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Kirsten D, de Vries U, Costabel U, Koschel D, Bonella F, Günther A, Behr J, Claussen M, Schwarz S, Prasse A, Kreuter M. [Linguistic Validation of the "German Lung Fibrosis Health Related Quality of Life Questionnaire"]. Pneumologie 2021; 75:753-760. [PMID: 34428830 DOI: 10.1055/a-1334-2745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
UNLABELLED Health status and quality of life are impaired in patients with idiopathic pulmonary fibrosis (IPF) and idiopathic non-specific interstitial fibrosis (iNSIP). In Germany exists only the K-BILD questionnaire for patients with ILD 1 in a professional translation by Kreuter et al. 2 This questionnaire focuses on the main problems in patients with progressive lung fibrosis in a limited manner. Therefore a new quality of life questionnaire for patients with idiopathic pulmonary fibrosis was developed and linguistically validated. METHODS The linguistic validation of our questionnaire was carried out in a multistage process in collaboration with the developer of the questionnaire and bilingual, professional translators. Review by the developers and back translations as well as clinical assessment by IPF- and iNSIP-patients ensured that the translated questionnaire reflected the intention of the original English version of our questionnaire.Cross-validation was carried out with the St. Georges Respiratory Questionnaire (SGRQ). RESULTS The new questionnaire concerning the health status was composed in English and German language. The questions cover five scales (sensitivity, selectivity and symptoms like breathlessness and cough and a visual analog scale on general health status) with 23 items. CONCLUSIONS The results show that the FFB maps the special needs of the patients with IPF and iNSIP well and can support clinical and scientific questions and can be helpful in monitoring the clinical course.
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Affiliation(s)
| | - U de Vries
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - U Costabel
- Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen
| | | | - F Bonella
- Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen
| | - A Günther
- Medizinische Klinik Universität Gießen
| | - J Behr
- Medzinische Klinik und Poliklinik V, LMU Klinikum, Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | | | - S Schwarz
- Asklepios Klinikum Harburg, Lungenabteilung
| | - A Prasse
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - M Kreuter
- Zentrum für interstitielle und seltene Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg und Deutsches Zentrum für Lungenforschung, Heidelberg
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Kreuter M, Ochmann U, Koschel D, Behr J, Bonella F, Claussen M, Costabel U, Jungmann S, Kolb M, Nowak D, Petermann F, Pfeifer M, Prasse A, Schreiber J, Wälscher J, Wirtz H, Kirsten D. Fragebogen der Sektion 7 der DGP zur Erfassung der Ursachen interstitieller und seltener Lungenerkrankungen. Pneumologie 2018. [DOI: 10.1055/s-0037-1619188] [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)
- M Kreuter
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik; Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (TLRC); Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - U Ochmann
- Institut für Arbeits-, Sozial- und Umweltmedizin; Klinikum der LMU-Universität München
| | - D Koschel
- Zentrum für Pneumologie-, Thorax- und Gefäßchirurgie, Fachkrankenhaus Coswig
| | | | | | | | | | | | - M Kolb
- Mcmaster University, Hamilton, Canada
| | - D Nowak
- Comprehensive Pneumology Center, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin; Klinikum der LMU München
| | - F Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - M Pfeifer
- Klinik Donaustauf und Universitätsklinikum Regensburg
| | - A Prasse
- Klinik für Pneumologie, Medizinische Hochschule, Hannover
| | - J Schreiber
- Fachbereich Pneumologie, Universitätsklinikum Magedeburg A. ö. R
| | - J Wälscher
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Thoraxklinik, Uniklinikum Heidelberg
| | - H Wirtz
- Pneumologie, Universitätsklinikum der Universität Leipzig
| | - D Kirsten
- Airway Research Center North (Arcn), Lungenclinic Grosshansdorf; Member of the German Center for Lung Research (DZL)
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Kreuter M, Ochmann U, Koschel D, Behr J, Bonella F, Claussen M, Costabel U, Jungmann S, Kolb M, Nowak D, Petermann F, Pfeiffer M, Polke M, Prasse A, Schreiber J, Wälscher J, Wirtz H, Kirsten D. Patientenfragebogen zur Erfassung der Ursachen interstitieller und seltener Lungenerkrankungen – klinische Sektion der DGP. Pneumologie 2018; 72:446-457. [DOI: 10.1055/s-0044-100207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund Interstitielle Lungenerkrankungen (ILD) umfassen verschiedenste heterogene, zumeist chronische Erkrankungen des Interstitiums und/oder der Alveolen mit bekannten und unbekannten Ursachen. Die Diagnostik der ILD ist sehr komplex und sollte interdisziplinär erfolgen. Eine der wesentlichen Basisuntersuchungen ist eine umfangreiche Anamnese. Hierzu kam im deutschsprachigen Raum bisher der Frankfurter Bogen von 1985 zur Anwendung, der mittlerweile jedoch sprachlich und inhaltlich einer Überarbeitung bedurfte.
