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154. Was hat das Pankreas mit Schulterschmerzen zu tun?

Author

Caf, P., primary, Kunz, J., additional, Flechsig, P., additional, Ullrich, E., additional, Reimer, P., additional, Barreto, M. Miranda, additional, Kappes, J., additional, Herth, F. J., additional, Warth, A., additional, Kauczor, H.-U., additional, and Heußel, C. P., additional

Published
2017
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159. Predictors of clinical outcome in emphysema patients with atelectasis following endoscopic valve therapy: A retrospective study

Author

Gompelmann, D. Hofbauer, T. Gerovasili, V. Eberhardt, R. Lim, H.-J. Herth, F. Heussel, C.-P.

Subjects
respiratory system, respiratory tract diseases
Abstract

Background and objective: The aim of endoscopic valve therapy in patients with emphysema is complete lobar atelectasis of the most emphysematous lobe. However, even after the radiological advent of atelectasis, great variability in clinical outcomes can be observed. Methods: The baseline clinical measures (vital capacity (VC), forced expiratory flow in 1 s (FEV1), residual volume (RV) and 6-min walk test (6-MWT)) and computed tomography variables (low attenuation volume (LAV) of the target lobe, LAV% of the target and the ipsilateral untreated lobe and LAV of the target lobe to LAV of the target lung and to LAV of the total lung) of 77 patients with complete atelectasis following valve therapy were retrospectively examined to determine their impact on patient´s outcome (changes in VC, FEV1, RV and 6-MWT from baseline to the time of atelectasis). Results: Low attenuation volume of the target lobe to LAV of the target lung predicts a significant FEV1 improvement in patients with complete lobar atelectasis following valve therapy. A 10% difference in that computed tomography predictor was associated with a 82-mL improvement in FEV1 (P = 0.006). Lower 6-MWT scores, low VC and high RV at baseline were significantly associated with greater improvement in the respective parameter (all P < 0.001). Conclusion: Low attenuation volume of the target lobe to LAV of the target lung and baseline clinical measures seem to significantly predict clinical outcomes in patients with complete lobar atelectasis following valve treatment. © 2016 Asian Pacific Society of Respirology

Published
2016

162. Der Mann, der es leid war, krank zu sein

Author

Grigaliûnas, G., primary, Csernus, R., additional, op den Winkel, J., additional, Herth, F., additional, Dienemann, H., additional, Kauczor, H. -U., additional, and Heußel, C. P., additional

Published
2017
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166. Testing Two Different Doses of Tiotropium Respimat® in Cystic Fibrosis: Phase 2 Randomized Trial Results

Author

Bradley, Jm, Koker, P, Deng, Q, Moroni Zentgraf, P, Ratjen, F, Geller, De, Elborn, Js, Clements, B, Greville, H, Middleton, P, Serisier, D, van Asperen, P, Dupont, L, Knoop, C, Malfroot, A, Belleguic, C, Chiron, R, Derelle, J, Dominique, S, Dusser, D, Ginies, Jl, Guillot, M, Horeau-Langlard, D, Le Bourgeois, M, Leroy, S, Marguet, C, Munck, A, Pautard, Jc, Reix, P, Uffredi, Ml, Ballmann, M, Bargon, J, Fischer, R, Herth, F, Heuer, He, Griese, M, Kamin, W, Kohlhäufl, M, Nährlich, L, Riethmüller, J, Sorichter, S, Wagner, T, Bennett, L, Crawford, M, Crossley, J, Derry, D, Doull, I, Elborn, J, Everard, M, Groggins, C, Johnson, M, Lee, T, Rayner, R, Reid, A, Smyth, A, Southern, K, Thomas, D, Walshaw, M, Whitehouse, J, Braggion, C, De Rose, V, Gagliardini, R, Minicucci, L, Reijers, M, Tiddens, Ha, O'Carroll, M, Wong, J, Barreto, C, Cardim, P, Loureiro, M, Rocha, H, Vaz, Ml, Asherova, I, Chepurnaya, M, Chuchalin, Ag, Ilkovich, M, Kapranov, N, Neretina, A, Orlov, A, Simonova, O, Ahrens, R, Anbar, R, Biller, J, Carveth, H, Daines, C, Fiel, S, Flume, P, Froh, D, 3rd, Harris J., Howenstine, M, Millard, Dl, Nasr, S, Parker, H, Pian, M, Royall, J, Sabogal, C, Salathe, M, Sannuti, A, Schaeffer, D, Strausbaugh, S, Toder, D, Reyes, S, Whittaker, L, and Zanni, R.

