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Frantzi N, Nguyen XP, Herr C, Alter P, Söhler S, Soriano D, Watz H, Waschki B, Trinkmann F, Eichenlaub M, Trudzinski FC, Michels-Zetsche JD, Omlor A, Seiler F, Moneke I, Biertz F, Rohde G, Stolz D, Welte T, Kauczor HU, Kahnert K, Jörres RA, Vogelmeier CF, Bals R, Fähndrich S. Statins did not reduce the frequency of exacerbations in individuals with COPD and cardiovascular comorbidities in the COSYCONET cohort. Respir Res 2024; 25:207. [PMID: 38750572 PMCID: PMC11097413 DOI: 10.1186/s12931-024-02822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The evidence regarding effects of statins on exacerbation risk in COPD remains controversial. Previous studies often excluded patients with cardiovascular comorbidities despite their high prevalence in COPD and role for exacerbations. Based on the cardioprotective properties of statins, we hypothesised that statins may reduce the risk of exacerbations especially in patients with cardiovascular comorbidities. METHODS One thousand eight hundred eighty seven patients of the German COPD cohort COSYCONET (COPD and Systemic Consequences Comorbidities Network) of GOLD grades 1-4 (37.8% female, mean age 64.78 ± 8.3) were examined at baseline and over a period of 4.5 years for the occurrence of at least one exacerbation or severe exacerbation per year in cross-sectional and longitudinal analyses adjusted for age, gender, BMI, GOLD grade and pack-years. Due to their collinearity, various cardiovascular diseases were tested in separate analyses, whereby the potential effect of statins in the presence of a specific comorbidity was tested as interaction between statins and comorbidity. We also identified patients who never took statins, always took statins, or initiated statin intake during the follow-up. RESULTS One thousand three hundred six patients never took statins, 31.6% were statin user, and 12.9% initiated statins during the follow-up. Most cardiovascular diseases were significantly (p < 0.05)may associated with an increased risk of COPD exacerbations, but in none of them the intake of statins was a significant attenuating factor, neither overall nor in modulating the increased risk linked to the specific comorbidities. The results of the cross-sectional and longitudinal analyses were consistent with each other, also those regarding at least 1 exacerbation or at least 1 severe exacerbation per year. CONCLUSION These findings complement the existing literature and may suggest that even in patients with COPD, cardiovascular comorbidities and a statin therapy that targets these comorbidities, the effects of statins on exacerbation risk are either negligible or more subtle than a reduction in exacerbation frequency. TRIAL REGISTRATION Trial registration ClinicalTrials.gov, Identifier: NCT01245933. Other Study ID (BMBF grant): 01GI0881, registered 18 November 2010, study start 2010-11, primary completion 2013-12, study completion 2023-09. https://clinicaltrials.gov/study/NCT01245933?cond=COPD&term=COSYCONET&rank=3.
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Affiliation(s)
- N Frantzi
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - X P Nguyen
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - C Herr
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - P Alter
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, German Center for Lung Research (DZL), Philipps University of Marburg (UMR), Marburg, Germany
| | - S Söhler
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, German Center for Lung Research (DZL), Philipps University of Marburg (UMR), Marburg, Germany
| | - D Soriano
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - H Watz
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
- LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - B Waschki
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
- Hospital Itzehoe, Pneumology, Itzehoe, Germany
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Trinkmann
- Department of Pneumology and Critical Care, Member of the German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - M Eichenlaub
- Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - F C Trudzinski
- Department of Pneumology and Critical Care, Member of the German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - J D Michels-Zetsche
- Department of Pneumology and Critical Care, Member of the German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - A Omlor
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - F Seiler
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - I Moneke
- Department of Thoracic Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - F Biertz
- Hannover Medical School, CAPNETZ STIFTUNG, Hannover, Germany
| | - G Rohde
- Department of Respiratory Medicine, Goethe University Frankfurt, University Hospital, Medical Clinic I, Frankfurt/Main, Germany
| | - D Stolz
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - T Welte
- Department of Respiratory Medicine, (BREATH), Member of the German Center for Lung Research (DZL), Research in Endstage and Obstructive Lung Disease Hannover, Hannover, Germany
| | - H U Kauczor
- Diagnostic and Interventional Radiology, Member of the German Center of Lung Research, University Hospital Heidelberg, Heidelberg, Germany
| | - K Kahnert
- Department of Internal Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), LMU University Hospital, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, German Center for Lung Research (DZL), Philipps University of Marburg (UMR), Marburg, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
- Helmholtz Centre for Infection Research (HZI), Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarland University Campus, Saarbrücken, Germany
| | - S Fähndrich
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
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Fähndrich S, Herr C, Teuteberg S, Alter P, Söhler S, Soriano D, Classen J, Adams J, Weinhold V, Watz H, Waschki B, Zeller T, Eichenlaub M, Trudzinski FC, Michels JD, Omlor A, Seiler F, Moneke I, Biertz F, Stolz D, Welte T, Kauczor HU, Kahnert K, Jörres RA, Vogelmeier CF, Bals R. Midregional proatrial naturetic peptide (MRproANP) and copeptin (COPAVP) as predictors of all-cause mortality in recently diagnosed mild to moderate COPD-results from COSYCONET. Respir Res 2024; 25:56. [PMID: 38267944 PMCID: PMC10809634 DOI: 10.1186/s12931-024-02690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND MRproANP and COPAVP are prognostic markers for mortality in chronic obstructive pulmonary disease (COPD). Furthermore, these biomarkers predict mortality due to cardiovascular diseases, which are important prognostically determining comorbidities in patients with COPD. However, less is known about these biomarkers in recently diagnosed mild to moderate COPD. Therefore, we analyzed these biomarkers as potential predictors of mortality in recently diagnosed mild to moderate COPD. METHODS The blood biomarkers considered were copeptin (COPAVP), midregional adrenomedullin (MRproADM), midregional proatrial naturetic peptide (MRproANP), and fibrinogen. Analyses were performed in patients with stable "recently diagnosed mild to moderate COPD" defined by GOLD grades 0-2 and diagnosis of COPD ≤ 5 years prior to inclusion into the COSYCONET cohort (COPD and Systemic Consequences-Comorbidities Network), using Cox regression analysis with stepwise adjustment for multiple COPD characteristics, comorbidities, troponin and NT-proBNP. RESULTS 655 patients with recently diagnosed mild to moderate COPD were included. In the initial regression model, 43 of 655 patients died during the 6-year follow-up, in the final model 27 of 487. Regression analyses with adjustment for confounders identified COPAVP and MRproANP as statistically robust biomarkers (p < 0.05 each) of all-cause mortality, while MRproADM and fibrinogen were not. The fourth quartile of MRproANP (97 pmol/L) was associated with a hazard ratio of 4.5 (95%CI: 1.6; 12.8), and the fourth quartile of COPAVP (9.2 pmol/L) with 3.0 (1.1; 8.0). The results for MRproANP were confirmed in the total cohort of grade 0-4 (n = 1470 finally). CONCLUSION In patients with recently diagnosed mild to moderate COPD, elevated values of COPVP and in particular MRproANP were robust, independent biomarkers for all-cause mortality risk after adjustment for multiple other factors. This suggests that these markers might be considered in the risk assessment of early COPD.
