Publications by authors named "Stehling F"

Article Synopsis
  • Duchenne muscular dystrophy is a common genetic disease in children that results in loss of motor skills, heart issues, and respiratory challenges.
  • Respiratory care by pediatric pulmonologists is crucial, including lung function monitoring, sleep studies, and managing ventilation support.
  • The article highlights the importance of collaboration among specialists to improve the treatment and quality of life for children with neuromuscular diseases like Duchenne muscular dystrophy.
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Cystic fibrosis bone disease (CFBD) is a common comorbidity in adult people with cystic fibrosis (pwCF), resulting in an increased risk of bone fractures. This study evaluated the capacity of artificial intelligence (AI)-assisted low-dose chest CT (LDCT) opportunistic screening for detecting low bone mineral density (BMD) in adult pwCF. In this retrospective single-center study, 65 adult pwCF (mean age 30.

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Objective: This study is an addition to the already published prospective randomized double-blinded trial by Tschiedel et al. that compared two different sedation regimes in fiberoptic flexible bronchoscopy in pediatric subjects. The objective of the presented study is to analyze the correlation between the neutrophil percentage of the bronchoalveolar lavage fluid (BALF) and coughing episodes during bronchoscopy.

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  • Maintaining physical fitness is crucial for adults with cystic fibrosis (pwCF), but there is limited data on how new therapies like ETI affect their fitness levels over time.
  • A study tracked 28 adult pwCF for about 5.6 years, measuring various physical fitness components and health indicators like BMI and FEV1, finding significant improvements in BMI and some health-related fitness measures after starting ETI therapy.
  • While ETI therapy showed some positive effects, the overall impact on fitness was small, suggesting that other factors also play a role in achieving high physical fitness in pwCF.
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  • Habitual physical activity and exercise training are crucial for improving health and quality of life in people with cystic fibrosis (pwCF), particularly with the advent of new CFTR modulator therapies like Elexacaftor/Tezacaftor/Ivacaftor (ETI).
  • A study was conducted to evaluate the effects of ETI on habitual physical activity, measuring steps per day and intensity among adult pwCF over time, with a focus on data collected during the post-pandemic period.
  • Results showed that pwCF on ETI increased daily steps by 25%, while those not receiving ETI saw a slight decline; however, changes in lung function were significant for those on
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In pediatrics chronic respiratory insufficiency is increasingly treated on an outpatient basis with home mechanical ventilation. Nursing and medical teams with different structures take care of the often complex ill children in the outpatient setting. Structured treatment processes, especially emergency plans for the management of respiratory emergencies of home mechanical ventilated children are lacking.

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Background: The influence of habitual physical activity and exercise capacity on health-related quality of life (HRQoL) in people with cystic fibrosis (pwCF) is poorly characterized. This study investigated the influence of habitual physical activity, exercise capacity, lung function, and body mass index (BMI) on HRQoL in adolescent and adult pwCF.

Method: Subjects were fitted with an accelerometer to determine habitual physical activity (steps/day), including time spent at different intensities, for up to 4 weeks.

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Children and adolescents with severe neurological impairment (SNI) require specialized care due to their complex medical needs. In particular, these patients are often affected by severe and recurrent lower respiratory tract infections (LRTIs). These infections, including viral and bacterial etiology, pose a significant risk to these patients, often resulting in respiratory insufficiency and long-term impairments.

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are a large order of ubiquitous saprophytic zygomycete fungi and act as opportunistic pathogens in humans. In pediatric patients, little is known about the role of in airway colonization and infection or their role as contaminants of respiratory samples. Currently, polymerase chain reaction (PCR) is the most sensitive mode of detection in clinical specimen.

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Article Synopsis
  • The study examines the impact of the Elexacaftor/Tezacaftor/Ivacaftor (ETI) therapy on health-related quality of life (HRQoL) in adults with cystic fibrosis (pwCF) over a period of about 5.6 years, comparing those who received ETI to those who did not.
  • It found that ETI significantly improved several HRQoL domains, while pwCF not on ETI saw little improvement in psychosocial factors and decline in physical health over time.
  • The findings suggest ETI therapy enhances both HRQoL and clinical outcomes, but disease progression appears to affect physical health more negatively than psychological aspects; however
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Unlabelled: Delay in diagnosing multidrug-resistant tuberculosis (MDR-pTB) in children prolongs time to effective treatment. Data on risk factors for pediatric MDR from low-incidence countries are scarce. Retrospective nationwide case-control study to analyze MDR-pTB cases in Germany between 2010 and 2020 in comparison to a drug-susceptible (DS)-pTB group.

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Background: Treatment with elexacaftor/tezacaftor/ivacaftor (ETI) improves multiple clinical outcomes in people with cystic fibrosis (pwCF) with at least one F508del allele. This study evaluated the real-world impact of ETI on lung function, nutritional status, pulmonary exacerbation frequency, and sweat chloride concentrations in a large group of pwCF.

Methods: This observational cohort study used data from the German CF Registry for pwCF who received ETI therapy and were followed up for a period of 12 months.

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Background: Antibiotic eradication therapies recommended for newly isolated Pseudomonas aeruginosa (Pa) in people with cystic fibrosis (pwCF) can be burdensome. ALPINE2 compared the efficacy and safety of a shortened 14-day course of aztreonam for inhalation solution (AZLI) with 28-day AZLI in paediatric pwCF.

Methods: ALPINE2 (a double-blind, phase 3b study) included children aged 3 months to <18 years with CF and new-onset Pa infection.

