572 results on '"Felix, J.F."'
Search Results
2. Role of multidrug-resistant bacteria in weaning from invasive mechanical ventilation
- Author
-
Julia D. Michels-Zetsche, Vicky Gassmann, Jasmin K. Jasuja, Benjamin Neetz, Philipp Höger, Jan Meis, Simone Britsch, Urte Sommerwerck, Sebastian Fähndrich, Florian Bornitz, Michael M. Müller, Felix J.F. Herth, and Franziska C. Trudzinski
- Subjects
Multidrug-resistant bacteria ,Weaning ,Prolonged weaning ,Weaning failure ,Mortality in weaning ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background Although multidrug-resistant bacteria (MDR) are common in patients undergoing prolonged weaning, there is little data on their impact on weaning and patient outcomes. Methods This is a retrospective analysis of consecutive patients who underwent prolonged weaning and were at a university weaning centre from January 2018 to December 2020. The influence of MDR colonisation and infection on weaning success (category 3a and 3b), successful prolonged weaning from invasive mechanical ventilation (IMV) with or without the need for non-invasive ventilation (NIV) compared with category 3c (weaning failure 3cI or death 3cII) was investigated. The pathogen groups considered were: multidrug-resistant gram-negative bacteria (MDRGN), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus spp. (VRE). Results A total of 206 patients were studied, of whom 91 (44.2%) showed evidence of MDR bacteria (32% VRE, 1.5% MRSA and 16% MDRGN), with 25 patients also meeting the criteria for MDR infection. 70.9% of the 206 patients were successfully weaned from IMV, 8.7% died. In 72.2% of cases, nosocomial pneumonia and other infections were the main cause of death. Patients with evidence of MDR (infection and colonisation) had a higher incidence of weaning failure than those without evidence of MDR (48% vs. 34.8% vs. 21.7%). In multivariate analyses, MDR infection (OR 4.9, p = 0.004) was an independent risk factor for weaning failure, along with male sex (OR 2.3, p = 0.025), Charlson Comorbidity Index (OR 1.2, p = 0.027), pH (OR 2.7, p
- Published
- 2024
- Full Text
- View/download PDF
3. Interventional pulmonology for chronic inflammatory airway diseases
- Author
-
Yang, Han, Chen, Si, Sun, Jiayuan, and Herth, Felix J.F.
- Published
- 2024
- Full Text
- View/download PDF
4. Efficacy of bronchoscopic thermal vapor ablation in patients with heterogeneous emphysema and lobar quantification by three-dimensional ventilation/perfusion single-photon emission computed tomography/computed tomography: a prospective pilot study from China
- Author
-
Wenjun Zhu, Yuchen Zhang, Felix J.F. Herth, Dan Liu, Hui Zhu, Jingyu Shi, Chujie Zhang, Gongshun Tang, Fengming Luo, and Peifang Wei
- Subjects
Medicine - Published
- 2022
- Full Text
- View/download PDF
5. Relationship between airway dysbiosis, inflammation and lung function in adults with cystic fibrosis
- Author
-
Frey, Dario L., Boutin, Sébastien, Dittrich, Susanne A., Graeber, Simon Y., Stahl, Mirjam, Wege, Sabine, Herth, Felix J.F., Sommerburg, Olaf, Schultz, Carsten, Mall, Marcus A., and Dalpke, Alexander H.
- Published
- 2021
- Full Text
- View/download PDF
6. A Pregnancy and Childhood Epigenetics Consortium (PACE) meta-analysis highlights potential relationships between birth order and neonatal blood DNA methylation
- Author
-
Li, S., Spitz, N., Ghantous, A., Abrishamcar, S., Reimann, B., Marques, I., Silver, M.J., Aguilar-Lacasaña, S., Kitaba, N., Rezwan, F.I., Röder, Stefan, Sirignano, L., Tuhkanen, J., Mancano, G., Sharp, G.C., Metayer, C., Morimoto, L., Stein, D.J., Zar, H.J., Alfano, R., Nawrot, T., Wang, C., Kajantie, E., Keikkala, E., Mustaniemi, S., Ronkainen, J., Sebert, S., Silva, W., Vääräsmäki, M., Jaddoe, V.W.V., Bernstein, R.M., Prentice, A.M., Cosin-Tomas, M., Dwyer, T., Håberg, S.E., Herceg, Z., Magnus, M.C., Munthe-Kaas, M.C., Page, C.M., Völker, M., Gilles, M., Send, T., Witt, S., Zillich, L., Gagliardi, L., Richiardi, L., Czamara, D., Räikkönen, K., Chatzi, L., Vafeiadi, M., Arshad, S.H., Ewart, S, Plusquin, M., Felix, J.F., Moore, S.E., Vrijheid, M., Holloway, J.W., Karmaus, W., Herberth, Gunda, Zenclussen, Ana Claudia, Streit, F., Lahti, J., Hüls, A., Hoang, T.T., London, S.J., Wiemels, J.L., Li, S., Spitz, N., Ghantous, A., Abrishamcar, S., Reimann, B., Marques, I., Silver, M.J., Aguilar-Lacasaña, S., Kitaba, N., Rezwan, F.I., Röder, Stefan, Sirignano, L., Tuhkanen, J., Mancano, G., Sharp, G.C., Metayer, C., Morimoto, L., Stein, D.J., Zar, H.J., Alfano, R., Nawrot, T., Wang, C., Kajantie, E., Keikkala, E., Mustaniemi, S., Ronkainen, J., Sebert, S., Silva, W., Vääräsmäki, M., Jaddoe, V.W.V., Bernstein, R.M., Prentice, A.M., Cosin-Tomas, M., Dwyer, T., Håberg, S.E., Herceg, Z., Magnus, M.C., Munthe-Kaas, M.C., Page, C.M., Völker, M., Gilles, M., Send, T., Witt, S., Zillich, L., Gagliardi, L., Richiardi, L., Czamara, D., Räikkönen, K., Chatzi, L., Vafeiadi, M., Arshad, S.H., Ewart, S, Plusquin, M., Felix, J.F., Moore, S.E., Vrijheid, M., Holloway, J.W., Karmaus, W., Herberth, Gunda, Zenclussen, Ana Claudia, Streit, F., Lahti, J., Hüls, A., Hoang, T.T., London, S.J., and Wiemels, J.L.
- Abstract
Higher birth order is associated with altered risk of many disease states. Changes in placentation and exposures to in utero growth factors with successive pregnancies may impact later life disease risk via persistent DNA methylation alterations. We investigated birth order with Illumina DNA methylation array data in each of 16 birth cohorts (8164 newborns) with European, African, and Latino ancestries from the Pregnancy and Childhood Epigenetics Consortium. Meta-analyzed data demonstrated systematic DNA methylation variation in 341 CpGs (FDR adjusted P < 0.05) and 1107 regions. Forty CpGs were located within known quantitative trait loci for gene expression traits in blood, and trait enrichment analysis suggested a strong association with immune-related, transcriptional control, and blood pressure regulation phenotypes. Decreasing fertility rates worldwide with the concomitant increased proportion of first-born children highlights a potential reflection of birth order-related epigenomic states on changing disease incidence trends.
- Published
- 2024
7. Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves
- Author
-
Koster, T. David, Shah, Pallav L., Valipour, Arschang, Criner, Gerard J., Herth, Felix J.F., Sue, Richard, Hogarth, Douglas K., Martin, Ralitza T., Mahajan, Amit K., Alalawi, Raed, Kopas, Lisa, Cohen, Avi, Wood, Douglas E., Kurman, Jonathan, Shargill, Narinder S., Dransfield, Mark, Slebos, Dirk Jan, Perch, Michael, Koster, T. David, Shah, Pallav L., Valipour, Arschang, Criner, Gerard J., Herth, Felix J.F., Sue, Richard, Hogarth, Douglas K., Martin, Ralitza T., Mahajan, Amit K., Alalawi, Raed, Kopas, Lisa, Cohen, Avi, Wood, Douglas E., Kurman, Jonathan, Shargill, Narinder S., Dransfield, Mark, Slebos, Dirk Jan, and Perch, Michael
- Abstract
Bronchoscopic lung volume reduction treatment with Zephyr one-way valves is an effective guideline-based treatment option for patients with severe emphysema and hyperinflation. However, in some cases the treatment response is less than anticipated or there might be a loss of initial treatment effect. Reasons for the lack of response can include incorrect assessment of collateral ventilation, improper valve placement, or patient related factors. Loss of initial benefit can be due to granulation tissue formation and subsequent valve dysfunction, or there may be side effects such as excessive coughing or infectious problems. Careful follow-up after treatment with valves is important and evaluation with a CT scan and/or bronchoscopy is helpful if there is no improvement after treatment or loss of initial benefit. This paper aims to describe the most important causes and provide a strategy of how to approach and manage these patients., Bronchoscopic lung volume reduction treatment with Zephyr one-way valves is an effective guideline-based treatment option for patients with severe emphysema and hyperinflation. However, in some cases the treatment response is less than anticipated or there might be a loss of initial treatment effect. Reasons for the lack of response can include incorrect assessment of collateral ventilation, improper valve placement, or patient related factors. Loss of initial benefit can be due to granulation tissue formation and subsequent valve dysfunction, or there may be side effects such as excessive coughing or infectious problems. Careful follow-up after treatment with valves is important and evaluation with a CT scan and/or bronchoscopy is helpful if there is no improvement after treatment or loss of initial benefit. This paper aims to describe the most important causes and provide a strategy of how to approach and manage these patients.
- Published
- 2024
8. Augmentation therapy with human alpha-1-proteinase inhibitor reduces exacerbations in patient with bronchiectasis and alpha-1-antitrypsin deficiency
- Author
-
Emanuel Buck, Maria Ada Presotto, Judith Brock, Kai Schlamp, Martina Veith, Felix J.F. Herth, and Franziska Christina Trudzinski
- Subjects
Alpha-1-antitrypsin ,(AATD) ,Alpha-1-antitrypsin deficiency ,Bronchiectasis ,Augmentation therapy ,AAT ,Diseases of the respiratory system ,RC705-779 - Abstract
Alpha-1-antitrypsin deficiency (AATD) is a rare cause of noncystic fibrosis (CF) bronchiectasis. The benefits of augmentation therapy in patients with chronic obstructive pulmonary disease (COPD) and pulmonary emphysema are well established. The role of augmentation therapy in AATD bronchiectasis in patients without pulmonary emphysema is not clear.We present the case of a 53-year-old woman (never smoker) who presented with increased susceptibility to infection, productive cough, and intermittent hemoptysis. Pulmonary function testing revealed restrictive impairment [VC 2,7 l (83% of pred.), FEV1 2,3 l (86% of pred.)]. A CT scan of the chest showed marked basal bronchiectasis with mucoid impaction, surrounding consolidation, and no emphysema. Despite frequent use of inhalation therapy, a satisfactory control of symptoms and exacerbations was not achieved.In the course of extended diagnostics regarding the genesis of bronchiectasis, a reduced alpha-1-antitrypsin (AAT) serum level was detected, and a genetic test revealed a homozygous Pi*ZZ genotype. We started augmentation therapy with AAT (Respreeza®, CLS Behring) at the dose of 60 mg/kg per week; the therapy was well tolerated by the patient, and she reported clinical improvement with a reduction in exacerbation frequency.AAT is a serine protease inhibitor and plays a major role in regulating inflammatory activities, in particular by inhibiting neutrophil elastase (NE). The present case illustrates the positive effect of augmentation therapy, including patients without airway obstruction. Among other causes, AATD should be considered as a possible cause of bronchiectasis, and the effects of augmentation therapy for this indication need to be prospectively studied.
