Publications by authors named "Carlos Koehler"

Article Synopsis
  • - This study analyzes the effects of mitral transcatheter edge-to-edge repair (M-TEER) on hospitalization rates for patients with functional mitral regurgitation (FMR) and symptomatic heart failure (HF), aiming to clarify conflicting results from previous research.
  • - The results indicate that patients who underwent M-TEER experienced significantly lower rates of recurrent heart failure hospitalizations and cardiovascular (CV) deaths over a 24-month period, as well as an improved quality of life compared to those in the control group.
  • - Specifically, patients in the M-TEER group spent fewer days in the hospital due to HF or CV issues, with a statistically significant reduction in total days lost due to these health complications.
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Article Synopsis
  • The study examined the effectiveness of transcatheter mitral-valve repair in patients suffering from heart failure and functional mitral regurgitation, comparing it to standard medical therapy.
  • In a trial with 505 patients, results showed that those who received the device had significantly lower rates of hospitalizations for heart failure and cardiovascular death compared to those who only received medical therapy.
  • Additionally, patients in the device group experienced a greater improvement in health status, as measured by the Kansas City Cardiomyopathy Questionnaire, indicating better outcomes with the transcatheter procedure.
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Objectives: To assess the safety and immunogenicity of a fourth vaccination (second booster) in individuals aged ≥75 years.

Methods: Participants were randomized to BNT162b2 (Comirnaty, 30 µg) or messenger RNA (mRNA)-1273 (Spikevax, 100 µg). The primary end point was the rate of two-fold antibody titer increase 14 days after vaccination, targeting the receptor binding domain (RBD) region of wild-type SARS-CoV-2.

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Aim: The RESHAPE-HF2 trial is designed to assess the efficacy and safety of the MitraClip device system for the treatment of clinically important functional mitral regurgitation (FMR) in patients with heart failure (HF). This report describes the baseline characteristics of patients enrolled in the RESHAPE-HF2 trial compared to those enrolled in the COAPT and MITRA-FR trials.

Methods And Results: The RESHAPE-HF2 study is an investigator-initiated, prospective, randomized, multicentre trial including patients with symptomatic HF, a left ventricular ejection fraction (LVEF) between 20% and 50% with moderate-to-severe or severe FMR, for whom isolated mitral valve surgery was not recommended.

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  • The COVID-19 pandemic has severely affected individuals with hematological malignancies due to their weakened immune systems, resulting in higher mortality rates and severe outcomes.
  • Data from the EPICOVIDEHA registry, which compiles COVID-19 cases from these patients worldwide, was collected from 2020 to 2022, including 8,767 cases from 152 centers across 41 countries.
  • Findings show a significant drop in critical infections and overall mortality rates, but hospitalization (especially in ICU) remains a serious risk factor; vaccination is linked to better survival outcomes, highlighting the need for ongoing monitoring and support for these patients.
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  • The document outlines the goal of creating standardized research definitions for invasive fungal diseases (IFD) in adult ICU patients without typical risk factors for these infections.
  • A panel of experts assessed existing definitions and lab tests for IFD, using the RAND/UCLA method to reach a consensus on new definitions.
  • Key standardized definitions were made for conditions like invasive candidiasis and aspergillosis, but more data is needed for other IFDs, with the intent to enhance future research studies.
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  • Implantable devices help patients with heart failure by working alongside medicines to treat the condition and improve their health.
  • While some devices are supported by strong evidence and show positive effects, others need more research before they can be widely used.
  • The Heart Failure Association and European Heart Rhythm Association suggest a better way to use these devices in care programs to help patients more effectively.
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Background: Vaccination remains crucial for protection against severe SARS-CoV-2 infection, especially for people of advanced age, however, optimal dosing regimens are as yet lacking.

Methods: EU-COVAT-1-AGED Part A is a randomised controlled, adaptive, multicentre phase II trial evaluating safety and immunogenicity of a 3rd vaccination (1st booster) in individuals ≥75 years. Fifty-three participants were randomised to full-doses of either mRNA-1273 (Spikevax®, 100 µg) or BNT162b2 (Comirnaty®, 30 µg).

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Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic, life-threatening disease commonly affecting immunocompromised patients. The distribution of predisposing diseases or conditions in critically ill patients admitted to intensive care unit (ICU) and subjected to diagnostic work-up for PJP has seldom been explored.

Materials And Methods: The primary objective of the study was to describe the characteristics of ICU patients subjected to diagnostic workup for PJP.

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Introduction: Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections and decrease hospitalisation and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, whereas molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir because it is associated with fewer drug-drug interactions and contraindications.

