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Intert E, Krause M, Hennersdorf F, Knop K, Rosenkranz T. [Rhabdomyolysis due to drug-drug interaction of atorvastatin and cobicistat]. Inn Med (Heidelb) 2022; 63:1189-1193. [PMID: 36001111 DOI: 10.1007/s00108-022-01377-x] [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] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
A 53-year-old man presented with rhabdomyolysis and acute kidney injury. The symptoms were presumably caused by a drug-drug interaction between an antiretroviral drug combination and atorvastatin. As a booster, cobicistat can also increase the toxicity of statins via inhibition of the enzyme cytochrome p450 3A4 (CYP3A4). After stopping atorvastatin and after intravenous fluid therapy, the symptoms regressed completely.
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Affiliation(s)
- E Intert
- Abteilung für Innere Medizin, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland.
| | - M Krause
- Abteilung für Innere Medizin, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland
| | - F Hennersdorf
- Abteilung für Innere Medizin, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland
| | - K Knop
- Muskelhistologisches Labor, Asklepios Klinik St. Georg, Hamburg, Deutschland
| | - T Rosenkranz
- Muskelhistologisches Labor, Asklepios Klinik St. Georg, Hamburg, Deutschland
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Newbold A, Warren FC, Taylor RS, Hulme C, Burnett S, Aas B, Botella C, Burkhardt F, Ehring T, Fontaine JRJ, Frost M, Garcia-Palacios A, Greimel E, Hoessle C, Hovasapian A, Huyghe VEI, Lochner J, Molinari G, Pekrun R, Platt B, Rosenkranz T, Scherer KR, Schlegel K, Schulte-Korne G, Suso C, Voigt V, Watkins ER. Promotion of mental health in young adults via mobile phone app: study protocol of the ECoWeB (emotional competence for well-being in Young adults) cohort multiple randomised trials. BMC Psychiatry 2020; 20:458. [PMID: 32962684 PMCID: PMC7510072 DOI: 10.1186/s12888-020-02857-w] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence (EC) skills via a mobile app may be an effective, scalable and acceptable way to do this. However, few large-scale controlled trials have examined the efficacy of mobile apps in promoting mental health in young people; none have tailored the app to individual profiles. METHOD/DESIGN The Emotional Competence for Well-Being in Young Adults cohort multiple randomised controlled trial (cmRCT) involves a longitudinal prospective cohort to examine well-being, mental health and EC in 16-22 year olds across 12 months. Within the cohort, eligible participants are entered to either the PREVENT trial (if selected EC scores at baseline within worst-performing quartile) or to the PROMOTE trial (if selected EC scores not within worst-performing quartile). In both trials, participants are randomised (i) to continue with usual practice, repeated assessments and a self-monitoring app; (ii) to additionally receive generic cognitive-behavioural therapy self-help in app; (iii) to additionally receive personalised EC self-help in app. In total, 2142 participants aged 16 to 22 years, with no current or past history of major depression, bipolar disorder or psychosis will be recruited across UK, Germany, Spain, and Belgium. Assessments take place at baseline (pre-randomisation), 1, 3 and 12 months post-randomisation. Primary endpoint and outcome for PREVENT is level of depression symptoms on the Patient Health Questionnaire-9 at 3 months; primary endpoint and outcome for PROMOTE is emotional well-being assessed on the Warwick-Edinburgh Mental Wellbeing Scale at 3 months. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and cost-effectiveness are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. CONCLUSIONS The trial aims to provide a better understanding of the causal role of learning EC skills using interventions delivered via mobile phone apps with respect to promoting well-being and preventing poor mental health in young people. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective Mobile-health public health strategies for preventing poor mental health and promoting well-being. TRIAL REGISTRATION ClinicalTrials.gov ( www.clinicaltrials.org ). Number of identification: NCT04148508 November 2019.