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Affiliation(s)
- S Fähndrich
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
| | - C Herr
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - S Teuteberg
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - P Alter
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
| | - S Söhler
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
| | - D Soriano
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - J Classen
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - J Adams
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - V Weinhold
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - H Watz
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
| | - B Waschki
- LungenClinic Grosshansdorf, Member of the German Center for Lung Research (DZL), Airway Research Center North (ARCN), Grosshansdorf, Germany
- Pneumology, Hospital Itzehoe, Itzehoe, Germany
- University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Zeller
- University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - M Eichenlaub
- Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - F C Trudzinski
- Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - J D Michels
- Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - A Omlor
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - F Seiler
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - I Moneke
- Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - F Biertz
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - D Stolz
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - T Welte
- Department of Respiratory Medicine, Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - H U Kauczor
- Diagnostic and Interventional Radiology, Member of the German Center of Lung Research, University Hospital Heidelberg, Heidelberg, Germany
| | - K Kahnert
- Department of Internal Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), LMU University Hospital, LMU Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
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Quarg C, Jörres RA, Engelhardt S, Alter P, Budweiser S. Characteristics and outcomes of patients hospitalized for infection with influenza, SARS-CoV-2 or respiratory syncytial virus in the season 2022/2023 in a large German primary care centre. Eur J Med Res 2023; 28:568. [PMID: 38053110 DOI: 10.1186/s40001-023-01482-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/28/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND In 2022/2023, Influenza A and Respiratory Syncytial Virus (RSV) reappeared in hospitalized patients, which was in parallel to ongoing SARS-CoV-2 infections. The aim of our study was to compare the characteristics and outcomes of these infections during the same time. METHODS We included patients of all ages with a positive polymerase chain reaction (PCR) test for Influenza A/B, RSV, or SARS-CoV-2 virus hospitalized in the neurological, internal or paediatric units of the RoMed Hospital Rosenheim, Germany, between October 1st 2022 and February 28th 2023. RESULTS A total of 906 patients were included (45.6% female; median age 68.0 years; 21.9% Influenza A, 48.2% SARS-CoV-2, 28.3% RSV). Influenza B (0.2%) and co-infections (1.5%) played a minor role. In patients aged ≥ 18 years (n = 637, 71%), Influenza A, SARS-CoV-2 and RSV groups differed in age (median 72, 79, 76 years, respectively; p < 0.001). Comorbidities, particularly asthma and COPD, were most prevalent for RSV. 103 patients were admitted to the intensive care unit (ICU) (16.3% Influenza A, 15.3% SARS-CoV-2, 19.2% RSV; p = 0.649), 56 died (6.8% Influenza A, 9% SARS-CoV-2, 11.1% RSV; p = 0.496). RSV showed the highest frequencies of low-flow oxygen supplementation for admission and stay. Differences in the length of stay were minor (median 7 days). Conversely, in patients aged < 18 years (n = 261, 28,8%), 19.5%, 17.6% and 60.2% were in the Influenza A, SARS-CoV-2 and RSV groups, respectively; 0.4% showed Influenza B and 2.3% co-infections. 17 patients were admitted to ICU (3.9% Influenza A, 9.6% RSV, 0% SARS-CoV-2); none died. RSV showed the highest frequencies of high- and low-flow oxygen supplementation, SARS-CoV-2 the lowest. CONCLUSION When comparing infections with Influenza, SARS-CoV-2 and RSV in the winter 2022/2023 in hospitalized adult patients, rates of ICU admission and mortality were similar. RSV showed the highest frequencies of obstructive airway diseases, and of oxygen supplementation. The latter was also true in children/adolescents, in whom RSV dominated. Thus, in the situation of declining importance of SARS-CoV-2, RSV showed a disease burden that was relatively higher than that from Influenza and SARS-CoV-2 across ages, and this might be relevant for the seasons coming.
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Affiliation(s)
- C Quarg
- Department of Internal Medicine III, Division of Pneumology and Respiratory Medicine, RoMed Hospital Rosenheim, Ellmaierstraße 23, 83022, Rosenheim, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Member of the German Center for Lung Research (DZL), LMU Hospital, Comprehensive Pneumology Center Munich (CPC-M), Ziemssenstraße 1, 80336, Munich, Germany
| | - S Engelhardt
- Department of Internal Medicine III, Division of Pneumology and Respiratory Medicine, RoMed Hospital Rosenheim, Ellmaierstraße 23, 83022, Rosenheim, Germany
| | - P Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Germany, Member of the German Center for Lung Research (DZL), University of Marburg (UMR), Baldingerstraße, 35043, Marburg, Germany
| | - S Budweiser
- Department of Internal Medicine III, Division of Pneumology and Respiratory Medicine, RoMed Hospital Rosenheim, Ellmaierstraße 23, 83022, Rosenheim, Germany.
- University Hospital Regensburg, Regensburg, Germany.
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Kahnert K, Föhrenbach M, Lucke T, Alter P, Trudzinski FT, Bals R, Lutter JI, Timmermann H, Söhler S, Förderreuther S, Nowak D, Watz H, Waschki B, Behr J, Welte T, Vogelmeier CF, Jörres RA. The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET. Respir Res 2020; 21:28. [PMID: 31959163 PMCID: PMC6971882 DOI: 10.1186/s12931-020-1293-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects. Methods We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters. Results 606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV1, 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same. Conclusion We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.
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Affiliation(s)
- K Kahnert
- Department of Internal Medicine V - Pulmonology, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), Marchioninisr. 15, 81377 München, and Ziemssenstr. 1, 80336, Munich, Germany.
| | - M Föhrenbach
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - T Lucke
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - P Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany.,Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - F T Trudzinski
- Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
| | - J I Lutter
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Ingolstädter Landstr. 1, 85764, Munich, Germany
| | - H Timmermann
- Hamburger Institut für Therapieforschung GmbH, Colonaden 72, 20354, Hamburg, Germany
| | - S Söhler
- ASCONET Study Coordination Office, University of Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - S Förderreuther
- Department of Neurology, Klinikum Innenstadt, Ludwig Maximilian University of Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - D Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - H Watz
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - B Waschki
- LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany.,Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
| | - J Behr
- Department of Internal Medicine V - Pulmonology, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), Marchioninisr. 15, 81377 München, and Ziemssenstr. 1, 80336, Munich, Germany
| | - T Welte
- Department of Pneumology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany
| | - R A Jörres
- Institute and Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M, member of German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
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Trudzinski FC, Kahnert K, Vogelmeier CF, Alter P, Seiler F, Fähndrich S, Watz H, Welte T, Speer T, Zewinger S, Biertz F, Kauczor HU, Jörres RA, Bals R. Combined effects of lung function, blood gases and kidney function on the exacerbation risk in stable COPD: Results from the COSYCONET cohort. Respir Med 2019; 154:18-26. [PMID: 31203096 DOI: 10.1016/j.rmed.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 11/15/2022]
Abstract
RATIONALE Alterations of acid-base metabolism are an important outcome predictor in acute exacerbations of COPD, whereas sufficient metabolic compensation and adequate renal function are associated with decreased mortality. In stable COPD there is, however, only limited information on the combined role of acid-base balance, blood gases, renal and respiratory function on exacerbation risk grading. METHODS We used baseline data of the COPD cohort COSYCONET, applying linear and logistic regression analyses, the results of which were implemented into a comprehensive structural equation model. As most informative parameters it comprised the estimated glomerular filtration rate (eGFR), lung function defined via forced expiratory volume in 1 s (FEV1), intrathoracic gas volume (ITGV) and (diffusing capacity for carbon monoxide (DLCO), moreover arterial oxygen content (CaO2), partial pressure of oxygen (PaCO2), base exess (BE) and exacerbation risk according to GOLD criteria. All measures were adjusted for age, gender, body-mass index, the current smoking status and pack years. RESULTS 1506 patients with stable COPD (GOLD grade 1-4; mean age 64.5 ± 8.1 y; mean FEV1 54 ± 18 %predicted, mean eGFR 82.3 ± 16.9 mL/min/1.73 m2) were included. BE was linked to eGFR, lung function and PaCO2 and played a role as indirect predictor of exacerbation risk via these measures; moreover, eGFR was directly linked to exacerbation risk. These associations remained significant after taking into account medication (diuretics, oral and inhaled corticosteroids), whereby corticosteroids had effects on exacerbation risk and lung function, diuretics on eGFR, BE and lung function. CONCLUSION Even in stable COPD acid-base metabolism plays a key integrative role in COPD risk assessment despite rather small deviations from normality. It partially mediates the effects of impairments in kidney function, which are also directly linked to exacerbation risk.
