TY  - JOUR
A1  - Schwaab, Bernhard
A1  - Bjarnason-Wehrens, Birna
A1  - Meng, Karin
A1  - Albus, Christian
A1  - Salzwedel, Annett
A1  - Schmid, Jean-Paul
A1  - Benzer, Werner
A1  - Metz, Matthes
A1  - Jensen, Katrin
A1  - Rauch, Bernhard
A1  - Bönner, Gerd
A1  - Brzoska, Patrick
A1  - Buhr-Schinner, Heike
A1  - Charrier, Albrecht
A1  - Cordes, Carsten
A1  - Dörr, Gesine
A1  - Eichler, Sarah
A1  - Exner, Anne-Kathrin
A1  - Fromm, Bernd
A1  - Gielen, Stephan
A1  - Glatz, Johannes
A1  - Gohlke, Helmut
A1  - Grilli, Maurizio
A1  - Gysan, Detlef
A1  - Härtel, Ursula
A1  - Hahmann, Harry
A1  - Herrmann-Lingen, Christoph
A1  - Karger, Gabriele
A1  - Karoff, Marthin
A1  - Kiwus, Ulrich
A1  - Knoglinger, Ernst
A1  - Krusch, Christian-Wolfgang
A1  - Langheim, Eike
A1  - Mann, Johannes
A1  - Max, Regina
A1  - Metzendorf, Maria-Inti
A1  - Nebel, Roland
A1  - Niebauer, Josef
A1  - Predel, Hans-Georg
A1  - Preßler, Axel
A1  - Razum, Oliver
A1  - Reiss, Nils
A1  - Saure, Daniel
A1  - von Schacky, Clemens
A1  - Schütt, Morten
A1  - Schultz, Konrad
A1  - Skoda, Eva-Maria
A1  - Steube, Diethard
A1  - Streibelt, Marco
A1  - Stüttgen, Martin
A1  - Stüttgen, Michaela
A1  - Teufel, Martin
A1  - Tschanz, Hansueli
A1  - Völler, Heinz
A1  - Vogel, Heiner
A1  - Westphal, Ronja
T1  - Cardiac rehabilitation in German speaking countries of Europe — evidence-based guidelines from Germany, Austria and Switzerland LLKardReha-DACH — part 2
JF  - Journal of Clinical Medicine
N2  - Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients' groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.
KW  - cardiac rehabilitation
KW  - scientific guidelines
KW  - secondary prevention
KW  - physical activity
KW  - exercise training
KW  - psychological interventions
KW  - education
KW  - gender
KW  - frailty
KW  - migration
KW  - old patients
KW  - young patients
KW  - tele-medicine
KW  - home-based-rehabilitation
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242645
SN  - 2077-0383
VL  - 10
IS  - 14
ER  - 
TY  - JOUR
A1  - El-Helou, Sabine M.
A1  - Biegner, Anika-Kerstin
A1  - Bode, Sebastian
A1  - Ehl, Stephan R.
A1  - Heeg, Maximilian
A1  - Maccari, Maria E.
A1  - Ritterbusch, Henrike
A1  - Speckmann, Carsten
A1  - Rusch, Stephan
A1  - Scheible, Raphael
A1  - Warnatz, Klaus
A1  - Atschekzei, Faranaz
A1  - Beider, Renata
A1  - Ernst, Diana
A1  - Gerschmann, Stev
A1  - Jablonka, Alexandra
A1  - Mielke, Gudrun
A1  - Schmidt, Reinhold E.
A1  - Schürmann, Gesine
A1  - Sogkas, Georgios
A1  - Baumann, Ulrich H.
A1  - Klemann, Christian
A1  - Viemann, Dorothee
A1  - Bernuth, Horst von
A1  - Krüger, Renate
A1  - Hanitsch, Leif G.
A1  - Scheibenbogen, Carmen M.
A1  - Wittke, Kirsten
A1  - Albert, Michael H.
A1  - Eichinger, Anna
A1  - Hauck, Fabian
A1  - Klein, Christoph
A1  - Rack-Hoch, Anita
A1  - Sollinger, Franz M.
A1  - Avila, Anne
A1  - Borte, Michael
A1  - Borte, Stephan
A1  - Fasshauer, Maria
A1  - Hauenherm, Anja
A1  - Kellner, Nils
A1  - Müller, Anna H.
A1  - Ülzen, Anett
A1  - Bader, Peter
A1  - Bakhtiar, Shahrzad
A1  - Lee, Jae-Yun
A1  - Heß, Ursula
A1  - Schubert, Ralf
A1  - Wölke, Sandra
A1  - Zielen, Stefan
A1  - Ghosh, Sujal
A1  - Laws, Hans-Juergen
A1  - Neubert, Jennifer
A1  - Oommen, Prasad T.
