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MacLachlan H, Dhutia H, Bhatia R, Boden K, Forenc K, Basu J, Miles C, Osborne R, Chandra N, Malhotra A, Stuart G, Peirce N, Sharma S, Papadakis M. Results of a nationally implemented cardiac screening programme in elite cricket players in England and Wales. J Sci Med Sport 2021; 25:287-292. [PMID: 35016820 DOI: 10.1016/j.jsams.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES We assessed the diagnostic yield and costs of an electrocardiogram-based national screening programme in elite cricket players and the incremental value of transthoracic echocardiography and periodic evaluation. DESIGN Cross-sectional study. METHODS Between 2008 and 2019, 1208 cricketers underwent screening with a health questionnaire, 12-lead electrocardiogram and cardiology consultation. Athletes with concerning findings underwent on-site transthoracic echocardiography and further investigations as necessary. In addition, despite a normal health questionnaire and electrocardiogram, 342 (28.3%) athletes had a transthoracic echocardiogram and 493 (40.8%) underwent repeat evaluations. RESULTS After initial evaluation, 47 (3.9%) athletes underwent on-site transthoracic echocardiography of whom 35 (2.8%) were referred for further evaluation. Four athletes (0.3%) were diagnosed with major cardiac conditions; hypertrophic cardiomyopathy (n = 1), arrhythmogenic cardiomyopathy (n = 1) and Wolff-Parkinson-White pattern (n = 2). Two athletes were identified with minor valvular abnormalities. Repeat evaluation of 493 athletes identified hypertrophic cardiomyopathy in a 22-year-old athlete, two years after his initial normal screening. During a follow-up of 5.8 ± 2.9 years no additional diagnoses or adverse cardiac events were reported. The cost of the electrocardiogram-based programme was £127,844, translating to £106 per athlete and £25,569 per major cardiac condition identified.Routine transthoracic echocardiography in 342 athletes identified two athletes with major cardiac conditions (bicuspid aortic valve with severe aortopathy and aortic regurgitation and an atrial septal defect associated with right ventricular volume overload) and 10 athletes with minor abnormalities. CONCLUSIONS An electrocardiogram-based national screening programme identified a major cardiac condition in 0.3% of athletes. Routine transthoracic echocardiography and periodic evaluation increased the diagnostic yield to 0.6%, at an incremental cost.
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Affiliation(s)
- H MacLachlan
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - H Dhutia
- Department of Cardiology, Glenfield Hospital, United Kingdom
| | - R Bhatia
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - K Boden
- England and Wales Cricket Board and National Centre for Sports and Exercise Medicine and National Cricket Performance Centre, Loughborough University, United Kingdom
| | - K Forenc
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - J Basu
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - C Miles
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - R Osborne
- Cardiac Risk in the Young, United Kingdom
| | - N Chandra
- Department of Cardiology, Frimley Park Hospital, United Kingdom
| | - A Malhotra
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom
| | - G Stuart
- National Institute of Health Research Cardiovascular Biomedical Research Centre, Bristol Heart Institute, United Kingdom
| | - N Peirce
- England and Wales Cricket Board and National Centre for Sports and Exercise Medicine and National Cricket Performance Centre, Loughborough University, United Kingdom
| | - S Sharma
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - M Papadakis
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom.
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Rickmann A, Macek MA, Szurman P, Boden K. [Acute monocular loss of vision : Differential diagnostic considerations apart from the internistic etiological clarification]. Ophthalmologe 2019; 115:676-679. [PMID: 28776160 DOI: 10.1007/s00347-017-0555-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report the case of acute painless monocular loss of vision in a 53-year-old man. An interdisciplinary etiological evaluation remained without pathological findings with respect to arterial branch occlusion. A reevaluation of the patient history led to a possible association with the administration of phosphodiesterase type 5 inhibitor (PDE5 inhibitor). A critical review of the literature on PDE5 inhibitor administration with ocular participation was performed.
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Affiliation(s)
- A Rickmann
- Knappschaft Augenklinik Sulzbach, Knappschaft Krankenhaus Saar, An der Klinik 10, 66280, Sulzbach/Saar, Deutschland.