Subjects
Male, Respimat, Cystic Fibrosis, Pulmonology, lcsh:Medicine, Cystic fibrosis, Pediatrics, Pulmonary function testing, law.invention, Clinical trials, Randomized controlled trial, law, Bronchodilator, Forced Expiratory Volume, lcsh:Science, Child, Medicine(all), Multidisciplinary, Agricultural and Biological Sciences(all), Area under the curve, Tiotropium bromide, Respiratory Function Tests, Research Design, Anesthesia, Female, Genetic Dominance, Phase II clinical investigation, medicine.drug, Research Article, Adult, medicine.medical_specialty, Adolescent, General Science & Technology, medicine.drug_class, Clinical Research Design, Pediatric Pulmonology, Scopolamine Derivatives, Placebo, Research and Analysis Methods, Young Adult, Double-Blind Method, MD Multidisciplinary, Administration, Inhalation, medicine, Genetics, Humans, Tiotropium Bromide, Medicine and health sciences, Autosomal Recessive Traits, business.industry, Biochemistry, Genetics and Molecular Biology(all), lcsh:R, Biology and Life Sciences, Human Genetics, medicine.disease, Fibrosis, respiratory tract diseases, Clinical medicine, Physical therapy, Tiotropium Cystic Fibrosis Study Group, lcsh:Q, business, Developmental Biology
Abstract

Background Tiotropium is a once-daily, long-acting anticholinergic bronchodilator with the potential to alleviate airway obstruction in cystic fibrosis. Our objective was to evaluate the efficacy and safety of 2.5 and 5 µg once-daily tiotropium delivered via the Respimat Soft Mist Inhaler vs. placebo in people with cystic fibrosis. Methods This phase 2, 12-week, randomized, double-blind, placebo-controlled parallel-group study of tiotropium Respimat as add-on to usual cystic fibrosis maintenance therapy included people with cystic fibrosis with pre-bronchodilator forced expiratory volume in 1 second (FEV1) ≥25% predicted. Co-primary efficacy end points were change from baseline in percent-predicted FEV1 area under the curve from 0 to 4 hours (FEV1 AUC0–4h), and trough FEV1 at the end of week 12. Findings A total of 510 subjects with cystic fibrosis aged 5–69 years were randomized. Both doses of tiotropium resulted in significant improvement compared with placebo in the co-primary efficacy end points at the end of week 12 (change from baseline in percent-predicted FEV1 AUC0–4h: 2.5 µg: 2.94%, 95% confidence interval 1.19–4.70, p = 0.001; 5 µg: 3.39%, 95% confidence interval 1.67–5.12, p = 0.0001; in percent-predicted trough FEV1∶2.5 µg: 2.24%, p = 0.2; 5 µg: 2.22%, p = 0.02). There was a greater benefit with tiotropium 5 vs. 2.5 µg. No treatment-related adverse events or unexpected safety findings were observed in patients taking tiotropium. Conclusions Tiotropium significantly improved lung function in people with cystic fibrosis. The improvement was greater with the higher dose than the lower dose, with no difference in adverse events. Trial Registration ClinicalTrials.gov NCT00737100 EudraCT 2008-001156-43.