A1  - Hönig, Manfred
A1  - Schulz, Ansgar
A1  - Steinmann, Sandra
A1  - Klaus, Schwarz
A1  - Dückers, Gregor
A1  - Lamers, Beate
A1  - Langemeyer, Vanessa
A1  - Niehues, Tim
A1  - Shai, Sonu
A1  - Graf, Dagmar
A1  - Müglich, Carmen
A1  - Schmalzing, Marc T.
A1  - Schwaneck, Eva C.
A1  - Tony, Hans-Peter
A1  - Dirks, Johannes
A1  - Haase, Gabriele
A1  - Liese, Johannes G.
A1  - Morbach, Henner
A1  - Foell, Dirk
A1  - Hellige, Antje
A1  - Wittkowski, Helmut
A1  - Masjosthusmann, Katja
A1  - Mohr, Michael
A1  - Geberzahn, Linda
A1  - Hedrich, Christian M.
A1  - Müller, Christiane
A1  - Rösen-Wolff, Angela
A1  - Roesler, Joachim
A1  - Zimmermann, Antje
A1  - Behrends, Uta
A1  - Rieber, Nikolaus
A1  - Schauer, Uwe
A1  - Handgretinger, Rupert
A1  - Holzer, Ursula
A1  - Henes, Jörg
A1  - Kanz, Lothar
A1  - Boesecke, Christoph
A1  - Rockstroh, Jürgen K.
A1  - Schwarze-Zander, Carolynne
A1  - Wasmuth, Jan-Christian
A1  - Dilloo, Dagmar
A1  - Hülsmann, Brigitte
A1  - Schönberger, Stefan
A1  - Schreiber, Stefan
A1  - Zeuner, Rainald
A1  - Ankermann, Tobias
A1  - Bismarck, Philipp von
A1  - Huppertz, Hans-Iko
A1  - Kaiser-Labusch, Petra
A1  - Greil, Johann
A1  - Jakoby, Donate
A1  - Kulozik, Andreas E.
A1  - Metzler, Markus
A1  - Naumann-Bartsch, Nora
A1  - Sobik, Bettina
A1  - Graf, Norbert
A1  - Heine, Sabine
A1  - Kobbe, Robin
A1  - Lehmberg, Kai
A1  - Müller, Ingo
A1  - Herrmann, Friedrich
A1  - Horneff, Gerd
A1  - Klein, Ariane
A1  - Peitz, Joachim
A1  - Schmidt, Nadine
A1  - Bielack, Stefan
A1  - Groß-Wieltsch, Ute
A1  - Classen, Carl F.
A1  - Klasen, Jessica
A1  - Deutz, Peter
A1  - Kamitz, Dirk
A1  - Lassy, Lisa
A1  - Tenbrock, Klaus
A1  - Wagner, Norbert
A1  - Bernbeck, Benedikt
A1  - Brummel, Bastian
A1  - Lara-Villacanas, Eusebia
A1  - Münstermann, Esther
A1  - Schneider, Dominik T.
A1  - Tietsch, Nadine
A1  - Westkemper, Marco
A1  - Weiß, Michael
A1  - Kramm, Christof
A1  - Kühnle, Ingrid
A1  - Kullmann, Silke
A1  - Girschick, Hermann
A1  - Specker, Christof
A1  - Vinnemeier-Laubenthal, Elisabeth
A1  - Haenicke, Henriette
A1  - Schulz, Claudia
A1  - Schweigerer, Lothar
A1  - Müller, Thomas G.
A1  - Stiefel, Martina
A1  - Belohradsky, Bernd H.
A1  - Soetedjo, Veronika
A1  - Kindle, Gerhard
A1  - Grimbacher, Bodo
T1  - The German national registry of primary immunodeficiencies (2012-2017)
JF  - Frontiers in Immunology
N2  - Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs. 

Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel. 

Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1-25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0-88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE-syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%-subcutaneous; 29%-intravenous; 1%-unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy. 

Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.