| | - M A Macek
- Knappschaft Augenklinik Sulzbach, Knappschaft Krankenhaus Saar, An der Klinik 10, 66280, Sulzbach/Saar, Deutschland
| | - P Szurman
- Knappschaft Augenklinik Sulzbach, Knappschaft Krankenhaus Saar, An der Klinik 10, 66280, Sulzbach/Saar, Deutschland
| | - K Boden
- Knappschaft Augenklinik Sulzbach, Knappschaft Krankenhaus Saar, An der Klinik 10, 66280, Sulzbach/Saar, Deutschland
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Künzer K, Moog U, Boden K, Groten T. Berufsgruppenspezifisches Risiko für eine Infektion mit Q-Fieber – wie gefährdet sind Hebammen und Ärzte im Kreissaal tatsächlich? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671156] [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] Open
Affiliation(s)
- K Künzer
- Universitätsklinikum Jena, Klinik für Kinder und Jugendpsychiatrie, Jena, Deutschland
| | - U Moog
- Thüringer Tierseuchenkasse, Jena, Deutschland
| | - K Boden
- Universitätsklinikum Jena, Institut für Medizinische Mikrobiologie, Jena, Deutschland
| | - T Groten
- Universitätsklinikum Jena, Geburtshilfe, Jena, Deutschland
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Künzer K, Moog U, Boden K, Groten T. Berufsgruppenspezifisches Risiko für eine Infektion mit Q-Fieber – wie gefährdet sind Hebammen und Ärzte im Kreissaal tatsächlich? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1645917] [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: 10/27/2022] Open
Affiliation(s)
- K Künzer
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Jena
| | - U Moog
- Thüringer Tierseuchenkasse, Jena
| | - K Boden
- Institut für Medizinische Mikrobiologie, Universitätsklinikum Jena
| | - T Groten
- Klinik für Geburtsmedizin, Universitätsklinikum Jena
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5
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Hermann B, Lehners N, Brodhun M, Boden K, Hochhaus A, Kochanek M, Meckel K, Mayer K, Rachow T, Rieger C, Schalk E, Weber T, Schmeier-Jürchott A, Schlattmann P, Teschner D, von Lilienfeld-Toal M. Influenza virus infections in patients with malignancies -- characteristics and outcome of the season 2014/15. A survey conducted by the Infectious Diseases Working Party (AGIHO) of the German Society of Haematology and Medical Oncology (DGHO). Eur J Clin Microbiol Infect Dis 2016; 36:565-573. [PMID: 27838792 PMCID: PMC5309266 DOI: 10.1007/s10096-016-2833-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/26/2016] [Indexed: 12/03/2022]
Abstract
Influenza virus infections (IVI) may pose a vital threat to immunocompromised patients such as those suffering from malignancies, but specific data on epidemiology and outcome in these patients are scarce. In this study, we collected data on patients with active cancer or with a history of cancer, presenting with documented IVI in eight centres in Germany. Two hundred and three patients were identified, suffering from haematological malignancies or solid tumours; 109 (54 %) patients had active malignant disease. Influenza A was detected in 155 (77 %) and Influenza B in 46 (23 %) of patients (genera not determined in two patients). Clinical symptoms were consistent with upper respiratory tract infection in 55/203 (27 %), influenza-like illness in 82/203 (40 %), and pneumonia in 67/203 (33 %). Anti-viral treatment with oseltamivir was received by 116/195 (59 %). Superinfections occurred in 37/203 (18 %), and admission on an intensive care unit was required in 26/203 (13 %). Seventeen patients (9 %) died. Independent risk factors for death were delayed diagnosis of IVI and bacterial or fungal superinfection, but not underlying malignancy or ongoing immunosuppression. In conclusion, patients with IVI show high rates of pneumonia and mortality. Early and rapid diagnosis is essential. The high rate of pneumonia and superinfections should be taken into account when managing IVI in these patients.
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Affiliation(s)
- B Hermann
- Leibniz Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, 07745 , Jena, Germany.
| | - N Lehners
- Department of Haematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Brodhun
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - K Boden
- Institut für Klinische Chemie und Laboratoriumsmedizin, University Hospital Jena, Jena, Germany
| | - A Hochhaus
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - M Kochanek
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - K Meckel
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - K Mayer
- Medizinische Klinik III, University Hospital Bonn, Bonn, Germany
| | - T Rachow
- Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - C Rieger
- Internistische Lehrpraxis der Ludwig-Maximilians-Universität München, University of Munich, Munich, Germany
| | - E Schalk
- Otto-von-Guericke University Magdeburg, Medical Centre, Department of Haematology and Oncology, Magdeburg, Germany
| | - T Weber
- University Hospital Halle, Halle, Germany
| | - A Schmeier-Jürchott
- University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - P Schlattmann
- Department of Medical Statistics, Informatics and Documentation, University Hospital Jena, Jena, Germany
| | - D Teschner
- University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - M von Lilienfeld-Toal
- Leibniz Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, 07745 , Jena, Germany.,Medizinische Klinik II, Abteilung für Haematologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.,Forschungscampus InfectoGnostics, Jena, Germany.,Integriertes Forschungs- und Behandlungszentrum Sepsis und Sepsisfolgen (CSCC), Universitätsklinikum Jena, Jena, Germany
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Boden K, Cedborg AIH, Eriksson LI, Hedström HW, Kuylenstierna R, Sundman E, Ekberg O. Swallowing and respiratory pattern in young healthy individuals recorded with high temporal resolution. Neurogastroenterol Motil 2009; 21:1163-e101. [PMID: 19614871 DOI: 10.1111/j.1365-2982.2009.01352.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The coordination of swallowing and respiration is essential for a safe swallow. Swallowing consists of several subsecond events. To study this, it is important to use modalities with high temporal resolution. In this study, we have examined young healthy individuals with simultaneous videofluoroscopy, videomanometry and respiratory recording, all with high temporal resolution. The onset of 13 predetermined swallowing and respiratory events and the surrounding respiratory phase pattern were studied in different body positions and during different respiratory drives. An increased respiratory drive was induced by breathing 5% CO(2). The results demonstrated a highly repeatable and fixed temporal coordination of the swallowing pattern despite body position and respiratory drive. Previous studies have demonstrated a period of centrally controlled apnoea during swallowing. This apnoea period has a variable length, varying from 1 to 5 s. During increased respiratory drive, we could demonstrate a significantly shorter period of apnoea during swallowing, mainly due to an earlier resumption of respiration. The high temporal recordings in this study have revealed that swallowing during expiration is present basically in all healthy individuals. This swallowing respiratory pattern seems to be appropriate for a safe swallow. This knowledge will be used as a reference for future studies on how swallowing and respiratory coordination might be altered due to ageing and diseases.
