1
|
Shitrit E, Valentin E, Baudrier N, Bohu Y, Rauline G, Lopes R, Bauer T, Hardy A. The ALR-RSI score can be used to evaluate psychological readiness to return to sport after acute Achilles tendon tear. Knee Surg Sports Traumatol Arthrosc 2023; 31:4961-4968. [PMID: 37612477 PMCID: PMC10598148 DOI: 10.1007/s00167-023-07548-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The return to sport is one of the main goals following Achilles tendon tear repair. Several psychological factors influence the return to sport after a sports injury. The traditional tools to assess the return to sport do not take into account psychological factors. The ankle ligament reconstruction-return to sport injury (ALR-RSI), validated for ankle instability, is a score to evaluate psychological readiness to return to sport. The goal of this study was to validate the ALR-RSI score for the assessment of the readiness to return to sport after Achilles tendon repair. METHODS The ALR-RSI score, adapted from the anterior cruciate ligament-return to sport injury (ACL-RSI) score used following knee ligament reconstruction, was validated according to the international COSMIN methodology. Patients operated for Achilles tendon repair responded to the questionnaire during the rehabilitation period. The EFAS, FAAM and VISA-A scores were used as reference questionnaires. RESULTS A total of 50 patients were included. The ALR-RSI score was strongly (r > 0.5) correlated to the EFAS score: r = 0.68 [0.50-0.80] the FAMM sport score: r = 0.7 [0.52-0.84] the FAAM AVQ score (r = 0.6 [0.35-0.78]), and the VISA-A score (r = 0.54 [0.26-0.76]). The discriminant validity was good with the ALR-RSI, which was significantly lower in the patients that did not return to sport: 60.7 (40-81.4) compared to those that did: 83.2 (64.3-100) p = 0.001. Reproducibility was excellent with an intra-class correlation coefficient ρ of 0.99 [097-1.00]. The internal consistency was excellent (alpha coefficient = 0.95). CONCLUSION The ALR-RSI score provides a valid, reproducible assessment of the psychological readiness to return to sport in patients who undergo surgical Achilles tendon suture repair. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- E Shitrit
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France
| | - E Valentin
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France
| | - N Baudrier
- Clinique Jouvenet, 6 Sq. Jouvenet, 75016, Paris, France
| | - Y Bohu
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France
| | - G Rauline
- , 34 Rue Michal, 75013, Paris, France
| | - R Lopes
- chirurgie orthopedique, Pied cheville Nantes Atlantique, sante Atlantique, avenue Claude-Bernard, 44800, Saint-Herblain, France
- Clinique Brétéché, 3, rue de la Béraudière, BP 54613, 44046, Nantes Cedex 1, France
| | - T Bauer
- Service de chirurgie orthopedique et traumatologique, hopital Ambroise Paré, universite Paris-Saclay, Assistance publique-Hôpitaux de Paris, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France
| | - A Hardy
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France.
| |
Collapse
|
2
|
Häcker B, Breuer C, Priwitzer M, Otto-Knapp R, Bauer T. TB screening of Ukrainian refugees in Germany. Int J Tuberc Lung Dis 2023; 27:641-642. [PMID: 37491750 PMCID: PMC10365551 DOI: 10.5588/ijtld.23.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/12/2023] [Indexed: 07/27/2023] Open
Affiliation(s)
- B Häcker
- German Central Committee against Tuberculosis e.V. (DZK), Berlin
| | - C Breuer
- German Central Committee against Tuberculosis e.V. (DZK), Berlin, Public Health Office, Dresden
| | | | - R Otto-Knapp
- German Central Committee against Tuberculosis e.V. (DZK), Berlin
| | - T Bauer
- German Central Committee against Tuberculosis e.V. (DZK), Berlin, Department of Respiratory Medicine, Heckeshorn Lung Unit, Helios Klinikum Emil von Behring, Berlin, Germany
| |
Collapse
|
3
|
Ngoc Tram HT, Thu Huong BT, Duc Hinh N, Thuy PT, Lan Anh LT, Kim Phuon DT, Thu Lan H, Cam Tu H, Koerber N, Bauer T, Khanh Lam H, Manh Ha N, Minh Duc N, Thanh Hiep N, Protzer U, Tien Dung N. Multidimensional Analysis of the Mother-to-child Transmission Risk Factors in Chronic Hepatitis B Virus Infection in Pregnant Women in Vietnam. Clin Ter 2023; 174:266-274. [PMID: 37199363 DOI: 10.7417/ct.2023.2533] [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] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Background Hepatitis B virus (HBV) infection remains a major public health problem. The interaction between HBV and the host inflammatory response is an important factor contributing to liver damage and disease development. We investigate of the correlation between peripheral blood cell levels, HBV DNA, and the risk of transmission to the baby in pregnant women infected with hepatitis B. Methods A multidimensional analysis was performed on data collected from 60 Vietnamese pregnant women and their babies (cord blood). Results Taking the risk ratio test results of cord blood HBsAg as a positive probability, the boundary of maternal PBMC concentration is 8.03x106 cells/ml (with negative correlation) and for CBMCs is 6.64x106 cells/ml (with positive correlation). That means that HBsAg positivity in the blood may be related to the increasing of CBMCs and the diminution of maternal PBMCs. When the maternal viral load is higher than 5x107 copies/ml, the risk of being HBsAg-positive in cord blood is 123% (RR=2.23 [1.48,3.36]); when the viral load is lower than this baseline, the risk is decreased by 55% (RR=0.45 [0.30,0.67]) (p<0.001). Conclusions With several steps of the analysis, this study found maternal peripheral blood cell levels and cord blood positively cor-related in pregnant women with a load lower than 5x107 copies of HBV DNA/ml. The study's results suggest that the role of PBMCs and HBV DNA in vertical infection is essential.
Collapse
Affiliation(s)
- H T Ngoc Tram
- Department of Obstetrics and Gynecology, Hanoi Medical University, Hanoi, Vietnam
- Department of Obstetrics and Gynecology, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - B T Thu Huong
- Department of Biochemistry, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
- Department of Immunology and Molecular Genetics, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
| | - N Duc Hinh
- Department of Obstetrics and Gynecology, Hanoi Medical University, Hanoi, Vietnam
| | - P T Thuy
- Department of Biochemistry, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - L T Lan Anh
- Department of Medical Biology and Genetics, Hanoi Medical University, Hanoi, Vietnam
| | - D T Kim Phuon
- Department of Medical Biology and Genetics, Hanoi Medical University, Hanoi, Vietnam
| | - H Thu Lan
- Department of Medical Biology and Genetics, Hanoi Medical University, Hanoi, Vietnam
| | - H Cam Tu
- Center of Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
- Institute of Virology, School of Medicine, Technical University of Munich, Munich, Germany
| | - N Koerber
- Institute of Virology, School of Medicine, Technical University of Munich, Helmholtz Zentrum München, Munich, Germany; German Center for Infection Research (DZIF), Munich and Hamburg Partner sites, Germany
| | - T Bauer
- Institute of Virology, School of Medicine, Technical University of Munich, Helmholtz Zentrum München, Munich, Germany; German Center for Infection Research (DZIF), Munich and Hamburg Partner sites, Germany
| | - H Khanh Lam
- Department of Telecomunication, Hung Yen University of Technology and Education, Hung Yen, Vietnam
| | - N Manh Ha
- Department of Histology and Embryology, Hanoi Medical University, Hanoi, Vietnam
| | - N Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - N Thanh Hiep
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - U Protzer
- Institute of Virology, School of Medicine, Technical University of Munich, Helmholtz Zentrum München, Munich, Germany; German Center for Infection Research (DZIF), Munich and Hamburg Partner sites, Germany
| | - N Tien Dung
- Department of Internal Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| |
Collapse
|
4
|
Schoeffski P, Yamamoto N, Bauer T, Patel M, Lorusso P, Lahmar M, Durland-Busbice S, Geng J, Gounder M. 42O A phase Ia/b, dose-escalation and expansion study evaluating the MDM2–p53 antagonist BI 907828 in patients with solid tumours: Safety and efficacy in patients with dedifferentiated liposarcoma (DDLPS). ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101079] [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: 04/05/2023] Open
|
5
|
Strobl K, Jin R, Artner L, Klufa J, Sibilia M, Bauer T. 546 Epidermal growth factor receptor as a key regulator of the immune privilege. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
6
|
Mas-Peiro S, Faerber G, Herrmann E, Bauer T, Bleiziffer S, Bekeredjian R, Boening A, Frerker C, Beckmann A, Moellmann H, Ensminger S, Hamm C, Beyersdorf F, Fichtlscherer S, Walther T. TAVI versus SAVR in intermediate-risk patients with severe aortic stenosis and chronic kidney disease: a matched comparison in a subcohort from the GARY registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
According to American and recent European guidelines, both transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) may be used to treat severe aortic stenosis in a subgroup of patients with intermediate surgical risk, in spite of slight differences in recommended age limits (ACC/AHA: 65–80 years and ESC/EACTS: <75 years). A shared therapeutic decision is made with the patient, based on a heart team assessment. For this, individual factors should be taken into account. Concomitant chronic kidney disease (CKD) is a prognostic factor in such patients, and CKD stage ≥3a and ≥3b has been shown to be a significant independent risk factor for SAVR and TAVI, respectively.
Purpose
To compare TAVI vs. SAVR outcomes in a subgroup of patients for whom both therapies could possibly be considered according to current guidelines.
Methods
The large nation-wide German Aortic Valve Registry (GARY) includes data from patients treated with TAVI or SAVR. A subcohort of patients from GARY with intermediate surgical risk (age ≤80 years, STS-score 4–8) and moderate-to-severe chronic kidney disease (CKD stages 3a, 3b, and 4) was selected. A matched analysis of 704 patients undergoing TAVI and 374 undergoing SAVR was carried out using a propensity score method. Primary endpoint was 1-year survival. Clinical complications and specifically the need for postprocedural new-onset dialysis were secondary endpoints.
Results
TAVI and SAVR showed similar survival results at 1 year in a Kaplan-Meier analysis (HR [95% CI] for TAVI: 1.271 [0.795,2.031], p=0.316). Despite a numerically higher post-procedural short-term survival in TAVI patients and a numerically higher 1-year survival in SAVR patients, such differences did not reach statistical significance (96.4% vs. 94.2%, p=0.199, and 86.2% vs. 81.2%, p=0.316, respectively). In weighted analyses, need for permanent pacemaker, vascular complications, and moderate-to-severe valvular regurgitation were significantly more common with TAVI, whereas patients undergoing SAVR had significantly higher rates of myocardial infarction, and transient ischaemic attack, needed more transfusions for bleeding, and had a significantly longer intensive care unit stay and overall hospital stay. The need for new-onset dialysis for a limited time was more common after SAVR (p<0.0001); however, very few patients required chronic dialysis either after TAVI or after SAVR.
