Universitatsklinikum Halle Saale

Halle (Saale), Germany

Universitatsklinikum Halle Saale

Halle (Saale), Germany
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Herth F.J.F.,Pneumology and Critical Care Medicine | Eberhardt R.,Pneumology and Critical Care Medicine | Gompelmann D.,Pneumology and Critical Care Medicine | Ficker J.H.,Klinikum Nurnberg | And 4 more authors.
European Respiratory Journal | Year: 2013

One-way endobronchial valves (EBVs) have been shown to relieve symptoms of emphysema, particularly in patients without collateral ventilation (CV) between the target and adjacent lobes. In this study, we investigated the ability of the bronchoscopic ChartisTM Pulmonary Assessment System to predict treatment response by determining the presence of CV. 80 EBV patients underwent a pre-treatment Chartis assessment. Before and 30 days after implantation, high-resolution computed tomography scans were taken to determine target lobe volume reduction (TLVR). A pre- to post-treatment reduction of o350 mL was defined as significant. In addition, clinical outcomes (forced expiratory volume in 1 s (FEV1), 6-min walk test and St George's Respiratory Questionnaire) were compared over the same time period. Of the 51 patients classified as having an absence of CV according to their Chartis reading, 36 showed a TLVR o350 mL. 29 patients were classified as having CV, and of these 24 did not meet this TLVR cut-off. Chartis showed an accuracy level of 75% in predicting whether or not the TLVR cut-off would be reached. Those predicted to respond showed significantly greater TLVR (p<0.0001) and FEV1 improvement (p=0.0013) than those predicted not to respond. Chartis is a safe and effective method of predicting response to EBV treatment.

Kneip C.,Theracode GmbH | Schmidt B.,Universitatsklinikum Halle Saale | Seegebarth A.,Bavarian Nordic | Weickmann S.,Charité - Medical University of Berlin | And 4 more authors.
Journal of Thoracic Oncology | Year: 2011

Introduction: Recently, analysis of DNA methylation of the SHOX2 locus was shown to reliably identify lung cancer in bronchial aspirates of patients with disease. As a plasma-based assay would expand the possible applications of the SHOX2 biomarker, this study aimed to develop a modified SHOX2 assay for use in a blood-based test and to analyze the performance of this optimized SHOX2 methylation assay in plasma. Methods: Quantitative real-time polymerase chain reaction was used to analyze DNA methylation of SHOX2 in plasma samples from 411 individuals. A training study (20 stage IV patients with lung cancer and 20 controls) was performed to show the feasibility of detecting the SHOX2 biomarker in blood and to determine a methylation cutoff for patient classification. The resulting cutoff was verified in a testing study composed of 371 plasma samples from patients with lung cancer and controls. Results: DNA methylation of SHOX2 could be used as a biomarker to distinguish between malignant lung disease and controls at a sensitivity of 60% (95% confidence interval: 53-67%) and a specificity of 90% (95% confidence interval: 84-94%). Cancer in patients with stages II (72%), III (55%), and IV (83%) was detected at a higher sensitivity when compared with stage I patients. Small cell lung cancer (80%) and squamous cell carcinoma (63%) were detected at the highest sensitivity when compared with adenocarcinomas. Conclusions: SHOX2 DNA methylation is a biomarker for detecting the presence of malignant lung disease in blood plasma from patients with lung cancer. © 2011 by the International Association for the Study of Lung Cancer.

Kliesch S.,Universitatsklinikum Munster | Zitzmann M.,Universitatsklinikum Munster | Behre H.M.,Universitatsklinikum Halle Saale
Urologe - Ausgabe A | Year: 2011

In the past 10 years, our knowledge about fertility chances of patients with Klinefelter syndrome (KS, 47,XXY) has changed considerably, especially when regarding the possibility of IVF ICSI treatment (in vitro fertilisation, intracytoplasmic sperm injection) with single testicular spermatozoa. Thus, it is important to take this knowledge into consideration when counselling Klinefelter patients. Germ cell degeneration in the testicles of Klinefelter patients due to their additional X chromosome is an important phenomenon in this disease which is not yet fully understood. When entering puberty, the testicular volume of KS patients increases for a short time with rising testosterone and inhibin B levels at the same time. These decrease, however, and FSH increases during puberty. This seems to indicate a critical point in time when spermatogenetic function of the testicles could still be existent. Thus, in early puberty there could possibly be a time slot when spermatozoa could be detected in the ejaculate or-if not-at least in the testicular tissue. These could be extracted by testicular sperm extraction, cryopreserved and used for intracytoplasmic sperm injection therapy later on. In the literature, a total of 133 births of children from Klinefelter fathers have been reported. This early specific procedure could lead to a better acceptance of their diagnosis and also offer the option of not being incurably infertile. © 2011 Springer-Verlag.

The paediatric Hodgkin lymphoma treatment optimisation concepts aim at reduction of treatment intensity with preservation of the high cure rates. A negative interim FDG-PET result after 2 cycles of chemotherapy is associated with a good prognosis. In the current EuroNet-PHL-C1 study radiotherapy is being omitted, if interim PET becomes negative. In addition to the early interim PET after 2 cycles of chemotherapy, all patients undergo an initial PET investigation which is part of the staging processs and plays an essential role for the interpretation of the interim PET. Skeletal involvement can be detected by a typical FDG-PET uptake pattern with high sensitivity and specifi ty. Therefore, in the forthcoming EuroNet-PHL-C2 study bone marrow biopsy and bone scintigraphy will no longer be part of the staging algorithm. © Georg Thieme Verlag KG Stuttgart • New York.