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Affiliation(s)
- A. Newbold
- grid.8391.30000 0004 1936 8024Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN UK
| | - F. C. Warren
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK
| | - R. S. Taylor
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK ,grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - C. Hulme
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK
| | - S. Burnett
- grid.8391.30000 0004 1936 8024Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN UK
| | - B. Aas
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - C. Botella
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castelló de la Plana, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | | | - T. Ehring
- grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - J. R. J. Fontaine
- grid.5342.00000 0001 2069 7798Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - M. Frost
- Monsenso ApS, Copenhagen, Denmark
| | - A. Garcia-Palacios
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castelló de la Plana, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - E. Greimel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - C. Hoessle
- grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - A. Hovasapian
- grid.5342.00000 0001 2069 7798Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - VEI Huyghe
- grid.5342.00000 0001 2069 7798Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - J. Lochner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany ,grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - G. Molinari
- grid.413448.e0000 0000 9314 1427CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - R. Pekrun
- grid.411958.00000 0001 2194 1270Department of Psychology, University of Essex, UK, and Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - B. Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - T. Rosenkranz
- grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - K. R. Scherer
- grid.8591.50000 0001 2322 4988University of Geneva, Geneva, Switzerland
| | - K. Schlegel
- grid.5734.50000 0001 0726 5157University of Bern, Bern, Switzerland
| | - G. Schulte-Korne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - C. Suso
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castelló de la Plana, Spain
| | - V. Voigt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - E. R. Watkins
- grid.8391.30000 0004 1936 8024Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN UK
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Flötotto F, Rosenkranz T, AlSamir K, Urban P, Terborg C. EP 85. Immunosuppression in Vogt-Koyanagi-Harada-syndrome. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.135] [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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Menke A, Luckner K, Wittkugel O, Terborg C, Rosenkranz T. Gutartiger Verlauf einer JC-Virus-assoziierten Kleinhirnatrophie nach langjähriger Natalizumab-Behandlung bei schubförmiger Multipler Sklerose. Akt Neurol 2016. [DOI: 10.1055/s-0042-104274] [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: 10/21/2022]
Affiliation(s)
- A. Menke
- Neurologie, Krankenhaus Buchholz, Buchholz
| | - K. Luckner
- Neurologie, Krankenhaus Buchholz, Buchholz
| | | | - C. Terborg
- Neurologie, Asklepios Klinik St. Georg, Hamburg
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Bayas A, Baum K, Bitsch A, Haas J, Hellwig K, Lang M, Lee DH, Rosenkranz T, Schreiber M, Ulzheimer J, Ziemssen T. Ein Jahr Alemtuzumab – was haben wir in der Praxis gelernt? Experten-Erfahrungsaustausch zur Therapie der Multiplen Sklerose. Akt Neurol 2015. [DOI: 10.1055/s-0035-1555891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- A. Bayas
- Neurologische Klinik und klinische Neurophysiologie, Klinikum Augsburg
| | - K. Baum
- Abteilung Neurologie, Klinik Hennigsdorf, Oberhavel Kliniken GmbH, Hennigsdorf
| | - A. Bitsch
- Klinik für Neurologie, Ruppiner Kliniken GmbH, Neuruppin
| | - J. Haas
- Zentrum für Multiple Sklerose, Jüdisches Krankenhaus Berlin
| | - K. Hellwig
- Neurologie, St. Josef Hospital, Ruhr-Universität Bochum
| | - M. Lang
- Nervenfachärztliche Gemeinschaftspraxis Ulm
| | - D.-H. Lee
- Neurologische Universitätsklinik, Erlangen
| | - T. Rosenkranz
- Abteilung Neurologie, Asklepios Klinik St. Georg, Hamburg
| | | | - J. Ulzheimer
- Klinik für Neurologie, Caritas-Krankenhaus Bad Mergentheim
| | - T. Ziemssen
- Neurologische Klinik und Poliklinik, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
