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Yayan J, Franke KJ, Biancosino C, Rasche K. Comparative systematic review on the safety of e-cigarettes and conventional cigarettes. Food Chem Toxicol 2024; 185:114507. [PMID: 38331086 DOI: 10.1016/j.fct.2024.114507] [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: 12/03/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND This systematic review evaluated the health risks of electronic cigarettes (e-cigarettes) compared to traditional cigarettes. It examines various studies and research on the subject to provide a comprehensive analysis of potential health risks associated with both smoking methods. METHODS The systematic review, incorporating searches in PubMed, Scopus, Web of Science, and the Cochrane Library up to July 2023, examines the results obtained in relevant studies, and provides a critical discussion of the results. RESULTS E-cigarettes exhibit reduced exposure to harmful toxins compared to traditional cigarettes. CONCLUSION However, concerns persist regarding respiratory irritation and potential health risks, especially among youth, emphasizing the need for comprehensive, long-term research and protective legislation.
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Affiliation(s)
- Josef Yayan
- Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Germany.
| | - Karl-Josef Franke
- Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Lüdenscheid, Witten/Herdecke University, Germany
| | - Christian Biancosino
- Witten/Herdecke University, Witten, Department of Thoracic Surgery, HELIOS Clinic Wuppertal, Germany
| | - Kurt Rasche
- Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Germany
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Yayan J, Franke KJ, Berger M, Windisch W, Rasche K. Adhesion, metastasis, and inhibition of cancer cells: a comprehensive review. Mol Biol Rep 2024; 51:165. [PMID: 38252369 PMCID: PMC10803487 DOI: 10.1007/s11033-023-08920-5] [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] [Received: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 01/23/2024]
Abstract
This comprehensive review delves into cancer's complexity, focusing on adhesion, metastasis, and inhibition. It explores the pivotal role of these factors in disease progression and therapeutic strategies. This review covers cancer cell migration, invasion, and colonization of distant organs, emphasizing the significance of cell adhesion and the intricate metastasis process. Inhibition approaches targeting adhesion molecules, such as integrins and cadherins, are discussed. Overall, this review contributes significantly to advancing cancer research and developing targeted therapies, holding promise for improving patient outcomes worldwide. Exploring different inhibition strategies revealed promising therapeutic targets to alleviate adhesion and metastasis of cancer cells. The effectiveness of integrin-blocking antibodies, small molecule inhibitors targeting Focal adhesion kinase (FAK) and the Transforming Growth Factor β (TGF-β) pathway, and combination therapies underscores their potential to disrupt focal adhesions and control epithelial-mesenchymal transition processes. The identification of as FAK, Src, β-catenin and SMAD4 offers valuable starting points for further research and the development of targeted therapies. The complex interrelationships between adhesion and metastatic signaling networks will be relevant to the development of new treatment approaches.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, Witten/Herdecke University, HELIOS Clinic Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany.
| | - Karl-Josef Franke
- Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Witten/Herdecke University, Lüdenscheid, Germany
| | - Melanie Berger
- Department of Pneumology, Cologne Merheim Hospital, Witten/Herdecke University, Cologne, Germany
| | - Wolfram Windisch
- Department of Pneumology, Cologne Merheim Hospital, Witten/Herdecke University, Cologne, Germany
| | - Kurt Rasche
- Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, Witten/Herdecke University, HELIOS Clinic Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany
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Yayan J, Rasche K. Risk Factors for Depression in Patients with Chronic Obstructive Pulmonary Disease. Respir Physiol Neurobiol 2023:104110. [PMID: 37393968 DOI: 10.1016/j.resp.2023.104110] [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: 01/03/2023] [Revised: 06/15/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
Depression, anxiety, and panic disorders are common in chronic obstructive pulmonary disease (COPD) and important for the further course of the disease, as they are associated with increased hospital admissions, longer hospital stays, more frequent doctor visits, and a worsened quality of life. There are also indications of premature death in affected patients. Therefore, knowledge of the risk factors for depression in COPD patients is all the more important for early detection and treatment. Hence, Embase, the Cochrane Library, and the MEDLINE/PubMed databases were analyzed for studies on these risk factors. The main factors are as follows: female gender; older/younger age; living alone; higher education; unemployment; retirement; a low quality of life; social isolation; high/low income; high cigarette and alcohol consumption; poor physical fitness; severe respiratory symptoms; high/low body mass index, airway obstruction, dyspnea, exercise capacity index scores; and comorbidities (mainly heart disease, cancer, diabetes, and stroke). This article presents the analyzed medical literature.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Witten, Germany.
| | - Kurt Rasche
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Witten, Germany
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Orth M, Rasche K. Schlafbezogene Atmungsstörungen und Gynäkologie. Somnologie 2022. [DOI: 10.1007/s11818-022-00377-1] [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: 11/29/2022]
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Orth M, Rasche K. Schwangerschaft und Schlafstörungen. Somnologie 2021. [DOI: 10.1007/s11818-021-00339-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bamidis AD, Koehler P, di Cristanziano V, Rasche K, Demirel B, Bacher P, Hallek M, Kochanek M, Klein F, Hofmann SC, Wesselmann U, Kofler DM. First manifestation of adult-onset Still's disease after COVID-19. Lancet Rheumatol 2021; 3:e319-e321. [PMID: 33817663 PMCID: PMC7997647 DOI: 10.1016/s2665-9913(21)00072-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Anna D Bamidis
- Center for Dermatology, Allergy and Dermatosurgery, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
| | - Philipp Koehler
- Department I of Internal Medicine, University of Cologne, Cologne 50931, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne 50931, Germany.,Centre for Molecular Medicine Cologne, University of Cologne, Cologne 50931, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | | | - Kurt Rasche
- Department of Pulmonology, Allergology, Sleep and Respiratory Medicine, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
| | | | - Petra Bacher
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Michael Hallek
- Department I of Internal Medicine, University of Cologne, Cologne 50931, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne 50931, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | - Matthias Kochanek
- Department I of Internal Medicine, University of Cologne, Cologne 50931, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
| | - Florian Klein
- Centre for Molecular Medicine Cologne, University of Cologne, Cologne 50931, Germany.,Institut of Virology, University of Cologne, Cologne 50931, Germany.,German Center for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Silke C Hofmann
- Center for Dermatology, Allergy and Dermatosurgery, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
| | - Ulrich Wesselmann
- Center for Dermatology, Allergy and Dermatosurgery, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
| | - David M Kofler
- Department I of Internal Medicine, University of Cologne, Cologne 50931, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany
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Meyer A, Rasche K, Hohenhorst W, Ostrowsky A, Pelser M, Randerath W. Unterkieferprotrusionsschienen bei schlafbezogenen Atmungsstörungen. Somnologie 2018. [DOI: 10.1007/s11818-018-0170-8] [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: 11/29/2022]
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Tabatabaei SV, Nitche C, Michel M, Rasche K, Hekmat K. Prognostic Impact of Extracapsular Lymph Node Invasion on Survival in non-Small-cell Lung Cancer: a Systematic Review of Medline and Meta-analysis>. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2779] [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: 11/05/2022]
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Alkhatib A, Mairose U, Sommerwerck U, Rasche K. Chronische eosinophile Pneumonie als Arzneimittelnebenwirkung von Nitrofurantoin. Pneumologie 2018. [DOI: 10.1055/s-0037-1619333] [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: 10/28/2022]
Affiliation(s)
- A Alkhatib
- Helios Universitätsklinikum Wuppertal; Universität Witten/Herdecke; Bergisches Lungenzentrum – Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
| | - U Mairose
- Helios Universitätsklinikum Wuppertal
| | - U Sommerwerck
- Helios Universitätsklinikum Wuppertal; Universität Witten/Herdecke; Bergisches Lungenzentrum – Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
| | - K Rasche
- Helios Universitätsklinikum Wuppertal; Universität Witten/Herdecke; Bergisches Lungenzentrum – Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
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Rasche K. [Snoring and daytime sleepiness]. MMW Fortschr Med 2018; 160:42-44. [PMID: 29464620 DOI: 10.1007/s15006-018-0199-4] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Kurt Rasche
- Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, HELIOS Universitätsklinikum Wuppertal - Universität Witten/Herdecke, Heusnerstr. 40, D-42283, Wuppertal, Deutschland.