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Affiliation(s)
- F C Trudzinski
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany.
| | - K Kahnert
- Department of Internal Medicine V, University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research, Munich, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - P Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR), Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - F Seiler
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - S Fähndrich
- Department of Pneumology, University Hospital Freiburg, Freiburg, Germany
| | - H Watz
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany
| | - T Welte
- Clinic for Pneumology, Hannover Medical School, Member of the German Center for Lung Research, Hannover, Germany
| | - T Speer
- Department of Internal Medicine IV - Nephrology, Saarland University Hospital, Homburg, Germany
| | - S Zewinger
- Department of Internal Medicine IV - Nephrology, Saarland University Hospital, Homburg, Germany
| | - F Biertz
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - H-U Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Member of the German Center of Lung Research, Heidelberg, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University (LMU), Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
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6
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Karrasch S, Radtke T, Simon M, Kronseder A, Dressel H, Jörres RA, Ochmann U. Acute effects of hypertonic saline inhalation on nitric oxide pulmonary diffusing capacity in healthy adults. Respir Physiol Neurobiol 2018; 258:40-46. [PMID: 30261306 DOI: 10.1016/j.resp.2018.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/13/2018] [Accepted: 09/21/2018] [Indexed: 11/26/2022]
Abstract
We investigated acute effects of inhalation of hypertonic saline solution (HSS) and oxygen (O2, control exposure) on pulmonary diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO). In a randomized crossover study, 20 healthy, non-smoking subjects were allocated to short-term inhalation of HSS or O2. Spirometry [(forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)] and combined single-breath DLNO-DLCO measurements were performed before and immediately after inhalation of either HSS or O2. Percent changes were presented as median values (interquartile range). After HSS inhalation, DLNO, FEV1 and FVC were decreased by -3.0% (-7.3, 0.5), -3.1% (-4.2, -1.6) and -1.2% (-3.3, 0.6), respectively (all P < 0.05), without significant effect on DLCO. No changes in spirometry and diffusing capacity were observed following O2 inhalation. Acute inhalation of HSS causes a slight decrease in membrane conductance, probably as a result of fluid imbalance at the alveolar surface and interstitial fluid accumulation, both of which could impair gas exchange.
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Affiliation(s)
- S Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Neuherberg, Germany
| | - T Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Division of Occupational and Environmental Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
| | - M Simon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - A Kronseder
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - H Dressel
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany; Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Division of Occupational and Environmental Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Neuherberg, Germany
| | - U Ochmann
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
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7
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Gümperlein I, Fischer E, Dietrich-Gümperlein G, Karrasch S, Nowak D, Jörres RA, Schierl R. Acute health effects of desktop 3D printing (fused deposition modeling) using acrylonitrile butadiene styrene and polylactic acid materials: An experimental exposure study in human volunteers. Indoor Air 2018; 28:611-623. [PMID: 29500848 DOI: 10.1111/ina.12458] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/25/2018] [Indexed: 05/05/2023]
Abstract
3D printers are increasingly run at home. Nanoparticle emissions from those printers have been reported, which raises the question whether adverse health effects from ultrafine particles (UFP) can be elicited by 3D printers. We exposed 26 healthy adults in a single-blinded, randomized, cross-over design to emissions of a desktop 3D printer using fused deposition modeling (FDM) for 1 hour (high UFP-emitting acrylonitrile butadiene styrene [ABS] vs low-emitting polylactic acid [PLA]). Before and after exposures, cytokines (IL-1β, IL-6, TNF-α, INF-γ) and ECP in nasal secretions, exhaled nitric oxide (FeNO), urinary 8-isoprostaglandin F2α (8-iso PGF2α ), and self-reported symptoms were assessed. The exposures had no significant differential effect on 8-iso PGF2α and nasal biomarkers. However, there was a difference (P < .05) in the time course of FeNO, with higher levels after ABS exposure. Moreover, indisposition and odor nuisance were increased for ABS exposure. These data suggest that 1 hour of exposure to 3D printer emissions had no acute effect on inflammatory markers in nasal secretions and urine. The slight relative increase in FeNO after ABS printing compared to PLA might be due to eosinophilic inflammation from inhaled UFP particles. This possibility should be investigated in further studies using additional biomarkers and longer observation periods.
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Affiliation(s)
- I Gümperlein
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - E Fischer
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - G Dietrich-Gümperlein
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - S Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
| | - D Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
| | - R Schierl
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
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8
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Seiler F, Trudzinski FC, Fähndrich S, Watz H, Jörres RA, Koch A, Welte T, Vogelmeier C, Biertz F, Bals R. Definition und Charakterisierung eines inflammatorischen Phänotyps bei Patienten mit chronisch obstruktiver Lungenerkrankung (COPD) – Ergebnisse aus der nationalen COPD-Kohorte COSYCONET. Pneumologie 2018. [DOI: 10.1055/s-0037-1619351] [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)
- F Seiler
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - FC Trudzinski
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - S Fähndrich
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Großhansdorf
| | - RA Jörres
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München
| | - A Koch
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - C Vogelmeier
- Schwerpunkt Pneumologie, Klinik für Innere Medizin, Universitätsklinikum Marburg
| | - F Biertz
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - R Bals
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
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9
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Lutter J, Wacker M, Jörres RA, Schulz H, Karrasch S, Karch A, Leidl R, Watz H, Vogelmeier C, Holle R. Welche Faktoren prädizieren eine Verschlechterung der gesundheitsbezogenen Lebensqualität bei COPD? Erste längsschnittliche Ergebnisse der COSYCONET COPD-Kohorte. Pneumologie 2018. [DOI: 10.1055/s-0037-1619341] [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)
- J Lutter
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - M Wacker
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - RA Jörres
- Institut für Arbeits-, Sozial- und Umweltmedizin, Ludwigs-Maximilians-Universität München
| | - H Schulz
- Institut für Epidemiologie, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - S Karrasch
- Institut für Epidemiologie, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - A Karch
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - R Leidl
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf GmbH, ARCN, Mitglied im Deutschen Zentrum für Lungenforschung (DZL)
| | - C Vogelmeier
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, UGMLC, Philipps-Universität Marburg, Mitglied im Deutschen Zentrum für Lungenforschung (DZL)
| | - R Holle
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
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10
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Trudzinski FC, Alqudrah M, Seiler F, Biertz F, Vogelmeier C, Welte T, Watz H, Fähndrich S, Jörres RA, Bals R. Patienten mit COPD und chronischer Niereninsuffizienz, Daten aus der COPD Kohorte COSYCONET. Pneumologie 2018. [DOI: 10.1055/s-0037-1619323] [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)
- FC Trudzinski
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - M Alqudrah
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - F Seiler
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - F Biertz
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - C Vogelmeier
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf
| | - S Fähndrich
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - RA Jörres
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
| | - R Bals
- Pneumologie, Allergologie, Intensivmedizin, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
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11
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Alter P, Watz H, Kahnert K, Rabe KF, Jung P, Biertz F, Graf J, Bals R, Vogelmeier C, Jörres RA. Einflüsse von Obstruktion und Überblähung bei COPD auf die elektrischen Herzachsen von P-Welle, QRS-Komplex und T-Welle im EKG. Pneumologie 2018. [DOI: 10.1055/s-0037-1619314] [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)