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Thoden J, Potthoff A, Bogner JR, Brockmeyer NH, Esser S, Grabmeier-Pfistershammer K, Haas B, Hahn K, Härter G, Hartmann M, Herzmann C, Hutterer J, Jordan AR, Lange C, Mauss S, Meyer-Olson D, Mosthaf F, Oette M, Reuter S, Rieger A, Rosenkranz T, Ruhnke M, Schaaf B, Schwarze S, Stellbrink HJ, Stocker H, Stoehr A, Stoll M, Träder C, Vogel M, Wagner D, Wyen C, Hoffmann C. Therapy and prophylaxis of opportunistic infections in HIV-infected patients: a guideline by the German and Austrian AIDS societies (DAIG/ÖAG) (AWMF 055/066). Infection 2013; 41 Suppl 2:S91-115. [PMID: 24037688 PMCID: PMC3776256 DOI: 10.1007/s15010-013-0504-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 04/23/2013] [Accepted: 06/28/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION There was a growing need for practical guidelines for the most common OIs in Germany and Austria under consideration of the local epidemiological conditions. MATERIALS AND METHODS The German and Austrian AIDS societies developed these guidelines between March 2010 and November 2011. A structured Medline research was performed for 12 diseases, namely Immune reconstitution inflammatory syndrome, Pneumocystis jiroveci pneumonia, cerebral toxoplasmosis, cytomegalovirus manifestations, candidiasis, herpes simplex virus infections, varizella zoster virus infections, progressive multifocal leucencephalopathy, cryptosporidiosis, cryptococcosis, nontuberculosis mycobacteria infections and tuberculosis. Due to the lack of evidence by randomized controlled trials, part of the guidelines reflects expert opinions. The German version was accepted by the German and Austrian AIDS Societies and was previously published by the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF; German Association of the Scientific Medical Societies). CONCLUSION The review presented here is a translation of a short version of the German-Austrian Guidelines of opportunistic infections in HIV patients. These guidelines are well-accepted in a clinical setting in both Germany and Austria. They lead to a similar treatment of a heterogeneous group of patients in these countries.
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Affiliation(s)
- J Thoden
- Private Practice Dr. C. Scholz and Dr. J. Thoden, Bertoldstrasse 8, 79098, Freiburg, Germany,
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Stiegler A, Rosenkranz T, Abele H, Zipfel S, Batra A. IRIS I - Ein Pilotprojekt zur Entwicklung einer individualisierten, risikoadaptierten Intervention zur Verringerung des Alkohol- und Tabakkonsums bei Schwangeren. Suchttherapie 2013. [DOI: 10.1055/s-0033-1351648] [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: 10/26/2022]
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Hofmann A, Stellmann JP, Kasper J, Ufer F, Elias WG, Pauly I, Repenthin J, Rosenkranz T, Weber T, Köpke S, Heesen C. Long-term treatment risks in multiple sclerosis: risk knowledge and risk perception in a large cohort of mitoxantrone-treated patients. Mult Scler 2012; 19:920-5. [DOI: 10.1177/1352458512461967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Balancing treatment benefits and risks is part of a shared decision-making process before initiating any treatment in multiple sclerosis (MS). Patients understand, appreciate and profit from evidence-based patient information (EBPI). While these processes are well known, long-term risk awareness and risk processing of patients has not been studied. Mitoxantrone treatment in MS is associated with long-term major potential harms – leukaemia (LK) and cardiotoxicity (CT). The risk knowledge and perception among patients currently or previously treated with mitoxantrone is unknown. Objectives: The objective of this article is to conduct a retrospective cohort study in greater Hamburg, Germany, to estimate risk awareness and perception in MS patients treated with mitoxantrone. Methods: MS patients with at least one dose of mitoxantrone between 1991 and 2010 from six major MS centres in greater Hamburg received a questionnaire assessing risk awareness and perception as well as a written EBPI about mitoxantrone-associated LK and CT. Results: Fifty-one per cent in the cohort of n = 575 patients returned the questionnaire. Forty per cent correctly estimated the risk of LK (CT 16%); 56% underestimated the risk (CT 82%). Reading the information increased the accuracy of LK risk estimation, and patients did not report an increase of worries. The EBPI was appreciated and recommended by 85%. Conclusion: Risk awareness of mitoxantrone-treated patients is insufficient, but can be increased by EBPI without increasing worries. Continued patient information during and after treatment should be implemented in management algorithms.