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Affiliation(s)
- K Boden
- Department of Radiology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
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Boden K, Sachse S, Baier M, Straube E, Isenmann S. Breitspektrum-PCR mit Sequenzierung zur Erregerdetektion bei Kultur-negativen bakteriellen ZNS-Infektionen. Akt Neurol 2007. [DOI: 10.1055/s-2007-988025] [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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8
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Boden K, Joachimski F, Ewald C, Behrendt W, Baier M, Schmidt KH, Straube E. [Multiple intracerebral lesions. Identification of the causative agent by 16S rDNA-PCR]. Nervenarzt 2006; 77:1473-6. [PMID: 17063323 DOI: 10.1007/s00115-006-2166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Molecular biological methods such as polymerase chain reaction (PCR) enable microbiologists to detect bacteria even if antibiotic treatment has already been started. Based on this case report of a 39-year-old man with multiple intracerebral lesions, we describe a PCR method called 16S rDNA-PCR which can be used to identify panbacterial DNA by focussing on the universal gene sequences for the bacterial 16S part of the ribosome.
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Affiliation(s)
- K Boden
- Institut für Medizinische Mikrobiologie, Klinikum der Friedrich-Schiller-Universität, Semmelweisstrasse 4, 07743 Jena, Germany.
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10
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Schmitt-Wrede HP, Fiebig S, Wunderlich F, Benten WP, Bettenhäuser U, Boden K, Mossmann H. Testosterone-induced susceptibility to Plasmodium chabaudi malaria: variant protein expression in functionally changed splenic non-T cells. Mol Cell Endocrinol 1991; 76:207-14. [PMID: 1820973 DOI: 10.1016/0303-7207(91)90275-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study investigates the effects of the male sex hormone, testosterone (Te), on self-healing of Plasmodium chabaudi malaria as well as on protein expression and functional properties of total spleen cells and splenic T cells in females of the mouse strain C57BL/10. About 90% of the B10 females survive a challenge with 10(6) P. chabaudi-infected erythrocytes. The percentage of self-healers, however, is reduced to about 60%, 40%, and 0% after pretreatment with Te for 1, 2, and 3 weeks, respectively. The progressive loss of the capability of self-healing is correlated with an increasing expression of five proteins in splenic non-T cells as revealed by two-dimensional fluorography after metabolic labelling of total spleen cells and T cells with [35S]methionine. These have molecular masses (isoelectric points) of about 10 kDa (pI 5.7), 14 kDa (pI 6.3), 14 kDa (pI 6.4), 38 kDa (pI 6.5), and 46 kDa (pI 5.5), respectively. Splenic non-T cells from mice treated with Te for 3 weeks have gained an increased capability to stimulate the concanavalin A-induced proliferative response of T cells. Te induces the changes in functional properties and protein expression of splenic non-T cells only in vivo and not in vitro. This suggests that the changes in splenic non-T cells as well as the prevention of self-healing P. chabaudi malaria are not directly induced by Te but rather indirectly, i.e. by a Te metabolite and/or Te-induced factor(s).
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Affiliation(s)
- H P Schmitt-Wrede
- Division of Parasitology, Heinrich Heine University, Düsseldorf, F.R.G
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Heller R, Boden K. [Blood transfusion from the viewpoint of anesthesia]. Krankenpfl Soins Infirm 1990; 83:20-3. [PMID: 2314015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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12
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Turss R, Boden K, Fehring G. [Corneal nutrition in alkali burns and the effect of tolazoline (author's transl)]. Albrecht Von Graefes Arch Klin Exp Ophthalmol 1974; 190:155-63. [PMID: 4545724 DOI: 10.1007/bf00414329] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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13
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Boden K, Schwesig H. Impulstechnik beim Röntgenkino. ROFO-FORTSCHR RONTG 1963. [DOI: 10.1055/s-0029-1227243] [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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