Methode Unter Schirmherrschaft der klinischen Sektion der DGP erfolgte die Erstellung eines neuen Patientenfragebogens zur Diagnostik interstitieller und seltener Lungenerkrankungen. Der Fragebogen entstand unter Mitarbeit von Pneumologen mit ILD-Expertise, Arbeitsmedizinern und Psychologen sowie der Unterstützung von Selbsthilfegruppen. Abschließend wurde der Fragebogen mithilfe von Patienten sprachlich optimiert.
Ergebnisse Der neu erstellte Patientenfragebogen zur Diagnostik interstitieller und seltener Lungenerkrankungen umfasst mehrere Bereiche: Initiale und aktuelle Symptome, Fragen zur Vorgeschichte inklusive Medikation, pulmonale und extrapulmonale Vorerkrankungen, mögliche Expositionen im häuslichen, privatem und beruflichem Umfeld sowie Familienanamnese und Reisetätigkeiten.
Schlussfolgerung Der neu erstellte Fragebogen kann in der klinischen Routine die Diagnostik bei Patienten mit Verdacht auf eine interstitielle Lungenerkrankung wesentlich erleichtern.
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Affiliation(s)
- M. Kreuter
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Thoraxklinik; Universitätsklinikum Heidelberg; Mitglied des Deutschen Zentrums für Lungenforschung
| | - U. Ochmann
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin; Klinikum der LMU München; Mitglied des Deutschen Zentrums für Lungenforschung
| | - D. Koschel
- Fachkrankenhaus Coswig; Zentrum für Pneumologie-, Thorax- und Gefäßchirurgie
| | - J. Behr
- Medizinische Klinik und Poliklinik V, Klinikum der Universität München, LMU und Asklepios Fachkliniken München-Gauting, Mitglied des Deutschen Zentrums für Lungenforschung
| | - F. Bonella
- Ruhrlandklinik, Universitätsmedizin Essen
| | - M. Claussen
- LungenClinic Grosshansdorf; Mitglied des Deutschen Zentrums für Lungenforschung
| | | | | | - M. Kolb
- McMasters Universität, Hamilton, Canada
| | - D. Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin; Klinikum der LMU München; Mitglied des Deutschen Zentrums für Lungenforschung
| | - F. Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - M. Pfeiffer
- Klinik Donaustauf und Universitätsklinikum Regensburg
| | - M. Polke
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Thoraxklinik; Universitätsklinikum Heidelberg; Mitglied des Deutschen Zentrums für Lungenforschung
| | - A. Prasse
- Medizinische Hochschule Hannover; Klinik für Pneumologie, Mitglied des Deutschen Zentrums für Lungenforschung
| | - J. Schreiber
- Universitätsklinik für Pneumologie, Universitätsklinikum Magdeburg
| | - J. Wälscher
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Thoraxklinik; Universitätsklinikum Heidelberg; Mitglied des Deutschen Zentrums für Lungenforschung
| | - H. Wirtz
- Universitätsklinikum der Universität Leipzig; Pneumologie
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Affiliation(s)
- H J Klippe
- Krankenhaus Großhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Großhansdorf
| | - D Kirsten
- Krankenhaus Großhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Großhansdorf
| | - C Andrée
- Institut für Geschichte der Medizin, Christian-Albrechts-Universität, Kiel
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Biancosino C, Welker L, Krüger M, Bölükbas S, Bittmann I, Kirsten D. Diagnostic Gain from Surgical Biopsy for Interstitial Lung Disease - When is it Worth the Risk? Pneumologie 2016; 70:205-10. [PMID: 26977754 DOI: 10.1055/s-0042-100551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND History, clinical presentation, lung function testing, radiographs including HRCT and nonsurgical biopsy techniques in most cases provide sufficient information for classification of interstitial lung disease (ILD). However, in a small percentage it is not possible to establish the diagnosis so that lung biopsy may be required. We analyzed under which circumstances a reduction of invasive procedures is reasonable. METHODS