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H Michels

Publications and source records attributed to H Michels.

At least 19 recordsLinked to original sources
PubMed2007

[Revision of the recommendations of the Commission on Pharmacotherapy of the German society for Rheumatology. Therapy with tumour necrosis factor blockers for inflammatory rheumatic illnesses].

Inflammatory rheumatic illnesses are associated with various types of pain as well as handicaps. The so called basic therapies are not sufficiently effective in many patients or are terminated due to side effects. This is where tumor necrosis factor blockers (TNF) can be used. In many cases, they lead to a substantial improvement of the symptoms, a reduction in disease related laboratory parameters, improvement in quality of life to stopping disease related damage when their effect is rapid. Common and severe side effects are few, although long-term data are still limited. The following contribution lists recommendations for the indications and symptomatology for the use of TNF blockers.

Antirheumatic Agents↗
PubMed2006

[Interdisciplinary guidelines on diagnosis and treatment for extracerebral amyloidoses--published by the German Society of Amyloid Diseases (www.amyloid.de)].

Within the past 10 years, a new range of knowledge has been achieved in the field of amyloidosis, especially with regard to pathogenesis, diagnosis and therapy. Amyloidosis leads to variable and distinct symptoms and is caused by different underlying conditions. Some amyloidoses are acquired secondary to a chronic condition; others are caused by genetic mutations. Amyloid and amyloidosis occur more frequently than they are perceived. Among the frequent localized forms are the cerebral amyloidosis linked to Alzheimer disease (AD) and the pancreatic amyloidosis linked to diabetes mellitus. Among the most frequent systemic (extracerebral) forms is AL amyloidosis, which often has a poor prognosis and if untreated can rapidly lead to death. Systemic amyloidosis that happen at infancy are mainly AA amyloidosis that can progress to death already at early or at middle adulthood. Amyloidosis can be treated but therapeutic success significantly depends upon early diagnosis and proper classification of the amyloid type. It is mandatory that differential diagnosis demonstrate the presence of amyloid and clearly identify the type of the disease. Development of methods and techniques have contributed to improvements in the diagnosis and treatment. Early diagnosis and proper classification of amyloid is decisive for therapeutic options and upon them depend quality of life and mortality. The therapeutic spectrum is various and includes organ transplantation, chemotherapy, and anti-inflammatory strategies. Gene therapy and biological active substances have to be considered in the near future.

Amyloidosis↗
PubMed2006

Potential use of copper surfaces to reduce survival of epidemic meticillin-resistant Staphylococcus aureus in the healthcare environment.

Epidemic meticillin-resistant Staphylococcus aureus (EMRSA) emerged in the early 1980s with EMRSA-15 and -16 being the most prevalent strains within the UK. MRSA transmission between patients is largely via the hands of healthcare workers, and contamination of the hospital environment may occur. The objective of this study was to evaluate the effectiveness of copper and brass to reduce the viability of air-dried deposits of three MRSA strains [MRSA (NCTC 10442), EMRSA-1 (NCTC 11939) and EMRSA-16 (NCTC 13143)] compared with stainless steel. MRSA and EMRSA [10(7)colony-forming units (CFU)] were inoculated on to coupons (1 cm x 1 cm) of copper, brass or stainless steel and incubated at either 22 degrees C or 4 degrees C for various time periods. Viability was determined by resuspending removed CFUs and plating out on tryptone soy agar plates in addition to staining with the respiratory indicator fluorochrome 5-cyano-2,3-ditolyl tetrazolium. On pure copper surfaces, 10(7) MRSA, EMRSA-1 and EMRSA-16 were completely killed after 45, 60 and 90 min, respectively, at 22 degrees C. In contrast, viable organisms for all three strains were detected on stainless steel (grade 304) after 72 h at 22 degrees C. At 4 degrees C, complete kill was achieved on copper for all three strains within 6 h. The results demonstrate an antimicrobial effect of copper on MRSA, EMRSA-1 and -16 in contrast to stainless steel. Consequently, the contemporary application of stainless steel in hospital environments for work surfaces and door furniture is not recommended.