- Published
- 2022
- Full Text
- View/download PDF
9. Versatile workflow for cell type–resolved transcriptional and epigenetic profiles from cryopreserved human lung
- Author
-
Maria Llamazares-Prada, Elisa Espinet, Vedrana Mijošek, Uwe Schwartz, Pavlo Lutsik, Raluca Tamas, Mandy Richter, Annika Behrendt, Stephanie T. Pohl, Naja P. Benz, Thomas Muley, Arne Warth, Claus Peter Heußel, Hauke Winter, Jonathan J. M. Landry, Felix J.F. Herth, Tinne C.J. Mertens, Harry Karmouty-Quintana, Ina Koch, Vladimir Benes, Jan O. Korbel, Sebastian M. Waszak, Andreas Trumpp, David M. Wyatt, Heiko F. Stahl, Christoph Plass, and Renata Z. Jurkowska
- Subjects
Pulmonology ,Medicine - Abstract
Complexity of lung microenvironment and changes in cellular composition during disease make it exceptionally hard to understand molecular mechanisms driving development of chronic lung diseases. Although recent advances in cell type–resolved approaches hold great promise for studying complex diseases, their implementation relies on local access to fresh tissue, as traditional tissue storage methods do not allow viable cell isolation. To overcome these hurdles, we developed a versatile workflow that allows storage of lung tissue with high viability, permits thorough sample quality check before cell isolation, and befits sequencing-based profiling. We demonstrate that cryopreservation enables isolation of multiple cell types from both healthy and diseased lungs. Basal cells from cryopreserved airways retain their differentiation ability, indicating that cellular identity is not altered by cryopreservation. Importantly, using RNA sequencing and EPIC Array, we show that gene expression and DNA methylation signatures are preserved upon cryopreservation, emphasizing the suitability of our workflow for omics profiling of lung cells. Moreover, we obtained high-quality single-cell RNA-sequencing data of cells from cryopreserved human lungs, demonstrating that cryopreservation empowers single-cell approaches. Overall, thanks to its simplicity, our workflow is well suited for prospective tissue collection by academic collaborators and biobanks, opening worldwide access to viable human tissue.
- Published
- 2021
- Full Text
- View/download PDF
10. Nebulized Ipratropium bromide protects against tracheal and bronchial secretion during bronchoscopy: A randomized controlled trial
- Author
-
Wang, Faping, Zheng, He, Zhang, Yanlin, Zhu, Hui, Shi, Jingyu, Luo, Yunxiao, Zhang, Xiang, Mao, Hui, Herth, Felix J.F., and Luo, Fengming
- Published
- 2019
- Full Text
- View/download PDF
11. Maternal educational attainment in pregnancy and epigenome-wide DNA methylation changes in the offspring from birth until adolescence
- Author
-
Choudhary, P., Monasso, G.S., Karhunen, V., Ronkainen, J., Mancano, G., Howe, C.G., Niu, Z., Zeng, X., Guan, W., Dou, J., Feinberg, J.I., Mordaunt, C., Pesce, G., Baïz, N., Alfano, R., Martens, D.S., Wang, C., Isaevska, E., Keikkala, E., Mustaniemi, S., Thio, C.H.L., Fraszczyk, E., Tobi, E.W., Starling, A.P., Cosin-Tomas, M., Urquiza, J., Röder, Stefan, Hoang, T.T., Page, C., Jima, D.D., House, J.S., Maguire, R.L., Ott, R., Pawlow, X., Sirignano, L., Zillich, L., Malmberg, A., Rauschert, S., Melton, P., Gong, T., Karlsson, R., Fore, R., Perng, W., Laubach, Z.M., Czamara, D., Sharp, G., Breton, C.V., Schisterman, E., Yeung, E., Mumford, S.L., Fallin, M.D., LaSalle, J.M., Schmidt, R.J., Bakulski, K.M., Annesi-Maesano, I., Heude, B., Nawrot, T.S., Plusquin, M., Ghantous, A., Herceg, Z., Nisticò, L., Vafeiadi, M., Kogevinas, M., Vääräsmäki, M., Kajantie, E., Snieder, H., Corpeleijn, E., Steegers-Theunissen, R.P.M., Yang, I.V., Dabelea, D., Fossati, S., Zenclussen, Ana Claudia, Herberth, Gunda, Magnus, M., Håberg, S.E., London, S.J., Munthe-Kaas, M.C., Murphy, S.K., Hoyo, C., Ziegler, A.-G., Hummel, S., Witt, S.H., Streit, F., Frank, J., Räikkönen, K., Lahti, J., Huang, R.-C., Almqvist, C., Hivert, M.-F., Jaddoe, V.W.V., Järvelin, M.-R., Kantomaa, M., Felix, J.F., Sebert, S., Choudhary, P., Monasso, G.S., Karhunen, V., Ronkainen, J., Mancano, G., Howe, C.G., Niu, Z., Zeng, X., Guan, W., Dou, J., Feinberg, J.I., Mordaunt, C., Pesce, G., Baïz, N., Alfano, R., Martens, D.S., Wang, C., Isaevska, E., Keikkala, E., Mustaniemi, S., Thio, C.H.L., Fraszczyk, E., Tobi, E.W., Starling, A.P., Cosin-Tomas, M., Urquiza, J., Röder, Stefan, Hoang, T.T., Page, C., Jima, D.D., House, J.S., Maguire, R.L., Ott, R., Pawlow, X., Sirignano, L., Zillich, L., Malmberg, A., Rauschert, S., Melton, P., Gong, T., Karlsson, R., Fore, R., Perng, W., Laubach, Z.M., Czamara, D., Sharp, G., Breton, C.V., Schisterman, E., Yeung, E., Mumford, S.L., Fallin, M.D., LaSalle, J.M., Schmidt, R.J., Bakulski, K.M., Annesi-Maesano, I., Heude, B., Nawrot, T.S., Plusquin, M., Ghantous, A., Herceg, Z., Nisticò, L., Vafeiadi, M., Kogevinas, M., Vääräsmäki, M., Kajantie, E., Snieder, H., Corpeleijn, E., Steegers-Theunissen, R.P.M., Yang, I.V., Dabelea, D., Fossati, S., Zenclussen, Ana Claudia, Herberth, Gunda, Magnus, M., Håberg, S.E., London, S.J., Munthe-Kaas, M.C., Murphy, S.K., Hoyo, C., Ziegler, A.-G., Hummel, S., Witt, S.H., Streit, F., Frank, J., Räikkönen, K., Lahti, J., Huang, R.-C., Almqvist, C., Hivert, M.-F., Jaddoe, V.W.V., Järvelin, M.-R., Kantomaa, M., Felix, J.F., and Sebert, S.
- Abstract
Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was found to be associated with DNA methylation at 473 cytosine-phosphate-guanine sites at birth, one in childhood, and four in adolescence. We observed enrichment for findings from previous EWAS on maternal folate, vitamin-B12 concentrations, maternal smoking, and pre-pregnancy BMI. The associations were directionally consistent with MEA being inversely associated with behaviours including smoking and BMI. Our findings form a bridge between socio-economic factors and biology and highlight potential pathways underlying effects of maternal education. The results broaden our understanding of bio-social associations linked to differential DNA methylation in multiple early stages of life. The data generated also offers an important resource to help a more precise understanding of the social determinants of health.
- Published
- 2023
12. Is the internet a sufficient source of information on sarcoidosis?
- Author
-
Buschulte, Katharina, Höger, Philipp, Ganter, Claudia, Wijsenbeek, Marlies, Kahn, Nicolas, Kriegsmann, Katharina, Wilkens, Finn M., Fisher, Jolene H., Ryerson, Christopher J., Herth, Felix J.F., Kreuter, Michael, Buschulte, Katharina, Höger, Philipp, Ganter, Claudia, Wijsenbeek, Marlies, Kahn, Nicolas, Kriegsmann, Katharina, Wilkens, Finn M., Fisher, Jolene H., Ryerson, Christopher J., Herth, Felix J.F., and Kreuter, Michael
- Abstract
Introduction: Many patients use the internet as a source of health information. Sarcoidosis is a complex disease, and internet resources have not yet been analyzed for reliability and content on sarcoidosis. Aims: Our study aimed to investigate the content and the quality of information on sarcoidosis provided by internet resources. Methods: Google, Yahoo, and Bing were searched for the term “sarcoidosis,” and the first 200 hits were saved in each case. Those websites that met the inclusion criteria (English language, no registration fees, and relevant to sarcoidosis) were then analyzed by two independent investigators for readability, quality (HON, JAMA, and DISCERN), and content (25 predefined key facts) of the provided information. Results: The websites were most commonly scientific or governmental (n = 57, 46%), and the median time since the last update was 24 months. Quality was rated with a median JAMA score of 2 (1; 4) and a median overall DISCERN score of 2.4 (1.1; 4.1), both scores represent partially sufficient information. In total, 15% of websites had a HON certificate. Website content measured by the median key fact score was 19 (ranging from 2.5 to 25) with the lowest scores for acute vs. chronic course of the disease, screening for extrapulmonary disease, and diffuse body pain. Poor results were achieved in industry websites and blogs (p = 0.047) with significant differences regarding definition (p = 0.004) and evaluation (p = 0.021). Discussion: Sarcoidosis-related content of internet resources is partially sufficient; however, several important aspects are frequently not addressed, and the quality of information is moderate. Future directions should focus on providing reliable and comprehensive information on sarcoidosis; physicians from different disciplines and patients including self-support groups should collaborate on achieving this.
- Published
- 2023
13. Epigenome-wide meta-analysis of prenatal maternal stressful life events and newborn DNA methylation
- Author
-
Kotsakis Ruehlmann, A., Sammallahti, S., Cortés Hidalgo, A.P., Bakulski, K.M., Binder, E.B., Campbell, M.L., Caramaschi, D., Cecil, C., Colicino, E., Cruceanu, C., Czamara, D., Dieckmann, L., Dou, J., Felix, J.F., Frank, J., Håberg, S.E., Herberth, Gunda, Hoang, T.T., Houtepen, L.C., Hüls, A., Koen, N., London, S.J., Magnus, M.C., Mancano, G., Mulder, R.H., Page, C.M., Räikkönen, K., Röder, Stefan, Schmidt, R.J., Send, T.S., Sharp, G., Stein, D.J., Streit, F., Tuhkanen, J., Witt, S.H., Zar, H.J., Zenclussen, Ana Claudia, Zhang, Y., Zillich, L., Wright, R., Lahti, J., Brunst, K.J., Kotsakis Ruehlmann, A., Sammallahti, S., Cortés Hidalgo, A.P., Bakulski, K.M., Binder, E.B., Campbell, M.L., Caramaschi, D., Cecil, C., Colicino, E., Cruceanu, C., Czamara, D., Dieckmann, L., Dou, J., Felix, J.F., Frank, J., Håberg, S.E., Herberth, Gunda, Hoang, T.T., Houtepen, L.C., Hüls, A., Koen, N., London, S.J., Magnus, M.C., Mancano, G., Mulder, R.H., Page, C.M., Räikkönen, K., Röder, Stefan, Schmidt, R.J., Send, T.S., Sharp, G., Stein, D.J., Streit, F., Tuhkanen, J., Witt, S.H., Zar, H.J., Zenclussen, Ana Claudia, Zhang, Y., Zillich, L., Wright, R., Lahti, J., and Brunst, K.J.
- Abstract
Prenatal maternal stressful life events are associated with adverse neurodevelopmental outcomes in offspring. Biologic mechanisms underlying these associations are largely unknown, but DNA methylation likely plays a role. This meta-analysis included twelve datasets from ten pregnancy cohorts (N=5,496) within the international Pregnancy and Childhood Epigenetics consortium to examine maternal stressful life events during pregnancy and DNA methylation in cord blood. Children whose mothers reported higher levels of cumulative maternal stressful life events during pregnancy exhibited differential methylation of cg26579032 in ALKBH3. Stressor-specific domains of conflict with family/friends, abuse (physical, sexual, and emotional), and death of a close friend/relative were also associated with differential methylation of CpGs in APTX, MyD88, and both UHRF1 and SDCCAG8, respectively; these genes are implicated in neurodegeneration, immune and cellular functions, regulation of global methylation levels, metabolism, and schizophrenia risk. Thus, differences in DNA methylation at these loci may provide novel insights into potential mechanisms of neurodevelopment in offspring.
