المؤلفون: Kalvelage, Christina, Zacharowski, Kai, Bauhofer, Artur, Gockel, Ulrich, Adamzik, Michael, Nierhaus, Axel, Kujath, Peter, Eckmann, Christian, Pletz, Mathias W., Bracht, Hendrik, Simon, Tim-Philipp, Winkler, Michael, Kindgen-Milles, Detlef, Albertsmeier, Markus, Weigand, Markus, Ellger, Björn, Ragaller, Maximilian, Ullrich, Roman, Marx, Gernot

مصطلحات موضوعية: 610 Medical sciences Medicine

الوقت: 610

الوصف: Background: Peritonitis is responsible for thousands of deaths annually in Germany alone. Even source control (SC) and antibiotic treatment often fail to prevent severe sepsis or septic shock, and this situation has hardly improved in the past two decades. Most experimental immunomodulatory therapeutics for sepsis have been aimed at blocking or dampening a specific pro-inflammatory immunological mediator. However, the patient collective is large and heterogeneous. There are therefore grounds for investigating the possibility of developing personalized therapies by classifying patients into groups according to biomarkers. This study aims to combine an assessment of the efficacy of treatment with a preparation of human immunoglobulins G, A, and M (IgGAM) with individual status of various biomarkers (immunoglobulin level, procalcitonin, interleukin 6, antigen D-related human leucocyte antigen (HLA-DR), transcription factor NF-κB1, adrenomedullin, and pathogen spectrum). Methods/design: A total of 200 patients with sepsis or septic shock will receive standard-of-care treatment (SoC). Of these, 133 patients (selected by 1:2 randomization) will in addition receive infusions of IgGAM for 5 days. All patients will be followed for approximately 90 days and assessed by the multiple-organ failure (MOF) score, by the EQ QLQ 5D quality-of-life scale, and by measurement of vital signs, biomarkers (as above), and survival. Discussion: This study is intended to provide further information on the efficacy and safety of treatment with IgGAM and to offer the possibility of correlating these with the biomarkers to be studied. Specifically, it will test (at a descriptive level) the hypothesis that patients receiving IgGAM who have higher inflammation status (IL-6) and poorer immune status (low HLA-DR, low immunoglobulin levels) have a better outcome than patients who do not receive IgGAM. It is expected to provide information that will help to close the knowledge gap concerning the association between the effect of IgGAM and the ...

وصف الملف: application/pdf

العلاقة: https://archiv.ub.uni-heidelberg.de/volltextserver/26160/1/13063_2019_Article_3244.pdfTest; urn:nbn:de:bsz:16-heidok-261603; Kalvelage, Christina; Zacharowski, Kai; Bauhofer, Artur; Gockel, Ulrich; Adamzik, Michael; Nierhaus, Axel; Kujath, Peter; Eckmann, Christian; Pletz, Mathias W.; Bracht, Hendrik; Simon, Tim-Philipp; Winkler, Michael; Kindgen-Milles, Detlef; Albertsmeier, Markus; Weigand, Markus; Ellger, Björn; Ragaller, Maximilian; Ullrich, Roman; Marx, Gernot (2019) Personalized medicine with IgGAM compared with standard of care for treatment of peritonitis after infectious source control (the PEPPER trial): study protocol for a randomized controlled trial. Trials, 20 (156). pp. 1-10. ISSN 1745-6215

الإتاحة: https://archiv.ub.uni-heidelberg.de/volltextserver/26160Test/
https://archiv.ub.uni-heidelberg.de/volltextserver/26160/1/13063_2019_Article_3244.pdfTest
https://nbn-resolving.org/urn:nbn:de:bsz:16-heidok-261603Test

المؤلفون: Marx, Gernot, Ullrich, Roman, Kalvelage, Christina, Zacharowski, Kai, Bauhofer, Artur, Gockel, Ulrich, Adamzik, Michael, Nierhaus, Axel, Kujath, Peter, Eckmann, Christian