Conclusion
In a matched analysis of intermediate-risk patients with severe aortic stenosis and a concomitant moderate-to-severe CKD, for whom both TAVI and SAVR could possibly be considered, both approaches showed excellent and comparable results.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The registry receives financial support in the form of unrestricted grants by medical device companies (Edwards Lifesciences, JenaValve Technology, Medtronic, Sorin, St. Jude Medical, Symetis S.A.).In addition, there is unrestricted support by funding statisticians by the DZHK (Deutsches Zentrum für Herz-Kreislaufforschung).
Collapse
Affiliation(s)
- S Mas-Peiro
- Wolfgang Goethe University , Frankfurt am Main , Germany
| | - G Faerber
- University Hospital Jena , Jena , Germany
| | - E Herrmann
- Wolfgang Goethe University , Frankfurt am Main , Germany
| | - T Bauer
- Sana Clinic Offenbach , Offenbach , Germany
| | - S Bleiziffer
- Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum , Bad Oeynhausen , Germany
| | | | - A Boening
- University Hospital Giessen and Marburg , Giessen , Germany
| | - C Frerker
- Heart Center at the University of Cologne , Cologne , Germany
| | - A Beckmann
- German Society for Thoracic and Cardiovascular Surgery , Berlin , Germany
| | | | - S Ensminger
- Schleswig-Holstein University Clinic, Lubeck Campus , Luebeck , Germany
| | - C Hamm
- University Hospital Giessen and Marburg , Giessen , Germany
| | - F Beyersdorf
- University Heart Center Freiburg-Bad Krozingen , Freiburg , Germany
| | | | - T Walther
- Wolfgang Goethe University , Frankfurt am Main , Germany
| |
Collapse
|
7
|
Choueiri T, Bauer T, Merchan J, Figlin R, Roy A, Perini R, Vickery D, Arrowsmith E. 1447O Phase II study of belzutifan plus cabozantinib as first-line treatment of advanced renal cell carcinoma (RCC): Cohort 1 of LITESPARK-003. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
8
|
Schoeffski P, Yamamoto N, Bauer T, Patel M, Gounder M, Geng J, Sailer R, Jayadeva G, Lorusso P. 452O A phase I dose-escalation and expansion study evaluating the safety and efficacy of the MDM2–p53 antagonist BI 907828 in patients (pts) with solid tumours. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
9
|
Altorki N, Wang X, Kozono D, Watt C, Landreneau R, Wigle D, Port J, Jones D, Conti M, Ashrafi A, Keenan R, Bauer T, Kohman L, Stinchcombe T, Vokes E. PL03.06 Lobar or Sub-lobar Resection for Peripheral Clinical Stage IA = 2 cm Non-small Cell Lung Cancer (NSCLC): Results From an International Randomized Phase III Trial (CALGB 140503 [Alliance]). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
10
|
Steinbrecher J, Bonk A, Bauer T. Status on Thermal Energy Storage with Molten Nitrate Salt above 600 °C. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
11
|
Bearz A, Felip E, Mazieres J, de Marinis F, Bauer T, Polli A, Messina R, Thurm H, Thomaidou D, Mok T, Solomon B. 979P Long-term intracranial safety and efficacy analyses from the phase III CROWN study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
12
|
Kunkel S, Seeliger F, Hanke A, Bauer T, Bonk A. Concentrating solar power at higher limits: Studies on molten nitrate salts at 620 °C in a laboratory pilot‐scale hot tank. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255349] [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: 11/07/2022]
Affiliation(s)
- S. Kunkel
- German Aerospace Center Stuttgart Technical Engineering Pfaffenwaldring 38–42 70569 Stuttgart Germany
| | - F. Seeliger
- German Aerospace Center Cologne Technical Engineering Linder Höhe 51147 Cologne Germany
| | - A. Hanke
- German Aerospace Center Stuttgart Technical Engineering Pfaffenwaldring 38–42 70569 Stuttgart Germany
| | - T. Bauer
- German Aerospace Center Cologne Technical Engineering Linder Höhe 51147 Cologne Germany
| | - A. Bonk
- German Aerospace Center Stuttgart Technical Engineering Pfaffenwaldring 38–42 70569 Stuttgart Germany
| |
Collapse
|
13
|
Arora S, Bauer T, Parappurath N, Barczyk R, Verhagen E, Kuipers L. Breakdown of Spin-to-Helicity Locking at the Nanoscale in Topological Photonic Crystal Edge States. Phys Rev Lett 2022; 128:203903. [PMID: 35657901 DOI: 10.1103/physrevlett.128.203903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/24/2022] [Indexed: 06/15/2023]
Abstract
We measure the local near-field spin in topological edge state waveguides that emulate the quantum spin Hall effect. We reveal a highly structured spin density distribution that is not linked to a unique pseudospin value. From experimental near-field real-space maps and numerical calculations, we confirm that this local structure is essential in understanding the properties of optical edge states and light-matter interactions. The global spin is reduced by a factor of 30 in the near field and, for certain frequencies, flipped compared to the pseudospin measured in the far field. We experimentally reveal the influence of higher-order Bloch harmonics in spin inhomogeneity, leading to a breakdown in the coupling between local helicity and global spin.
Collapse
Affiliation(s)
- S Arora
- Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, Netherlands
| | - T Bauer
- Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, Netherlands
| | - N Parappurath
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - R Barczyk
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - E Verhagen
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - L Kuipers
- Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, Netherlands
| |
Collapse
|
14
|
Louati A, Bouche PA, Bauer T, Hardy A. Translation and validation of the shoulder instability-return to sport after injury (SIRSI) score in French. J Exp Orthop 2022; 9:41. [PMID: 35524076 PMCID: PMC9076763 DOI: 10.1186/s40634-022-00470-2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- A Louati
- South Francilien Hospital, 40 avenue Serge Dassault, 91100, Corbeil-Essonnes, France. .,Georges Pompidou European Hospital, 20 Rue Leblanc, 75015, Paris, France.
| | - P A Bouche
- Lariboisière Hospital AP-HP, 2 rue Ambroise Paré, 75010, Paris, France
| | - T Bauer
- Ambroise-Paré Hospital AP-HP, 9 Avenue Charles De Gaulle, 92100, Boulogne-Billancourt, France
| | - A Hardy
- Sport Clinic, 36, Boulevard Saint-Marcel, 75005, Paris, France
| |
Collapse
|
15
|
Davido B, Noussair L, El Sayed F, Jaffal K, Le Liepvre H, Marmouset D, Bauer T, Herrmann JL, Rottman M, Cremieux AC, Saleh-Mghir A. Hip joint infections caused by multidrug-resistant Enterobacterales among patients with spinal cord injury: experience of a reference center in the Greater Paris area. Open Forum Infect Dis 2022; 9:ofac209. [PMID: 35783683 PMCID: PMC9246273 DOI: 10.1093/ofid/ofac209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We aimed to describe the management and treatment of hip joint infections caused by multidrug-resistant Enterobacterales among patients with spinal cord injury (SCI).
Methods
We included all hip joint infections associated with grade IV decubitus ulcers caused by Extended-Spectrum Beta-Lactamase producing Enterobacterales (ESBL-PE) and Carbapenemase-Producing Enterobacterales (CPE) treated in a reference center for bone and joint infections (BJIs) over 9 years in a retrospective study.
Results
Seventeen SCI patients with ischial pressure ulcers breaching the hip capsule (mean age 52 ± 15 years) were analyzed. In 16 patients, paraplegia was secondary to trauma and one was secondary to multiple sclerosis. Infections were mostly polymicrobial (n=15; 88.2%), notably caused by Klebsiella pneumoniae (n=10) and S. aureus (n=10). The carbapenemases identified were exclusively OXA-48-type (n=3) including 2 isolates co-expressed with ESBL-PE within the same bacterial host.
Multidrug-resistant Enterobacterales were commonly resistant to fluoroquinolones (n=12; 70.6%). Most therapies were based on carbapenems (n=10) and combination therapies (n=13). Median duration of treatment was 45 (6-60) days. Of 17 cases of hip joint infections, 94.1% (n=16) benefited from a femoral head and neck resection.
Infection control was initially achieved in 58.8% (n=10) of cases and up to 88.2% after revision surgeries, after a median follow-up of 3 (1-36) months.
Conclusion
Hip infections among SCI patients caused by multidrug-resistant Enterobacterales are often polymicrobial and fluoroquinolones-resistant infections caused by K. pneumoniae and S. aureus, highlighting the need for expert centers with pluridisciplinary meetings associating experienced surgeons, clinical microbiologists and infectious disease specialists.