- Published
- 2023
14. Analysis of DNA methylation at birth and in childhood reveals changes associated with season of birth and latitude
- Author
-
Kadalayil, L., Alam, M., White, C.H., Ghantous, A., Walton, E., Gruzieva, O., Merid, S.K., Kumar, A., Roy, R., Solomon, O., Huen, K., Eskenazi, B., Rzehak, P., Grote, V., Langhendries, J.-P., Verduci, E., Ferre, N., Gruszfeld, D., Gao, L., Guan, W., Zeng, X., Schisterman, E.F., Dou, J., Bakulski, K.M., Feinberg, J.I., Soomro, M.H., Pesce, G., Baiz, N., Isaevska, E., Plusquin, M., Vafeiadi, M., Roumeliotaki, T., Langie, S.A.S., Standaert, A., Allard, C., Perron, P., Bouchard, L., van Meel, E.R., Felix, J.F., Jaddoe, V.W.V., Yousefi, P.D., Ramlau‑Hansen, C.H., Relton, C.L., Tobi, E.W., Starling, A.P., Yang, I.V., Llambrich, M., Santorelli, G., Lepeule, J., Salas, L.A., Bustamante, M., Ewart, S.L., Zhang, H., Karmaus, W., Röder, Stefan, Zenclussen, Ana Claudia, Jin, J., Nystad, W., Page, C.M., Magnus, M., Jima, D.D., Hoyo, C., Maguire, R.L., Kvist, T., Czamara, D., Räikkönen, K., Gong, T., Ullemar, V., Rifas‐Shiman, S.L., Oken, E., Almqvist, C., Karlsson, R., Lahti, J., Murphy, S.K., Håberg, S.E., London, S., Herberth, Gunda, Arshad, H., Sunyer, J., Grazuleviciene, R., Dabelea, D., Steegers‑Theunissen, R.P.M., Nohr, E.A., Sørensen, T.I.A., Duijts, L., Hivert, M.-F., Nelen, V., Popovic, M., Kogevinas, M., Nawrot, T.S., Herceg, Z., Annesi‑Maesano, I., Fallin, M.D., Yeung, E., Breton, C.V., Koletzko, B., Holland, N., Melén, E., Sharp, G.C., Silver, M.J., Kadalayil, L., Alam, M., White, C.H., Ghantous, A., Walton, E., Gruzieva, O., Merid, S.K., Kumar, A., Roy, R., Solomon, O., Huen, K., Eskenazi, B., Rzehak, P., Grote, V., Langhendries, J.-P., Verduci, E., Ferre, N., Gruszfeld, D., Gao, L., Guan, W., Zeng, X., Schisterman, E.F., Dou, J., Bakulski, K.M., Feinberg, J.I., Soomro, M.H., Pesce, G., Baiz, N., Isaevska, E., Plusquin, M., Vafeiadi, M., Roumeliotaki, T., Langie, S.A.S., Standaert, A., Allard, C., Perron, P., Bouchard, L., van Meel, E.R., Felix, J.F., Jaddoe, V.W.V., Yousefi, P.D., Ramlau‑Hansen, C.H., Relton, C.L., Tobi, E.W., Starling, A.P., Yang, I.V., Llambrich, M., Santorelli, G., Lepeule, J., Salas, L.A., Bustamante, M., Ewart, S.L., Zhang, H., Karmaus, W., Röder, Stefan, Zenclussen, Ana Claudia, Jin, J., Nystad, W., Page, C.M., Magnus, M., Jima, D.D., Hoyo, C., Maguire, R.L., Kvist, T., Czamara, D., Räikkönen, K., Gong, T., Ullemar, V., Rifas‐Shiman, S.L., Oken, E., Almqvist, C., Karlsson, R., Lahti, J., Murphy, S.K., Håberg, S.E., London, S., Herberth, Gunda, Arshad, H., Sunyer, J., Grazuleviciene, R., Dabelea, D., Steegers‑Theunissen, R.P.M., Nohr, E.A., Sørensen, T.I.A., Duijts, L., Hivert, M.-F., Nelen, V., Popovic, M., Kogevinas, M., Nawrot, T.S., Herceg, Z., Annesi‑Maesano, I., Fallin, M.D., Yeung, E., Breton, C.V., Koletzko, B., Holland, N., Melén, E., Sharp, G.C., and Silver, M.J.
- Abstract
BackgroundSeasonal variations in environmental exposures at birth or during gestation are associated with numerous adult traits and health outcomes later in life. Whether DNA methylation (DNAm) plays a role in the molecular mechanisms underlying the associations between birth season and lifelong phenotypes remains unclear.MethodsWe carried out epigenome-wide meta-analyses within the Pregnancy And Childhood Epigenetic Consortium to identify associations of DNAm with birth season, both at differentially methylated probes (DMPs) and regions (DMRs). Associations were examined at two time points: at birth (21 cohorts, N = 9358) and in children aged 1–11 years (12 cohorts, N = 3610). We conducted meta-analyses to assess the impact of latitude on birth season-specific associations at both time points.ResultsWe identified associations between birth season and DNAm (False Discovery Rate-adjusted p values < 0.05) at two CpGs at birth (winter-born) and four in the childhood (summer-born) analyses when compared to children born in autumn. Furthermore, we identified twenty-six differentially methylated regions (DMR) at birth (winter-born: 8, spring-born: 15, summer-born: 3) and thirty-two in childhood (winter-born: 12, spring and summer: 10 each) meta-analyses with few overlapping DMRs between the birth seasons or the two time points. The DMRs were associated with genes of known functions in tumorigenesis, psychiatric/neurological disorders, inflammation, or immunity, amongst others. Latitude-stratified meta-analyses [higher (≥ 50°N), lower (< 50°N, northern hemisphere only)] revealed differences in associations between birth season and DNAm by birth latitude. DMR analysis implicated genes with previously reported links to schizophrenia (LAX1), skin disorders (PSORS1C, LTB4R), and airway inflammation including asthma (LTB4R), present only at birth in the higher latitudes (≥ 50°N).ConclusiosIn this large epigenome-wide meta-analysis study, we provide eviden
- Published
- 2023
15. Interventional therapy in patients with severe emphysema: evaluation of contraindications and their incidence
- Author
-
Markus Polke, Matthias Rötting, Nilab Sarmand, Johannes Krisam, Ralf Eberhardt, Felix J.F. Herth, and Daniela Gompelmann
- Subjects
Diseases of the respiratory system ,RC705-779 - Abstract
Background: Endoscopic and surgical interventions may be beneficial for selected patients with emphysema. Rates of treatment failure decrease when the predictors for successful therapy are known. The aim of the study was to evaluate the number of patients with severe emphysema who were not eligible for any intervention, and the reasons for their exclusion. Methods: The study was a retrospective analysis of 231 consecutive patients with advanced emphysema who were considered for interventional therapy in 2016 at the Thoraxklinik, Heidelberg, Germany. The reasons for not receiving valve or coil therapy were assessed for all patients who did not receive any therapy. Results: Of the 231 patients, 50% received an interventional therapy for lung volume reduction (LVR) (82% valve therapy, 6% coil therapy, 4.3% polymeric LVR or bronchial thermal vapour ablation, 4.3% total lung denervation, and 3.4% lung volume reduction surgery [LVRS]). A total of 115 patients did not undergo LVR. Out of these, valve or coil therapy was not performed due to one or more of the following reasons: incomplete fissure in 37% and 0%; missing target lobe in 31% and 30%; personal decision in 18% and 28%; pulmonary function test results in 8% and 15%; ventilatory failure in 4% and 4%; missing optimal standard medical care and/or continued nicotine abuse in 4% and 3%; general condition too good in less than 1% and 3%; cardiovascular comorbidities in 0% and 3%; age of patient in 0% and less than 1%. Both techniques were not performed due to one or more of the following reasons: solitary pulmonary nodule(s)/consolidation in 27%; bronchopathy in 7%; neoplasia in 2%; destroyed lung in 2%; prior LVRS in less than 1%. Conclusions: The main reason for not placing valves was an incomplete fissure and for coils a missing target lobe. Numerous additional contraindications that may exclude a patient from interventional emphysema therapy should be respected.
- Published
- 2019
- Full Text
- View/download PDF
16. Enhanced LPS-induced activation of IL-27 signalling in sarcoidosis
- Author
-
Ringkowski, Sabine, Loke, Joshua, Huang, Shuying, Ahmadzai, Hasib, Herth, Felix J.F., Thomas, Paul S., and Herbert, Cristan
- Published
- 2016
- Full Text
- View/download PDF
17. Optical coherence tomography detects structural abnormalitiesof the nasal mucosa in patients with cystic fibrosis
- Author
-
Oltmanns, Ute, Palmowski, Karin, Wielpütz, Mark, Kahn, Nicolas, Baroke, Eva, Eberhardt, Ralf, Wege, Sabine, Wiebel, Matthias, Kreuter, Michael, Herth, Felix J.F., and Mall, Marcus A.
- Published
- 2016
- Full Text
- View/download PDF
18. Figure S1 from Glycodelin: A New Biomarker with Immunomodulatory Functions in Non–Small Cell Lung Cancer
- Author
-
Michael Meister, Thomas Muley, Hendrik Dienemann, Felix J.F. Herth, Michael Thomas, Philipp A. Schnabel, Arne Warth, Martin Granzow, and Marc A. Schneider
- Abstract
Figure S1. Survival of females with high PAEP expression.
- Published
- 2023
19. Supplemental Material and Methods from Glycodelin: A New Biomarker with Immunomodulatory Functions in Non–Small Cell Lung Cancer
- Author
-
Michael Meister, Thomas Muley, Hendrik Dienemann, Felix J.F. Herth, Michael Thomas, Philipp A. Schnabel, Arne Warth, Martin Granzow, and Marc A. Schneider
- Abstract
Supplemental Material and Methods. More detailed Material and Methods.
- Published
- 2023
20. Table S1 from Glycodelin: A New Biomarker with Immunomodulatory Functions in Non–Small Cell Lung Cancer
- Author
-
Michael Meister, Thomas Muley, Hendrik Dienemann, Felix J.F. Herth, Michael Thomas, Philipp A. Schnabel, Arne Warth, Martin Granzow, and Marc A. Schneider
- Abstract
Table S1. Most regulated genes after PAEP knockdown in Affymetrix gene expression analyses.
- Published
- 2023
21. Supplemental Figure Legends from Glycodelin: A New Biomarker with Immunomodulatory Functions in Non–Small Cell Lung Cancer
- Author
-
Michael Meister, Thomas Muley, Hendrik Dienemann, Felix J.F. Herth, Michael Thomas, Philipp A. Schnabel, Arne Warth, Martin Granzow, and Marc A. Schneider
- Abstract
Supplemental Figure Legends. Figure legends for the supplemental figures.
- Published
- 2023
22. Data from Glycodelin: A New Biomarker with Immunomodulatory Functions in Non–Small Cell Lung Cancer
- Author
-
Michael Meister, Thomas Muley, Hendrik Dienemann, Felix J.F. Herth, Michael Thomas, Philipp A. Schnabel, Arne Warth, Martin Granzow, and Marc A. Schneider
- Abstract
Purpose: In recent years, immune therapeutic strategies against non–small cell lung cancer (NSCLC) based on tissue-derived biomarkers, for example PD1/PD-L1 (CD274), have evolved as novel and promising treatment options. However, the crosstalk between tumor and immune cells is poorly understood. Glycodelin (gene name PAEP), initially described in the context of pregnancy and trophoblastic implantation, is a secreted immunosuppressive glycoprotein with an as-of-yet largely unknown function in lung cancer.Experimental Design: In this study, we characterized the expression and role of glycodelin in NSCLC through mRNA and protein expression analyses, functional knockdown experiments, and correlations with clinicopathologic parameters.Results: Glycodelin mRNA expression was significantly elevated in tumors (n = 336) compared with matched normal tissue (P < 0.0001). Overall survival (OS) was significantly reduced in NSCLC with high glycodelin mRNA levels in women but not in men. Glycodelin was detected in the sera of patients, and the levels correlated with recurrence and metastatic disease. Knockdown of glycodelin with siRNAs in NSCLC cell lines resulted in significant upregulation of immune system modulatory factors such as PDL1, CXCL5, CXCL16, MICA/B, and CD83 as well as proliferation stimulators EDN1 and HBEGF. Furthermore, decreased migration of tumor cells was observed.Conclusions: Altogether, the comprehensive characterization of glycodelin in NSCLC provides strong support for its use as a biomarker with immune modulatory function. Clin Cancer Res; 21(15); 3529–40. ©2015 AACR.