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Orth M, Schäfer T, Schiermeier S, Rasche K. [Obstructive Sleep Apnea Syndrome and Pregnancy]. Pneumologie 2017; 72:187-196. [PMID: 28841741 DOI: 10.1055/s-0043-113429] [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: 10/19/2022]
Abstract
ZusammenfassungDie Schwangerschaft hat einen erheblichen Einfluss auf Atmungsregulation und Atemmechanik sowie auf die Schlafregulation: Durch seine Größenzunahme schränkt der Uterus zwar die maximale willkürliche Ventilation ein, das Schwangerschaftshormon Progesteron hingegen bewirkt eine kompensierende Bronchodilatation und eine markante Hyperventilation mit arteriellen PCO2-Werten der Schwangeren unter 30 mmHg. Die Schlafqualität nimmt in der Schwangerschaft ab, insbesondere aufgrund steigender Hormonspiegel des Progesterons, einer generellen Stoffwechselsteigerung, Nykturie, fetaler Bewegungen und wegen der Begünstigung schlafbezogener Atmungsstörungen. Beim Embryo entwickelt sich bereits in der 4. Woche die Lungenanlage und reift über ein pseudoglanduläres, kanalikuläres, sakkuläres zum alveolaren Stadium. Ab Schwangerschaftswoche 29 – 30 sezernieren Typ-2-Alveozyten Surfactant. Ab der Mitte des zweiten Trimenons sind fetale Atembewegungen nachweisbar. Ohne sie fehlt der Stimulus für ein adäquates Lungenwachstum. Sie sind abhängig vom Ruhe-/Aktivitätsrhythmus des Fetusses und antworten auf erhöhten Kohlendioxidpartialdruck, während sie durch Sauerstoffmangel inhibiert werden. Die innere Uhr entwickelt sich beim Fetus im letzten Trimester und wird durch Zeitgeber der Mutter, zum Beispiel durch den Melatoninspiegel synchronisiert. In den letzten 10 Wochen der Schwangerschaft lassen sich Phasen ruhigen (NREM-) und aktiven (REM-)Schlafes differenzieren. Schwangerschaft und intrauterine Entwicklung sind von erheblichen Veränderungen von Atmung und Schlaf bei Mutter und Kind begleitet, die Ansatzpunkte pathophysiologischer Entwicklungen sein können.Schlafbezogene Atmungsstörungen (SBAS) in Form von Schnarchen oder obstruktivem Schlafapnoe-Syndrom (OSAS) sind auch bei Frauen insbesondere nach der Menopause häufige Schlafstörungen. Aber auch prämenopausal tritt das OSAS mit einer Häufigkeit von mehr als 2 % auf. Einige während der Schwangerschaft auftretende physiologische Veränderungen sind prinzipiell in der Lage, das Auftreten von obstruktiven SBAS zu fördern. Gerade jüngere Frauen haben aber oft eine nicht SBAS-typische Symptomatik. Screening-Fragebögen auf SBAS sind für jüngere Frauen und somit auch in der Schwangerschaft daher weniger geeignet. Die Prävalenzangaben von SBAS bei Schwangeren sind unterschiedlich je nach Definition, Methode und Untersuchungskollektiv. Schnarchen und OSA sind aber bei gesunden normalgewichtigen Frauen zu Beginn der Schwangerschaft eher selten. Übergewicht und Alter sind die entscheidenden Risikofaktoren für das Auftreten von pathologischem Schnarchen und OSAS zu Beginn der Schwangerschaft und für die Zunahme der Häufigkeit während der Schwangerschaft. Im 3. Trimenon muss mit einer Häufigkeit von SBAS von ca. 10 – 30 % gerechnet werden. Diese Schwangerschaften sind als Risikoschwangerschaften einzuschätzen und haben wahrscheinlich einen negativen Effekt auf maternal-fetale Morbidität und Mortalität.Die Koinzidenz von Schwangerschaft und OSAS stellt im Hinblick auf Schwangerschaftskomplikationen sowohl für die Schwangere als auch das Ungeborene ein gesundheitliches Risiko dar. Frauen, die in der Schwangerschaft schnarchen, haben ein signifikant höheres Risiko im Hinblick auf Erkrankungen wie Kardiomyopathie, Lungenembolie, Eklampsie und Präeklampsie sowie eine erhöhte Müttersterblichkeit. Zu den sog. „adverse effects“ bei Ungeborenen bzw. Neonaten von Müttern mit OSAS zählen die vorzeitige Geburt, häufigere Entbindung per Sectio caesarea, ein niedriges bzw. nicht altersentsprechendes Geburtsgewicht sowie ein signifikant niedrigerer 1- und 5-Minuten-APGAR-Wert.Aufgrund der potenziellen und verhältnismäßig häufigen Koinzidenz von Schwangerschaft und OSAS sowie der genannten Gefährdung von Mutter und Kind müssen nicht nur Schlafmediziner, sondern auch insbesondere Gynäkologen diesem Umstand zunehmend Beachtung schenken.