Colony Count, Microbial↗
PubMed2006

[A multicentre comparative study of the ESPrit and the Nucleus 22].

BACKGROUND: Cochlear implant recipients often report additional difficulty in comprehension of speech in noisy conditions and of softly spoken speech. The aim of this clinical study was to evaluate and compare the performance advantages offered by the ear level ESPrit 3G for experienced Nucleus Mini 22 cochlear implantees. PATIENTS AND METHODS: Twenty-eight German-speaking implanted subjects, who had had experience with either the Spectra 22 or the ESPrit 22 for at least 6 months, were evaluated with their current processor and the ESPrit 3G (on microphone, M, and whisper, W, settings) following a 4-week trial. Freiburger monosyllabic words (FMW) were used at soft and conversational levels in quiet conditions and Oldenburger sentences (OLSA) were used in noisy conditions to compare performance. Subjective impressions of sound quality and user aspects were evaluated and combined with data from 31 English-speaking subjects from a parallel study. RESULTS: In comparison to the previously worn processor, statistically significantly superior performance (p<0.001) was observed at soft and conversational levels in quiet conditions for FMW in 15 subjects when using the W setting and in noisy conditions for the OLSA in 21 subjects when using the M setting (p<0.001). The ESPrit 3G was preferred by 86% of subjects (51/59). CONCLUSION: The ESPrit 3G for Nucleus 22 users has the potential to further improve speech understanding in quiet conditions at soft intensity levels and also in noisy conditions at conversational levels relative to the currently worn speech processor, the Spectra 22 or the ESPrit 22, for the majority of subjects. Subjectively, together with the improvement in sound quality, the majority of subjects also reported improved ease of use and wearer comfort.

Adolescent↗
PubMed2006

[Gaucher disease, Fabry disease and mucopolysaccharidosis type I--how can the rheumatologist recognise these patients?].

The lysosomal storage diseases Gaucher disease, Fabry disease and MPS I are rare inheritable metabolic disorders that are now treatable with enzyme replacement therapy. In order to avoid irreversible complications, an early diagnosis and initiation of therapy is important. Due to the musculoskeletal symptoms associated with these storage diseases, patients are likely to visit a rheumatologist, who should, therefore, be able to recognise and diagnose these rare diseases. On the basis of the causal factors behind Gaucher disease, Fabry disease und MPS I (here Scheie syndrome), key symptoms that the rheumatologist (internist or paediatrician) should be familiar with for the differential diagnosis of these patients will be discussed. In addition, a short introduction to the pathophysiology and data on the prognosis and therapy for these diseases will be presented.

Diagnosis, Differential↗
PubMed2006

[Structural quality of rheumatology clinics for children and adolescents. Paper by a task force of the "Society of Pediatric and Adolescent Rheumatology" and of the "Association of Rheumatology Clinics in Germany"].

Rheumatic diseases in childhood and adolescence differ from those of adulthood according to type, manifestation, treatment and course. A specialized therapy, starting as early as possible, improves the prognosis, can prevent long-term damage and saves the costs of long-term care. Only a specialized pediatric care system can guarantee optimum quality of the processes involved and the results for rheumatology in childhood and adolescence within a global financial system. This requires adequate structural quality of the specialized clinics and departments for pediatric rheumatology. The management of rheumatic diseases in childhood and adolescence is comprehensive and requires a multidisciplinary, specialized and engaged team which can cover the whole spectrum of rheumatic diseases with their various age-dependent aspects. In order to guarantee an adequate, cost-efficient routine, a specialized center which concentrates on inpatient care should treat at least 300 patients with pediatric rheumatic diseases per year. The diagnoses should be divided among the various disease categories with at least 70% of them involving inflammatory rheumatic diseases. For the inpatient care of small children, an accompanying person (parent) is necessary, requiring adequate structures and services. Patient rooms as well as diagnostic (radiography, sonography, etc.) and therapeutic services (physiotherapy, occupational therapy, pool, etc.) must be adequate for small children and school children as well as adolescents. Suitable mother-child units must also be provided and a school for patients is required within the clinic. A pediatric rheumatologist must be available 24 h a day, and it must be possible to reach other specialists within a short time. For painful therapeutic procedures, age-appropriate pain management is obligatory. A continuous adjustment of these recommendations to changing conditions in health politics is intended.