- P Alter
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf
| | - K Kahnert
- Medizinische Klinik V, Klinikum der Universität München LMU
| | - KF Rabe
- Zentrum für Pneumologie und Thoraxchirurgie, Lungenclinic Grosshansdorf GmbH
| | - P Jung
- Zentrum für Innere Medizin Dachau
| | - F Biertz
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - J Graf
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
| | - R Bals
- Innere Medizin V, Universitätsklinikum des Saarlandes
| | - C Vogelmeier
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg
| | - RA Jörres
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
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12
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Kahnert K, Alter P, Young D, Lucke T, Heinrich J, Huber RM, Behr J, Wacker M, Biertz F, Watz H, Bals R, Welte T, Wirtz H, Herth FJF, Vestbo J, Wouters EFM, Vogelmeier C, Jörres RA. The revised GOLD 2017 COPD categorization in relation to comorbidities. Pneumologie 2018. [DOI: 10.1055/s-0037-1619396] [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)
- K Kahnert
- Medizinische Klinik V, Klinikum der Universität München LMU
| | - P Alter
- Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg
| | - D Young
- David Young Communications, Horsham, UK
| | - T Lucke
- Klinikum der Universität München
| | - J Heinrich
- Institut für Epidemiologie I, Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL); German Research Center for Environmental Health
| | - RM Huber
- Division of Respiratory Medicine and Thoracic Oncology, Department of Internal Medicine V, Ludwig Maximilian University of Munich and Thoracic Oncology Centre
| | - J Behr
- Medizinische Klinik und Poliklinik V, Klinikum der LMU München, Comprehensive Pneumology Center
| | - M Wacker
- Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Helmholtz Zentrum München; Comprehensive Pneumology Center Munich (CPC-M), Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - F Biertz
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - H Watz
- Pneumologisches Forschungsinstitut an der Lungenclinic Grosshansdorf
| | - R Bals
- Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - H Wirtz
- Pneumologie, Universitätsklinikum der Universität Leipzig
| | - FJF Herth
- Pneumology, Institute of Internal Medicine III, Thoraxklinik, University Hospital Heidelberg
| | - J Vestbo
- Respiratory Research Group, Manchester Academic Health Sciences Centre
| | | | - C Vogelmeier
- Pulmonary and Critical Care Medicine, Department of Medicine, University Medical Centre Gießen and Marburg, Phillips-University Marburg, Member of the German Centre for Lung Research (DZL)
| | - RA Jörres
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der LMU München
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13
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Herbig B, Jörres RA, Schierl R, Simon M, Langner J, Seeger S, Nowak D, Karrasch S. Psychological and cognitive effects of laser printer emissions: A controlled exposure study. Indoor Air 2018; 28:112-124. [PMID: 28960517 DOI: 10.1111/ina.12429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 09/23/2017] [Indexed: 06/07/2023]
Abstract
The possible impact of ultrafine particles from laser printers on human health is controversially discussed although there are persons reporting substantial symptoms in relation to these emissions. A randomized, single-blinded, cross-over experimental design with two exposure conditions (high-level and low-level exposure) was conducted with 23 healthy subjects, 14 subjects with mild asthma, and 15 persons reporting symptoms associated with laser printer emissions. To separate physiological and psychological effects, a secondary physiologically based categorization of susceptibility to particle effects was used. In line with results from physiological and biochemical assessments, we found no coherent, differential, or clinically relevant effects of different exposure conditions on subjective complaints and cognitive performance in terms of attention, short-term memory, and psychomotor performance. However, results regarding the psychological characteristics of participants and their situational perception confirm differences between the participants groups: Subjects reporting symptoms associated with laser printer emissions showed a higher psychological susceptibility for adverse reactions in line with previous results on persons with multiple chemical sensitivity or idiopathic environmental intolerance. In conclusion, acute psychological and cognitive effects of laser printer emissions were small and could be attributed only to different participant groups but not to differences in exposure conditions in terms of particle number concentrations.
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Affiliation(s)
- B Herbig
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - R A Jörres
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - R Schierl
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - M Simon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - J Langner
- Division Materials and Air Pollutants, BAM Federal Institute for Materials Research and Testing, Berlin, Germany
| | - S Seeger
- Division Materials and Air Pollutants, BAM Federal Institute for Materials Research and Testing, Berlin, Germany
| | - D Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - S Karrasch
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
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14
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Schullcke B, Krueger-Ziolek S, Gong B, Jörres RA, Mueller-Lisse U, Moeller K. Ventilation inhomogeneity in obstructive lung diseases measured by electrical impedance tomography: a simulation study. J Clin Monit Comput 2017; 32:753-761. [PMID: 29019006 DOI: 10.1007/s10877-017-0069-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 09/23/2017] [Indexed: 12/01/2022]
Abstract
Electrical impedance tomography (EIT) has mostly been used in the Intensive Care Unit (ICU) to monitor ventilation distribution but is also promising for the diagnosis in spontaneously breathing patients with obstructive lung diseases. Beside tomographic images, several numerical measures have been proposed to quantitatively assess the lung state. In this study two common measures, the 'Global Inhomogeneity Index' and the 'Coefficient of Variation' were compared regarding their capability to reflect the severity of lung obstruction. A three-dimensional simulation model was used to simulate obstructed lungs, whereby images were reconstructed on a two-dimensional domain. Simulations revealed that minor obstructions are not adequately recognized in the reconstructed images and that obstruction above and below the electrode plane may result in misleading values of inhomogeneity measures. EIT measurements on several electrode planes are necessary to apply these measures in patients with obstructive lung diseases in a promising manner.
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Affiliation(s)
- B Schullcke
- Institute of Technical Medicine, Furtwangen University, VS-Schwenningen, Germany. .,Department of Radiology, Ludwig-Maximilians-Universität, Munich, Germany.
| | - S Krueger-Ziolek
- Institute of Technical Medicine, Furtwangen University, VS-Schwenningen, Germany.,Department of Radiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - B Gong
- Institute of Technical Medicine, Furtwangen University, VS-Schwenningen, Germany.,Department of Radiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - U Mueller-Lisse
- Department of Radiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - K Moeller
- Institute of Technical Medicine, Furtwangen University, VS-Schwenningen, Germany
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15
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Karrasch S, Simon M, Herbig B, Langner J, Seeger S, Kronseder A, Peters S, Dietrich-Gümperlein G, Schierl R, Nowak D, Jörres RA. Health effects of laser printer emissions: a controlled exposure study. Indoor Air 2017; 27:753-765. [PMID: 28054389 DOI: 10.1111/ina.12366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/22/2016] [Indexed: 06/06/2023]
Abstract
Ultrafine particles emitted from laser printers are suspected to elicit adverse health effects. We performed 75-minute exposures to emissions of laser printing devices (LPDs) in a standardized, randomized, cross-over manner in 23 healthy subjects, 14 mild, stable asthmatics, and 15 persons reporting symptoms associated with LPD emissions. Low-level exposures (LLE) ranged at the particle background (3000 cm-3 ) and high-level exposures (HLE) at 100 000 cm-3 . Examinations before and after exposures included spirometry, body plethysmography, transfer factors for CO and NO (TLCO, TLNO), bronchial and alveolar NO, cytokines in serum and nasal secretions (IL-1β, IL-5, IL-6, IL-8, GM-CSF, IFNγ, TNFα), serum ECP, and IgE. Across all participants, no statistically significant changes occurred for lung mechanics and NO. There was a decrease in volume-related TLNO that was more pronounced in HLE, but the difference to LLE was not significant. ECP and IgE increased in the same way after exposures. Nasal IL-6 showed a higher increase after LLE. There was no coherent pattern regarding the responses in the participant subgroups or single sets of variables. In conclusion, the experimental acute responses to short but very high-level LPD exposures were small and did not indicate clinically relevant effects compared to low particle number concentrations.
