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1. Disease trajectories in interstitial lung diseases – data from the EXCITING-ILD registry

Author

Buschulte, Katharina, Kabitz, Hans-Joachim, Hagmeyer, Lars, Hammerl, Peter, Esselmann, Albert, Wiederhold, Conrad, Skowasch, Dirk, Stolpe, Christoph, Joest, Marcus, Veitshans, Stefan, Höffgen, Marc, Maqhuzu, Phillen, Schwarzkopf, Larissa, Hellmann, Andreas, Pfeifer, Michael, Behr, Jürgen, Karpavicius, Rainer, Günther, Andreas, Polke, Markus, Höger, Philipp, Somogyi, Vivien, Lederer, Christoph, Markart, Philipp, and Kreuter, Michael

Published
2024
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2. Hospitalisation patterns in interstitial lung diseases: data from the EXCITING-ILD registry

Author

Buschulte, Katharina, Kabitz, Hans-Joachim, Hagmeyer, Lars, Hammerl, Peter, Esselmann, Albert, Wiederhold, Conrad, Skowasch, Dirk, Stolpe, Christoph, Joest, Marcus, Veitshans, Stefan, Höffgen, Marc, Maqhuzu, Phillen, Schwarzkopf, Larissa, Hellmann, Andreas, Pfeifer, Michael, Behr, Jürgen, Karpavicius, Rainer, Günther, Andreas, Polke, Markus, Höger, Philipp, Somogyi, Vivien, Lederer, Christoph, Markart, Philipp, and Kreuter, Michael

Published
2024
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6. Altered fibrin clot structure and dysregulated fibrinolysis contribute to thrombosis risk in severe COVID-19

Author

Wygrecka, Malgorzata, Birnhuber, Anna, Seeliger, Benjamin, Michalick, Laura, Pak, Oleg, Schultz, Astrid-Solveig, Schramm, Fabian, Zacharias, Martin, Gorkiewicz, Gregor, David, Sascha, Welte, Tobias, Schmidt, Julius J., Weissmann, Norbert, Schermuly, Ralph T., Barreto, Guillermo, Schaefer, Liliana, Markart, Philipp, Brack, Markus C., Hippenstiel, Stefan, Kurth, Florian, Sander, Leif E., Witzenrath, Martin, Kuebler, Wolfgang M., Kwapiszewska, Grazyna, and Preissner, Klaus T.

Published
2022
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11. Erratum: Antihistone Properties of C1 Esterase Inhibitor Protect against Lung Injury

Author

Wygrecka, Malgorzata, primary, Wujak, Lukasz, additional, Markart, Philipp, additional, Kosanovic, Djuro, additional, Müller-Redetzky, Holger C., additional, Witzenrath, Martin, additional, Henneke, Ingrid, additional, Schermuly, Ralph T., additional, Seeger, Werner, additional, Schaefer, Liliana, additional, Kwapiszewska, Grazyna, additional, Marsh, Leigh M., additional, Baal, Nelli, additional, Hackstein, Holger, additional, Maat, Steven de, additional, and Maas, Coen, additional

Published
2022
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12. Covid-19 triage in the emergency department 2.0: how analytics and AI transform a human-made algorithm for the prediction of clinical pathways

Author

Bartenschlager, Christina C., Grieger, Milena, Erber, Johanna, Neidel, Tobias, Borgmann, Stefan, Vehreschild, Jörg J., Steinbrecher, Markus, Rieg, Siegbert, Stecher, Melanie, Dhillon, Christine, Ruethrich, Maria M., Jakob, Carolin E. M., Hower, Martin, Heller, Axel R., Vehreschild, Maria, Wyen, Christoph, Messmann, Helmut, Piepel, Christiane, Brunner, Jens O., Hanses, Frank, Römmele, Christoph, Spinner, Christoph, Ruethrich, Maria Madeleine, Lanznaster, Julia, Wille, Kai, Tometten, Lukas, Dolff, Sebastian, von Bergwelt-Baildon, Michael, Merle, Uta, Rothfuss, Katja, Isberner, Nora, Jung, Norma, Göpel, Siri, vom Dahl, Juergen, Degenhardt, Christian, Strauss, Richard, Gruener, Beate, Eberwein, Lukas, Hellwig, Kerstin, Rauschning, Dominic, Neufang, Mark, Westhoff, Timm, Raichle, Claudia, Akova, Murat, Jensen, Bjoern-Erik, Schubert, Joerg, Grunwald, Stephan, Friedrichs, Anette, Trauth, Janina, de With, Katja, Guggemos, Wolfgang, Kielstein, Jan, Heigener, David, Markart, Philipp, Bals, Robert, Stieglitz, Sven, Voigt, Ingo, Taubel, Jorg, and Milovanovic, Milena

