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Aarau, Switzerland

Sievi N.A.,University of Zurich | Senn O.,University of Zurich | Brack T.,Cantonal Hospital of Glarus | Brutsche M.H.,Cantonal Hospital of St. Gallen | And 7 more authors.
Respirology | Year: 2015

Background and objective Both comorbidities and physical inactivity have been shown to impair quality of life and contribute to hospital admissions and mortality in chronic obstructive pulmonary disease (COPD) patients. We hypothesized that the comorbid status predicts the level of daily physical activity (PA) in COPD. Methods In 228 patients with COPD (76% men; median (quartiles) age: 64 (59/69) years; percentage of predicted forced expiratory volume in 1 s (FEV1% pred): 44 (31/63)), comorbidities were assessed by medical history, clinical interviews, examination and blood analysis. PA level (PAL) was measured by an activity monitor (SenseWear Pro, Bodymedia Inc., Pittsburgh, PA, USA). The association between PAL and comorbidities was investigated by univariate and multivariate regression analysis. Results Seventy-nine per cent of the COPD patients had at least one additional chronic comorbidity, 56% had two or more comorbidities and 35% had three or more comorbidities. In univariate analysis body mass index, the number of pack years and having at least one additional comorbidity was negatively associated with PAL while there was a positive nonlinear association between FEV1 and PAL. The presence of at least one additional comorbidity was independently associated with PAL irrespective of airflow limitation. Conclusions In this cohort, almost 80% of COPD patients had at least one additional chronic comorbidity. The level of daily PA seems to be significantly impaired by the presence of comorbidities irrespective of the type of comorbidity and independent of the degree of airflow limitation. copy; 2015 Asian Pacific Society of Respirology. Source


Schonmann M.,University of Zurich | Sievi N.A.,University of Zurich | Clarenbach C.F.,University of Zurich | Brack T.,Cantonal Hospital of Glarus | And 8 more authors.
Lung | Year: 2015

Purpose: Acute exacerbations (AE) in patients with COPD are associated with a decline in lung function, increased risk of hospitalization, and mortality. In this cross-sectional study we tested whether the level of objectively measured daily physical activity and exercise capacity are associated with the number of COPD exacerbations. Methods: In 210 patients with COPD (67 % men; mean (SD) age: 63 (8) years) enrolled in The Obstructive Pulmonary Disease Outcomes Cohort of Switzerland (TOPDOCS) physical activity (PA) (steps per day, physical activity level, (PAL)), exercise capacity (6-min walking distance, (6MWD)), comorbidities, lung function, and medication were assessed. Differences between COPD patients with frequent (≥2 year) and infrequent (0–1 year) exacerbations were assessed. Univariate and multivariate analyses were performed to investigate whether the level of objectively measured daily physical activity and exercise capacity are associated with the number of COPD exacerbations. Results: Patients with frequent AE had a significantly lower FEV1 and 6MWD compared to patients with infrequent AE. In univariate analysis, the number of exacerbations was inversely associated with FEV1, 6MWD, BMI, and smoking status while there was a positive association with RV/TLC and combined inhaled medication. However, there was no significant association with PAL and steps per day. In multivariate analysis, FEV1 and the use of combined inhaled medication were independently associated with the number of AE, after correction for covariates. Conclusions: The findings of this study imply that FEV1, independent of inhaled medication, is significantly associated with COPD exacerbations. Neither physical activity nor exercise capacity was independently associated with COPD exacerbations. © 2014, Springer Science+Business Media New York. Source


Giger-Tobler C.,University of Zurich | Eisenack J.,University of Zurich | Holzmann D.,University of Zurich | Pangalu A.,University of Zurich | And 4 more authors.
Klinische Monatsblatter fur Augenheilkunde | Year: 2015