Published
2014

167. Clinical highlights from the ERS congress in Barcelona

Author

Spruit, M. A., Marvisi, M., Coolen, J., Poletti, V., Gasparini, S., Ställberg, B., Herth, F. J. F., and Clini, Enrico

Subjects
primary care, interventional pneumology, COPD, rehabilitation, interstitial lung diseases
Published
2014

171. Treatment of idiopathic pulmonary fibrosis with ambrisentan: a parallel, randomized trial

Author

Raghu, G, Behr, J, Brown, K, Egan, J, Kawut, S, Flaherty, K, Martinez, F, Nathan, S, Wells, A, Collard, H, Costabel, U, Richeldi, L, de Andrade, J, Khalil, N, Morrison, L, Lederer, D, Shao, L, Li, X, Pedersen, P, Montgomery, A, Chien, J, O'Riordan, T, Amin, D, Baker, A, Baratz, D, Baughman, R, Cagino, A, Chan, A, Chapman, J, Cordova, F, Edelman, J, Enelow, R, Ettinger, N, Glassberg, M, Golden, J, Ilowite, J, Kreider, M, Kureishy, S, Lancaster, L, Limper, A, Strek, M, Padilla, M, Fisher, M, Riley, D, Mohabir, P, Safdar, Z, Sahn, S, Schaumberg, T, Scholand, M, Smith, C, Sussman, R, Yung, G, Saggar, R, Geffen, D, Zibrak, J, Alvarez, J, Chan, K, Ruzi, J, Mcconnell, J, Mehta, J, Verghese, G, Talwar, A, Haddad, T, Sood, N, Goldberg, H, Sundar, K, Ziedalski, T, Gibson, K, Chan, C, Lien, D, Fell, C, Fox, G, Poirier, C, Provencher, S, Wilcox, P, Vilayi Weiler, Z, Kramer, M, Yigla, M, Baloira, A, Parakova, Z, Kra, H, Schwarz, Y, Martinez, C, Ben Dov, I, Kahler, C, Xaubet, A, Skrickova, J, Kolek, V, Parfrey, H, Echave Sustaeta, J, Wuyts, W, Geiser, T, Muller Quernheim, J, Whyte, M, Pfeifer, M, Grohe, C, Bourdin, A, Olschewski, H, Sibille, Y, Snizek, T, Vytiska, J, Pesek, M, Crestani, B, Wallaert, B, Chanez, P, Biet, D, Pompidou, G, Dromer, C, Gläser, S, Wagner, U, Witt, C, Herth, F, Hoeffken, G, Coswig, F, Breuer, R, Kerem, E, Adir, Y, Agostini, C, Cremona, G, Vitulo, P, Poletti, V, Rottoli, P, Rybacki, C, Piotrowski, W, Morera, J, Hattotuwa, K, Warburton, C, Corris, P, Leonard, C, Booth, H, Britton, M, Marchand Adam, S, Marquette, C, Tamm, M, Lazor, R, Chalmers, G, Hirani, N, De Vuyst, P, Saltini, C, Harari, S, Maher, T, Campos, F, Ramirez, A, Wehbe, L, Altieri, H, Fuchigami, A, Salinas, C, Mattos, W, Posadas, R, Fiss, E, Diaz Castanon, J, Munoz, S, Ramirez, L, Chercoff, J, Fritscher, C, Cardoso, A, Moreira, M, Steidle, L, Arakaki, J, Florenzano, M, Leon, L, Bernardini, S, Gilberto, A, Duque, C, Awad, C, Severiche, D, Lucro, D, Grimaldos, F, Rubin, A, Barrera, C, Ore, D, Heredia, C, Mazzei, J, Matiz, C, Glanville, A, Hopkins, P, Smallwood, D, Veitch, E, Musk, M, Glaspole, I, Wood Baker, R, Veale, A, and Costabel, Ulrich (Beitragende*r)

Subjects
Adult, Male, medicine.medical_specialty, Ambrisentan, Endothelin A Receptor Antagonists, Settore MED/10 - Malattie dell'Apparato Respiratorio, Medizin, Placebo, Idiopathic pulmonary fibrosis, Aged, Aged, 80 and over, Disease Progression, Double-Blind Method, Female, Humans, Idiopathic Pulmonary Fibrosis, Lung, Middle Aged, Phenylpropionates, Prospective Studies, Pyridazines, Treatment Outcome, Internal medicine, 80 and over, Internal Medicine, medicine, Clinical endpoint, Prospective cohort study, business.industry, Hazard ratio, General Medicine, medicine.disease, Interim analysis, Pulmonary hypertension, Surgery, business, medicine.drug
Abstract