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Affiliation(s)
- A Hofmann
- Institute for Neuroimmunology and Clinical MS Research (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany
| | - JP Stellmann
- Institute for Neuroimmunology and Clinical MS Research (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany
| | - J Kasper
- Institute for Neuroimmunology and Clinical MS Research (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany
- Department of Primary Medical Care, University Medical Center Hamburg, Germany
- Unit of Health Science and Education, University of Hamburg, Germany
| | - F Ufer
- Institute for Neuroimmunology and Clinical MS Research (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany
| | | | - I Pauly
- Department of Neurology, Asklepios Klinik Nord, Germany
| | - J Repenthin
- Department of Neurology, Asklepios Klinik Barmbek, Germany
| | - T Rosenkranz
- Department of Neurology, Asklepios Klinik St. Georg, Germany
| | - T Weber
- Department of Neurology, Marienkrankenhaus, Germany
| | - S Köpke
- Institute for Neuroimmunology and Clinical MS Research (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany
- Nursing Research Group, Institute for Social Medicine, University of Lübeck, Germany
| | - C Heesen
- Institute for Neuroimmunology and Clinical MS Research (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany
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Ramm A, Rosenkranz T, Terborg C. Foudroyanter Verlauf einer Multiplex-Neuropathie als Erstmanifestation eines Morbus Wegener. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schwabe J, Rosenkranz T, Knop KC, Terborg C. Steroid-responsive Myalgien: atypische Polymyalgia rheumatica oder unspezifische Autoimmunerkrankung mit muskulärer Beteiligung? Akt Neurol 2009. [DOI: 10.1055/s-0029-1238820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schippling S, Orth M, Beisiegel U, Rosenkranz T, Vogel P, Munchau A, Hagel C, Seedorf U. SEVERE TANGIER DISEASE WITH A NOVEL ABCA1 GENE MUTATION. Neurology 2008; 71:1454-5. [DOI: 10.1212/01.wnl.0000327870.29639.20] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Knop K, Klein M, Rosenkranz T, Terborg C. Therapieresistente und schwer verlaufende Dermatomyositis mit Kriterien einer immunvermittelten nekrotisierenden Myopathie mit SRP Autoantikörpern. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086711] [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: 10/21/2022]
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Strucksberg K, Rosenkranz T, Fitter J. Reversible and irreversible unfolding of multi-domain proteins. Biochimica et Biophysica Acta (BBA) - Proteins and Proteomics 2007; 1774:1591-603. [DOI: 10.1016/j.bbapap.2007.09.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 09/06/2007] [Accepted: 09/10/2007] [Indexed: 10/22/2022]
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Hoffmann C, Ernst M, Meyer P, Wolf E, Rosenkranz T, Plettenberg A, Stoehr A, Horst HA, Marienfeld K, Lange C. Evolving characteristics of toxoplasmosis in patients infected with human immunodeficiency virus-1: clinical course and Toxoplasma gondii-specific immune responses. Clin Microbiol Infect 2007; 13:510-5. [PMID: 17298486 DOI: 10.1111/j.1469-0691.2007.01683.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Toxoplasmic encephalitis (TE) is the most important opportunistic infection of the central nervous system in patients infected with human immunodeficiency virus (HIV)-1. This study evaluated the effect of highly active anti-retroviral therapy (HAART) and Toxoplasma gondii-specific immune responses on the occurrence of TE. The clinical characteristics of all patients diagnosed with TE in two centres since 1990 (n = 140) were analysed. Patients were grouped according to the date of diagnosis (period 1, 1990-1993; period 2, 1994-1996; period 3, 1997 onwards). Immune responses to T. gondii were evaluated in a subgroup (n = 12) by interferon (IFN)-gamma-specific ELISPOT tests. There were marked differences in the estimated Kaplan-Meier overall survival (OS), with a 1-year OS (5-year OS) of 41% (7%) in period 1, 56% (29%) in period 2, and 90% (78%) in period 3 (p <0.0001). In period 3, TE was found to be the first AIDS-defining illness more frequently than in earlier periods (74% vs. 38%, p 0.0002). Persistent neurological deficits caused by TE were present in 37% of the patients. Patients with an acute episode of TE or a TE relapse had significantly lower responses in the T. gondii-specific ELISPOT than patients who discontinued maintenance therapy and were relapse-free (p 0.0044). Survival of HIV patients with TE has improved markedly since the introduction of HAART, but persistent neurological deficits are often present in surviving patients. While preventive therapy remains essential, evaluation of T. gondii-specific immune responses may be an important step in improving estimates of the individual risk of TE and TE relapses.