Collapse
Affiliation(s)
- B. Davido
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
- UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - L. Noussair
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
| | - F. El Sayed
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - K. Jaffal
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
| | - H. Le Liepvre
- Medecine Physique et reeducation, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
| | - D. Marmouset
- Service d’Orthopédie, Université Paris-Saclay, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - T. Bauer
- Service d’Orthopédie, Université Paris-Saclay, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - JL. Herrmann
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
- UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - M. Rottman
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
- UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - AC. Cremieux
- Service de Maladies Infectieuses, Université Paris Nord, Hôpital Saint-Louis, AP-HP, Paris, France
- UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - A. Saleh-Mghir
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond Poincaré, AP-HP, Garches, France
- UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| |
Collapse
|
16
|
Vogt F, Santarpino G, Fujita B, Frerker C, Bauer T, Bekeredjian R, Bleiziffer S, Beckmann A, Möllmann H, Walther T, Beyersdorf F, Hamm C, Böning A, Baldus S, Ensminger S, Fischlein T, Eckner D. Surgical Aortic Valve Replacement in Patients Aged 50 to 69 Years: Insights from the German Aortic Valve Registry (GARY). Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742941] [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: 10/19/2022]
Affiliation(s)
- F. Vogt
- Department of Cardiac Surgery, Nürnberg, Deutschland
| | - G. Santarpino
- Cardiac Surgery, Città di Lecce Hospital, GVM Care & Research, Lecche, Italy
| | - B. Fujita
- Department of Thoracic and Cardiaovascular Surgery, Lübeck, Deutschland
| | - C. Frerker
- Department of Cardiology, Ratzeburger Allee 160, Lübeck, Deutschland
| | - T. Bauer
- Department of Cardiology, Offenbach, Deutschland
| | | | - S. Bleiziffer
- Department of Thoracic and Cardiovascular Surgery, Bad Oeynhausen, Deutschland
| | - A. Beckmann
- Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie e.V., Berlin, Deutschland
| | - H. Möllmann
- Department of Internal Medicine, Dortmund, Deutschland
| | - T. Walther
- Department of Cardiac, Thoracic and Thoracic Vascular Surgery, Frankfurt, Deutschland
| | - F. Beyersdorf
- Department of Cardiovascular Surgery, Freiburg, Deutschland
| | - C. Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Deutschland
| | - A. Böning
- Department of Cardiothoracic Surgery, Gießen, Deutschland
| | - S. Baldus
- Department of Internal Medicine III, Heart Center Cologne, Köln, Deutschland
| | - S. Ensminger
- Clinic for Heart and Thoracic Vessel Surgery, Lübeck, Deutschland
| | - T. Fischlein
- Department of Cardiac Surgery, Nürnberg, Deutschland
| | - D. Eckner
- Department of Cardiology, Nürnberg, Deutschland
| |
Collapse
|
17
|
Davido B, Saleh-Mghir A, Rottman M, Jaffal K, Salomon E, Bouchand F, Lawrence C, Bauer T, Herrmann JL, De Truchis P, Noussair L, Cremieux AC. Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area. Int J Antimicrob Agents 2021; 59:106497. [PMID: 34906675 DOI: 10.1016/j.ijantimicag.2021.106497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 11/05/2022]
Abstract
Antibiotic treatment of native osteomyelitis caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) is a challenge. Limited epidemiological and outcome data are available. This retrospective cohort study included osteomyelitis patients with ESBL-PE infections treated in a reference centre for bone and joint infections (BJIs) between 2011-2019. Twenty-nine patients with native BJI (mean age, 44.4 ± 15.7 years) were analysed. Fifteen cases were paraplegic patients with ischial pressure sores breaching the hip capsule. Other cases included eight other hip infections, four tibial infections and two foot infections. Infections were mostly polymicrobial (n = 23; 79.3%), including Staphylococcus aureus (n = 13; 8 methicillin-resistant). Klebsiella pneumoniae (n = 13) was the most frequent ESBL-producing species identified, followed by Escherichia coli (n = 10), including 3 E. coli/K. pneumoniae co-infections, and Enterobacter spp. (n = 9). ESBL-PE were rarely susceptible to fluoroquinolones (n = 4; 13.8%). Most therapies were based on carbapenems (n = 22) and combination therapies (n = 19). The median duration of treatment was 41 (5-60) days. Primary control of the infection was achieved in 62.1% (18/29) of cases and up to 86.2% after second look surgeries, after a median follow-up of 6 (1-36) months. Infection with ESBL-producing K. pneumoniae was associated with failure (P = 0.001), whereas age, infection location, prior colonisation and antimicrobial therapy were not found to be predictors of outcome. ESBL-PE native BJIs are often polymicrobial and fluoroquinolone-resistant infections caused by K. pneumoniae, highlighting the need for expert centres with pluridisciplinary meetings with experienced surgeons.
Collapse
Affiliation(s)
- B Davido
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny-le-Bretonneux, France.
| | - A Saleh-Mghir
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny-le-Bretonneux, France
| | - M Rottman
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny-le-Bretonneux, France
| | - K Jaffal
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France
| | - E Salomon
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - F Bouchand
- Pharmacie Hospitalière, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France
| | - C Lawrence
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France
| | - T Bauer
- Service d'Orthopédie, Université Paris-Saclay, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - J L Herrmann
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny-le-Bretonneux, France
| | - P De Truchis
- Service des Maladies Infectieuses, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France
| | - L Noussair
- Laboratoire de Microbiologie, Université Paris-Saclay, Hôpital Raymond-Poincaré, AP-HP, Garches, France
| | - A C Cremieux
- Service de Maladies Infectieuses, Université Paris Nord, Hôpital Saint-Louis, AP-HP, Paris, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny-le-Bretonneux, France
| |
Collapse
|
18
|
Leha A, Huber C, Friede T, Bauer T, Beckmann A, Bekeredjian R, Bleiziffer S, Herrmann E, Moellmann H, Walther T, Kutschka I, Hasenfuss G, Ensminger S, Frerker C, Seidler T. Refined prediction and validation of individual risk using machine learning in transcatheter aortic valve implantation: TAVI Risk Machine (TRIM) scores. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Given the recent option for treatment using TAVI irrespective of surgical risk, general surgical risk scores have become less relevant, while TAVI-specific scores require refinement. Additionally, post-TAVI risk models are lacking; however, such risk models can support decision between post-TAVI treatment approaches, such as early discharge or close surveillance.
Purpose
This study aimed to predict 30-day mortality following transcatheter aortic valve implantation (TAVI) based on machine learning (ML) using data from the German Aortic Valve Registry.
Methods
Mortality risk was determined using a random forest ML model that was condensed in the newly developed TAVI Risk Machine (TRIM) scores, designed to represent clinically meaningful risk modelling before (TRIMpre) and after (TRIMpost) TAVI. Algorithm was trained and cross-validated on data of 24,452 patients and generalisation was examined on data of 5,889 patients.
Results
TRIMpost demonstrated significantly better performance than traditional scores (C-statistics value, 0.79; 95% confidence interval [CI] [0.74; 0.83]). An abridged TRIMpost score comprising 25 features (calculated using a web interface) exhibited significantly higher performance than traditional scores (C-statistics value, 0.74; 95% CI [0.70; 0.78]).
Conclusion
TRIM scores have high performance for risk estimation before and after TAVI. Together with clinical judgement, they may support standardised and objective decision-making before and after TAVI.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Leha
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - C Huber
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - T Friede
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - T Bauer
- Sana Klinikum Offenbach, Offenbach, Germany
| | - A Beckmann
- German Society for Thoracic and Cardiovascular Surgery, Berlin, Germany
| | | | - S Bleiziffer
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - E Herrmann
- Johann Wolfgang Goethe University, Frankfurt, Germany
| | | | - T Walther
- Johann Wolfgang Goethe University, Frankfurt, Germany
| | - I Kutschka
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - G Hasenfuss
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - S Ensminger
- University Medical Center of Schleswig-Holstein, Luebeck, Germany
| | - C Frerker
- University Medical Center of Schleswig-Holstein, Luebeck, Germany
| | - T Seidler
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| |
Collapse
|
19
|
Ji Q, Afridi KK, Bauer T, Giesbrecht G, Hou Y, Lal A, Ni D, Persaud A, Qin Z, Seidl P, Sinha S, Schenkel T. Beam power scale-up in micro-electromechanical systems based multi-beam ion accelerators. Rev Sci Instrum 2021; 92:103301. [PMID: 34717413 DOI: 10.1063/5.0058175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
We report on the development of multi-beam radio frequency (RF) linear ion accelerators that are formed from stacks of low cost wafers and describe the status of beam power scale-up using an array of 112 beams. The total argon ion current extracted from the 112-beamlet extraction column was 0.5 mA. The measured energy gain in each RF gap reached as high as 7.25 keV. We present a path toward using this technology to achieve ion currents >1 mA and ion energies >100 keV for applications in material processing.
Collapse
Affiliation(s)
- Q Ji
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - K K Afridi
- Cornell University, Ithaca, New York 14850, USA
| | - T Bauer
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - G Giesbrecht
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - Y Hou
- Cornell University, Ithaca, New York 14850, USA
| | - A Lal
- Cornell University, Ithaca, New York 14850, USA
| | - D Ni
- Cornell University, Ithaca, New York 14850, USA
| | - A Persaud
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - Z Qin
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - P Seidl
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Sinha
- Cornell University, Ithaca, New York 14850, USA
| | - T Schenkel
- Acceleration Technology and Applied Physics, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| |
Collapse
|
20
|
Metzler J, Morandi EM, Schwaiger K, Wolfram D, Cakl T, Djedovic G, Bauer T, Pierer G, Wechselberger G, Tasch C. Ski- and snowboard related open peroneal nerve injury: A 20-year retrospective case series study. Ann Med Surg (Lond) 2021; 69:102662. [PMID: 34429947 PMCID: PMC8371230 DOI: 10.1016/j.amsu.2021.102662] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Traumatic peroneal nerve injury (PNI) caused by ski or snowboard edges is a severe but scarcely reported accident. Methods In a 20-year retrospective study, all skiers and snowboarders with this injury treated surgically at the Department of Plastic, Reconstructive and Aesthetic Surgery at the Medical University of Innsbruck, Austria, were included, covering a period from 1999/2000 to 2018/2019. Results In total, 34 patients were included in this study (30 males (88.2%) and 4 (11.8%) females). Of these 34 injured skiers or snowboarders, 33 (97.1%) were recreational athletes and Non-Austrian citizens, and 21 (61.8%) patients sustained accidental injuries without collision. All of the injuries under investigation, i.e., open lacerations, most often with complete transection, were the patients’ main injuries. Surgery was performed with direct coaptation in 24 patients (70.6%), and with a suralis nerve graft in the other 10 patients (29.4%). Conclusion Traumatic laceration of the peroneal nerve at the knee level by sharp ski or snowboard edges is a rare but severe injury. Causes for this injury may be multifactorial. Recommendations to reduce the risk of such an injury may follow general instructions and warnings to skiers and snowboarders regarding equipment, familiarity with the region, as well as appropriate skills and training. In accidents of skiers and snowboarders traumatic laceration of the peroneal nerve is a severe, but rare injury. This injury type is rarely reported. The injuries are caused by the sharp edges of modern skies or snowboards and require urgent microsurgical intervention. Our 20 years study shows that this injury type primarily affects recreational athletes and guest skiers. Current equipment, e.g. ski trousers do not protect the affected region on the lateral side of the knee.