BACKGROUND Idiopathic pulmonary fibrosis (IPF) is characterized by formation and proliferation of fibroblast foci. Endothelin-1 induces lung fibroblast proliferation and contractile activity via the endothelin A (ETA) receptor. OBJECTIVE To determine whether ambrisentan, an ETA receptor-selective antagonist, reduces the rate of IPF progression. DESIGN Randomized, double-blind, placebo-controlled, event-driven trial. (ClinicalTrials.gov: NCT00768300). SETTING Academic and private hospitals. PARTICIPANTS Patients with IPF aged 40 to 80 years with minimal or no honeycombing on high-resolution computed tomography scans. INTERVENTION Ambrisentan, 10 mg/d, or placebo. MEASUREMENTS Time to disease progression, defined as death, respiratory hospitalization, or a categorical decrease in lung function. RESULTS The study was terminated after enrollment of 492 patients (75% of intended enrollment; mean duration of exposure to study medication, 34.7 weeks) because an interim analysis indicated a low likelihood of showing efficacy for the end point by the scheduled end of the study. Ambrisentan-treated patients were more likely to meet the prespecified criteria for disease progression (90 [27.4%] vs. 28 [17.2%] patients; P = 0.010; hazard ratio, 1.74 [95% CI, 1.14 to 2.66]). Lung function decline was seen in 55 (16.7%) ambrisentan-treated patients and 19 (11.7%) placebo-treated patients (P = 0.109). Respiratory hospitalizations were seen in 44 (13.4%) and 9 (5.5%) patients in the ambrisentan and placebo groups, respectively (P = 0.007). Twenty-six (7.9%) patients who received ambrisentan and 6 (3.7%) who received placebo died (P = 0.100). Thirty-two (10%) ambrisentan-treated patients and 16 (10%) placebo-treated patients had pulmonary hypertension at baseline, and analysis stratified by the presence of pulmonary hypertension revealed similar results for the primary end point. LIMITATION The study was terminated early. CONCLUSION Ambrisentan was not effective in treating IPF and may be associated with an increased risk for disease progression and respiratory hospitalizations. PRIMARY FUNDING SOURCE Gilead Sciences.