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Affiliation(s)
- C Hoffmann
- University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
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Schippling S, Rosenkranz T, Vogel P, Beisiegel U, Münchau A, Hagel C, Seedorf U. Tangier disease with syringomyelia-like phenotype in a family from Afghanistan caused by a novel mutation in the ABCA1 gene. Akt Neurol 2006. [DOI: 10.1055/s-2006-953311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Illies T, Rosenkranz T, Lange R, Vogel P. Susac Syndrom und Multiple Sklerose in einer Familie – Eine seltene und eine häufige Autoimmunerkrankung des ZNS? – Case report. Akt Neurol 2006. [DOI: 10.1055/s-2006-953229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- T Rosenkranz
- Abteilung für Neurologie, Allgemeines Krankenhaus St. Georg Hamburg.
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Hoffmann C, Tabrizian S, Wolf E, Eggers C, Stoehr A, Plettenberg A, Buhk T, Stellbrink HJ, Horst HA, Jäger H, Rosenkranz T. Survival of AIDS patients with primary central nervous system lymphoma is dramatically improved by HAART-induced immune recovery. AIDS 2001; 15:2119-27. [PMID: 11684931 DOI: 10.1097/00002030-200111090-00007] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the impact of immune recovery induced by highly active antiretroviral therapy (HAART) on the survival of AIDS patients with primary central nervous system lymphoma (PCNSL). METHODS In a multicentric retrospective analysis, 29 HIV-infected patients with histologically confirmed PCNSL were identified. To evaluate median survival, Kaplan-Meier statistics were used. To explore the effects of different variables on survival, a Weibull accelerated failure time regression analysis was performed. RESULTS Median age at manifestation of PCNSL was 39.1 years and median CD4 cell count was 11 x 10(6) cells/l. Seventy per cent of the patients had had a prior AIDS-defining illness. Cranial radiation (CR) was given to 12 out of 29 patients. Six patients were treated with HAART. Survival time of these patients and of the patients treated with CR alone differed significantly from those receiving neither CR nor HAART (median Kaplan-Meier survival estimate: 1093, 132, and 33 days, respectively). In the multivariate regression model, HAART and CR were identified as the only variables independently associated with prolonged survival. HAART versus no HAART and CR versus no CR increased the time to event by a factor of 6.1 (95% confidence interval, 2.4-16.0; P = 0.0002) and 3.1 (95% confidence interval, 1.5-6.3; P = 0.002), respectively. Four out of six patients on HAART showed a marked immune recovery and survived for more than 1.5 years, with two patients still alive. CONCLUSION Data from this cohort indicate that immune recovery induced by HAART leads to dramatic improvement in survival of patients with AIDS-associated PCNSL. These findings may have important implications for future treatment strategies.
