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61. Vorderwandinfarkt bei einem 18jährigen Patienten mit M. Hodgkin: Möglicher Zusammenhang zwischen Mediastinalbestrahlung, akzelerierter Arteriosklerose und Vincristin-Chemotherapie

Author

Ehninger G, Steidle B, R. Jacksch, K. R. Karsch, M. Mauser, Schuler U, and Wolfram Voelker

Subjects
medicine.medical_specialty, Vincristine, Chemotherapy, business.industry, medicine.medical_treatment, Mediastinum, General Medicine, Arteriosclerosis, medicine.disease, Surgery, Radiation therapy, medicine.anatomical_structure, Aneurysm, Occlusion, cardiovascular system, Medicine, cardiovascular diseases, Myocardial infarction, business, medicine.drug
Abstract

An 18-year-old male patient with Hodgkin's disease, having undergone radiotherapy to the mediastinum two-and-a-half years previously, developed symptoms of an acute myocardial infarction within three hours of a vincristine injection (the first course of vincristine chemotherapy had been finished eight days previously). Invasive investigation after three weeks revealed single-vessel occlusion of the anterior interventricular branch with an anterior-wall aneurysm. The most likely cause of the coronary heart disease in this patient is changes in the anterior interventricular branch resulting from the mediastinal radiotherapy. The infarct itself occurred in close temporal relationship to the vincristine injection, which in several case reports has been implicated in the triggering of coronary spasms.

Published
2008
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65. State of integration of palliative care at Comprehensive Cancer Centers funded by German Cancer Aid

Author

Berendt, J., Oechsle, K., Thomas, M., van Oorschot, B., Schmitz, A., Radbruch, L., Simon, S. T., Gaertner, J., Thuss-Patience, P., Schuler, U. S., Hense, J., Gog, C., Viehrig, M., Mayer-Steinacker, R., Stachura, P., Stiel, S., Ostgathe, C., Berendt, J., Oechsle, K., Thomas, M., van Oorschot, B., Schmitz, A., Radbruch, L., Simon, S. T., Gaertner, J., Thuss-Patience, P., Schuler, U. S., Hense, J., Gog, C., Viehrig, M., Mayer-Steinacker, R., Stachura, P., Stiel, S., and Ostgathe, C.

Published
2016

70. Polymerase chain reaction monitoring reduces the incidence of cytomegalovirus disease and the duration and side effects of antiviral therapy after bone marrow transplantation

Author

Schuler U, P. Mackes, Gerhard Ehninger, Holger Hebart, Knut M. Wittkowski, Hermann Einsele, Claudia A. Müller, Thomas Klingebiel, M. Herter, Gerhard Jahn, Silvia Wagner, and Jürgen Löffler

Subjects
Adult, Male, Ganciclovir, medicine.medical_specialty, Neutropenia, Time Factors, Adolescent, Immunology, Cytomegalovirus, Antibodies, Viral, Antiviral Agents, Polymerase Chain Reaction, Biochemistry, Gastroenterology, Betaherpesvirinae, Acute lymphocytic leukemia, Internal medicine, medicine, Humans, Child, Survival rate, Bone Marrow Transplantation, biology, business.industry, Incidence (epidemiology), Cell Biology, Hematology, Middle Aged, biology.organism_classification, medicine.disease, Survival Rate, medicine.anatomical_structure, Cytomegalovirus Infections, DNA, Viral, Chemoprophylaxis, Female, Bone marrow, business, medicine.drug
Abstract