Collapse
Affiliation(s)
- J Metzler
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of St. John of God (Barmherzige Brüder) Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - E M Morandi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - K Schwaiger
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of St. John of God (Barmherzige Brüder) Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - D Wolfram
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - T Cakl
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - G Djedovic
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - T Bauer
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - G Pierer
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - G Wechselberger
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital of St. John of God (Barmherzige Brüder) Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - C Tasch
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
21
|
Diel R, Schaberg T, Nienhaus A, Otto-Knapp R, Kneitz C, Krause A, Fabri M, Mrowietz U, Bauer T, Häcker B. Joint Statement (DZK, DGRh, DDG) on the Tuberculosis Risk with Treatment Using Novel Non-TNF-Alpha Biologicals. Pneumologie 2021; 75:293-303. [PMID: 33598901 DOI: 10.1055/a-1294-1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND While the risk of tuberculosis (TB) reactivation is adequately documented in relation to TNF-alpha inhibitors (TNFi), the question of what the tuberculosis risk is for newer, non-TNF biologics (non-TNFi) has not been thoroughly addressed. METHODS We conducted a systematic review of randomized phase 2 and phase 3 studies, and long-term extensions of same, published through March 2019. Of interest was information pertaining to screening and treating of latent tuberculosis (LTBI) in association with the use of 12 particular non-TNFi. Only rituximab was excluded. We searched MEDLINE and the ClinicalTrial.gov database for any and all candidate studies meeting these criteria. RESULTS 677 citations were retrieved; 127 studies comprising a total of 34,293 patients who received non-TNFi were eligible for evaluation. Only 80 out of the 127 studies, or 63 %, captured active TB (or at least opportunistic diseases) as potential outcomes and 25 TB cases were reported. More than two thirds of publications (86/127, 68 %) mentioned LTBI screening prior to inclusion of study participants in the respective trial, whereas in only 4 studies LTBI screening was explicitly considered redundant. In 21 studies, patients with LTBI were generally excluded from the trials and in 42 out of the 127 trials, or 33 %, latently infected patients were reported to receive preventive therapy (PT) at least 3 weeks prior to non-TNFi treatment. CONCLUSIONS The lack of information in many non-TNFi studies on the number of patients with LTBI who were either excluded prior to participating or had been offered PT hampers assessment of the actual TB risk when applying the novel biologics. Therefore, in case of insufficient information about drugs or drug classes, the existing recommendations of the German Central Committee against Tuberculosis should be applied in the same way as is done prior to administering TNFi. Well designed, long-term "real world" register studies on TB progression risk in relation to individual substances for IGRA-positive cases without prior or concomitant PT may help to reduce selection bias and to achieve valid conclusions in the future.
Collapse
Affiliation(s)
- R Diel
- Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, Campus Kiel, Germany. Member of the German Center for Lung Research (ARCN).,LungClinic Grosshansdorf, Germany. Airway Research Center North (ARCN), German Center for Lung Research (DZL).,German Central Committee against Tuberculosis, Berlin, Germany
| | - T Schaberg
- German Central Committee against Tuberculosis, Berlin, Germany
| | - A Nienhaus
- Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany.,Institute for Health Service Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Otto-Knapp
- German Central Committee against Tuberculosis, Berlin, Germany
| | - C Kneitz
- Medicine, Rheumatology, rheumatological main practice Schwerin, Germany
| | - A Krause
- Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin, Germany
| | - M Fabri
- Department of Dermatology, University of Cologne, Germany
| | - U Mrowietz
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - T Bauer
- German Central Committee against Tuberculosis, Berlin, Germany
| | - B Häcker
- German Central Committee against Tuberculosis, Berlin, Germany
| |
Collapse
|
22
|
Häcker B, Kaufmann SHE, Bauer T, Otto-Knapp R. History of BCG Vaccination Recommendations in East and West Germany from 1951 to Date. Pneumologie 2020; 74:811-812. [DOI: 10.1055/a-1295-8922] [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: 10/22/2022]
Affiliation(s)
- B. Häcker
- German Central Committee against tuberculosis (DZK), Berlin, Germany
| | - S. H. E. Kaufmann
- Max-Planck-Institute for Infection Biology, Berlin, Germany
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - T. Bauer
- German Central Committee against tuberculosis (DZK), Berlin, Germany
- Helios Klinikum Emil von Behring, Lungenklinik Heckeshorn, Berlin, Germany
| | - R. Otto-Knapp
- German Central Committee against tuberculosis (DZK), Berlin, Germany
| |
Collapse
|
23
|
Lommatzsch M, Rabe KF, Taube C, Joest M, Kreuter M, Wirtz H, Blum TG, Kolditz M, Geerdes-Fenge H, Otto-Knapp R, Häcker B, Schaberg T, Ringshausen FC, Vogelmeier CF, Reinmuth N, Reck M, Gottlieb J, Konstantinides S, Meyer FJ, Worth H, Windisch W, Welte T, Bauer T. [Risk Assessment for Patients with Chronic Respiratory and Pulmonary Conditions in the Context of the SARS-CoV-2 Pandemic - Statement of the German Respiratory Society (DGP) with the Support of the German Association of Respiratory Physicians (BdP)]. Pneumologie 2020; 75:19-30. [PMID: 33242887 DOI: 10.1055/a-1321-3400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M Lommatzsch
- Zentrum für Innere Medizin, Abteilung Pneumologie, Universitätsmedizin Rostock, Rostock
| | - K F Rabe
- LungenClinic Großhansdorf, Großhansdorf.,Deutsches Zentrum für Lungenforschung
| | - C Taube
- Klinik für Pneumologie, Universitätsmedizin Essen-Ruhrlandklinik, Westdeutsches Lungenzentrum, Essen
| | - M Joest
- Lungen- und Allergiezentrum Bonn, Bonn
| | - M Kreuter
- Zentrum für interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg.,Deutsches Zentrum für Lungenforschung
| | - H Wirtz
- Abt. Pneumologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - T G Blum
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | - M Kolditz
- Medizinische Klinik 1, Bereich Pneumologie, Universitätsklinikum Carl Gustav Carus, Dresden
| | - H Geerdes-Fenge
- Universitätsmedizin Rostock, Zentrum für Innere Medizin, Abteilung für Infektionskrankheiten und Tropenmedizin, Rostock
| | - R Otto-Knapp
- Dtsch. Zentralkomitee zur Bekämpfung der Tuberkulose, DZK, Berlin
| | - B Häcker
- Dtsch. Zentralkomitee zur Bekämpfung der Tuberkulose, DZK, Berlin
| | | | - F C Ringshausen
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover.,Deutsches Zentrum für Lungenforschung
| | - C F Vogelmeier
- Klinik für Pneumologie, Universitätsklinikum Marburg, Marburg.,Deutsches Zentrum für Lungenforschung
| | - N Reinmuth
- Asklepios Fachkliniken München-Gauting, Thorakale Onkologie, Gauting.,Deutsches Zentrum für Lungenforschung
| | - M Reck
- LungenClinic Großhansdorf, Großhansdorf.,Deutsches Zentrum für Lungenforschung
| | - J Gottlieb
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover.,Deutsches Zentrum für Lungenforschung
| | - S Konstantinides
- Centrum für Thrombose und Hämostase (CTH), Universitätsmedizin Mainz, Mainz
| | - F J Meyer
- Lungenzentrum München (Bogenhausen-Harlaching), München Klinik, München
| | | | - W Windisch
- Lungenklinik, Kliniken der Stadt Köln GmbH, Lehrstuhl für Pneumologie der Universität Witten-Herdecke
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover.,Deutsches Zentrum für Lungenforschung
| | - T Bauer
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| |
Collapse
|
24
|
Loddenkemper R, Konietzko N, Seehausen V, Bauer T, Pfeifer M. [125 Years German Central Committee for the Fight against Tuberculosis (DZK)]. Pneumologie 2020; 74:719-741. [PMID: 33202436 DOI: 10.1055/a-1234-7581] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The German Central Committee for the Fight against Tuberculosis (DZK) celebrates this year its 125th birthday. On this occasion, the DZK as one of the oldest TB organizations worldwide is looking back on the development during its history and records the results in a comprehensive book, summarized in this article. In the book, the various political changes with their impact on the DZK are mirrored, starting with the German Empire, the Weimar Republic, the so-called "Third Reich", the two German states separated after the Second World War and the current FRG. Tuberculosis (TB) was the dominant widespread disease in the 19th century, today it is the leading infectious disease worldwide. As a consequence of migration, this affects also Germany. After meanwhile - in particular in 2015/16 - risen numbers of new cases (especially of those not born in Germany, which in 2019 accounted for 72 % of all cases), the impact of drug-resistant tuberculosis (in 2019, 11.4 % of all new cases had some resistance (384 cases), including 87 cases of MDR-TB, and of these 8 cases of XDR-TB and 27 cases of pre-XDR-TB), as well as the high proportion (81,5 %) - in 2019 - of open and thus very infectious pulmonary TB among new TB cases in Germany, impressively show that TB continues to be a health problem that should not be underestimated and that is increasingly concentrated in risk groups (socially disadvantaged persons, people from high-prevalence countries, homeless people, drug addicts, alcoholics, HIV-infected persons). The DZK therefore continues to play an important role in TB control as a link between the national and international organizations responsible for combating TB.
Collapse
Affiliation(s)
- R Loddenkemper
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | - N Konietzko
- vormals Ruhrlandklinik, Universitätsmedizin Essen, Essen
| | - V Seehausen
- Institut für Geschichte der Medizin und Ethik in der Medizin, Charité - Universitätsmedizin Berlin
| | - T Bauer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin.,Helios Klinikum Emil von Behring, Lungenklinik Heckeshorn, Berlin
| | - M Pfeifer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin.,Klinik Donaustauf, Universitätsklinikum Regensburg, Regensburg
| |
Collapse
|
25
|
Mas-Peiro S, Faerber G, Bauer T, Bleiziffer S, Bekeredjian R, Boening A, Frerker C, Beckmann A, Moellmann H, Vasa-Nicotera M, Ensminger S, Hamm C, Beyersdorf F, Walther T, Fichtlscherer S. Clinical outcomes after surgical or transcatheter aortic valve replacement in patients with chronic kidney disease: an analysis in 29 893 patients from the German Aortic Valve Registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic kidney disease (CKD) is a key risk factor in patients undergoing transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR).
Purpose
We analyzed the impact of eGFR and different stages of chronic kidney disease (CKD), on short- and mid-term survival in patients undergoing TAVI or SAVR.
Methods
Data from 29893 patients enrolled in the German Aortic Valve registry (GARY) from January 2011 to December 2015 receiving TAVI (n=12834) or SAVR (n=17059) at 88 sites were included. The impact of renal impairment, as measured by eGFR and CKD stages, was investigated. The primary endpoint was 1-year cumulative all-cause mortality. A propensity score method was used to compare TAVI vs. SAVR in patients with intermediate risk and mild-to-moderate renal disease being eligible for both therapies.
Results
Higher CKD stages were significantly associated to lower in-hospital, 30-day- and 1-year survival rates. Both TAVI- and SAVR-treated patients in CKD 3a, 3b, 4, and 5 stages showed significant and gradually increasing HR values for 1-year all-cause mortality. The same trend persisted in multivariable analysis, although HR values for CKD 3a and 5 did not reach significance in TAVI patients, whereas CKD 4+5 did not reach statistical significance in SAVR. Likewise, eGFR as a continuous variable was a significant predictor for 1-year mortality, with the best cut-off points being 47.4 mL/min/1.73 m2 for TAVI and 59.8 mL/min/1.73 m2 for SAVR. Significant 8.6% and 9.0% increases in 1-year mortality were observed for every 5-mL reduction in eGFR for TAVI and SAVR, respectively. No significant differences in survival were found between TAVI and SAVR in a matched group of intermediate-risk patients potentially eligible for both therapies (HR [(95% CI] for TAVI vs SAVR 1.24 [0.76, 2.02], p=0.240).
