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Koch B.,University of Greifswald | Friedrich N.,Institute of Clinical Chemistry and Laboratory Medicine | Volzke H.,University of Greifswald | Jorres R.A.,Ludwig Maximilians University of Munich | And 4 more authors.
Respirology | Year: 2013

Background and objective: The assessment of static lung volumes and airway resistance is a frequently performed diagnostic procedure and considered as an important tool in medical surveillance to detect pulmonary diseases. The objectives of the study are to establish reference equations for body plethysmographic parameters in a representative adult population across a wide age range and to compare the normative values from this sample with previous ones. Methods: Body plethysmography was applied in 1809 participants (885 males) of a cross-sectional, population-based survey (Study of Health in Pomerania). Individuals with cardiopulmonary disorders and/or a pack-year smoking history >10 years and participants with a body mass index >30 kg/m2 were excluded. In total, 686 healthy individuals (275 males) aged 25-85 years were assessed. Results: Prediction equations for both genders were established by quantile regression analysis taking into account the influence of age, height and weight. Conclusions: The study provides a novel set of prediction equations for static lung volumes and airway resistance obtained using body plethysmography. Compared with our findings, existing equations underestimated some normal values. The results emphasize the need for up-to-date reference equations. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Enko D.,Institute of Clinical Chemistry and Laboratory Medicine
European Journal of Clinical Nutrition | Year: 2016

Background/Objectives:Primary adult-type lactose malabsorption (PALM) is a widespread inherited autosomal recessive condition, which is considered to be associated with osteoporosis. This prospective study aimed at assessing the 25-hydroxy-vitamin D (25(OH)D) status and serum CrossLaps levels in individuals with PALM and normal controls.Subjects/Methods:All participants (n=210) underwent genotyping for the LCT C/T-13910 polymorphism, 25(OH)D and CrossLaps measurements and clinical examinations. In addition, the anthropometric data (that is, height, weight and body mass index) were determined.Results:Fifty-five individuals with PALM (that is, LCT C/C-13910 homozygotes) showed lower 25(OH)D (mean: 24.95±10.04 vs 28.59±9.56 ng/ml, P=0.018) and higher CrossLaps serum levels (mean: 0.46±0.31 vs 0.43±0.49 ng/ml, P=0.251) compared with 155 normal controls (that is, LCT C/T-13910 hetero- or T/T-13910 homozygotes). Anthropometric data were similar between PALM probands and controls.Conclusions:Individuals with PALM were found to have lower 25(OH)D and higher CrossLaps serum levels compared with normal controls. In order to preserve life-long bone health, routine 25(OH)D and CrossLaps serum measurements should be performed in individuals with PALM.European Journal of Clinical Nutrition advance online publication, 27 April 2016; doi:10.1038/ejcn.2016.66. © 2016 Macmillan Publishers Limited

Mohlenkamp S.,Clinic of Cardiology and Intensive Care Medicine | Leineweber K.,University of Duisburg - Essen | Lehmann N.,University of Duisburg - Essen | Braun S.,Institute of Clinical Chemistry and Laboratory Medicine | And 9 more authors.
Basic Research in Cardiology | Year: 2014

We determined the prognostic value of transient increases in high-sensitive serum troponin I (hsTnI) during a marathon and its association with traditional cardiovascular risk factors and imaging-based risk markers for incident coronary events and all-cause mortality in recreational marathon runners. Baseline data of 108 marathon runners, 864 age-matched controls and 216 age- and risk factor-matched controls from the general population were recorded and their coronary event rates and all-cause mortality after 6 ± 1 years determined. hsTnI was measured in 74 marathon finishers before and after the race. Other potential predictors for coronary events, i.e., Framingham Risk Score (FRS), coronary artery calcium (CAC) and presence of myocardial fibrosis as measured by magnetic resonance imaging-based late gadolinium enhancement (LGE), were also assessed. An increase beyond the 99 % hsTnI-threshold, i.e., 0.04 μg/L, was observed in 36.5 % of runners. FRS, CAC, or prevalent LGE did not predict hsTnI values above or increases in hsTnI beyond the median after the race, nor did they predict future events. However, runners with versus without LGE had higher hsTnI values after the race (median (Q1/Q3), 0.08 μg/L (0.04/0.09) versus 0.03 μg/L (0.02/0.06), p = 0.039), and higher increases in hsTnI values during the race (median (Q1/Q3), 0.05 μg/L (0.03/0.08) versus 0.02 μg/L (0.01/0.05), p = 0.0496). Runners had a similar cumulative event rate as age-matched or age- and risk factor-matched controls, i.e., 6.5 versus 5.0 % or 4.6 %, respectively. Event rates in runners with CAC scores <100, 100-399, and ≥400 were 1.5, 12.0, and 21.4 % (p = 0.002 for trend) and not different from either control group. Runners with coronary events had a higher prevalence of LGE than runners without events (57 versus 8 %, p = 0.003). All-cause mortality was similar in marathon runners (3/108, 2.8 %) and controls (26/864, 3.0 % or 5/216, 2.4 %, respectively). Recreational marathon runners with prevalent myocardial fibrosis develop higher hsTnI values during the race than those without. Increasing coronary artery calcium scores and prevalent myocardial fibrosis, but not increases in hsTnI are associated with higher coronary event rates. All-cause mortality in marathon runners is similar to that in risk factor-matched controls. © 2013 Springer-Verlag Berlin Heidelberg.