Adolescent↗
PubMed2006

Use of copper cast alloys to control Escherichia coli O157 cross-contamination during food processing.

The most notable method of infection from Escherichia coli O157 (E. coli O157) is through contaminated food products, usually ground beef. The objective of this study was to evaluate seven cast copper alloys (61 to 95% Cu) for their ability to reduce the viability of E. coli O157, mixed with or without ground beef juice, and to compare these results to those for stainless steel. E. coli O157 (NCTC 12900) (2 x 10(7) CFU) mixed with extracted beef juice (25%) was inoculated onto coupons of each copper cast alloy or stainless steel and incubated at either 22 degrees C or 4 degrees C for up to 6 h. E. coli O157 viability was determined by plate counts in addition to staining in situ with the respiratory indicator fluorochrome 5-cyano-2,3-ditolyl tetrazolium. Without beef extract, three alloys completely killed the inoculum during the 6-h exposure at 22 degrees C. At 4 degrees C, only the high-copper alloys (>85%) significantly reduced the numbers of O157. With beef juice, only one alloy (95% Cu) completely killed the inoculum at 22 degrees C. For stainless steel, no significant reduction in cell numbers occurred. At 4 degrees C, only alloys C83300 (93% Cu) and C87300 (95% Cu) significantly reduced the numbers of E. coli O157, with 1.5- and 5-log kills, respectively. Reducing the inoculum to 10(3) CFU resulted in a complete kill for all seven cast copper alloys in 20 min or less at 22 degrees C. These results clearly demonstrate the antimicrobial properties of cast copper alloys with regard to E. coli O157, and consequently these alloys have the potential to aid in food safety.

Alloys↗
PubMed2005

The survival of Escherichia coli O157 on a range of metal surfaces.

Escherichia coli O157:H7 is a serious pathogen causing haemorrhagic colitis. It has been responsible for several large-scale outbreaks in recent years. E. coli O157:H7 is able to survive in a range of environments, under various conditions. The risk of infection from contaminated surfaces is recognised, especially due to the low infectious dose required. In this study, a high concentration (10(7) cells) of E. coli O157 was placed onto different metals and survival time measured. Results showed E. coli O157 to survive for over 28 days at both refrigeration and room temperatures on stainless steel. Copper, in contrast, has strong antibacterial properties (no bacteria can be recovered after only 90 min exposure at 20 degrees C, increasing to 270 min at 4 degrees C) but its poor corrosion resistance and durability make it unsuitable for use as a surface material. Other copper-containing alloys, such as copper nickels and copper silvers, have improved durability and anticorrosion properties and greatly reduce bacterial survival times at these two temperatures (after 120 min at 20 degrees C and 360 min at 4 degrees C, no E. coli could be detected on a copper nickel with a 73% copper content). Use of a surface material with antibacterial properties could aid in preventing cross-contamination events in food processing and domestic environments, if standard hygiene measures fail.

Alloys↗
PubMed2004

The German etanercept registry for treatment of juvenile idiopathic arthritis.

