77 results on '"Roehle R"'
Search Results
2. Evaluation einer möglichen ambulant operativen Versorgung von Mammakarzinomen aus Betroffenensicht
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Ertürk, E, additional, Roehle, R, additional, Blohmer, J-U, additional, and Karsten, MM, additional
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- 2022
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3. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography
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Feger, S., Rief, M., Zimmermann, E., Richter, F., Roehle, R., Dewey, M., and Schönenberger, E.
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- 2015
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4. Discordance between estimated and measured changes in plasma volume among patients with acute heart failure
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Swolinsky, J.S., Tuvshinbat, E., Leistner, D.M., Edelmann, F., Knebel, F., Nerger, N.P., Lemke, C., Roehle, R., Haase, M., Costanzo, M.R., Rauch, G., Mitrovic, V., Gasanin, E., Meier, D., McCullough, P.A., Eckardt, K.U., Molitoris, B.A., and Schmidt-Ott, K.M.
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Cardiovascular and Metabolic Diseases ,sense organs ,skin and connective tissue diseases - Abstract
AIMS: In acute heart failure (AHF), changes of venous haemoglobin (Hb) concentrations, haematocrit (Hct), and estimated plasma volume (ePV) have been proposed as surrogates of decongestion. These estimates are based on the theoretical assumptions that changes of Hb concentrations and Hct are driven by the intravascular volume status and that the intravascular Hb pool remains stable. The objective of this study was to assess the relationship of changes of measured plasma volume (mPV) with changes of Hb, Hct, and ePV in AHF. METHODS AND RESULTS: We studied 36 AHF patients, who received two sequential assessments of mPV, measured red cell volume (mRCV) and measured total blood volume (mTBV) (48 h apart), during the course of diuretic therapy using a novel visible fluorescent injectate (VFI) technique based on the indicator dilution principle. Changes of ePV were calculated based on the Kaplan–Hakim or Strauss formula. AHF patients receiving diuretics (median intravenous furosemide equivalent 160 mg/48 h) displayed a wide range of changes of mPV (−25.4% to +37.0%). Changes in mPV were not significantly correlated with changes of Hb concentration [Pearson's r (r) = −0.241, P = 0.157], Hct (r = −0.307, P = 0.069), ePVKaplan–Hakim (r = 0.228, P = 0.182), or ePVStrauss (r = 0.237, P = 0.163). In contrast to theoretical assumptions, changes of mTBV were poorly correlated with changes of Hb concentrations and some patients displayed unanticipated variability of mRCV, suggesting an unstable intravascular red cell pool. CONCLUSIONS: Changes of Hb or Hct were not reflective of directly measured changes of intravascular volume status in AHF patients. Basing clinical assessment of decongestion on changes of Hb or Hct may misguide clinical decision-making on an individual patient level.
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- 2022
5. Serum creatinine and cystatin C-based estimates of glomerular filtration rate are misleading in acute heart failure
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Swolinsky, J.S., Nerger, N.P., Leistner, D.M., Edelmann, F., Knebel, F., Tuvshinbat, E., Lemke, C., Roehle, R., Haase, M., Costanzo, M.R., Rauch, G., Mitrovic, V., Gasanin, E., Meier, D., McCullough, P.A., Eckardt, K.U., Molitoris, B.A., and Schmidt-Ott, K.M.
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Cardiovascular and Metabolic Diseases ,urologic and male genital diseases - Abstract
AIMS: We aimed to test whether the endogenous filtration markers serum creatinine or cystatin C and equation-based estimates of glomerular filtration rate (GFR) based on these markers appropriately reflect changes of measured GFR in patients with acute heart failure. METHODS: In this prospective cohort study of 50 hospitalized acute heart failure patients undergoing decongestive therapy, we applied an intravenous visible fluorescent injectate (VFI), consisting of a low molecular weight component to measure GFR and a high molecular weight component to correct for measured plasma volume. Thirty-eight patients had two sequential GFR measurements 48 h apart. The co-primary endpoints of the study were safety of VFI and plasma stability of the high molecular weight component. A key secondary endpoint was to compare changes in measured GFR (mGFR) to changes of serum creatinine, cystatin C and estimated GFR. RESULTS: VFI-based GFR measurements were safe and consistent with plasma stability of the high molecular weight component and glomerular filtration of the low molecular weight component. Filtration marker-based point estimates of GFR, when compared with mGFR, provided only moderate correlation (Pearson's r, range 0.80-0.88, depending on equation used), precision (r(2) , range 0.65-0.78) and accuracy (56%-74% of estimates scored within 30% of mGFR). Correlations of 48-h changes GFR estimates and changes of mGFR were significant (P < 0.05) but weak (Pearson's r, range 0.35-0.39). Observed decreases of eGFR by more than 15% had a low sensitivity (range 38%-46%, depending on equation used) in detecting true worsening mGFR, defined by a >15% decrease in mGFR. CONCLUSIONS: In patients hospitalized for acute heart failure, serum creatinine- and cystatin C-based predictions performed poorly in detecting actual changes of GFR. These data challenge current clinical strategies to evaluate dynamics of kidney function in acute heart failure.
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- 2021
6. Notfallchirurgie des blutenden Ulcus duodeni mit organerhaltender Technik und 'erweiterter' selektiver Vagotomie
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Bull, P. G., Fortelny, R., Roehle, R., Kreuzer, W., and Hartel, W., editor
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- 1994
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7. Mental health of a large group of adults with disorders of sex development in six European countries
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De Vries ALC, Roehle R, Marshall L, Frisen L, van de Grift TC, Kreukels BPC, Bouvattier C, Kohler B, Thyen U, Nordenstrom A, Rapp M, Cohen-Kettenis PT, and dsd-LIFE Group
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medicine.medical_specialty ,business.industry ,medicine ,Disorders of sex development ,Large group ,medicine.disease ,business ,Psychiatry ,Mental health - Published
- 2020
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8. POS-055 ESTIMATED VERSUS MEASURED GLOMERULAR FILTRATION RATE IN ACUTE DECOMPENSATED HEART FAILURE
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SWOLINSKY, J., primary, Nerger, N., additional, Leistner, D.M., additional, Edelmann, F., additional, Knebel, F., additional, Tuvshinbat, E., additional, Lemke, C., additional, Roehle, R., additional, Rauch, G., additional, Mitrovic, V., additional, Gasanin, E., additional, Meier, D., additional, McCullough, P.A., additional, Eckardt, K.U., additional, Molitoris, B.A., additional, and Schmidt-Ott, K., additional
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- 2021
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9. A pilot study evaluating the effects of Magtrace for sentinel biopsy regarding care process optimization, reimbursement, surgical time and patient comfort compared to standard Technetium
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Shams, S, additional, Lippold, K, additional, Roehle, R, additional, Paepke, S, additional, Blohmer, JU, additional, and Karsten, MM, additional
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- 2020
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10. Hypoxia mediates the inflammation in human adipose tissue: O14–06
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Rega, G, Kaun, C, Demyanets, S, Hohensinner, P J, Enserer, C, Roehle, R, Maurer, G, Huber, K, and Wojta, J
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- 2008
11. Relevance of age and preoperative risk in laparoscopic colorectal surgery
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Thaler, K., Roehle, R., and Kreuzer, W.
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- 2000
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12. 109P Routine collection of patient-reported outcomes: Impact of breast cancer therapies on body image
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Afshar-Bakshloo, M., Albers, S., Berninger, O., Richter, C., Röhle, R., Hage, A.M., and Karsten, M.M.
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- 2022
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13. Applicability and accuracy of pretest probability calculations implemented in the NICE clinical guideline for decision making about imaging in patients with chest pain of recent onset (vol 28, pg 4006, 2018)
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Roehle, R., Wieske, V., Schuetz, G.M., Gueret, P., Andreini, D., Meijboom, W.B., Pontone, G., Garcia, M., Alkadhi, H., Honoris, L., Hausleiter, J., Bettencourt, N., Zimmermann, E., Leschka, S., Gerber, B., Rochitte, C., Schoepf, U.J., Shabestari, A.A., Norgaard, B., Sato, A., Knuuti, J., Meijs, M.F.L., Brodoefel, H., Jenkins, S.M.M., Ovrehus, K.A., Diederichsen, A.C.P., Hamdan, A., Halvorsen, B.A., Rodriguez, V.M., Wan, Y.L., Rixe, J., Sheikh, M., Langer, C., Ghostine, S., Martuscelli, E., Niinuma, H., Scholte, A., Nikolaou, K., Ulimoen, G., Zhang, Z.Q., Mickley, H., Nieman, K., Kaufmann, P.A., Buechel, R.R., Herzog, B.A., Clouse, M., Halon, D.A., Leipsic, J., Bush, D., Jakamy, R., Sun, K., Yang, L., Johnson, T., Laissy, J.P., Marcus, R., Muraglia, S., Tardif, J.C., Chow, B., Paul, N., Maintz, D., Hoe, J., Roos, A. de, Haase, R., Laule, M., Schlattmann, P., and Dewey, M.