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  • The study investigates the personality traits of adult patients with cystic fibrosis (CF) and their relationship to health-related quality of life (HRQoL) and clinical severity indicators.
  • Seventy adults completed specific questionnaires, revealing that CF patients displayed varying personality traits compared to the norm, with two distinct personality clusters identified based on their scores.
  • Results indicate that psychological factors, particularly personality, significantly affect HRQoL in CF patients, suggesting that those with pronounced personality traits could benefit from psychosocial support to improve their quality of life.
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Recently, cystic fibrosis transmembrane regulator modulator therapy with elexacaftor/tezacaftor/ivacaftor has become available for children with cystic fibrosis (CF) carrying at least one mutation. To assess the intermediate term effects of elexacaftor/tezacaftor/ivacaftor in children with cystic fibrosis in a real-world setting. We performed a retrospective analysis of records of children with cystic fibrosis, who started elexacaftor/tezacaftor/ivacaftor between 8/2020 and 10/2022.

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The number of children with tracheostomies with and without home mechanical ventilation has grown continuously in recent years. For some of these children, the need for tracheostomy resolves and the child can be weaned from the tracheal cannula. Choosing the optimal time point for decannulation after elaborated prior diagnostic work-up needs careful consideration.

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Background: Paediatric diffuse alveolar haemorrhage (DAH) is a rare heterogeneous condition with limited knowledge on clinical presentation, treatment and outcome.

Methods: A retrospective, descriptive multicentre follow-up study initiated from the European network for translational research in children's and adult interstitial lung disease (Cost Action CA16125) and chILD-EU CRC (the European Research Collaboration for Children's Interstitial Lung Disease). Inclusion criteria were DAH of any cause diagnosed before the age of 18 years.

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Elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) has been shown to be safe and effective in people with cystic fibrosis (CF) aged ⩾6 years with at least one allele but has not been studied in younger children. To evaluate the safety, pharmacokinetics, pharmacodynamics, and efficacy of ELX/TEZ/IVA in children with CF aged 2-5 years. In this phase 3, open-label, two-part study (parts A and B), children weighing <14 kg (on Day 1) received ELX 80 mg once daily (qd), TEZ 40 mg qd, and IVA 60 mg each morning and 59.

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Background: The majority of patients with childhood interstitial lung disease (chILD) caused by pathogenic variants in ATP binding cassette subfamily A member 3 (ABCA3) develop severe respiratory insufficiency within their first year of life and succumb to disease if not lung transplanted. This register-based cohort study reviews patients with ABCA3 lung disease who survived beyond the age of 1 year.

Method: Over a 21-year period, patients diagnosed as chILD due to ABCA3 deficiency were identified from the Kids Lung Register database.

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Objectives: People with cystic fibrosis (pwCF) are at risk for infection with nontuberculous mycobacteria (NTM). The epidemiology and screening practice of NTM among pwCF in Germany are largely unknown and require investigation.

Methods: We analyzed the data of the German Cystic Fibrosis Registry from 2016 to 2020 for NTM.

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Article Synopsis
  • Mycobacterium chimaera is a non-tuberculous mycobacterium linked to difficult infections in cystic fibrosis patients, primarily affecting the lungs and rare in other sites unless there's immune deficiency.
  • A case study of an 8-year-old cystic fibrosis patient showed recurrent pulmonary issues and a confirmed M. chimaera infection in a central venous port, diagnosed using next-generation sequencing.
  • The patient's recovery highlights the need for catheter removal and targeted therapy as key steps in treating MAC infections, underscoring the importance of biofilm formation in such cases.
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Background: Infections, major surgeries, and hyperinflammatory syndromes are known to trigger Systemic Inflammatory Response Syndrome (SIRS). Discrimination between infectious and noninfectious inflammation often poses a challenge in chronically ill patients with multiple comorbidities. These patients are routinely treated with a variety of anti-infective medications before a pathogen is identified.

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  • Obstructive sleep apnea (OSA), nocturnal hypoxemia, and excessive daytime sleepiness (EDS) are frequently observed in adults with cystic fibrosis (pwCF), highlighting the need for better understanding of sleep-related issues.* -
  • In a study of 52 adult pwCF, 40% exhibited abnormal apnea-hypopnea indices, with 25% experiencing nocturnal hypoxemia, while 15% reported significant EDS as measured by the Epworth Sleepiness Scale.* -
  • Despite the prevalence of these sleep disorders, no strong predictive factors were identified; the study recommends routine sleep assessments (polysomnography and Epworth Sleepiness Scale) for adult pwCF regardless of their general health
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Article Synopsis
  • Physical activity (PA) is a key part of cystic fibrosis (CF) treatment, but barriers to participation need to be identified and managed, prompting this study to assess those obstacles.
  • The study involved 88 individuals with CF, who completed a questionnaire about their physical and psychosocial barriers to exercise before and during a 12-month exercise program, revealing that physical barriers were more significant than psychosocial ones.
  • Supervision during the exercise program did not significantly improve barrier management, highlighting the need for personalized discussions about individual barriers and strategies to encourage more PA in daily life.
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  • Gain-of-function variants in the STING gene are responsible for STING-Associated Vasculopathy with onset in Infancy (SAVI), previously thought to only occur with heterozygous mutations.
  • Recent findings highlight a specific homozygous variant, c.841C>T, causing SAVI in four unrelated patients, all presenting with interstitial lung disease and varying disease severity.
  • This research challenges the established view of SAVI as an autosomal dominant condition, suggesting an autosomal recessive inheritance pattern and potentially aiding in diagnosis and treatment approaches.
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