Publications by authors named "Felix J F Herth"

During the COVID-19 pandemic the effectiveness of vaccines against SARS-CoV-2 in immunodeficient patients did not only affect the individual risk of these vulnerable patients but endangered the selection of new variants of concern due to prolonged virus shedding by these patients. In a tertiary center for pulmonary diseases, we investigated the immune response of 11 patients with primary humoral immunodeficiency and 13 healthy controls on the humoral and cellular level after full vaccination with a mRNA or vector vaccine against SARS-CoV-2. In the majority of patients (73%), we found antibodies against the Spike protein above the thresh-old of positivity.

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Background: Pneumothorax is a major complication after endoscopic lung volume reduction with valves, with a prevalence of up to 34%. Although some patients benefit from valve implantation despite pneumothorax, others are significantly impaired after lung collapse.

Research Question: What are the differences in the severity grades of pneumothorax and how do these affect clinical practice?

Study Design And Methods: This single-center retrospective study analyzed patients undergoing endoscopic valve implantation with and without pneumothorax after intervention.

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Background: Established structured weaning approaches, which are effective for patients in simple and difficult weaning, are often not appropriate for patients undergoing prolonged weaning. Addressing the complexity of weaning failure requires personalized precision medicine. The therapeutic concept of treatable traits (TTs) has been proposed as a new paradigm for the management of chronic respiratory diseases.

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Article Synopsis
  • - The study aimed to evaluate tracheal collapsibility using low-dose 4D CT, comparing the results with traditional methods like inspiratory-expiratory CT and bronchoscopy in patients suspected of tracheal collapse.
  • - Researchers analyzed 4D CT scans from 52 patients, finding that 48% exhibited significant tracheal collapsibility (50% or greater) and noted differences between visual 4D CT assessments and other diagnostic methods regarding detection rates of collapsibility.
  • - Results showed that 4D CT was superior in identifying patients with severe collapsibility compared to both paired CT and bronchoscopy, with significant differences in collapsibility measurements between the groups assessed.
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  • - Chronic inflammatory airway diseases like chronic bronchitis, COPD, emphysema, and asthma are significant healthcare issues that can be addressed with interventional treatments alongside standard medical therapy.
  • - These minimally invasive procedures, such as bronchial thermoplasty and lung volume reduction techniques, directly target the airways to relieve symptoms and improve lung function by reducing hyperinflation and mucus production.
  • - The review provides insights into various interventional methods based on specific disease types, helping pulmonologists choose the best treatment options for their patients.
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  • The study investigates how sex influences the outcomes of patients undergoing prolonged weaning from invasive ventilation, utilizing a retrospective analysis at a hospital in Germany.
  • Out of 785 patients, both men and women showed relatively high rates of successful weaning (77.9% for women and 75.4% for men), with sex not identified as a significant risk factor for weaning failure.
  • Key risk factors differed between sexes: for men, age and duration of ventilation were critical, while for women, previous non-invasive ventilation, critical illness polyneuropathy, and delirium played significant roles.
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Introduction: Currently, there is a lack of bronchoscopic lung volume reduction options that do not depend on fissure integrity. Endobronchial coils have been extensively studied to address this need but exhibited variable patient response and have been discontinued. Lung tension device (LTD) coils represent the next-generation coil treatment.

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Background And Objective: Radiofrequency ablation (RFA) is an emerging treatment of lung cancer, yet it is accompanied by certain safety concerns and operational limitations. This first multi-centre, large-scale clinical trial aimed to investigate the technical performance, efficacy and safety of an innovative transbronchial RFA system for lung tumours.

Methods: The study enrolled patients with malignant lung tumours who underwent transbronchial RFA using an automatic saline microperfusion system between January 2021 and December 2021 across 16 medical centres.

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Background: To date there are no data on sex aspects evaluating outcomes of interventional pneumology (IP). Our aim was to investigate sex differences in transbronchial lung cryobiopsy (TBLC) outcomes in the diagnosis of interstitial lung disease (ILD).

Methods: All consecutive (TBLC)s performed for ILD evaluation between Nov 17 and Dec 21 at a tertiary referral center for ILDs and IP were analyzed.

