzelmann G, Henri G, Hermann G, Hinton JA, Hofmann W, Hoischen C, Holch TL, Holler M, Horns D, Ivascenko A, Iwasaki H, Jacholkowska A, Jamrozy M, Janiak M, Jankowsky D, Jankowsky F, Jingo M, Jouvin L, Jung-Richardt I, Kastendieck MA, Katarzyński K, Katsuragawa M, Katz U, Kerszberg D, Khangulyan D, Khélifi B, King J, Klepser S, Klochkov D, Kluźniak W, Komin N, Kosack K, Krakau S, Kraus M, Krüger PP, Laffon H, Lamanna G, Lau J, Lees JP, Lefaucheur J, Lemière A, Lemoine-Goumard M, Lenain JP, Leser E, Liu R, Lohse T, Lorentz M, López-Coto R, Lypova I, Malyshev D, Marandon V, Marcowith A, Mariaud C, Marx R, Maurin G, Maxted N, Mayer M, Meintjes PJ, Meyer M, Mitchell AMW, Moderski R, Mohamed M, Mohrmann L, Morå K, Moulin E, Murach T, Nakashima S, de Naurois M, Ndiyavala H, Niederwanger F, Niemiec J, Oakes L, O'Brien P, Odaka H, Ohm S, Ostrowski M, Oya I, Padovani M, Panter M, Parsons RD, Pekeur NW, Pelletier G, Perennes C, Petrucci PO, Peyaud B, Piel Q, Pita S, Poireau V, Poon H, Prokhorov D, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Raab S, Rauth R, Reimer A, Reimer O, Renaud M, de Los Reyes R, Rieger F, Rinchiuso L, Romoli C, Rowell G, Rudak B, Rulten CB, Sahakian V, Saito S, Sanchez DA, Santangelo A, Sasaki M, Schandri M, Schlickeiser R, Schüssler F, Schulz A, Schwanke U, Schwemmer S, Seglar-Arroyo M, Settimo M, Seyffert AS, Shafi N, Shilon I, Shiningayamwe K, Simoni R, Sol H, Spanier F, Spir-Jacob M, Stawarz Ł, Steenkamp R, Stegmann C, Steppa C, Sushch I, Takahashi T, Tavernet JP, Tavernier T, Taylor AM, Terrier R, Tibaldo L, Tiziani D, Tluczykont M, Trichard C, Tsirou M, Tsuji N, Tuffs R, Uchiyama Y, van der Walt J, van Eldik C, van Rensburg C, van Soelen B, Vasileiadis G, Veh J, Venter C, Viana A, Vincent P, Vink J, Voisin F, Völk HJ, Vuillaume T, Wadiasingh Z, Wagner SJ, Wagner P, Wagner RM, White R, Wierzcholska A, Willmann P, Wörnlein A, Wouters D, Yang R, Zaborov D, Zacharias M, Zanin R, Zdziarski AA, Zech A, Zefi F, Ziegler A, Zorn J, Żywucka N. Search for γ-Ray Line Signals from Dark Matter Annihilations in the Inner Galactic Halo from 10 Years of Observations with H.E.S.S. Phys Rev Lett 2018; 120:201101. [PMID: 29864326 DOI: 10.1103/physrevlett.120.201101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/05/2018] [Indexed: 06/08/2023]
Abstract
Spectral lines are among the most powerful signatures for dark matter (DM) annihilation searches in very-high-energy γ rays. The central region of the Milky Way halo is one of the most promising targets given its large amount of DM and proximity to Earth. We report on a search for a monoenergetic spectral line from self-annihilations of DM particles in the energy range from 300 GeV to 70 TeV using a two-dimensional maximum likelihood method taking advantage of both the spectral and spatial features of the signal versus background. The analysis makes use of Galactic center observations accumulated over ten years (2004-2014) with the H.E.S.S. array of ground-based Cherenkov telescopes. No significant γ-ray excess above the background is found. We derive upper limits on the annihilation cross section ⟨σv⟩ for monoenergetic DM lines at the level of 4×10^{-28} cm^{3} s^{-1} at 1 TeV, assuming an Einasto DM profile for the Milky Way halo. For a DM mass of 1 TeV, they improve over the previous ones by a factor of 6. The present constraints are the strongest obtained so far for DM particles in the mass range 300 GeV-70 TeV. Ground-based γ-ray observations have reached sufficient sensitivity to explore relevant velocity-averaged cross sections for DM annihilation into two γ-ray photons at the level expected from the thermal relic density for TeV DM particles.
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Affiliation(s)
- H Abdallah
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Abramowski
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - F Aharonian
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
- National Academy of Sciences of the Republic of Armenia, Marshall Baghramian Avenue, 24, 0019 Yerevan, Armenia
| | - F Ait Benkhali
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - E O Angüner
- Instytut Fizyki Jądrowej PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - M Arakawa
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima-ku, Tokyo 171-8501, Japan
| | - M Arrieta
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - P Aubert
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - M Backes
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek, Namibia
| | - A Balzer
- GRAPPA, Anton Pannekoek Institute for Astronomy and Institute of High-Energy Physics, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - M Barnard
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - Y Becherini
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - J Becker Tjus
- Institut für Theoretische Physik, Lehrstuhl IV: Weltraum und Astrophysik, Ruhr-Universität Bochum, D 44780 Bochum, Germany
| | - D Berge
- GRAPPA, Anton Pannekoek Institute for Astronomy and Institute of High-Energy Physics, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - S Bernhard
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R Blackwell
- School of Chemistry and Physics, University of Adelaide, Adelaide 5005, Australia
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - J Bolmont
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | | | - P Bordas
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J Bregeon
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - F Brun
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - P Brun
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Bryan
- GRAPPA, Anton Pannekoek Institute for Astronomy and Institute of High-Energy Physics, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - M Büchele
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - T Bulik
- Astronomical Observatory, The University of Warsaw, Al. Ujazdowskie 4, 00-478 Warsaw, Poland
| | - M Capasso
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - S Caroff
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - A Carosi
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - J Carr
- Aix Marseille Université, CNRS/IN2P3, CPPM UMR 7346, 13288 Marseille, France
| | - S Casanova
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- Instytut Fizyki Jądrowej PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - M Cerruti
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | - N Chakraborty
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R C G Chaves
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - A Chen
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - J Chevalier
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - S Colafrancesco
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - B Condon
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J Conrad
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
| | - I D Davids
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek, Namibia
| | - J Decock
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Deil
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J Devin
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - P deWilt
- School of Chemistry and Physics, University of Adelaide, Adelaide 5005, Australia
| | - L Dirson
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - A Djannati-Ataï
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - W Domainko
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Donath
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - L O'C Drury
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
| | - K Dutson
- Department of Physics and Astronomy, The University of Leicester, University Road, Leicester LE1 7RH, United Kingdom
| | - J Dyks
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - T Edwards
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - P Eger
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - G Emery
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | - J-P Ernenwein
- Aix Marseille Université, CNRS/IN2P3, CPPM UMR 7346, 13288 Marseille, France
| | - S Eschbach
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - C Farnier
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
| | - S Fegan
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - M V Fernandes
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - A Fiasson
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - A Förster
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - S Funk
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | | | - S Gabici
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - Y A Gallant
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - T Garrigoux
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - F Gaté
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | | | - B Giebels
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - D Glawion
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - J F Glicenstein
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Gottschall
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M-H Grondin
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J Hahn
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - M Haupt
- DESY, D-15738 Zeuthen, Germany
| | - J Hawkes
- School of Chemistry and Physics, University of Adelaide, Adelaide 5005, Australia
| | - G Heinzelmann
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - G Henri
- Université Grenoble Alpes, CNRS, IPAG, F-38000 Grenoble, France
| | - G Hermann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - C Hoischen
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - T L Holch
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - A Ivascenko
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - H Iwasaki
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima-ku, Tokyo 171-8501, Japan
| | - A Jacholkowska
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ul. Orla 171, 30-244 Kraków, Poland
| | - M Janiak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - D Jankowsky
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - M Jingo
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - L Jouvin
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - I Jung-Richardt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - M A Kastendieck
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - K Katarzyński
- Centre for Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Grudziadzka 5, 87-100 Toruń, Poland
| | - M Katsuragawa
- Japan Aeropspace Exploration Agency (JAXA), Institute of Space and Astronautical Science (ISAS), 3-1-1 Yoshinodai, Chuo-ku, Sagamihara, Kanagawa 229-8510, Japan
| | - U Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - D Kerszberg
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | - D Khangulyan
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima-ku, Tokyo 171-8501, Japan
| | - B Khélifi
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - J King
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | | | - D Klochkov
