Publications by authors named "Th Koehler"

Introduction: With the increasing use of aeromedical transport for critically ill patients, it is essential to understand the impact of pressure changes on drug infusion delivery systems. As airplanes ascend and descend, gases/bubbles are released from solutions when ambient pressure decreases and dissolves when pressure increases. This may affect mechanical fluid delivery systems and cause clinically significant changes, especially within a critical care setting.

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Theranostics in nuclear oncology combines diagnostic and therapeutic procedures using radiotracers to target tumor cells. Prostate-specific membrane antigen (PSMA) is a key target in metastatic prostate cancer, and the radioligand [177Lu]Lu-PSMA-617, which binds to PSMA, has shown promising results in treating metastatic castration-resistant prostate cancer (mCRPC), leading to its approval by the European Medicines Agency in 2022.In this narrative review, the current evidence of [177Lu]Lu-PSMA-617 in mCRPC was discussed in the context of selected studies and the joint EANM/SNMMI guidelines for Lutetium-177-labeled PSMA-targeted radioligand therapy.

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Background: To examine the feasibility and safety of the SENSEI drop-in gamma probe for robot-assisted, prostate-specific membrane antigen (PSMA)-radioguided salvage surgery (RGS) in lymph node or local oligorecurrent prostate cancer (PCa), detected via PSMA positron emission tomography/computed tomography (PET/CT).

Methods: The first thirteen patients with pelvic oligorecurrent PCa who underwent [Tc]Tc-PSMA-I&S RGS using the SENSEI drop-in gamma probe at the Martini-Klinik (February-June 2024) were retrospectively analyzed. Radioactivity measurements in counts per second (CPS) as absolute values or ratios (CPS of tumor specimens/mean CPS from the patients' benign tissues) were correlated with preoperative imaging and pathological findings (benign/malignant, lesion size).

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We report on a 32-year-old woman with multiple, progressive cavitary lung lesions. Lung cavities may occur in the context of various diseases and, thus, represent a huge diagnostic challenge. The spectrum of diseases comprises infections, systemic autoimmune rheumatic diseases, and malignancies.

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  • * Germany has taken a leading role in implementing telemedicine for CHF, resulting in improved patient quality of life and fewer hospitalizations, supported by governmental backing and substantial research evidence.
  • * This review analyzes the evolution of telemonitoring for CHF in Germany, highlighting key studies and the journey towards integrating telemedicine into standard care for high-risk patients.
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Background: The prognosis of patients with anaplastic thyroid cancer (ATC) remains dismal. A small portion of patients experience longterm survival and need to be identified before treatment allocation. Survival scores may guide clinicians making more informed decisions about treatment options and improve the understanding of patients' prognosis.

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Tuberculosis is the leading cause of death from an infectious disease, and is caused by Mycobacterium tuberculosis (M.tb). More than 1 billion people worldwide are thought to harbor an M.

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  • - The study explores how atmospheric pressure changes during flights can influence insulin delivery from pumps in people with type 1 diabetes, potentially leading to issues like hypoglycaemia.
  • - An in vitro flight simulation mimicking airline conditions revealed that insulin pumps can over-deliver and under-deliver insulin at different stages of flight, particularly significant during emergency decompression scenarios.
  • - Real-world data from pilots using continuous subcutaneous insulin infusion (CSII) showed that insulin levels remained stable with only a small percentage of blood glucose readings falling outside the safe range, indicating effective management while flying.
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  • * It emphasizes that complete decongestive therapy (CDT) includes key components such as examination, compression, and education, and should be administered by certified lymphedema therapists.
  • * The therapy should be tailored to the individual patient's specific condition and needs, considering factors like their lymphedema causes, associated health issues, and overall clinical situation.*
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Hybrid closed-loop (HCL) systems remain underexplored within aviation, and as atmospheric pressure changes can independently affect insulin pumps and continuous glucose monitoring readings, this preliminary study assessed the feasibility of HCL safety evaluation, in both fasting and post-prandial states, by using hypobaric chamber to simulate flights. Participants with type 1 diabetes and on HCL were studied: Medtronic Guardian 4-Medtronic 780G-SmartGuard ( = 4), Dexcom G6-Omnipod DASH-Android APS ( = 1), and Dexcom G6-Ypsomed Pump-CamAPS ( = 1). Flight cabin pressures of 550 mmHg and 750 mmHg were simulated in a hypobaric chamber.

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Breast cancer-related lymphedema (BCRL) remains a challenging condition impacting function and quality of life. Complete decongestive therapy (CDT) is the current standard of care, necessitating a comprehensive review of its impact. This paper presents a systematic review (SR) of SRs on CDT's efficacy in BCRL, and the components of manual lymph drainage (MLD) and exercise.