Conclusions
CKD≥3b and CKD≥3a is an independent major risk factor for mortality in patients undergoing TAVI and SAVR, respectively. In the overall population of patients with severe aortic stenosis, an appropriate stratification based on CKD substage may contribute to a better selection of patients suitable for such therapies. TAVI and SAVR appear to achieve similar survival rates in intermediate-risk patients with moderate-to-severe renal dysfunction.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Unrestricted grants by medical device companies (Edwards Lifesciences, JenaValve Technology, Medtronic, Sorin, St. Jude Medical, Symetis S.A.). Unrestricted support by funding statisticians by the DZHK (Deutsches Zentrum für Herz-Kreislaufforschung).
Collapse
Affiliation(s)
- S Mas-Peiro
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - G Faerber
- University Hospital Jena, Jena, Germany
| | - T Bauer
- Sana Klinikum Offenbach, Offenbach, Germany
| | | | | | - A Boening
- University hospital Giessen and Marburg, Giessen, Germany
| | - C Frerker
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - A Beckmann
- Charite - Campus Virchow-Klinikum (CVK), Berlin, Germany
| | | | | | - S Ensminger
- University hospital Schleswig-Holstein Campus Lübeck, Luebeck, Germany
| | - C.W Hamm
- University hospital Giessen and Marburg, Giessen, Germany
| | - F Beyersdorf
- University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany
| | - T Walther
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | | |
Collapse
|
26
|
Otto-Knapp R, Knappik M, Häcker B, Starzacher K, Bauer T, Lange C, Maurer FP, Schaberg T, Günther G. Die neuen WHO-Empfehlungen für schnelle Diagnostik und Therapie resistenter Tuberkulose in Deutschland, Österreich und der Schweiz. Pneumologie 2020; 74:742-749. [DOI: 10.1055/a-1266-5207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungDie erfreulicherweise zunehmende Evidenz hat in den letzten Jahren mehrfache Änderungen der internationalen Empfehlungen für die Diagnostik und Therapie der resistenten Tuberkulose notwendig gemacht. In diesem Jahr hat die WHO umfassende Empfehlungen veröffentlicht, die die Entwicklungen der letzten Jahre berücksichtigen. Die aktuelle deutsche Tuberkuloseleitlinie erschien im Jahr 2017 und weicht in einigen Bereichen von diesen Empfehlungen ab. Hier werden die Neuerungen der WHO-Empfehlungen von 2020 für schnelle Diagnostik und die Therapie resistenter Tuberkulose zusammengefasst und relevante Abweichungen für Deutschland, Österreich und die Schweiz kommentiert. Eine Neubewertung der Literatur findet derzeit im Rahmen der Aktualisierung der deutschsprachigen AWMF-2k-Leitlinie statt.
Collapse
Affiliation(s)
- R. Otto-Knapp
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | - M. Knappik
- Klinik Penzing, Abteilung für Atemwegs- und Lungenkrankheiten, Wien
| | - B. Häcker
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | - K. Starzacher
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | - T. Bauer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
- Deutsche Gesellschaft für Pneumologie e. V. (DGP)
- Helios Klinikum Emil von Behring, Lungenklinik Heckeshorn, Berlin
| | - C. Lange
- Medizinische Klinik und FG Klinische Infektiologie, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel
- Deutsches Zentrum für Infektionsforschung (DZIF), Klinische Tuberkuloseforschung, Standort Borstel-Hamburg-Lübeck-Riems
- Respiratory Medicine & International Health, Universität zu Lübeck, Lübeck
- Exzellenzcluster Präzisionsmedizin bei chronischer Entzündung, Kiel
| | - F. P. Maurer
- Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - T. Schaberg
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | - G. Günther
- Universitätsklinik für Pneumologie, Inselspital, Universitätsspital Bern, Universität Bern, Schweiz
- Department of Medicine, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| |
Collapse
|
27
|
Davido B, Noussair L, Saleh-Mghir A, Salomon E, Bouchand F, Matt M, Lawrence C, Bauer T, Herrmann JL, Perronne C, Gaillard JL, Rottman M, Dinh A. Case series of carbapenemase-producing Enterobacteriaceae osteomyelitis: Feel it in your bones. J Glob Antimicrob Resist 2020; 23:74-78. [PMID: 32882450 DOI: 10.1016/j.jgar.2020.08.007] [Citation(s) in RCA: 3] [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: 05/18/2020] [Revised: 07/20/2020] [Accepted: 08/14/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Limited data have been reported regarding osteomyelitis due to carbapenemase-producing Enterobacteriaceae (CPE), including co-infections with extended-spectrum β-lactamase (ESBL)-producing micro-organisms. METHODS We conducted a retrospective study in a reference centre for bone and joint infections from 2011 to 2019 among patients infected with CPE. RESULTS Nine patients (mean age 46.8 ± 16.6 years), including three with infected implants, were identified. Infections were mostly polymicrobial (n = 8/9), including Staphylococcus aureus (n = 6/9). CPE were mainly OXA-48-type, associated with ESBL-producing Enterobacteriaceae (n = 8/9), of which 5/9 isolates were Klebsiella pneumoniae. Control of the infection was achieved in seven cases. CONCLUSIONS CPE osteomyelitides are essentially polymicrobial and fluoroquinolone-resistant infections, highlighting the need for efficient surgery with implant removal.
Collapse
Affiliation(s)
- B Davido
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France.
| | - L Noussair
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| | - A Saleh-Mghir
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| | - E Salomon
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - F Bouchand
- Pharmacie Hospitalière, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| | - M Matt
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| | - C Lawrence
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| | - T Bauer
- Service d'Orthopédie, Centre Hospitalier Universitaire Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - J L Herrmann
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - C Perronne
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| | - J L Gaillard
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Ambroise Paré, AP-HP, Boulogne-Billancourt, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - M Rottman
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France; UMR UVSQ INSERM U1173, UFR Simone Veil des Sciences de la Santé, Montigny le Bx, France
| | - A Dinh
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France
| |
Collapse
|
28
|
Otto-Knapp R, Häcker B, Breuer C, Diel R, Kaufmann SHE, Korr G, Pfeiffer M, Schaberg T, Schönfeld N, Witte P, Bauer T. [DZK Recommendations for Tuberculosis, BCG and COVID-19 in Germany - (Official Abbreviation of Coronavirus Disease 2019 Caused by the New Coronavirus SARS-CoV-2)]. Pneumologie 2020; 74:412-416. [PMID: 32674189 DOI: 10.1055/a-1199-6721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- R Otto-Knapp
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK)
| | - B Häcker
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK)
| | - C Breuer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).,Gesundheitsamt Dresden, Dresden
| | - R Diel
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).,LungenClinic Grosshansdorf, Airway Disease Center North (ARCN), Großhansdorf
| | | | - G Korr
- Bundesministerium für Gesundheit, Berlin
| | - M Pfeiffer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).,Klinik Donaustauf, Universitätsklinikum Regensburg, Regensburg.,Deutsche Gesellschaft für Pneumologie e. V. (DGP)
| | - T Schaberg
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK)
| | - N Schönfeld
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).,Helios Klinikum Emil von Behring, Lungenklinik Heckeshorn, Berlin
| | - P Witte
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).,Institut für Krankenhaushygiene der Mühlenkreiskliniken, Universitätsklinikum Johannes-Wesling Minden
| | - T Bauer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).,Deutsche Gesellschaft für Pneumologie e. V. (DGP).,Helios Klinikum Emil von Behring, Lungenklinik Heckeshorn, Berlin
| |
Collapse
|
29
|
Kolditz M, Dellweg D, Geerdes-Fenge H, Lepper PM, Schaberg T, Ewig S, Pfeifer M, Bauer T. [Treatment with Dexamethasone in Patients with COVID-19 - A Position Paper of the German Respiratory Society (DGP)]. Pneumologie 2020; 74:493-495. [PMID: 32674177 PMCID: PMC7516361 DOI: 10.1055/a-1216-5739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M Kolditz
- Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Klinik und Poliklinik für Innere Medizin I, Dresden
| | - D Dellweg
- Fachkrankenhaus Kloster Grafschaft GmbH, Akademisches Lehrkrankenhaus der Philipps-Universität Marburg, Schmallenberg Grafschaft
| | - H Geerdes-Fenge
- Universitätsmedizin Rostock, Zentrum für Innere Medizin, Abteilung für Infektionskrankheiten und Tropenmedizin, Rostock
| | - P M Lepper
- Universitätsklinikum des Saarlandes, Innere Medizin V - Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Homburg/Saar
| | | | - S Ewig
- Thoraxzentrum Ruhrgebiet, Department of Respiratory and Infectious Diseases, EVK Herne and Augusta-Krankenanstalt Bochum, Bochum
| | - M Pfeifer
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinik Regensburg, Regensburg.,Abteilung für Pneumologie, Fachklinik für Lungenerkrankungen Donaustauf.,Krankenhaus Barmherzige Brüder, Klinik für Pneumologie und konservative Intensivmedizin, Regensburg
| | - T Bauer
- Helios Klinikum Emil von Behring GmbH, Lungenklinik Heckeshorn, Berlin
| |
Collapse
|
30
|
Pfeifer M, Ewig S, Voshaar T, Randerath W, Bauer T, Geiseler J, Dellweg D, Westhoff M, Windisch W, Schönhofer B, Kluge S, Lepper PM. [Position Paper for the State of the Art Application of Respiratory Support in Patients with COVID-19 - German Respiratory Society]. Pneumologie 2020; 74:337-357. [PMID: 32323287 PMCID: PMC7378547 DOI: 10.1055/a-1157-9976] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Against the background of the pandemic caused by infection with the SARS-CoV-2, the German Society for Pneumology and Respiratory Medicine (DGP e.V.), in cooperation with other associations, has designated a team of experts in order to answer the currently pressing questions about therapy strategies in dealing with COVID-19 patients suffering from acute respiratory insufficiency (ARI).The position paper is based on the current knowledge that is evolving daily. Many of the published and cited studies require further review, also because many of them did not undergo standard review processes.Therefore, this position paper is also subject to a continuous review process and will be further developed in cooperation with the other professional societies.This position paper is structured into the following five topics:1. Pathophysiology of acute respiratory insufficiency in patients without immunity infected with SARS-CoV-22. Temporal course and prognosis of acute respiratory insufficiency during the course of the disease3. Oxygen insufflation, high-flow oxygen, non-invasive ventilation and invasive ventilation with special consideration of infectious aerosol formation4. Non-invasive ventilation in ARI5. Supply continuum for the treatment of ARIKey points have been highlighted as core statements and significant observations. Regarding the pathophysiological aspects of acute respiratory insufficiency (ARI), the pulmonary infection with SARS-CoV-2 COVID-19 runs through three phases: early infection, pulmonary manifestation and severe hyperinflammatory phase.There are differences between advanced COVID-19-induced lung damage and those changes seen in Acute Respiratory Distress Syndromes (ARDS) as defined by the Berlin criteria. In a pathophysiologically plausible - but currently not yet histopathologically substantiated - model, two types (L-type and H-type) are distinguished, which correspond to an early and late phase. This distinction can be taken into consideration in the differential instrumentation in the therapy of ARI.The assessment of the extent of ARI should be carried out by an arterial or capillary blood gas analysis under room air conditions and must include the calculation of the oxygen supply (measured from the variables of oxygen saturation, the Hb value, the corrected values of the Hüfner number and the cardiac output). In principle, aerosols can cause transmission of infectious viral particles. Open systems or leakage systems (so-called vented masks) can prevent the release of respirable particles. Procedures in which the invasive ventilation system must be opened, and endotracheal intubation must be carried out are associated with an increased risk of infection.The protection of personnel with personal protective equipment should have very high priority because fear of contagion must not be a primary reason for intubation. If the specifications for protective equipment (eye protection, FFP2 or FFP-3 mask, gown) are adhered to, inhalation therapy, nasal high-flow (NHF) therapy, CPAP therapy or NIV can be carried out according to the current state of knowledge without increased risk of infection to the staff. A significant proportion of patients with respiratory failure presents with relevant hypoxemia, often also caused by a high inspiratory oxygen fraction (FiO2) including NHF, and this hypoxemia cannot be not completely corrected. In this situation, CPAP/NIV therapy can be administered under use of a mouth and nose mask or a respiratory helmet as therapy escalation, as long as the criteria for endotracheal intubation are not fulfilled.In acute hypoxemic respiratory insufficiency, NIV should be performed in an intensive care unit or in a comparable unit by personnel with appropriate expertise. Under CPAP/NIV, a patient can deteriorate rapidly. For this reason, continuous monitoring with readiness to carry out intubation must be ensured at all times. If CPAP/NIV leads to further progression of ARI, intubation and subsequent invasive ventilation should be carried out without delay if no DNI order is in place.In the case of patients in whom invasive ventilation, after exhausting all guideline-based measures, is not sufficient, extracorporeal membrane oxygenation procedure (ECMO) should be considered to ensure sufficient oxygen supply and to remove CO2.