KW  - registry for primary immunodeficiency
KW  - primary immunodeficiency (PID)
KW  - German PID-NET registry
KW  - PID prevalence
KW  - European Society for Immunodeficiencies (ESID)
KW  - IgG substitution therapy
KW  - CVID
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226629
VL  - 10
ER  - 
TY  - THES
A1  - Herrmann, Johannes Bernd
T1  - Rolle des Komplement C5a-Rezeptors 1 in der Pathophysiologie der Meningokokken-Sepsis
T1  - Role of complement C5a-Receptor 1 in Pathophysiology of Meningococcal Sepsis
N2  - Das bekapselte, Gram-negative, diplokokkenförmige Bakterium Neisseria meningitidis (Nme) ist ein asymptomatischer Kommensale des oberen Nasenrachenraums im Men-schen. Gerade bei Kindern ist es dem humanspezifischen Pathogen in seltenen Fällen möglich, in den Blutstrom einzuwandern und lebensbedrohliche Krankheitsbilder wie Meningoenzephalitis und Sepsis auszulösen, welche als „Invasive Meningokokkener-krankung“ (IMD) zusammengefasst werden. Jährlich ereignen sich weltweit bis zu 1,2 Mio Fälle von IMD, welche aufgrund des fulminanten Verlaufs und der hohen Letalität gefürchtet sind. In der Bekämpfung der Nme-Sepsis ist das humane Komplementsystem von entscheidender Bedeutung. Vor diesem Hintergrund ist die protektive Rolle des lytischen (Membranangriffskomplex MAK) und opsonisierenden Arms (Opsonine iC3b und C1q) der Komplementkaskade gut dokumentiert. Dagegen ist der Beitrag des in-flammatorischen Arms (Anaphylatoxine C3a und C5a) in der Nme-Sepsis bisher unklar. Aus diesem Grunde wurde mit dieser Arbeit die Rolle des inflammatorischen Arms an-hand des Komplement C5a-Rezeptors 1 (C5aR1) in der Pathophysiologie der Nme-Sepsis am Mausmodell untersucht. Nach Etablierung des murinen, intraperitonealen In-fektionsmodells konnte ein schädlicher Effekt des C5aR1 in der Nme-Sepsis beobachtet werden. Aus der Abwesenheit des C5aR1 resultierte eine höhere Überlebensrate, ein besserer klinischer Zustand, eine niedrigere Bakteriämie und niedrigere Konzentrationen der pro-inflammatorischen Mediatoren IL-6, CXCL-1 und TNF-α. Im Hinblick auf den zellulären Pathomechanismus sprechen Ergebnisse dieser Arbeit dafür, dass der C5aR1 primär eine gesteigerte Freisetzung inflammatorischer Mediatoren durch verschiedene Zellpopulationen triggert (Zytokinsturm), wodurch sekundär Zellparalyse, steigende Bakteriämie und höhere Letalität bedingt sind. Durch Depletionsversuche und Immun-fluoreszenzfärbungen konnte, unabhängig vom C5aR1, eine allgemein protektive Rolle von neutrophilen Granulozyten und Monozyten/Makrophagen in der Nme-Sepsis beo-bachtet werden. Darüber hinaus präsentierte sich der zyklische C5aR1-Antagonist PMX205 als erfolgsversprechende Therapieoption, um Parameter einer murinen Nme-Sepsis zu verbessern. Weitere Untersuchungen sind nötig, um die Wirksamkeit dieser Substanz in der humanen Nme-Sepsis zu erforschen. Zudem könnte das murine, intrape-ritoneale Infektionsmodell zur Klärung der Rolle des C5aR2 in der Nme-Sepsis genutzt werden.
N2  - The encapsulated, Gram-negative diplococcus Neisseria meningitidis (Nme) is an asymp-tomatic commensal in the human upper respiratory tract. In rare cases and especially in children, this human-specific pathogen is able to invade into the blood stream and cause life-threatening disorders like meningoencephalitis and septicemia, which are subsumed as „invasive meningococcal disease“ (IMD). The estimated number of cases is about 1.2 mio per year worldwide. IMD is greatly feared because of its fulminant progression and its high lethality. It is very well known, that the human complement system holds an essential role to fight meningococcal sepsis. In this context, the protective effects of the lytic (membrane attack complex MAC) and opsonizing branches (opsonines iC3b and C1q) are well established. On the contrary, very little is known about the contribution of the inflammatory branch (anaphylatoxines C3a and C5a) in meningococcal sepsis. Therefore, this work focused on the role of the C5a-Receptor 1 (C5aR1) in pathophysi-ology of meningococcal sepsis in a murine model. After having established the para-mount role of complement in murine intraperitoneal infection model, we could observe a detrimental effect of C5aR1 in Meningococcal sepsis. The absence of C5aR1 resulted in a higher overall survival, ameliorated clinical status, lower bacteremia and lower levels of the proinflammatory mediators IL-6, CXCL-1, TNF-α. Particularly with regard to results about the cellular pathomechanism, the C5aR1 seems to cause an increased re-lease of proinflammatory mediators (cytokine storm) exerted by various cell populations. As a consequence, cellular paralysis, increasing bacterial burden and higher lethality rate seems to occur. In reference to depletion experiments and immunofluorescence stain-ings, we could observe protective overall effects of neutrophils and mono-cytes/macrophages, uncorrelated to C5aR1 presence. Ultimately, the cyclic C5aR1-antagonist PMX205 appeared to be a promising option to improve parameters in murine meningococcal sepsis. Further experiments are required to examine the potential of this compound in human meningococcal sepsis. Moreover, the murine, intraperitoneal infec-tion model could be used to clarify the role of C5aR2 in meningococcal sepsis.
KW  - Komplement C5a
KW  - Neisseria meningitidis
KW  - Meningokokken-Sepsis
KW  - Komplement C5a Rezeptor 1
KW  - C5aR1-Antagonist
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-184533
ER  -