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Affiliation(s)
- C Hoffmann
- Curatorium for Immunedeficiency, Munich, Germany
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Strohmaier WL, Schubert G, Rosenkranz T, Weigl A. Comparison of extracorporeal shock wave lithotripsy and ureteroscopy in the treatment of ureteral calculi: a prospective study. Eur Urol 1999; 36:376-9. [PMID: 10516445 DOI: 10.1159/000020017] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
146 patients whose ureteral stones did not pass spontaneously participated in a prospective study on optimal management. Patients were offered two treatment options: extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS). The stone was treated with the technique preferred by the patient. In case of treatment failure after first-line therapy, patients again could decide on how to proceed. Stone analysis could be obtained from 72.6% patients. ESWL was the primary treatment in 66.4% patients. In 2 patients, ESWL was the secondary treatment after failed URS. URS was the first-line therapy in 33.6% patients. In 29 patients URS was done after failed ESWL. For analgesia, sedoanalgesia or spinal anesthesia were used. Analgesia was required in 74.2% ESWL and 100% URS sessions. Following ESWL, 70.1% patients became stone free. In 29.9% ESWL failed. Distal stones had a higher failure rate than proximal or mid-ureteral calculi. Distal stones treated without success were significantly larger than those treated successfully. Failures were switched to URS. Stone analysis could be obtained in 26 patients with failed ESWL: 23/26 consisted of pure whewellite or mixed whewellite stones. Clinically relevant complications were not observed. After URS, 94.9% of the patients became stone free. In distal stones, the stone-free rate was 97.5%. There was only 1 relevant complication: a proximal ureteral lesion requiring surgical repair. Our study demonstrates that URS is a safe and highly effective treatment option for ureteral stones. In patients with distal ureteral stones, it should be offered as a first-line treatment. When whewellite is expected as the stone mineral, URS is the treatment of choice.
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Weber JR, Angstwurm K, Rosenkranz T, Lindauer U, Freyer D, Bürger W, Busch C, Einhäupl KM, Dirnagl U. Heparin inhibits leukocyte rolling in pial vessels and attenuates inflammatory changes in a rat model of experimental bacterial meningitis. J Cereb Blood Flow Metab 1997; 17:1221-9. [PMID: 9390654 DOI: 10.1097/00004647-199711000-00011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Heparin is a natural proteoglycan that was first described in 1916. In addition to its well characterized effect on blood coagulation, it is becoming clear that heparin also modulates inflammatory processes on several levels, including the interference with leukocyte-endothelium interaction. Anecdotal observations suggest a better clinical outcome of heparin-treated patients with bacterial meningitis. The authors demonstrate that heparin, a glycosaminoglycan, inhibits significantly in the early phase of experimental pneumococcal meningitis the increase of 1) regional cerebral blood flow (125 +/- 18 versus 247 +/- 42%), 2) intracranial pressure (4.5 +/- 2.0 versus 12.1 +/- 2.2 mm Hg), 3) brain edema (brain water content: 78.23 +/- 0.33 versus 79.49 +/- 0.46%), and 4) influx of leukocytes (571 +/- 397 versus 2400 +/- 875 cells/microL) to the cerebrospinal fluid compared with untreated rats. To elucidate the possible mechanism of this observation, the authors investigated for the first time leukocyte rolling in an inflammatory model in brain venules by confocal laser scanning microscopy in vivo. Heparin significantly attenuates leukocyte rolling at 2, 3, and 4 hours (2.8 +/- 1.3 versus 7.9 +/- 3.2/100 microm/min), as well as leukocyte sticking at 4 hours (2.1 +/- 0.4 versus 3.5 +/- 1.0/100 microm/min) after meningitis induction compared with untreated animals. The authors conclude that heparin can modulate acute central nervous system inflammation and, in particular, leukocyte-endothelium interaction, a key process in the cascade of injury in bacterial meningitis. They propose to evaluate further the potential of heparin in central nervous system inflammation in basic and clinical studies.