مصطلحات موضوعية: Personalized medicine, Biomarkers, Pentaglobin, IgGAM, Sepsis, Peritonitis, Severe bacterial infection

جغرافية الموضوع: UMW:14615

الوصف: Background Peritonitis is responsible for thousands of deaths annually in Germany alone. Even source control (SC) and antibiotic treatment often fail to prevent severe sepsis or septic shock, and this situation has hardly improved in the past two decades. Most experimental immunomodulatory therapeutics for sepsis have been aimed at blocking or dampening a specific pro-inflammatory immunological mediator. However, the patient collective is large and heterogeneous. There are therefore grounds for investigating the possibility of developing personalized therapies by classifying patients into groups according to biomarkers. This study aims to combine an assessment of the efficacy of treatment with a preparation of human immunoglobulins G, A, and M (IgGAM) with individual status of various biomarkers (immunoglobulin level, procalcitonin, interleukin 6, antigen D-related human leucocyte antigen (HLA-DR), transcription factor NF-κB1, adrenomedullin, and pathogen spectrum). Methods/design A total of 200 patients with sepsis or septic shock will receive standard-of-care treatment (SoC). Of these, 133 patients (selected by 1:2 randomization) will in addition receive infusions of IgGAM for 5 days. All patients will be followed for approximately 90 days and assessed by the multiple-organ failure (MOF) score, by the EQ QLQ 5D quality-of-life scale, and by measurement of vital signs, biomarkers (as above), and survival. Discussion This study is intended to provide further information on the efficacy and safety of treatment with IgGAM and to offer the possibility of correlating these with the biomarkers to be studied. Specifically, it will test (at a descriptive level) the hypothesis that patients receiving IgGAM who have higher inflammation status (IL-6) and poorer immune status (low HLA-DR, low immunoglobulin levels) have a better outcome than patients who do not receive IgGAM. It is expected to provide information that will help to close the knowledge gap concerning the association between the effect of IgGAM and the ...

وصف الملف: text/html

العلاقة: vignette : https://repositorium.meduniwien.ac.at/titlepage/urn/urn:nbn:at:at-ubmuw:3-45103/128Test; urn:nbn:at:at-ubmuw:3-45103; https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-45103Test; local:99146065903403331; system:AC16219046

الإتاحة: https://doi.org/10.1186/s13063-019-3244-4Test
https://resolver.obvsg.at/urn:nbn:at:at-ubmuw:3-45103Test

المؤلفون: Förster, Matti, Mahn, Friederike, Gockel, Ulrich, Brosz, Mathias, Freynhagen, Rainer, Tölle, Thomas R., Baron, Ralf

المساهمون: Eldabe, Sam

المصدر: PLoS ONE ; volume 8, issue 7, page e68273 ; ISSN 1932-6203

الإتاحة: https://doi.org/10.1371/journal.pone.0068273Test

المؤلفون: Koroschetz, Jana, Rehm, Stefanie E, Gockel, Ulrich, Brosz, Mathias, Freynhagen, Rainer, Tölle, Thomas R, Baron, Ralf

الوصف: Background Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms of pain generation. The aims were (1) to compare epidemiological features and co-morbidities and (2) to identify similarities and differences of sensory symptoms in both entities. Methods The present multi-center study compares epidemiological data and sensory symptoms of a large cohort of 1434 fibromyalgia patients and 1623 patients with painful diabetic neuropathy. Data acquisition included standard demographic questions and self-report questionnaires (MOS sleep scale, PHQ-9, Pain DETECT ). To identify subgroups of patients with characteristic combinations of symptoms (sensory profiles) a cluster analysis was performed using all patients in both cohorts. Results Significant differences in co-morbidities (depression, sleep disturbance) were found between both disorders. Patients of both aetiologies chose very similar descriptors to characterize their sensory perceptions. Burning pain, prickling and touch-evoked allodynia were present in the same frequency. Five subgroups with distinct symptom profiles could be detected. Two of the subgroups were characteristic for fibromyalgia whereas one profile occurred predominantly in DPN patients. Two profiles were found frequently in patients of both entities (20-35%). Conclusions DPN and fibromyalgia patients experience very similar sensory phenomena. The combination of sensory symptoms - the sensory profile - is in most cases distinct and almost unique for each one of the two entities indicating aetiology-specific mechanisms of symptom generation. Beside the unique aetiology-specific sensory profiles an overlap of sensory profiles can be found in 20-35% of patients of both ...