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Affiliation(s)
- M Orth
- Medizinische Klinik III, Pneumologie, pneumologische Onkologie, Allergologie, Schlaf- und Beatmungsmedizin, Theresienkrankenhaus und St. Hedwig Klinik GmbH, Mannheim
| | - T Schäfer
- Ruhr-Universität Bochum, Medizinische Fakultät, Bochum, Helios Klinik Hagen-Ambrock, Klinische Physiologie, Hagen
| | - S Schiermeier
- Frauenklinik der Universität Witten/Herdecke, Marien-Hospital Witten
| | - K Rasche
- Bergisches Lungenzentrum, Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Universität Witten/Herdecke, Helios Universitätsklinikum Wuppertal
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Jamaly S, Leidag M, Schneider HW, Domanksi U, Rasche K, Schröder M, Nilius G. The effect of singing therapy compared to standard physiotherapeutic lung sport in COPD. Pneumologie 2017. [DOI: 10.1055/s-0037-1598260] [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)
- S Jamaly
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Bergisches Lungenzentrum
| | - M Leidag
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Bergisches Lungenzentrum
| | | | - U Domanksi
- Helios Klinik Hagen-Ambrock, Universität Witten/Herdecke, Pneumologie
| | - K Rasche
- Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Bergisches Lungenzentrum
| | | | - G Nilius
- Helios Klinik Hagen-Ambrock, Universität Witten/Herdecke, Pneumologie
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Yayan J, Ghebremedhin B, Rasche K. Cefepime shows good efficacy and no antibiotic resistance in pneumonia caused by Serratia marcescens and Proteus mirabilis - an observational study. BMC Pharmacol Toxicol 2016; 17:10. [PMID: 27004519 PMCID: PMC4804506 DOI: 10.1186/s40360-016-0056-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 09/19/2015] [Accepted: 02/17/2016] [Indexed: 12/02/2022] Open
Abstract
Background Many antibiotics have no effect on Gram-positive and Gram-negative microbes, which necessitates the prescription of broad-spectrum antimicrobial agents that can lead to increased risk of antibiotic resistance. These pathogens constitute a further threat because they are also resistant to numerous beta-lactam antibiotics, as well as other antibiotic groups. This study retrospectively investigates antimicrobial resistance in hospitalized patients suffering from pneumonia triggered by Gram-negative Serratia marcescens or Proteus mirabilis. Methods The demographic and clinical data analyzed in this study were obtained from the clinical databank of the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, for inpatients presenting with pneumonia triggered by S. marcescens or P. mirabilis from 2004 to 2014. An antibiogram was conducted for the antibiotics utilized as part of the management of patients with pneumonia triggered by these two pathogens. Results Pneumonia was caused by Gram-negative bacteria in 115 patients during the study period from January 1, 2004, to August 12, 2014. Of these, 43 (37.4 %) hospitalized patients [26 males (60.5 %, 95 % CI 45.9 %–75.1 %) and 17 females (39.5 %, 95 % CI 24.9 %–54.1 %)] with mean age of 66.2 ± 13.4 years had pneumonia triggered by S. marcescens, while 20 (17.4 %) patients [14 males (70 %, 95 % CI 49.9 %–90.1 %) and 6 females (30 %, 95 % CI 9.9 %–50.1 %)] with a mean age of 64.6 ± 12.8 years had pneumonia caused by P. mirabilis. S. marcescens showed an increased antibiotic resistance to ampicillin (100 %), ampicillin-sulbactam (100 %), and cefuroxime (100 %). P. mirabilis had a high resistance to tetracycline (100 %) and ampicillin (55 %). S. marcescens (P < 0.0001) and P. mirabilis (P = 0.0003) demonstrated no resistance to cefepime in these patients with pneumonia. Conclusions S. marcescens and P. mirabilis were resistant to several commonly used antimicrobial agents, but showed no resistance to cefepime.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Witten, Germany.
| | - Beniam Ghebremedhin
- Witten/Herdecke University, Institute of Medical Laboratory Diagnostics, Center for Clinical and Translational Research, HELIOS Clinic Wuppertal, Witten, Germany
| | - Kurt Rasche
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Witten, Germany
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Yayan J, Rasche K. Rarity of Mixed Species Malaria with Plasmodium falciparum and Plasmodium malariae in Travelers to Saarland in Germany. Advances in Experimental Medicine and Biology 2016; 944:35-45. [DOI: 10.1007/5584_2016_47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Abstract
Cannabis is the most widely smoked illicit substance in the world. It can be smoked alone in its plant form, marijuana, but it can also be mixed with tobacco. The specific effects of smoking cannabis are difficult to assess accurately and to distinguish from the effects of tobacco; however its use may produce severe consequences. Cannabis smoke affects the lungs similarly to tobacco smoke, causing symptoms such as increased cough, sputum, and hyperinflation. It can also cause serious lung diseases with increasing years of use. Cannabis can weaken the immune system, leading to pneumonia. Smoking cannabis has been further linked with symptoms of chronic bronchitis. Heavy use of cannabis on its own can cause airway obstruction. Based on immuno-histopathological and epidemiological evidence, smoking cannabis poses a potential risk for developing lung cancer. At present, however, the association between smoking cannabis and the development of lung cancer is not decisive.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Heusner 40, 42283, Wuppertal, Germany.
| | - Kurt Rasche
- Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Heusner 40, 42283, Wuppertal, Germany
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Vasic N, Dudeck M, Knein AM, Rasche K, Mentel R, Streb J, Connemann BJ, Sosic-Vasic Z, Otte S. [Questionnaire for Investigating Therapeutic Alliance in Forensic Setting (FTBF): Results of a Pilot Study]. Fortschr Neurol Psychiatr 2015; 83:686-93. [PMID: 26714250 DOI: 10.1055/s-0041-110391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The relation between patient and therapist has a substantial effect on the success of psychotherapy. So far, in German-speaking regions questionnaires translated from English have been used, particularly for studying outpatients. Studies investigating and concerned with specialised features of hospitalised forensic psychiatry patients are sparse. The preliminary results of this study evaluating a recently developed questionnaire aimed to investigate the quality of the therapeutic relationship in forensic psychiatry ("Fragebogen zur therapeutischen Beziehung in der Forensik, FTBF") are reported. The data were collected both in general and forensic psychiatry departments. Factor analyses yielded two essential factors, namely "positive emotional aspects" (12 items, main features trust, respect, helpfulness, harmony, and sympathy; Cronbach's α = .933) and "negative emotional aspects" (4 items, main features power divide and punishment; Cronbach's α = .805). Forensic patients experienced power divide and punishment tendencies more intensively than general psychiatry patients (p < 0.001). Our questionnaire therefore demonstrates not only excellent reliabilities but also differential validity, enabling a differentiation between general and forensic psychiatry patients. Studies with larger samples would enable conclusions about the impact of the therapists' perspective, specific diagnostic subgroups and different psychotherapeutic orientations, on the patient-therapist relationship in forensic psychiatry.