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - K Kosack
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Krakau
- Institut für Theoretische Physik, Lehrstuhl IV: Weltraum und Astrophysik, Ruhr-Universität Bochum, D 44780 Bochum, Germany
| | - M Kraus
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - P P Krüger
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - H Laffon
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - G Lamanna
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - J Lau
- School of Chemistry and Physics, University of Adelaide, Adelaide 5005, Australia
| | - J-P Lees
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - J Lefaucheur
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - A Lemière
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - M Lemoine-Goumard
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J-P Lenain
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | - E Leser
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - R Liu
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - M Lorentz
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - R López-Coto
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | | | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - V Marandon
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - C Mariaud
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - R Marx
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - G Maurin
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - N Maxted
- School of Chemistry and Physics, University of Adelaide, Adelaide 5005, Australia
| | - M Mayer
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - P J Meintjes
- Department of Physics, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - M Meyer
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
| | - A M W Mitchell
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - M Mohamed
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - L Mohrmann
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Strasse 1, D 91058 Erlangen, Germany
| | - K Morå
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
| | - E Moulin
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | | | - S Nakashima
- Japan Aeropspace Exploration Agency (JAXA), Institute of Space and Astronautical Science (ISAS), 3-1-1 Yoshinodai, Chuo-ku, Sagamihara, Kanagawa 229-8510, Japan
| | - M de Naurois
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - H Ndiyavala
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| | - F Niederwanger
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - J Niemiec
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| | - L Oakes
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| | - P O'Brien
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| | - H Odaka
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| | - S Ohm
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| | - M Ostrowski
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| | - I Oya
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| | - M Padovani
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - M Panter
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| | - R D Parsons
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| | - N W Pekeur
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - G Pelletier
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| | - C Perennes
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252 Paris Cedex 5, France
| | - P-O Petrucci
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| | - B Peyaud
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| | - Q Piel
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| | - S Pita
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| | - V Poireau
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| | - H Poon
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| | - D Prokhorov
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| | - H Prokoph
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| | - M Punch
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| | - A Quirrenbach
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| | - S Raab
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| | - R Rauth
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| | - A Reimer
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| | - O Reimer
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| | - M Renaud
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| | - R de Los Reyes
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| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - C B Rulten
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| | - V Sahakian
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| | - S Saito
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| | - D A Sanchez
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| | - A Santangelo
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| | - M Sasaki
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| | - M Schandri
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| | - R Schlickeiser
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| | - F Schüssler
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| | | | - U Schwanke
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| | - M Seglar-Arroyo
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| | - M Settimo
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| | - A S Seyffert
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - N Shafi
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - I Shilon
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| | - M Spir-Jacob
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| | - C Steppa
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| | - T Takahashi
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| | - J-P Tavernet
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| | - T Tavernier
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | | | - R Terrier
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - L Tibaldo
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| | - D Tiziani
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| | - M Tluczykont
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| | - C Trichard
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| | - M Tsirou
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| | - N Tsuji
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| | - C van Eldik
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| | - C van Rensburg
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| | - B van Soelen
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| | - G Vasileiadis
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| | - J Veh
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| | - C Venter
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| | - A Viana
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| | - P Vincent
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| | - J Vink
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| | - H J Völk
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| | - T Vuillaume
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| | - Z Wadiasingh
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| | - S J Wagner
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| | - P Wagner
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - R M Wagner
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| | - R White
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| | - A Wierzcholska
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| | - A Wörnlein
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| | - D Wouters
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| | - D Zaborov
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| | - M Zacharias
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| | - R Zanin
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| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - A Zech
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| | - F Zefi
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| | - A Ziegler
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| | - J Zorn
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| | - N Żywucka
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ul. Orla 171, 30-244 Kraków, Poland
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Abeysekara AU, Albert A, Alfaro R, Alvarez C, Álvarez JD, Arceo R, Arteaga-Velázquez JC, Avila Rojas D, Ayala Solares HA, Barber AS, Bautista-Elivar N, Becerril A, Belmont-Moreno E, BenZvi SY, Berley D, Bernal A, Braun J, Brisbois C, Caballero-Mora KS, Capistrán T, Carramiñana A, Casanova S, Castillo M, Cotti U, Cotzomi J, Coutiño de León S, De León C, De la Fuente E, Dingus BL, DuVernois MA, Díaz-Vélez JC, Ellsworth RW, Engel K, Enríquez-Rivera O, Fiorino DW, Fraija N, García-González JA, Garfias F, Gerhardt M, González Muñoz A, González MM, Goodman JA, Hampel-Arias Z, Harding JP, Hernández S, Hernández-Almada A, Hinton J, Hona B, Hui CM, Hüntemeyer P, Iriarte A, Jardin-Blicq A, Joshi V, Kaufmann S, Kieda D, Lara A, Lauer RJ, Lee WH, Lennarz D, Vargas HL, Linnemann JT, Longinotti AL, Luis Raya G, Luna-García R, López-Coto R, Malone K, Marinelli SS, Martinez O, Martinez-Castellanos I, Martínez-Castro J, Martínez-Huerta H, Matthews JA, Miranda-Romagnoli P, Moreno E, Mostafá M, Nellen L, Newbold M, Nisa MU, Noriega-Papaqui R, Pelayo R, Pretz J, Pérez-Pérez EG, Ren Z, Rho CD, Rivière C, Rosa-González D, Rosenberg M, Ruiz-Velasco E, Salazar H, Salesa Greus F, Sandoval A, Schneider M, Schoorlemmer H, Sinnis G, Smith AJ, Springer RW, Surajbali P, Taboada I, Tibolla O, Tollefson K, Torres I, Ukwatta TN, Vianello G, Weisgarber T, Westerhoff S, Wisher IG, Wood J, Yapici T, Yodh G, Younk PW, Zepeda A, Zhou H, Guo F, Hahn J, Li H, Zhang H. Extended gamma-ray sources around pulsars constrain the origin of the positron flux at Earth. Science 2018; 358:911-914. [PMID: 29146808 DOI: 10.1126/science.aan4880] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/09/2017] [Indexed: 11/02/2022]
Abstract
The unexpectedly high flux of cosmic-ray positrons detected at Earth may originate from nearby astrophysical sources, dark matter, or unknown processes of cosmic-ray secondary production. We report the detection, using the High-Altitude Water Cherenkov Observatory (HAWC), of extended tera-electron volt gamma-ray emission coincident with the locations of two nearby middle-aged pulsars (Geminga and PSR B0656+14). The HAWC observations demonstrate that these pulsars are indeed local sources of accelerated leptons, but the measured tera-electron volt emission profile constrains the diffusion of particles away from these sources to be much slower than previously assumed. We demonstrate that the leptons emitted by these objects are therefore unlikely to be the origin of the excess positrons, which may have a more exotic origin.