OBJECTIVE: To describe a registry set up to monitor children treated with etanercept in Germany and Austria. METHODS: Giannini's criteria, duration of morning stiffness, number of swollen, tender and contracted joints, adverse events, and reasons for discontinuation were assessed. RESULTS: 322 patients with juvenile idiopathic arthritis (JIA) and 12 additional patients with non-JIA rheumatic diagnoses were included. Therapeutic efficacy was observed from one month after treatment was started. The number of patients with significant improvement and the degree of improvement increased during the first year. The mean (SD) number of tender and swollen joints decreased from 9 (9) and 8.4 (9) to 3.0 (6.5) and 4.5 (7) after one month, and to 2.2 (5.5) and 3.3 (5.5) after three months; morning stiffness decreased from 45 (65) minutes to 12 (30) and 7 (19) after one and three months (p<0.001 for all). Using Gianinni's criteria of 30%, 50%, and 70% improvement, a therapeutic response in JIA patients was achieved in, respectively, 66%, 54%, and 30% after one month, 78%, 61%, and 38% after three months, and 83%, 72%, and 52% after six months. Therapeutic efficacy was lower in patients with systemic onset arthritis. Overall tolerability was good: in 592 patient treatment-years there were 69 reports of adverse events in 56 patients, including one CNS demyelination. There were no opportunistic infections or lupus-like reactions. Treatment was discontinued in 53 JIA patients, in 25 because of lack of efficacy. CONCLUSION: Etanercept treatment was safe and led to a significant improvement in most JIA patients resistant to conventional treatment.

Adrenal Cortex Hormones↗
PubMed2004

[Evidence-based use of methotrexate in children with rheumatic disorders. Consensus statement of the Working Group for Children and Adolescents with Rheumatic Diseases in Germany (AGKJR) and the Working Group Pediatric Rheumatology Austria].

Juvenile idiopathic arthritis (JIA) is the most common diagnosis in children and adolescents with rheumatic disorders. In many children and adolescents, JIA is successfully treated with nonsteroidal antiinflammatory drugs (NSAR) and physiotherapy. Still, in a significant number of cases the disease is resistant to this therapy and treatment with "second line" disease modifying antirheumatic drugs (DMARDs) is required. Methotrexate (MTX) is frequently referred to as "first choice second line agent" for the treatment of JIA. However, there are considerable differences among pediatric rheumatologists on how and when to use MTX. To increase drug safety, the Working Group for Children and Adolescents with Rheumatic Diseases in Germany (AGKJR) and the Working Group Pediatric Rheumatology Austria have initiated the formulation of evidence-based recommendations. Evidence is based on consensus expert meetings, a MEDLINE search with the key words "Methotrexate" and "juvenile arthritis" limited to age 0-18 years, standard textbooks and review articles, data from the central registry of the German Research Center for Rheumatic Diseases (Deutsches Rheumaforschungszentrum Berlin), experience with MTX in adults with rheumatoid arthritis (RA) and recommendations of the German Society of Rheumatology (DGRh). Based on these data, evidence and recommendations are graded and evidence-based recommendations for the use of MTX in children and adolescents with rheumatic disease are presented.

Adolescent↗
PubMed2003

[Temporomandibular disorders in juvenile patients with rheumatic diseases].

PURPOSE: The aim of the study was to investigate the incidence of temporomandibular disorders (TMD) in juvenile patients with rheumatic diseases. Furthermore, correlations between the degree of the rheumatic disease and the clinical symptoms were evaluated. MATERIAL AND METHODS: In a prospective investigation the temporomandibular joints of 48 children with rheumatic diseases were evaluated clinically regarding clicking, crepitation, pain, duration of the rheumatic disease, and the number of affected peripheral joints. The degree of rheumatic disease was assessed with Steinbrocker's classification. RESULTS: 26 patients (54.17%) showed clinical symptoms of TMD. No significant correlation was found between the degree of the rheumatic disease and the awareness of TMD. A high number of affected peripheral joints does not lead to a significant increase of TMD. A significant correlation between the duration of the rheumatic disease and TMD could be detected. A significant correlation between the duration of the rheumatic disease and clicking or crepitation was found ( p=0.011). CONCLUSION: Rheumatic diseases lead to a higher incidence of TMD in juvenile patients. A longer duration of rheumatic diseases leads to a higher incidence of TMD.

Adolescent↗
PubMed2002

[Influence of information campaigns on the vaccination immunity among the population of a small town area - seroepidemiological results of the 'Wittlich Vaccination Study'].