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Affiliation(s)
- N Vasic
- Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg, Universität Ulm, Günzburg
| | - M Dudeck
- Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg, Universität Ulm, Günzburg
| | - A M Knein
- Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg, Universität Ulm, Günzburg
| | - K Rasche
- Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg, Universität Ulm, Günzburg
| | - R Mentel
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Greifswald
| | - J Streb
- Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg, Universität Ulm, Günzburg
| | - B J Connemann
- Klinik für Psychiatrie und Psychotherapie III, Universität Ulm
| | - Z Sosic-Vasic
- Klinik für Psychiatrie und Psychotherapie III, Universität Ulm
| | - S Otte
- Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg, Universität Ulm, Günzburg
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Yayan J, Ghebremedhin B, Rasche K. No development of ciprofloxacin resistance in the Haemophilus species associated with pneumonia over a 10-year study. BMC Infect Dis 2015; 15:514. [PMID: 26567094 PMCID: PMC4644324 DOI: 10.1186/s12879-015-1267-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 11/05/2015] [Indexed: 11/10/2022] Open
Abstract
Background The widespread overuse of antibiotics promotes the development of antibiotic resistance in bacteria, which can cause severe illness and constitutes a major public health concern. Haemophilus species are a common cause of community- and nosocomial-acquired pneumonia. The antibiotic resistance of these Gram-negative bacteria can be prevented through the reduction of unnecessary antibiotic prescriptions, the correct use of antibiotics, and good hygiene and infection control. This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species. Methods The demographic, clinical, and laboratory data of all patients with community- and nosocomial-acquired pneumonia caused by Haemophilus species were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within a study period from 2004 to 2014. Antimicrobial susceptibility testing was performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by Haemophilus species. Results During the study period of January 1, 2004, to August 12, 2014, 82 patients were identified with community- and nosocomial-acquired pneumonia affected by Haemophilus species. These patients had a mean age of 63.8 ± 15.5 (60 [73.2 %, 95 % CI 63.6 %–82.8 %] males and 22 [26.8 %, 95 % CI 17.2 %–36.4 %] females). Haemophilus species had a high resistance rate to erythromycin (38.3 %), ampicillin (24.4 %), piperacillin (20.8 %), cefuroxime (8.5 %), ampicillin-sulbactam (7.3 %), piperacillin-sulbactam (4.3 %), piperacillin-tazobactam (2.5 %), cefotaxime (2.5 %), and levofloxacin (1.6 %). In contrast, they were not resistant to ciprofloxacin in patients with pneumonia (P = 0.016). Conclusion Haemophilus species were resistant to many of the typically used antibiotics. Resistance toward ciprofloxacin was not detected in patients with pneumonia caused by Haemophilus species.
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Affiliation(s)
- Josef Yayan
- Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany.
| | - Beniam Ghebremedhin
- Witten/Herdecke University, Witten, Institute of Medical Laboratory Diagnostics, Center for Clinical and Translational Research, HELIOS Clinic Wuppertal, Wuppertal, Germany.
| | - Kurt Rasche
- Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany.
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Yayan J, Ghebremedhin B, Rasche K. Antibiotic Resistance of Pseudomonas aeruginosa in Pneumonia at a Single University Hospital Center in Germany over a 10-Year Period. PLoS One 2015; 10:e0139836. [PMID: 26430738 PMCID: PMC4592231 DOI: 10.1371/journal.pone.0139836] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/17/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pseudomonas aeruginosa is a common cause of community-acquired and nosocomial-acquired pneumonia. The development of resistance of P. aeruginosa to antibiotics is increasing globally due to the overuse of antibiotics. This article examines, retrospectively, the antibiotic resistance in patients with community-acquired versus nosocomial-acquired pneumonia caused by P. aeruginosa or multidrug-resistant (MDR) P. aeruginosa. METHODS Data from patients with community-acquired and nosocomial-acquired pneumonia caused by P. aeruginosa and MDR P. aeruginosa were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, between January 2004 and August 2014. An antibiogram was created from all study patients with community-acquired and nosocomial-acquired pneumonia caused by P. aeruginosa or MDR P. aeruginosa. RESULTS A total of 168 patients with mean age 68.1 ± 12.8 (113 [67.3% males and 55 [32.7%] females) were identified; 91 (54.2%) had community-acquired and 77 (45.8%) had nosocomial-acquired pneumonia caused by P. aeruginosa. Patients with community-acquired versus nosocomial-acquired pneumonia had a mean age of 66.4 ± 13.8 vs. 70.1 ± 11.4 years [59 vs. 54 (64.8% vs. 70.1%) males and 32 vs. 23 (35.2% vs. 29.9%) females]. They included 41 (24.4%) patients with pneumonia due to MDR P. aeruginosa: 27 (65.9%) community-acquired and 14 (34.1%) nosocomial-acquired cases. P. aeruginosa and MDR P. aeruginosa showed a very high resistance to fosfomycin (community-acquired vs. nosocomial-acquired) (81.0% vs. 84.2%; 0 vs. 85.7%). A similar resistance pattern was seen with ciprofloxacin (35.2% vs. 24.0%; 70.4% vs. 61.5%), levofloxacin (34.6% vs. 24.5%; 66.7% vs. 64.3%), ceftazidime (15.9% vs. 30.9; 33.3% vs. 61.5%), piperacillin (24.2% vs. 29.9%; 44.4% vs. 57.1%), imipenem (28.6% vs. 27.3%; 55.6% vs. 50.0%), piperacillin and tazobactam (23.1% vs. 28.6%; 44.4% vs. 50.0%), tobramycin (28.0% vs. 17.2%; 52.0% vs. 27.3%), gentamicin (26.4% vs. 18.2%; 44.4% vs. 21.4%), and meropenem (20.2% vs. 20.3%; 42.3% vs. 50.0%). An elevated resistance of P. aeruginosa and MDR P. aeruginosa was found for cefepime (11.1% vs. 23.3%; 25.9% vs. 50.0%), and amikacin (10.2% vs. 9.1%; 27.3% vs. 9.1%). Neither pathogen was resistant to colistin (P = 0.574). CONCLUSION While P. aeruginosa and MDR P. aeruginosa were resistant to a variety of commonly used antibiotics, they were not resistant to colistin in the few isolates recovered from patients with pneumonia.