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- 2018
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14. Stellenwert der interdisziplinären Chirurgie beim organüberschreitendem Eingriff im Bereiche des kleinen Beckens
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Kreuzer, W., primary, Fortelny, R., additional, and Roehle, R., additional
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- 1992
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15. Correction to: Applicability and accuracy of pretest probability calculations implemented in the NICE clinical guideline for decision making about imaging in patients with chest pain of recent onset (European Radiology, (2018), 28, 9, (4006-4017), 10.1007/s00330-018-5322-5)
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Roehle, R, Wieske, V, Schuetz, Gm, Gueret, P, Andreini, D, Meijboom, Wb, Pontone, G, Garcia, M, Alkadhi, H, Honoris, L, Hausleiter, J, Bettencourt, N, Zimmermann, E, Leschka, S, Gerber, B, Rochitte, C, Schoepf, Uj, Shabestari, Aa, Norgaard, B, Sato, A, Knuuti, J, Meijs, Mfl, Brodoefel, H, Jenkins, Smm, Ovrehus, Ka, Diederichsen, Acp, Hamdan, A, Halvorsen, Ba, Rodriguez, Vm, Wan, Yl, Rixe, J, Sheikh, M, Langer, C, Ghostine, S, Martuscelli, E, Niinuma, H, Scholte, A, Nikolaou, K, Ulimoen, G, Zhang, Z, Mickley, H, Nieman, K, Kaufmann, Pa, Buechel, Rr, Herzog, Ba, Clouse, M, Halon, Da, Leipsic, J, Bush, D, Jakamy, R, Sun, K, Yang, L, Johnson, T, Laissy, J, Marcus, R, Muraglia, S, Tardif, J, Chow, B, Paul, N, Maintz, D, Hoe, J, de Roos, A, Haase, R, Laule, M, Schlattmann, P, and Dewey, M
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cardiac CT ,Settore MED/11 - Malattie dell'Apparato Cardiovascolare - Published
- 2018
16. Sex/Gender and age differences in health behavior of employees participating and not participating in work health promotion measures in the German Federal Armed Forces - a cross-sectional study
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Ludwig, S, Reinhold, T, Roehle, R, Dickob, C, Bauer, M D, Hauck, M, Ucar, J, Arnold, L, Willich, S N, Seeland, U, and Roy, R
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- 2024
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17. Disease distribution disaggregated by sex and age in employees of the german federal armed forces to improve workplace health promotion measures
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Seeland, U, Roy, R, Roehle, R, Dickob, C, Bauer, M D, Ucar, J, Hauck, M, Arnold, L, Willich, S, Reinhold, T, and Ludwig, S
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- 2024
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18. Health status in 1040 adults with disorders of sex development (DSD): a European multicenter study
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Falhammar, H., Claahsen-van der Grinten, H.L., Reisch, N., Slowikowska-Hilczer, J., Nordenstrom, A., Roehle, R., Bouvattier, C., Kreukels, B.P., Köhler, B., Falhammar, H., Claahsen-van der Grinten, H.L., Reisch, N., Slowikowska-Hilczer, J., Nordenstrom, A., Roehle, R., Bouvattier, C., Kreukels, B.P., and Köhler, B.
- Abstract
Contains fulltext : 190440.pdf (publisher's version ) (Open Access)
- Published
- 2018
19. P1733Coronary sinus signal amplitude predicts left atrial scarring
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Attanasio, PJ., primary, Qaiyumi, D., additional, Roehle, R., additional, Wutzler, A., additional, Safak, E., additional, Muntean, B., additional, Boldt, LH., additional, Pieske, B., additional, Haverkamp, W., additional, and Huemer, M., additional
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- 2017
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20. Vascular Endothelial Growth Factor Is Induced by the Inflammatory Cytokines Interleukin-6 and Oncostatin M in Human Adipose Tissue In Vitro and in Murine Adipose Tissue In Vivo
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Rega, G., primary, Kaun, C., additional, Demyanets, S., additional, Pfaffenberger, S., additional, Rychli, K., additional, Hohensinner, P.J., additional, Kastl, S.P., additional, Speidl, W.S., additional, Weiss, T.W., additional, Breuss, J.M., additional, Furnkranz, A., additional, Uhrin, P., additional, Zaujec, J., additional, Zilberfarb, V., additional, Frey, M., additional, Roehle, R., additional, Maurer, G., additional, Huber, K., additional, and Wojta, J., additional
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- 2007
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21. Inflammatory Cytokines Interleukin-6 and Oncostatin M Induce Plasminogen Activator Inhibitor-1 in Human Adipose Tissue
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Rega, G., primary, Kaun, C., additional, Weiss, T.W., additional, Demyanets, S., additional, Zorn, G., additional, Kastl, S.P., additional, Steiner, S., additional, Seidinger, D., additional, Kopp, C.W., additional, Frey, M., additional, Roehle, R., additional, Maurer, G., additional, Huber, K., additional, and Wojta, J., additional
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- 2005
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22. Relevance of Age and Preoperative Risk in Laparoscopic Colorectal Surgery
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Thaler, K., primary, Roehle, R., additional, and Kreuzer, W., additional
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- 2000
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23. Inflammatory cytokines interleukin-6 and oncostatin M increase vascular endothelial growth factor in human adipose tissue
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Rega, G., Christoph Kaun, Weiss, T., Hohensinner, P., Demyanets, S., Roehle, R., Frey, M., Maurer, G., Huber, K., and Wojta, J.
24. Vascular endothelial growth factor is increased by inflammatory cytokines interleukin-6 and oncostatin M in human adipose tissue-derived stem cells
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Rega, G., Kaun, C., Weiss, T., Hohensinner, P., Demyanets, S., Roehle, R., Frey, M., Maurer, G., Huber, K., and Johann Wojta
25. Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography: protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT)
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Schuetz Georg M, Schlattmann Peter, Achenbach Stephan, Budoff Matthew, Garcia Mario J, Roehle Robert, Pontone Gianluca, Meijboom Willem Bob, Andreini Daniele, Alkadhi Hatem, Honoris Lily, Bettencourt Nuno, Hausleiter Jörg, Leschka Sebastian, Gerber Bernhard L, Meijs Matthijs FL, Shabestari Abbas Arjmand, Sato Akira, Zimmermann Elke, Schoepf Uwe J, Diederichsen Axel, Halon David A, Mendoza-Rodriguez Vladimir, Hamdan Ashraf, Nørgaard Bjarne L, Brodoefel Harald, Øvrehus Kristian A, Jenkins Shona MM, Halvorsen Bjørn A, Rixe Johannes, Sheikh Mehraj, Langer Christoph, Martuscelli Eugenio, Romagnoli Andrea, Scholte Arthur JHA, Marcus Roy P, Ulimoen Geir R, Nieman Koen, Mickley Hans, Nikolaou Konstantin, Tardif Jean-Claude, Johnson Thorsten RC, Muraglia Simone, Chow Benjamin JW, Maintz David, Laule Michael, and Dewey Marc
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Collaborative meta-analysis on cardiac CT ,CoMe-CCT ,Coronary CT angiography ,Individual patient data meta-analysis ,IPD ,Positive and negative predictive value ,Pretest likelihood ,Sensitivity and specificity ,Study protocol ,Medicine - Abstract
Abstract Background Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography. To do this, a test should have, at clinically appropriate pretest likelihoods, minimal false-negative outcomes resulting in a high negative predictive value. However, little is known about the influence of patient characteristics on the clinical predictive values of coronary computed tomography angiography. Previous regular systematic reviews and meta-analyses had to rely on limited summary patient cohort data offered by primary studies. Performing an individual patient data meta-analysis will enable a much more detailed and powerful analysis and thus increase representativeness and generalizability of the results. The individual patient data meta-analysis is registered with the PROSPERO database (CoMe-CCT, CRD42012002780). Methods/Design The analysis will include individual patient data from published and unpublished prospective diagnostic accuracy studies comparing coronary computed tomography angiography with conventional coronary angiography. These studies will be identified performing a systematic search in several electronic databases. Corresponding authors will be contacted and asked to provide obligatory and additional data. Risk factors, previous test results and symptoms of individual patients will be used to estimate the pretest likelihood of coronary artery disease. A bivariate random-effects model will be used to calculate pooled mean negative and positive predictive values as well as sensitivity and specificity. The primary outcome of interest will be positive and negative predictive values of coronary computed tomography angiography for the presence of coronary artery disease as a function of pretest likelihood of coronary artery disease, analyzed by meta-regression. As a secondary endpoint, factors that may influence the diagnostic performance and clinical value of computed tomography, such as heart rate and body mass index of patients, number of detector rows, and administration of beta blockade and nitroglycerin, will be investigated by integrating them as further covariates into the bivariate random-effects model. Discussion This collaborative individual patient data meta-analysis should provide answers to the pivotal question of which patients benefit most from noninvasive coronary computed tomography angiography and thus help to adequately select the right patients for this test.
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- 2013
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26. Correction: Suitability and safety of L-5-methyltetrahydrofolate as a folate source in infant formula: A randomized-controlled trial.