العلاقة: http://www.biomedcentral.com/1471-2377/11/55Test

الإتاحة: http://www.biomedcentral.com/1471-2377/11/55Test

المؤلفون: Tölle Thomas R, Brosz Mathias, Freynhagen Rainer, Gockel Ulrich, Rehm Stefanie E, Koroschetz Jana, Baron Ralf

المصدر: BMC Neurology, Vol 11, Iss 1, p 55 (2011)

مصطلحات موضوعية: Neurology. Diseases of the nervous system, RC346-429

الوصف: Background Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms of pain generation. The aims were (1) to compare epidemiological features and co-morbidities and (2) to identify similarities and differences of sensory symptoms in both entities. Methods The present multi-center study compares epidemiological data and sensory symptoms of a large cohort of 1434 fibromyalgia patients and 1623 patients with painful diabetic neuropathy. Data acquisition included standard demographic questions and self-report questionnaires (MOS sleep scale, PHQ-9, Pain DETECT ). To identify subgroups of patients with characteristic combinations of symptoms (sensory profiles) a cluster analysis was performed using all patients in both cohorts. Results Significant differences in co-morbidities (depression, sleep disturbance) were found between both disorders. Patients of both aetiologies chose very similar descriptors to characterize their sensory perceptions. Burning pain, prickling and touch-evoked allodynia were present in the same frequency. Five subgroups with distinct symptom profiles could be detected. Two of the subgroups were characteristic for fibromyalgia whereas one profile occurred predominantly in DPN patients. Two profiles were found frequently in patients of both entities (20-35%). Conclusions DPN and fibromyalgia patients experience very similar sensory phenomena. The combination of sensory symptoms - the sensory profile - is in most cases distinct and almost unique for each one of the two entities indicating aetiology-specific mechanisms of symptom generation. Beside the unique aetiology-specific sensory profiles an overlap of sensory profiles can be found in 20-35% of patients of both ...

العلاقة: http://www.biomedcentral.com/1471-2377/11/55Test; https://doaj.org/toc/1471-2377Test; https://doaj.org/article/67dc5b122379416b9851f9cbd6d1319bTest

الإتاحة: https://doi.org/10.1186/1471-2377-11-55Test
https://doaj.org/article/67dc5b122379416b9851f9cbd6d1319bTest

المؤلفون: Mahn, Friederike, Hüllemann, Philipp, Gockel, Ulrich, Brosz, Mathias, Freynhagen, Rainer, Tölle, Thomas R., Baron, Ralf

المساهمون: Priller, Josef

المصدر: PLoS ONE ; volume 6, issue 5, page e18018 ; ISSN 1932-6203

الإتاحة: https://doi.org/10.1371/journal.pone.0018018Test

المؤلفون: Rehm, Stefanie E., Koroschetz, Jana, Gockel, Ulrich, Brosz, Mathias, Freynhagen, Rainer, Tölle, Thomas R., Baron, Ralf