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Affiliation(s)
- Josef Yayan
- Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic, Wuppertal, Germany
- * E-mail:
| | - Beniam Ghebremedhin
- Witten/Herdecke University, Witten, Institute of Medical Laboratory Diagnostics, Center for Clinical and Translational Research, HELIOS Clinic, Wuppertal, Germany
| | - Kurt Rasche
- Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic, Wuppertal, Germany
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Abstract
BACKGROUND Antibiotic resistance continues to rise due to the increased number of antibiotic prescriptions and is now a major threat to public health. In particular, there is an increase in antibiotic resistance to Escherichia coli according to the latest reports. TRIAL DESIGN This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by E coli. METHODS The data of all patients with community- and nosocomial-acquired pneumonia caused by E coli were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within the study period 2004 to 2014. An antibiogram was performed for the study patients with pneumonia caused by E coli. Antimicrobial susceptibility testing was performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by E coli. All demographic, clinical, and laboratory data of all of the patients with pneumonia caused by E coli were collected from the patients' records. RESULTS During the study period of January 1, 2004 to August 12, 2014, 135 patients were identified with community- and nosocomial-acquired pneumonia affected by E coli. These patients had a mean age of 72.5 ± 11.6 (92 [68.1%, 95% CI 60.2%-76.0%] males and 43 [31.9%, 95% CI 24.0%-39.8%] females). E coli had a high resistance rate to ampicillin (60.7%), piperacillin (56.3%), ampicillin-sulbactam (44.4%), and co-trimoxazole (25.9%). No patients with pneumonia caused by E coli showed resistance to imipenem (P < 0.0001). CONCLUSION E coli was resistant to many of the typically used antibiotics. No resistance was detected toward imipenem in patients with pneumonia caused by E coli.
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Affiliation(s)
- Josef Yayan
- From the Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Wuppertal (JY, KR); Institute for Medical Laboratory Diagnostics, Center for Clinical and Translational Research Wuppertal, Witten/Herdecke University, Witten (BG), Germany
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Otte S, Lang FU, Rasche K, Bernheim D, Vasic N, Dudeck M. [Convergent validity of SCID-II and TCI: categorical vs. dimensional diagnostics of personality disorders using the example of short-term prisoners]. Fortschr Neurol Psychiatr 2015; 83:157-61. [PMID: 25794321 DOI: 10.1055/s-0034-1399245] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In order to objectify the diagnostics of personality disorders, questionnaires and structured interviews are used. Nevertheless, due to different methodological approaches even those instruments arrive at different results very often. Therefore, this study aimed to check the convergent validity of two frequently used instruments - the Structured Clinical Interview for DSM IV Axis II Disorders (SCID-II) and the Temperament and Character Inventory (TCI) - the first one representing the categorical and the latter one the dimensional approach for diagnosing personality disorders. The diagnostic concordances were statistically described with Cohen's Kappa, Yule's Y, and correlations. The results indicate that there are striking differences in diagnoses and that the SCID-II rather tends to diagnose a personality disorder earlier than the TCI.
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Affiliation(s)
- S Otte
- Klinik für Forensische Psychiatrie und Psychotherapie am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg
| | - F U Lang
- Klinik für Psychiatrie und Psychotherapie II am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg
| | - K Rasche
- Klinik für Forensische Psychiatrie und Psychotherapie am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg
| | - D Bernheim
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Universität Ulm
| | - N Vasic
- Klinik für Forensische Psychiatrie und Psychotherapie am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg
| | - M Dudeck
- Klinik für Forensische Psychiatrie und Psychotherapie am Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg
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Rasche K. [New score for lung cancer risk in COPD]. MMW Fortschr Med 2015; 157:36. [PMID: 25743976 DOI: 10.1007/s15006-015-2766-2] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
Klebsiella species are a common cause of community- and nosocomial-acquired pneumonia. Antibiotic resistance to the class of carbapenem in patients with pneumonia caused by Klebsiella species is unusual. New studies report carbapenem resistance in patients with pneumonia caused by Klebsiella species.This article examines, retrospectively, antibiotic resistance in patients with community- and nosocomial-acquired pneumonia caused by Klebsiella species.The data of all patients with community- and nosocomial-acquired pneumonia caused by Klebsiella species were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, within the study period 2004 to 2014. An antibiogram was created from all of the study patients with pneumonia caused by Klebsiella species. Sensitivity and resistance profiles were performed for the different antibiotics that have been consistently used in the treatment of patients with pneumonia caused by Klebsiella species. All demographic, clinical, and laboratory data of all of the patients with pneumonia caused by Klebsiella species were collected from the patients' records.During the study period of January 1, 2004, to August 12, 2014, 149 patients were identified with community- and nosocomial-acquired pneumonia affected by Klebsiella species. These patients had a mean age of 70.6 ± 13 (107 [71.8%, 95% CI 64.6%-79%] men and 42 [28.2%, 95% CI 21%-35.4%] women). In all of the patients with pneumonia caused by Klebsiella species, there was resistance to ampicillin (P < 0.0001). Many patients with pneumonia caused by Klebsiella species (75.3%) also showed resistance to piperacillin (P < 0.0001). However, no patients with pneumonia caused by Klebsiella species showed resistance to imipenem or meropenem (P < 0.0001).Antibiotic resistance to the antibiotic class of carbapenem was not detected in patients with pneumonia caused by Klebsiella species.
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Affiliation(s)
- Josef Yayan
- From the HELIOS Clinic Wuppertal, Witten/Herdecke University, Wuppertal, Germany
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Yayan J, Ghebremedhin B, Rasche K. No Resistance to Penicillin, Cefuroxime, Cefotaxime, or Vancomycin in Pneumococcal Pneumonia. Int J Med Sci 2015; 12:980-6. [PMID: 26664260 PMCID: PMC4661297 DOI: 10.7150/ijms.13203] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/26/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Group B Streptococcus is a primary source of pneumonia, which is a leading cause of death worldwide. During the last few decades, there has been news of growing antibiotic resistance in group B streptococci to penicillin and different antibiotic agents. This clinical study retrospectively analyzes antimicrobial resistance in inpatients who were diagnosed with group B streptococcal pneumonia. METHODS All of the required information from inpatients who were identified to have group B streptococcal pneumonia was sourced from the database at the Department of Internal Medicine of HELIOS Clinic Wuppertal, Witten/Herdecke University, in Germany, from 2004-2014. Antimicrobial susceptibility testing was performed for the different antimicrobial agents that were regularly administered to these inpatients. RESULTS Sixty-six inpatients with a mean age of 63.3 ± 16.1 years (45 males [68.2%, 95% CI 60.0%-79.4%] and 21 females [31.8%, 95% CI 20.6%-43.0%]) were detected to have group B streptococcal pneumonia within the study period from January 1, 2004, to August 12, 2014. Group B Streptococcus had a high resistance rate to gentamicin (12.1%), erythromycin (12.1%), clindamycin (9.1%), and co-trimoxazole (3.0%), but it was not resistant to penicillin, cefuroxime, cefotaxime, or vancomycin (P < 0.0001). CONCLUSION No resistance to penicillin, cefuroxime, cefotaxime, or vancomycin was detected among inpatients with pneumonia caused by group B streptococci.