Published
2013

172. Treatment of Idiopathic Pulmonary Fibrosis With Ambrisentan

Author

Raghu, G, Behr, J, Brown, Kk, Egan, Jj, Kawut, Sm, Flaherty, Kr, Martinez, Fj, Nathan, Sd, Wells, Au, Collard, Hr, Costabel, U, Richeldi, L, de Andrade, J, Khalil, N, Morrison, Ld, Lederer, Dj, Shao, L, Li, X, Pedersen, Ps, Montgomery, Ab, Chien, Jw, O'Riordan, Tg, ARTEMIS IPF Investigators: Amin, D, Baker, A, Baratz, D, Baughman, R, Cagino, A, Chan, A, Chapman, J, Cordova, F, Edelman, J, Enelow, R, Ettinger, N, Glassberg, M, Golden, J, Ilowite, J, Kreider, M, Kureishy, S, Lancaster, L, Lederer, D, Limper, A, Morrison, L, Nathan, S, Strek, M, Padilla, M, Fisher, M, Riley, D, Mohabir, P, Safdar, Z, Sahn, S, Schaumberg, T, Scholand, Mb, Smith, C, Sussman, R, Yung, G, Saggar, R, Geffen, D, Zibrak, J, Alvarez, J, Chan, K, Ruzi, J, Mcconnell, J, Mehta, J, Verghese, G, Talwar, A, Haddad, T, Sood, N, Goldberg, H, Sundar, K, Ziedalski, T, Gibson, K, Chan, C, Lien, D, Fell, C, Fox, G, Poirier, C, Provencher, S, Wilcox, P, Vilayi Weiler, Z, Kramer, M, Yigla, M, Baloira, A, Parakova, Z, Kra, H, Schwarz, Y, Martinez, C, Ben Dov, I, Kahler, C, Xaubet, A, Skrickova, J, Kolek, V, Parfrey, H, Echave Sustaeta, J, Wuyts, W, Geiser, T, Muller Quernheim, J, Whyte, M, Pfeifer, M, Grohe, C, Bourdin, A, Olschewski, H, Sibille, Y, Snizek, T, Vytiska, J, Pesek, M, Crestani, B, Wallaert, B, Chanez, P, Biet, Di, Pompidou, G, Dromer, C, Gläser, S, Wagner, U, Witt, C, Herth, F, Hoeffken, G, Coswig, F, Egan, J, Breuer, R, Kerem, E, Adir, Y, Agostini, Carlo, Cremona, G, Vitulo, P, Poletti, V, Rottoli, P, Rybacki, C, Piotrowski, W, Morera, J, Hattotuwa, K, Warburton, C, Corris, P, Leonard, C, Booth, H, Britton, M, Marchand Adam, S, Marquette, Ch, Tamm, M, Lazor, R, Chalmers, Gw, Hirani, N, De Vuyst, P, Saltini, C, Harari, Sa, Maher, T, Campos, F, Ramirez, A, Wehbe, L, Altieri, H, Fuchigami, Am, Salinas, Cc, Mattos, W, Posadas, R, Fiss, E, Diaz Castanon, J, Munoz, S, Ramirez, Ln, Chercoff, J, Fritscher, Cc, Cardoso, A, Moreira, Ma, Steidle, L, Arakaki, J, Florenzano, M, Leon, Lp, Bernardini, Su, Gilberto, A, Duque, Ca, Awad, C, Severiche, D, Lucro, De, Grimaldos, Fb, Rubin, A, Barrera, Ci, Ore, Dj, Heredia, C, Mazzei, J, Matiz, C, Glanville, A, Hopkins, P, Smallwood, D, Veitch, E, Musk, M, Glaspole, I, Wood Baker, R, and Veale, A.

Published
2013

176. Selected clinical highlights from the ERS congress

Author

Robalo Cordeiro, C., Singh, S., Herth, F., Ley, S., Chavannes, N. H., Clini, Enrico, and Cottin, V.

Subjects
interstitial lung disease, pulmonary fibrosis, interventional pneumology, high resolution computed tomography, rehabilitation, pulmonary hypertension, lymphangioleiomyomatosis
Published
2011

178. SURGICAL MANAGEMENT OF PNEUMOTHORAX

Author

Hecker, Erich, Bayer, B, Muller, S, Herth, F, Hoffmann, H, Muley, T, Bergmann, A, and Dienemann, H

Subjects
Thoracoscopy -- Methods, Pneumothorax -- Methods, Surgery -- Methods, Health, Methods
Abstract

Erich Hecker, MD(*); B Bayer, MD; S Muller, MD; F Herth, MD; H Hoffmann, MD; T Muley, MD; A Bergmann, MD and H Dienemann, MD. Surgery; Endoscopy and Statistics, Thoraxklinik [...]

Published
2000

179. LONG-TERM OUTCOME IN PATIENTS WITH HEMOPTYSIS OF UNKNOWN ORIGIN

Author

Herth, F, Ernst, A, and Becker, H D.

Subjects
Hemorrhage -- Causes of, Bronchoscopy, Health, Causes of
Abstract

F Herth, MD(*); A Ernst, MD, FCCP and H D Becker, MD, FCCP. Department of Endoscopy, Thoraxklinik, Heidelberg, Germany and Pulmonolgy, Beath Israel Deaconess Medical Center, Boston, MA. PURPOSE: Hemoptysis [...]