Darr R.,TU Dresden | Lenders J.W.M.,Radboud University Nijmegen | Naumann B.,TU Dresden | Eisenhofer G.,Institute of Clinical Chemistry and Laboratory Medicine
Therapeutic Advances in Endocrinology and Metabolism | Year: 2012

Pheochromocytomas are rare endocrine tumors that can present insidiously and remain undiagnosed until death or onset of clear manifestations of catecholamine excess. They are often referred to as one of the 'great mimics' in medicine. These tumors can no longer be regarded as a uniform disease entity, but rather as a highly heterogeneous group of chromaffin cell neoplasms with different ages of onset, secretory profiles, locations, and potential for malignancy according to underlying genetic mutations. These aspects all have to be considered when the tumor is encountered, thereby enabling optimal management for the patient. Referral to a center of specialized expertise for the disease should be considered wherever possible. This is not only important for surgical management of patients, but also for post-surgical follow up and screening of disease in patients with a hereditary predisposition to the tumor. While preoperative management has changed little over the last 20 years, surgical procedures have evolved so that laparoscopic resection is the standard of care and partial adrenalectomy should be considered in all patients with a hereditary condition. Follow-up testing is essential and should be recommended and ensured on a yearly basis. Managing such patients must now also take into account possible underlying mutations and the appropriate selection of genes for testing according to disease presentation. Patients and family members with identified mutations then require an individualized approach to management. This includes consideration of distinct patterns of biochemical test results during screening and the appropriate choice of imaging studies for tumor localization according to the mutation and associated differences in predisposition to adrenal, extra-adrenal and metastatic disease. © The Author(s), 2012.

Singler K.,Nuremberg Hospital | Bertsch T.,Institute of Clinical Chemistry and Laboratory Medicine | Heppner H.J.,Nuremberg Hospital | Kob R.,Institute for Biomedicine of Aging | And 4 more authors.
Age and Ageing | Year: 2013

Objective: we examined the diagnostic accuracy of different methods of body temperature measurement to diagnose infection in geriatric patients presenting to the emergency department (ED). Methods: this observational study was done in consecutive patients ≥75 years old presenting to the ED. Body temperature was determined by tympanal thermometry, temporal artery thermometry and rectal temperature measurement. Adjudicated final diagnosis of infection was done by two experts including patient history, clinical and laboratory findings as well as radiographic studies. Results: a total of 427 patients were included in the data analysis (age: 82.7 ± 5.1 years). Infection was present in 105 patients (24.6%). Respiratory rate, heart rate and body temperature were significantly higher in patients with infection, blood pressure was lower (P < 0.01). Body temperature measured by tympanal and temporal artery thermometry was correlated with rectal thermometry. Body temperature was significantly higher in patients with infection compared with those without infection independent of the method of body temperature measurement (P < 0.001). The diagnostic accuracy for infection quantified by the area under curve (AUC) was comparable among rectal [AUC: 0.72 (95% CI: 0.65-0.80)] and tympanal thermometry [AUC: 0.73 (95% CI: 0.66-0.81)], but significantly lower in temporal artery thermometry [AUC: 0.65 (95% CI: 0.57-0.73; P < 0.001)]. Compared with rectal measurement tympanal thermometry showed a higher bias than temporal artery thermometry (0.54 versus 0.03°C), while its limits of agreement were more narrow (-0.14 to 1.21°C versus -0.94-1.01°C). Conclusion: diagnostic accuracy for the identification of infection was comparable among tympanal and rectal thermometry and lower for temporal artery thermometry. Different cut-offpoints should be used to identify infection using tympanal (37.3°C) or rectal (37.9°C) thermometry. In general, temperature measurement is an insensitive method to identify geriatric patients with infection. Registration number clinicaltrials.com: KSMC-tempger-1. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

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