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Affiliation(s)
- Josef Yayan
- 1. Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Germany
| | - Beniam Ghebremedhin
- 2. Witten/Herdecke University, Witten, Institute of Medical Laboratory Diagnostics, Center for Clinical and Translational Research, HELIOS Clinic Wuppertal, Germany
| | - Kurt Rasche
- 1. Witten/Herdecke University, Witten, Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Germany
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30
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Rasche K. [Acute exacerbations of COPD: Prophylactic antibiotics often makes sense]. MMW Fortschr Med 2014; 156:42. [PMID: 25417470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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31
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Rasche K. [Not Available]. MMW Fortschr Med 2014; 156:42. [PMID: 25507198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Rasche K. [With sleep apnea into social isolation]. MMW Fortschr Med 2014; 156:34. [PMID: 24851441 DOI: 10.1007/s15006-014-2972-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Randerath W, Hein H, Arzt M, Galetke W, Nilius G, Penzel T, Rasche K, Rühle KH, Mayer G. Konsensuspapier zur Diagnostik und Therapie schlafbezogener Atmungsstörungen bei Erwachsenen. Somnologie 2014. [DOI: 10.1007/s11818-013-0649-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leidag M, Kaufmann P, Kohli A, Hader C, Rasche K. Primär extranodales, diffuses pulmonales großzelliges B-Zell-Lymphom – ein Fallbericht. Pneumologie 2014. [DOI: 10.1055/s-0034-1368013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Randerath WJ, Hein H, Arzt M, Galetke W, Nilius G, Penzel T, Rasche K, Rühle KH, Mayer G. [Consensus paper on the diagnosis and treatment of sleep disordered breathing]. Pneumologie 2014; 68:106-23. [PMID: 24497048 DOI: 10.1055/s-0033-1359221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Diagnosis and treatment of sleep disordered breathing (SDB) undergo substantial changes, both in terms of increasing scientific knowledge and also in terms of patient provision and socio-economic aspects. Increasing evidence shows the relevance of SDB on morbidity and mortality of affected patients. The precise differentiation of different phenotypes of SDBs has improved substantially in recent years. These proceedings influence the approach to the patients suspected of suffering from SDB. The scientific advances on the one hand are facing intentions to simplify diagnostical processes and treatment initiation and intentions to translate duties of physicians to non-medical personnel on the other hand. This consensus paper presents the principals of diagnosis, treatment initiation and provision, including the role of different participants of the healthcare system, and compares different treatment options. Major aspects include the differentiation of the diagnostical process in screening, affirmation of diagnosis and differential diagnosis. In addition, it focusses on the relevance of the pretest probability and describes a therapeutical algorithm.
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Affiliation(s)
- W J Randerath
- Krankenhaus Bethanien gGmbH, Institut für Pneumologie an der Universität Witten/Herdecke, Solingen
| | - H Hein
- Praxis für Innere Medizin, Pneumologie, Allergologie und Schlafmedizin, Reinbek
| | - M Arzt
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg
| | - W Galetke
- Krankenhaus der Augustinerinnen, Köln
| | - G Nilius
- HELIOS Klinik Hagen-Ambrock, Hagen
| | - T Penzel
- Charité-Universitätsmedizin Berlin, Schlafmedizinisches Zentrum, Berlin
| | | | | | - G Mayer
- Hephata-Klinik, Schwalmstadt
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Rasche K, Keller T, Hader C, Leidag M, Prinz C. Impact of Obstructive Sleep Apnoea on Type 2 Diabetes and Vice Versa. Eur Endocrinol 2013; 9:107-109. [PMID: 29922363 PMCID: PMC6003579 DOI: 10.17925/ee.2013.09.02.107] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/30/2013] [Indexed: 12/29/2022]
Abstract
Type 2 diabetes and obstructive sleep apnoea (OSA) are diseases with high prevalence and major public health impact. There is evidence that OSA is independently associated with alterations in glucose metabolism. Furthermore, OSA is a significant risk factor for the development of type 2 diabetes. Possible causes might be intermittent hypoxaemia and sleep fragmentation with increased oxidative stress and sympathetic activity, which are typical features of OSA. OSA might also be a reason for ineffective treatment of type 2 diabetes. There is further evidence that the treatment of OSA by continuous positive airway pressure (CPAP) therapy might improve glucose metabolism. On the other hand, there are also hints in the literature that type 2 diabetes might induce sleep apnoea, especially in patients with autonomic neuropathy, but that OSA also facilitates the development of neuropathy in terms of mutual interactions between OSA, type 2 diabetes and diabetic neuropathy. Based on the current scientific data, clinicians have to be aware of the relations between OSA and type 2 diabetes, both from the sleep medical and the diabetological point of view.
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Affiliation(s)
- Kurt Rasche
- Head Pulmonologist and Professor of Internal Medicine, HELIOS Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
| | - Tanja Keller
- Pulmonologist, Pulmonary Practice Aeroprax Wuppertal, Germany
| | - Claus Hader
- Pulmonologist, Pulmonary Practice Aeroprax Wuppertal, Germany
| | - Markus Leidag
- Deputy Head Pulmonologist, HELIOS Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
| | - Christian Prinz
- Head Internal Specialist and Professor of Internal Medicine, Chair of Internal Medicine, HELIOS Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
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Orth M, Rasche K. [Snoring and sleep disorders]. MMW Fortschr Med 2013; 155:50-51. [PMID: 23668177 DOI: 10.1007/s15006-013-0434-y] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- M Orth
- Theresienkrankenhaus und St.Hedwig Klinik GmbH, Medizinische Onkologie, Allergologie, Pneumologische Onkologie, Allergologie, Schlaf-und Beatmungsmedizin Bassermannstr, Mannheim.