Published
2000

180. A randomized study of endobronchial valves for advanced emphysema

Author

Sciurba, Fc, Ernst, A, Herth, Fj, Strange, C, Criner, Gj, Marquette, Ch, Kovitz, Kl, Chiacchierini, Rp, Goldin, J, Mclennan, G, Sciurba, F, Landreneau, R, Crespo, M, Lane, L, Slivka, W, Fuhrman, C, Ferson, P, Witt, C, End, A, Schneider, F, Klepetko, W, Stanzel, F, Weber, N, Haeussinger, K, Gasparini, S, De Luca, S, Golden, E, Smith, M, Williams, G, Feller Kopman, D, Garland, R, Ashiku, S, Decamp, M, Ferguson, G, Thompson, Tm, McKenna R., Jr, Geaga, C, Kusuanco, D, Pison, Ch, Wuyam, B, Ferretti, G, Vivodtzev, I, Righini, C, Lebargy, F, Deslee, G, Dury, S, Schmidt, B, Gonzalez Bermejo, J, Trosini Desert, V, Similowski, T, Beigelman, C, Becquemin, Mh, Simoff, M, Almario, R, Mal, H, Marceau, A, Fournier, M, Brugière, O, Dauriat, G, Marquette, C, Leroy, S, Perez, T, Bautin, N, Massard, G, Kessler, R, Charloux, A, Jeung, My, Jory, A, Muir, Jf, Viacroze, C, Benhamou, D, Cuvelier, A, Molano, L, Degano, B, Hermant, C, Pontier, S, Rami, J, Chabbert, V, Vergnon, Jm, Veyret, C, Costes, F, De Matos, L, Febvre, M, Chouaid, C, Lebeau, B, Pinet, C, Dutau, H, Thomas, P, Badier, M, Gaubert, Jy, Xaubet, A, Torres, A, Agustí, C, Barberà, J, Agustí, A, Togores, B, Renom, F, Sauleda, J, Ramos, R, Nathan, S, Ahmad, S, Collazo, L, Battle, E, Hecker, E, Volmerig, J, Jahn, T, Ficker, J, Wagner, M, Fink, T, Egan, J, Coyle, J, Edell, E, Midthun, D, Utz, J, Andrist, B, Meiras, K, Silvestri, G, Williams Cummings, E, Freilich, E, Amin, D, Masson, J, Orlando, D, Morgan, L, Bowler, R, Wheeler, C, Mitchell, K, Maxfield, R, Ginsburg, M, Jellen, P, Brogan, F, Valipour, A, Kohansal, R, Burghuber, C, Elton, D, Sy, A, Mcfarland, E, Haase, N, Stout, M, Tillis, W, Whitten, P, Crabb, J, Hartwig, K, Scott, A, Levine, B, Ross, J, Baratz, D, Fu, L, Cordasco, E, Adamo, J, Botte, J, Voelker, K, Horiuchi, T, Hurwitz, K, Ferreira, G, Morgan, K, Jantz, M, Deem, A, Fox, A, Campbell, S, Vincent, T, Shen, W, Hazelrigg, S, Boley, T, Boomer, Wm, Goulet, J, Mullins, C, Cicena, J, O'Neill, P, Criner, G, Travaline, J, Chatila, W, Jones, G, Herth, F, Eberhardt, R, Leeds, W, Fair, G, Ludlow, L, Nicklin, S, Davis, C, Kovitz, K, Ditta, S, Chan, A, Allen, R, Albertson, T, Morrissey, B, Juarez, M, Germonpre, P, Janssens, A, De Backer, W, Noppen, M, De Mey, J, Meysman, M, Ferguson, J, Ross, A, Sprenger, K, Keating, J, Zgoda, M, Berger, R, Mcclung, J, Cortes, R, Krasna, M, Britt, J, Gamliel, Z, Moskowitz, I, Gay, S, Konkle, J, Goodnight White, S, Soubra, S, Smithwick, P, Velamuri, K, Cooper, C, Badduke, B, Hsiao, E, Wise, R, Celli, B, Ciccone, Annamaria, Keenan, R, Gilman, D, Brown, M, McNitte Gray, M, da Costa, I, Ho, J, Kaplan, R, Ganiats, T, Groessl, E, Harvey, J, Mulligan, B., Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
MESH: Exercise Tolerance, Exacerbation, MESH: Pulmonary Disease, Chronic Obstructive, law.invention, MESH: Proportional Hazards Models, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Randomized controlled trial, law, Forced Expiratory Volume, Medicine, 030212 general & internal medicine, Antibiotic prophylaxis, Pneumonectomy, MESH: Aged, COPD, Exercise Tolerance, MESH: Middle Aged, Respiratory disease, Prostheses and Implants, General Medicine, Middle Aged, Bronchodilator Agents, 3. Good health, Pulmonary Emphysema, MESH: Pulmonary Emphysema, Respiratory Physiological Phenomena, Adult, medicine.medical_specialty, Randomization, MESH: Prostheses and Implants, MESH: Forced Expiratory Volume, 03 medical and health sciences, Internal medicine, Bronchoscopy, MESH: Antibiotic Prophylaxis, Humans, MESH: Bronchoscopy, Aged, Proportional Hazards Models, MESH: Humans, business.industry, Proportional hazards model, MESH: Pneumonectomy, Endobronchial valve, MESH: Adult, Antibiotic Prophylaxis, medicine.disease, Surgery, MESH: Respiratory Physiological Phenomena, 030228 respiratory system, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Bronchodilator Agents, business
Abstract