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  • Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is limited in diagnosing certain conditions like lymphoma and sarcoidosis, prompting research on a new technique called transbronchial node biopsy (EBUS-TBNB) to improve tissue sample quality and diagnostic accuracy.
  • A systematic review compared the safety and diagnostic yields of EBUS-TBNB and EBUS-TBNA, revealing a higher overall diagnostic yield for EBUS-TBNB (86.01%) compared to EBUS-TBNA (77.80%).
  • The study found that EBUS-TBNB showed greater success rates in diagnosing both malignancies and benign conditions, although complications were relatively low, encompassing risks
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Article Synopsis
  • * Results indicated slight improvements in lung function measurements (FEV and RV) and a significant increase in walking distance, with some patients experiencing atelectasis and a manageable risk of complications.
  • * The findings suggest that simultaneous implantation of both valve types leads to meaningful clinical benefits and is a viable treatment option for patients with severe emphysema.
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Introduction: Endobronchial ultrasound (EBUS)-guided transbronchial mediastinal cryobiopsy (TBMC) is increasingly used to diagnose mediastinal lymphadenopathy. Various methods have been used to create a tunnel between the airway wall and the lesions for this procedure, such as electrocautery and penetration with the sheath of the needle for EBUS-transbronchial fine needle aspiration. However, those methods are complex.

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Introduction: The aim of the study was to establish an ultrasonographic radiomics machine learning model based on endobronchial ultrasound (EBUS) to assist in diagnosing benign and malignant mediastinal and hilar lymph nodes (LNs).

Methods: The clinical and ultrasonographic image data of 197 patients were retrospectively analyzed. The radiomics features extracted by EBUS-based radiomics were analyzed by the least absolute shrinkage and selection operator.

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The use and availability of diverse advanced X-ray based imaging and guidance systems in the field of interventional pulmonology are rapidly growing. This popularity links inextricably to an increase in ionizing radiation use. Knowing ionizing radiation is hazardous, knowledge and competent use of X-ray imaging and guidance systems are important.

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Background: Central airway obstruction (CAO), seen in a variety of malignant and nonmalignant airway disorders, is associated with a poor prognosis. The management of CAO is dependent on provider training and local resources, which may make the clinical approach and outcomes highly variable. We reviewed the current literature and provided evidence-based recommendations for the management of CAO.

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Background: Patients with COPD are often affected by loss of bone mineral density (BMD) and osteoporotic fractures. Natriuretic peptides (NP) are known as cardiac markers, but have also been linked to fragility-associated fractures in the elderly. As their functions include regulation of fluid and mineral balance, they also might affect bone metabolism, particularly in systemic disorders such as COPD.

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Introduction: Subglottic stenosis, manifested by granulation tissue hyperplasia, is challenging and requires multiple repeated treatments and stent maintenance at times. Corticosteroids prevent severe subglottic stenosis development owing to their antifibrotic and anti-inflammatory properties. Submucosal injection of glucocorticoids, a useful adjuvant therapeutic method, improves the mean interval between endoscopic procedures and reduces airway restenosis risks.

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Introduction: Transbronchial lung cryobiopsy (TBLC) is increasingly used to diagnose interstitial lung disease (ILD). The 1.1-mm cryoprobe has recently been available in clinical practice.

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Introduction: The diaphragm thickening fraction (DTF) may be a valuable tool for estimating respiratory effort in non-invasive ventilation. The primary aim of this physiological study is the investigation of the correlation of DTF with oesophageal pressure swings (ΔP). A secondary aim is to assess the discriminatory capacity of the index tests for different exercise loads.

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Introduction: Patients with chronic obstructive pulmonary disease (COPD) and emphysema experience malnutrition and pulmonary cachexia. Endoscopic lung volume reduction (ELVR) with endobronchial valves has not only improved lung function, exercise capacity, and quality of life but also influenced body weight. Only a few data are available on body composition changes after ELVR.

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  • The study addresses the challenge of diagnosing tracheobronchopathia osteochondroplastica (TO), a rare disease, since many young doctors may struggle to identify it through bronchoscopy.
  • Researchers developed an artificial intelligence (AI) model using bronchoscopic images to accurately distinguish TO from other similar airway diseases such as amyloidosis and tumors.
  • Results showed the AI model achieved a high accuracy of 89.2% in detecting TO among multinodular lesions, and an external validation confirmed the model's effectiveness with an accuracy of 89.8% in diagnosing patients with TO.
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Management of multiple primary lung cancer (MPLC) remains challenging, partly due to its increasing incidence, especially with the significant rise in cases of multiple lung nodules caused by low-dose computed tomography screening. Moreover, the indefinite pathogenesis, diagnostic criteria, and treatment selection add to the complexity. In recent years, there have been continuous efforts to dissect the molecular characteristics of MPLC and explore new diagnostic approaches as well as treatment modalities, which will be reviewed here, with a focus on newly emerging evidence and future perspectives, hope to provide new insights into the management of MPLC and serve as inspiration for future research related to MPLC.

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