Between January 1997 and December 2009 we examined 3399 specimens from 1299 patients with benign inflammatory and granulomatous diseases in whom ILD was clinically hypothesized. We compared the probability of disease according to Bayes before and after surgery which corresponds to the clinical diagnosis (a priori probability) and the final diagnosis (a posteriori probability). Additionally, procedures, operation related complications and the patients' smoking habits were documented. RESULTS In 111 patients (8.5 %) surgical evaluation was performed (14 mediastinoscopies, 97 thoracotomies/VATS biopsies). All mediastinoscopies substantiated a epitheloid cell granulomatosis. In 30 % of all VATS procedures a prolonged air leak of more than 4 days was observed. One patient died and one had to get a new chest tube after removal. Changes of a priori/a posteriori probabilities was shown for non-smokers in Wegner's granulomatosis (0.6 vs. 2.2 %) and IPF (16.7 vs. 34.8 %), for smokers in Langerhans' cell histiocytosis (1.4 vs. 7.8 %) and IPF (16.7 vs. 33.3 %). In the majority of cases even a reduction of probability was seen. CONCLUSION Considering complications and limited diagnostic gain, lung biopsies for diagnosis of ILD should be recommended only in selected patients.
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Affiliation(s)
- C Biancosino
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - L Welker
- Lung Clinic Grosshansdorf, Center for Pneumology and Thoracic Surgery, Grosshansdorf, Germany
| | - M Krüger
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - S Bölükbas
- Department of Thoracic Surgery, Helios Klinikum Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany
| | - I Bittmann
- Institute of Pathology, Clinic Rotenburg, Rotenburg, Germany
| | - D Kirsten
- Lung Clinic Grosshansdorf, Center for Pneumology and Thoracic Surgery, Grosshansdorf, Germany
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Bahmer T, Watz H, Waschki B, Gramm M, Magnussen H, Rabe KF, Wirtz H, Kirsten D, Kirsten AM. Körperliche Aktivität und der Einfluss von Atemwegsobstruktion, Gesundheitsstatus und Fatigue bei Patienten mit Lymphangioleiomyomatose. Pneumologie 2016. [DOI: 10.1055/s-0036-1572068] [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: 10/22/2022]
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Behr J, Bonella F, Bonnet R, Gläser S, Grohé C, Günther A, Koschel D, Kreuter M, Kirsten D, Krögel C, Markart P, Müller-Quernheim J, Neurohr C, Pfeifer M, Prasse A, Schönfeld N, Schreiber J, Wirtz H, Witt C, Costabel U. [Position Paper: Significance of the Forced Vital Capacity in Idiopathic Pulmonary Fibrosis]. Pneumologie 2015; 69:455-8. [PMID: 26227628 DOI: 10.1055/s-0034-1392602] [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] [Indexed: 10/23/2022]
Abstract
Spirometry is a highly standardized method which allows to measure the forced vital capacity (FVC) with high precision and reproducibility. In patients with IPF FVC is directly linked to the disease process which is characterized by scaring of alveoli and shrinkage of the lungs. Consequently, there is ample evidence form clinical studies that the decline of FVC over time is consistently associated with mortality in IPF. As for the first time effective drugs for the treatment of IPF are available it becomes obvious that in studies which could demonstrate that the drug reduces FVC decline, a numerical effect on mortality was also observed, while in one study where a significant effect on FVC decline was missed, there was also no change in mortality. Based on these studies FVC decline is a validated surrogate of mortality in IPF. It is concluded that FVC decline is not only accepted as an endpoint of clinical treatment trials in IPF but is also valid as a patient related outcome parameter which should be considered for the assessment of the efficacy of an IPF drug.