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Troesch B, Demmelmair J, Gimpfl M, Hecht C, Lakovic G, Roehle R, Sipka L, Trisic B, Vusurovic M, Schoop R, Zdjelar S, and Koletzko B
- Abstract
[This corrects the article DOI: 10.1371/journal.pone.0216790.]., (Copyright: © 2024 Troesch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2024
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27. Longitudinal assessment of real-world patient adherence: a 12-month electronic patient-reported outcomes follow-up of women with early breast cancer undergoing treatment.
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Gebert P, Hage AM, Blohmer JU, Roehle R, and Karsten MM
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- Humans, Female, Middle Aged, Longitudinal Studies, Aged, Prospective Studies, Adult, Follow-Up Studies, Carcinoma, Intraductal, Noninfiltrating therapy, Carcinoma, Intraductal, Noninfiltrating psychology, Carcinoma, Intraductal, Noninfiltrating drug therapy, COVID-19, Breast Neoplasms drug therapy, Breast Neoplasms psychology, Breast Neoplasms therapy, Patient Reported Outcome Measures, Patient Compliance statistics & numerical data, Quality of Life
- Abstract
Background: Electronic patient-reported outcomes (ePROs) assess patients' health status and quality of life, improving patient care and treatment effects, yet little is known about their use and adherence in routine patient care., Aims: We evaluated the adherence of invasive breast cancer and ductal carcinoma in situ (DCIS) patients to ePROs follow-up and whether specific patient characteristics are related to longitudinal non-adherence., Methods: Since November 2016, the Breast Center at Charité - Universitätsmedizin Berlin has implemented an ongoing prospective PRO routine program, requiring patients to complete ePROs assessments and consent to email-based follow-up in the first 12 months after therapy starts. Frequencies and summary statistics are presented. Multiple logistic regression models were performed to determine an association between patient characteristics and non-adherence., Results: Out of 578 patients, 239 patients (41.3%, 95%CI: 37.3-45.5%) completed baseline assessment and all five ePROs follow-up during the first 12 months after therapy. On average, above 70% of those patients responded to the ePROs follow-up assessment. Adherence to the ePROs follow-up was higher during the COVID-19 pandemic than in the time periods before (47.4% (111/234) vs. 33.6% (71/211)). Factors associated with longitudinal non-adherence were younger age, a higher number of comorbidities, no chemotherapy, and a low physical functioning score in the EORTC QLQ-C30 at baseline., Conclusions: The study reveals moderate adherence to 12-month ePROs follow-up assessments in invasive early breast cancer and DCIS patients, with response rates ranging from 60 to 80%. Emphasizing the benefits for young patients and those with high disease burdens might further increase adherence., (© 2024. The Author(s).)
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- 2024
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28. Impact of elevated lipoprotein(a) on coronary artery disease phenotype and severity.
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Leistner DM, Laguna-Fernandez A, Haghikia A, Abdelwahed YS, Schatz AS, Erbay A, Roehle R, Fonseca AF, Ferber P, and Landmesser U
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- Humans, Male, Female, Aged, Cross-Sectional Studies, Middle Aged, Up-Regulation, Risk Assessment, Risk Factors, Coronary Artery Disease blood, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease diagnosis, Lipoprotein(a) blood, Severity of Illness Index, Phenotype, Coronary Angiography, Biomarkers blood
- Abstract
Aims: A thorough characterization of the relationship between elevated lipoprotein(a) [Lp(a)] and coronary artery disease (CAD) is lacking. This study aimed to quantitatively assess the association of increasing Lp(a) levels and CAD severity in a real-world population., Methods and Results: This non-interventional, cross-sectional, LipidCardio study included patients aged ≥21 years undergoing angiography (October 2016-March 2018) at a tertiary cardiology centre, who have at least one Lp(a) measurement. The association between Lp(a) and CAD severity was determined by synergy between PCI with taxus and cardiac surgery (SYNTAX)-I and Gensini scores and angiographic characteristics. Overall, 975 patients (mean age: 69.5 years) were included; 70.1% were male, 97.5% had Caucasian ancestry, and 33.2% had a family history of premature atherosclerotic cardiovascular disease. Median baseline Lp(a) level was 19.3 nmol/L. Patients were stratified by baseline Lp(a): 72.9% had < 65 nmol/L, 21.0% had ≥100 nmol/L, 17.2% had ≥125 nmol/L, and 12.9% had ≥150 nmol/L. Compared with the normal (Lp(a) < 65 nmol/L) group, elevated Lp(a) groups (e.g. ≥ 150 nmol/L) had a higher proportion of patients with prior CAD (48.4% vs. 62.7%; P < 0.01), prior coronary revascularization (39.1% vs. 51.6%; P = 0.01), prior coronary artery bypass graft (6.0% vs. 15.1%; P < 0.01), vessel(s) with lesions (68.5% vs. 81.3%; P = 0.03), diffusely narrowed vessels (10.9% vs. 16.5%; P = 0.01) or chronic total occlusion lesions (14.3% vs. 25.2%; P < 0.01), and higher median SYNTAX-I (3.0 vs. 5.5; P = 0.01) and Gensini (10.0 vs. 16.0; P < 0.01) scores., Conclusion: Elevated Lp(a) was associated with a more severe presentation of CAD. Awareness of Lp(a) levels in patients with CAD may have implications in their clinical management., Competing Interests: Conflict of interest: D.M.L. has received educational grant, honorarium, and travel grant for attending meetings from Novartis. A.H. has received honoraria for lectures from Novartis, NovoNordisk, and AstraZeneca, travel grant for attending meetings from Novartis, and advisory board fee from Novartis and NovoNordisk. Y.S.A., A.-S.S., A.E., and R.R. have no conflict of interest to declare. A.L.-F., A.F.F., and P.F. are employees and own stocks of Novartis Pharma AG, Basel. U.L. has received grant support from Novartis; consulting fees from Amgen, Novartis, Pfizer, and CRISPR Therapeutics; and honoraria from Amgen, AstraZeneca, Bayer, Boeringer Ingelheim, Daiichi Sankyo, Novartis, NovoNordisk, Pfizer, Sanofi, Amarin, and Berlin-Chemie., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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29. Quality of life after risk-reducing salpingo-oophorectomy in women with a pathogenic BRCA variant.
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Zilski N, Speiser D, Bartley J, Roehle R, Blohmer JU, Keilholz U, and Goerling U
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- Humans, Female, Salpingo-oophorectomy adverse effects, BRCA1 Protein genetics, Quality of Life, BRCA2 Protein genetics, Ovariectomy adverse effects, Mutation, Breast Neoplasms genetics, Breast Neoplasms surgery, Ovarian Neoplasms genetics, Ovarian Neoplasms surgery
- Abstract
Background: Risk-reducing salpingo-oophorectomy (RRSO) is recommended to women with a pathogenic BRCA variant, but as a main side effect, RRSO could lead to an early onset of menopause., Aim: To evaluate the impact of RRSO and preoperative menopausal status on menopausal symptoms, sexual functioning, and quality of life (QOL)., Methods: The study was conducted between November 2019 and April 2020. Women were included who tested positive for a pathogenic BRCA1/2 variant between 2015 and 2018. Depression levels, QOL, and global health status were measured and compared with those of women who opted against RRSO. Furthermore, women who underwent RRSO treatment were asked to report menopausal complaints that they experienced at 1 month postsurgery and any current complaints., Outcomes: RRSO had no significant impact on QOL, but women who were premenopausal at the time of surgery reported more sexual complaints than postmenopausal women., Results: In total, 134 carriers of a BRCA mutation were included: 90 (67%) underwent RRSO and 44 (33%) did not. At the time of the survey, neither the control nor experimental group experienced significant changes in QOL (b = -0.18, P = .59). Women who underwent RRSO reported a significantly lower global health status (b = -0.66, P = .05). Women who were premenopausal at the time of surgery were bothered more by sexual symptoms (b = 0.91, P = .19) but experienced fewer vasomotor complaints (b = -1.09, P = .13) than women who were postmenopausal at the time of RRSO., Clinical Implications: The decrease of sexual functioning after RRSO should be an integral part of preoperative counseling because it is important for BRCA carriers, especially for premenopausal women., Strengths and Limitations: Some strengths of the present study were the long follow-up, a high response rate, and the existence of a control group, whereas defining menopausal status by last menstrual bleeding and self-report of data (eg, breast cancer history) increased the risk of errors., Conclusion: Our study indicated that women who underwent RRSO experienced no difference in QOL when compared with women without RRSO and that patients with premenopausal status seemed to be at higher risk to experience sexual complaints after surgery., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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30. How breast cancer therapies impact body image - real-world data from a prospective cohort study collecting patient-reported outcomes.