In the course of the three-phase 'Wittlich Vaccination Study' the population immunity against tetanus, diphtheria and poliomyelitis was controlled in all age groups of the regional population. Antibody measuring was done in specific validated enzyme immunoassays and neutralisation tests. After performing several campaigns for training and informing medical staff and the population about vaccinations the effect of these campaigns was checked in an additional control of the population immunity. The part of not or only partially protected participants decreased for tetanus from 36.7 % to 2.8 % and for diphtheria from 61 % to 51 %. The gap in population immunity was reduced for polio virus type 1 from 6.7 % to 3.1 %, for polio virus type 2 from 6.2 % to 2.5 % and for polio virus type 3 from 13.2 % to 3.6 %. The study design can be transferred to regions with comparable structure of their population.

Adolescent↗
PubMed2000

Litter size, ovulation rate and prenatal survival in relation to ewe body weight: genetics review.

Lamb's birth weight and litter weight were found to be related to ewe weight. Deviations from generally applicable formulae indicated an interaction between the genotype of the lamb and the maternal environment, as suggested in egg transfer experiments. Land's (1977) hypothesis on the spare conceptus capacity, when comparing large and small breeds within a species, with respect to prolificacy, was more applicable to genetically homogeneous groups within a breed than between breeds and lines within a breed. A hypothesis suggests that variation in the within breed genetic correlation between ewe weight and prolificacy may largely depend on the relative uniformity of selection criteria applied. It can further be argued whether selection based on body weight or growth rate, compared to selection on reproductive performance, could be important sources of within breed as well as among breed variations in the genetic correlation estimates between ewe weight and prolificacy. The dynamics of the genetic correlation between ewe weight and prolificacy has an effect of long-term selection for body weight, growth rate and reproduction traits. This leads to the problem of the relative incompatibility of selection of an association between body proportions with reproductive traits, especially in meat type breeds. There is a parallellism or antagonism in the genetic correlations between ewe weight and prolificacy as compared to those between ewe weight and other reproduction traits. The within breed relationship between ewe weight and ovulation rate was found to be positive in some breeds. The effects of body condition at mating were contradictory. Genotypexenvironment interactions were observed in certain cases. Among most breeds, differences in ewe weight were unrelated to differences in ovulation rate. There were no relationships between ewe weight and prenatal survival within breeds or in lines within a breed. However, there exists a differential relationship between ovulation rates and prenatal survival rates in relation to ewe weight, depending on the selection criteria applied. A clearcut relationship between litter weight components and ewe weight cannot be generalized but may vary among differentially selected breeds and lines within them. This is a final, unifying and unresolved question.

Journal Article↗
PubMed2000

Bcr-Abl kinase down-regulates cyclin-dependent kinase inhibitor p27 in human and murine cell lines.

Chronic myeloid leukemia (CML) is a malignant stem cell disease characterized by an expansion of myeloid progenitor cells expressing the constitutively activated Bcr-Abl kinase. This oncogenic event causes a deregulation of apoptosis and cell cycle progression. Although the molecular mechanisms protecting from apoptosis in CML cells are well characterized, the cell cycle regulatory event is poorly understood. An inhibitor of the cyclin-dependent kinases, p27, plays a central role in the regulation of growth factor dependent proliferation of hematopoietic cells. Therefore, we have analyzed the influence of Bcr-Abl in the regulation of p27 expression in various hematopoietic cell systems. An active Bcr-Abl kinase causes down-regulation of p27 expression in murine Ba/F3 cells and human M07 cells. Bcr-Abl blocks up-regulation of p27 after growth factor withdrawal and serum reduction. In addition, p27 induction by transforming growth factor-beta (TGF-beta) is completely blocked in Bcr-Abl positive M07/p210 cells. This deregulation is directly mediated by the activity of the Bcr-Abl kinase. A Bcr-Abl kinase inhibitor completely abolishes p27 down-regulation by Bcr-Abl in both Ba/F3 cells transfected either with a constitutively active Bcr-Abl or with a temperature sensitive mutant. The down-regulation of p27 by Bcr-Abl depends on proteasomal degradation and can be blocked by lactacystin. Overexpression of wild-type p27 partially antagonizes Bcr-Abl-induced proliferation in Ba/F3 cells. We conclude that Bcr-Abl promotes cell cycle progression and activation of cyclin-dependent kinases by interfering with the regulation of the cell cycle inhibitory protein p27. (Blood. 2000;96:1933-1939)