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Affiliation(s)
- J Behr
- Medizinische Klinik und Poliklinik V, Klinikum der Universität München und Asklepios Fachkliniken München-Gauting, Comprehensive Pneumology Center, Mitglied des Deutschen Zentrums für Lungenforschung
| | - F Bonella
- Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen gGmbH
| | - R Bonnet
- Abteilung Pneumologie, Zentralklinik Bad Berka GmbH
| | - S Gläser
- Klinik für Innere Medizin B - Bereich Pneumologie, Infektiologie und Weaningzentrum Forschungsbereich Pneumologie und Pneumologische Epidemiologie Universitätsmedizin Greifswald
| | - C Grohé
- Pneumologische Klinik Evangelische Lungenklinik Berlin - Krankenhausbetriebs gGmbH
| | - A Günther
- Medizinische Klinik III, Pneumologie und Internistische Intensivmedizin Agaplesion Evangelisches Krankenhaus Mittelhessen und Schwerpunkt "Fibrosierende Lungenerkrankungen", Universitätsklinikum Gießen Marburg GmbH, Mitglied des Deutschen Zentrums für Lungenforschung
| | - D Koschel
- Abteilung Innere Medizin/Pneumologie, Fachkrankenhaus Coswig GmbH Zentrum für Pneumologie, Allergologie, Beatmungsmedizin, Thorax- und Gefäßchirurgie
| | - M Kreuter
- Pneumologie und Beatmungsmedizin, Zentrum für seltene und interstitielle Lungenerkrankungen Thoraxklinik, Universitätsklinikum Heidelberg, Mitglied des Deutschen Zentrums für Lungenforschung
| | | | - C Krögel
- Abteilung Pneumologie & Allergologie/Immunologie, Medizinische Klinik I, Klinikum der Universität Jena
| | - P Markart
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen und Medizinische Klinik V (Pneumologie), Herz-Thorax-Zentrum, Klinikum Fulda gAG
| | | | - C Neurohr
- Medizinische Klinik und Poliklinik V, Klinikum der Universität München, Comprehensive Pneumology Center, Mitglied des Deutschen Zentrums für Lungenforschung
| | - M Pfeifer
- Klinik Donaustauf, Klinik für Pneumologie und konservative Intensivmedizin Krankenhaus Barmherzige Brüder, Regensburg, Klinik und Poliklinik für Innere Medizin II Universität Regensburg
| | - A Prasse
- Abteilung Pneumologie, Medizinische Hochschule Hannover
| | - N Schönfeld
- Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin
| | - J Schreiber
- Klinik für Pneumologie, Universitätsklinikum der Otto-von-Guericke-Universität, Magdeburg
| | - H Wirtz
- Abteilung Pneumologie, Universitätsklinikum Leipzig
| | - C Witt
- Abteilung Pneumologie und Transplantation, Universitätsklinikum Charité, Berlin
| | - U Costabel
- Senior Consultant, Interstitielle und Seltene Lungenkrankheiten, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen gGmbH
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Kirsten AM, Watz H, Kirsten D. Lymphangioleiomyomatose und Pneumothoraxrisiko beim Fliegen. Pneumologie 2015. [DOI: 10.1055/s-0035-1544813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kreuter M, Kirsten D, Bahmer T, Penzel R, Claussen M, Oltmanns U, Ehlers-Tenenbaum S, Muley T, Palmowski K, Kugler C, Baroke E, Eichinger M, Schnabel PA, Heussel CP, Herth FJF, Rabe KF, Bittmann I, Warth A. Untersuchung von Lungenbiopsien bei Patienten mit interstitiellen Lungenerkrankungen (ILD) auf Helicobater pylori mittels PCR. Pneumologie 2015. [DOI: 10.1055/s-0035-1544825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kanappilly A, Gökce-Gün D, Kirsten D, Welker L. Chamäleon: Tuberkulose. Pneumologie 2014. [DOI: 10.1055/s-0034-1367894] [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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Kirsten D. Professor Ulrich Costabel zum 65. Geburtstag. Pneumologie 2014. [DOI: 10.1055/s-0033-1359243] [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: 10/25/2022]
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Abstract
Sarcoidosis is a multisystemic granulomatous disorder of unknown origin, which can involve multiple organs. However the lymph node and lung manifestations dominate. Most frequent symptoms are cough, fatigue, dyspnea and exercise limitations. About one third of the patients have no symptoms. The lung function test is mostly restrictive. The clinical course is very variable, spontaneous remissions occur in about 60 %. Acute sarcoidosis is a highly inflammatory disease with a very good prognosis even without steroid therapy. Chronic pulmonary sarcoidosis can lead to progressive loss of lung function. Indications to therapy are severe symptoms and loss of lung function as well as progressive lung involvement with fibrosis pattern. In chronic disease corticosteroids are effective in the majority of patients. Other immunosuppressives, cytotoxic and immunomodulatory agents are reserved for patients with severe side-effects to steroid-therapy or for patients, who cannot maintained on reasonable low doses of steroids. Lung transplantation is an option for life-threatening cases failing medical therapy.