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Affiliation(s)
- J R Weber
- Department of Neurology, Universitätsklinikum Charité, Humboldt University, Berlin, Germany
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Weber JR, Angstwurm K, Rosenkranz T, Lindauer U, Bürger W, Einhäupl KM, Dirnagl U. Histamine (H1) receptor antagonist inhibits leukocyte rolling in pial vessels in the early phase of bacterial meningitis in rats. Neurosci Lett 1997; 226:17-20. [PMID: 9153631 DOI: 10.1016/s0304-3940(97)00233-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The present study tested the hypothesis whether a histamine dependent pathway is involved in leukocyte-endothel interaction in the early phase of bacterial meningitis. Using confocal laser scanning microscopy we investigated leukocyte rolling in brain venules in vivo during 4 h in experimental pneumococcal meningitis in the rat. Leukocyte rolling, but not firm adhesion induced by intracisternally (i.c.) injected pneumococcal cell wall components, was temporarily inhibited (2 h, 5.6 +/- 1.9 vs. 2.3 +/- 0.9; 3 h, 7.4 +/- 2.7 vs. 3.1 +/- 1.3/100 microm/min) by diphenhydramine, a histamine H1 receptor antagonist. Histamine, possibly released by activated mast cells, is known to initiate P-selectin upregulation and subsequent leukocyte rolling. This data suggest that histamine is a mediator of leukocyte rolling in the early phase of bacterial meningitis.
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Affiliation(s)
- J R Weber
- Department of Neurology, Universitätsklinikum Charité, Humboldt University Berlin, Germany.
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25
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Neuwirth J, Andresen B, Seifert R, Stark FM, Spehr W, Thomasius R, Rosenkranz T. [Quantitative EEG, basic disorders and smoking in etiopathogenetically different groups of paranoid-hallucinatory psychoses--an exploratory study]. Fortschr Neurol Psychiatr 1995; 63:78-89. [PMID: 7705743 DOI: 10.1055/s-2007-996606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We performed an exploratory study of quantitative EEG in aetiopathogenetically different paranoid-hallucinatory psychoses divided into the following groups: a) patients with familial psychoses (n = 12), b) patients with neuropsychological deficits (n = 16), c) patients with alcohol and drug abuse (n = 22) and d) patients with so-called sporadic psychoses (n = 12). We found a significant reduction of relative alpha power in the group with neuropsychological deficits. In the group with familial psychosis there was a significant reduction of absolute delta power and a significant increase of relative beta power and dominant beta frequency, especially for the frontal leads. Patients with drug abuse showed a reduction of absolute beta power and an increase of absolute and relative theta power. The group with sporadic psychosis showed a significant slowing of the dominant beta frequency and a significant increase of the absolute power of fast alpha rhythms. The group with sporadic psychoses showed lowered scores for the paranoid-hallucinatory basic symptom factor. The group with neuropsychological deficits showed the most visceral-somatoform basic symptoms, the highest nicotine consumption, increased dyskinesias and more perinatal complications. This group also showed the highest level of neuroleptic and antiparkinson medication. All in all, the group with neuropsychological deficits showed a complex interaction of somatic-exogenic and medical-iatrogenic factors. Furthermore, there was a significant positive correlation between paranoid-hallucinatory basic symptoms and nicotine abuse and high frequency beta waves.
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MESH Headings
- Adult
- Brain Damage, Chronic/complications
- Brain Damage, Chronic/diagnosis
- Brain Damage, Chronic/genetics
- Diagnosis, Differential
- Electroencephalography
- Female
- Hallucinations/diagnosis
- Hallucinations/etiology
- Hallucinations/genetics
- Humans
- Male
- Middle Aged
- Neurocognitive Disorders/diagnosis
- Neurocognitive Disorders/etiology
- Neurocognitive Disorders/genetics
- Neuropsychological Tests
- Paranoid Disorders/diagnosis
- Paranoid Disorders/etiology
- Paranoid Disorders/genetics
- Psychoses, Alcoholic/diagnosis
- Psychoses, Alcoholic/etiology
- Psychoses, Alcoholic/genetics
- Risk Factors
- Schizophrenia, Paranoid/diagnosis
- Schizophrenia, Paranoid/etiology
- Schizophrenia, Paranoid/genetics
- Smoking/adverse effects
- Substance-Related Disorders/diagnosis
- Substance-Related Disorders/etiology
- Substance-Related Disorders/genetics
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Affiliation(s)
- J Neuwirth
- Psychiatrische und Nervenklinik, Universitätskrankenhauses Hamburg-Eppendorf
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