Collapse
Affiliation(s)
- M Pfeifer
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinik Regensburg, Regensburg
- Abteilung für Pneumologie, Fachklinik für Lungenerkrankungen Donaustauf
- Krankenhaus Barmherzige Brüder, Klinik für Pneumologie und konservative Intensivmedizin, Regensburg
| | - S Ewig
- Thoraxzentrum Ruhrgebiet, Department of Respiratory and Infectious Diseases, EVK Herne and Augusta-Krankenanstalt Bochum, Bochum
| | - T Voshaar
- Schwerpunkt Pneumologie, Allergologie, Klinische Immunologie, Zentrum für Schlaf- und Beatmungsmedizin, Krankenhaus Bethanien, Moers
| | - W Randerath
- Institut für Pneumologie an der Universität zu Köln, Köln
- Klinik für Pneumologie, Krankenhaus Bethanien, Solingen
| | - T Bauer
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring GmbH, Berlin
| | - J Geiseler
- Medizinische Klinik IV: Klinik für Pneumologie, Beatmungs- und Schlafmedizin, Klinikum Vest GmbH, Paracelsus-Klinik, Marl
| | - D Dellweg
- Fachkrankenhaus Kloster Grafschaft GmbH, Akademisches Lehrkrankenhaus der Philipps-Universität Marburg, Schmallenberg Grafschaft
| | - M Westhoff
- Klinik für Pneumologie, Lungenklinik Hemer, Hemer
- Universität Witten-Herdecke, Witten
| | - W Windisch
- Universität Witten-Herdecke, Witten
- Klinik für Pneumologie, Klinikum Köln-Merheim, Kliniken der Stadt Köln, Lehrstuhl für Pneumologie der Universität Witten-Herdecke, Köln
| | - B Schönhofer
- Pneumologische Praxis und pneumologischer Konsildienst im Klinikum Agnes Karll Laatzen, Klinikum Region Hannover, Laatzen
| | - S Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - P M Lepper
- Innere Medizin V - Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar
| |
Collapse
|
31
|
Sahm J, Baier G, Lang J, Gretser S, Bauer T. [Erratum to: Panton-valentine leukocidin (PVL)-positive Staphylococcus aureus causing necrotizing pneumonia after infection with parainfluenza virus type 2]. Med Klin Intensivmed Notfmed 2020; 116:266. [PMID: 32356042 DOI: 10.1007/s00063-020-00695-y] [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: 11/28/2022]
Affiliation(s)
- J Sahm
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland.
| | - G Baier
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
| | - J Lang
- Zentralinstitut für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Sana Klinikum Offenbach, Offenbach am Main, Deutschland
| | - S Gretser
- Dr. Senckenbergisches Institut für Pathologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - T Bauer
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
| |
Collapse
|
32
|
van Gogh MA, Bauer T, De Angelis L, Kuipers L. Poynting singularities in the transverse flow-field of random vector waves. Opt Lett 2020; 45:2600-2603. [PMID: 32356826 DOI: 10.1364/ol.389301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/18/2020] [Indexed: 06/11/2023]
Abstract
In order to utilize the full potential of tailored flows of electromagnetic energy at the nanoscale, we need to understand its general behavior given by its generic representation of interfering random waves. For applications in on-chip photonics as well as particle trapping, it is important to discern between the topological features in the flow-field of the commonly investigated cases of fully vectorial light fields and their 2D equivalents. We demonstrate the distinct difference between these cases in both the allowed topology of the flow-field and the spatial distribution of its singularities, given by their pair correlation function g(r). Specifically, we show that a random field confined to a 2D plane has a divergence-free flow-field and exhibits a liquid-like correlation, whereas its freely propagating counterpart has no clear correlation and features a transverse flow-field with the full range of possible 2D topologies around its singularities.
Collapse
|
33
|
Sahm J, Baier G, Lang J, Gretser S, Bauer T. [Panton-valentine leukocidin (PVL)-positive Staphylococcus aureus causing necrotizing pneumonia after infection with parainfluenza virus type 2]. Med Klin Intensivmed Notfmed 2020; 116:262-265. [PMID: 32291504 PMCID: PMC7154571 DOI: 10.1007/s00063-020-00679-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 12/03/2022]
Affiliation(s)
- J Sahm
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland.
| | - G Baier
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
| | - J Lang
- Zentralinstitut für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Sana Klinikum Offenbach, Offenbach am Main, Deutschland
| | - S Gretser
- Dr. Senckenbergisches Institut für Pathologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - T Bauer
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
| |
Collapse
|
34
|
Haase S, Bauer T, Hilpmann G, Lange M, Ayubi MM, Abiev R. Simultaneous Detection of Hydrodynamics, Mass Transfer and Reaction Rates in a Three-Phase Microreactor. Theor Found Chem Eng 2020. [DOI: 10.1134/s0040579520010091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
35
|
Angevin E, Groenland S, Bauer T, Rischin D, Gardeazabal I, Moreno V, Trigo J, Chisamore M, Shaik J, Rigat F, Ellis C, Chen H, Gagnon R, Scherer S, Turner D, Yadavilli S, Ballas M, Hoos A, Maio M. 11P Pharmacokinetic/pharmacodynamic (PK/PD) exposure-response characterization of GSK3359609 (GSK609) from INDUCE-1, a phase I open-label study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.01.059] [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] Open
|
36
|
Lot AS, Sawczynski B, Bauer T, Teillet L, Sellier C. Bilan médicoéconomique de l’ouverture d’une unité périopératoire gériatrique au CHU d’Ambroise-Paré. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.065] [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] Open
|
37
|
Blumenstein J, Möllmann H, Bleiziffer S, Bauer T, Ensminger S, Bekeredjian R, Walther T, Frerker C, Beyersdorf F, Hamm C, Beckmann A. Transcatheter aortic valve implantation in nonagenarians: insights from the German Aortic Valve Registry (GARY). Clin Res Cardiol 2020; 109:1099-1106. [PMID: 31989251 DOI: 10.1007/s00392-020-01601-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/14/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to compare the outcome of nonagenarians (≥ 90 years) with that of younger (< 90 years) patients undergoing transcatheter aortic valve implantation (TAVI) in current practice. METHODS Data are collected from the German Aortic Valve Registry (GARY), which was designed to evaluate current practice in the invasive treatment of patients with aortic valve diseases in Germany. Data were analyzed regarding procedural outcome, 30-day, and 1-year outcomes of nonagenarians in comparison to that of younger patients. RESULTS Between 2011 and 2015, 2436/33,051 (7.3%) nonagenarians underwent TAVI and were included in GARY. Nonagenarians were significantly more often male (45.2% vs. 40.0%, p < 0.001), frail (38.7% vs. 34.7%, p < 0.001), and had higher EuroSCORE scores than younger patient group (23.2% vs. 17.0%). Nonagenarians were significantly less often treated via transapical access (16.3% vs. 22.3%, p < 0.001). Procedure was performed significantly less often in general anesthesia (58.2% vs. 60.7%, p = 0.02) in nonagenarians, while necessity of pacemaker implantation was significantly higher in nonagenarians (27.2% vs. 24.8%, p > 0.001). The incidence of other typical postprocedural complications such as severe bleeding events and vascular complications were comparable between groups. However, 30-day (5.2% vs. 3.9%) and 1-year (22.7% vs. 17.7%) mortality rates were significantly higher among nonagenarians and age ≥ 90 years could be identified as an isolated risk factor for mortality. CONCLUSION TAVI is a highly standardized procedure that can be performed safely with high procedural success even in very old patients. Although mortality is significantly higher in these patients-most probably due to the intrinsic higher risk profile of the very old patients-the results are still acceptable. To optimize outcome, especially elderly patients seem to profit from a procedure under local anesthesia or conscious sedation, to minimize the rate of postoperative delirium and the length of stay and to facilitate early mobilization.