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Article Synopsis
  • The ECMM conducted a study across 20 European countries to analyze the outcomes of patients with culture-proven candidaemia, focusing on how well hospitals followed treatment guidelines.
  • A total of 632 patients were included, revealing a high 90-day mortality rate of 43%, with factors such as age, ICU admission, comorbidity score, and specific types of Candida predicting mortality.
  • Adherence to clinical management guidelines, measured by EQUAL Candida scores, was associated with better survival outcomes, reinforcing the importance of following established treatment protocols.
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Background: Trichoderma spp. are filamentous fungi causing invasive fungal diseases in patients with haematological malignancies and in peritoneal dialysis patients.

Objectives: To analyse clinical presentation, predisposing factors, treatment and outcome of Trichoderma infections.

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DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6   6   6 m liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light.

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Given the highly variable clinical phenotype of Coronavirus disease 2019 (COVID-19), a deeper analysis of the host genetic contribution to severe COVID-19 is important to improve our understanding of underlying disease mechanisms. Here, we describe an extended genome-wide association meta-analysis of a well-characterized cohort of 3255 COVID-19 patients with respiratory failure and 12 488 population controls from Italy, Spain, Norway and Germany/Austria, including stratified analyses based on age, sex and disease severity, as well as targeted analyses of chromosome Y haplotypes, the human leukocyte antigen region and the SARS-CoV-2 peptidome. By inversion imputation, we traced a reported association at 17q21.

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The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM).

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Background: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality.

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Purpose: About one third of patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer who have residual invasive disease after neoadjuvant chemotherapy (NACT) will relapse. Thus, additional therapy is needed. Palbociclib is a cyclin-dependent kinase 4 and 6 inhibitor demonstrating efficacy in the metastatic setting.

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Background: Palbociclib plus endocrine therapy (ET) is the standard treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative, metastatic breast cancer (MBC). However, its efficacy has not been compared with that of chemotherapy in a phase III trial.

Patients And Methods: PEARL is a multicentre, phase III randomised study in which patients with aromatase inhibitor (AI)-resistant MBC were included in two consecutive cohorts.

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For interpreting the pressure induced shifts of resonance lines of folded as well as unfolded proteins the availability of data from well-defined model systems is indispensable. Here, we report the pressure dependence of H and N chemical shifts of the side chain atoms in the protected tetrapeptides Ac-Gly-Gly-Xxx-Ala-NH (Xxx is one of the 20 canonical amino acids) measured at 800 MHz proton frequency. As observed earlier for other nuclei the chemical shifts of the side chain nuclei have a nonlinear dependence on pressure in the range from 0.

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Background: Calvaria skin has a reduced thickness, and its initial damage produced by irradiation was scarcely reported. We aimed to identify the initial effects of x-ray irradiation in the rat calvaria skin.

Methods: After approval by the Animal Ethical Committee, calvaria skin sections of five Wistar rats per time point were evaluated on days 4, 9, 14, and 25 following a single 15-Gy x-ray irradiation of the head.

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Background: Recent outbreaks of Candida auris further exemplify that invasive Candida infections are a substantial threat to patients and healthcare systems. Even short treatment delays are associated with higher mortality rates. Epidemiological shifts towards more resistant Candida spp.

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Background: The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU).

Objectives: To develop a standard set of definitions for IFD in critically ill adult patients in ICU.

Methods: Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons.

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For evaluating the pressure responses of folded as well as intrinsically unfolded proteins detectable by NMR spectroscopy the availability of data from well-defined model systems is indispensable. In this work we report the pressure dependence of C chemical shifts of the side chain atoms in the protected tetrapeptides Ac-Gly-Gly-Xxx-Ala-NH (Xxx, one of the 20 canonical amino acids). Contrary to expectation the chemical shifts of a number of nuclei have a nonlinear dependence on pressure in the range from 0.

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Background: Surgical site infections (SSIs) remain a morbid and costly complication in abdominal surgery. Topical antibiotic delivery via intraoperative irrigation and barrier wound protection are strategies for preventing SSI. We tested the safety and efficacy of a novel wound protector device with an integrated fluid irrigation platform in a porcine model.

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For a better understanding of nuclear magnetic resonance (NMR) detected pressure responses of folded as well as unstructured proteins the availability of data from well-defined model systems are indispensable. In this work we report the pressure dependence of chemical shifts of the backbone atoms (1)H(α), (13)C(α) and (13)C' in the protected tetrapeptides Ac-Gly-Gly-Xxx-Ala-NH2 (Xxx one of the 20 canonical amino acids). Contrary to expectation the chemical shifts of these nuclei have a nonlinear dependence on pressure in the range from 0.

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