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Affiliation(s)
- D Kirsten
- Ambulanz für Seltene Lungenkrankheiten und Sarkoidose an der LungenClinic Grosshansdorf, Großhansdorf, Germany
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Kirsten A, Kirsten D. Sarkoidose der Nasennebenhöhlen. Pneumologie 2012. [DOI: 10.1055/s-0032-1302839] [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: 10/28/2022]
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Lotz P, Claussen M, Kirsten D, Nowak D, Tannapfel A, Rabe KF. Lungenfibrose aus dem Nagelstudio. Pneumologie 2012. [DOI: 10.1055/s-0032-1302539] [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: 10/28/2022]
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms. Pneumologie 2011; 65:e51-75. [DOI: 10.1055/s-0030-1256562] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Klippe H, Kirsten D. Marcello Malpighi (1628 – 1694) und die Begriffe Miliar und Tuberkel. Pneumologie 2011; 65:432-5. [DOI: 10.1055/s-0030-1256492] [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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Prediger M, Köhler S, Deubler G, Kirsten D. Progrediente Knochenläsionen in der Wirbelsäule. Pneumologie 2011. [DOI: 10.1055/s-0031-1272071] [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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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer. Pneumologie 2010; 65:39-59. [DOI: 10.1055/s-0030-1255961] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [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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Kirsten D. Die Lungenkrankheit von Thomas Bernhard. Pneumologie 2010; 64:322. [DOI: 10.1055/s-0029-1244179] [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: 10/19/2022]
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker JH, Freitag L, Lübbe AS, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum RP, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle RM, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heussel CP, Hilbe W, Hoffmeyer F, Horneber M, Huber RM, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang SM, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen HW, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. [Prevention, diagnosis, therapy, and follow-up of lung cancer]. Pneumologie 2010; 64 Suppl 2:e1-164. [PMID: 20217630 DOI: 10.1055/s-0029-1243837] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Biancosino C, Welker L, Vollmer E, Magnussen H, Kirsten D. Beitrag und Risiko thoraxchirurgischer Verfahren zur Differenzialdiagnostik interstitieller Lungenerkrankungen. Pneumologie 2010. [DOI: 10.1055/s-0030-1251315] [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: 10/19/2022]
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24
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Schmitz J, Weinberg G, Dragun D, Claussen M, Magnussen H, Kirsten D. Goodpasture's disease als Berufskrankheit? Pneumologie 2010. [DOI: 10.1055/s-0030-1251194] [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: 10/19/2022]
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Klippe H, Kirsten D. 200 Jahre Bronchitis – 1808 bis 2008. Pneumologie 2009; 63:228-30. [DOI: 10.1055/s-0028-1119572] [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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27
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Licht J, Diefenbach C, Stang A, Hartmann V, Bolte J, Kirsten D. Tuberculoma of the myocardium: a rare case of intra-vitam diagnosis. Clin Res Cardiol 2009; 98:331-3. [DOI: 10.1007/s00392-009-0003-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 02/13/2009] [Indexed: 10/21/2022]