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Affiliation(s)
- S Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - M Simon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - B Herbig
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - J Langner
- Division Materials and Air Pollutants, BAM Federal Institute for Materials Research and Testing, Berlin, Germany
| | - S Seeger
- Division Materials and Air Pollutants, BAM Federal Institute for Materials Research and Testing, Berlin, Germany
| | - A Kronseder
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - S Peters
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - G Dietrich-Gümperlein
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - R Schierl
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - D Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich/Neuherberg, Germany
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Karl FM, Holle R, Bals R, Greulich T, Jörres RA, Karch A, Karrasch S, Koch A, Leidl R, Schulz H, Vogelmeier C, Wacker M. Kosten und gesundheitsbezogene Lebensqualität bei COPD-Patienten mit Alpha-1-Antitrypsin-Mangel: Ergebnisse der COSYCONET COPD-Kohorte. Pneumologie 2017. [DOI: 10.1055/s-0037-1598549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- FM Karl
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - R Holle
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - R Bals
- Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes
| | - T Greulich
- Klinik für Innere Medizin Schwerpunkt Pneumologie, Universitätsklinikum Marburg, Universities Gießen and Marburg Lung Center (Ugmlc), Mitglied des Deutschen Zentrums für Lungenforschung
| | - RA Jörres
- Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität München
| | - A Karch
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - S Karrasch
- Institut für Epidemiologie I, Helmholtz Zentrum München, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - A Koch
- Institut für Biometrie, Medizinische Hochschule Hannover
| | - R Leidl
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - H Schulz
- Institut für Epidemiologie I, Helmholtz Zentrum München, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - C Vogelmeier
- Klinik für Innere Medizin Schwerpunkt Pneumologie, Universitätsklinikum Marburg, Universities Gießen and Marburg Lung Center (Ugmlc), Mitglied des Deutschen Zentrums für Lungenforschung
| | - M Wacker
- Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
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Wacker ME, Jörres RA, Schulz H, Heinrich J, Karrasch S, Karch A, Koch A, Leidl R, Vogelmeier C, Holle R. The effect of comorbidities and respiratory symptoms on healthcare costs in patients with COPD. Results from the COSYCONET cohort. Pneumologie 2016. [DOI: 10.1055/s-0036-1584636] [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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18
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Karrasch S, Schäfer J, Kiehl G, Lucke T, Sußmann M, Luzak A, Ochmann U, Nowak D, Jörres RA, Vogelmeier C, Watz H, Schulz H. Accelerometric assessment of physical activity in COPD: Correlation between measures by two different devices. Pneumologie 2016. [DOI: 10.1055/s-0036-1584639] [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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19
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Alter P, Jörres RA, Watz H, Welte T, Gläser S, Schulz H, Bals R, Karch A, Wouters E, Vestbo J, Young D, Vogelmeier CF. Lung function impairment is associated with increased left ventricular cardiac wall stress in COPD: The German multicenter COSYCONET study. Pneumologie 2016. [DOI: 10.1055/s-0036-1584656] [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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20
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Brand P, Bertram J, Chaker A, Jörres RA, Kronseder A, Kraus T, Gube M. Biological effects of inhaled nitrogen dioxide in healthy human subjects. Int Arch Occup Environ Health 2016; 89:1017-24. [PMID: 27155612 DOI: 10.1007/s00420-016-1139-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Several epidemiological studies indicate that inhaled nitrogen dioxide (NO2) at low concentrations have been statistically associated with adverse health effects. However, these results are not reflected by exposure studies in humans. The aim of the study was to assess the acute functional and cellular responses to different NO2 concentrations in healthy human subjects with various techniques. METHODS Twenty-five subjects were exposed for 3 h to NO2 concentrations 0, 0.1, 0.5, and 1.5 ppm in a randomized crossover study design during 4 consecutive weeks. In each subject, lung function, diffusion capacity and exhaled nitric oxide were measured and inflammation markers were assessed in blood, nasal secretions, induced sputum and exhaled breath condensate. RESULTS From all lung function indices under consideration, only intrathoracic gas volume was borderline significantly increased after 0.5 ppm (p = 0.048) compared to 0.1 ppm NO2. Regarding the cellular effect parameters, the macrophage concentration in induced sputum decreased with increasing NO2 concentration, although these changes were only borderline significant (p = 0.05). CONCLUSION These results do not suggest a considerable acute adverse response in human subjects after 3 h of exposure to NO2 in the NO2 concentration range investigated in this study.
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Affiliation(s)
- P Brand
- Institute for Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany.
| | - J Bertram
- Institute for Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
| | - A Chaker
- Department of Otolaryngology, Klinikum rechts der Isar and Center of Allergy and Environment (ZAUM), Technische Universität München, Munich, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - A Kronseder
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - T Kraus
- Institute for Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
| | - M Gube
- Institute for Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
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21
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Karrasch S, Obst A, Söhler S, Thorand B, Huth C, Ladwig KH, Flexeder C, Wacker M, Peters A, Heinrich J, Ewert R, Jörres RA, Vogelmeier C, Gläser S, Schulz H. Prävalenz von Komorbiditäten bei COPD-Patienten und lungengesunden Kontrollen der Studie COSYCONET. Pneumologie 2016. [DOI: 10.1055/s-0036-1571970] [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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22
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Wacker M, Jörres RA, Schulz H, Heinrich J, Karrasch S, Koch A, Karch A, Peters A, Leidl R, Vogelmeier C, Holle R. Direkte und indirekte Kosten bei COPD: Ergebnisse der COSYCONET COPD Kohorte im Vergleich zu bevölkerungsbezogenen Kontrollen. Pneumologie 2016. [DOI: 10.1055/s-0036-1572263] [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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23
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Criée CP, Baur X, Berdel D, Bösch D, Gappa M, Haidl P, Husemann K, Jörres RA, Kabitz HJ, Kardos P, Köhler D, Magnussen H, Merget R, Mitfessel H, Nowak D, Ochmann U, Schürmann W, Smith HJ, Sorichter S, Voshaar T, Worth H. [Standardization of spirometry: 2015 update. Published by German Atemwegsliga, German Respiratory Society and German Society of Occupational and Environmental Medicine]. Pneumologie 2015; 69:147-64. [PMID: 25750095 DOI: 10.1055/s-0034-1391345] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Spirometry is a simple test and considered the gold standard in lung function. An obstructive ventilatory defect is a disproportionate reduction of maximal airflow from the lung in relation to the maximal volume that can be displaced from the lung. It implies airway narrowing and is defined by a reduced FEV1/FVC ratio below the 5th percentile of the predicted value (lower limit of normal, LLN). A restrictive disorder may be suspected when vital capacity (FVC) is reduced and FEV1/FVC is normal. It is definitely proven, however, only by a decrease in TLC below the 5th percentile of predicted value (LLN). The measurement of TLC by body plethysmography is necessary to confirm or exclude a restrictive defect or hyperinflation of the lung when FVC is below the LLN. 2012 a task force of the ERS published new reference values based on 74,187 records from healthy non-smoking males and females from 26 countries. The new reference equations for the 3-95 age range are now available that include appropriate age-dependent mean values and lower limits of normal (LLN). This presentation aims at providing the reader with recommendations dealing with standardization and interpretation of spirometry.
