Husten, Atemnot und B-Symptome bei einer 40-jährigen Frau

Zusammenfassung: Der Morbus Castleman ist eine seltene polyklonale, lymphoproliferative Erkrankung, bei der Mediatoren von Entzündungsreaktionen, v.a. Interleukin-6, eine wichtige pathophysiologische Rolle spielen. Zur Behandlung dieser Krankheit ist keine Standardtherapie etabliert. Wir berichten über den Fall einer 40-jährigen HIV-negativen Patientin mit primär pulmonaler Manifestation eines HHV-8-negativen, plasmazellreichen multizentrischen Morbus Castleman. Verschiedene Therapieversuche mit Immunmodulatoren wurden durchgeführt, bevor eine Behandlung mit dem Interleukin-6-Rezeptor-Antikörper Tocilizumab begonnen wurde. Seit 5Jahren ist der klinische Verlauf unter fortgesetzter Tocilizumabgabe stabi

Sarcopenia in COPD: a systematic review and meta-analysis

COPD is associated with a progressive loss of muscle mass and function. However, there is an unmet need to define and standardise methods to estimate the prevalence of sarcopenia in COPD patients.We performed a systematic review and meta-analysis of the prevalence of this extrapulmonary manifestation in COPD patients. We searched Embase, Medline (Ovid), CINAHL (EBSCO), Web of Science, Scopus and Google Scholar for studies published up to January 17, 2019, assessing sarcopenia in COPD patients based on low muscle mass and decreased muscle function. Interventional studies, in vitro experiments, protocols or reviews and meta-analyses were excluded. We estimated heterogeneity (I2) and assessed significance (Q) using a Chi-squared test for estimates obtained from random-effects models.4465 articles were initially identified. After removing the duplicates and applying the selection criteria, we reviewed 62 full-text articles. Finally, 10 articles (n=2565 COPD patients) were included in this systematic review and meta-analyses. Overall, the prevalence of sarcopenia in patients with COPD was 21.6% (95% CI 14.6-30.9%, I2=94%), ranging from 8% in population-based to 21% in clinic-based studies, and 63% in COPD patients residing in nursing homes.Sarcopenia is frequently observed in COPD patients, with varying prevalence across population settings. Sarcopenia in COPD should be assessed using standardised tests and cut-off points from sarcopenia consensus criteria for clinical practice and international comparisons

An Observational Overview of Solar Flares

We present an overview of solar flares and associated phenomena, drawing upon a wide range of observational data primarily from the RHESSI era. Following an introductory discussion and overview of the status of observational capabilities, the article is split into topical sections which deal with different areas of flare phenomena (footpoints and ribbons, coronal sources, relationship to coronal mass ejections) and their interconnections. We also discuss flare soft X-ray spectroscopy and the energetics of the process. The emphasis is to describe the observations from multiple points of view, while bearing in mind the models that link them to each other and to theory. The present theoretical and observational understanding of solar flares is far from complete, so we conclude with a brief discussion of models, and a list of missing but important observations.Comment: This is an article for a monograph on the physics of solar flares, inspired by RHESSI observations. The individual articles are to appear in Space Science Reviews (2011

Microflares and the Statistics of X-ray Flares

This review surveys the statistics of solar X-ray flares, emphasising the new views that RHESSI has given us of the weaker events (the microflares). The new data reveal that these microflares strongly resemble more energetic events in most respects; they occur solely within active regions and exhibit high-temperature/nonthermal emissions in approximately the same proportion as major events. We discuss the distributions of flare parameters (e.g., peak flux) and how these parameters correlate, for instance via the Neupert effect. We also highlight the systematic biases involved in intercomparing data representing many decades of event magnitude. The intermittency of the flare/microflare occurrence, both in space and in time, argues that these discrete events do not explain general coronal heating, either in active regions or in the quiet Sun.Comment: To be published in Space Science Reviews (2011

Husten, Atemnot und B-Symptome bei einer 40-jährigen Frau

Multicentric Castleman's disease (MCD) is a rare polyclonal lymphoproliferative disorder that is typically accompanied by an overproduction of circulating cytokines (mainly interleukin-6). We here report the case of a 40-year-old HIV-negative woman with pulmonary manifestation of MCD. There is no standard treatment for MCD. In our patient, various treatment courses with immunomodulatory drugs were unsuccessful. Finally, treatment with the interleukin-6 receptor antibody tocilizumab has resulted in continual clinical improvement over the last 5 years. Der Morbus Castleman ist eine seltene polyklonale, lymphoproliferative Erkrankung, bei der Mediatoren von Entzündungsreaktionen, v. a. Interleukin-6, eine wichtige pathophysiologische Rolle spielen. Zur Behandlung dieser Krankheit ist keine Standardtherapie etabliert. Wir berichten über den Fall einer 40-jährigen HIV-negativen Patientin mit primär pulmonaler Manifestation eines HHV-8-negativen, plasmazellreichen multizentrischen Morbus Castleman. Verschiedene Therapieversuche mit Immunmodulatoren wurden durchgeführt, bevor eine Behandlung mit dem Interleukin-6-Rezeptor-Antikörper Tocilizumab begonnen wurde. Seit 5 Jahren ist der klinische Verlauf unter fortgesetzter Tocilizumabgabe stabil