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Affiliation(s)
- A U Abeysekara
- Department of Physics and Astronomy, University of Utah, Salt Lake City, UT, USA
| | - A Albert
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - R Alfaro
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - C Alvarez
- Universidad Autónoma de Chiapas, Tuxtla Gutiérrez, Chiapas, Mexico
| | - J D Álvarez
- Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - R Arceo
- Universidad Autónoma de Chiapas, Tuxtla Gutiérrez, Chiapas, Mexico
| | | | - D Avila Rojas
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - H A Ayala Solares
- Department of Physics, Michigan Technological University, Houghton, MI, USA
| | - A S Barber
- Department of Physics and Astronomy, University of Utah, Salt Lake City, UT, USA
| | | | - A Becerril
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - E Belmont-Moreno
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - S Y BenZvi
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, USA
| | - D Berley
- Department of Physics, University of Maryland, College Park, MD, USA
| | - A Bernal
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J Braun
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - C Brisbois
- Department of Physics, Michigan Technological University, Houghton, MI, USA
| | | | - T Capistrán
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, Mexico
| | - A Carramiñana
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, Mexico
| | - S Casanova
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland.,Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - M Castillo
- Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - U Cotti
- Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - J Cotzomi
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - S Coutiño de León
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, Mexico
| | - C De León
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - E De la Fuente
- Departamento de Física, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Guadalajara, Mexico
| | - B L Dingus
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - M A DuVernois
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - J C Díaz-Vélez
- Departamento de Física, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Guadalajara, Mexico
| | - R W Ellsworth
- School of Physics, Astronomy, and Computational Sciences, George Mason University, Fairfax, VA, USA
| | - K Engel
- Department of Physics, University of Maryland, College Park, MD, USA
| | - O Enríquez-Rivera
- Instituto de Geofísica, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - D W Fiorino
- Department of Physics, University of Maryland, College Park, MD, USA
| | - N Fraija
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J A García-González
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - F Garfias
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - M Gerhardt
- Department of Physics, Michigan Technological University, Houghton, MI, USA
| | - A González Muñoz
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - M M González
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J A Goodman
- Department of Physics, University of Maryland, College Park, MD, USA
| | - Z Hampel-Arias
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - J P Harding
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - S Hernández
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - A Hernández-Almada
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J Hinton
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - B Hona
- Department of Physics, Michigan Technological University, Houghton, MI, USA
| | - C M Hui
- Astrophysics Office, NASA Marshall Space Flight Center Huntsville, AL, USA
| | - P Hüntemeyer
- Department of Physics, Michigan Technological University, Houghton, MI, USA
| | - A Iriarte
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - A Jardin-Blicq
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - V Joshi
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - S Kaufmann
- Universidad Autónoma de Chiapas, Tuxtla Gutiérrez, Chiapas, Mexico
| | - D Kieda
- Department of Physics and Astronomy, University of Utah, Salt Lake City, UT, USA
| | - A Lara
- Instituto de Geofísica, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - R J Lauer
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, NM, USA
| | - W H Lee
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - D Lennarz
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, GA, USA
| | - H León Vargas
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - J T Linnemann
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI, USA
| | - A L Longinotti
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, Mexico
| | - G Luis Raya
- Universidad Politecnica de Pachuca, Pachuca, Hidalgo, Mexico
| | - R Luna-García
- Centro de Investigación en Computación, Instituto Politécnico Nacional, Mexico City, Mexico
| | - R López-Coto
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany.
| | - K Malone
- Department of Physics, Pennsylvania State University, University Park, PA, USA
| | - S S Marinelli
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI, USA
| | - O Martinez
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - J Martínez-Castro
- Centro de Investigación en Computación, Instituto Politécnico Nacional, Mexico City, Mexico
| | - H Martínez-Huerta
- Physics Department, Centro de Investigacion y de Estudios Avanzados del IPN, Mexico City, Mexico
| | - J A Matthews
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, NM, USA
| | | | - E Moreno
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - M Mostafá
- Department of Physics, Pennsylvania State University, University Park, PA, USA
| | - L Nellen
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - M Newbold
- Department of Physics and Astronomy, University of Utah, Salt Lake City, UT, USA
| | - M U Nisa
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, USA
| | | | - R Pelayo
- Centro de Investigación en Computación, Instituto Politécnico Nacional, Mexico City, Mexico
| | - J Pretz
- Department of Physics, Pennsylvania State University, University Park, PA, USA
| | - E G Pérez-Pérez
- Universidad Politecnica de Pachuca, Pachuca, Hidalgo, Mexico
| | - Z Ren
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, NM, USA
| | - C D Rho
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, USA
| | - C Rivière
- Department of Physics, University of Maryland, College Park, MD, USA
| | - D Rosa-González
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, Mexico
| | - M Rosenberg
- Department of Physics, Pennsylvania State University, University Park, PA, USA
| | - E Ruiz-Velasco
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - H Salazar
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - F Salesa Greus
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland.