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Affiliation(s)
| | - X Baur
- Charité - Universitätsklinik Berlin, Berlin
| | | | - D Bösch
- Pneumologische Klinik Dingolfing - Deggendorf, Donau Isar Klinikum
| | | | - P Haidl
- Fachkrankenhaus Kloster Grafschaft, Schmallenberg
| | - K Husemann
- Robert-Bosch-Krankenhaus/Klinik Schillerhöhe, Gerlingen
| | - R A Jörres
- Arbeits-, Sozial-, Umweltmedizin, Klinikum Universität München
| | - H-J Kabitz
- II. Medizinische Klinik, Klinikum Konstanz
| | - P Kardos
- Internistische Facharztpraxis und Zentrum für Allergologie, Pneumologie Schlafmedizin an der Klinik Maingau, Frankfurt am Main
| | - D Köhler
- Klinik Kloster Grafschaft, Schmallenberg, seit Mitte 2013 Ruhestand
| | - H Magnussen
- Pneumologisches Forschungsinstitut an der LungenClinic Großhansdorf
| | - R Merget
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität-Bochum (IPA)
| | | | - D Nowak
- Arbeits-, Sozial-, Umweltmedizin, Klinikum Universität München
| | - U Ochmann
- Arbeits-, Sozial-, Umweltmedizin, Klinikum Universität München
| | | | | | - S Sorichter
- RKK-Klinikum, St. Josefskrankenhaus, Freiburg
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Jörres RA, Ehret M, Karrasch S, Herbig B, Schierl R, Seeger S, Langner J, Nowak D. Respiratorische Effekte von Drucker- und Kopierer-Emissionen – eine kontrollierte Expositionsstudie. Pneumologie 2015. [DOI: 10.1055/s-0035-1544873] [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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Wanka ER, Bayerstadler A, Heumann C, Nowak D, Jörres RA, Fischer R. Weather and air pollutants have an impact on patients with respiratory diseases and breathing difficulties in Munich, Germany. Int J Biometeorol 2014; 58:249-262. [PMID: 24091656 DOI: 10.1007/s00484-013-0730-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 08/27/2013] [Accepted: 09/02/2013] [Indexed: 06/02/2023]
Abstract
This study determined the influence of various meteorological variables and air pollutants on airway disorders in general, and asthma and/or chronic obstructive pulmonary disease in particular, in Munich, Bavaria, during 2006 and 2007. This was achieved through an evaluation of the daily frequency of calls to medical and emergency call centres, ambulatory medical care visits at general practitioners, and prescriptions of antibiotics for respiratory diseases. Meteorological parameters were extracted from data supplied by the European Centre for Medium Range Weather Forecast. Data on air pollutant levels were extracted from the air quality database of the European Environmental Agency for different measurement sites. In addition to descriptive analyses, a backward elimination procedure was performed to identify variables associated with medical outcome variables. Afterwards, generalised additive models (GAM) were used to verify whether the selected variables had a linear or nonlinear impact on the medical outcomes. The analyses demonstrated associations between environmental parameters and daily frequencies of different medical outcomes, such as visits at GPs and air pressure (-27 % per 10 hPa change) or ozone (-24 % per 10 μg/m(3) change). The results of the GAM indicated that the effects of some covariates, such as carbon monoxide on consultations at GPs, or humidity on medical calls in general, were nonlinear, while the type of association varied between medical outcomes. These data suggest that the multiple, complex effect of environmental factors on medical outcomes should not be assumed homogeneous or linear a priori and that different settings might be associated with different types of associations.
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Affiliation(s)
- E R Wanka
- Institute for Emergency Medicine and Management in Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Schillerstr. 53, 80336, Munich, Germany,
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Nguyen-Huu KD, Schober W, Fromme H, Koczulla R, Nowak D, Jörres RA. Analyse der Ausatemluft mittels elektronischer Nase nach Rauchen elektronischer Zigaretten. Pneumologie 2014. [DOI: 10.1055/s-0034-1368021] [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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Nguyen-Huu KD, Jung P, Koczulla R, Nowak D, Jörres RA, Ochmann U. Analyse der Ausatemluft kardiologischer Patienten mittels elektronischer Nase. Pneumologie 2014. [DOI: 10.1055/s-0034-1368078] [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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Zilz C, Blaas S, Jörres R, Pfeifer M, Budweiser S. Biomarker und psychische Gesundheit bei der schweren COPD. Pneumologie 2014. [DOI: 10.1055/s-0034-1367823] [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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Pöschinger S, Wanka ER, Nowak D, Jörres RA, Ochmann U. Meta-Analyse der Wirkungen von Ozon und Anwendung auf Expositionsprofile im Flugbetrieb. Pneumologie 2014. [DOI: 10.1055/s-0034-1368019] [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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Wanka ER, Kutschenreuter L, Seng S, Jörres RA, Budweiser S. Wetter und Luftschadstoffe: Einfluss auf die tägliche Anzahl von Notarzteinsätzen aufgrund von Atemwegsbeschwerden in Graz. Pneumologie 2014. [DOI: 10.1055/s-0034-1367882] [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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Dias A, Gorzelniak L, Schultz K, Wittmann M, Rudnik J, Jörres R, Horsch A. Classification of exacerbation episodes in chronic obstructive pulmonary disease patients. Methods Inf Med 2014; 53:108-14. [PMID: 24515082 DOI: 10.3414/me12-01-0108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 12/01/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting the airways, which constitutes a major cause of chronic morbidity and a significant economic and social burden throughout the world. Despite the fact that in COPD patients exacerbations are common acute events causing significant and often fatal worsening of symptoms, an accurate prognostication continues to be difficult. OBJECTIVES To build computational models capable of distinguishing between normal life days from exacerbation days in COPD patients, based on physical activity measured by accelerometers. METHODS We recruited 58 patients suffering from COPD and measured their physical activity with accelerometers for 10 days or more, from August 2009 to March 2010. During this period we recorded six exacerbation episodes in the patients, accounting for 37 days. We were able to analyse data for 52 patients (369 patient days), and extracted three distinct sets of features from the data, one set of basic features such as average, one set based on the frequency domain and the last exploring the cross-information among sensors pairs. These were used by three machine-learning techniques (logarithmic regression, neural networks, support vector machines) to distinguish days with exacerbation events from normal days. RESULTS The support vector machine classifier achieved an AUC of 90% ± 9, when supplied with a set of features resulting from sequential feature selection method. Neu- ral networks achieved an AUC of 83% ± 16 and the logarithmic regression an AUC of 67% ± 15. CONCLUSIONS None of the individual feature sets provided robust for reasonable classification of PA recording days. Our results indicate that this approach has the potential to extract useful information for, but are not robust enough for medical application of the system.