Subjects
ddc:610
Abstract

The Covid-19 pandemic has pushed many hospitals to their capacity limits. Therefore, a triage of patients has been discussed controversially primarily through an ethical perspective. The term triage contains many aspects such as urgency of treatment, severity of the disease and pre-existing conditions, access to critical care, or the classification of patients regarding subsequent clinical pathways starting from the emergency department. The determination of the pathways is important not only for patient care, but also for capacity planning in hospitals. We examine the performance of a human-made triage algorithm for clinical pathways which is considered a guideline for emergency departments in Germany based on a large multicenter dataset with over 4,000 European Covid-19 patients from the LEOSS registry. We find an accuracy of 28 percent and approximately 15 percent sensitivity for the ward class. The results serve as a benchmark for our extensions including an additional category of palliative care as a new label, analytics, AI, XAI, and interactive techniques. We find significant potential of analytics and AI in Covid-19 triage regarding accuracy, sensitivity, and other performance metrics whilst our interactive human-AI algorithm shows superior performance with approximately 73 percent accuracy and up to 76 percent sensitivity. The results are independent of the data preparation process regarding the imputation of missing values or grouping of comorbidities. In addition, we find that the consideration of an additional label palliative care does not improve the results.

Published
2023

13. Consensus guideline on the interdisciplinary diagnosis of interstitial lung diseases

Author

Kreuter, Michael, Behr, Jürgen, Bonella, Francesco, Costabel, Ulrich, Gerber, Alexander, Hamer, Okka W., Heussel, Claus Peter, Jonigk, Danny, Krause, Andreas, Koschel, Dirk, Leuschner, Gabriela, Markart, Philipp, Nowak, Dennis, Pfeifer, Michael, Wälscher, Julia, Prasse, Antje, Winter, Hauke, Kabitz, Hans-Joachim, and Publica

Subjects
Pulmonary and Respiratory Medicine, Medizin
Abstract

ZusammenfassungDie Beurteilung von Patienten mit v. a. einer interstitiellen Lungenerkrankung (ILD) umfasst die Beurteilung klinischer, radiologischer und oft histopathologischer Daten. Da bislang noch keine dezidierten Empfehlungen für die Evaluation bei Verdacht auf eine ILD in Deutschland existierten, war es Ziel dieses interdisziplinären Konsensusstatements, eine praktische Orientierungshilfe für den klinischen Alltag in Bezug auf die interdisziplinäre Diagnostik der ILDs zu geben. Dazu gehören die umfassende klinisch-pneumologische und in vielen Fällen auch eine rheumatologische Beurteilung, radiologische Diagnostik sowie Probenentnahme zur histopathologischen Evaluation sowie die abschließende Diskussion im multidisziplinären Team.

Published
2023

17. Costs of Pharmacological and Non-Pharmacological Interventions in Interstitial Lung Disease Management in Germany.

Author

Maqhuzu, Phillen Nozibuyiso, Schwarzkopf, Larissa, Markart, Philipp, Behr, Juergen, Holle, Rolf, Leidl, Reiner, and Kreuter, Michael

Subjects
RESEARCH, SCIENTIFIC observation, IDIOPATHIC pulmonary fibrosis, SARCOIDOSIS, PHYSICAL therapy, HYPERSENSITIVITY pneumonitis, INTERSTITIAL lung diseases, MEDICAL care costs, REGRESSION analysis, COMPARATIVE studies, TREATMENT effectiveness, HOSPITAL care, COST analysis, OUTPATIENT services in hospitals
Abstract