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Afshar-Bakshloo M, Albers S, Richter C, Berninger O, Blohmer JU, Roehle R, Speiser D, and Karsten MM
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- Humans, Female, Mastectomy methods, Quality of Life, Body Image, Prospective Studies, Mastectomy, Segmental methods, Patient Reported Outcome Measures, Breast Neoplasms surgery
- Abstract
Background: In breast cancer patients body image (BI) is a crucial aspect of quality of life (QoL). This study examined the postoperative impact of different surgical approaches on long-term BI analyzing real-world data to guide pre- and postoperative patient care and preserve QoL., Methods: EORTC QLQ-BR23 BI scores were collected electronically in 325 breast cancer patients within routine clinical care for a duration of 41.5 months (11/17/2016 - 4/30/2020) at predefined time points preoperatively and repeatedly up to two years after breast-conserving surgery (BCS) (n = 212), mastectomy alone (M) (n = 27) or mastectomy with immediate breast reconstruction (MIBR) (n = 86). Higher scores indicated better BI. A linear mixed regression model was used to analyze the impact of BCS, M and MIBR, as well as non-surgical therapies on BI at treatment initiation and over time., Results: BI scores deteriorated by 5 points (95%-confidence interval (CI) -8.94 to -1.57, p≈0.005) immediately after BCS, by 7 points (95%-CI -12.13 to -1.80, p≈0.008) after MIBR and by 19 points (95%-CI -27.34 to -10.34, p < 0.001) after M. The change over time after BCS (+ 0.10 points per week, 95%-CI -0.17 to 0.38), MIBR (-0.07 points per week, 95%-CI -0.35 to 0.20) and M (+ 0.14 points per week, 95%-CI -0.19 to 0.48) were not statistically significant (each p > 0.05). At treatment initiation chemotherapy was associated with a 22-point decline (95%-CI -25.39 to -17.87, p < 0.001) in BI score, while radiotherapy was associated with a 5-point increase (95%-CI 1.74 to 9.02, p≈0.004). However, over time chemotherapy was associated with a score recovery (+ 0.28 points per week, 95%-CI 0.19 to 0.37, p < 0.001), whereas for radiotherapy a trend towards BI deterioration was observed (-0.11 points per week, 95%-CI -0.23 to 0.02, p≈0.101)., Conclusions: Breast cancer surgery negatively affects BI. BCS and MIBR presumably harm BI less than M in the early postoperative period. Our data suggests BI to be deteriorating in the long term after MIBR while improving after BCS or M. Radiotherapy seems to have an additional negative long-term impact on BI. These findings should be confirmed in further studies to enable evidence-based patient information as part of preoperative shared decision-making and postoperative patient care., (© 2023. The Author(s).)
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- 2023
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31. Statistical review of animal trials-A guideline.
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Piper SK, Zocholl D, Toelch U, Roehle R, Stroux A, Hoessler J, Zinke A, and Konietschke F
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- Animals, Germany, Animal Welfare
- Abstract
Any experiment involving living organisms requires justification of the need and moral defensibleness of the study. Statistical planning, design, and sample size calculation of the experiment are no less important review criteria than general medical and ethical points to consider. Errors made in the statistical planning and data evaluation phase can have severe consequences on both results and conclusions. They might proliferate and thus impact future trials-an unintended outcome of fundamental research with profound ethical consequences. Unified statistical standards are currently missing for animal review boards in Germany. In order to accompany, we developed a biometric form to be filled and handed in with the proposal at the concerned local authority on animal welfare. It addresses relevant points to consider for biostatistical planning of animal experiments and can help both the applicants and the reviewers in overseeing the entire experiment(s) planned. Furthermore, the form might also aid in meeting the current standards set by the 3+3R's principle of animal experimentation: Replacement, Reduction, Refinement as well as Robustness, Registration, and Reporting. The form has already been in use by the concerned local authority of animal welfare in Berlin, Germany. In addition, we provide reference to our user guide giving more detailed explanation and examples for each section of the biometric form. Unifying the set of biostatistical aspects will help both the applicants and the reviewers to equal standards and increase quality of preclinical research projects, also for translational, multicenter, or international studies., (© 2022 The Authors. Biometrical Journal published by Wiley-VCH GmbH.)
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- 2023
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32. Long-term indoor gunshot exposure of special police forces induces bronchitic reactions and elevated blood lead levels-The Berlin shooting range study.
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Witt C, Kienast C, Bölke G, Hoffmann C, Roehle R, Bender O, Nowak D, Tauber R, Gunga HC, Hoffmann P, Coats AJS, and Liebers U
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- Humans, Lead adverse effects, Lead analysis, Berlin, Cross-Sectional Studies, Police, Occupational Exposure analysis
- Abstract
Background: Gunshot emissions contain toxic elements that can harm those frequently exposed, such as police officers. Several years ago, police indoor firing ranges were closed by the Berlin municipality in response to police officer health complaints, and an investigation was launched into the possible respiratory health risks of frequent gunshot emission exposure. We, therefore, conducted an exploratory cross-sectional study to investigate clinical and functional parameters of respiratory health as well as the burden of trace elements in policemen with long-term high exposure to indoor gunshot emissions, compared to low-exposure and control groups., Methods: We conducted lung function tests and collected blood and urine samples from Berlin police officers and government employees who were divided into three subject groups based on exposure to gunshot emissions: high exposure (n = 53), low exposure (n = 94) and no exposure (n = 76). Lung function was examined using body plethysmography. Blood and urine samples were tested via inductively coupled plasma mass spectrometry for the presence of common gunshot powder elements (antimony, lead and manganese). Exposure and symptoms were assessed using records as well as questionnaires., Results: Higher exposure was associated with more respiratory symptoms during gun shooting practice (64% vs. 21%, P < 0.001) compared to the low-exposure group. Headache, cough, discoloured mucous and shortness of breath were also more common as were some other symptoms. The cough symptomatology of the high-exposure group also persisted significantly longer (median: 0.67 vs. 0.01 days, range: 0 to 5 days, P = 0.029) compared to the low-exposure group. They also showed a lower forced expiratory volume in 1 s/forced vital capacity quotient (Tiffeneau index), P = 0.018 between the three groups and P = 0.005 for the high-exposure group, a possible marker of early, subclinical bronchial obstruction. We observed increased blood lead concentrations depending on subject's age (+1.2% per year, 95% confidence interval: 0.5-1.9%, P < 0.001) and cumulative gunshot exposure (+0.34% per 100 000 shots, 0.02-0.66%, P = 0.037)., Conclusions: These first results suggest that long-term exposure to indoor gunshot emissions induces bronchitic reactions due to repeated irritation of the airways. Higher levels of exposure lead to more negatively impacted lung function and higher blood lead levels with the possible reason that more frequent exposure may mean shorter regeneration phases for the respiratory mucous membrane. We recommend a reduction of exposure to gunshot emissions in order to decrease symptoms and avoid any-even small-deterioration in spirometry., (© 2022 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.)
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- 2023
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33. Corrigendum to 'Real-world reference scores for EORTC QLQ-C30 and EORTC QLQ-BR23 in early breast cancer patients [European Journal of Cancer 163 (2022) 128-139].
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Karsten MM, Roehle R, Albers S, Pross T, Hage AM, Weiler K, Fischer F, Rose M, Kühn F, and Blohmer JU
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- 2022
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34. Long-Term Results of Surgical Treatment and Patient-Reported Outcomes in Congenital Adrenal Hyperplasia-A Multicenter European Registry Study.
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Krege S, Falhammar H, Lax H, Roehle R, Claahsen-van der Grinten H, Kortmann B, Duranteau L, and Nordenskjöld A
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Representatives for congenital adrenal hyperplasia (CAH) continue to desire early feminizing surgery in girls with 46,XX-CAH. The aim of this analysis, which included 174 46,XX- individuals with salt-wasting (SW) or simple-virilizing (SV) CAH, a female gender identity, and an age > 16 years participating in a multicenter cross-sectional clinical evaluation study (dsd-LIFE), was to evaluate the long-term results of surgery and patient-reported outcomes (PRO). The gynecological examination (n = 84) revealed some shortcomings concerning surgical feminization. A clitoris was absent in 9.5% of cases, while a clitoral hood was missing in 36.7% of cases. Though all women had large labia, they didn’t look normal in 22.6% of cases. Small labia were absent in 23.8% of cases. There was no introitus vaginae, and the urethra and vagina had no separate opening in 5.1% of cases. A mucosal lining was missing in 15.4% of cases. Furthermore, 86.2% of the women had scars at the region of their external genitalia. A vaginal stenosis was described in 16.5% of cases, and a meatal stenosis was described in 2.6% of cases. Additionally, PRO data showed a very-/high satisfaction rate of 21.3%/40.2% with cosmesis and 23.8%/38.1% with functionality, while 3.3%/10.7% showed a very-/low satisfaction with cosmesis as well as 5.6%/10.3% with functionality. The remaining women—24.6% and 23.8%—were indifferent. Satisfaction concerning sex life was very-/high in 9.6%/27.7%. In 12.0%/16.9% it was very-/low. Furthermore, 33.7% had no opinion. Furthermore, 27.0%/31.6% of the women reported that clitoriplasty, but not clitoridectomy, had a very-/positive influence on their lives, while 1.3%/8.9% felt it to be very-/negative, and 28.4% were indifferent. Vaginoplasty had a very-/positive influence in 25.7%/33.8% and a very-/negative effect in 3.6%/6.8%. 29.7% had no opinion. Additionally, 75.7% of the women preferred feminizing surgery during infancy/childhood, especially concerning clitoreduction. In conclusion, though the majority of the participants (76%) preferred early feminizing surgery and 60% described a positive effect on their lives, about 10% felt it to have been negative. About 15% of the women suffered from insufficient cosmesis and functionality after surgery. Sex life was even described as poor in nearly 30%. Therefore, the decision about early genital surgery in 46,XX-CAH girls should be considered carefully. Parents should get detailed information about possible complications of surgery and should receive support to understand that postponing surgery does not inevitably cause harm for their child. Importantly, genital surgery when performed in children should only be performed in expert centers with a specialized team including surgeons who are trained in feminizing surgery.