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Migliori GB, Eker B, Richardson MD, Sotgiu G, Zellweger JP, Skrahina A, Ortmann J, Girardi E, Hoffmann H, Besozzi G, Bevilacqua N, Kirsten D, Centis R, Lange C. A retrospective TBNET assessment of linezolid safety, tolerability and efficacy in multidrug-resistant tuberculosis. Eur Respir J 2009; 34:387-93. [PMID: 19282348 DOI: 10.1183/09031936.00009509] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Linezolid is used to treat patients with multidrug-resistant (MDR)/extensively drug-resistant (XDR)-tuberculosis (TB) cases, although clinical data on its safety, tolerability and efficacy are lacking. We performed a retrospective, nonrandomised, unblinded observational study evaluating the safety and tolerability of linezolid at 600 mg q.d. or b.i.d. in MDR/XDR-TB treatment in four European countries. Efficacy evaluation compared end-points of 45 linezolid-treated against 110 linezolid-nontreated cases. Out of 195 MDR/XDR-TB patients, 85 were treated with linezolid for a mean of 221 days. Of these, 35 (41.2%) out of 85 experienced major side-effects attributed to linezolid (anaemia, thrombocytopenia and/or polyneuropathy), requiring discontinuation in 27 (77%) cases. Most side-effects occurred after 60 days of treatment. Twice-daily administration produced more major side-effects than once-daily dosing (p = 0.0004), with no difference in efficacy found. Outcomes were similar in patients treated with/without linezolid (p = 0.8), although linezolid-treated cases had more first-line (p = 0.002) and second-line (p = 0.02) drug resistance and a higher number of previous treatment regimens (4.5 versus 2.3; p = 0.07). Linezolid 600 mg q.d. added to an individualised multidrug regimen may improve the chance of bacteriological conversion, providing a better chance of treatment success in only the most complicated MDR/XDR-TB cases. Its safety profile does not warrant use in cases for which there are other, safer, alternatives.
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Affiliation(s)
- G B Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
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Hörster R, Kirsten D, Gaede K, Jafari C, Strassburg A, Greinert U, Ernst M, Lange C. Antimycobacterial immuneresponses in patients with pulmonary sarcoidosis. Pneumologie 2009. [DOI: 10.1055/s-0029-1214108] [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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Eker B, Ortmann J, Migliori G, Sotgiu G, Mütterlein R, Centis R, Hoffmann H, Kirsten D, Schaberg T, Ruesch-Gerdes S, Lange C. Multidrug- and extensively-drug resistant tuberculosis: a TBNET survey in Germany. Pneumologie 2009. [DOI: 10.1055/s-0029-1214069] [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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31
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Kirsten D, Kirsten A, Schmitz J, Heinrichs D, Magnussen H. Lebensbedrohliche Komplikationen bei Lungensarkoidose? Pneumologie 2008. [DOI: 10.1055/s-2008-1074156] [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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32
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Kirsten D, Kirsten A, Schmitz J, Magnussen H. Bullöse Lungenveränderungen bei Sarkoidose? Pneumologie 2008. [DOI: 10.1055/s-2008-1074158] [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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Ernst M, Kirsten D, Hörster R, Strassburg A, Kalsdorf B, Lange C. Systemic and local immune phenotype and function of patients with pulmonary sarcoidosis and tuberculosis. Pneumologie 2008. [DOI: 10.1055/s-2008-1074359] [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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Lotz P, Diemel K, Bittmann I, Kidess M, Magnussen H, Kirsten D. Belastungsabhängige Hämoptysen bei einer 52-jährigen Patientin aus Ghana. Pneumologie 2008. [DOI: 10.1055/s-2008-1074168] [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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Anamelechi K, Welker L, Pfeiffer KF, Kirsten D, Magnussen H. CSS – Kasuistik: einer seltenen primären systemischen Vaskulitis. Pneumologie 2008. [DOI: 10.1055/s-2008-1074142] [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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36
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Heinrichs D, Kirsten D, Schmitz J, Zeschnigk T, Magnussen H. Exogen-allergische Alveolitis und Emphysem. Pneumologie 2008. [DOI: 10.1055/s-2008-1074154] [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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37