Introduction: Interstitial lung diseases (ILDs) are associated with a high economic burden, yet prospective data of the German healthcare system are sparse. Objective: We assessed average ILD-related costs of pharmacological and non-pharmacological (hospitalizations, outpatient, rehabilitation, physiotherapy, and medical aids) interventions in ILD. Methods: We used data from the multicenter, observational, prospective Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases registry to evaluate adjusted per capita costs and cost drivers for ILD-related healthcare costs over 4 years, using generalized estimating equation regression models. Results: Idiopathic pulmonary fibrosis (IPF) had the highest annual pharmacological costs >EUR 21,000, followed by connective tissue disease-associated ILD (CTD-ILD) averaging EUR 6,000. Other idiopathic interstitial pneumonias and hypersensitivity pneumonitis averaged below EUR 2,400 and sarcoidosis below EUR 400. There were no significant differences in pharmacological costs over time. Trends in non-pharmacological costs were statistically significant. At year 1, CTD-ILD had the highest costs (EUR 7,700), while sarcoidosis had the lowest (EUR 2,547). By year 4, these declined to EUR 3,218 and EUR 232, respectively. Regarding cost drivers, the ILD subtype had the greatest impact with 75 times higher pharmacological costs in IPF and 4 times higher non-pharmacological costs in CTD-ILD, compared to the reference. Pulmonary hypertension (PH) and gastroesophageal reflux disease (GERD) triggered higher pharmacological costs, and higher values of forced vital capacity % predicted were associated with lower pharmacological and non-pharmacological costs. Conclusion: Stabilizing lung function and reducing the impact of PH and GERD are crucial in reducing the economic burden of ILD. There is an urgent need for effective treatment options, especially in CTD-ILD. [ABSTRACT FROM AUTHOR]

Published
2022
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18. Neurological symptoms and complications in predominantly hospitalized COVID-19 patients: Results of the European multinational Lean European Open Survey on SARS-Infected Patients (LEOSS)

Author

Kleineberg, Nina N., Knauss, Samuel, Gülke, Eileen, Pinnschmidt, Hans O., Jakob, Carolin E. M., Lingor, Paul, Hellwig, Kerstin, Berthele, Achim, Höglinger, Günter, Fink, Gereon R., Endres, Matthias, Gerloff, Christian, Klein, Christine, Stecher, Melanie, Classen, Annika Y., Rieg, Siegbert, Borgmann, Stefan, Hanses, Frank, Haselberger, Martina, Merle, Uta, Dolff, Sebastian, Degenhardt, Christian, Jensen, Björn-Erik O., Vehreschild, Maria J. G. T., Erber, Johanna, Franke, Christiana, Warnke, Clemens, Spinner, Christoph, Lanzster, Julia, Jensen, Björn, Vehreschild, Maria, Hower, Martin, Rüthrich, Maria Madeleine, Rothfuss, Katja, Piepel, Christiane, Wyen, Christopf, Römmele, Christoph, Eberwein, Lukas, Käding, Kadja, Wille, Kai, Haake, Hendrik, Voigt, Ingo, Tometten, Lukas, Neufang, Mark, Jung, Norma, Schultheis, Beate, Raichle, Claudia, von Bergwelt-Baildon, Michael, Göpel, Siri, Strauß, Richard, Rauschning, Dominic, Isberner, Nora, Walter, Lorenz, Milovanovic, Mile, D'Hooghe, Marie, Grunwald, Stephan, Akova, Murat, Markart, Philipp, Grüner, Beate, Kielstein, Jan, Guggemos, Wolfgang, Trauth, Janina, Heigener, David, Beutel, Gernot, Gramatniece, Alise, de With, Katja, Bals, Robert, Friedrichs, Anette, Röseler, Stefani, Müller-Jörger, Gabriele, Ritter, Annika, Vehreschild, Jörg Janne, Pilgram, Lisa, Schons, Max, de Miranda, Susana Nunes, Schulze, Nick, Fuhrmann, Sandra, Claßen, Annika, Franke, Bernd, Praßer, Fabian, Lablans, Martin, and LEOSS Study Group

Subjects
medicine.medical_specialty, Nausea, medicine.medical_treatment, Medizin, Disease, SARS‐CoV‐2, COVID‐19, Internal medicine, medicine, Extracorporeal membrane oxygenation, Humans, Clinical significance, ddc:610, Stroke, business.industry, SARS-CoV-2, Headache, COVID-19, Neurodegenerative Diseases, Odds ratio, Original Articles, medicine.disease, Neurology, neurological manifestations, Delirium, Original Article, Neurology (clinical), medicine.symptom, Complication, business
Abstract

