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2011 (pdf, 4 MB) - Universitätsklinikum Hamburg-Eppendorf

2011 (pdf, 4 MB) - Universitätsklinikum Hamburg-Eppendorf

Arbeits- und

Arbeits- und Forschungsbericht 2011 und Planung 2012 Reduced Diffusion in the Lung – Comparison of Different Methods Further Development of FeNO Analyses directed by the Central Executive and accumulated asbestos fibre-years for 64 asbestos-exposed patients, some with asbestos-induced pleural and lung disorders. Presentation of initial results at the Annual General Meeting of the DGAUM and the ERS–congress (Preisser AM, Velasco Garrido M, Goldenstein ES, Schumann G, Manuwald U, Wilken D, Baur X. Arbeitsmed Sozialmed Umweltmed 2011;46(3):173-174; Eur Respir J 2011;38(Suppl 55):188s) • Continuation of the WHO project ”Detection of impaired lung function in early stages of asbestosis by means of gas diffusion parameters“ • Publication of the meta-analysis of lung function impairments as a function of the Xray findings and asbestos fibre-dose. (Wilken D, Velasco Garrido M, Manuwald U, Baur X. Arbeitsmed Sozialmed Umweltmed 2011;46(3):174; Wilken D, Manuwald U, Velasco Garrido M, Baur X. Lung function in asbestos-exposed workers, a systematic review and meta-analysis. J Occup Med Toxicol 2011, 6:21) Plan 2012 • Evaluation and presentation of the results from spirometry and DL,CO at the ATS Congress 2012 (Preisser AM, Manuwald U, Schumann G, Goldenstein ES, Baur X; accepted). International publication of the investigations using spirometry and of measurements of diffusion, lung compliance and FeNO • Continuation of the major theme “Asbestos-induced Diseases“ as a WHO Collaborating Centre • Project: Comparative pathogenic potential of chrysotile and crocidolite asbestos (directed by the Central Executive), review of literature Status 2011 Measurements of the resting CO-diffusion capacity (DL,CO), blood gas analysis and alveolearterial oxygen partial pressure difference, both resting and when exercising, were compared and assigned to different lung pathology groups. The study was extended to include NO diffusion capacity with n=240 patients and all results have been obtained. Initial statistical comparisons between DL,CO and other parameters have been concluded. Plan 2012 • Completion of the statistical comparisons for a congress presentation. Preparation for publication • Comparison of DL,CO and NO diffusion capacity relationships in the various patient groups Comparison of the FeNO data for smokers and non-smokers, validation of the NO values in a 2-compartment (KM)-model Status 2011 • Subsequent publication comparing smokers and non-smokers in respect of NO values in various compartments of the respiratory tract (Barbinova L, Preisser A, Baur X. Pneumologie 2011;65(2):103-109 • The analysis of the 2-KM-model was presented at the DGP and DGAUM meetings (Barbinova L, Baur X. Arbeitsmed Sozialmed Umweltmed 2011; 46(3):180), Barbinova L, Baur X. Pneumologie 2011; 65(Suppl 1):S.33 Plan 2012 • Development of a new (continuous) model. Further analysis of the structure of the bronchial tree. Comparison of the dichotomy model with the classical model of parallel-switched bronchi for calculation of respiratory resistance. • Changes in FeNO during a metacholine test Status 2011 The relationships between bronchial obstruction and various NO parameters of the respiration tract were investigated. Presentation of initial results at the Annual General Meeting of the DGAUM and the ERS congresses (Baur X, Barbinova L, Preisser A. Arbeitsmed Sozialmed Umweltmed 2011;46 (3):179-180; Barbinova L, Preisser A, Baur X. Eur Respir J 2011;38(Suppl 55):375s). Plan 2012 • The number of study participants will be continously increased. Upon attainment of 50 45

Working and Research Activities 2011 and Plans 2012 Extra Activities Identification and characterisation of individual allergens (in coffee, wheat flour and maize) by using phage display cooperation with: Biozentrum Klein Flottbek, AG Maritime Medicine Evaluation of preventative measures in flour dustsensitised bakers cooperation with: BerufsgenossenschaftNahrungsmittel und Gastgewerbe (Statutory Accident Insurance of the Food and Hotel Industry) Precautionary and aptitude investigations of workers for offshore duties cooperation with: Deutsche Gesellschaft für Maritime Medizin e.V. (DGMM) and the VGB PowerTech e.V. Database system of quality control for diagnostic support in occupational medi- patients, the NO changes during and after a methacholine challenge will be performed. Preparation for publication • Bronchospasmolytic changes in FeNO • Accumulation of data on the role of bronchospasmolytic (β-sympathomimetic) agents in obstructive asthma • Study plan for investigating the influence of parasympatholytic agents on NO in patients with COPD; ethics application, recruitment of patients • Investigation of relationship between exhaled NO and pulmonary gaseous exchange • Analysis of the correlation between various FeNO parameters and pulmonary gaseous exchange. Presentation of initial results From phage display of cDNA libraries made from coffee, wheat flour and maize, it is intended to identify and isolate individual antigens using the antibodies from sensitised workers. The identified antigens will then be screened against the sera of a large collective of sensitized workers to assess allergenic activity. The allergens identified can then be used to improve diagnostic specificity and even provide a form of sensitisation profiling. Status 2011 • Identification and characterisation of a chitinase from Coffea arabica as an allergen and its entry in the IUIS Allergen Nomenclature database, publication in press (International Archives of Allergy and Immunology) • Identification of 4 further coffee allergens • Identification of 3 wheat allergens • Identification of 5 maize allergens Plan 2012 Characterisation of these novel coffee, wheat flour and maize allergens, with their presumed entry as new allergens in the IUIS Allergen Nomenclature database. Publication of results Status 2011 Lung function tests with non-specific bronchial challenge testing, allergy testing and FeNO measurements for 14 flour dust-sensitized bakers, who have remained at their job, were published nationally (Preisser AM, Wilken D, Baur X. DMW 2011;136:637-641) and presented at a meeting (Wilken D, Preisser A, Gau B, Velasco Garrido M, Hausner T, Baur X. Pneumologie 2011;65:S.48) Plan 2012 Collation of data for the total patient collective, prospective follow-ups in the long-term Composer and contributor to the recommendations by the DGMM for the fit for duty testing of offshore workers from the occupational medicine perspective. Completed at end of 2010 Status 2011 Completed English translation (via the VGB e.V.); contributions to “Offshore Workshop on Occupational Medicine“; compilation of a national list of practicing occupational medicine clinicians. International presentation of the concept (Preisser AM, Faesecke KP. International Symposium on Maritime Health. 6-10 September, Odessa, Ukraine. Book of abstracts, Odessa 2011:97) Plan 2012 Development of the DGMM recommendations (directed by AG Clinical Occupational Medicine) for the fit for duty testing of offshore workers from the occupational medicine perspective to include investigation content, exclusion from duty criteria and their certification, online access facilitated • A commercial system for the compilation of routine patient data and investigation records was purchased. A complementary database of research findings and investi- 46

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