Background: Quantification of the optic nerve sheath diameter is a promising approach for the detection of elevated intracranial pressure. The comparability of current methods is unclear. The objective of this study was to assess the relationship between optic nerve sheath diameter as measured with computed tomography, magnetic resonance tomography and ultrasound in patients without known optic nerve disease or increased intracranial pressure. Patients and Methods: 15 patients (60.8 [years] ±16.73SD; 7 female) with paranasal sinus pathology in whom computed tomography and magnetic resonance imaging were performed underwent optic nerve sheath diameter measurements by ultrasound, as well as an ophthalmological examination. Ultrasound-, computed tomography- and magnetic resonance imaging-derived maximal optic nerve sheath diameter values 3mm behind the globe were compared. Results: Optic nerve sheath diameter measured (n=30) by ultrasound (mean 6.2 [mm] ±0.84SD) was significantly (p<0.01) higher than optic nerve sheath diameter in computed tomography (5.2±1.11) or magnetic resonance imaging (5.3±1.14). There was no significant (p=0.24) difference between optic nerve sheath diameter measured in computed tomography and magnetic resonance tomography. Conclusions: The comparability of optic nerve sheath diameter measurements in patients without known optic nerve disease and assumed normal intracranial pressure appears to be given between computed tomography and magnetic resonance tomography, while comparability between ultrasound and computed tomography or magnetic resonance tomography seems to be less reliable. Source


Fruh M.,Cantonal Hospital of St. Gallen | Cathomas R.,Cantonal Hospital of Graubunden | Siano M.,Cantonal Hospital of St. Gallen | Tscherry G.,Hospital of Uster | And 9 more authors.
Clinical Lung Cancer | Year: 2013

Introduction: Small-cell lung cancer (SCLC) is a highly vascularized tumor. ASA404 is a tumor vascular disrupting agent. This is the first trial to report the effects of combining chemotherapy with ASA404 in SCLC. Methods: Patients with untreated metastatic SCLC were treated with carboplatin (area under curve, 6) plus paclitaxel (175 mg/m2) plus ASA404 (1800 mg/m2) on day 1 every 21 days for up to 6 cycles. The primary endpoint was the progression-free survival (PFS) rate at 24 weeks. Results: Median age was 61 years; 53% were women, 41% had weight loss; and 96% had a performance status of 0-1. Twelve patients completed all 6 cycles, and most adverse events were related to chemotherapy. Median PFS and time to progression were 7.0 months (95% CI, 5.7-9.4 months) and 7.5 months (95% CI, 5.7-9.4 months), respectively. The progression-free survival (PFS) rate at 24 weeks was 41% (95% CI, 18%-65%). The overall response rate was 94%. The median overall survival time was 14.2 months (95% CI, 8.2-16.0 months) and 1-year survival was 57%. The median follow-up time was 17.7 months. Due to negative results with ASA404 in non-small-cell lung cancer trials, the trial was stopped prematurely after 17 of 56 planned patients were being accrued. Conclusions: This is the first report of a clinical trial with a vascular disrupting agent in SCLC. No unexpected toxicity was observed. PFS was not prolonged with carboplatin and paclitaxel plus ASA404. © 2013 Elsevier Inc. All rights reserved. Source


Sturm V.,Cantonal Hospital of St. Gallen | Sturm V.,University of Zurich | Menke M.N.,Cantonal Hospital of Aarau | Jaggi G.P.,University of Zurich | And 2 more authors.
Klinische Monatsblatter fur Augenheilkunde | Year: 2015

Background: Surgical management of large-angle infantile esotropia and decompensated microtropia has been controversially debated. There seems to be a relative bias against surgery on more than two horizontal muscles to avoid overcorrections. In our study we report on the sensory and motor outcomes after three horizontal muscle surgery. Furthermore we aim to suggest a table to guide surgery amounts. Patients and Methods: This study was a retrospective interventional cohort of 27 patients (16 female, 11 male; mean age 7.9 [years], ranging from 1 to 27 [years]) with infantile esotropia and decompensated microtropia who underwent three horizontal muscle surgery (bilateral medial rectus muscle recession and lateral rectus muscle plication) between 2005 and 2013. Results: Preoperative deviation in primary position measured 30.2 [°] (mean; range 21.9 to 48.0). Postoperatively esotropia was significantly reduced to 2.6 [°] (mean; range -16.7 to 16.7). After six months deviation measured 5.5 [°] (mean, range -14.1 to 21.9). An effect of 1.63°/mm was calculated for the combined three muscle surgery. Conclusions: For the correction of large-angle infantile esotropia and decompensated microtropia three horizontal muscle surgery is associated with a high success rate. Only a very low rate of consecutive exotropia does occur. Source

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