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  • Peru has a high concentration of malaria cases in the Loreto department, particularly among Indigenous populations in isolated riverine communities, highlighting the need for targeted prevention efforts.
  • A study involving interviews with 33 community members from the Maijuna people revealed varied levels of knowledge about malaria prevention, confusion about disease transmission, and a general acceptance of bed nets as a preventive measure.
  • The findings suggest that local beliefs and experiences should inform future health interventions in these communities, emphasizing the importance of culturally relevant programming to address health issues like malaria.
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  • The study created a comprehensive reference atlas of human prenatal skin (7-17 weeks post-conception) using advanced techniques like single-cell and spatial transcriptomics to explore the roles of immune cells, specifically macrophages, in skin development.
  • It was found that interactions between immune and non-immune cells are essential for key processes in skin development, such as hair follicle formation, scarless wound healing, and blood vessel growth.
  • Additionally, while a skin organoid model mimicked certain features of prenatal skin, it lacked immune cells and showed limited blood vessel diversity, highlighting the important roles of macrophages and their derived factors in skin morphology and development.
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Background: To evaluate how prostate-specific antigen (PSA) levels decrease after removal of isolated prostate cancer (PCa) nodal metastases in relation to their diameter/volume ("PSA-density of PCa-metastases") and maximum standardized uptake value (SUV).

Methods: A total of 83 consecutive patients with solitary nodal recurrence after radical prostatectomy who underwent prostate-specific membrane antigen-radioguided salvage surgery were retrospectively analyzed. Using multivariable linear regression models, the PSA-decrease after removal of each PCa-metastases (=PSA-contribution of each PCa-metastases) was correlated with the long axis diameter/estimated volume and the SUV of each removed metastasis.

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Introduction: A clear immune correlate of protection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has not been defined. We explored antibody, B-cell, and T-cell responses to the third-dose vaccine and relationship to incident SARS-CoV-2 infection.

Methods: Adults in a prospective cohort provided blood samples at day 0, day 14, and 10 months after the third-dose SARS-CoV-2 vaccine.

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Background: The incidence, risk factors, and outcomes of venous thromboembolism (VTE) in patients with chronic lymphocytic leukemia (CLL) and monoclonal B-cell lymphocytosis (MBL) are not well described.

Objectives: We aimed to determine the clinical characteristics, risk factors, and outcomes of incident VTE in patients with newly diagnosed MBL/CLL and compare the incidence to the age- and sex-matched general population.

Methods: Using the Mayo Clinic CLL Database, we identified 946 patients with newly diagnosed MBL/CLL between 1998 and 2021.

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  • Immune checkpoint blockade (ICB) therapies help revive T cell responses in some cancers, but many tumors fail to respond and can develop resistance.
  • This review explores the mechanisms behind T cell dysfunction, emphasizing the roles of key transcription factor (TF) networks in T cell activity.
  • It also examines potential strategies for using small molecule modulators to target these TFs, which could enhance T cell responses and lead to long-lasting immunity against cancer.
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In 2022, mpox virus (MPXV) spread worldwide, causing 99,581 mpox cases in 121 countries. Modified vaccinia Ankara (MVA) vaccine use reduced disease in at-risk populations but failed to deliver complete protection. Lag in manufacturing and distribution of MVA resulted in additional MPXV spread, with 12,000 reported cases in 2023 and an additional outbreak in Central Africa of clade I virus.

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Background And Purpose: A Medication Therapy Management (MTM) encounter allows pharmacists to gather information to make appropriate assessments and recommendations regardless of the patient's language needs and the encounter environment utilized. With the goal of improving comfort and confidence in providing MTM services, working with an interpreter, and providing care in a virtual environment, students participated in a virtual MTM activity with English and non-English speaking patients.

Educational Activity And Setting: In groups, students completed two MTM encounters during a virtual skills laboratory.

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  • - 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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Objective: The development of glucagon-like peptide-1 receptor (GLP-1R) agonists for the treatment of type 2 diabetes and obesity has been accompanied by evidence for anti-inflammatory and cytoprotective actions in the heart, blood vessels, kidney, and brain. Whether GLP-1R agonists might be useful clinically for attenuating deterioration of cognitive dysfunction and reducing the progression of Alzheimer's disease remains uncertain.

Methods: Here we evaluated the actions of semaglutide and tirzepatide, clinically distinct GLP-1 medicines, in two mouse models of neurodegeneration.

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  • 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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Telemedical care concepts provide opportunities to improve the care of patients with chronic heart failure (CHF). The current state of telemedical technologies enables the effective monitoring of the disease. Germany is one of the first European countries with an entitlement to telemedical supporting care for CHF patients.

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Indoor air pollution is a growing public health concern globally and is associated with increased respiratory symptoms and morbidity. Individuals spend most of their time indoors, and pollutant-related health effects are often driven by the indoor environment. Understanding effective interventions to improve indoor air quality and their impact on respiratory outcomes is key to decreasing the burden of air pollution for high-risk populations across the life-span.

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