Animals↗
PubMed2000

The tyrosine kinase inhibitor CGP 57148 (ST1 571) induces apoptosis in BCR-ABL-positive cells by down-regulating BCL-X.

CGP 57148 is a potent inhibitor of the ABL protein tyrosine kinase and a promising new compound for the treatment of a variety of BCR-ABL-positive leukemias. We used this enzyme inhibitor to characterize the biological effects of BCR-ABL in primary cells and two growth factor-dependent BCR-ABL-transfected cell lines. The effect of CGP 57148 on primary cells is dependent on the stage of differentiation. The growth of maturing chronic myeloid leukemia cells is independent of BCR-ABL in the presence of growth factors. However, the proliferation of leukemic immature cobblestone-forming area cells is almost completely blocked after the inhibition of the BCR-ABL kinase. In the BCR-ABL-transfected cell lines, M07/ p210 and Ba/F3/p185, CGP 57148 induces apoptosis by releasing cytochrome c, activating caspase 3, and cleavage of PARP. No alteration of the expression level of the apoptosis regulator BCL-2 was observed. In contrast, BCL-X was down-regulated after exposure to CGP 57148. Inhibitors of signal transduction proteins such as PI-3 kinase, mitogen-activated protein/extracellular signal-regulated kinase kinase, and Janus-activated kinase 2 pathways were not capable of a comparable down-regulation of BCL-X. The Fas/Fas ligand system was not involved either in the induction of apoptosis by CGP 57148. We conclude that the inhibition of the BCR-ABL kinase by CGP 57148 (a) preferentially inhibits the growth of immature leukemic precursor cells, (b) efficiently reverts the antiapoptotic effects of BCR-ABL by down-regulation of BCL-X, and (c) is more effective than the inhibition of the downstream signal transduction pathways of PI-3 kinase, mitogen-activated protein/extracellular signal-regulated kinase kinase, and Janus-activated kinase 2.

Animals↗
PubMed2000

What is low-dose corticosteroid therapy in juvenile idiopathic arthritis? A worldwide, questionnaire-based survey.

OBJECTIVE: To determine pediatric rheumatologists' personal definitions of systemic low-dose, long-term (> 4 weeks) corticosteroid therapy of juvenile idiopathic arthritis (JIA). METHODS: Pediatric rheumatologists from America, the Near East (Israel), Australia and Europe were asked for their personal definition of a low-dose long-term corticosteroid therapy of JIA with the aid a standardized questionnaire. RESULTS: Of 99 questionnaires returned, 92 were evaluable. The dosage still considered low turned out to be 0.26 +/- 0.14 mg prednisolone/kgBW/day (min-max = 0.04-0.50 mg, n = 92). Higher dosages were indicated from Northern Europe (0.29 +/- 0.12, n = 9), Western Europe (0.42 +/- 0.14, n = 7), Southern Europe (0.30 +/- 0.14, n = 9), Eastern Europe (0.25 +/- 0.14, n = 6) and North America (0.33 +/- 0.17, n = 16) than from Central Europe (0.19 +/- 0.09, n = 43). CONCLUSION: Pediatric rheumatologists' personal definitions of low-dose, long-term corticosteroid therapy vary within a wide range. The reason for these differences and the impact on patients should be investigated. In addition, a generally accepted definition for low-dose, long-term corticosteroid therapy should be developed and subsequently examined in studies.

Adolescent↗