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Affiliation(s)
- A Dias
- André Dias, Department of Computer Science, University of Tromsø, Breivika Campus, 9010 Tromsø, Norway, E-mail:
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Schneckenpointner R, Jörres RA, Meidenbauer N, Kollert F, Pfeifer M, Budweiser S. The clinical significance of anaemia and disturbed iron homeostasis in chronic respiratory failure. Int J Clin Pract 2014; 68:130-8. [PMID: 24341307 DOI: 10.1111/ijcp.12216] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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] [Received: 03/24/2013] [Accepted: 05/20/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Anaemia is a frequent, clinically relevant condition in various chronic diseases. It seems also to be prevalent in patients with chronic respiratory failure (CRF). We studied the characteristics of anaemia in CRF and its associations with clinical outcome. METHODS In a prospective design, 271 consecutive patients with CRF were evaluated; patients with other conditions often associated with anaemia were excluded. Haematological laboratory and physiological parameters, health-related quality of life (HRQL), dyspnoea and 48-month survival were determined. Anaemia was defined according to WHO [haemoglobin (Hb)< 13 g/l (male); Hb< 12 g/dl (female)] and using an established algorithm. RESULTS Among 185 patients included, 18.4% showed anaemia, not depending on chronic obstructive pulmonary disease (COPD) vs. non-COPD (17.6% vs. 19.0%; p = 0.851) or on gender [16.5% (female) vs. 19.8% (male); p = 0.702]. Anaemic patients had higher age, creatinine (p < 0.05 each) and erythropoietin levels (p < 0.001), but lower transferrin saturation (TSAT), serum iron and vitamin B12 levels (p < 0.01 each). By definition, most anaemic patients (67.6%) had disturbances in iron homeostasis according to 'anaemia of chronic disease' and/or true iron deficiency anaemia. Hb was independently related to dyspnoea and HRQL, while TSAT ≥ 20% was linked to less dyspnoea and better subjective exercise capability. Non-survivors had lower Hb and serum iron levels (p < 0.05 each). In multivariate analysis, lower serum iron levels and TSAT were independently associated with mortality (p < 0.05 each). CONCLUSION Anaemia was common in patients with CRF and often because of disturbed iron homeostasis. Hb and TSAT were linked to functional outcome and HRQL. Lower serum iron levels and TSAT were independent prognostic parameters.
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Affiliation(s)
- R Schneckenpointner
- Centre for Pneumology, Donaustauf Hospital, Ludwigstrasse 68, Donaustauf, Germany
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Schulz H, Flexeder C, Behr J, Holle R, Huber RM, Jörres RA, Nowak D, Peters A, Wichmann HE, Heinrich J, Karrasch S. Referenzwerte für impulsoszillometrische Parameter bei Erwachsenen: Ergebnisse der KORA F4L und KORA Age Studie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334676] [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: 10/27/2022]
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Ehret M, Karrasch S, Kronseder A, Peters S, Nowak D, Jörres RA, Ochmann U. Wirkung einer kurzzeitigen Inhalation von hypertoner Kochsalzlösung oder Sauerstoff auf nichtinvasive Lungenfunktionsmarker bei Gesunden. Pneumologie 2013. [DOI: 10.1055/s-0033-1334508] [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: 10/27/2022]
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Karrasch S, Behr J, Huber RM, Nowak D, Peters A, Heinrich J, Jörres RA, Schulz H. Diffusionskapazität für NO und CO im Alter bei anamnestisch Lungengesunden mit besseren oder schlechteren Spirometriewerten. Pneumologie 2013. [DOI: 10.1055/s-0033-1334641] [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: 10/27/2022]
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Kronseder A, Schramm T, Truger M, Peters S, Karrasch S, Koczulla RA, Nowak D, Jörres RA. Phänotypisierung von COPD-Patienten durch die Analyse der Ausatemluft mittels Ionenmobilitäts-Spektrometrie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334509] [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: 10/27/2022]
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Schulz H, Albrecht E, Behr J, Huber RM, Nowak D, Klopp N, Codd V, Saman N, Gieger C, Heinrich J, Wichmann HE, Peters A, Jörres RA, Karrasch S. Are spirometric lung function indices associated with telomere length of circulating leukocytes? Pneumologie 2012. [DOI: 10.1055/s-0032-1315556] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Peters A, Döring A, Ladwig KH, Meisinger C, Linkohr B, Autenrieth C, Baumeister SE, Behr J, Bergner A, Bickel H, Bidlingmaier M, Dias A, Emeny RT, Fischer B, Grill E, Gorzelniak L, Hänsch H, Heidbreder S, Heier M, Horsch A, Huber D, Huber RM, Jörres RA, Kääb S, Karrasch S, Kirchberger I, Klug G, Kranz B, Kuch B, Lacruz ME, Lang O, Mielck A, Nowak D, Perz S, Schneider A, Schulz H, Müller M, Seidl H, Strobl R, Thorand B, Wende R, Weidenhammer W, Zimmermann AK, Wichmann HE, Holle R. [Multimorbidity and successful aging: the population-based KORA-Age study]. Z Gerontol Geriatr 2012; 44 Suppl 2:41-54. [PMID: 22270973 DOI: 10.1007/s00391-011-0245-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [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: 11/25/2022]
Abstract
BACKGROUND The objective of the KORA-Age research consortium is to assess the determinants and consequences of multimorbidity in the elderly and to look into reasons for successful aging in the general public. PATIENTS AND METHODS In the KORA-Age cohort study 9,197 persons were included who where born in the year 1943 or before and participants of previous KORA cohort studies conducted between 1984 and 2001 (KORA: Cooperative Health Research in the Region of Augsburg). The randomized intervention study KORINNA (Coronary infarct follow-up treatment in the elderly) tested a nurse-based case management program with 338 patients with myocardial infarct and included an evaluation in health economics. RESULTS A total of 2,734 deaths were registered, 4,565 participants submitted a postal health status questionnaire and 4,127 participants were interviewed by telephone (response 76.2% and 68.9% respectively). A gender and age-stratified random sample of the cohort consisting of 1,079 persons took part in a physical examination (response 53.8%). CONCLUSION The KORA-Age consortium was able to collect data in a large population-based sample and is contributing to the understanding of multimorbidity and successful aging.
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Affiliation(s)
- A Peters
- Institut für Epidemiologie II, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt GmbH, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland.
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Oeder S, Dietrich S, Weichenmeier I, Schober W, Pusch G, Jörres RA, Schierl R, Nowak D, Fromme H, Behrendt H, Buters JTM. Toxicity and elemental composition of particulate matter from outdoor and indoor air of elementary schools in Munich, Germany. Indoor Air 2012; 22:148-58. [PMID: 21913995 DOI: 10.1111/j.1600-0668.2011.00743.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
UNLABELLED Outdoor particulate matter (PM(10)) is associated with detrimental health effects. However, individual PM(10) exposure occurs mostly indoors. We therefore compared the toxic effects of classroom, outdoor, and residential PM(10). Indoor and outdoor PM(10) was collected from six schools in Munich during teaching hours and in six homes. Particles were analyzed by scanning electron microscopy and X-ray spectroscopy (EDX). Toxicity was evaluated in human primary keratinocytes, lung epithelial cells and after metabolic activation by several human cytochromes P450. We found that PM(10) concentrations during teaching hours were 5.6-times higher than outdoors (117 ± 48 μg/m(3) vs. 21 ± 15 μg/m(3), P < 0.001). Compared to outdoors, indoor PM contained more silicate (36% of particle number), organic (29%, probably originating from human skin), and Ca-carbonate particles (12%, probably originating from paper). Outdoor PM contained more Ca-sulfate particles (38%). Indoor PM at 6 μg/cm(2) (10 μg/ml) caused toxicity in keratinocytes and in cells expressing CYP2B6 and CYP3A4. Toxicity by CYP2B6 was abolished with the reactive oxygen species scavenger N-acetylcysteine. We concluded that outdoor PM(10) and indoor PM(10) from homes were devoid of toxicity. Indoor PM(10) was elevated, chemically different and toxicologically more active than outdoor PM(10). Whether the effects translate into a significant health risk needs to be determined. Until then, we suggest better ventilation as a sensible option. PRACTICAL IMPLICATIONS Indoor air PM(10) on an equal weight base is toxicologically more active than outdoor PM(10). In addition, indoor PM(10) concentrations are about six times higher than outdoor air. Thus, ventilation of classrooms with outdoor air will improve air quality and is likely to provide a health benefit. It is also easier than cleaning PM(10) from indoor air, which has proven to be tedious.