مصطلحات موضوعية: CLINICAL SCIENCE

الوصف: Objectives. Patients with FM are heterogeneous. They present with a variety of pain qualities, sensory abnormalities and additional comorbidities. The aim was to identify clinically distinguishable subgroups of patients. Methods. This investigation uses epidemiological and clinical data of 3035 FM patients from a cross-sectional survey (pain DETECT ) to (i) describe characteristic epidemiological data and comorbidities and (ii) detect subgroups of patients with typical patterns of sensory symptoms and comorbidities. Results. Clinically relevant sensory abnormalities (strongly, very strongly present) included pressure pain (58%), prickling (33%), burning (30%) and thermal hypersensitivity (24%). Pain attacks were complained by 40% of patients. Moderate to severe comorbid depression occurred in 66% of patients. Only ∼30% of the patients had optimal sleep. A hierarchical cluster analysis using descriptors of sensory abnormalities as well as the extent of comorbidities revealed five distinct subgroups of patients showing a characteristic clinical profile. Four subgroups of patients suffer from severe sensory disturbances in various combinations but lack pronounced comorbidities. In one subgroup, however, severe comorbidities dominate the clinical picture. Differences in pathophysiological mechanisms of pain generation can be attributed to each subgroup. Conclusions. The results of this study indicate that FM patients can be classified on the basis of their sensory symptoms and comorbidities by the use of a patient-reported questionnaire. Subgrouping of patients with FM may be used for future research and to tailor optimal treatment strategies for the appropriate patient.

وصف الملف: text/html

العلاقة: http://rheumatology.oxfordjournals.org/cgi/content/short/49/6/1146Test; http://dx.doi.org/10.1093/rheumatology/keq066Test

الإتاحة: https://doi.org/10.1093/rheumatology/keq066Test
http://rheumatology.oxfordjournals.org/cgi/content/short/49/6/1146Test

المؤلفون: Freynhagen, Rainer, Tölle, Thomas R., Gockel, Ulrich, Baron, Ralf

المصدر: Current Medical Research and Opinion ; volume 32, issue 6, page 1033-1057 ; ISSN 0300-7995 1473-4877

الإتاحة: https://doi.org/10.1185/03007995.2016.1157460Test

المؤلفون: Schmidt, Carsten O., Schweikert, Bernd, Wenig, Christina M., Schmidt, Uwe, Gockel, Ulrich, Freynhagen, Rainer, Tölle, Thomas R., Baron, Ralf, Kohlmann, Thomas

المصدر: European Journal of Pain ; volume 13, issue 10, page 1030-1035 ; ISSN 1090-3801 1532-2149

الوصف: Background: Although there is increasing knowledge of the prevalence of neuropathic pain, little has been done to isolate the cost of neuropathic pain, especially with reference to the frequent complaint of back pain. Aims: To estimate the prevalence of neuropathic components in back pain and associated costs. Methods: We used available epidemiological data to model the prevalence of neuropathic back pain in the general adult population, combining three studies: pain DETECT 1, pain DETECT 2, and the German back pain research network (GBPRN) study, representing a total of 21,047 subjects. The pain DETECT screening questionnaire was used in the former two surveys to assess neuropathic pain components. Costing data were obtained from 1718 participants in the GBPRN survey. Results: According to our model, approximately 4% of the general adult population experienced back pain with a neuropathic component. Owing to the greater severity of neuropathic pain, its costs were found to be disproportionately high: among patients with persistent back pain, typical costs associated with a person suffering neuropathic back pain were higher than those of an average back pain patient, and as much as 67% higher than those of a patient with nociceptive back pain only. Approximately, 16% of the total costs associated with back pain were attributable to pain with a neuropathic component. Conclusions: Back pain with neuropathic components is likely to affect a relevant proportion of the general adult population and cause a disproportionately high share of back pain‐related costs.

الإتاحة: https://doi.org/10.1016/j.ejpain.2008.12.003Test

المؤلفون: Baron, Ralf, Tölle, Thomas R., Gockel, Ulrich, Brosz, Mathias, Freynhagen, Rainer

المصدر: Pain ; volume 146, issue 1, page 34-40 ; ISSN 0304-3959

الإتاحة: https://doi.org/10.1016/j.pain.2009.06.001Test
http://journals.lww.com/00006396-200911000-00011Test