International audience; BACKGROUND: Endobronchial valves that allow air to escape from a pulmonary lobe but not enter it can induce a reduction in lobar volume that may thereby improve lung function and exercise tolerance in patients with pulmonary hyperinflation related to advanced emphysema. METHODS: We compared the safety and efficacy of endobronchial-valve therapy in patients with heterogeneous emphysema versus standard medical care. Efficacy end points were percent changes in the forced expiratory volume in 1 second (FEV1) and the 6-minute walk test on intention-to-treat analysis. We assessed safety on the basis of the rate of a composite of six major complications. RESULTS: Of 321 enrolled patients, 220 were randomly assigned to receive endobronchial valves (EBV group) and 101 to receive standard medical care (control group). At 6 months, there was an increase of 4.3% in the FEV1 in the EBV group (an increase of 1.0 percentage point in the percent of the predicted value), as compared with a decrease of 2.5% in the control group (a decrease of 0.9 percentage point in the percent of the predicted value). Thus, there was a mean between-group difference of 6.8% in the FEV1 (P=0.005). Roughly similar between-group differences were observed for the 6-minute walk test. At 12 months, the rate of the complications composite was 10.3% in the EBV group versus 4.6% in the control group (P=0.17). At 90 days, in the EBV group, as compared with the control group, there were increased rates of exacerbation of chronic obstructive pulmonary disease (COPD) requiring hospitalization (7.9% vs. 1.1%, P=0.03) and hemoptysis (6.1% vs. 0%, P=0.01). The rate of pneumonia in the target lobe in the EBV group was 4.2% at 12 months. Greater radiographic evidence of emphysema heterogeneity and fissure completeness was associated with an enhanced response to treatment. CONCLUSIONS: Endobronchial-valve treatment for advanced heterogeneous emphysema induced modest improvements in lung function, exercise tolerance, and symptoms at the cost of more frequent exacerbations of COPD, pneumonia, and hemoptysis after implantation. (Funded by Pulmonx; ClinicalTrials.gov number, NCT00129584.)

Published
2010

196. Tumour cell proliferation (Ki-67) in non-small cell lung cancer: a critical reappraisal of its prognostic role

Author

Warth, A, primary, Cortis, J, additional, Soltermann, A, additional, Meister, M, additional, Budczies, J, additional, Stenzinger, A, additional, Goeppert, B, additional, Thomas, M, additional, Herth, F J F, additional, Schirmacher, P, additional, Schnabel, P A, additional, Hoffmann, H, additional, Dienemann, H, additional, Muley, T, additional, and Weichert, W, additional

Published
2014
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