- Published
- 2023
23. Bronchoscopic Lung Volume Reduction Coil Treatment for Severe Emphysema: A Systematic Review and Meta-Analysis of Individual Participant Data
- Author
-
Sharyn A. Roodenburg, Jorine E. Hartman, Gaëtan Deslée, Felix J.F. Herth, Karin Klooster, Frank C. Sciurba, Pallav L. Shah, Arschang Valipour, Zaid Zoumot, and Dirk-Jan Slebos
- Subjects
Emphysema ,Pulmonary and Respiratory Medicine ,Meta-analysis ,Bronchoscopic lung volume reduction ,Chronic obstructive pulmonary disease ,Bronchoscopy - Abstract
Background: Lung volume reduction coil (LVR-coil) treatment provides a minimally invasive treatment option for severe emphysema patients which has been studied in multiple clinical trials. Objectives: The aim of the study was to assess the effect of LVR-coil treatment on pulmonary function, quality of life, and exercise capacity using individual participant data. Method: PubMed, Web of Science, and EMBASE were searched until May 17, 2021. Prospective single-arm and randomized controlled trials that evaluated the effect of LVR-coil treatment on forced expiratory volume in 1 s (FEV1), residual volume (RV), St. George Respiratory Questionnaire (SGRQ) total score, and/or 6-min walk distance (6MWD) and were registered in an official clinical trial database were eligible for inclusion. Individual patient data were requested, and a linear mixed effects model was used to calculate overall treatment effects. Results: Eight trials were included in the final analysis, representing 680 individual patients. LVR-coil treatment resulted in a significant improvement in FEV1 at 3- (0.09 L [95% confidence interval (95% CI): 0.06–0.12]) and 6-month follow-up (0.07 L [95% CI: 0.03–0.10]), a significant reduction in RV at 3- (−0.45L [95% CI: −0.62 to −0.28]), 6- (−0.33L [95% CI: −0.52 to −0.14]), and 12-month follow-up (−0.36L [95% CI: −0.64 to −0.08]), a significant reduction in SGRQ total score at 3- (−12.3 points [95% CI: −15.8 to −8.8]), 6- (−10.1 points [95% CI: −12.8 to −7.3]), and 12-month follow-up (−9.8 points [95% CI: −15.0 to −4.7]) and a significant increase in 6MWD at 3-month follow-up (38 m [95% CI: 18–58]). Conclusions: LVR-coil treatment in emphysema patients results in sustained improvements in pulmonary function and quality of life and shorter lived improvements in exercise capacity. Since the owner of this LVR-coil has decided to stop the production and newer generations LVR-coils are currently being developed, these results can act as a reference for future studies and clinical guidance.
- Published
- 2022
24. Risk Factors for Prolonged Mechanical Ventilation and Weaning Failure: A Systematic Review
- Author
-
Franziska C. Trudzinski, Benjamin Neetz, Florian Bornitz, Michael Müller, Aline Weis, Dorothea Kronsteiner, Felix J.F. Herth, Noemi Sturm, Vicky Gassmann, Timm Frerk, Claus Neurohr, Alessandro Ghiani, Biljana Joves, Armin Schneider, Joachim Szecsenyi, Selina von Schumann, and Jan Meis
- Subjects
Pulmonary and Respiratory Medicine - Abstract
Introduction: Prolonged mechanical ventilation (PMV) and weaning failure are factors associated with prolonged hospital length of stay and increased morbidity and mortality. In addition to the burden these places on patients and their families, it also imposes high costs on the public health system. The aim of this systematic review was to identify risk factors for PMV and weaning failure. Methods: The study was conducted according to PRISMA guidelines. After a comprehensive search of the COCHRANE Library, CINHAL, Web of Science, MEDLINE, and the LILACS Database a PubMed request was made on June 8, 2020. Studies that examined risk factors for PMV, defined as mechanical ventilation ≥96 h, weaning failure, and prolonged weaning in German and English were considered eligible; reviews, meta-analyses, and studies in very specific patient populations whose results are not necessarily applicable to the majority of ICU patients as well as pediatric studies were excluded from the analysis. This systematic review was registered in the PROSPERO register under the number CRD42021271038. Results: Of 532 articles identified, 23 studies with a total of 23,418 patients met the inclusion criteria. Fourteen studies investigated risk factors of PMV including prolonged weaning, 9 studies analyzed risk factors of weaning failure. The concrete definitions of these outcomes varied considerably between studies. For PMV, a variety of risk factors were identified, including comorbidities, site of intubation, various laboratory or blood gas parameters, ventilator settings, functional parameters, and critical care scoring systems. The risk of weaning failure was mainly related to age, previous home mechanical ventilation (HMV), cause of ventilation, and preexisting underlying diseases. Elevated PaCO2 values during spontaneous breathing trials were indicative of prolonged weaning and weaning failure. Conclusion: A direct comparison of risk factors was not possible because of the heterogeneity of the studies. The large number of different definitions and relevant parameters reflects the heterogeneity of patients undergoing PMV and those discharged to HMV after unsuccessful weaning. Multidimensional scores are more likely to reflect the full spectrum of patients ventilated in different ICUs than single risk factors.
- Published
- 2022
25. Primary Mediastinal Large B-Cell Lymphoma Achieved by Non-Cautery Assisted Transbronchial Mediastinal Cryobiopsy
- Author
-
Jing Zhang, Zan-Sheng Huang, Xian-Li Wu, An-Mei Zhang, Wan-Lei Fu, Gang Liu, Felix J.F. Herth, and Ye Fan
- Subjects
Pulmonary and Respiratory Medicine - Abstract
Transbronchial mediastinal cryobiopsy is a novel sampling strategy that shows improved diagnostic utility for mediastinal lesions, particularly in rare tumors and benign disorders, as compared to standard endobronchial ultrasound-guided transbronchial needle aspiration. During this procedure, electrocautery incision is frequently needed to advance the cryoprobe through the airway into the mediastinal lesion, which however results in increased operative difficulty and prolonged procedural time. Here we present a case of mediastinal large B-cell lymphoma successfully diagnosed by transbronchial mediastinal cryobiopsy without cautery-induced airway incision.
- Published
- 2022
26. Computed tomographic airway morphology after targeted lung denervation treatment in COPD
- Author
-
Jorine E. Hartman, Felix J.F. Herth, Pallav Shah, Christophe Pison, Arschang Valipour, Dirk-Jan Slebos, Christine Abele, Irene Firlinger, Kiran Kothakuzhakal, Marina Duller, Bernd Lamprecht, Roland Kropfmueller, Kornelia Holzmann, Sandra Rathmeier, Ralf Hubner, Leonore Erdmann, Bettina Temmesfeld-Wollbrück, Christoph Ruwwe Glösenkamp, Wolfgang Gesierich, Frank Reichenberger, Christa Niehaus, Felix Herth, Ralf Eberhardt, Daniela Gompelmann, Brigitte Rump, Kaid Darwiche, Stephan Eisenmann, Ulrike Kaiser, Birte Schwarz, Ulrike Sampel, Christian Schumann, Robert Kaiser, Kathryn Schumann-Stoiber, Dirk Skowasch, Sabine Ring, Amandine Briault, Francois Arbib, Marie Jondot, Thierry Perez, Clement Fournier, Regis Matran, Michele Catto, Nathalie Bautin, Virginie De Broucker, Marie Willemin, Anne Prevotat, Ludivine Wemeau, Alice Gicquello, Morgane Foulon, Hasna Camara, Gaetan Deslee, Herve Vallerand, Sandra Dury, Delphine Gras, Margaux Bonnaire-Verdier, Romain Kessler, Sandrine Hirschi, Michele Porzio, Tristan Degot, Mathieu Canuet, Armelle Schuller, Julien Stauder, Sahra Ali Azouaou, Armelle Marceau, Hervé Mal, Yolande Costa, Pallav L. Shah, Justin Garner, Karthi Srikanthan, Cielito Caneja, John Thornton, Nick Ten Hacken, Jorine Hartman, Karin Klooster, Sonja Augustijn, Peter Bonta, Jouke Annema, Marianne van de Pol, Annika Goorsenberg, VU University medical center, Groningen Research Institute for Asthma and COPD (GRIAC), Pulmonology, ACS - Pulmonary hypertension & thrombosis, AII - Infectious diseases, AII - Inflammatory diseases, AII - Cancer immunology, CCA - Cancer biology and immunology, and CCA - Imaging and biomarkers
- Subjects
Pulmonary and Respiratory Medicine - Abstract
This post-hoc analysis of the AIRFLOW-2 trial investigated the changes in airway CT-parameters after targeted lung denervation (TLD) and whether these changes are associated with treatment response. In the treatment group (n = 32), an improvement in air trapping was significantly associated with an improvement in residual volume (RV). Furthermore, improvements in Pi10 and airway lumen were significantly associated with an improvement in both RV and FEV1. Our results could suggest that when improving airway characteristics like decreasing airway wall thickness and increasing the airway lumen, this leads to less air trapping and an improvement in clinical outcomes.
- Published
- 2023
27. Alpha 1 Antitrypsin Therapy in Patients with Alpha 1 Antitrypsin Deficiency: Perspectives from a Registry Study and Practical Considerations for Self-Administration During the COVID-19 Pandemic
- Author
-
Timm Greulich, Robert A. Sandhaus, Alice M Turner, Felix J.F. Herth, Maria Sucena, and Tobias Welte
- Subjects
medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,efficacy ,Alpha (ethology) ,Review ,law.invention ,Pulmonary Disease, Chronic Obstructive ,Quality of life ,Randomized controlled trial ,law ,alpha 1-Antitrypsin Deficiency ,Pandemic ,Clinical endpoint ,Medicine ,Humans ,Registries ,Intensive care medicine ,Pandemics ,COPD ,Alpha 1-antitrypsin deficiency ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,medicine.disease ,Alpha 1 Antitrypsin deficiency ,alpha 1-Antitrypsin ,Alpha 1 Antitrypsin ,Self-administration ,business ,self-administration - Abstract
Alpha 1 Antitrypsin deficiency (AATD) is a hereditary condition characterized by low serum Alpha 1 Antitrypsin (AAT) levels and a predisposition towards early-onset emphysema. Infusion of AAT is the only disease-modifying therapy that can sufficiently raise plasma AAT levels above the putative protective threshold and reduce the decline in lung density loss. Several randomized controlled trials (RCTs) and registry studies support the clinical efficacy of AAT therapy in slowing the progression of AATD-related emphysema and improving survival outcomes. The COVID-19 pandemic has prompted physicians to develop additional strategies for delivering AAT therapy, which are not only more convenient for the patient, but are “COVID-19 friendly”, thereby reducing the risk of exposing these vulnerable patients. Intravenous (IV) self-administration of AAT therapy is likely to be beneficial in certain subgroups of patients with AATD and can remove the need for weekly hospital visits, thereby improving independence and well-being. Increasing the awareness of self-administration in AATD through the development of formal guidelines and training programs is required among both physicians and patients and will play an essential role, especially post-COVID-19, in encouraging physicians to consider self-administration for AATD in suitable patients. This review summarizes the benefits of AAT therapy on the clinical endpoints of mortality and quality of life (QoL) and discusses the benefits of self-administration therapy compared with conventional therapy administered by a healthcare professional. In addition, this review highlights the challenges of providing AAT therapy during the COVID-19 pandemic and the potential considerations for its implementation thereafter.