| | - A Sandoval
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - M Schneider
- Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - H Schoorlemmer
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - G Sinnis
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - A J Smith
- Department of Physics, University of Maryland, College Park, MD, USA
| | - R W Springer
- Department of Physics and Astronomy, University of Utah, Salt Lake City, UT, USA
| | - P Surajbali
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - I Taboada
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, GA, USA
| | - O Tibolla
- Universidad Autónoma de Chiapas, Tuxtla Gutiérrez, Chiapas, Mexico
| | - K Tollefson
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI, USA
| | - I Torres
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Puebla, Mexico
| | - T N Ukwatta
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - G Vianello
- Hansen Experimental Physics Laboratory Stanford University, Stanford, CA, USA
| | - T Weisgarber
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - S Westerhoff
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - I G Wisher
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - J Wood
- Department of Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - T Yapici
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI, USA
| | - G Yodh
- Department of Physics and Astronomy, University of California, Irvine, Irvine, CA, USA
| | - P W Younk
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - A Zepeda
- Physics Department, Centro de Investigacion y de Estudios Avanzados del IPN, Mexico City, Mexico.,Universidad Autónoma de Chiapas, Tuxtla Gutiérrez, Chiapas, Mexico
| | - H Zhou
- Los Alamos National Laboratory, Los Alamos, NM, USA.
| | - F Guo
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J Hahn
- Max-Planck Institute for Nuclear Physics, Heidelberg, Germany
| | - H Li
- Los Alamos National Laboratory, Los Alamos, NM, USA
| | - H Zhang
- Los Alamos National Laboratory, Los Alamos, NM, USA
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Greve J, Hahn J. Recombinant human C1 esterase inhibitor for hereditary angio-oedema. Lancet 2017; 390:1566-1567. [PMID: 28754495 DOI: 10.1016/s0140-6736(17)31966-9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Jens Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm D-89075 Germany.
| | - Janina Hahn
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm D-89075 Germany
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Hahn J, Choi JH, Chang MJ. Pharmacokinetic changes of antibiotic, antiviral, antituberculosis and antifungal agents during extracorporeal membrane oxygenation in critically ill adult patients. J Clin Pharm Ther 2017; 42:661-671. [PMID: 28948652 DOI: 10.1111/jcpt.12636] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 09/07/2017] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Extracorporeal membrane oxygenation (ECMO) is a life-saving system used for critically ill patients with cardiac and/or respiratory failure. The pharmacokinetics (PK) of drugs can change in patients undergoing ECMO, which can result in therapeutic failure or drug toxicity requiring further management of drug complications. In this review, we discussed changes in the PK of antibiotic, antiviral, antituberculosis and antifungal agents administered to adult patients on ECMO. These drugs are crucial for managing infections, which commonly occur during ECMO. METHODS A literature search was conducted using the PubMed and EMBASE databases with the following keywords: "extracorporeal membrane oxygenation OR extracorporeal membrane oxygenations OR ECMO" and "PK OR pharmacokinetics OR pharmacokinetic*" and "anti infective* OR antibiotic* OR antiviral* OR antituberculosis OR antifungal*." RESULTS AND DISCUSSION Generally, the volume of distribution (Vd) increases and drug clearance (CL) and elimination decrease during ECMO. Highly significant changes in drug PK can occur by interactions with the ECMO device itself, drug characteristics, pathological changes and patient characteristics. This may affect the blood concentrations of drugs, which influence the success of therapy. The PK of vancomycin, piperacillin-tazobactam, meropenem, azithromycin, amikacin and caspofungin did not change significantly in adult patients receiving ECMO. However, there were significant changes in the PK of imipenem, oseltamivir, rifampicin and voriconazole. The trough concentrations of imipenem were highly variable; oseltamivir had a decreased CL and increased Vd, and rifampicin concentrations were below therapeutic levels, even when a higher-than-standard dose was used in patients treated with ECMO. Additionally, voriconazole exhibited high mean peak concentrations during ECMO. WHAT IS NEW AND CONCLUSION The impact of ECMO on PK varies among drugs in adult patients, and there is no consistent correlation between the effects observed in adult and infant studies. This review suggested that doses of imipenem, oseltamivir, rifampicin and voriconazole should be adjusted and therapeutic drug monitoring is needed when ECMO is used in adult patients. In the future, large PK trials in adults on ECMO are needed to provide optimal dosing guidelines. A PK/PD modelling approach will be useful for determining the precise impact of ECMO and other factors that contribute to PK changes for each drug. Finally, it is important to develop dosing guidelines based on PK/PD modelling studies that can be used in clinical practice.
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Affiliation(s)
- J Hahn
- Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University, Incheon, Korea
| | - J H Choi
- Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University, Incheon, Korea
| | - M J Chang
- Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University, Incheon, Korea.,Department of Pharmaceutical Medicine and Regulatory Science, College of Medicine and Pharmacy, Yonsei University, Incheon, Korea
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Hahn J, Hoffmann TK, Bock B, Nordmann-Kleiner M, Trainotti S, Greve J. Angioedema. Dtsch Arztebl Int 2017; 114:489-496. [PMID: 28818177 DOI: 10.3238/arztebl.2017.0489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 12/13/2016] [Accepted: 04/24/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Acute angioedema of the upper airways can be life-threatening. An important distinction is drawn between mast-cell-mediated angioedema and bradykinin-mediated angioedema; the treatment of these two entities is fundamentally different. METHODS This review is based on pertinent articles retrieved by a selective search in PubMed and on guidelines concerning the treatment of angioedema. The authors draw on their own clinical experience in their assessment of the literature. RESULTS In the emergency clinical situation, the most important information comes from accompanying manifestations such as itching and urticaria and from the patient's drug history and family history. When angioedema affects the head and neck, securing the upper airways is the highest priority. Angioedema is most commonly caused by mast-cell mediators, such as histamine. This type of angioedema is sometimes accompanied by urticaria and can be effectively treated with antihistamines or glucocorticoids. In case of a severe allergic reaction or anaphylaxis, epinephrine is given intramuscularly in a dose that is adapted to the patient's weight (150 μg for body weight >10 kg, 300 μg for body weight >30 kg). Bradykinin-mediated angioedema may arise as either a hereditary or an acquired tendency. Acquired angioedema can be caused by angiotensin converting enzyme (ACE) inhibitors and by angiotensin II receptor blockers. Bradykinin-mediated angioedema should be treated specifically with C1-esterase inhibitor concentrates or bradykinin-2 receptor antagonists. CONCLUSION Angioedema of the upper airways requires a well-coordinated diagnostic and therapeutic approach. Steroids and antihistamines are very effective against mast-cell-mediated angioedema, but nearly useless against bradykinin-mediated angioedema. For angioedema induced by ACE inhibitors, no causally directed treatment has yet been approved.