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- 2022
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35. Prospective, double-blind diagnostic multicentre study of confocal laser endomicroscopy for wheat sensitivity in patients with irritable bowel syndrome.
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Bojarski C, Tangermann P, Barmeyer C, Buchkremer J, Kiesslich R, Ellrichmann M, Schreiber S, Schmidt C, Stallmach A, Roehle R, Loddenkemper C, Daum S, Siegmund B, Schumann M, and Ullrich R
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- Diet, Gluten-Free, Humans, Lasers, Prospective Studies, Celiac Disease, Irritable Bowel Syndrome diagnosis
- Abstract
Objective: A considerable proportion of patients with irritable bowel syndrome (IBS) may be wheat-sensitive and respond to a gluten-free diet (GFD) although they do not have coeliac disease. However, a diagnostic test for wheat sensitivity (WS) is missing. Our study evaluated the diagnostic accuracy (sensitivity and specificity) of confocal laser endomicroscopy (CLE) for the identification of WS as primary outcome., Design: In this prospective, double-blind diagnostic study 147 non-coeliac patients fulfilling the Rome III criteria for IBS were tested by CLE for duodenal changes after wheat (index test), soy, yeast or milk exposure. Patients with IBS responding to 2 months of GFD were classified as having WS (reference test) using response criteria recommended by regulatory bodies for pharmaceutical trials of patients with IBS. After 2 months, CLE results were unblinded and patients were advised to exclude those food components that had led to a positive CLE reaction. The clinical response was assessed at follow-up after 6 and 12 months., Results: Of 130 patients who completed the study per protocol, 74 (56.9%) responded to GFD and were classified as WS after 2 months, and 38 of these 74 patients were correctly identified by CLE (sensitivity 51.4%; 97.5% CI: 38.7% to 63.9%). A total of 38 of 56 patients without WS were correctly identified by CLE (specificity 67.9%; 97.5% CI: 52.9% to 79.9%). At 6 months follow-up, CLE correctly identified 49 of 59 food-sensitive patients (sensitivity 83.1%; 97.5% CI: 69.9% to 91.3%) but specificity was only 32% (97.5% CI: 15.7% to 54.3%)., Conclusion: In light of the high proportion of patients with IBS responding to GFD, the diagnostic accuracy of CLE is too low to recommend widespread use of this invasive procedure., Trail Registration Number: This study was registered as clinical trial in the German Registry for Clinical Studies (DRKS00010123)., Competing Interests: Competing interests: CBo, MS and RU received research grants from Dr. Schär AG. ME obtained consulting and lecture fees from Maunakeatech, Boston Scientific, Takeda, Abbvie, Janssen. CS received research grants and lecture fees from Olympus and Pentax. AS obtained consulting fees from Abbvie, Amgen, Astellas, Biogen, Celltrion, Consal, CSL Behring, Galapagos, Gilead, Institut Allergosan, Janssen, MSD, Norgine, Pfizer Pharma, Roche, Shire and Takeda, lecture fees and travel support from Abbvie, Astellas, Celltrion, Falk Foundation, Ferring, Janssen, MSD, Recordati Pharma and Takeda, and research support from Abbvie. SD obtained lecture fees from BMS, Recordati, Amgen and Falk. BS has served as consultant for Abbvie, Arena, BMS, Boehringer, Celgene, Falk, Janssen, Lilly, Pfizer, Prometheus and Takeda and received speaker’s fees from Abbvie, CED Service, Falk, Ferring, Janssen, Novartis, Pfizer, Takeda (served as representative of the Charité)., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2022
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36. Data of real-world reference scores for EORTC QLQ-C30 and QLQ-BR23 at baseline in women with early breast cancer and other breast diseases.
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Gebert P, Dordevic AD, Roehle R, Hage AM, and Karsten MM
- Abstract
Patient-reported outcomes are information about health status and health-related quality of life collected directly from patients. The data in this publication contain the first assessment of patient-reported outcomes (PROs) from real-life measurements in the breast cancer center at Charité - Universitätsmedizin Berlin between November 2016 and March 2021. At baseline (before the start of treatment), 1727 ambulatory patients with early breast cancer, ductal carcinoma in situ (DCIS), fibroadenoma, and other breast diseases were registered in the digital PRO-system as part of clinical routine. Patients' sociodemographic data, medical history, clinical variables, and raw scores of the EORTC QLQ-C30 and EORTC QLQ-BR23 are provided in this publication. This dataset can be used as a reference for PROs in a clinical care setting or in clinical studies with breast diseases and contribute to the discussion about the interpretation of score values. Furthermore, the association between patients' sociodemographic data, clinical variables, and PRO data at baseline can be analysed further., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)
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- 2022
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37. Real-world reference scores for EORTC QLQ-C30 and EORTC QLQ-BR23 in early breast cancer patients.
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Karsten MM, Roehle R, Albers S, Pross T, Hage AM, Weiler K, Fischer F, Rose M, Kühn F, and Blohmer JU
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- Female, Health Status, Humans, Quality of Life psychology, Regression Analysis, Surveys and Questionnaires, Breast Diseases psychology, Breast Diseases therapy, Breast Neoplasms psychology, Breast Neoplasms therapy, Carcinoma, Intraductal, Noninfiltrating psychology, Carcinoma, Intraductal, Noninfiltrating therapy, Fibroadenoma psychology, Fibroadenoma therapy
- Abstract
Purpose: To deliver patient-reported outcome (PRO) reference data for breast cancer and various other breast diseases to facilitate the interpretation of PRO scores during routine breast cancer treatment., Methods: To determine reference baseline values for the PRO measures EORTC QLQ-C30 and EORTC QLQ-BR23, PRO data captured in the breast cancer centre at Charité - Universitätsmedizin Berlin from 2016 to 2021 were evaluated. As part of the clinical routine, ambulatory patients were asked to answer a digital survey regarding their medical history, current health status and health-related quality of life using the aforementioned questionnaires prior to their doctor's appointment in the outpatient breast clinic. Adjusted linear and variable dispersion beta regression models were used to compare different diagnosis groups., Results: A total of 3689 patients were included in the digital PRO program, of which 1478 were eligible for this study; 729 had invasive breast cancer or ductal carcinoma in situ, 270 patients were diagnosed with fibroadenoma and 479 patients had other breast diseases such as cysts, mastopathy or abscesses. Overall, patients with breast cancer reported worse scores in almost all domains except for role functioning, sexual functioning and body image. Compared to previously published reference scores for early breast cancer, the current data show a more pronounced impact on perceived emotional and cognitive functioning., Conclusion: The results of this study are of high value for the interpretation of PROs and facilitate their use in clinical practice and clinical trials. The scores indicate an urgent need for psychosocial support prior to treatment., Competing Interests: Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2022
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38. Discordance between estimated and measured changes in plasma volume among patients with acute heart failure.
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Swolinsky JS, Tuvshinbat E, Leistner DM, Edelmann F, Knebel F, Nerger NP, Lemke C, Roehle R, Haase M, Costanzo MR, Rauch G, Mitrovic V, Gasanin E, Meier D, McCullough PA, Eckardt KU, Molitoris BA, and Schmidt-Ott KM
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- Diuretics therapeutic use, Furosemide, Humans, Heart Failure therapy, Plasma Volume
- Abstract
Aims: In acute heart failure (AHF), changes of venous haemoglobin (Hb) concentrations, haematocrit (Hct), and estimated plasma volume (ePV) have been proposed as surrogates of decongestion. These estimates are based on the theoretical assumptions that changes of Hb concentrations and Hct are driven by the intravascular volume status and that the intravascular Hb pool remains stable. The objective of this study was to assess the relationship of changes of measured plasma volume (mPV) with changes of Hb, Hct, and ePV in AHF., Methods and Results: We studied 36 AHF patients, who received two sequential assessments of mPV, measured red cell volume (mRCV) and measured total blood volume (mTBV) (48 h apart), during the course of diuretic therapy using a novel visible fluorescent injectate (VFI) technique based on the indicator dilution principle. Changes of ePV were calculated based on the Kaplan-Hakim or Strauss formula. AHF patients receiving diuretics (median intravenous furosemide equivalent 160 mg/48 h) displayed a wide range of changes of mPV (-25.4% to +37.0%). Changes in mPV were not significantly correlated with changes of Hb concentration [Pearson's r (r) = -0.241, P = 0.157], Hct (r = -0.307, P = 0.069), ePV
Kaplan-Hakim (r = 0.228, P = 0.182), or ePVStrauss (r = 0.237, P = 0.163). In contrast to theoretical assumptions, changes of mTBV were poorly correlated with changes of Hb concentrations and some patients displayed unanticipated variability of mRCV, suggesting an unstable intravascular red cell pool., Conclusions: Changes of Hb or Hct were not reflective of directly measured changes of intravascular volume status in AHF patients. Basing clinical assessment of decongestion on changes of Hb or Hct may misguide clinical decision-making on an individual patient level., (© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)- Published
- 2022
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39. The influence of psychosocial and sexual wellbeing on quality of life in women with differences of sexual development.