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Bauer TT, Nilius G, Grüning W, Rasche K. [Diagnosis and therapy of COPD exacerbation]. Med Klin Intensivmed Notfmed 2012; 107:172-8. [PMID: 22476704 DOI: 10.1007/s00063-011-0065-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 03/04/2012] [Indexed: 10/28/2022]
Abstract
The acute exacerbation of COPD (AECOPD) is a life-threatening clinical situation. This review summarizes the definition of AECOPD, the severity assessment, typical clinical signs and symptoms, and refers to clinical pitfalls of diagnosis and therapy. Important aspects of clinical history and physical examination in severe exacerbations are reported. The necessary accompanying examinations like chest X-ray, blood gas analysis, ECG and echocardiography and their differential diagnosis as well as therapeutic significance are described. The most important lab examinations are summarized and controversial parameters, e.g., procalcitonin, are commented upon. The differentiated need for a microbiological sputum screening is emphasized. The authors place special weight on the essential components of the therapeutic management of severe AECOPD. Practical aspects of uncontrolled oxygen therapy, drug selection, and application form of inhalative acute therapy, dose, and duration of glucocorticoids, the indication for antibiotics, mechanical ventilation, and also opiates are summarized.
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Affiliation(s)
- T T Bauer
- Lungenklinik Heckeshorn, Klinik für Pneumologie, HELIOS-Klinikum Emil von Behring, Berlin, Deutschland
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Rasche K. [Not Available]. MMW Fortschr Med 2011; 153:27. [PMID: 27368247 DOI: 10.1007/bf03368380] [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: 06/06/2023]
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Criée CP, Sorichter S, Smith HJ, Kardos P, Merget R, Heise D, Berdel D, Köhler D, Magnussen H, Marek W, Mitfessel H, Rasche K, Rolke M, Worth H, Jörres RA. Body plethysmography--its principles and clinical use. Respir Med 2011; 105:959-71. [PMID: 21356587 DOI: 10.1016/j.rmed.2011.02.006] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [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] [Received: 09/30/2010] [Revised: 01/07/2011] [Accepted: 02/06/2011] [Indexed: 01/14/2023]
Abstract
Body plethysmography allows to assess functional residual capacity (FRC(pleth)) and specific airway resistance (sRaw) as primary measures. In combination with deep expirations and inspirations, total lung capacity (TLC) and residual volume (RV) can be determined. Airway resistance (Raw) is calculated as the ratio of sRaw to FRC(pleth). Raw is a measure of airway obstruction and indicates the alveolar pressure needed to establish a flow rate of 1 L s(-1). In contrast, sRaw can be interpreted as the work to be performed by volume displacement to establish this flow rate. These measures represent different functional aspects and should both be considered. The measurement relies on the fact that generation of airflow needs generation of pressure. Pressure generation means that a mass of air is compressed or decompressed relative to its equilibrium volume. This difference is called "shift volume". As the body box is sealed and has rigid walls, its free volume experiences the same, mirror image-like shift volume as the lung. This shift volume can be measured via the variation of box pressure. The relationship between shift volume and alveolar pressure is assessed in a shutter maneuver, by identifying mouth and alveolar pressure under zero-flow conditions. These variables are combined to obtain FRC(pleth), sRaw and Raw. This presentation aims at providing the reader with a thorough and precise but non-technical understanding of the working principle of body plethysmography. It also aims at showing that this method yields significant additional information compared to spirometry and even bears a potential for further development.
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Affiliation(s)
- C P Criée
- Evangelisches Krankenhaus Göttingen-Weende gGmbH, Department of Pneumology, Respiratory Care, Sleep Medicine, Pappelweg 5, D-37120 Bovenden-Lenglern, Germany.
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Abstract
Type 2 diabetes and obstructive sleep apnea (OSA) are diseases with high prevalence and major public health impact. There is evidence that regular snoring and OSA are independently associated with alterations in glucose metabolism. Thus, OSA might be a risk factor for the development of type 2 diabetes. Possible causes might be intermittent hypoxia and sleep fragmentation, which are typical features of OSA. OSA might also be a reason of ineffective treatment of type 2 diabetes. There is further evidence that the treatment of OSA by continuous positive airway pressure (CPAP) therapy might correct metabolic abnormalities in glucose metabolism. It is assumed that this depends on therapy compliance to CPAP. On the other hand, there are also hints in the literature that type 2 diabetes per se might induce sleep apnea, especially in patients with autonomic neuropathy. Pathophysiological considerations open up new insights into that problem. Based on the current scientific data, clinicians have to be aware of the relations between the two diseases, both from the sleep medical and the diabetological point of view. The paper summarizes the most important issues concerning the different associations of OSA and type 2 diabetes.
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Affiliation(s)
- Kurt Rasche
- HELIOS Klinikum Wuppertal, Klinikum der Privaten Universität Witten/Herdecke, Wuppertal, Germany.
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Rasche K, Merget R. In memoriam Privatdozent Dr. rer. nat. Wolfgang Marek. Pneumologie 2011; 65:123-4. [DOI: 10.1055/s-0030-1256102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rasche K. [Not Available]. MMW Fortschr Med 2011; 153:25. [PMID: 27368906 DOI: 10.1007/bf03367819] [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: 06/06/2023]
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Rasche K. [Not Available]. MMW Fortschr Med 2010; 152:34. [PMID: 27371050 DOI: 10.1007/bf03367206] [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: 06/06/2023]
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Rasche K, Orth M. Sleep and breathing in idiopathic pulmonary fibrosis. J Physiol Pharmacol 2009; 60 Suppl 5:13-14. [PMID: 20134032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 10/15/2009] [Indexed: 05/28/2023]
Abstract
The outcome of patients with idiopathic pulmonary fibrosis (IPF), which represents the most common type of idiopathic pulmonary pneumonias, is poor. Breathlessness and coughing are usually progressive and about 50% of he patients die within 3 years after diagnosis. The effect of medical treatment in terms of survival is disappointing. Most of the currently available studies only focus on daytime diagnostics and therapy. The role of sleep quality and sleep disordered breathing in IPF is only investigated in a small number of papers, which can be summarized as follows: sleep fragmentation in IPF is very common. The reasons might be coughing, nocturnal oxygen desaturations, and increased respiratory drive. Sleep disorders in IPF have a profound impact on the quality of life. Oxygen desaturations often appear during sleep and can be predicted by the PaO(2) during wakefulness. There are no evidence-based recommendations concerning the indication for oxygen therapy and non-invasive ventilation during sleep in IPF. Obstructive sleep apnea (OSA) has no increased incidence with the exception of the IPF patients with an increased body mass index. If, however, OSA is present in IPF oxygen desaturations are more profound. The therapy of sleep disorders and sleep disordered breathing in IPF is individual. But in the absence of an effective treatment of IPF, optimization of sleep and life quality by the treatment of sleep disorders seems to be a primary goal. Further studies are needed to determine special sleep-related treatment effects.