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Affiliation(s)
- Janina Hahn
- Department of Otorhinolaryngology, Ulm University Hospital; Department of Anaesthesiology, Ulm University Hospital
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Schmaier AH, Cicardi M, Reshef A, Moldovan D, Mócsai A, López-Trascasa M, Lera AL, Brown NJ, Germenis AE, Filippelli-Silva R, Duarte DA, Martin RP, Veronez CL, Bouvier M, Bader M, Costa-Neto CM, Pesquero JB, Charest-Morin X, Marceau F, Rivard GÉ, Bonnefoy A, Wagner É, Debreczeni ML, Németh Z, Kajdácsi E, Schwaner E, Cervenak L, Oroszlán G, Szilágyi A, Dani R, Závodszky P, Gál P, Dobó J, Hébert J, Vincent M, Boursiquot JN, Chapdeleine H, Desjardins M, Laramée B, Gagnon R, Payette N, Lepeshkina O, Charignon D, Ghannam A, Ponard D, Drouet C, Joseph K, Tholanikunnel BG, Sexton DJ, Kaplan AP, Loffredo S, Bova M, Ferrara AL, Petraroli A, Suffritti C, Veszeli N, Zanichelli A, Farkas H, Marone G, Luyasu S, Favier B, Martin L, Kőhalmi KV, Temesszentandrási G, Várnai K, Varga L, Zuraw BL, Feussner A, Tortorici MA, Pawaskar D, Li HH, Anderson J, Bernstein JA, Zhang Y, Pragst I, Aygören-Pürsün E, Jacobson K, Christensen J, Van Leerberghe A, Wang Y, Schranz J, Martinez-Saguer I, Soteres D, Steiner U, Panovska VG, Rae W, Aberer W, Huissoon A, Bygum A, Magerl M, Graff J, Longhurst H, Lleonart R, Fang L, Cornpropst M, Clemons D, Mathis A, Collis P, Dobo S, Sheridan WP, Maurer M, Riedl MA, Craig T, Banerji A, Shennak M, Yang W, Baptista J, Busse P, Kalfus I, McDonald A, Qian S, Roberts A, Panousis C, Green T, Gille A, Zamanakou M, Loules G, Csuka D, Psarros F, Parsopoulou F, Speletas M, Firinu D, De Pasquale TMA, Zoli A, Radice A, Pizzimenti S, Manoussakis E, Konstantinou GN, Bafunno V, Montinaro V, Cancian M, Margaglione M, Bork K, Wulff K, Witzke G, Hardt J, Bouillet L, Caballero T, Grumach AS, Pommie C, Andresen I, Ettingshausen CE, Gutowski Z, Andritschke K, Linde R, Andrási N, Szilágyi T, Leibovich-Nassi I, Symons C, Dempster J, Boccon-Gibod I, Pagnier A, Lehmann A, Kreiberg KB, Nieto SA, Martins R, Martins R, Menendez A, Valle SOR, Olivares M, Hernandez-Landeros ME, Nievas E, Fili N, Barrera OM, Bailleau R, Gallardo-Olivos AM, Grau M, Rodriguez-Galindo J, Carabantes MJO, Zapata-Venegas E, Alfonso MM, Rosario-Grauert M, Ratti M, Vaszquez D, Josviack D, Landivar-Salinas LF, Calderón-Llosa OME, Campilay-Sarmiento R, Raby P, Fabiani J, Lumry WR, Feuersenger H, Watson DJ, Machnig T, Lamacchia D, Hernanz A, Alvez A, Lluncor M, Pedrosa M, Cabañas R, Prior N, Nordenfelt P, Nilsson M, Lindfors A, Wahlgren CF, Björkander J, Hakl R, Kuklínek P, Krčmová I, Hanzlíková J, Vachová M, Zachová R, Sobotková M, Strenková J, Litzman J, Palasopoulou M, Tsinti G, Gianni P, Kompoti M, Garrido S, Dyga W, Bogdali A, Obtułowicz A, Tomasz M, Czarnobilska E, Obtulowicz K, Książek T, Koncz A, Gulyás D, Staevska M, Jesenak M, Hrubiskova K, Bellizzi L, Relan A, Wu MA, Castelli A, Colombo R, Podda G, Del Medico M, Catena E, Casella F, Perego F, Afifi NA, Tobaldini E, Montano N, Sánchez-Jareño M, Stobiecki M, Obtułowicz K, Guryanova I, Polyakova E, Lebedz V, Salivonchik A, Aleshkevich S, Belevtsev M, Nordmann-Kleiner M, Trainotti S, Hahn J, Greve J, Zabrodska L, Alonso MLO, Tórtora RP, França AT, Ribeiro MG, Fu L, Kanani A, Lacuesta G, Waserman S, Betschel S, Espinosa MI, Contreras FA, Hrubisko M, Vavrova L, Banovcin P, Ayazi M, Fazlollahi MR, Saghafi S, Mohammadian S, Deshiry SN, Bidad K, Shoormasti RS, Mohammadzadeh I, Bemanian MH, Mahdaviani SA, Pourpak Z, Valerieva A, Vasileva M, Velikova T, Petkova E, Dimitrov V, Di Maulo R, Somech R, Golander H, Sifuentes EJ, Mansard C, Gompel A, Floccard B, Blanchard-Delaunay C, Launay D, Fain O, Sobel A, Gayet S, Amarger S, Armengol G, Ollivier Y, Zélinsky-Gurung A, Jeandel PY, Kanny G, Coppéré B, Dubrel M, Pelletier F, Du Thanh A, Trouiller S, Laurent J, De Moreuil C, Pajot CA, Belot A, Rodríguez A, Roa D, Prieto A, Baeza ML, Krusheva B, Almeida SKA, Constantino-Silva RN, Melo N, Simoes JA, Palma SMU, da Silva J, de Azevedo BF, Mansour E, González-Quevedo T, Marcos C, Lobera T, de San Pedro BS, Avilla E, Badiou J, Binkley K, Borici-Mazi R, Howlett L, Keith PK, Rowe A, Waite P, Billebeau A, Boccon-Gibbod I, Lis K, Laitman Y, Friedman E, Gokmen NM, Gulbahar O, Onay H, Koc ZP, Sin AZ. Abstracts from the 10th C1-inhibitor deficiency workshop. Allergy Asthma Clin Immunol 2017. [PMCID: PMC5496025 DOI: 10.1186/s13223-017-0198-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hahn J, Trainotti S, Hoffmann TK, Greve J. Drug-Induced Inhibition of Angiotensin Converting Enzyme and Dipeptidyl Peptidase 4 Results in Nearly Therapy Resistant Bradykinin Induced Angioedema: A Case Report. Am J Case Rep 2017; 18:576-579. [PMID: 28539578 PMCID: PMC5453401 DOI: 10.12659/ajcr.901960] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bradykinin is an underestimated mediator of angioedema. One subgroup of bradykinin induced angioedema is angioedema triggered by treatment with angiotensin converting enzyme (ACE) inhibitors. Due to its localization in the head and neck region and its unpredictable course, it is a possibly life-threatening condition. There is not an officially approved treatment for ACE inhibitor induced angioedema. CASE REPORT We present a case of an 83-year-old woman, who presented to our ENT department because of acute swelling of the tongue. On admission, there was no pharyngeal or laryngeal edema and no dyspnea. Treatment with glucocorticoids and antihistamines had no response. The patient had ramipril as regular medication, so we assumed ACE inhibitor induced angioedema and treated consequently with C1-inhibitor (human) 1,500 IU. Nevertheless, swelling was progressive and required intubation. Even after the second specific treatment with icatibant, her angioedema subsided extremely slowly. The patient also had regular treatment with saxagliptin, a dipeptidyl peptidase 4 inhibitor, so we assumed that the simultaneous inhibition of two bradykinin degrading enzymes led to a treatment-refractory course of angioedema. CONCLUSIONS General awareness for bradykinin induced angioedema due to regular medication is limited. Our case demonstrated the importance of improving awareness and knowledge about this side effect. We need a better understanding of the pathomechanism to aid in more precise clinical diagnosis. Securing the patient's airway as well as administration of an officially approved therapy is of utmost importance. As the number of patients simultaneously treated with antihypertensive and antidiabetic drugs is likely to increase, the incidence of bradykinin mediated drug induced angioedema is likely to increase as well.