- Published
- 2021
28. Severe Dysbiosis and Specific Haemophilus and Neisseria Signatures as Hallmarks of the Oropharyngeal Microbiome in Critically Ill Coronavirus Disease 2019 (COVID-19) Patients
- Author
-
Roman Rohrbach, Silvana Hengler, Alwin Krämer, Rogier Gaiser, Michael W. Müller, Felix J.F. Herth, Jochen Schneider, Dina Khalid, Nyssa Cullin, Theresa Hippchen, Christoph K. Stein-Thoeringer, Peter Hau, Stamatia M Papagiannarou, Matthias P. Ebert, Dirk Jäger, Yascha Khodamoradi, Andreas Teufel, Maria J G T Vehreschild, Ralf Bartenschlager, Bernd Salzberger, Daniel Duerschmied, Juliana de Castilhos, Andreas Hiergeist, Paul Schnitzler, André Gessner, Eran Elinav, Melanie Neubauer, Sabine Schmidt, Hendrik Poeck, Roland M. Schmid, Hanna Schumacher, Uta Merle, Tonia Müller-Esch, Bettina Beuthien-Baumann, Sabrina Kunz, Eli Zamir, and Johann F Eberhardt
- Subjects
Adult ,Microbiology (medical) ,medicine.medical_specialty ,medicine.drug_class ,Critical Illness ,medicine.medical_treatment ,Antibiotics ,Haemophilus ,microbiome ,medicine.disease_cause ,Internal medicine ,intensive medical care ,Major Article ,medicine ,Humans ,Microbiome ,Coronavirus ,Mechanical ventilation ,biology ,SARS-CoV-2 ,business.industry ,Microbiota ,COVID-19 ,dysbiosis ,medicine.disease ,biology.organism_classification ,Cross-Sectional Studies ,AcademicSubjects/MED00290 ,machine learning ,Infectious Diseases ,Respiratory virus ,Neisseria ,business ,Dysbiosis - Abstract
Background At the entry site of respiratory virus infections, the oropharyngeal microbiome has been proposed as a major hub integrating viral and host immune signals. Early studies suggested that infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are associated with changes of the upper and lower airway microbiome, and that specific microbial signatures may predict coronavirus disease 2019 (COVID-19) illness. However, the results are not conclusive, as critical illness can drastically alter a patient’s microbiome through multiple confounders. Methods To study oropharyngeal microbiome profiles in SARS-CoV-2 infection, clinical confounders, and prediction models in COVID-19, we performed a multicenter, cross-sectional clinical study analyzing oropharyngeal microbial metagenomes in healthy adults, patients with non-SARS-CoV-2 infections, or with mild, moderate, and severe COVID-19 (n = 322 participants). Results In contrast to mild infections, patients admitted to a hospital with moderate or severe COVID-19 showed dysbiotic microbial configurations, which were significantly pronounced in patients treated with broad-spectrum antibiotics, receiving invasive mechanical ventilation, or when sampling was performed during prolonged hospitalization. In contrast, specimens collected early after admission allowed us to segregate microbiome features predictive of hospital COVID-19 mortality utilizing machine learning models. Taxonomic signatures were found to perform better than models utilizing clinical variables with Neisseria and Haemophilus species abundances as most important features. Conclusions In addition to the infection per se, several factors shape the oropharyngeal microbiome of severely affected COVID-19 patients and deserve consideration in the interpretation of the role of the microbiome in severe COVID-19. Nevertheless, we were able to extract microbial features that can help to predict clinical outcomes.
- Published
- 2021
29. Relationship between airway dysbiosis, inflammation and lung function in adults with cystic fibrosis
- Author
-
Mirjam Stahl, Simon Y. Graeber, Alexander H. Dalpke, Carsten Schultz, Dario L. Frey, Olaf Sommerburg, Sabine Wege, Marcus A. Mall, Susanne A. Dittrich, Felix J.F. Herth, and Sébastien Boutin
- Subjects
Adult ,Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Spirometry ,Adolescent ,Cystic Fibrosis ,Inflammation ,Cystic fibrosis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Microbiome ,Child ,Aged ,biology ,medicine.diagnostic_test ,business.industry ,Sputum ,Middle Aged ,respiratory system ,medicine.disease ,Respiratory Function Tests ,respiratory tract diseases ,Cross-Sectional Studies ,030104 developmental biology ,030228 respiratory system ,Neutrophil elastase ,Pediatrics, Perinatology and Child Health ,Immunology ,biology.protein ,Dysbiosis ,Biomarker (medicine) ,Female ,medicine.symptom ,business ,Biomarkers - Abstract
Airway dysbiosis has been associated with lung disease severity in patients with cystic fibrosis (CF). However, the relationship between dysbiosis, airway inflammation and lung function impairement remains poorly understood. The aim of this study was therefore to determine how the structure of the sputum microbiota, airway inflammation markers and spirometry are related in patients with CF. Sputum samples were collected from 106 CF patients between 12 and 72 years. These were analyzed by 16S rRNA gene amplicon sequencing. Moreover, levels of pro-inflammatory cytokines (IL-1β, IL-8, IL-6 and TNF-α) and Neutrophil elastase (NE) were determined. The relationship between the microbiota, inflammation markers and forced expiratory volume in one second percent predicted (FEV1% predicted) was evaluated by multi-parameter analysis. The microbiota α-diversity correlated inverse with inflammation markers IL-1β, IL-8, TNF-α, NE and positively with FEV1% predicted. Patients could be divided into 7 clusters based on their microbiota structure. The most diverse cluster was defined by oropharyngeal-like flora (OF) while the others were characterized by the dominance of a single pathogen. Patients with the diverse OF microbiota cluster had lower sputum inflammatory markers and higher FEV1% predicted compared to patients with a pathogen-dominated microbiota including Pseudomonas aeruginosa. Our results suggest that the diversity of the airway microbiota is an important biomarker of the severity of airway inflammation linking dysbiosis to lung function decline in patients with CF.
- Published
- 2021
30. Controversies in EUS: Do we need miniprobes?
- Author
-
Christoph F. Dietrich, Bogdan Silvio Ungureanu, Barbara Braden, Anand V. Sahai, Alberto Larghi, Mihai Rimbas, Hans Seifert, Paolo Giorgio Arcidiacono, Pietro Fusaroli, Adrian Saftoiu, Bertrand Napoleon, Michael Hocke, Felix J.F. Herth, Seifert H., Fusaroli P., Arcidiacono P., Braden B., Herth F., Hocke M., Larghi A., Napoleon B., Rimbas M., Ungureanu B., Saftoiu A., Sahai A., and Dietrich C.
- Subjects
Pancreatic duct ,medicine.medical_specialty ,Hepatology ,business.industry ,Bile duct ,Gastroenterology ,catheter probes ,high-frequency ultrasound ,digestive system diseases ,catheter probe ,Entire intestinal tract ,Training Course ,medicine.anatomical_structure ,Intraductal ultrasound ,Medicine ,cancer ,miniprobes ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,intraductal ultrasound ,EUS ,High frequency ultrasound - Abstract
This is the fifth in a series of papers entitled 'Controversies in EUS.' In the current paper, we deal with high-resolution catheter probes, otherwise known as EUS miniprobes (EUS-MPs). The application of miniprobes for early carcinomas in the entire intestinal tract, for subepithelial lesions, and for findings in the bile duct and pancreatic duct as well as endobronchial use is critically discussed. Submucous lesions, especially in the colon, but also early carcinomas in special cases are considered the most important indications. The argument is illustrated by numerous examples.
- Published
- 2021
31. Endobronchial Coil System versus Standard-of-Care Medical Management in the Treatment of Subjects with Severe Emphysema
- Author
-
Felix J.F. Herth, Dirk-Jan Slebos, Ralf-Harto Huebner, Armelle Marceau, Dirk Skowasch, Romain Kessler, Karin Klooster, Hervé Dutau, Francesca Conway, Hervé Mal, Arschang Valipour, Kaid Darwiche, Martin Hetzel, Gaëtan Deslée, Arnaud Bourdin, Michaela Bezzi, P Hammerl, Christian Schumann, Christian Grah, Charles-Hugo Marquette, Jacques Boutros, Franz Stanzel, Christophe Pison, Pallav L. Shah, University Medical Center Groningen [Groningen] (UMCG), Klinik Floridsdorf [Wien], FHU OncoAge - Pathologies liées à l’âge [CHU Nice] (OncoAge), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Pharmacologie Moléculaire et Cellulaire [UNIV Côte d'Azur] (UPMC)-Université Côte d'Azur (UCA), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Royal Brompton Hospital, Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire [Grenoble] (CHU), Klinik für Anthroposophische Medizin, Krankenhaus vom Roten Kreuz Bad Cannstatt, Klinikverbund Kempten-Oberallgäu gGmbH, Nouvel Hôpital Civil de Strasbourg, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Universitätsklinikum Bonn (UKB), Ruhrlandklinik University Hospital, Lungenfachklinik Immenhausen, Lungenklinik Hemer, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia [Brescia], Service de Pneumologie et Allergie - Hôpital Nord [Marseille], Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University Medical Center Heidelberg, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Groningen Research Institute for Asthma and COPD (GRIAC)
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Bronchoscopic lung volume reduction ,Endobronchial coil treatment ,[SDV]Life Sciences [q-bio] ,Medizin ,Hyperinflation ,Severity of Illness Index ,Quality of life ,Internal medicine ,Bronchoscopy ,MINIMAL IMPORTANT DIFFERENCE ,Interventional Pulmonology ,Humans ,Medicine ,Lung volumes ,Prospective Studies ,Respiratory system ,Pneumonectomy ,Adverse effect ,Aged ,Aged, 80 and over ,Emphysema ,business.industry ,Prostheses and Implants ,Middle Aged ,respiratory system ,3. Good health ,respiratory tract diseases ,Clinical trial ,LUNG-VOLUME REDUCTION ,Electromagnetic coil ,Early Termination of Clinical Trials ,Cohort ,Cardiology ,Female ,business - Abstract
Background: Bronchoscopic lung volume reduction using endobronchial coils is a new treatment for patients with severe emphysema. To date, the benefits have been modest and have been suggested to be much larger in patients with severe hyperinflation and nonmulti-comorbidity. Objective: We aimed to evaluate the efficacy and safety of endobronchial coil treatment in a randomized multicenter clinical trial using optimized patient selection. Method: Patients with severe emphysema on HRCT scan with severe hyperinflation (residual volume [RV] ≥200% predicted and RV/total lung capacity [TLC] >55%) were randomized to coil treatment or control. Primary outcome measures were differences in the forced expiratory volume in 1 s (FEV1) and St George’s Respiratory Questionnaire (SGRQ) total score at 6 months. Results: Due to premature study termination, a total of 120 patients (age 63 ± 7 years, FEV1 29 ± 7% predicted, RV 251 ± 41% predicted, RV/TLC 67 ± 6%, and SGRQ 58 ± 13 points), instead of 210 patients, were randomized. At study termination, 91 patients (57 coil and 34 control) had 6-month results available. Analyses showed significantly greater improvements in favor of the coil group. The increase in FEV1 was greater in the coil group than that in the control group by + 10.3 [+4.7 to +16.0] % and in SGRQ by −10.6 [−15.9 to −5.4] points. At study termination, there were 5 (6.8%) deaths in the coil cohort reported. Conclusion: Despite early study termination, coil treatment compared to control results in a significant improvement in the lung function and quality of life benefits for up to 6 months in patients with emphysema and severe hyperinflation. These improvements were of clinical importance but were associated with a higher likelihood of serious adverse events.
