Ziel der vorliegenden Studie war es, einen Einblick in die medizinischen Behandlungsmethoden von Patienten mit chronischer Rhinosinusitis (CRS) in Deutschland zu geben. Eine Untersuchung der ICD-Codes und der ATC-Klassen von CRS-Patienten in Hausarzt (HA)- und HNO-Praxen sollte das vorherrschende Behandlungsverhalten aufzeigen.
The aim of the present study was to give an insight into the medical treatment methods of patients with chronic rhinosinusitis (CRS) in Germany. Examination of the ICD codes and ATC classes of CRS patients in general practitioner (GP) and ENT practices should demonstrate prevalent treatment behaviors.
Background: Evidence of a beneficial effect of exercise training on mediators of vascular disease is accumulating in chronic kidney disease (CKD), but its effect on vascular function in vivo still has to be established. The present study was designed to investigate whether a formal aerobic exercise training program improves peripheral endothelial function in patients with CKD stages 3 to 4. Study Design: Randomized controlled trial with a parallel-group design. Setting & Participants: 48 patients with CKD stages 3 to 4 without established cardiovascular disease were randomly assigned to either an exercise training program or usual care. 40 patients completed the study (exercise training, 19; usual care, 21). Intervention: The 3-month home-based aerobic training program consisted of 4 daily cycling sessions of 10 minutes each at a target heart rate, calculated as 90% of the heart rate achieved at the anaerobic threshold. Patients in the usual-care group were given standard therapy. Outcomes: The primary outcome was peripheral endothelial function. Secondary outcomes were aerobic capacity, arterial stiffness, numbers of endothelial (EPCs) and osteogenic progenitor cells (OPCs), migratory function of circulatory angiogenic cells, and health-related quality of life. Measurements: Endothelial function was assessed with flow-mediated dilation of the brachial artery, aerobic capacity by peak oxygen uptake (Vo2peak), arterial stiffness by carotid-femoral pulse wave velocity, numbers of EPCs and OPCs by flow cytometry, circulatory angiogenic cell function by an in vitro migratory assay, and quality of life by the Kidney Disease Quality of Life2Short Form questionnaire. Results: Exercise training significantly improved Vo2peak and quality of life, but not in vivo vascular function (flow-mediated dilation and carotid-femoral pulse wave velocity) or cellular markers for vascular function (EPC and OPC count and circulatory angiogenic cell migratory function). Limitations: Short duration and intermittent nature of the exercise intervention. Conclusions: In patients with CKD stages 3 to 4 without overt cardiovascular disease, 3 months of aerobic exercise training improved Vo2peak and quality of life, without altering endothelial function or arterial stiffness. Am J Kidney Dis. 66(2):285-296. a 2015 by the National Kidney Foundation, Inc.
Objective Chronic rhinosinusitis with nasal polyps (CRSwNP) in Europe is mostly associated with a type 2 inflammatory endotype based on local cytokine patterns. Our aim was to map the inflammatory involvement of affected structures, being polypoid and non-polypoid mucosa of the nose and sinuses in CRSwNP patients.
Exercise training is an effective way to improve exercise capacity in chronic kidney disease (CKD), but the underlying mechanisms are only partly understood. In healthy subjects (HS), microRNA (miRNA or miR) are dynamically regulated following exercise and have, therefore, been suggested as regulators of cardiovascular adaptation to exercise. However, these effects were not studied in CKD before. The effect of acute exercise (i.e., an acute exercise bout) was assessed in 32 patients with CKD and 12 age- and sex-matched HS ( study 1). miRNA expression in response to chronic exercise (i.e., a 3-mo exercise training program) was evaluated in 40 CKD patients ( study 2). In a subgroup of study 2, the acute-exercise induced effect was evaluated at baseline and at follow-up. Plasma levels of a preselected panel miRNA, involved in exercise adaptation processes such as angiogenesis (miR-126, miR-210), inflammation (miR-21, miR-146a), hypoxia/ischemia (miR-21, miR-210), and progenitor cells (miR-150), were quantified by RT-PCR. Additionally, seven miRNA involved in similar biological processes were quantified in the subgroup of study 2. Baseline, studied miRNA were comparable in CKD and HS. Following acute exercise, miR-150 levels increased in both CKD (fold change 2.12 ± 0.39, P = 0.002; and HS: fold change 2.41 ± 0.48 P = 0.018, P for interaction > 0.05). miR-146a acutely decreased in CKD (fold change 0.92 ± 0.13, P = 0.024), whereas it remained unchanged in HS. Levels of miR-21, miR-126, and miR-210 remained unaltered. Chronic exercise did not elicit a significant change in the studied miRNA levels. However, an acute exercise-induced decrease in miR-210 was observed in CKD patients, only after training (fold change 0.76 ± 0.15). The differential expression in circulating miRNA in response to acute and chronic exercise may point toward a physiological role in cardiovascular adaptation to exercise, also in CKD.
Zielsetzung Die Chronische Rhinosinusitis mit Nasenpolypen (CRSwNP) ist in Europa meist mit einer Typ-2 Inflammation assoziiert. Unser Ziel war es, die Entzündung in der einzelnen betroffenen sinunasale Schleimhaut mittels Mapping zu analysieren und dabei polypöse und nicht-polypöse Schleimhaut zu unterscheiden.