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Affiliation(s)
- Janina Hahn
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm-Michelsberg, Germany
| | - Susanne Trainotti
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm-Michelsberg, Germany
| | - Thomas K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm-Michelsberg, Germany
| | - Jens Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm-Michelsberg, Germany
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Hahn J, Friebe-Hoffmann U, Bischof F. [Unilateral Supraclavicular Swelling during Pregnancy]. Laryngorhinootologie 2017; 96:312-313. [PMID: 28437808 DOI: 10.1055/s-0043-105795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Al-Naamani A, Meyer A, Jawad K, Fischer J, Siegemund A, Siegemund T, Oberbach A, Hahn J, Lehmann S, Mohr F, Garbade J. Antiphospholipid Syndrome in Patients with Left Ventricular Assist Device. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Fischer J, Meyer A, Jawad K, Addas A, Zoric M, Lehmann S, Hahn J, Mohr F, Garbade J. Blood Pressure Measurement in Patients with a HeartMate 3. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jansson K, Hahn J, Sommer W, Avsar M, Salman J, Siemeni T, Knoefel AK, Pauksch L, Haverich A, Warnecke G. Delayed Non-Myeloablative Irradiation to Induce Allograft Acceptance in a Large Animal Lung Transplantation Model. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598929] [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)
- K. Jansson
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - J. Hahn
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - W. Sommer
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - M. Avsar
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - J. Salman
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - T. Siemeni
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - A.-K. Knoefel
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - L. Pauksch
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - A. Haverich
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - G. Warnecke
- Department of Cardiothoracic-, Vascular- and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany
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Gaidzik VI, Teleanu V, Papaemmanuil E, Weber D, Paschka P, Hahn J, Wallrabenstein T, Kolbinger B, Köhne CH, Horst HA, Brossart P, Held G, Kündgen A, Ringhoffer M, Götze K, Rummel M, Gerstung M, Campbell P, Kraus JM, Kestler HA, Thol F, Heuser M, Schlegelberger B, Ganser A, Bullinger L, Schlenk RF, Döhner K, Döhner H. RUNX1 mutations in acute myeloid leukemia are associated with distinct clinico-pathologic and genetic features. Leukemia 2016; 30:2282. [PMID: 27804971 DOI: 10.1038/leu.2016.207] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abdalla H, Abramowski A, Aharonian F, Ait Benkhali F, Akhperjanian AG, Andersson T, Angüner EO, Arrieta M, Aubert P, Backes M, Balzer A, Barnard M, Becherini Y, Becker Tjus J, Berge D, Bernhard S, Bernlöhr K, Birsin E, Blackwell R, Böttcher M, Boisson C, Bolmont J, Bordas P, Bregeon J, Brun F, Brun P, Bryan M, Bulik T, Capasso M, Carr J, Casanova S, Chakraborty N, Chalme-Calvet R, Chaves RCG, Chen A, Chevalier J, Chrétien M, Colafrancesco S, Cologna G, Condon B, Conrad J, Couturier C, Cui Y, Davids ID, Degrange B, Deil C, Devin J, deWilt P, Djannati-Ataï A, Domainko W, Donath A, Drury LO, Dubus G, Dutson K, Dyks J, Dyrda M, Edwards T, Egberts K, Eger P, Ernenwein JP, Eschbach S, Farnier C, Fegan S, Fernandes MV, Fiasson A, Fontaine G, Förster A, Funk S, Füßling M, Gabici S, Gajdus M, Gallant YA, Garrigoux T, Giavitto G, Giebels B, Glicenstein JF, Gottschall D, Goyal A, Grondin MH, Grudzińska M, Hadasch D, Hahn J, Hawkes J, Heinzelmann G, Henri G, Hermann G, Hervet O, Hillert A, Hinton JA, Hofmann W, Hoischen C, Holler M, Horns D, Ivascenko A, Jacholkowska A, Jamrozy M, Janiak M, Jankowsky D, Jankowsky F, Jingo M, Jogler T, Jouvin L, Jung-Richardt I, Kastendieck MA, Katarzyński K, Katz U, Kerszberg D, Khélifi B, Kieffer M, King J, Klepser S, Klochkov D, Kluźniak W, Kolitzus D, Komin N, Kosack K, Krakau S, Kraus M, Krayzel F, Krüger PP, Laffon H, Lamanna G, Lau J, Lees JP, Lefaucheur J, Lefranc V, Lemière A, Lemoine-Goumard M, Lenain JP, Leser E, Liu R, Lohse T, Lorentz M, Lypova I, Marandon V, Marcowith A, Mariaud C, Marx R, Maurin G, Maxted N, Mayer M, Meintjes PJ, Meyer M, Mitchell AMW, Moderski R, Mohamed M, Morå K, Moulin E, Murach T, de Naurois M, Niederwanger F, Niemiec J, Oakes L, O'Brien P, Odaka H, Ohm S, Ostrowski M, Öttl S, Oya I, Padovani M, Panter M, Parsons RD, Paz Arribas M, Pekeur NW, Pelletier G, Perennes C, Petrucci PO, Peyaud B, Pita S, Poon H, Prokhorov D, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Raab S, Reimer A, Reimer O, Renaud M, de Los Reyes R, Rieger F, Romoli C, Rosier-Lees S, Rowell G, Rudak B, Rulten CB, Sahakian V, Salek D, Sanchez DA, Santangelo A, Sasaki M, Schlickeiser R, Schüssler F, Schulz A, Schwanke U, Schwemmer S, Settimo M, Seyffert AS, Shafi N, Shilon I, Simoni R, Sol H, Spanier F, Spengler G, Spies F, Stawarz Ł, Steenkamp R, Stegmann C, Stinzing F, Stycz K, Sushch I, Tavernet JP, Tavernier T, Taylor AM, Terrier R, Tibaldo L, Tluczykont M, Trichard C, Tuffs R, van der Walt J, van Eldik C, van Soelen B, Vasileiadis G, Veh J, Venter C, Viana A, Vincent P, Vink J, Voisin F, Völk HJ, Vuillaume T, Wadiasingh Z, Wagner SJ, Wagner P, Wagner RM, White R, Wierzcholska A, Willmann P, Wörnlein A, Wouters D, Yang R, Zabalza V, Zaborov D, Zacharias M, Zdziarski AA, Zech A, Zefi F, Ziegler A, Żywucka N. H.E.S.S. Limits on Linelike Dark Matter Signatures in the 100 GeV to 2 TeV Energy Range Close to the Galactic Center. Phys Rev Lett 2016; 117:151302. [PMID: 27768338 DOI: 10.1103/physrevlett.117.151302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Indexed: 06/06/2023]
Abstract
UNLABELLED A search for dark matter linelike signals iss performed in the vicinity of the Galactic Center by the H.E.S.S. experiment on observational data taken in 2014. An unbinned likelihood analysis iss developed to improve the sensitivity to linelike signals. The upgraded analysis along with newer data extend the energy coverage of the previous measurement down to 100 GeV. The 18 h of data collected with the H.E.S.S. array allow one to rule out at 95% C.L. the presence of a 130 GeV line (at l=-1.5°, b=0° and for a dark matter profile centered at this location) previously reported in Fermi-LAT data. This new analysis overlaps significantly in energy with previous Fermi-LAT and H.E.S.S. RESULTS No significant excess associated with dark matter annihilations was found in the energy range of 100 GeV to 2 TeV and upper limits on the gamma-ray flux and the velocity weighted annihilation cross section are derived adopting an Einasto dark matter halo profile. Expected limits for present and future large statistics H.E.S.S. observations are also given.
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Affiliation(s)
- H Abdalla
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Abramowski
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - F Aharonian
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
- National Academy of Sciences of the Republic of Armenia, Marshall Baghramian Avenue, 24, 0019 Yerevan, Republic of Armenia
| | - F Ait Benkhali
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A G Akhperjanian
- National Academy of Sciences of the Republic of Armenia, Marshall Baghramian Avenue, 24, 0019 Yerevan, Republic of Armenia
- Yerevan Physics Institute, 2 Alikhanian Brothers Street, 375036 Yerevan, Armenia
| | - T Andersson
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - E O Angüner
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - M Arrieta
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - P Aubert
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - M Backes
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek, Namibia
| | - A Balzer
- GRAPPA, Anton Pannekoek Institute for Astronomy, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - M Barnard
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - Y Becherini
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - J Becker Tjus
- Institut für Theoretische Physik, Lehrstuhl IV: Weltraum und Astrophysik, Ruhr-Universität Bochum, D 44780 Bochum, Germany