- Published
- 2021
32. Characteristics of lung cancer after a previous malignancy
- Author
-
Reinmuth, Niels, Stumpf, Patrick, Stumpf, Andreas, Muley, Thomas, Kobinger, Sonja, Hoffmann, Hans, Herth, Felix J.F., Schnabel, Philipp A., Bischoff, Helge, and Thomas, Michael
- Published
- 2014
- Full Text
- View/download PDF
33. Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET
- Author
-
Kathrin Kahnert, Claus Vogelmeier, Michael Pfeifer, Johanna I. Lutter, Robert Bals, Franziska C. Trudzinski, Peter Alter, Hans-Ulrich Kauczor, Sandra Söhler, Felix J.F. Herth, Jürgen Behr, Tobias Welte, Henrik Watz, and Rudolf A. Jörres
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,COPD ,Remote Consultation ,business.industry ,media_common.quotation_subject ,MEDLINE ,medicine.disease ,Obstructive lung disease ,Hygiene ,Internal medicine ,Pandemic ,Cohort ,medicine ,Medicine ,Infection control ,Original Article ,business ,media_common - Abstract
Background:Infection control measures for coronavirus disease 2019 (COVID-19) might have affected management and clinical state of patients with COPD. We analysed to which extent this common notion is fact-based.Methods:Patients of the COSYCONET cohort were contacted with three recurring surveys (COVID1, 2 and 3 at 0, 3 and 6 months, respectively). The questionnaires comprised behaviour, clinical and functional state, and medical treatment. The responses to the questionnaires were compared amongst themselves and with pre-COVID information from the last visit of COSYCONET.Results:Overall, 594 patients were contacted and 375 patients (58% males, forced expiratory volume in 1 s (FEV1) 61±22% predicted) provided valid data in COVID1 and COVID2. Five patients reported infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most patients – except for patients with higher education – reported compliance with recommended protective measures, whereby compliance to hygiene, contact and access to physicians slightly improved between COVID1 and COVID2. Also, patients obtained more information from physicians than from public media. In the majority of cases, the personal physician could not be substituted by remote consultation. Over time, symptoms slightly increased and self-assessed physical capacity decreased. Results of COVID3 were similar. Women and patients with more exacerbations and dyspnoea avoided medical consultations, whereas Global Initiative for Chronic Obstructive Lung Disease (GOLD) D patients were more amenable to tele-consultation.Conclusion:In well-characterised COPD patients, we observed on average slight deteriorations of clinical state during the period of COVID-19 restrictions, with high and partially increasing adherence to protective measures. The data suggest that in particular, women and GOLD D patients should be actively contacted by physicians to identify deteriorations.
- Published
- 2021
34. Temporal Trends in Tunneled Pleural Catheter Utilization in Patients With Malignancy
- Author
-
Fabien Maldonado, Justin E. Lewis, Trinidad M. Sanchez, Kevin Davidson, Lonny Yarmus, Nicholas J. Pastis, Chakravarthy Reddy, Benjamin Bevill, Mohammed K. AlSarraj, Samira Shojaee, Christopher R. Gilbert, Felix J.F. Herth, Momen M. Wahidi, Horiana B. Grosu, Jeffrey Thiboutot, Amber N. Wright, Lance Roller, Rachelle Asciak, Ashley Delgado, Candice L. Wilshire, Shu Ching Chang, Najib M. Rahman, Jason Akulian, Henry Steer, David Ost, Hans J. Lee, and Jed A. Gorden
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,MEDLINE ,Critical Care and Intensive Care Medicine ,Malignancy ,medicine.disease ,Text mining ,medicine ,Pleural catheter ,In patient ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
35. Consolidating Lung Volume Reduction Surgery After Endoscopic Lung Volume Reduction Failure
- Author
-
Claus P. Heussel, Martin E. Eichhorn, Katrin Hornemann, Daniela Gompelmann, Hans Hoffmann, Ralf Eberhardt, Konstantina Kontogianni, Sascha Dreher, Hauke Winter, Felix J.F. Herth, and Johannes Haag
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Lung volume reduction ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Lung volume reduction surgery ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Symptom relief ,medicine ,Humans ,Volume reduction ,In patient ,Lung volumes ,Treatment Failure ,Pneumonectomy ,Lung ,Aged ,Retrospective Studies ,business.industry ,Endoscopy ,Middle Aged ,Respiratory Function Tests ,Surgery ,Pulmonary Emphysema ,030228 respiratory system ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Bronchoscopic valve placement constitutes an effective endoscopic lung volume reduction (ELVR) therapy in patients with severe emphysema and low collateral ventilation. After the most destroyed lobe is occluded with valves, significant target lobe volume reduction leads to improvements in lung function, exercise capacity, and quality of life. The effects are not consistent in some patients, leading to long-term therapy failure. We hypothesized that surgical lung volume reduction (LVRS) would reestablish ELVR short-term clinical improvements after ELVR long-term failure. Methods This retrospective single-center analysis included all patients who underwent consolidating LVRS by lobectomy after long-term failure of valve therapy between 2010 and 2015. Changes in forced expiratory volume in 1 second, residual volume, 6-minute walking distance, and Modified Medical Research Council dyspnea score 90 days after ELVR and LVRS were analyzed, and the outcomes of both procedures were compared. Results LVRS was performed in 20 patients after ELVR failure. A lower lobectomy was performed in 90%. The 30-day mortality of the cohort was 0% and 90-day mortality was 5% (1 of 20). The remaining 19 patients showed a significant increase in forced expiratory volume in 1 second (+27.5% ± 19.4%) and a reduction in residual volume (−21.0% ± 17.4%) and total lung capacity (−11.1% ± 11.1%). This resulted in significant improvements in exercise tolerance (6-minute walking distance: +56 ± 60 m) and relief of dyspnea (ΔModified Medical Research Council: −1.8 ± 1.4 points.). Conclusions Consolidating LVRS by lobectomy after failure of a previously successful ELVR is feasible and results in significant symptom relief and improvement of lung function.
- Published
- 2021
36. Deciphering the immunosuppressive tumor microenvironment in ALK- and EGFR-positive lung adenocarcinoma
- Author
-
Jan Budczies, Cornelius F. Waller, Amanda Tufman, Martina Kirchner, Torsten Goldmann, Albrecht Stenzinger, Peter Schirmacher, Petros Christopoulos, Michael Meister, Mark Kriegsmann, Michael Thomas, Martin Reck, Solange Peters, Klaus Kluck, Hauke Winter, Julia Glade, Daniel Kazdal, Stefan Fröhling, Michael Allgäuer, Thomas Muley, Felix J.F. Herth, CP Heußel, and Martin Wermke
- Subjects
Lung adenocarcinoma ,Male ,Cancer Research ,Lung Neoplasms ,medicine.medical_treatment ,0302 clinical medicine ,hemic and lymphatic diseases ,Carcinoma, Non-Small-Cell Lung ,Tumor Cells, Cultured ,Tumor Microenvironment ,Immunology and Allergy ,Anaplastic Lymphoma Kinase ,Aged, 80 and over ,0303 health sciences ,Immunosuppression ,Middle Aged ,Prognosis ,ErbB Receptors ,Gene Expression Regulation, Neoplastic ,Survival Rate ,Oncology ,030220 oncology & carcinogenesis ,Adenocarcinoma ,Original Article ,Female ,Immunotherapy ,Adult ,Immunology ,Adenocarcinoma of Lung ,ALK fusion ,03 medical and health sciences ,Immune system ,Lymphocytes, Tumor-Infiltrating ,medicine ,Biomarkers, Tumor ,Humans ,Lung cancer ,030304 developmental biology ,Aged ,Retrospective Studies ,Tumor microenvironment ,business.industry ,Gene Expression Profiling ,medicine.disease ,Immune checkpoint ,Gene expression profiling ,Cancer research ,EGFR mutation ,business ,Immune checkpoint blockade ,Follow-Up Studies - Abstract
Introduction The advent of immune checkpoint blockade (ICB) has led to significantly improved disease outcome in lung adenocarcinoma (ADC), but response of ALK/EGFR-positive tumors to immune therapy is limited. The underlying immune biology is incompletely understood. Methods We performed comparative mRNA expression profiling of 31 ALK-positive, 40 EGFR-positive and 43 ALK/EGFR-negative lung ADC focused on immune gene expression. The presence and levels of tumor infiltration lymphocytes (TILs) as well as fourteen specific immune cell populations were estimated from the gene expression profiles. Results While total TILs were not lower in ALK-positive and EGFR-positive tumors compared to ALK/EGFR-negative tumors, specific immunosuppressive characteristics were detected in both subgroups: In ALK-positive tumors, regulatory T cells were significantly higher compared to EGFR-positive (fold change: FC = 1.9, p = 0.0013) and ALK/EGFR-negative tumors (FC = 2.1, p = 0.00047). In EGFR-positive tumors, cytotoxic cells were significantly lower compared to ALK-positive (FC = − 1.7, p = 0.016) and to ALK/EGFR-negative tumors (FC = − 2.1, p = 2.0E-05). A total number of 289 genes, 40 part of cytokine–cytokine receptor signaling, were differentially expressed between the three subgroups. Among the latter, five genes were differently expressed in both ALK-positive and EGFR-positive tumors, while twelve genes showed differential expression solely in ALK-positive tumors and eleven genes solely in EGFR-positive tumors. Conclusion Targeted gene expression profiling is a promising tool to read out tumor microenvironment characteristics from routine diagnostic lung cancer biopsies. Significant immune reactivity including specific immunosuppressive characteristics in ALK- and EGFR-positive lung ADC, but not a total absence of immune infiltration supports further clinical evaluation of immune-modulators as partners of ICB in such tumors.
- Published
- 2021
37. Echo<scp>Time‐Dependent</scp>Observed Lung<scp>T1</scp>in Patients With Chronic Obstructive Pulmonary Disease in Correlation With Quantitative Imaging and Clinical Indices
- Author
-
Claus Vogelmeier, Rudolf A. Jörres, Oliver Weinheimer, Mark O. Wielpütz, Jens Vogel-Claussen, Hans-Ulrich Kauczor, Jürgen Biederer, Bertram J. Jobst, Claus Peter Heußel, Simon M. F. Triphan, Marcel Gutberlet, and Felix J.F. Herth
- Subjects
COPD ,education.field_of_study ,Lung ,business.industry ,Population ,medicine.disease ,Spearman's rank correlation coefficient ,030218 nuclear medicine & medical imaging ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,DLCO ,Diffusing capacity ,medicine ,Radiology, Nuclear Medicine and imaging ,education ,Nuclear medicine ,business ,Perfusion - Abstract
Background There is a clinical need for imaging-derived biomarkers for the management of chronic obstructive pulmonary disease (COPD). Observed pulmonary T1 (T1 (TE)) depends on the echo-time (TE) and reflects regional pulmonary function. Purpose To investigate the potential diagnostic value of T1 (TE) for the assessment of lung disease in COPD patients by determining correlations with clinical parameters and quantitative CT. Study type Prospective non-randomized diagnostic study. Population Thirty COPD patients (67.7 ± 6.6 years). Data from a previous study (15 healthy volunteers [26.2 ± 3.9 years) were used as reference. Field strength/sequence Study participants were examined at 1.5 T using dynamic contrast-enhanced three-dimensional gradient echo keyhole perfusion sequence and a multi-echo inversion recovery two-dimensional UTE (ultra-short TE) sequence for T1 (TE) mapping at TE1-5 = 70 μsec, 500 μsec, 1200 μsec, 1650 μsec, and 2300 μsec. Assessment Perfusion images were scored by three radiologists. T1 (TE) was automatically quantified. Computed tomography (CT) images were quantified in software (qCT). Clinical parameters including pulmonary function testing were also acquired. Statistical tests Spearman rank correlation coefficients (ρ) were calculated between T1 (TE) and perfusion scores, clinical parameters and qCT. A P-value Results Median values were T1 (TE1-5 ) = 644 ± 78 msec, 835 ± 92 msec, 835 ± 87 msec, 831 ± 131 msec, 893 ± 220 msec, all significantly shorter than previously reported in healthy subjects. A significant increase of T1 was observed from TE1 to TE2 , with no changes from TE2 to TE3 (P = 0.48), TE3 to TE4 (P = 0.94) or TE4 to TE5 (P = 0.02) which demonstrates an increase at shorter TEs than in healthy subjects. Moderate to strong Spearman's correlations between T1 and parameters including the predicted diffusing capacity for carbon monoxide (DLCO, ρ -0.69) were found. Overall, correlations were strongest at TE2 , weaker at TE1 and rarely significant at TE4 -TE5 . Data conclusion In COPD patients, the increase of T1 (TE) with TE occurred at shorter TEs than previously found in healthy subjects. Together with the lack of correlation between T1 and clinical parameters of disease at longer TEs, this suggests that T1 (TE) quantification in COPD patients requires shorter TEs. The TE-dependence of correlations implies that T1 (TE) mapping might be developed further to provide diagnostic information beyond T1 at a single TE. Level of evidence 2 TECHNICAL EFFICACY: Stage 1.