Background and purpose During acute coronavirus disease 2019 (COVID‐19) infection, neurological signs, symptoms and complications occur. We aimed to assess their clinical relevance by evaluating real‐world data from a multinational registry. Methods We analyzed COVID‐19 patients from 127 centers, diagnosed between January 2020 and February 2021, and registered in the European multinational LEOSS (Lean European Open Survey on SARS‐Infected Patients) registry. The effects of prior neurological diseases and the effect of neurological symptoms on outcome were studied using multivariate logistic regression. Results A total of 6537 COVID‐19 patients (97.7% PCR‐confirmed) were analyzed, of whom 92.1% were hospitalized and 14.7% died. Commonly, excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%) were reported. In patients with a complicated or critical disease course (53%) the most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (ICB; 2.2%). ICB peaked in the critical disease phase (5%) and was associated with the administration of anticoagulation and extracorporeal membrane oxygenation (ECMO). Excessive tiredness (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.20–1.68) and prior neurodegenerative diseases (OR 1.32, 95% CI 1.07–1.63) were associated with an increased risk of an unfavorable outcome. Prior cerebrovascular and neuroimmunological diseases were not associated with an unfavorable short‐term outcome of COVID‐19. Conclusion Our data on mostly hospitalized COVID‐19 patients show that excessive tiredness or prior neurodegenerative disease at first presentation increase the risk of an unfavorable short‐term outcome. ICB in critical COVID‐19 was associated with therapeutic interventions, such as anticoagulation and ECMO, and thus may be an indirect complication of a life‐threatening systemic viral infection., We retrospectively analyzed data from 6537 predominantly hospitalized COVID‐19 patients registered in the European multinational Lean European Open Survey on SARS‐Infected Patients (LEOSS) registry between January 2020 and February 2021. Common neurological symptoms were excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%). Most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (2.2%) in patients with a complicated or critical disease course. Excessive tiredness (odds ratio [OR] 1.42) and prior neurodegenerative disease (OR 1.32) were associated with an increased risk of an unfavorable outcome.

Published
2021

20. Altered fibrin clot structure contributes to thrombosis risk in severe COVID-19

Author

Wygrecka, Malgorzata, primary, Birnhuber, Anna, additional, Seeliger, Benjamin, additional, Michalick, Laura, additional, Pak, Oleg, additional, Schultz, Astrid-Solveig, additional, Schramm, Fabian, additional, Zacharias, Martin, additional, Gorkiewicz, Gregor, additional, David, Sascha, additional, Welte, Tobias, additional, Schmidt, Julius J., additional, Weissmann, Norbert, additional, Schermuly, Ralph T, additional, Barreto, Guillermo, additional, Schäfer, Liliana, additional, Markart, Philipp, additional, Brack, Markus C., additional, Hippenstiel, Stefan, additional, Kurth, Florian, additional, Sander, Leif E, additional, Witzenrath, Martin, additional, Kuebler, Wolfgang M., additional, Kwapiszewska, Grazyna, additional, and Preissner, Klaus T, additional

Published
2021
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21. Outcomes of patients with progressive fibrosing interstitial lung disease (PF-ILD) – data from a prospective ILD registry

Author

Kreuter, Michael, primary, Kabitz, Hans-Joachim, additional, Hagmeyer, Lars, additional, Hammerl, Peter, additional, Esselmann, Albert, additional, Wiederhold, Conrad, additional, Skowasch, Dirk, additional, Stolpe, Christoph, additional, Joest, Marcus, additional, Veitshans, Stefan, additional, Höffgen, Marc, additional, Maqhuzu, Phillen, additional, Schwarzkopf, Larisa, additional, Hellmann, Andreas, additional, Pfeifer, Michael, additional, Behr, Jürgen, additional, Karpavicius, Rainer, additional, Günther, Andreas, additional, Herth, Felix J. F., additional, and Markart, Philipp, additional

Published
2021
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27. Surfactant alteration and replacement in acute respiratory distress syndrome

Author

Walmrath Dieter, Grimminger Friedrich, Markart Philipp, Schmidt Reinhold, Ruppert Clemens, Günther Andreas, and Seeger Werner

Subjects
acute lung injury, ARDS, pulmonary surfactant, surfactant replacement, Diseases of the respiratory system, RC705-779
Abstract

Abstract The acute respiratory distress syndrome (ARDS) is a frequent, life-threatening disease in which a marked increase in alveolar surface tension has been repeatedly observed. It is caused by factors including a lack of surface-active compounds, changes in the phospholipid, fatty acid, neutral lipid, and surfactant apoprotein composition, imbalance of the extracellular surfactant subtype distribution, inhibition of surfactant function by plasma protein leakage, incorporation of surfactant phospholipids and apoproteins into polymerizing fibrin, and damage/inhibition of surfactant compounds by inflammatory mediators. There is now good evidence that these surfactant abnormalities promote alveolar instability and collapse and, consequently, loss of compliance and the profound gas exchange abnormalities seen in ARDS. An acute improvement of gas exchange properties together with a far-reaching restoration of surfactant properties was encountered in recently performed pilot studies. Here we summarize what is known about the kind and severity of surfactant changes occuring in ARDS, the contribution of these changes to lung failure, and the role of surfactant administration for therapy of ARDS.