Collapse
Affiliation(s)
- J Blumenstein
- Department of Internal Medicine I, St. Johannes Hospital, Johannesstrasse 9-13, 44137, Dortmund, Germany
| | - H Möllmann
- Department of Internal Medicine I, St. Johannes Hospital, Johannesstrasse 9-13, 44137, Dortmund, Germany.
| | - S Bleiziffer
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - T Bauer
- Department of Cardiology, Sana-Klinikum, Offenbach, Germany
| | - S Ensminger
- Department of Thoracic and Cardiovascular Surgery, University Hospital, Lübeck, Germany
| | - R Bekeredjian
- Department of Cardiology, Robert-Bosch Hospital, Stuttgart, Germany
| | - T Walther
- Department of Thoracic and Cardiovascular Surgery, University Hospital, Frankfurt, Germany
| | - C Frerker
- Department of Cardiology, University Hospital, Heart Center, Cologne, Germany
| | - F Beyersdorf
- Department of Thoracic and Cardiovascular Surgery, University Hospital, Heart Center, Freiburg, Germany
| | - C Hamm
- Department of Medical Clinic I, University Hospital, Giessen, Germany.,Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - A Beckmann
- Deutsche Gesellschaft für Thorax, Herz- Und Gefäßchirurgie, Berlin, Germany
| |
Collapse
|
38
|
Naing A, Bauer T, Papadopoulos K, Rahma O, Tsai F, Garralda E, Naidoo J, Pai S, Gibson M, Rybkin I, Wang D, McDermott D, Fasolo A, de Miguel M, Shaheen M, Jenkins Y, Kallender H, Gogov S, Kuriakose E, Pishvaian M. Phase I study of the arginase inhibitor INCB001158 (1158) alone and in combination with pembrolizumab (PEM) in patients (Pts) with advanced/metastatic (adv/met) solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
39
|
Maio M, Groenland S, Bauer T, Rischin D, Gardeazabal I, Moreno V, Trigo Perez J, Chisamore M, Sadik Shaik J, Rigat F, Ellis C, Chen H, Gagnon R, Scherer S, Turner D, Yadavilli S, Ballas M, Hoos A, Angevin E. Pharmacokinetic/ pharmacodynamic (PK/PD) exposure-response characterization of GSK3359609 (GSK609) from INDUCE-1, a phase I open-label study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
40
|
Meric-Bernstam F, Somaiah N, DuBois S, Dumbrava EEI, Shapiro G, Patel M, Goel S, Bauer T, Pinchasik D, Annis A, Aivado M, Vukovic V, Saleh M. A phase IIa clinical trial combining ALRN-6924 and palbociclib for the treatment of patients with tumours harboring wild-type p53 and MDM2 amplification or MDM2/CDK4 co-amplification. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
41
|
Drilon A, Oxnard G, Wirth L, Besse B, Gautschi O, Tan S, Loong H, Bauer T, Kim Y, Horiike A, Park K, Shah M, McCoach C, Bazhenova L, Seto T, Brose M, Pennell N, Weiss J, Matos I, Peled N, Cho B, Ohe Y, Reckamp K, Boni V, Satouchi M, Falchook G, Akerley W, Daga H, Sakamoto T, Patel J, Lakhani N, Barlesi F, Burkard M, Zhu V, Moreno Garcia V, Medioni J, Matrana M, Rolfo C, Lee D, Nechushtan H, Johnson M, Velcheti V, Nishio M, Toyozawa R, Ohashi K, Song L, Han J, Spira A, De Braud F, Staal Rohrberg K, Takeuchi S, Sakakibara J, Waqar S, Kenmotsu H, Wilson F, B.Nair, Olek E, Kherani J, Ebata K, Zhu E, Nguyen M, Yang L, Huang X, Cruickshank S, Rothenberg S, Solomon B, Goto K, Subbiah V. PL02.08 Registrational Results of LIBRETTO-001: A Phase 1/2 Trial of LOXO-292 in Patients with RET Fusion-Positive Lung Cancers. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.059] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
42
|
Jonasch E, Plimack E, Bauer T, Merchan J, Papadopoulos K, McDermott D, Michaelson M, Appleman L, Thamake S, Zojwalla N, Choueiri T. A first-in-human phase I/II trial of the oral HIF-2a inhibitor PT2977 in patients with advanced RCC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
43
|
Mccann B, Muhr R, O'Rourke N, Blum T, Milroy R, Morrison D, Kollmeier J, Misch D, Van Der Horst J, Sens B, Massalski O, Bauer T. P2.16-11 ADVANCE-1: Development and Feasibility Testing of a Benchmarking Approach for Quality Improvement in Lung Cancer Care. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1878] [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]
|
44
|
Baumann S, Werner N, Al-Rashid F, Schaefer A, Bauer T, Sotoudeh R, Bojara W, Shamekhi J, Sinning JM, Becher T, Eder F, Akin I. P962Follow-up of protected high-risk percutaneous coronary intervention with microaxial Impella pump. Results from the retrospective German Impella Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Percutaneous coronary intervention (PCI) presents a relevant alternative to coronary bypass surgery for the treatment of patients with complex coronary artery disease and high perioperative risk. By temporary implantation of a percutaneous ventricular assist devices (pVAD) interventionalists attempt to anticipate the hemodynamic risk of those high-risk patients in a so-called protected PCI. The Impella® system presents the currently most common device for protected PCI and could show hemodynamic stability in earlier trials.
Methods
This study is a retrospective, observational multi-center registry of ten hospitals in Germany. We included patients undergoing protected high-risk PCI with Impella® support. The primary endpoint was defined as major adverse cardiac events (MACE) during a 180-day follow-up and consisted of all-cause mortality, myocardial infarction (MI) and stroke.
Results
Six of the participating hospitals performed a follow-up. In total, 157 patients (80.3% male; mean age 71.8±10.8 years) were included in the present study. Prior to PCI, median left ventricular ejection fraction was 39.0% (25.0%-50.0%) and median SYNTAX-Score I was 33.0 (24.0–40.5). The 180-day follow-up was available for 149 patients (94.9%). Eight patients (5.1%) were lost to follow-up. During the follow-up period, 34 patients (22.8%) suffered from a MACE. A total of 27 patients (18.1%) died. Nine patients (6.0%) sustained a MI, while 4 patients (2.7%) had a stroke.
Kaplan-Meier curves for primary endpoint
Conclusions
Patients undergoing protected high-risk PCI with Impella® support show a good 180-day clinical outcome regarding rates of MACE and mortality. However, a head-to-head comparison of Impella supported patients to protected PCI with other pVADs is pending.
Acknowledgement/Funding
S.B., N.W., F.A.-R., J.-M.S., A.S., R.S., I.A. receive consulting fees/honoraria from Abiomed (Danvers, MA, USA).
Collapse
Affiliation(s)
- S Baumann
- University Medical Centre of Mannheim, First Department of Medicine - Cardiology, Faculty of Medicine Mannheim, Mannheim, Germany
| | - N Werner
- University Hospital Bonn, Department of Internal Medicine II, Bonn, Germany
| | - F Al-Rashid
- University Clinic Essen, The Department of Cardiology and Vascular Medicine of the West-German Heart and Vascular Center, Essen, Germany
| | - A Schaefer
- Hannover Medical School, Department of Cardiology and Angiology, Hannover, Germany
| | - T Bauer
- University Hospital Giessen and Marburg, Department of Cardiology, Giessen, Germany
| | - R Sotoudeh
- Hospital Foundation Mittelrhein GmbH, Department of Internal Medicine/Cardiology, Koblenz, Germany
| | - W Bojara
- Hospital Foundation Mittelrhein GmbH, Department of Internal Medicine/Cardiology, Koblenz, Germany
| | - J Shamekhi
- University Hospital Bonn, Department of Internal Medicine II, Bonn, Germany
| | - J.-M Sinning
- University Hospital Bonn, Department of Internal Medicine II, Bonn, Germany
| | - T Becher
- University Medical Centre of Mannheim, First Department of Medicine - Cardiology, Faculty of Medicine Mannheim, Mannheim, Germany
| | - F Eder
- University Medical Centre of Mannheim, First Department of Medicine - Cardiology, Faculty of Medicine Mannheim, Mannheim, Germany
| | - I Akin
- University Medical Centre of Mannheim, First Department of Medicine - Cardiology, Faculty of Medicine Mannheim, Mannheim, Germany
| |
Collapse
|
45
|
Nef HM, Wiebe J, Schmidt G, Möllmann H, Boeder NF, Dörr O, Bauer T, Blachutzik F, Liebetrau C, Elsässer A, Foin N, Hamm CW. Everolimus- vs. novolimus-eluting bioresorbable scaffolds in patients with acute coronary syndrome. Herz 2019; 45:95-104. [PMID: 31209520 DOI: 10.1007/s00059-019-4822-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/28/2019] [Revised: 05/08/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Limited data exist on bioresorbable scaffolds (BRS) in patients with acute coronary syndrome (ACS). The aim of the present study was to evaluate novolimus-eluting BRS (DESolve) as interventional treatment for patients with ACS, and to compare its 12-month outcomes with the everolimus-eluting bioresorbable scaffolds (Absorb). METHODS In this retrospective study, patients with ACS (including unstable angina pectoris, ST-segment elevation myocardial infarction, or non-ST-segment elevation myocardial infarction) treated with either the Absorb or the DESolve BRS were evaluated in a 1:1 matched-pair analysis. Major adverse cardiac events (MACE), including death, myocardial infarction, and target lesion revascularization, were evaluated as a major endpoint. The occurrence of scaffold thrombosis was also assessed. RESULTS A total of 102 patients were eligible for this analysis. The rate of MACE at 12 months was comparable between the Absorb and the DESolve group (8.3% vs. 6.8%, p = 0.738). The occurrence of target lesion revascularization (6.2% vs. 4.7%; p = 0.700) and scaffold thrombosis (4.1% vs. 2.1%; p = 0.580) was comparable as well. All instances of scaffold thrombosis occurred within 30 days of the index procedure. CONCLUSION In this study, similar 12-month event rates were observed for both BRS types after implantation for the treatment of ACS.