- Published
- 2021
38. 'Patient self-inflicted lung injury' (P-SILI)
- Author
-
Benjamin Neetz, Thomas Flohr, Michael M. Müller, and Felix J.F. Herth
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Breathing Effort ,Emergency Nursing ,Lung injury ,Critical Care and Intensive Care Medicine ,Pathophysiology ,03 medical and health sciences ,0302 clinical medicine ,Emergency Medicine ,Internal Medicine ,medicine ,Respiratory effort ,030212 general & internal medicine ,business ,Clinical evaluation - Abstract
Die Etablierung der unterstutzten Spontanatmung gilt allgemein als eine vorteilhafte und wenig gefahrdende Phase der Beatmungstherapie. Allerdings geben neuere Erkenntnisse Hinweise auf eine potenzielle Schadigung durch exzessive Spontanatembemuhungen vor allem bei akuter Lungenschadigung. Das Syndrom wird unter dem Begriff „patient self-inflicted lung injury“ zusammengefasst. Arzte, Pflegepersonen und Atmungstherapeuten sollten fur diese Thematik sensibilisiert werden. Parameter, die mittels Osophagusdruckmessung oder einfacher Manover am Respirator bestimmt werden konnen, sind bei der Entscheidung zur Durchfuhrung und zur Uberwachung von Spontanatmung auch in den akuten Phasen der Lungenschadigung hilfreich. Weiterhin gibt es im Umgang mit hohem Atemantrieb oder erhohter Atemanstrengung therapeutische Moglichkeiten, diesen zu begegnen.
- Published
- 2021
39. Bronchoscopy and bleeding risk
- Author
-
Felix J.F. Herth
- Subjects
Diseases of the respiratory system ,RC705-779 - Published
- 2017
- Full Text
- View/download PDF
40. The revised GOLD 2017 COPD categorization in relation to comorbidities
- Author
-
Rudolf M. Huber, Frank Biertz, Joachim Heinrich, Henrik Watz, Jørgen Vestbo, Rudolf A. Jörres, Kathrin Kahnert, Jürgen Behr, Felix J.F. Herth, Tobias Welte, Tanja Lucke, Emiel F.M. Wouters, Claus F. Vogelmeier, David Young, Peter Alter, Hubert Wirtz, Margarethe Wacker, Robert Bals, Pulmonologie, MUMC+: MA Longziekten (3), and RS: NUTRIM - R3 - Respiratory & Age-related Health
- Subjects
Male ,Exacerbation ,PREDICTION ,Vital Capacity ,Comorbidity ,Severity of Illness Index ,Comorbidities ,Coronary artery disease ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,MARKERS ,Risk Factors ,Forced Expiratory Volume ,Germany ,030212 general & internal medicine ,POPULATION ,education.field_of_study ,COPD ,Sleep apnea ,Middle Aged ,Obstructive lung disease ,LUNG-FUNCTION ,Cohort ,HEART-FAILURE ,Female ,Copd ,Gold Categorization ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Population ,OBSTRUCTIVE PULMONARY-DISEASE ,GOLD categorization ,ACUTE EXACERBATIONS ,03 medical and health sciences ,Internal medicine ,MANAGEMENT ,medicine ,Humans ,education ,Aged ,Asthma ,business.industry ,MORTALITY ,medicine.disease ,DEFINITION ,Cross-Sectional Studies ,030228 respiratory system ,Heart failure ,business - Abstract
Introduction The COPD classification proposed by the Global Initiative for Obstructive Lung Disease was recently revised, and the A to D grouping is now based on symptoms and exacerbations only. Potential associations with comorbidities have not been assessed so far. Thus the aim of the present study was to determine the relationship between the revised (2017) GOLD groups A-D and major comorbidities. Methods We used baseline data from the COPD cohort COSYCONET. Comorbidities were identified from patient self-reports and disease-specific medication: gastrointestinal disorders, asthma, sleep apnea, hyperuricemia, hyperlipidemia, diabetes, osteoporosis, mental disorders, heart failure, hypertension, coronary artery disease. The A-D groups were based on either the COPD Assessment Test or the modified Medical Research Council scale. Exacerbations were also categorized as per GOLD recommendations. Results Data from 2228 patients were analyzed. Using GOLD group A as a reference, group D was associated with nearly all comorbidities, followed by group B and C. When groups A-D were dichotomized as AC vs. BD (symptoms) and AB vs. CD (exacerbations), all comorbidities correlated with symptoms and/or exacerbations. This was true for both mMRC- and CAT-based categorizations. Conclusions These findings suggest that the recently modified GOLD categorization is clinically relevant beyond being purely an assessment of symptoms and exacerbations. As the A-D groups correlated with the risk of important comorbidities, with some differences in terms of the correlation with symptoms and exacerbations, the findings underline the importance of identifying comorbidities in COPD, particularly in non-responders to therapy who have high symptoms and/or exacerbation rates.
- Published
- 2022
- Full Text
- View/download PDF
41. Association between Tunneled Pleural Catheter Use and Infection in Patients Immunosuppressed from Antineoplastic Therapy. A Multicenter Study
- Author
-
Christopher R. Gilbert, Ashley Delgado, Jeffrey Thiboutot, Jed A. Gorden, Hans J. Lee, Justin E. Lewis, Nicholas J. Pastis, David Ost, Fabien Maldonado, Samira Shojaee, Shu Ching Chang, Lonny Yarmus, Chakravarthy Reddy, Henry Steer, Felix J.F. Herth, Horiana B. Grosu, Trinidad M. Sanchez, Kevin Davidson, Lance Roller, Candice L. Wilshire, Mohammed K. AlSarraj, Benjamin Bevill, Jason Akulian, Rachelle Asciak, Momen M. Wahidi, Amber N. Wright, and Najib M. Rahman
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Pleural infection ,Antineoplastic Agents ,respiratory system ,Pleural Effusion, Malignant ,respiratory tract diseases ,Surgery ,Catheters, Indwelling ,Multicenter study ,Drainage ,Humans ,Medicine ,Pleural catheter ,In patient ,business ,Pleurodesis - Abstract
Rationale: Patients with malignant/paramalignant pleural effusions (MPE/PMPEs) may have tunneled pleural catheter (TPC) management withheld due to infection concerns from immunosuppression associated with antineoplastic therapy. Objective: To determine the rate of infections related to TPC use and to determine the relationship to antineoplastic therapy, immune system competency and overall survival (OS)? Methods: We performed an international, multi-institutional study of MPE/PMPE patients undergoing TPC management from 2008-2016. Patients were stratified by whether or not they underwent antineoplastic therapy and/or were immunocompromised or not. Cumulative incidence functions and multivariable competing risk regression analyses were performed to identify independent predictors of TPC-related infection. Kaplan-Meier method and multivariable Cox proportional-hazards modeling were performed to examine for independent effects on OS. Results: A total of 1,408 TPCs were placed in 1,318 patients. Patients had a high frequency of overlap between antineoplastic therapy and an immunocompromised state (75-83%). No difference in the overall (6-7%), deep pleural (3-5%) or superficial (3-4%) TPC-related infection rates between subsets of patients stratified by antineoplastic therapy or immune status was observed. The median time to infection was 41 (interquartile range: 19-87) days following TPC insertion. Multivariable competing risk analyses demonstrated longer TPC duration was associated with a higher risk of TPC-related infection [subdistribution hazard ratio (95% CI): 1.03 (1.00-1.06), p=0.028]. Cox proportional-hazards analysis showed antineoplastic therapy was associated with better OS [hazard ratio (95% CI): 0.84 (0.73-0.97), p=0.015]. Conclusion: The risk of TPC-related infection does not appear to be increased by antineoplastic therapy use or an immunocompromised state. The overall rates of infection are low and comparable to immunocompetent patients with no relevant antineoplastic therapy. These results support TPC palliation for MPE/PMPE regardless of plans for antineoplastic therapy.
- Published
- 2021
42. Diagnosis and staging of lung cancer with the use of one single echoendoscope in both the trachea and the esophagus: A practical guide
- Author
-
Lars Konge, Sara Colella, Paul Frost Clementsen, Goran Nadir Salih, Christian Jenssen, Christian N Meyer, Shailesh Kolekar, Uffe Bodtger, Christoph F. Dietrich, Rafi Nessar, Ida Skovgaard Christiansen, Michael Hocke, and Felix J.F. Herth
- Subjects
medicine.medical_specialty ,Staging ,diagnosis ,Mediastinoscopy ,Diagnosis ,medicine ,Fluoroscopy ,Radiology, Nuclear Medicine and imaging ,Esophagus ,Lung cancer ,Hepatology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Magnetic resonance imaging ,staging ,medicine.disease ,Lung ultrasound ,respiratory tract diseases ,Training Course ,Echoendoscope ,medicine.anatomical_structure ,echoendoscope ,Positron emission tomography ,Radiology ,Tomography ,business - Abstract
Accurate staging of non-small cell lung cancer (NSCLC) is crucial for allocation to surgical, medical or multimodal treatment. EUS and endobronchial ultrasound (EBUS) have gained ground in the diagnosis and staging of lung cancer in addition to radiological imaging (e.g., computed tomography, fluoroscopy, and magnetic resonance imaging), nuclear medicine techniques (e.g. positron emission tomography, PET), combined techniques (e.g., fluorodesoxyglucosepositron emission tomography scanning), and sonographic imaging including conventional transcutaneous mediastinal and lung ultrasound. By using one single echoendoscope in both the trachea and the esophagus, surgical staging procedures (e.g. mediastinoscopy and video assisted thoracoscopy) can be avoided in a considerable proportion of patients with NSCLC.
- Published
- 2021
43. Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters
- Author
-
Katharina Roth, Felix J.F. Herth, Martin Borggrefe, Arne Hermanns, Joachim Saur, Joshua Gawlitza, Frederik Trinkmann, Thomas Ganslandt, Julia Schäfer, Ibrahim Akin, and Máté E. Maros
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Percentile ,Sulfur Hexafluoride ,Lung Clearance Index ,Anthropometric parameters ,Reference Values ,Internal medicine ,medicine ,Humans ,In patient ,Lung Diseases, Obstructive ,MULTIPLE BREATH WASHOUT ,Aged ,Aged, 80 and over ,Smokers ,Anthropometry ,business.industry ,Age Factors ,Middle Aged ,medicine.disease ,Healthy Volunteers ,Obstructive lung disease ,Respiratory Function Tests ,Cross-Sectional Studies ,Breath Tests ,Reference values ,Breathing ,Cardiology ,Female ,business - Abstract
BackgroundMultiple breath washout (MBW) using sulfur hexafluoride (SF6) has the potential to reveal ventilation heterogeneity which is frequent in patients with obstructive lung disease and associated small airway dysfunction. However, reference data are scarce for this technique and mostly restricted to younger cohorts. We therefore set out to evaluate the influence of anthropometric parameters on SF6-MBW reference values in pulmonary healthy adults.MethodsWe evaluated cross-sectional data from 100 pulmonary healthy never-smokers and smokers (mean 51 (SD 20), range 20–88 years). Lung clearance index (LCI), acinar (Sacin) and conductive (Scond) ventilation heterogeneity were derived from triplicate SF6-MBW measurements. Global ventilation heterogeneity was calculated for the 2.5% (LCI2.5) and 5% (LCI5) stopping points. Upper limit of normal (ULN) was defined as the 95th percentile.ResultsAge was the only meaningful parameter influencing SF6-MBW parameters, explaining 47% (CI 33% to 59%) of the variance in LCI, 32% (CI 18% to 47%) in Sacin and 10% (CI 2% to 22%) in Scond. Mean LCI increases from 6.3 (ULN 7.4) to 8.8 (ULN 9.9) in subjects between 20 and 90 years. Smoking accounted for 2% (CI 0% to 8%) of the variability in LCI, 4% (CI 0% to 13%) in Sacin and 3% (CI 0% to 13%) in Scond.ConclusionSF6-MBW outcome parameters showed an age-dependent increase from early adulthood to old age. The effect was most pronounced for global and acinar ventilation heterogeneity and smaller for conductive ventilation heterogeneity. No influence of height, weight and sex was seen. Reference values can now be provided for all important SF6-MBW outcome parameters over the whole age range.Trial registration numberNCT04099225.