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Watz H, Oltmanns A, Magnussen H, Wirtz H, Kirsten D. Lymphangioleiomyomatose: klinische Daten von 32 Patientinnen. Pneumologie 2008. [DOI: 10.1055/s-2008-1074230] [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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38
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Lange C, Eker B, Rüsch-Gerdes S, Ortmann J, Migliori G, Mütterlein R, Hannemann P, Esselmann A, Kretz B, Schaberg T, Hang H, Ott S, Kirsten D, Schaudt C, Hammel P, Eberhardt R, Pletz M, Flick H. Multi-drug-resistant- (MDR-) and extensively-drug-resistant- (XDR-) tuberculosis in Germany. Pneumologie 2008. [DOI: 10.1055/s-2008-1074446] [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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39
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Kirsten D, Bittmann I, Stiebeler S, Lenigk B, Nakashima M, Magnussen H. Eine Noxe verursacht drei seltene Lungenkrankheiten. Pneumologie 2008. [DOI: 10.1055/s-2008-1074157] [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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Watz H, Oltmanns A, Kimmel S, Magnussen H, Wirtz H, Kirsten D. [Sporadic lymphangioleiomyomatosis. Clinical and lung functional characteristics of 32 female patients]. Dtsch Med Wochenschr 2008; 133:705-8. [PMID: 18363188 DOI: 10.1055/s-2008-1067310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Lymphangioleiomyomatosis (LAM) is a rare and progressive multi-systemic disorder almost exclusively of women. Clinical and lung functional data of a substantial number of German patients have not so far been published. PATIENTS AND METHODS In 32 women with sporadic LAM we performed the following investigations: medical history, clinical examination, lung function (spirometry, bodyplethysmography, diffusion capacity for carbon monoxide), ECG, echocardiography, and abdominal ultrasound. RESULTS The mean age at the time of investigation was 48 (25 - 66) years, while the mean age at time of diagnosis had been 45 (21 - 61) years. The median time between onset of first symptoms and diagnosis was 8 years (1 months - 30 years). Most frequently stated first symptom was dyspnea on exertion (12/32 patients) and the most frequently stated first clinical sign was pneumothorax (12/32). Changes of hormonal status (contraception, treatment for fertility, pregnancy) occurred in 31 of the 32 patients before onset of first symptoms or clinical signs. Hormonal (16/32) and antiobstructive therapy (16/32) were the most frequently applied forms of treatment. Airway obstruction (26/32 patients), hyperinflation (20/32) and reduced diffusion capacity for carbon monoxide (24/32) were found on lung function test. Abnormal auscultation (6 patients), ECG signs of chronic cor pulmonale (4/32) and an elevated systolic pulmonary artery pressure (2 patients) were rare findings. Abdominal lesions (angiomyolipoma, 11/32 patients; lymphangioleiomyoma, 4 patients) were common. CONCLUSION Lymphangioleiomyomatosis should be considered in women with spontaneous pneumothorax, unexplainable dyspnoea or angiomyolipoma.
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Affiliation(s)
- H Watz
- Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie.
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Jafari C, Ernst M, Strassburg A, Greinert U, Kalsdorf B, Kirsten D, Lange C. Local immunodiagnosis of pulmonary tuberculosis by enzyme-linked immunospot. Eur Respir J 2008; 31:261-5. [DOI: 10.1183/09031936.00096707] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [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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Sennekamp J, Müller-Wening D, Amthor M, Baur X, Bergmann KC, Costabel U, Kirsten D, Koschel D, Kroidl R, Liebetrau G, Nowak D, Schreiber J, Vogelmeier C. [Guidelines for diagnosing extrinsic allergic alveolitis (hypersensitivity pneumonitis) (German Extrinsic Allergic Alveolitis Study Group)]. Pneumologie 2007; 61:52-6. [PMID: 17253211 DOI: 10.1055/s-2006-944326] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- J Sennekamp
- Die Institutsangaben sind am Ende des Beitrags gelistet.