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Affiliation(s)
- S Oeder
- ZAUM-Center of Allergy and Environment, Helmholtz Zentrum München/Technische Universität München, Munich, Germany
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Schulz H, Albrecht E, Karrasch S, Behr J, Huber RM, Nowak D, Klopp N, Codd V, Samani N, Gieger C, Heinrich J, Wichmann HE, Peters A, Jörres RA. Gibt es eine Assoziation zwischen spirometrischen Kennwerten und der Telomerenlänge in Leukozyten des peripheren Bluts? Pneumologie 2012. [DOI: 10.1055/s-0032-1302538] [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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Ochmann U, Kellberger J, Kotschy-Lang N, Raab W, Nowak D, Jörres RA. Evaluation der stationären Rehabilitation von Patienten mit pneumologischen Berufskrankheiten. Pneumologie 2012. [DOI: 10.1055/s-0032-1302535] [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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Ochmann U, Kellberger J, Kotschy-Lang N, Raab W, Nowak D, Jörres RA. Beziehungen zwischen maximaler Ergometerleistung und 6-Minuten-Gehtest – Ist eine Prädiktion von Wmax bei Patienten mit pneumologischen Erkrankungen möglich? Pneumologie 2012. [DOI: 10.1055/s-0032-1302715] [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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Peters S, Kronseder A, Karrasch S, Neff P, Haaks M, Koczulla RA, Nowak D, Jörres RA. Wasserstoffperoxid in der Ausatemluft: Eine Fehlerquelle, eine Paradoxie und ihre Auflösung. Pneumologie 2012. [DOI: 10.1055/s-0032-1302734] [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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Luszpinski MA, Jörres RA, Schierl R, de la Motte D, Kramer M, Nowak D. Experimentelle Exposition gegenüber Nanopartikeln: Effekte auf Lungenfunktion und Befindlichkeit bei anamnestisch Gesunden. Pneumologie 2012. [DOI: 10.1055/s-0032-1302537] [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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Arzt M, Obermeier R, Jörres RA, Wieland WF, Pfeifer M, Budweiser S. Einfluss von CPAP auf die erektile Dysfunktion bei Patienten mit obstruktiver Schlafapnoe. Pneumologie 2012. [DOI: 10.1055/s-0032-1302782] [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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Abstract
BACKGROUND In patients with severe chronic obstructive pulmonary disease (COPD), anaemia is common and associated with impaired long-term survival and quality of life. Whether anaemia is also prevalent in patients with other severe, non-inflammatory respiratory diseases has not yet been systematically tested. METHODS In 595 patients with obstructive (OD, 54.8%) or restrictive disease (RD, 45.2%) and chronic respiratory failure (CRF), anthropometric data, laboratory parameters, lung function, blood gases and comorbidities were assessed prior to initiation of home mechanical ventilation. Patients were classified as anaemic based on haemoglobin (Hb) levels (Hb<12/13 g/dl, female patients/male patients). Patients with known causes for anaemia were excluded. RESULTS In patients with CRF the prevalence of anaemia was 13.3% and not different between RD (11.5%) and OD (14.7%) (p=0.276). A sex-related difference occurred only in OD [7.9% (f) vs. 17.3% (m); p=0.035]. Patients with OD and anaemia presented with higher age (p=0.003), pH (p=0.014) and arterial oxygen pressure (PaO(2) ) (p=0.012), lower body mass index (BMI) (p=0.011) and total protein (p=0.012) and higher rates of coronary heart disease (p=0.01), cardiac arrhythmia (p=0.014) and diabetes mellitus (p=0.003) in comparison to non-anaemic patients. In patients with RD anaemia was associated with higher age, (p=0.008), pH (p=0.011) and lower leucocytes numbers (p=0.006). CONCLUSIONS Anaemia is frequent not only in COPD but also in other severe respiratory diseases combined with CRF. It was associated with advanced age, several comorbidities, impaired nutritional state and elevations of pH and PaO(2) , probably because of hyperventilation. Its prognostic impact has to be elucidated in future studies.
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Affiliation(s)
- F Kollert
- Centre for Pneumology, Donaustauf Hospital, Donaustauf, Germany.
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Hüttmann EM, Hattesohl A, Schmid S, Greulich T, Noeske S, John G, Jörres R, Müller B, Vogelmeier C, Bals R, Koczulla RM. Vergleich von zwei Geräten und zwei Atemmustern bei der Gewinnung von exhaliertem Atemwegskondensat. Pneumologie 2011. [DOI: 10.1055/s-0031-1274954] [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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Koczulla R, Hattesohl A, Biller H, Hofbauer J, Hohlfeld J, Oeser C, Wirtz H, Jörres RA. [Comparison of four identical electronic noses and three measurement set-ups]. Pneumologie 2011; 65:465-70. [PMID: 21437859 DOI: 10.1055/s-0030-1256280] [Citation(s) in RCA: 5] [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: 12/18/2022]
Abstract
BACKGROUND Volatile organic compounds (VOCs) can be used as biomarkers in exhaled air. VOC profiles can be detected by an array of nanosensors of an electronic nose. These profiles can be analysed using bioinformatics. It is, however, not known whether different devices of the same model measure identically and to which extent different set-ups and the humidity of the inhaled air influence the VOC profile. METHODS Three different measuring set-ups were designed and three healthy control subjects were measured with each of them, using four devices of the same model (Cyranose 320™, Smiths Detection). The exhaled air was collected in a plastic bag. Either ambient air was used as reference (set-up Leipzig), or the reference air was humidified (100% relative humidity) (set-up Marburg and set-up Munich). In the set-up Marburg the subjects inhaled standardised medical air (Aer medicinalis Linde, AGA AB) out of a compressed air bottle through a demand valve; this air (after humidification) was also used as reference. In the set-up Leipzig the subjects inhaled VOC-filtered ambient air, in the set-up Munich unfiltered room air. The data were evaluated using either the real-time data or the changes in resistance as calculated by the device. RESULTS The results were clearly dependent on the set-up. Apparently, humidification of the reference air could reduce the variance between devices, but this result was also dependent on the evaluation method used. When comparing the three subjects, the set-ups Munich and Marburg mapped these in a similar way, whereas not only the signals but also the variance of the set-up Leipzig were larger. CONCLUSION Measuring VOCs with an electronic nose has not yet been standardised and the set-up significantly affects the results. As other researchers use further methods, it is currently not possible to draw generally accepted conclusions. More systematic tests are required to find the most sensitive and reliable but still feasible set-up so that comparability is improved.
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Affiliation(s)
- R Koczulla
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Philipps-Universität Marburg, Germany.
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Koczulla A, Hattesohl A, Biller H, Hofbauer J, Hohlfeld J, Oeser C, Gessner C, Vogelmeier C, Baumbach J, Wirtz H, Jörres R. Krankheiten erriechen? Eine kurze Übersicht über elektronische Nasen. Pneumologie 2011; 65:401-5. [DOI: 10.1055/s-0030-1256252] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Koczulla RA, Hüttmann E, Jörres RA, Noeske S, Bals R, Schmid S, Hattesohl A, Greulich T, John G, Müller B, Vogelmeier C. Vergleich von zwei Geräten und zwei Atemmustern bei der Gewinnung von exhaliertem Atemwegskondensat. Pneumologie 2011. [DOI: 10.1055/s-0031-1272089] [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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