Culture-based preemptive therapy with ganciclovir was shown to reduce the incidence of cytomegalovirus (CMV) disease after bone marrow transplantation (BMT). Culture techniques did not detect CMV in 12% to 13% of patients before the onset of CMV disease. In a prospective study, 71 patients either received preemptive therapy based on polymerase chain reaction (PCR) technique (37 patients) or on culture assays (34 patients). In both groups, therapy was continued until clinical signs disappeared and PCR negativity was documented. Twenty-two patients in the PCR group and 15 patients in the culture group received antiviral therapy. PCR allowed detection of the virus (median day, +32 v day +49; P = .006) and introduction of antiviral therapy (median day, +44 v day +54; P = .02) earlier than did culture assays. The incidences of CMV disease (2 of 37 v 8 of 34 in PCR group v culture group, respectively; P = .02) and CMV-associated mortality (0 of 37 v 5 of 34 in PCR group v culture group, respectively; P = .02) were decreased, and the duration of ganciclovir therapy (P < .001) was shorter in the PCR-monitored group. Incidence and median duration of severe neutropenia (less than 500/microL) were lower in the PCR group (two v eight episodes, P = .02; median duration, 1.5 v 5 days, P = .04), as was the incidence of nonviral infections during/after antiviral therapy (2 of 37 v 9 of 34; P = .012). Thus, preemptive therapy based on more sensitive detection methods such as the PCR assay reduces the incidence of CMV disease and CMV-related mortality. Additionally, stopping and withholding antiviral therapy in a PCR-negative patient is safe and allows reduction of the duration and side effects of antiviral therapy.

Published
1995
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72. Applications of e-SOTER related to major soil threats

Author

Hessel, R., Verzandvoort, S.J.E., Walvoort, D.J.J., Heidema, A.H., Yigini, Y., Schuler, U., Daroussin, J., and Jones, B.

Subjects
Alterra - Soil geography, Life Science, Wageningen Environmental Research, Alterra - Soil physics and land use, CB - Bodemfysica en Landgebruik, Alterra - Bodemgeografie, SS - Soil Physics and Land Use, Alterra - Bodemfysica en landgebruik
Published
2012

73. Integration der Palliativmedizin in die von der Deutschen Krebshilfe e. V. geförderten onkologischen Spitzenzentren

Author

Berendt, J., additional, Oechsle, K., additional, Thomas, M., additional, van Oorschot, B., additional, Schmitz, A., additional, Radbruch, L., additional, Simon, S., additional, Gärtner, J., additional, Thuß-Patience, P., additional, Schuler, U., additional, Hense, J., additional, Gog, C., additional, Viehrig, M., additional, Mayer-Steinacker, R., additional, Stachura, P., additional, Stiel, S., additional, and Ostgathe, C., additional

Published
2016
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75. a Treatment cost of invasive fungal disease (Ifd) in patients with acute myelogenous leukaemia (Aml) or myelodysplastic syndrome (Mds) in German hospitals

Author

Rieger, C. T., Cornely, O. A., Hoppe-Tichy, T., Kiehl, M., Knoth, H., Thalheimer, M., Schuler, U., Ullmann, A. J., Ehlken, B., Ostermann, H., Rieger, C. T., Cornely, O. A., Hoppe-Tichy, T., Kiehl, M., Knoth, H., Thalheimer, M., Schuler, U., Ullmann, A. J., Ehlken, B., and Ostermann, H.

Abstract

Invasive fungal disease (IFD) causes increasing morbidity and mortality in haematological cancer patients. Reliable cost data for treating IFD in German hospitals is not available. Objective of the study was to determine the institutional cost of treating the IFD. Data were obtained by retrospective chart review in German hospitals. Patients had either newly diagnosed or relapsed acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS). Direct medical cost was calculated from hospital providers perspective. A total of 108 patients were enrolled at 5 tertiary care hospitals, 36 IFD patients and 72 controls. The vast majority of IFD patients (74%) were diagnosed with invasive aspergillosis. On average, the hospital stay for IFD patients was 12 days longer than in control patients. All patients in the IFD group and 89% of patients in the control group received antifungal drugs. Mean direct costs per patient were 51 pound 517 in the IFD group and 30 pound 454 in the control group. Incremental costs of 21 pound 063 were dominated by cost for antifungal drugs (36%), hospital stay (32%) and blood products (23%). From the perspective of hospitals in Germany the economic burden of IFD in patients with AML or MDS is substantial. Therefore, prevention of IFD is necessary with respect to both clinical and economic reasons.

Published
2012

76. Lack of efficacy of imatinib in a patient with metastatic Leydig cell tumor

Author

Froehner, M., Beuthien-Baumann, B., Dittert, D.-D., Schuler, U., Wirth, M. P., Froehner, M., Beuthien-Baumann, B., Dittert, D.-D., Schuler, U., and Wirth, M. P.

