Publications by authors named "Welte Tobias"

A significant number of patients experience prolonged symptoms following COVID-19 in particular cases of fatigue. Yet, pathomechanisms of COVID-19-related fatigue remain unclear. This study investigated patients after confirmed SARS-CoV-2 infection (PC) with relevant fatigue according to the Fatigue Assessment Scale (≥22 points) to rule out malnutrition as a driving factor for fatigue and to evaluate daily activity and sleep characteristics.

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Background: Lung transplantation is the treatment of choice for end-stage nonmalignant lung disease. It has become a routine procedure through advances in donor lung preservation, extracorporeal membrane oxygenation, immunosuppression, intensive care medicine, and follow-up care.

Methods: This review is based on publications about lung transplantation that were retrieved by a selective literature search, and on the procedures and experience of two large-volume lung transplantation centers.

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Background: In patients with chronic diseases, including those with chronic obstructive pulmonary disease (COPD), knowledge on the disease and its self-management is considered as relevant for improving disease control and long-term outcome. We studied to which extent components of knowledge depended on potential predictors, such as participation in educational programs and disease severity. For example, the perception of exacerbations or GOLD grade might modulate the content and reliability of COPD understanding.

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Objectives: Severe pulmonary hypertension (PH) is the leading indication for a lung transplant in younger patients. Despite the availability of validated risk scores, their influence on lung allocation has been negligible, with continued reliance on decompensation and bridging with extracorporeal membrane oxygenation (ECMO).This single-centre, retrospective study assessed outcome of ECMO bridging in lung transplant for PH and evaluated short-term predictability of ECMO bridging.

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Background: Severe asthma affects the working life of millions of people worldwide. Interleukin (IL)-5/anti-interleukin-5 receptor α (IL-5Rα) antibodies are highly effective in reducing symptoms in patients with severe eosinophilic asthma. We analysed effects of anti-IL-5/anti-IL-5Rα treatment on self-reported productivity and absenteeism at work in patients with severe eosinophilic asthma.

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Bronchiectasis is an etiologically heterogeneous, chronic, and often progressive respiratory disease characterized by irreversible bronchial dilation. It is frequently associated with significant symptom burden, multiple complications, and reduced quality of life. For several years, there has been a marked global increase in the prevalence of bronchiectasis, which is linked to a substantial economic burden on healthcare systems.

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Background: The serum antiglycopeptidolipid core IgA antibody test has been proposed as a diagnostic tool for Mycobacterium avium complex pulmonary diseases. Cross-reactivity with other nontuberculous mycobacteria (NTM), including Mycobacterium abscessus, indicates that it may have a role as a broader screening test for nontuberculous mycobacterial pulmonary disease (NTM-PD). NTM-PD is believed to be underdiagnosed in patients with bronchiectasis.

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Article Synopsis
  • - The study evaluated the efficacy of the MVA-BN-RSV vaccine, designed for older adults (≥60 years), against respiratory disease caused by RSV during the 2022-2023 season, involving 18,348 participants who received either the vaccine or a placebo.
  • - Vaccine efficacy was reported as 42.9% against RSV-associated lower respiratory tract disease (LRTD) with 3 symptoms and 59.0% against LRTD with 2 symptoms; however, the primary endpoint was not met due to the lower confidence interval being below a predetermined success criterion.
  • - The vaccine demonstrated mild to moderate side effects, showed promise by confirming immunogenicity (increased antibody responses), but provided
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Background: Biliary atresia (BA) is a rare condition of unknown origin in newborns with jaundice. In BA bile ducts are non-functional, causing neonatal cholestasis and following liver fibrosis and failure.

Methods: This retrospective study included liver biopsies of 14 infants with BA aged [mean ± SD] 63 ± 23 days.

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Background: Treatment guidelines were developed early in the pandemic when much about COVID-19 was unknown. Given the evolution of SARS-CoV-2, real-world data can provide clinicians with updated information. The objective of this analysis was to assess mortality risk in patients hospitalized for COVID-19 during the Omicron period receiving remdesivir+dexamethasone versus dexamethasone alone.

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Introduction: Validation of functional free-breathing MRI involves a comparison to more established or more direct measurements. This procedure is cost-intensive, as it requires access to patient cohorts, lengthy protocols, expenses for consumables, and binds working time. Therefore, the purpose of this study is to introduce a synthetic lung model (ASYLUM), which mimics dynamic MRI acquisition and includes predefined lung abnormalities for an alternative validation approach.

