TY  - JOUR
A1  - Walter, Maggie C.
A1  - Reilich, Peter
A1  - Thiele, Simone
A1  - Schessl, Joachim
A1  - Schreiber, Herbert
A1  - Reiners, Karlheinz
A1  - Kress, Wolfram
A1  - Müller-Reible, Clemens
A1  - Vorgerd, Matthias
A1  - Urban, Peter
A1  - Schrank, Bertold
A1  - Deschauer, Marcus
A1  - Schlotter-Weigel, Beate
A1  - Kohnen, Ralf
A1  - Lochmüller, Hans
T1  - Treatment of dysferlinopathy with deflazacort: a double-blind, placebo-controlled clinical trial
JF  - Orphanet Journal of Rare Diseases
N2  - Background: Dysferlinopathies are autosomal recessive disorders caused by mutations in the dysferlin (DYSF) gene encoding the dysferlin protein. DYSF mutations lead to a wide range of muscular phenotypes, with the most prominent being Miyoshi myopathy (MM) and limb girdle muscular dystrophy type 2B (LGMD2B). 
Methods: We assessed the one-year-natural course of dysferlinopathy, and the safety and efficacy of deflazacort treatment in a double-blind, placebo-controlled cross-over trial. After one year of natural course without intervention, 25 patients with genetically defined dysferlinopathy were randomized to receive deflazacort and placebo for six months each (1 mg/kg/day in month one, 1 mg/kg every 2nd day during months two to six) in one of two treatment sequences. Results: During one year of natural course, muscle strength declined about 2% as measured by CIDD (Clinical Investigation of Duchenne Dystrophy) score, and 76 Newton as measured by hand-held dynamometry. Deflazacort did not improve muscle strength. In contrast, there is a trend of worsening muscle strength under deflazacort treatment, which recovers after discontinuation of the study drug. During deflazacort treatment, patients showed a broad spectrum of steroid side effects. 
Conclusion: Deflazacort is not an effective therapy for dysferlinopathies, and off-label use is not warranted. This is an important finding, since steroid treatment should not be administered in patients with dysferlinopathy, who may be often misdiagnosed as polymyositis.
KW  - Deflazacort
KW  - muscle strength
KW  - gridle muscular-dystrophy
KW  - Duchenne dystrphy
KW  - Miyoshi myopathy
KW  - mutation
KW  - prednisone
KW  - gene
KW  - 2B
KW  - children
KW  - design
KW  - steroids
KW  - therapy
KW  - dysferlinopathy
KW  - Limb girdle muscular dystrophy (LGMD)
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125663
SN  - 1750-1172
VL  - 8
IS  - 26
ER  - 
TY  - JOUR
A1  - Vollmuth, Christoph
A1  - Muljukov, Olga
A1  - Abu-Mugheisib, Mazen
A1  - Angermeier, Anselm
A1  - Barlinn, Jessica
A1  - Busetto, Loraine
A1  - Grau, Armin J.
A1  - Günther, Albrecht
A1  - Gumbinger, Christoph
A1  - Hubert, Nikolai
A1  - Hüttemann, Katrin
A1  - Klingner, Carsten
A1  - Naumann, Markus
A1  - Palm, Frederick
A1  - Remi, Jan
A1  - Rücker, Viktoria
A1  - Schessl, Joachim
A1  - Schlachetzki, Felix
A1  - Schuppner, Ramona
A1  - Schwab, Stefan
A1  - Schwartz, Andreas
A1  - Trommer, Adrian
A1  - Urbanek, Christian
A1  - Volbers, Bastian
A1  - Weber, Joachim
A1  - Wojciechowski, Claudia
A1  - Worthmann, Hans
A1  - Zickler, Philipp
A1  - Heuschmann, Peter U.
A1  - Haeusler, Karl Georg
A1  - Hubert, Gordian Jan
T1  - Impact of the coronavirus disease 2019 pandemic on stroke teleconsultations in Germany in the first half of 2020
JF  - European Journal of Neurology
N2  - Background and purpose
The effects of the coronavirus disease 2019 (COVID-19) pandemic on telemedical care have not been described on a national level. Thus, we investigated the medical stroke treatment situation before, during, and after the first lockdown in Germany.

Methods
In this nationwide, multicenter study, data from 14 telemedical networks including 31 network centers and 155 spoke hospitals covering large parts of Germany were analyzed regarding patients' characteristics, stroke type/severity, and acute stroke treatment. A survey focusing on potential shortcomings of in-hospital and (telemedical) stroke care during the pandemic was conducted.

Results
Between January 2018 and June 2020, 67,033 telemedical consultations and 38,895 telemedical stroke consultations were conducted. A significant decline of telemedical (p < 0.001) and telemedical stroke consultations (p < 0.001) during the lockdown in March/April 2020 and a reciprocal increase after relaxation of COVID-19 measures in May/June 2020 were observed. Compared to 2018–2019, neither stroke patients' age (p = 0.38), gender (p = 0.44), nor severity of ischemic stroke (p = 0.32) differed in March/April 2020. Whereas the proportion of ischemic stroke patients for whom endovascular treatment (14.3% vs. 14.6%; p = 0.85) was recommended remained stable, there was a nonsignificant trend toward a lower proportion of recommendation of intravenous thrombolysis during the lockdown (19.0% vs. 22.1%; p = 0.052). Despite the majority of participating network centers treating patients with COVID-19, there were no relevant shortcomings reported regarding in-hospital stroke treatment or telemedical stroke care.

Conclusions
Telemedical stroke care in Germany was able to provide full service despite the COVID-19 pandemic, but telemedical consultations declined abruptly during the lockdown period and normalized after relaxation of COVID-19 measures in Germany.
KW  - COVID-19
KW  - SARS-CoV- 2
KW  - stroke
KW  - telemedicine
KW  - survey
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259396
VL  - 28
IS  - 10
ER  -