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Biomedical subjects

Olaf Penack

Publications and source records attributed to Olaf Penack.

8 recordsLinked to original sources

Management of sepsis in neutropenia: guidelines of the infectious diseases working party (AGIHO) of the German Society of Hematology and Oncology (DGHO).

These guidelines from the infectious diseases working party (AGIHO) of the German Society of Hematology and Oncology (DGHO) give recommendations for the management of adults with neutropenia and the diagnosis of sepsis. The guidelines are written for clinicians and focus on pathophysiology, diagnosis, and treatment of sepsis. The manuscript contains evidence-based recommendations for the assessment of the quality and strength of the data.

Cardiotonic Agents↗

The anti-lymphoma effect of antibody-mediated immunotherapy is based on an increased degranulation of peripheral blood natural killer (NK) cells.

BACKGROUND: In patients treated with rituximab and alemtuzumab for lymphomas or CLL, antibody-dependent cellular cytotoxicity (ADCC) is a major mechanism of action. Therefore, assessment of ADCC is mandatory to understand the complex mechanisms leading to the anti-lymphoma effects of monoclonal antibodies (mAb). Due to methodical difficulties, little is yet known about the relevant cell subpopulations and effector mechanisms leading to tumor lysis in ADCC. METHODS: We used a novel flow cytometric assay that detects CD107a as a marker for NK-cell degranulation to characterize and quantify peripheral blood natural killer (NK) cells mediating ADCC in vitro and in vivo. RESULTS: We observed specific and dose-dependent NK-cell activation after administration of rituximab and alemtuzumab. The number of degranulating NK cells was closely related to the concentration of mAb and the effector:target ratio. We were able to quantify and characterize the peripheral blood NK cells mediating ADCC. The majority of degranulating NK cells had the phenotype: CD56(dim), CD69(+), NKG2D(+), NKp30(-), NKp46(-), and CD94(-). Furthermore, we found that the CD107a assay can also visualize ADCC under clinical conditions as we observed increased numbers of NK cells degranulating in response to CD20(+) lymphoma cell lines in patients with non-Hodgkin's lymphoma treated with rituximab. CONCLUSIONS: We were able to quantify and characterize NK cells mediating ADCC with a new and feasible method. The CD107a assay may be useful for predicting treatment responses of individual patients and may help find the optimal dosage and timing for treatment with mAb.

Antibodies, Monoclonal↗

Value of surveillance blood cultures in neutropenic patients--a pilot study.

In this prospective pilot study we evaluated the efficacy of blood cultures (BC) in detecting bacteremia and fungemia prior to the occurrence of infectious signs. Between February 2003 and July 2003, BC were performed twice weekly in neutropenic hematological patients using blood drawn from central venous catheters. Microbial growth prior to the onset of infectious symptoms was detected in 3 of 45 neutropenic episodes in 39 patients and led to modifications in patient management. These results suggest that further prospective studies are warranted to determine the clinical usefulness of surveillance with BC in neutropenic patients.

Adult↗

Evaluation of heated humidifiers for use on intubated patients: a comparative study of humidifying efficiency, flow resistance, and alarm functions using a lung model.

OBJECTIVE: Evaluation of humidification efficiency, flow resistance, and alarm functions of heated humidifiers (HH;(Kendall-Aerodyne-delta, Fisher&Paykel-MR 730; Dräger-Aquapor; Puritan-Bennett-Cascade II) in accordance with ISO/EN-8185:1997 and on a ventilated lung model in accordance with ISO/EN-9360:2000. METHODS: Humidification efficiency was evaluated by (a) measuring the water content of the inspiratory air on perfusion with different gas flows, (b) measuring the water loss of a lung model, and (c) simultaneous measurement of the in- and expiratory water content with a capacitive hybrid sensor. The resistance characteristics were measured, the data were compared with a mathematical approximation. The alarm functions were determined. RESULTS: The humidification efficiency of HHs is a function of gas flow and design characteristics. In HHs with tube heating it is possible to make settings at which the inspiratory humidity falls below the minimal value of 33 mgH(2)O/l stipulated by ISO/EN-8185:1997. The inspiratory resistances extend from 0.5 to 4.4 cmH(2)O l(-1) s(-1); the expiratory flow resistances of the devices are low. The alarm functions of HHs with tube heating are inadequate for cases involving both "dry start" and "running dry." CONCLUSIONS: Efficiency data that allow a direct comparison with heat and moisture exchangers data according to ISO/EN-9360:2000 can also be determined for HH. HH do not prevent pulmonary water losses in intubated patients. These losses can exceed the physiological range. The airway resistance of the Cascade II prohibits its use in spontaneously breathing patients. The warning and shut-off features of HH are unacceptable and hazardous.

Equipment Design↗