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Article Synopsis
  • The executive summary outlines evidence-based recommendations for diagnosing and treating nosocomial pneumonia, focusing on practical guidelines for healthcare providers in Germany.
  • It was developed through a systematic review process by an interdisciplinary panel, with the help of an independent methodologist, and presents 26 total recommendations, including ones based on strong evidence and expert consensus.
  • Key recommendations include distinguishing patients at risk for multidrug-resistant pathogens, limitations of routine bacterial PCR testing, and guidelines for antibiotic therapy, emphasizing focused treatments and the importance of rapidly de-escalating unnecessary antibiotics when patients stabilize.
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Staphylococcus aureus is a prevalent pathogen in pneumonia and harbors glycolipids, which may serve as molecular patterns in Mincle (macrophage-inducible C-type lectin)-dependent pathogen recognition. We examined the role of Mincle in lung defense against S aureus in wild-type (WT), Mincle knockout (KO), and Mincle transgenic (tg) mice. Two glycolipids, glucosyl-diacylglycerol (Glc-DAG) and diglucosyl-diacylglycerol (Glc2-DAG), were purified, of which only Glc-DAG triggered Mincle reporter cell activation and professional phagocyte responses.

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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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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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Article Synopsis
  • In patients with COPD, impaired left ventricular (LV) filling can be categorized into two patterns: small LV size and heart failure with preserved ejection fraction (HFpEF), both linked to increased all-cause mortality.
  • A study involving 1,752 COPD patients found that 8% had small LV, 16% had HFpEF features, and 45% had normal cardiac function, with those having small LV or HFpEF showing significantly higher mortality rates.
  • Small LV is an independent predictor of mortality, contrasting with HFpEF as patients with small LV exhibit reduced LV filling but normal filling pressure and lower biomarker levels.
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Article Synopsis
  • This study explored how CT imaging of pulmonary vessels relates to lung function, disease severity, and mortality risk in patients with chronic obstructive pulmonary disease (COPD).
  • Researchers used automatic software to analyze CT scans from a nationwide cohort, focusing on the features of arterial and venous vessels during breathing.
  • Findings revealed that certain expiratory vessel characteristics, particularly venous volume, are significant predictors of lung function and mortality in COPD patients.
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Background: Ventilator-associated pneumonia (VAP) is a prevalent and grave hospital-acquired infection that affects mechanically ventilated patients. Diverse diagnostic criteria can significantly affect VAP research by complicating the identification and management of the condition, which may also impact clinical management.

Objectives: We conducted this review to assess the diagnostic criteria and the definitions of the term "ventilator-associated" used in randomised controlled trials (RCTs) of VAP management.

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Background: Exacerbations of chronic obstructive pulmonary disease (COPD) were reported less frequently during the COVID-19 pandemic. We report real-world data on COPD exacerbation rates before and during this pandemic.

Methods: Exacerbation patterns were analysed using electronic medical records or claims data of patients with COPD before (2017-2019) and during the COVID-19 pandemic (2020 through early 2022) in France, Germany, Italy, the United Kingdom and the United States.

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Aims: Neutrophils perform various functions in a circadian-dependent manner; therefore, we investigated here whether the effect of alpha1-antitrypsin (AAT), used as augmentation therapy, is dependent on the neutrophil circadian clock. AAT is a vital regulator of neutrophil functions, and its qualitative and/or quantitative defects have significant implications for the development of respiratory diseases.

Methods: Whole blood from 12 healthy women age years, mean (SD) 29.

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Assessment of lung function is an important clinical tool for the diagnosis and monitoring of chronic lung diseases, including idiopathic pulmonary fibrosis (IPF). In mice, lung function maneuvers use algorithm-based ventilation strategies including forced oscillation technique (FOT), negative pressure-driven forced expiratory (NPFE) and pressure-volume (PV) maneuvers via the FlexiVent system. This lung function test (LFT) is usually performed as end-point measurement only, requiring several mice for each time point to be analyzed.

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Background: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Limited evidence is available on the most effective diagnostic approaches, management strategies, and long-term outcomes for CAP in patients who have undergone solid organ transplantation.

Research Question: What is the acute and long-term morbidity and mortality after CAP in organ transplant recipients?

Study Design And Methods: We retrospectively analyzed hospitalizations for CAP in solid organ recipients at the largest German transplant center.

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Introduction: Ceftazidime-avibactam (CAZ-AVI) is a combination of the third-generation cephalosporin ceftazidime and the novel, non-β-lactam β-lactamase inhibitor avibactam that is approved for the treatment of pediatric (≥ 3 months) and adult patients with complicated infections including hospital-acquired and ventilator-associated pneumonia (HAP/VAP), and bacteremia. This systematic literature review and meta-analysis (PROSPERO registration: CRD42022362856) aimed to provide a quantitative and qualitative synthesis to evaluate the effectiveness of CAZ-AVI in treating adult patients with bacteremia or nosocomial pneumonia caused by carbapenem-resistant Enterobacterales (non metallo-β-lactamase-producing strains) and multi-drug resistant (MDR) Pseudomonas aeruginosa infections.

Methods: The databases included in the search, until November 7, 2022, were Embase and PubMed.

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Rationale: The inflammasome is a key regulatory complex of the inflammatory response leading to interleukin-1β (IL-1β) release and activation. IL-1β amplifies inflammatory responses and induces mucus secretion and hyperconcentration in other diseases. The role of IL-1β in bronchiectasis has not been investigated.

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