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Blau IW, Schmidt-Hieber M, Basara N, Hopfenmüller W, Bischoff M, Günzelmann S, Kirsten D, Schmetzer B, Roemer E, Kiehl MG, Thiel E, Fauser AA. Long-term follow-up of peripheral blood stem cell transplantation from mismatched related and unrelated donors. Clin Transplant 2007; 21:110-6. [PMID: 17302599 DOI: 10.1111/j.1399-0012.2006.00614.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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Allogeneic stem cell transplantation (SCT) is best performed with an HLA-identical sibling donor (matched related donor, MRD) to reduce the risk of early complications such as acute graft-vs.-host disease (aGvHD). However, as only about 30% of recipients have an MRD for this potentially curative approach, the use of family donors with one or two mismatches in the HLA-antigens (mismatch related donor, MMRD) or fully matched unrelated donors (MUD) (''alternative donors'') has been introduced in the allogeneic SCT setting in recent years. To evaluate the feasibility of allogeneic SCT from alternative donors by using peripheral blood stem cells (PBSC) we initiated a prospective, phase II study in 1996. From April 1996 to July 1998, 18 patients with various hematological malignancies underwent allogeneic SCT from alternative donors (two patients with MUD and 16 patients with MMRD). All patients received stable engraftment and none of the patients had graft rejection. The rate of aGvHD (grades II-IV) and the relapse rate at last follow-up (seven to nine yr after SCT) were with 40% and 24%, respectively, comparable with those found in patients receiving allogeneic SCT from MRD. However, five yr after allogeneic SCT only 17% were alive, which was mainly due to the treatment-related mortality (TRM) rate of 59%. We conclude that allogeneic PBSC transplantation by using alternative donors is associated with an unsatisfying long-term TRM rate. The significance of TRM and particular late deaths has to be evaluated further in this transplantation setting.
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Affiliation(s)
- I W Blau
- Department of Hematology, Oncology and Transfusion Medicine, Charité-Campus Benjamin Franklin, Berlin, Germany
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Watz H, Engels K, Löschke S, Amthor M, Kirsten D, Magnussen H. Lymphangioleiomyomatose – Nachweis von Rezeptor Tyrosin Kinasen und des Angiogenesefaktors VEGF-A als mögliche Therapieoptionen. Pneumologie 2007. [DOI: 10.1055/s-2007-973253] [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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Jafari C, Ernst M, Kalsdorf B, Greinert U, Kirsten D, Lalvani A, Lange C. Rapid diagnosis of smear negative tuberculosis by bronchoalveolar-lavage enzyme-linked immunospot: an update. Pneumologie 2007. [DOI: 10.1055/s-2007-973116] [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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46
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Jafari C, Ernst M, Greinert U, Kalsdorf B, Jafari M, Kirsten D, Lange C. MTB-specific lymphocytes are selectively recruited to the site of infection in active pulmonary tuberculosis. Pneumologie 2007. [DOI: 10.1055/s-2007-973143] [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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47
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Watz H, Engels K, Loeschke S, Amthor M, Kirsten D, Magnussen H. Lymphangioleiomyomatose – Expression von Rezeptor Tyrosin Kinasen und des Angiogenesefaktors VEGF-A in Biopsiematerial. Pneumologie 2006. [DOI: 10.1055/s-2006-958873] [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: 10/19/2022]
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48
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Watz H, Engels K, Amthor M, Kirsten D, Magnussen H. Expression des „Epidermal Growth-Factor Receptor“ (EGFR) und des „Vascular Endothelial Growth Factor“ (VEGF) bei Lymphangioleiomyomatose (LAM). Pneumologie 2006. [DOI: 10.1055/s-2006-934022] [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: 10/19/2022]
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Wewel AR, Jörres RA, Kirsten D. [Possibilities and perspectives of home-based exercise training in patients with chronic obstructive pulmonary diseases]. Pneumologie 2005; 59:328-36. [PMID: 15902598 DOI: 10.1055/s-2004-830196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In Germany there is a long tradition of rehabilitation and exercise training programs to improve the clinical state and physical function of patients with chronic obstructive pulmonary diseases. This is particularly true regarding inpatient rehabilitation. Based on experiences gained in other countries, outpatient and home-based programs are currently getting more attention. One of the key components of pulmonary rehabilitation is exercise training which can be expected to exert direct and indirect beneficial effects on physical performance, health-related quality of life and even the progress of the disease. Most of the available experience refers to patients with COPD -- besides those with bronchial asthma. The data available so far suggest that exercise training programs can reduce exacerbation rates and that this effect is achievable by minimal personal assistance. Thus the most important aim of future studies seems to be the development and evaluation of training programs which are efficient but also easy to implement and minimally expensive. Furthermore it needs to be studied whether such programs can be transferred to pulmonary disorders other than obstructive airway diseases.
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Affiliation(s)
- A R Wewel
- Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Grosshansdorf.
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50
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Affiliation(s)
- D Kirsten
- Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie.
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