- Published
- 2021
44. Switch from IL-5 to IL-5-Receptor α Antibody Treatment in Severe Eosinophilic Asthma
- Author
-
Christian Taube, Tobias Welte, Benjamin Seeliger, Felix J.F. Herth, Karl-Christian Bergmann, Juergen Behr, Stephanie Korn, Nikolaus Kneidinger, Katrin Milger, Hendrik Suhling, Jan Fuge, Roland Buhl, Maren Schuhmann, Nora Drick, and Benjamin Kendziora
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.drug_class ,Gastroenterology ,Pulmonary function testing ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Reslizumab ,Internal medicine ,Immunology and Allergy ,Medicine ,0601 history and archaeology ,Adverse effect ,Interleukin 5 ,060102 archaeology ,biology ,business.industry ,06 humanities and the arts ,Benralizumab ,030228 respiratory system ,chemistry ,biology.protein ,Corticosteroid ,Antibody ,business ,Mepolizumab ,medicine.drug - Abstract
Background Anti-IL-5 antibodies represent an established therapy for severe eosinophilic asthma (SEA), but some patients show inadequate response. The objective of this study was to assess the effects of a switch to anti-IL-5Rα therapy in patients with inadequate response to anti-IL-5 therapy. Methods In this retrospective multi-centre, real-life study, we analysed all SEA patients switched from anti-IL-5 to anti-IL-5Rα therapy due to inadequate response or intolerability. Pulmonary function tests, blood gas analyses, asthma control tests (ACT) and oral corticosteroid (OCS) usage were analysed and compared at three timepoints: baseline (BL, before anti-IL-5 therapy), timepoint 1 (T1, under anti-IL-5 therapy) and timepoint 2 (T2, under anti-IL-5Rα therapy). Results Of 665 patients treated with anti-IL-5 antibodies, 70 were switched to anti-IL-5Rα and 60 were included in the analysis. Median treatment duration was 8 months [IQR 5; 15] for anti-IL-5 and 5 months [IQR 4; 6] for anti-IL-5Rα therapy. FEV1 was 61% of predicted at BL [IQR 41; 74], 61% [IQR 43; 79] at T1 and 68% [IQR 49; 87] at T2 (pT1-T2=0.011). ACT score was 10 [IQR 8; 13], 16 [IQR 10; 19] and 19 [IQR 14; 22], respectively (both p
- Published
- 2020
45. Longitudinal associations of DNA methylation and sleep in children: a meta‑analysis
- Author
-
Sammallahti, S., Koopman‑Verhoeff, M.E., Binter, A.-C., Mulder, R.H., Cabré‑Riera, A., Kvist, T., Malmberg, A.L.K., Pesce, G., Plancoulaine, S., Heiss, J.A., Rifas‐Shiman, S.L., Röder, Stefan, Starling, A.P., Wilson, R., Guerlich, K., Haftorn, K.L., Page, C.M., Luik, A.I., Tiemeier, H., Felix, J.F., Raikkonen, K., Lahti, J., Relton, C.L., Sharp, G.C., Waldenberger, M., Grote, V., Heude, B., Annesi‑Maesano, I., Hivert, M.-F., Zenclussen, Ana Claudia, Herberth, Gunda, Dabelea, D., Grazuleviciene, R., Vafeiadi, M., Håberg, S.E., London, S.J., Guxens, M., Richmond, R.C., Cecil, C.A.M., Sammallahti, S., Koopman‑Verhoeff, M.E., Binter, A.-C., Mulder, R.H., Cabré‑Riera, A., Kvist, T., Malmberg, A.L.K., Pesce, G., Plancoulaine, S., Heiss, J.A., Rifas‐Shiman, S.L., Röder, Stefan, Starling, A.P., Wilson, R., Guerlich, K., Haftorn, K.L., Page, C.M., Luik, A.I., Tiemeier, H., Felix, J.F., Raikkonen, K., Lahti, J., Relton, C.L., Sharp, G.C., Waldenberger, M., Grote, V., Heude, B., Annesi‑Maesano, I., Hivert, M.-F., Zenclussen, Ana Claudia, Herberth, Gunda, Dabelea, D., Grazuleviciene, R., Vafeiadi, M., Håberg, S.E., London, S.J., Guxens, M., Richmond, R.C., and Cecil, C.A.M.
- Abstract
Background Sleep is important for healthy functioning in children. Numerous genetic and environmental factors, from conception onwards, may influence this phenotype. Epigenetic mechanisms such as DNA methylation have been proposed to underlie variation in sleep or may be an early-life marker of sleep disturbances. We examined if DNA methylation at birth or in school age is associated with parent-reported and actigraphy-estimated sleep outcomes in children. Methods We meta-analysed epigenome-wide association study results. DNA methylation was measured from cord blood at birth in 11 cohorts and from peripheral blood in children (4–13 years) in 8 cohorts. Outcomes included parent-reported sleep duration, sleep initiation and fragmentation problems, and actigraphy-estimated sleep duration, sleep onset latency and wake-after-sleep-onset duration. Results We found no associations between DNA methylation at birth and parent-reported sleep duration (n = 3658), initiation problems (n = 2504), or fragmentation (n = 1681) (p values above cut-off 4.0 × 10–8). Lower methylation at cg24815001 and cg02753354 at birth was associated with longer actigraphy-estimated sleep duration (p = 3.31 × 10–8, n = 577) and sleep onset latency (p = 8.8 × 10–9, n = 580), respectively. DNA methylation in childhood was not cross-sectionally associated with any sleep outcomes (n = 716–2539). Conclusion DNA methylation, at birth or in childhood, was not associated with parent-reported sleep. Associations observed with objectively measured sleep outcomes could be studied further if additional data sets become available.  
- Published
- 2022
46. Pro-inflammatory diet pictured in children with atopic dermatitis or food allergy: nutritional data of the LiNA cohort
- Author
-
Schütte, Olivia, Bachmann, Larissa, Shivappa, N., Hebert, J.R., Felix, J.F., Röder, Stefan, Sack, U., Borte, M., Kiess, W., Zenclussen, Ana Claudia, Stangl, G.I., Herberth, Gunda, Junge, Kristin, Schütte, Olivia, Bachmann, Larissa, Shivappa, N., Hebert, J.R., Felix, J.F., Röder, Stefan, Sack, U., Borte, M., Kiess, W., Zenclussen, Ana Claudia, Stangl, G.I., Herberth, Gunda, and Junge, Kristin
- Abstract
Lifestyle and environmental factors are known to contribute to allergic disease development, especially very early in life. However, the link between diet composition and allergic outcomes remains unclear. In the present population-based cohort study we evaluated the dietary intake of 10-year-old children and analyses were performed with particular focus on atopic dermatitis or food allergy, allergic diseases known to be affected by dietary allergens. Dietary intake was assessed via semi-quantitative food frequency questionnaires. Based on these data, individual nutrient intake as well as children’s Dietary Inflammatory Index (C-DII TM) scores were calculated. Information about atopic manifestations during the first 10 years of life and confounding factors were obtained from standardized questionnaires during pregnancy and annually thereafter. Analyses from confounder-adjusted logistic regression models (n=211) revealed that having atopic outcomes was associated with having a pro-inflammatory pattern at the age of 10 years: OR=2.22 (95% CI: 1.14–4.31) for children with atopic dermatitis and OR=3.82 (95% CI: 1.47-9.93) for children with food allergy in the first 10 years of life. A pro-inflammatory dietary pattern might worsen the atopic outcome and reduce the buffering capacity of the individual against harmful environmental exposures or triggers. For paediatricians it is recommended to test for the individual tolerance of allergenic foods and to increase the nutrient density of tolerable food items to avoid undesirable effects of eating a pro-inflammatory diet.
- Published
- 2022
47. Sugar-containing beverage intake in toddlers and body composition up to age 6 years: the Generation R Study
- Author
-
Leermakers, E.T.M., Felix, J.F., Erler, N.S., Cerimagic, A., Wijtzes, A.I., Hofman, A., Raat, H., Moll, Ha, Rivadeneira, F., Jaddoe, V.W.V., Franco, O.H., and Kiefte-de Jong, J.C.
- Subjects
Weight gain -- Risk factors ,Body mass index -- Measurement ,Child nutrition -- Research ,Soft drinks -- Health aspects ,Food/cooking/nutrition ,Health - Abstract
BACKGROUND/OBJECTIVE: Intake of sugar-containing beverages (SCBs) has been associated with higher body mass index (BMI) in childhood. The potential effect of SCB intake during infancy is unclear. We examined the association of SCB intake at 13 months with BMI development until 6 years and body composition at age 6 years. SUBJECTS/METHODS: This study included 2371 Dutch children from a population-based prospective cohort study. SCB intake at 13 months was assessed using a Food Frequency Questionnaire with validation against 24-h recalls and was standardized for total energy. BMI was calculated from repeated weight and height measurements, and age- and sex- specific s.d. scores were calculated. Adiposity was measured using Dual-energy X-ray absorptiometry. RESULTS: In girls, higher SCB intake at 13 months was significantly associated with higher BMI at ages 2, 3, 4 and 6 years (at age 6 years BMI (s.d. score) increase 0.11 (95% confidence interval (CI) +0.00;0.23), high versus low intake). We observed a tendency towards higher android/gynoid fat ratio in girls with high intake (s.d. increase 0.14 (95% CI - 0.02;0.29), versus low intake) but not with body fat percentage. In boys, there was no association with BMI or body composition, but boys with high SCB intake at 13 months were taller at age 6 years (s.d. increase 0.14 (95% CI +0.00; 0.27), versus low intake). CONCLUSIONS: Higher SCB intake at 13 months was associated with higher BMI up to age 6 years in girls but not in boys. Our results imply that the unfavorable effects of SCB intake start early in life and that dietary advice regarding limiting SCB intake should already be given early in life. European Journal of Clinical Nutrition (2015) 69, 314-321; doi: 10.1038/ejcn.2015.2; published online 4 February 2015, INTRODUCTION The prevalence of childhood obesity has increased dramatically over the past decades. In 2010, it was estimated to be 11.7% in the developed countries. (1) Similarly, intake of sugar-containing [...]
- Published
- 2015
- Full Text
- View/download PDF
48. von Willebrand factor plasma levels, genetic variations and coronary heart disease in an older population
- Author
-
van LOON, J.E., KAVOUSI, M., LEEBEEK, F.W.G., FELIX, J.F., HOFMAN, A., WITTEMAN, J.C.M., and de MAAT, M.P.M.
- Published
- 2012
- Full Text
- View/download PDF
49. Efficacy of bronchoscopic thermal vapor ablation in patients with heterogeneous emphysema and lobar quantification by three-dimensional ventilation/perfusion single-photon emission computed tomography/computed tomography: a prospective pilot study from China
- Author
-
Zhu, Wenjun, primary, Zhang, Yuchen, additional, Herth, Felix J.F., additional, Liu, Dan, additional, Zhu, Hui, additional, Shi, Jingyu, additional, Zhang, Chujie, additional, Tang, Gongshun, additional, and Luo, Fengming, additional
- Published
- 2022
- Full Text
- View/download PDF
50. Behandlungsempfehlungen zur Beatmung von COVID‑19-Patienten
- Author
-
Felix J.F. Herth, Michael M. Müller, and B Neetz
- Subjects
Mechanical ventilation ,Gynecology ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,medicine.medical_treatment ,Medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aufgrund der Neuartigkeit der COVID‑19-Erkrankung existieren keine evidenzbasierten Empfehlungen fur die Beatmung dieser Patienten. Darstellung von Parametern, die eine individualisierte lungen- und diaphragmaprotektive Beatmung ermoglichen. Selektive Literaturrecherche und Diskussion von Expertenempfehlungen. In der aktuellen Literatur wird der Unterschied des ARDS bei COVID‑19 zum klassischen ARDS beschrieben. Evidenzbasierte Empfehlungen zum Umgang mit dieser Diskrepanz gibt es nicht. In der Vergangenheit wurden bereits Parameter und Ansatze fur eine personalisierte Beatmungsstrategie eingefuhrt und erprobt. Unter Verwendung der dargestellten Parameter ist es moglich, die Beatmung von COVID‑19-Patienten zu individualisieren, um so dem heterogenen klinischen Bild des COVID‑19-ARDS gerecht zu werden.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.