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Affiliation(s)
- K Rasche
- Lungcenter, St. Antonius Hospital, Wuppertal, Germany.
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Leidag M, Hader C, Keller T, Meyer Y, Rasche K. Mask leakage in continuous positive airway pressure and C-Flex. J Physiol Pharmacol 2008; 59 Suppl 6:401-406. [PMID: 19218664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/06/2008] [Accepted: 08/26/2008] [Indexed: 05/27/2023]
Abstract
Many patients with obstructive sleep apnea syndrome (OSAS) receiving continuous positive airway pressure (CPAP) complain of leaky masks or too high pressure during expiration. C-Flex is a breathing mode with a constant CPAP pressure during inspiration and a reduced pressure during expiration. We compared the leakage data between CPAP and C-Flex and their influence on patients' compliance. Thirty patients (22 men, 8 women, aged 55.4 +/- 11.7 yr, BMI 32.0 +/- 7.4 kg/m(2)) with polysomnographically diagnosed OSAS got a CPAP or C-Flex therapy in a randomized double-blind and cross-over design. After 6 weeks, an adjustment to the other mode followed. Leakage data were sampled during all polysomnographic examinations. Twelve patients dropped out of the study (7 after C-Flex, 5 after CPAP), 4 of them gave up CPAP therapy completely (2 after CPAP, 2 after C-Flex). The leakage in CPAP mode was 27.5 +/-11.5 l/min and in C-Flex mode 28.0 +/-10 l/min (ns). The average nightly use in CPAP mode was 350.0 +/- 70.2 min and in C-Flex mode 347.0 +/- 70.8 min (ns). In the final decision of therapy, 9 patients chose C-Flex and 4 patients CPAP (P=0.001). Five patients had no preference regarding the therapy mode. There is no difference in leakage and compliance between CPAP and C-Flex. But significantly more patients decided for a therapy with the C-Flex mode. There must be other unknown factors that influence the decision for the mode of therapy.
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Affiliation(s)
- M Leidag
- Kliniken St. Antonius - Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf, Lungenzentrum - Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Wuppertal, Germany.
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Orth M, Diekmann C, Suchan B, Duchna HW, Widdig W, Schultze-Werninghaus G, Rasche K, Kotterba S. Driving performance in patients with chronic obstructive pulmonary disease. J Physiol Pharmacol 2008; 59 Suppl 6:539-547. [PMID: 19218679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/12/2008] [Accepted: 09/05/2008] [Indexed: 05/27/2023]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) present with impairments of their cognitive performance. It is still unknown whether cognitive deficits influence driving abilities in patients with COPD. The present study investigates driving performance in patients with COPD and healthy controls. Driving simulation was performed in 17 patients with COPD and 10 healthy controls. Patients with COPD demonstrated significantly worse results in terms of accident frequency in the simulated driving situation. No correlations existed between the severity of disease, assessed from the polysomnographical findings (e.g., lung function, blood gas analysis, sleep disturbance, nocturnal ventilation, and oxygen saturation), and driving performance. We conclude that impairments of driving performance in patients with COPD cannot be predicted on the basis of the severity of the disease. The impairment of driving performance in the simulated driving situation in COPD patients may have crucial consequences for driving licensing in these patients.
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Affiliation(s)
- M Orth
- Department of Internal Medicine, Division of Pneumology, Allergology and Sleep Medicine, University Hospital Bergmannsheil, Germany.
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Orth M, Walther J, Yalzin S, Bauer T, de Zeeuw J, Kotterba S, Baberg H, Schultze-Werninghaus G, Rasche K, Duchna HW. Einfluss der nächtlichen Sauerstofftherapie auf die Lebensqualität bei Patienten mit COPD und isolierter schlafbezogener Hypoxämie: Eine prospektive, plazebokontrollierte cross-over Studie. Pneumologie 2008; 62:11-6. [DOI: 10.1055/s-2007-980129] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Keller T, Hader C, De Zeeuw J, Rasche K. Obstructive sleep apnea syndrome: the effect of diabetes and autonomic neuropathy. J Physiol Pharmacol 2007; 58 Suppl 5:313-318. [PMID: 18204141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Several studies indicate an association between obstructive sleep apnea syndrome (OSAS) and diabetic autonomic neuropathy (DAN). Observed frequency of OSAS in diabetic patients with DAN varies between 26% and 30%. Excessive daytime sleepiness is one of the major clinical symptoms of sleep disordered breathing. Diabetics with autonomic neuropathy might have abnormal control of respiration during sleep, probably resulting in a reduced daytime sleepiness. We investigated the impact of autonomic diabetic neuropathy on clinical symptoms (e.g., daytime sleepiness, measured by Epworth Sleepiness Scale, ESS) in patients with suspected OSAS. We examined 196 patients suspected of sleep apnea (52 female, 144 male, mean age 58.7 yrs, mean BMI 30.57 kg/m2). All patients underwent overnight polysomnography and were tested for autonomic neuropathy by a method of measuring heart rate variabilty and heart rate response to the Valsalva maneuver, standing and deep breathing using a computerized data analysis system. Eighty diabetic subjects: 52 DAN-, 28 DAN+; 116 subjects without diabetes: 101 without autonomic neuropathy (AN), 15 AN+. The group of diabetics with DAN+ had a mean apnoea/hypopnea index (AHI) of 38.6/h, mean oxygen desaturation: 77.5%, mean ESS-Score: 9.86. Diabetic patients DAN-: mean AHI:30.4/h, mean oxygen desaturation: 79.3%, mean ESS-Score 9.73. Defining OSAS as AHI>5/h and ESS-Score>9, 46% of the diabetic patients DAN+ were positive, whereas in the DAN- group 61% met the criteria (non-diabetic patients without AN 50.5%; with AN: 60%). Although the group of diabetic patients with autonomic neuropathy had the lowest percentage of OSAS, statistical analysis showed no significance in comparisons between DAN-/DAN+ or diabetic/non-diabetic. In conclusion, although this study did not give statistical evidence, there is reason to assume that patients with diabetic autonomic neuropathy show fewer clinical symptoms of OSAS than those without it. The examination for OSAS might be indicated even without excessive daytime sleepiness because of elevated cardiovascular risk.
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Affiliation(s)
- T Keller
- Kliniken St. Antonius, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf, Zentrum für Innere Medizin- Schwerpunkt Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Wuppertal, Germany
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