Watzke S.,Martin Luther University of Halle Wittenberg | Watzke S.,Universitatsklinikum Halle Saale
Nervenheilkunde | Year: 2013

Valid prediction models of rehabilitation success are necessary conditions for choosing the appropriate rehabilitation programme for patients suffering from severe mental disorders. In numerous studies, rehabilitation success was predicted by the patients' cognitive performance. However, classic neuropsychological testing only describes current cognitive functions and therefore has only limited validity in the prognosis of performance chance that is targeted by rehabilitation. Dynamic cognitive testing offers the possibility to assess cognitive performance change or learning potential beyond current cognitive performance. This new diagnostic approach is introduced. Studies on the associations between cognitive learning potential and psychosocial, functional or rehabilitation outcome are presented. Finally, consequences for the selection of appropriate rehabilitation programmes according to the individual cognitive performance and learning potential are discussed. © Schattauer 2013.

Nutritional factors may contribute to the etiology of rheumatoid arthritis (RA). This is illustrated by the association of RA with malnutrition in infancy and with low birth weight. The contribution of single components of our daily diet to the risk of RA was demonstrated with respect to the protective effects of low- to moderate alcohol consumption and probably to an above-average intake of fish with a high content of fish oil. So far, interventional studies that have investigated the impact of definite dietary regimens on the course of RA have been disappointing with respect to quality and reliability. A Mediterranean diet may be helpful for RA patients, especially regarding the reduction of cardiovascular risks. Data demonstrating a benefit of nutritional supplements are scant. Fish oil capsules with a high content of omega-3-fatty acids may offer a mild therapeutic effect. Iron and vitamin D should be prescribed if indicated according to objective criteria and current guidelines. © 2015 Georg Thieme Verlag KG Stuttgart. New York.

Ebelt H.,Universitatsklinikum Halle Saale | Werdan K.,Universitatsklinikum Halle Saale
Internist | Year: 2010

In patients suffering from severe sepsis an impairment of cardiac function is seen constantly. Patients with septic shock often show a transient reduction of cardiac ejection fraction. Besides, a tremendous impairment of heart rate variability corresponding to a poor prognosis is often found. Endotoxin might play a pivotal role in the conjunction of inflammation and the disturbance of heart rate regulation. Experimental studies show that the complex interactions of endotoxin, the cardiac pacemaker current I f, and the autonomous nervous system lead to an increase of resting heart rate and in parallel to a decrease of heart rate variability - as typically seen in patients with severe sepsis. The method of choice to quantify the degree of septic cardiomyopathy at the intensive care unit certainly is to determine cardiac output in relation to systemic vascular resistance. Unfortunately, clinical trials aiming to influence the causal pathogenesis of septic cardiomyopathy (inhibition of excess formation of nitric oxide, suppression of cytokine release etc.) were rather disappointing so far. Positive effects might be assumed for the administration of activated protein C thereby underlining the role of microcirculatory alterations in the development of septic cardiomyopathy. © 2010 Springer-Verlag.

Liebau A.,Universitatsklinikum Halle Saale | Plontke S.K.,Universitatsklinikum Halle Saale
HNO | Year: 2015

The indications for local drug therapy of inner ear hearing loss include sudden sensorineural hearing loss, Menière’s disease, autoimmune-associated hearing loss, ototoxicity as a side effect of other therapies, acute acoustic trauma and improvement of the safety and performance of cochlear implants. Various drugs are currently being used and tested for local treatment of inner ear hearing loss, including glucocorticoids, growth factors, apoptosis inhibitors, antioxidants, TNF-α inhibitors and antibodies. To further a better understanding of pharmacokinetics and the development of rational pharmacotherapy of the inner ear, the“liberation, absorption, distribution, metabolism, elimination” (LADME) principle can be applied to local therapy of the inner ear. Local application strategies can be differentiated into intratympanic applications to the middle ear cavity and direct intralabyrinthine or intracochlear applications. © 2014, Springer-Verlag Berlin Heidelberg.

Both polymyalgia rheumatica and giant cell arteritis possess a multifaceted differential diagnosis. Since both entities are typical diseases of the elderly, degenerative disorders of the musculoskeletal system as well as ischemic heart disease and malignancies have to be taken into account. The incidence of neuropsychiatric diagnoses such as Parkinson's disease and depression is rising with age as well. Both conditions are known to cause chronic and widespread musculoskeletal pain. Drug induced side effects can mimic polymyalgia rheumatica as well as infections, the latter also leading to increased acute phase parameters. © Georg Thieme Verlag KG Stuttgart · New York.

Polymyalgia rheumatica and temporal arteritis are related entities. Both diseases strongly prefer patients of higher age, indicating that their relevance will increase in an aging society. Among persons older than 50 years, the incidence of polymyalgia rheumatica is higher than that of temporal arteritis, reaching almost 60 cases per 100 000 inhabitants. In the U. S. A. as well as in Europe, the incidence of both diseases is higher in northern regions. © Georg Thieme Verlag KG Stuttgart · New York.

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