Abstract

Imatinib is a tyrosine kinase inhibitor with activity in gastrointestinal stromal tumor and a variety of other solid and hematological malignancies. Studies in vitro and in a mouse model suggested that the imatinib might also be active in malignant Leydig cell tumor. We report on the—to our knowledge—first treatment experiment with imatinib in a patient with metastatic Leydig cell tumor. Unfortunately, the tumor progressed during treatment.

Published
2006

77. Reduced intensity conditioning before allografting: moderate enthusiasm may be more appropriate

Author

Schuler U

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Immunosuppression, Surgery, Transplantation, surgical procedures, operative, Reduced Intensity Conditioning, Toxicity, medicine, Autogenous bone, Stem cell, business, Preparative Regimen
Abstract

Since the first clinical series of allogeneic bone marrow transplants were reported, the procedure has been associated with a considerable amount of pulmonary complications, among many other problems. Over the last three decades, huge efforts have been devoted to the avoidance and the effective treatment of these complications. In the past, numerous patients did not undergo transplantation, either because they were considered too ill or too old to tolerate these procedure-related side-effects. In this issue of the European Respiratory Journal (ERJ) , Nusair et al. 1 from Jerusalem report on their experience with pulmonary complications as observed after transplants with “nonmyeloablative” conditioning. Stem cell transplantation (SCT) can be divided into three components: the conditioning therapy (chemotherapy with/without irradiation), the source and composition of the graft, and the post-transplant immunosuppression. Modifications of all three components may contribute to the profile of efficacy and toxicity of the procedure. The group from the Hadassah University Hospital in Jerusalem was among the first to develop a procedure that tried to minimise the toxicity of the preparative regimen and relied more on the graft- versus -leukaemia (GVL) effect of the transplanted allogeneic immune system 2. Numerous other centres then followed and this has resulted …

Published
2004
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84. Erhöhte Parameter der systemischen Inflammation korrelieren mit der erniedrigten Konzentration von Glutamin, Arginin und Citrullin im Plasma von Patienten mit soliden Tumoren unter Chemo- und Radiotherapie

Author

Suchner, U, primary, Schuler, U, additional, Duerr, EM, additional, Schäpers, B, additional, Degenhart, A, additional, Stockheim, B, additional, Stehle, P, additional, Alteheld, B, additional, Zwingers, T, additional, Zimmer, HG, additional, and Schlemmer, M, additional

Published
2010
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85. Reliabilität und Validität des Hannoverschen Screenings der subjektiven Rehabilitationsbedürftigkeit für den Einsatz in der ärztlichen Praxis

Author

Kobelt, A., primary, Karpinski, N., additional, Gutenbrunner, C., additional, Ehlebracht-König, I., additional, Schmid-Ott, G., additional, Jacobi, C., additional, Schulz, K., additional, Nounla, J., additional, Machens, R., additional, Feige, A., additional, Stumpf, R., additional, Bremen, W. V., additional, Ricken, U., additional, Geib, U., additional, Backhaus, S., additional, Schuler, U., additional, and Petermann, F., additional

Published
2009
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88. Präferenzen und Erfahrungen in der Kommunikation mit Ärzten – Eine Befragung deutscher Patienten mit lebenslimitierenden Erkrankungen

Author

Gog, C, primary, Annweiler, B, additional, Braun, H, additional, Dathe, A, additional, Heringer, O, additional, Hübner, J, additional, Koch, S, additional, Kummer, K, additional, Müller, A, additional, Scharnagel, R, additional, Schürmann, RP, additional, Sörgel, H, additional, Sprenger, K, additional, Suchner, U, additional, Winkelmann, P, additional, Schubert, B, additional, and Schuler, U, additional

Published
2008
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91. Aufbau der Deutschen Knochenmarkspenderdatei

Author

Ehninger, G., primary, Rutt, C. M. A., additional, Ebert, A., additional, Harf, P., additional, Hoelzer, D., additional, Niethammer, D., additional, Keller, J. von, additional, Rodert, A., additional, and Schuler, U., additional

Published
2008
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