| | - D Berge
- GRAPPA, Anton Pannekoek Institute for Astronomy and Institute of High-Energy Physics, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - S Bernhard
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - E Birsin
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - R Blackwell
- School of Chemistry & Physics, University of Adelaide, Adelaide 5005, Australia
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - J Bolmont
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - P Bordas
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - J Bregeon
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - F Brun
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | - P Brun
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | - M Bryan
- GRAPPA, Anton Pannekoek Institute for Astronomy, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - T Bulik
- Astronomical Observatory, The University of Warsaw, Aleje Ujazdowskie 4, 00-478 Warsaw, Poland
| | - M Capasso
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - J Carr
- Aix Marseille Université, CNRS/IN2P3, CPPM UMR 7346, 13288 Marseille, France
| | - S Casanova
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- Instytut Fizyki Jądrowej PAN, ulica Radzikowskiego 152, 31-342 Kraków, Poland
| | - N Chakraborty
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R Chalme-Calvet
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - R C G Chaves
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - A Chen
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - J Chevalier
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université Savoie Mont-Blanc, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - M Chrétien
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - S Colafrancesco
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - G Cologna
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - B Condon
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J Conrad
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
- Wallenberg Academy Fellow
| | - C Couturier
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - Y Cui
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - I D Davids
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek, Namibia
| | - B Degrange
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - C Deil
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J Devin
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - P deWilt
- School of Chemistry & Physics, University of Adelaide, Adelaide 5005, Australia
| | - A Djannati-Ataï
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - W Domainko
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Donath
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - L O'C Drury
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
| | - G Dubus
- Université Grenoble Alpes, IPAG, F-38000 Grenoble, France CNRS, IPAG, F-38000 Grenoble, France
| | - K Dutson
- Department of Physics and Astronomy, The University of Leicester, University Road, Leicester LE1 7RH, United Kingdom
| | - J Dyks
- Nicolaus Copernicus Astronomical Center, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - M Dyrda
- Instytut Fizyki Jądrowej PAN, ulica Radzikowskiego 152, 31-342 Kraków, Poland
| | - T Edwards
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Straße 24/25, D 14476 Potsdam, Germany
| | - P Eger
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J-P Ernenwein
- Aix Marseille Université, CNRS/IN2P3, CPPM UMR 7346, 13288 Marseille, France
| | - S Eschbach
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - C Farnier
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
| | - S Fegan
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - M V Fernandes
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - A Fiasson
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université de Savoie, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - A Förster
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - S Funk
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | | | - S Gabici
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - M Gajdus
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - Y A Gallant
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - T Garrigoux
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | | | - B Giebels
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | | | - D Gottschall
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - A Goyal
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ulica Orla 171, 30-244 Kraków, Poland
| | - M-H Grondin
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - M Grudzińska
- Astronomical Observatory, The University of Warsaw, Aleje Ujazdowskie 4, 00-478 Warsaw, Poland
| | - D Hadasch
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - J Hahn
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J Hawkes
- School of Chemistry & Physics, University of Adelaide, Adelaide 5005, Australia
| | - G Heinzelmann
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - G Henri
- Université Grenoble Alpes, IPAG, F-38000 Grenoble, France CNRS, IPAG, F-38000 Grenoble, France
| | - G Hermann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - O Hervet
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - A Hillert
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - C Hoischen
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Straße 24/25, D 14476 Potsdam, Germany
| | - M Holler
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - A Ivascenko
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Jacholkowska
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ulica Orla 171, 30-244 Kraków, Poland
| | - M Janiak
- Nicolaus Copernicus Astronomical Center, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - D Jankowsky
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - M Jingo
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - T Jogler
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - L Jouvin
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - I Jung-Richardt
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - M A Kastendieck
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - K Katarzyński
- Centre for Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Grudziadzka 5, 87-100 Torun, Poland
| | - U Katz
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - D Kerszberg
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - B Khélifi
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - M Kieffer
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - J King
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | | | - D Klochkov
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - D Kolitzus
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - Nu Komin
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - K Kosack
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | - S Krakau
- Institut für Theoretische Physik, Lehrstuhl IV: Weltraum und Astrophysik, Ruhr-Universität Bochum, D 44780 Bochum, Germany
| | - M Kraus
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - F Krayzel
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université de Savoie, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - P P Krüger
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - H Laffon
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - G Lamanna
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université de Savoie, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - J Lau
- School of Chemistry & Physics, University of Adelaide, Adelaide 5005, Australia
| | - J-P Lees
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université de Savoie, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - J Lefaucheur
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - V Lefranc
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | - A Lemière
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - M Lemoine-Goumard
- Université Bordeaux 1, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J-P Lenain
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - E Leser
- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
| | - R Liu
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - M Lorentz
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | | | - V Marandon