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Liedmeier A, Jendryczko D, Rapp M, Roehle R, Thyen U, and Kreukels BPC
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Background: Previous research indicating that women with differences of sexual development (DSD), namely women with Turner syndrome (TS), women with congenital adrenal hyperplasia (CAH), and women with XY-DSD, have an impaired psychosocial and sexual well-being and quality of life (QOL), was often limited by small samples and inadequate control groups (CGs). Only few studies analysed which psychosocial and sexual factors influence QOL in women with DSD and no study so far has examined whether the DSD-condition itself and the diagnostic group to which they belong moderate this influence., Methods: We compared 301 women with TS, 221 women with CAH and 142 women with XY-DSD with 603 non-DSD women regarding depression, anxiety, self-esteem, attention deficit hyperactivity disorder, autism, social participation, body acceptance, relationship status, sexual satisfaction and QOL. Furthermore, we investigated the influence of psychosocial and sexual well-being on QOL within and between diagnostic groups and examined whether the DSD-condition moderates the influence of psychosocial and sexual well-being on QOL., Results: Women with DSD reported average psychosocial well-being and QOL; only women with CAH reported an impaired physical QOL. However, women with DSD were less satisfied with their body and had less often a partner than women in the CG. Women with CAH and XY-DSD were less satisfied with their sex life compared to women in the CG. Across groups, better health and lower depression scores predicted better QOL, whereas higher self-esteem especially predicted better QOL in women with DSD. The presence of DSD moderated the influence of psychosocial and sexual well-being on QOL, however, the specific diagnosis group mainly moderated the influence on physical QOL., Conclusion: We have learned that body and sexual satisfaction need further attention in women with DSD. To optimize their QOL, psychosocial well-being should be taken in account. The improvement of self-esteem seems particularly relevant for women with DSD, as this helps coping with having a variant of sexual development., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)
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- 2021
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40. Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic: a prospective observational study.
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Thibeault C, Mühlemann B, Helbig ET, Mittermaier M, Lingscheid T, Tober-Lau P, Meyer-Arndt LA, Meiners L, Stubbemann P, Haenel SS, Bosquillon de Jarcy L, Lippert L, Pfeiffer M, Stegemann MS, Roehle R, Wiebach J, Hippenstiel S, Zoller T, Müller-Redetzky H, Uhrig A, Balzer F, von Kalle C, Suttorp N, Jones TC, Drosten C, Witzenrath M, Sander LE, Corman VM, and Kurth F
- Subjects
- COVID-19 therapy, Cohort Studies, Germany epidemiology, Hospitalization, Humans, Hypertension complications, Kinetics, Prospective Studies, Respiration, Artificial, Risk Factors, Tertiary Care Centers, Time Factors, Viral Load, Virus Shedding, COVID-19 epidemiology, COVID-19 virology, SARS-CoV-2 physiology
- Abstract
Purpose: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course., Methods: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed., Results: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10-1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00-16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26-46.75, vs 18 days, IQR 16-46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6-15.5) for non-IMV and 49.5 days (IQR 36.8-82.5) for IMV patients., Conclusions: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19., (© 2021. The Author(s).)
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- 2021
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41. Serum creatinine and cystatin C-based estimates of glomerular filtration rate are misleading in acute heart failure.
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Swolinsky JS, Nerger NP, Leistner DM, Edelmann F, Knebel F, Tuvshinbat E, Lemke C, Roehle R, Haase M, Costanzo MR, Rauch G, Mitrovic V, Gasanin E, Meier D, McCullough PA, Eckardt KU, Molitoris BA, and Schmidt-Ott KM
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- Creatinine, Glomerular Filtration Rate, Humans, Prospective Studies, Cystatin C, Heart Failure diagnosis
- Abstract
Aims: We aimed to test whether the endogenous filtration markers serum creatinine or cystatin C and equation-based estimates of glomerular filtration rate (GFR) based on these markers appropriately reflect changes of measured GFR in patients with acute heart failure., Methods: In this prospective cohort study of 50 hospitalized acute heart failure patients undergoing decongestive therapy, we applied an intravenous visible fluorescent injectate (VFI), consisting of a low molecular weight component to measure GFR and a high molecular weight component to correct for measured plasma volume. Thirty-eight patients had two sequential GFR measurements 48 h apart. The co-primary endpoints of the study were safety of VFI and plasma stability of the high molecular weight component. A key secondary endpoint was to compare changes in measured GFR (mGFR) to changes of serum creatinine, cystatin C and estimated GFR., Results: VFI-based GFR measurements were safe and consistent with plasma stability of the high molecular weight component and glomerular filtration of the low molecular weight component. Filtration marker-based point estimates of GFR, when compared with mGFR, provided only moderate correlation (Pearson's r, range 0.80-0.88, depending on equation used), precision (r
2 , range 0.65-0.78) and accuracy (56%-74% of estimates scored within 30% of mGFR). Correlations of 48-h changes GFR estimates and changes of mGFR were significant (P < 0.05) but weak (Pearson's r, range 0.35-0.39). Observed decreases of eGFR by more than 15% had a low sensitivity (range 38%-46%, depending on equation used) in detecting true worsening mGFR, defined by a >15% decrease in mGFR., Conclusions: In patients hospitalized for acute heart failure, serum creatinine- and cystatin C-based predictions performed poorly in detecting actual changes of GFR. These data challenge current clinical strategies to evaluate dynamics of kidney function in acute heart failure., (© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)- Published
- 2021
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42. Physical and Reported Subjective Health Status in 222 Individuals with XY Disorder of Sex Development.
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Gong XL, Raile K, Slowikowska-Hilczer J, Pienkowski C, Quinkler M, Roehle R, Nordenström A, and Neumann U
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Context: Little is known about the physical health of individuals with 46,XY disorders of sex development (DSD)., Objective: To assess physical and reported subjective health of individuals with XY DSD., Methods: As part of the dsd-LIFE study, patients with an XY DSD condition were analyzed in different diagnosis groups for metabolic parameters, comorbidities, metabolic syndrome, bone outcomes, and reported subjective health. Findings were evaluated by descriptive statistics., Results: A total of 222 patients with XY DSD were included with a mean age of 28.8 ± 12.2 years, mean height of 175.3 ± 7.7 cm, mean weight of 74.3 ± 20.0 kg, and mean body mass index of 24.1 ± 6.0 kg/m
2 . Obesity rate was not increased when descriptively compared with Eurostat data. Fourteen patients had metabolic syndrome (14/175; 8.0%). In descriptive comparison with data from the DECODE study and World Health Organization, subjects fared better in the categories waist circumference, glucose, triglyceride, cholesterol, and high-density lipoprotein. Of participants with available bone health data, 19/122 (15.6%) patients had a Z-score ≤ -2.0 at lumbar spine indicating lowered bone mineral density (BMD). Mostly gonadectomized individuals with complete androgen insensitivity syndrome (CAIS) and no estrogen therapy had lowered BMD at lumbar spine. Individuals with XY DSD performed poorly in the category subjective health in descriptive comparison with Eurostat data., Conclusion: Participants reported a lower subjective health status than Eurostat data but their overall metabolic health status was good. Decreased BMD at lumbar spine was especially present in gonadectomized individuals with CAIS and no estrogen therapy., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society.)- Published
- 2021
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43. Self- and proxy-reported outcomes after surgery in people with disorders/differences of sex development (DSD) in Europe (dsd-LIFE).