Published
2001
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30. S2K Guideline for Diagnosis of Idiopathic Pulmonary Fibrosis

Author

Behr, Jürgen, primary, Günther, Andreas, additional, Bonella, Francesco, additional, Dinkel, Julien, additional, Fink, Ludger, additional, Geiser, Thomas, additional, Geissler, Klaus, additional, Gläser, Sven, additional, Handzhiev, Sabin, additional, Jonigk, Danny, additional, Koschel, Dirk, additional, Kreuter, Michael, additional, Leuschner, Gabriela, additional, Markart, Philipp, additional, Prasse, Antje, additional, Schönfeld, Nicolas, additional, Schupp, Jonas Christian, additional, Sitter, Helmut, additional, Müller-Quernheim, Joachim, additional, and Costabel, Ulrich, additional

Published
2021
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32. Sex-specific Effect and Disconnect Between Plasma Levels of FXII and FXIIa-C1-esterase Inhibitor Complexes in Pneumonia

Author

Ehrlich, Kristin, primary, Wilhelm, Jochen, additional, Wolff, Jens-Christian, additional, Markart, Philipp, additional, Bein, Gregor, additional, Pak, Oleg, additional, Barreto, Guillermo, additional, Weissmann, Norbert, additional, Seeger, Werner, additional, Schaefer, Liliana, additional, Kuebler, Wolfgang, additional, and Wygrecka, Malgorzata, additional

Published
2020
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36. Fibrinolysis-inhibitory capacity of clot-embedded surfactant is enhanced by SP-B and SP-C

Author

Markart, Philipp, Ruppert, Clemens, Grimminger, Friedrich, Seeger, Werner, and Gunther, Andreas

Subjects
Acute respiratory distress syndrome -- Physiological aspects, Fibrin -- Physiological aspects, Biological sciences
Abstract

Incorporation of pulmonary surfactant into fibrin inhibits its plasmic degradation. In the present study we investigated the influence of surfactant proteins (SP)-A, SP-B, and SP-C on the fibrinolysis-inhibitory capacity of surfactant phospholipids. Plasmin-induced fibrinolysis was quantifed by means of a [sup.125]I-fibrin plate assay, and surfactant incorporation into polymerizing fibrin was analyzed by measuring the incorporation of [sup.3]H-labeled L-[alpha]-dipalmitoylphosphatidylcholine into the insoluble clot material. Incorporation of a calf lung surfactant extract (Alveofact) and an organic extract of natural rabbit large surfactant aggregates (LSA) into a fibrin clot revealed a stronger inhibitory effect on plasmic cleavage of this clot than a synthetic phospholipid mixture (PLX) and unprocessed LSA. Reconstitution of PLX with SP-B and SP-C increased, whereas reconstitution with SP-A decreased, the fibrinolysis-inhibitory capacity of the phospholipids. The SP-B effect was paralleled by an increased incorporation of phospholipids into fibrin. We conclude that the inhibitory effect of surfactant incorporation into polymerizing fibrin on its susceptibility to plasmic cleavage is enhanced by SP-B and SP-C but reduced by SP-A. In the case of SP-B, increased phospholipid incorporation may underlie this finding. hyaline membrane; coagulation; pulmonary surfactant; surfactant protein; acute respiratory distress syndrome; fibrosis

Published
2003

43. Loss of LRP1 promotes acquisition of contractile-myofibroblast phenotype and release of active TGF-β1 from ECM stores

Author

Schnieder, Jennifer, primary, Mamazhakypov, Argen, additional, Birnhuber, Anna, additional, Wilhelm, Jochen, additional, Kwapiszewska, Grazyna, additional, Ruppert, Clemens, additional, Markart, Philipp, additional, Wujak, Lukasz, additional, Rubio, Karla, additional, Barreto, Guillermo, additional, Schaefer, Liliana, additional, and Wygrecka, Malgorzata, additional

Published
2020
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48. Treatment and survival diversities in different forms of ILD in Germany - EXCITING registry

Author

Kreuter, Michael, primary, Kabitz, Hans-Joachim, additional, Hagmeyer, Lars, additional, Hammerl, Peter, additional, Esselmann, Albert, additional, Wiederhold, Conrad, additional, Skowasch, Dirk, additional, Stolpe, Christoph, additional, Joest, Marcus, additional, Veitshans, Stefan, additional, Maqhuzu, Phillen, additional, Schwarzkopf, Larissa, additional, Hellmann, Andreas, additional, Pfeifer, Michael, additional, Behr, Jürgen, additional, Kauschka, Dagmar, additional, Günther, Andreas, additional, Herth, Felix J. F., additional, and Markart, Philipp, additional

Published
2019
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