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - C Mariaud
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, CNRS/IN2P3, F-91128 Palaiseau, France
| | - R Marx
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - G Maurin
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| | - N Maxted
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| | - M Mayer
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| | - P J Meintjes
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| | - M Meyer
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| | - A M W Mitchell
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| | - R Moderski
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| | - M Mohamed
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| | - K Morå
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| | - E Moulin
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | - T Murach
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - M de Naurois
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| | - F Niederwanger
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - J Niemiec
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| | - L Oakes
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| | - P O'Brien
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| | - H Odaka
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - S Ohm
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| | - M Ostrowski
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| | - S Öttl
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - I Oya
- DESY, D-15738 Zeuthen, Germany
| | - M Padovani
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - M Panter
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| | - R D Parsons
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| | - M Paz Arribas
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- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - G Pelletier
- Université Grenoble Alpes, IPAG, F-38000 Grenoble, France CNRS, IPAG, F-38000 Grenoble, France
| | - C Perennes
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| | - P-O Petrucci
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| | - B Peyaud
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| | - S Pita
- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - H Poon
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - D Prokhorov
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| | - H Prokoph
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| | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Punch
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- APC, AstroParticule et Cosmologie, Université Paris Diderot, CNRS/IN2P3, CEA/Irfu, Observatoire de Paris, Sorbonne Paris Cité, 10, rue Alice Domon et Léonie Duquet, 75205 Paris Cedex 13, France
| | - A Quirrenbach
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| | - S Raab
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| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier 2, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - R de Los Reyes
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - F Rieger
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - C Romoli
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
| | - S Rosier-Lees
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université de Savoie, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - G Rowell
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| | - B Rudak
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| | - V Sahakian
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| | - D Salek
- GRAPPA, Institute of High-Energy Physics, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - D A Sanchez
- Laboratoire d'Annecy-le-Vieux de Physique des Particules, Université de Savoie, CNRS/IN2P3, F-74941 Annecy-le-Vieux, France
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Sasaki
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - R Schlickeiser
- Institut für Theoretische Physik, Lehrstuhl IV: Weltraum und Astrophysik, Ruhr-Universität Bochum, D 44780 Bochum, Germany
| | - F Schüssler
- DSM/Irfu, CEA Saclay, F-91191 Gif-Sur-Yvette Cedex, France
| | | | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, D 12489 Berlin, Germany
| | - S Schwemmer
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - M Settimo
- Sorbonne Universités, UPMC Université Paris 06, Université Paris Diderot, Sorbonne Paris Cité, CNRS, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 place Jussieu, F-75252, Paris Cedex 5, France
| | - A S Seyffert
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - N Shafi
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - I Shilon
- Universität Erlangen-Nürnberg, Physikalisches Institut, Erwin-Rommel-Straße 1, D 91058 Erlangen, Germany
| | - R Simoni
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- LUTH, Observatoire de Paris, PSL Research University, CNRS, Université Paris Diderot, 5 Place Jules Janssen, 92190 Meudon, France
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| | - G Spengler
- Oskar Klein Centre, Department of Physics, Stockholm University, Albanova University Center, SE-10691 Stockholm, Sweden
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- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - Ł Stawarz
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| | - J Vink
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| | - T Vuillaume
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| | - A Wierzcholska
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| | - A A Zdziarski
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| | - A Zech
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| | - A Ziegler
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Boch T, Spiess B, Cornely O, Vehreschild J, Rath P, Steinmann J, Heinz W, Hahn J, Krause S, Kiehl M, Egerer G, Liebregts T, Koldehoff M, Klein M, Nolte F, Mueller M, Merker N, Will S, Mossner M, Popp H, Hofmann WK, Reinwald M, Buchheidt D. Diagnosis of invasive fungal infections in haematological patients by combined use of galactomannan, 1,3-β-D-glucan, Aspergillus PCR, multifungal DNA-microarray, and Aspergillus azole resistance PCRs in blood and bronchoalveolar lavage samples: results of a prospective multicentre study. Clin Microbiol Infect 2016; 22:862-868. [DOI: 10.1016/j.cmi.2016.06.021] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/09/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
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Hahn J, Bas M, Hoffmann TK, Greve J. [Bradykinin-induced angioedema: Definition, pathogenesis, clinical presentation, diagnosis and therapy]. HNO 2016; 63:885-93; quiz 894-5. [PMID: 26597136 DOI: 10.1007/s00106-015-0084-8] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The incidence of bradykinin-induced angioedema is considerably lower than that of histamine-induced forms; however, the same is true for the clinician's knowledge of this condition. Bradykinin-induced angioedemas include hereditary angioedema (HAE), as well as acquired forms induced by drugs or antibody formation, e.g., during the course of oncologic disease. Drug-induced forms affect almost exclusively the head and neck region, and are thus important for the otorhinolaryngologist. Clear differentiation between histamine-induced angioedema (e. g., connected to allergy/urticaria) and bradykinin-induced angioedema is essential for selection of the specific treatment and may be lifesaving. Antihistamines and cortisone derivatives have no relevant effect in bradykinin induced-angioedema, whereas blood-derived C1 esterase inhibitor and bradykinin receptor 2 antagonists represent effective therapeutic options--both for acute and prophylactic treatment.
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Affiliation(s)
- J Hahn
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89070, Ulm, Deutschland.
| | - M Bas
- Hals-Nasen-Ohren-Klinik und Poliklinik, Technische Universität München, München, Deutschland
| | - T K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89070, Ulm, Deutschland
| | - J Greve
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89070, Ulm, Deutschland
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