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Rapp M, Duranteau L, van de Grift TC, Schober J, Hirschberg AL, Krege S, Nordenstrom A, Roehle R, Thyen U, Bouvattier C, Kreukels BPC, and Nordenskjold A
- Subjects
- Adolescent, Adult, Cross-Sectional Studies, Europe, Humans, Patient Reported Outcome Measures, Urogenital Surgical Procedures, Disorders of Sex Development surgery, Sexual Development
- Abstract
Background: Surgery is performed in many individuals with disorders/differences of sex development (DSD). Irreversibility of some surgical procedures, lack of information about the procedures, and lack of follow-up care for physical and psychological outcomes, lead to wish for more knowledge from both surgeons and patients. After the consensus conference in 2006, multidisciplinary care is provided to a higher degree with psychological support and more restricted surgical procedures. Outcome studies after genital surgery often lack of patient's perspective., Objective: To describe surgical procedures in relation to diagnosis, to evaluate the outcomes of surgery through genital examination, and through patient's and observer's satisfaction with the anatomical and functional result after genital surgery., Study Design: In a cross-sectional clinical study performed in six European countries in 2014/15, we have included 500 participants where surgery was performed, from a total of 1040 adolescents (≥16years) and adults with a DSD. Diagnoses included Turner syndrome (n = 301), mixed gonadal dysgenesis (45,XO/46,XY; n = 45), Klinefelter syndrome (n = 218), XYY (n = 1), 46, XY DSD (n = 222) and 46, XX DSD (n = 253). Study protocol included clinical report files, an optional gynecological or urological examination, patient reported outcomes including received surgical interventions, satisfaction with appearance and function after surgery, and impact of the surgical procedure on life., Results: Five hundred participants had received genital or breast surgery, with the highest rate in 46, XY DSD and the lowest in Turner syndrome. Altogether; 240 participants had feminizing surgery, 112 had masculinizing surgery, and 217 underwent gonadectomy. Physicians evaluated anatomical appearance at genital examination as poor in less than 10%. Dissatisfaction with anatomical appearance was reported by 22% of the participants, dissatisfaction with function by 20%. Being (very) dissatisfied with anatomical appearance and function was reported by 13% of the study participants. Most participants reported no impact, or positive impact, of the surgical procedures on their lives, but 29% experienced a negative effect of gonadectomy on their life., Discussion: There might be a selection bias and/or a recall bias for participating in our studies. Due to poor data quality about surgical procedures performed in the past, we also relied on participants memory about surgical procedures in their past. Ideally, patient reported outcomes should be evaluated both before and after surgical procedures., Conclusion: A vast majority are satisfied with appearance and function, but still genital or breast surgery have a long-lasting effect on patient's life. Self-reported satisfaction is usually lower than the observer's evaluation regarding both appearance and function., Competing Interests: Conflicts of interest The authors have no competing interests., (Copyright © 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
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44. Cannabidivarin for HIV-Associated Neuropathic Pain: A Randomized, Blinded, Controlled Clinical Trial.
- Author
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Eibach L, Scheffel S, Cardebring M, Lettau M, Özgür Celik M, Morguet A, Roehle R, and Stein C
- Subjects
- Adult, Aged, Analgesics, Cannabinoids administration & dosage, Cannabinoids adverse effects, Cross-Over Studies, Double-Blind Method, Female, Humans, Male, Middle Aged, Pain Measurement, Quality of Life, Cannabinoids therapeutic use, HIV Infections complications, Neuralgia drug therapy, Neuralgia etiology
- Abstract
HIV remains a major burden to the health care system and neuropathic pain is the most common neurological complication of HIV infection. Because current treatment strategies often lack satisfying pain relief, cannabinoids (CBs) are discussed as a new option. We investigated cannabidivarin (CBDV) as treatment for HIV-associated neuropathic pain. We conducted a randomized, double-blind, placebo-controlled crossover study. Patients underwent two successive treatment phases (4 weeks each) and were treated with CBDV (400 mg/day) or placebo in a randomized order. A 3-week washout phase was designed to eliminate potential carry-over effects. Patients were followed up for 3 weeks after the end of the second treatment phase. The primary end point was pain intensity on an 11-point numeric rating scale, recorded in a diary. Secondary end points were additional pain medication, pain characteristics, and quality of life. We included 32 patients. The mean pain intensity under CBDV was 0.62 points higher compared with placebo (P = 0.16, 95% confidence interval -0.27 to 1.51). CBDV did not influence the amount of additional pain medication, pain characteristics, or quality of life. The incidence of adverse events was similar during both treatments. No suspected unexpected adverse reactions occurred during either treatment. CBDV was safe but failed to reduce neuropathic pain in patients with HIV. This may be explained by a lack of CB receptor activation, as indicated by preclinical experiments. Although a larger patient number might be desirable, we would not expect a change in the conclusions because the present differences are far from statistical significance. Therefore, we would currently not consider CBDV as a clinically meaningful treatment option for neuropathic pain., (© 2020 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)
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- 2021
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45. Impact of age, sex, and joint form on degenerative lesions of the sacroiliac joints on CT in the normal population.
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Ziegeler K, Kreutzinger V, Diekhoff T, Roehle R, Poddubnyy D, Pumberger M, Hamm B, and Hermann KGA
- Subjects
- Adult, Age Factors, Aged, Female, Humans, Male, Middle Aged, Sacroiliac Joint diagnostic imaging, Sacroiliac Joint pathology, Sex Characteristics, Tomography, X-Ray Computed
- Abstract
Degeneration of the sacroiliac joints (SIJs) is a common finding, while its underlying cause and development remain incompletely understood. The aim of this investigation was to describe the spatial distribution of degenerative SIJ changes across age groups and to investigate for the first time their relationship to anatomical form and sex. For this IRB-approved investigation, demographic data of 818 patients without SIJ disease were retrieved from electronic patient records. High-resolution computed tomography (CT) datasets of all patients were analysed retrospectively for seven predefined age groups (ten-year increments, from < 25 to ≥ 75). A structured scoring system was applied to assess sclerosis, osteophytes, joint space alterations, and anatomical form. Chi-square tests were used to compare frequencies of degenerative lesions, and logistic regression analyses were performed to investigate associations between demographic data, anatomical form, and the presence of structural lesions. Sclerosis and osteophytes were common findings, with an overall prevalence of 45.7% and 46.8%, respectively. Female sex had an odds ratio (OR) of 0.15 (95% CI: 0.08-0.27) for the presence of ventral osteophytes and of 4.42 (95% CI: 2.77-7.04) for dorsal osteophytes. Atypical joint forms were significantly more prevalent in women with 62.1% vs. 14.1% in men (p < 0.001). Accessory joints increased the likelihood of dorsal sclerosis (OR 2.735; 95% CI 1.376-5.436) while a typical joint form decreased its likelihood (OR 0.174; 95% CI 0.104-0.293). Sex and anatomical joint form have a major impact on the development of degenerative lesions of the SIJs and their spatial distribution.
- Published
- 2021
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46. STABIL-study: The Course of Therapy, Safety and Pharmacokinetic Parameters of Conversion of Prograf® to Tacrolimus HEXAL®/Crilomus® in Renal Transplant Recipients - an Observational Study in Germany.
- Author
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Lehner LJ, Kalb K, Weigand K, Pein U, Schenker P, Seeger W, Roehle R, Dienes K, Halleck F, and Budde K
- Subjects
- Humans, Immunosuppressive Agents adverse effects, Retrospective Studies, Transplant Recipients, Kidney Transplantation adverse effects, Tacrolimus adverse effects
- Abstract
Background/objective: Tacrolimus HEXAL®/Crilomus® is an approved generic immunosuppressant for the prevention and treatment of rejection following renal transplantation. For safe and socioeconomically efficient conversion of the innovator into a generic formulation, high- -quality data are necessary, in view of the different and country-specific comorbidities and pharmacokinetics in kidney transplant recipients., Patients and Methods: From 2014 to 2017, we enrolled 32 kidney transplant recipients, receiving newly prescribed Tacrolimus HEXAL®/Crilomus® in 5 German centers. Efficacy and safety data were collected over 6-8 months and retrospectively compared to the period prior to conversion., Results: The mean tacrolimus trough level was 4.91 ng/mL Standard Deviation (SD) (SD ±1.7) before and 5.06 ng/mL (SD ±1.97) after conversion. Mean tacrolimus trough concentration-dose-ratio (+/- SD) was 187.1 ng/mL/mg/kg/day (SD 99.2) for the reference and 205.1 ng/mL/mg/kg/day (SD 133) for the generic product, resulting in a non-significant difference of 18.0 ng/mL/mg/kg/day (SD 71.8) (p=0.84, Wilcoxon V=180). Overall, dosing had to be changed in 4 (14.8%) patients. Graft function remained stable and no rejections occurred., Conclusion: In conclusion, conversion to the generic tacrolimus formulation can be considered safe and feasible in long-term kidney transplant recipients in Germany. As suggested by guidelines, vigilant therapeutic drug monitoring is recommended to account for possible tacrolimus concentration variability on the individual patient level., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2021
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47. Treatment of Severe TRIcuspid Regurgitation in Patients with Advanced Heart Failure with CAval Vein Implantation of the Edwards Sapien XT VALve (TRICAVAL): a randomised controlled trial.