Collapse
Affiliation(s)
- H M Nef
- Medizinische Klinik I, Department of Cardiology and Angiology, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.
| | - J Wiebe
- Deutsches Herzzentrum Muenchen, Munich, Germany
| | - G Schmidt
- Medizinische Klinik I, Department of Cardiology and Angiology, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany
| | - H Möllmann
- Department of Cardiology, St. Johannes Hospital, Dortmund, Germany
| | - N F Boeder
- Medizinische Klinik I, Department of Cardiology and Angiology, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany
| | - O Dörr
- Medizinische Klinik I, Department of Cardiology and Angiology, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany
| | - T Bauer
- Medizinische Klinik I, Department of Cardiology and Angiology, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany
| | - F Blachutzik
- Department of Cardiology, University of Erlangen, Erlangen, Germany
| | - C Liebetrau
- Kerckhoff Heart Center, Bad Nauheim, Germany
| | - A Elsässer
- Department of Cardiology, University of Oldenburg, Oldenburg, Germany
| | - N Foin
- Duke-NUS Medical School, National Heart Centre Singapore, Singapore, Singapore
| | - C W Hamm
- Medizinische Klinik I, Department of Cardiology and Angiology, University of Giessen, Klinikstraße 33, 35392, Giessen, Germany.,Kerckhoff Heart Center, Bad Nauheim, Germany
| |
Collapse
|
46
|
Maurer FP, Bauer T, Diel R, Häcker B, Lange C, Niemann S, Otto-Knapp R, Schönfeld N. [Joint Statement on the New WHO Recommendations for Treatment of Multidrug- and Rifampicin-Resistant Tuberculosis]. Pneumologie 2019; 73:270-273. [PMID: 31083750 DOI: 10.1055/a-0880-9987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- F P Maurer
- Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel
| | - T Bauer
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (DZK e. V.), Berlin.,Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | - R Diel
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (DZK e. V.), Berlin.,LungenClinic Großhansdorf, Großhansdorf
| | - B Häcker
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (DZK e. V.), Berlin.,Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| | - C Lange
- Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel.,Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel
| | - S Niemann
- Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel.,Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel
| | - R Otto-Knapp
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (DZK e. V.), Berlin
| | - N Schönfeld
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose (DZK e. V.), Berlin.,Klinik für Pneumologie, Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
| |
Collapse
|
47
|
Huynh E, Klouche S, Martinet C, Le Mercier F, Bauer T, Lecoeur A. Can the number of surgery delays and postponements due to unavailable instrumentation be reduced? Evaluating the benefits of enhanced collaboration between the sterilization and orthopedic surgery units. Orthop Traumatol Surg Res 2019; 105:563-568. [PMID: 30862491 DOI: 10.1016/j.otsr.2019.01.012] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/10/2019] [Accepted: 01/25/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The development of outpatient surgery, cost-reduction pressures and instrumentation storage limitations have led to their use "just-in-time". A recent study showed that stoppage of surgical procedures immediately before the incision (No-Go) was often due to the management of supplies and implantable medical devices. To our knowledge, since the development of outpatient surgery and the shortening of hospital stays, managing the flow of instrumentation has not been optimized. At our hospital, we used a two-prong approach consisting of a tool to manage instrumentation and working group from the sterilization and orthopedic surgery units. The aims of this study were to: 1) evaluate whether this approach led to better notification of the risk of supply shortage for instrumentation and 2) determine whether it could reduce by at least half operating room disruptions such as delays or cancellation of surgical procedures. HYPOTHESIS This approach results in better notification of the risk of supply shortage for instrumentation and reduces by at least half operating room disruptions such as delays or cancellation of surgical procedures. MATERIAL AND METHODS A tool was developed to manage instrumentation flow based on a retrospective analysis of data from 2015. This tool consisted of: (1) a list of instrumentation needed for each surgical procedure from an analysis of the surgical schedule and verification of traceability labels of the instrumentation actually used, (2) a list of reasons for supply shortage identified from an analysis of non-conformities occurring in the sterilization process of instrumentation kits. These analyses resulted in the development of checklists for instrument sets for each procedure, while identifying those with a high risk of shortage. In 2017, a working group focused on instrumentation was set up with personnel from the sterilization unit and the orthopedic surgery unit. Based on the check-lists and the schedule 24hours before the surgery, the sterilization unit alerted the surgery unit by email of the risk of material shortage; the surgery ward replied with potential changes to the material or the surgery planning. This approach (instrumentation management tool and working group) was named just-in-time (JIT). The main outcome was the number of notifications of potential supply shortage with and without JIT over a 10-week period. The secondary outcomes were the number of notifications resolved in time and the occurrence of operating room disruptions (delay>30min or postponement of surgery) related to unavailable instrumentation. RESULTS Nine reasons for potential supply shortage were identified such as instrumentation kits used for several types of procedures, those with fast rotation and low stock, or in double pathways (on loan and on deposit). The working group reported 163 potential shortages with JIT versus 41 without (p<10-5), of which 150 (92.5%) were resolved. Thirteen operating room disruptions occurred; only one was not detected by the JIT approach. CONCLUSION Our JIT approach (instrumentation management tool and working group) is effective at preventing instrumentation supply shortages. LEVEL OF EVIDENCE III, prospective comparative study.
Collapse
Affiliation(s)
- E Huynh
- Stérilisation centrale, hôpital Ambroise-Paré, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 92100 Boulogne-Billancourt, France
| | - S Klouche
- Orthopaedic surgery, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
| | - C Martinet
- Orthopaedic surgery, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - F Le Mercier
- Stérilisation centrale, hôpital Ambroise-Paré, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 92100 Boulogne-Billancourt, France
| | - T Bauer
- Orthopaedic surgery, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - A Lecoeur
- Stérilisation centrale, hôpital Ambroise-Paré, hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 92100 Boulogne-Billancourt, France
| |
Collapse
|
48
|
Im SA, Bang YJ, Oh DY, Giaccone G, Bauer T, Nordstrom J, Li H, Moore P, Hong S, Baughman J, Rock E, Burris H. Abstract P6-18-11: Long-term responders to single-agent margetuximab, an Fc-modified anti-HER2 monoclonal antibody, in metastatic HER2+ breast cancer patients with prior anti-HER2 therapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Margetuximab is an Fc-optimized anti-HER2 antibody that recognizes the same epitope as trastuzumab. Margetuximab has increased affinity for the activating CD16A Fc-receptor on NK cells and macrophages as well as decreased affinity for the inhibitory CD32B receptor compared to trastuzumab. In a Phase 1 study (NCT01148849) of 66 patients with relapsed or metastatic HER2+ cancer across multiple indications, margetuximab was well tolerated at all doses. Among 60 response-evaluable patients, confirmed partial response (PR) and stable disease (SD) were seen in 7 (12%) and 30 (50%) patients, respectively. Tumor reductions occurred in 18/23 (78%) evaluable breast cancer patients. Ex-vivo analyses of patient peripheral blood mononuclear cell samples confirmed margetuximab's ability to enhance antibody dependent cell-mediated cytotoxicity over that from trastuzumab. We report on 3 breast cancer patients with prior anti-HER2 therapy failure with durable (≥ 3.5 years) SD (1) or PR (2).
Methods
Enrolled patients had histologically/cytologically-confirmed carcinoma with documented HER2 overexpression by immunohistochemistry (2+ or 3+) and disease progression during/following last therapy. Eligibility included life expectancy ≥3 months; performance status ≤1; measurable disease by Response Criteria for Solid Tumors 1.1; adequate bone marrow, renal, hepatic function; and left ventricular ejection fraction ≥50%. Margetuximab was given by intravenous infusion at 0.1 – 6.0 mg/kg for 3 of every 4 weeks or once every 3 weeks (10 – 18 mg/kg).
Results
Three of 17 HER2 3+ metastatic breast cancer patients received long-term margetuximab. Patient 35 had 3 prior regimens (adjuvant doxorubicin+cyclophosphamide followed by docetaxol+trastuzumab; gemcitabine+vinorelbine; lapatinib+capecitabine) and received margetuximab at 10 mg/kg q3wk, 88 cycles to date, with PR achieved Cycle 1 Day 43, maintained 4.4 years. Patient 44 had 3 prior regimens for metastatic disease (docetaxel+trastuzumab+pertuzumab; doxorubicin+cyclophosphamide; lapatinib+capecitabine) and received margetuximab at 15 mg/kg q3wk, 79 cycles to date with SD for 4.3 years. Patient 50 had 4 prior regimens for recurrent/metastatic disease (tamoxifen; anastrozole; capecitabine+trastuzumab; lapatinib+capecitabine) and received margetuximab dose of 18 mg/kg q3wk with PR achieved Cycle 1 Day 43, maintained 3.5 years. Progression was noted at Cycle 57, and margetuximab continues at 63 cycles to date. No cardiac toxicities were found during long-term follow-up for these 3 patients and there were no treatment-related adverse events ≥Grade 3.
Conclusions
Margetuximab is well-tolerated without cardiac toxicities in long-term responders, with single-agent activity including durable responses in heavily pre-treated metastatic breast cancer. A Phase 3, randomized, multi-center clinical trial (SOPHIA; NCT02492711) is enrolling patients with metastatic breast cancer, comparing margetuximab plus chemotherapy to trastuzumab plus chemotherapy in patients who have received 1 to 3 lines of therapy for advanced disease.
Citation Format: Im S-A, Bang Y-J, Oh D-Y, Giaccone G, Bauer T, Nordstrom J, Li H, Moore P, Hong S, Baughman J, Rock E, Burris H. Long-term responders to single-agent margetuximab, an Fc-modified anti-HER2 monoclonal antibody, in metastatic HER2+ breast cancer patients with prior anti-HER2 therapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-11.
Collapse
Affiliation(s)
- S-A Im
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - Y-J Bang
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - D-Y Oh
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - G Giaccone
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - T Bauer
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - J Nordstrom
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - H Li
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - P Moore
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - S Hong
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - J Baughman
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - E Rock
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| | - H Burris
- Seoul National University Hospital, Seoul, Republic of Korea; Georgetown University, Washington, DC; Sarah Cannon Research Institute, Nashville, TN; MacroGenics, Inc., Rockville, MD
| |
Collapse
|
49
|
Fujita B, Schmidt T, Bleiziffer S, Bauer T, Beckmann A, Bekeredjian R, Möllmann H, Walther T, Landwehr S, Hamm C, Beyersdorf F, Katus H, Harringer W, Ensminger S, Frerker C. Incidence of new Permanent Pacemaker Implantation after Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Implantation and Its Impact on 1-Year Mortality—Insights from the German Aortic Valve Registry. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- B. Fujita
- Department of Heart and Thoracic Vascular Surgery, University of Schleswig-Holstein, Lübeck Campus, Lübeck, Germany
| | - T. Schmidt
- Asklepios Klinik St. Georg, Hamburg, Germany
| | | | - T. Bauer
- Universität Gießen, Gießen, Germany
| | - A. Beckmann
- Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, Berlin, Germany
| | | | | | - T. Walther
- Universität Frankfurt, Frankfurt, Germany
| | - S. Landwehr
- BQS Institut für Qualität und Patientensicherheit, Düsseldorf, Germany
| | - C. Hamm
- Kerckhoff-Heart Center Bad Nauheim, Bad Nauheim, Germany
| | - F. Beyersdorf
- Universitäts Herzzentrum - Freiburg/Bad Krozingen, Freiburg, Germany
| | - H. Katus
- Universität Heidelberg, Heidelberg, Germany
| | | | - S. Ensminger
- Department of Heart and Thoracic Vascular Surgery, University of Schleswig-Holstein, Lübeck Campus, Lübeck, Germany
| | - C. Frerker
- Asklepios Klinik St. Georg, Hamburg, Germany
| |
Collapse
|
50
|
Velcheti V, Bauer T, Luke J, Rixe O, Bajor D, Naik G, Sirard C, Davar D. Anti-GITR agonist TRX518 in combination with gemcitabine in advanced solid cancers: Preliminary safety and efficacy from a multi-center phase Ib trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy487.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|