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Dreger H, Mattig I, Hewing B, Knebel F, Lauten A, Lembcke A, Thoenes M, Roehle R, Stangl V, Landmesser U, Grubitzsch H, Stangl K, and Laule M
- Subjects
- Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Cardiac Catheterization mortality, Catheterization, Central Venous adverse effects, Catheterization, Central Venous instrumentation, Cause of Death, Heart Failure diagnosis, Heart Failure mortality, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Humans, Minnesota epidemiology, Prosthesis Design, Quality of Life, Severity of Illness Index, Survival Rate, Treatment Outcome, Tricuspid Valve physiopathology, Tricuspid Valve Insufficiency complications, Tricuspid Valve Insufficiency epidemiology, Vena Cava, Inferior physiopathology, Cardiac Catheterization methods, Catheterization, Central Venous methods, Heart Failure complications, Heart Valve Prosthesis Implantation methods, Tricuspid Valve Insufficiency surgery
- Abstract
Aims: The aim of our study was to compare the impact of implantation of a balloon-expandable transcatheter valve into the inferior vena cava (CAVI) on exercise capacity with optimal medical therapy (OMT) in patients with severe tricuspid regurgitation (TR) and high surgical risk., Methods and Results: Twenty-eight patients were randomised to OMT (n=14) or CAVI (n=14). The primary endpoint was maximal oxygen uptake at the three-month follow-up. Secondary endpoints included six-minute walk test, NYHA class, NT-proBNP levels, right heart function, unscheduled heart failure hospitalisation, and quality of life as assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Patients underwent follow-up examinations one, three, six, and twelve months after randomisation. Maximal oxygen uptake did not change significantly in either group after three months and there was no difference between the OMT and CAVI groups (-0.1±1.8 ml∙kg-1∙min-1 vs -1.0±1.6 ml∙kg-1∙min-1, p=0.4995). Compared to baseline, CAVI improved NYHA class, dyspnoea, and quality of life after three months. However, there were no statistically significant differences in the secondary endpoints between the groups. Four periprocedural complications occurred after CAVI, resulting in open heart surgery. Four patients in the OMT group and eight patients (including four after conversion to surgery) in the CAVI group died from right heart failure, sepsis or haemorrhage., Conclusions: CAVI did not result in a superior functional outcome compared to OMT. Due to an unexpectedly high rate of valve dislocations, the study was stopped for safety reasons.
- Published
- 2020
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48. Bone mineral density and fractures in congenital adrenal hyperplasia: Findings from the dsd-LIFE study.
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Riehl G, Reisch N, Roehle R, Claahsen van der Grinten H, Falhammar H, and Quinkler M
- Subjects
- Absorptiometry, Photon, Adolescent, Adult, Bone Density, Female, Glucocorticoids adverse effects, Humans, Infant, Newborn, Lumbar Vertebrae diagnostic imaging, Male, Adrenal Hyperplasia, Congenital drug therapy, Fractures, Bone etiology
- Abstract
Background: In patients with congenital adrenal hyperplasia (CAH) type and doses of glucocorticoids used as well as sex hormone secretion during puberty have important actions on bone mineral density (BMD) in adulthood., Aim: To evaluate BMD in adult CAH patients depending on current glucocorticoid therapy and on androgen levels in adulthood and at age 16 years., Methods: We included 244 CAH patients from the dsd-LIFE cohort (women n = 147, men n = 97; salt-wasting n = 148, simple-virilizing n = 71, nonclassical n = 25) in which BMD and bloods were available. Clinical and hormonal data at age 16years were retrieved from patients' files., Results: Simple-virilizing women showed lower BMD compared to salt-wasting women at trochanter (0.65 ± 0.12 vs 0.75 ± 0.15 g/cm
2 ; P < .050), whole femur T-score (-0.87 ± 1.08 vs -0.16 ± 1.24; P < .05) and lumbar T-score (-0.81 ± 1.34 vs 0.09 ± 1.3; P < .050). Fracture prevalence did not differ significantly between the CAH groups. Prednisolone vs. hydrocortisone only therapy caused worse trochanter Z-score (-1.38 ± 1.46 vs -0.47 ± 1.16; P < .050). In women lumbar spine, BMD correlated negatively with hydrocortisone-equivalent dose per body surface (r2 = 0.695, P < .001). Furthermore, BMI at age 16years correlated positively with lumbar spine T-score (r2 = 0.439, P = .003) and BMD (r2 = 0.420, P = .002) in women. The androstenedione/testosterone ratio at age 16years correlated positively with lumbar spine Z-score in women (r2 = 0.284, P = .024) and trochanter Z-score in men (r2 = 0.600, P = .025)., Conclusion: Higher glucocorticoid doses seemed to cause lower BMD especially in women. Prednisolone appeared to have more detrimental effects on BMD than hydrocortisone. Higher glucocorticoid doses (lower androstenedione/testosterone ratio) during adolescence may cause lower BMD in adulthood., (© 2019 John Wiley & Sons Ltd.)- Published
- 2020
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49. Split-bolus vs. multiphasic contrast bolus protocol in patients with pancreatic cancer or cholangiocarcinoma.
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Muenzfeld H, Mahjoub S, Roehle R, Pelzer U, Bahra M, Boening G, Hamm B, Geisel D, and Auer TA
- Subjects
- Aged, Bile Ducts diagnostic imaging, Bile Ducts radiation effects, Clinical Protocols, Female, Humans, Iohexol administration & dosage, Iohexol analogs & derivatives, Iopamidol administration & dosage, Iopamidol analogs & derivatives, Liver diagnostic imaging, Liver radiation effects, Male, Multidetector Computed Tomography methods, Neoplasm Recurrence, Local diagnostic imaging, Pancreas diagnostic imaging, Pancreas radiation effects, Portal Vein diagnostic imaging, Portal Vein radiation effects, Prospective Studies, Radiation Dosage, Radiation Exposure, Sensitivity and Specificity, Bile Duct Neoplasms diagnostic imaging, Carcinoma, Pancreatic Ductal diagnostic imaging, Cholangiocarcinoma diagnostic imaging, Contrast Media administration & dosage, Pancreatic Neoplasms diagnostic imaging
- Abstract
Purpose: To investigate the image quality, diagnostic accuracy, and dose reduction potential of a split-bolus protocol(SBP) compared with a multiphasic protocol(MPP) in the detection of recurrent or progressive pancreatic ductal adenocarcinoma(PDAC) or cholangiocarcinoma(CC) using contrast- enhanced computed tomography(CECT)., Materials and Methods: This prospective study included 56 patients who underwent CECT, 28 with our institutional standard MPP(100 ml contrast bolus) and 28 with a novel SBP(110 ml). Radiation exposure was determined in terms of total dose- length product(DLP) and computed tomography dose index(CTDI). Image quality was measured objectively by analysis of attenuation in Hounsfield units(HU) in regions of interest(ROIs) and subjectively by two blinded readers using a Likert scale. Diagnostic accuracy and interreader variability were tested., Results: The total DLP of the SBP group(498.1 ± 43.7 mGy*cm) was significantly lower than in the MPP group(1,092.5 ± 106.9 mGy*cm; p < 0.001). The SBP showed higher contrast enhancement of all critical anatomical structures including portal vein, liver, and pancreas compared with the MPP, except for the aorta(SBP: 326.9 ± 15.7 HU vs. MPP: 246.7 ± 12.2 HU; p < 0.001). Subjective analysis revealed poorer image quality ratings for important landmarks with the MPP (resection surface: p = 0.624, portal vein: p = 0.395, liver p = 0.361). The two blinded readers correlated significantly. Sensitivity, specificity, positive and negative predictive values (PPV/NPV), and overall interreader variabilities correlated significantly. Furthermore, significantly fewer slices per exam were required for the SBP(1,823 vs. 3,235; p < 0.001)., Conclusion: The SBP provides the same image quality and diagnostic accuracy as an MPP while significantly lowering radiation exposure in CT follow-up of PDAC or CC., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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50. Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries.
- Author
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de Vries ALC, Roehle R, Marshall L, Frisén L, van de Grift TC, Kreukels BPC, Bouvattier C, Köhler B, Thyen U, Nordenström A, Rapp M, and Cohen-Kettenis PT
- Subjects
- Adolescent, Adult, Comorbidity, Cross-Sectional Studies, Europe epidemiology, Female, Humans, Klinefelter Syndrome epidemiology, Male, Middle Aged, Young Adult, Anxiety epidemiology, Attention Deficit Disorder with Hyperactivity epidemiology, Autism Spectrum Disorder epidemiology, Depression epidemiology, Disorders of Sex Development epidemiology, Self Concept
- Abstract
Objective: The aim of the study was to evaluate psychiatric symptoms among 1022 persons with various disorders of sex development (DSDs)., Methods: The study was a European multicenter cross-sectional clinical evaluation in six countries. The mean (SD) age of participants was 32.1 (13.4) years. The cohort consisted of 325 individuals with Turner syndrome, 219 individuals with Klinefelter syndrome (KS), female individuals with various XY-DSD conditions (107 with and 67 without androgenization), 87 male individuals with XY-DSD conditions, and 221 female individuals with congenital adrenal hyperplasia. The Hospital Anxiety and Depression Scale, the Short Autism Spectrum Quotient, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, and self-reported mental health history were used to assess psychiatric symptoms., Results: Across the six DSD diagnostic groups, clinical cutoff symptom scores were reached in 19.5% of participants for anxiety, in 7.1% for depression, in 4.1% for attention-deficit/hyperactivity disorder, and in 9.1% for autism. The mean depression and anxiety scores were higher compared with population norms in men with KS and men with XY-DSD. Compared with participants with other DSD conditions, men with KS reported significantly more mental health symptoms. Self-esteem, satisfaction with care, body dissatisfaction, and experiences of shame were associated with psychiatric symptoms in many DSD conditions., Conclusions: A substantial minority of adults with DSD, with KS in particular, experience psychiatric morbidity. Across DSD conditions, adults may share feelings of shame. Developing a positive self-esteem and body image may be challenging. Multidisciplinary DSD care that involves specialized mental health support can be of important value., Trial Registration: German Clinical Trials Register DRKS00006072.
- Published
- 2019
- Full Text
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