A Strassburg

Research Center Borstel, Borstel, Lower Saxony, Germany

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Publications (34)61.15 Total impact

  • M Blaukovitsch · A Strassburg · E Müller · P Zabel · H-P Hauber
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    ABSTRACT: The purpose of this retrospective study was to investigate the efficacy and safety of an indwelling pleural device (PleurX, Denver Biomedical, USA) for the treatment of recurrent pleural effusions. In cases when life expectancy tends to be very short and also surgical decortication is not recommended, pleurodesis is another treatment option but requires complete drainage of the whole pleural fluid for optimal results which is sometimes hard to achieve. The PleurX catheter is an alternative therapeutic option. We retrospectively analysed the clinical data from a total of 21 patients who were treated with a PleurX alone (11 patients) or who initially received pleurodesis and afterwards a PleurX catheter (10 patients). Mean survival was 25 weeks after initial diagnosis of the underlying disease. The mean amount of pleural effusion drained per week was 725 mL. 16 patients used the catheter until they died at least 1 - 2 times a week. The complication rate was 19 % and thus within a reasonable range when compared to other treatment options for recurrent pleural effusions. There was no statistically significant difference in clinical outcome in both groups (pleurodesis and subsequent PleurX vs. PleurX alone). The amount of evacuated pleural effusion was inversely correlated with the remaining life time. The use of an indwelling pleural device is a safe alternative treatment option for patients with chronic pleural effusions and trapped lung signs. We should be aware of this device and propagate its use at an earlier stage of malignant diseases with recurrent pleural effusions, especially when the remaining life time is short.
    No preview · Article · Apr 2011 · Pneumologie
  • A Strassburg · K Dalhoff · I Engelmann · S Ewig · F J Herth · J Knobloch · G Rohde · H Sahly · B Schaaf · C Lange

    No preview · Article · Oct 2010 · Pneumologie
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    ABSTRACT: Lower respiratory tract infections play an important role in the ambulatory and hospital health-care sectors. State-of-the-art diagnoses of lower respiratory tract infections and methods to differentiate bacterial lower respiratory tract infections from colonisation have been described in the first two parts of this review series. The present article summarises current diagnostic methods and treatment indications for viral and fungal respiratory infections. These recommendations may guide clinicians in their decision to prescribe or withhold antibiotic therapies in daily clinical practice.
    No preview · Article · Aug 2010 · Pneumologie
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    ABSTRACT: Interferon (IFN)-gamma release assays (IGRA) have improved tuberculosis contact tracing, but discrimination of recent from remote Mycobacterium tuberculosis contacts is not possible by IGRA alone. We present results of a tuberculosis contact investigation with a new early-secretory-antigenic-target (ESAT)-6 and culture-filtrate-protein (CFP)-10 specific interleukin (IL)-2 ELISpot in addition to ESAT-6 and CFP-10 specific IFN-gamma ELISpot and tuberculin skin testing (TST). Results of the TST, IFN-gamma ELISpot and IL-2 ELISpot were positive in 6/172 (3.4%), 7/167 (4.2%) and 6/196 (3.1%) of contacts, respectively. Close contact (> or =100 hours) to the index case increased the risk of positive results in the IFN-gamma ELISpot, TST, and IL-2 ELISpot by 40.8, 19.3, and 2.5 times, respectively. Individuals with a positive IFN-gamma ELISpot/negative IL-2 ELISpot result had a median (IQR) duration of index case exposure of 568 hours (133_1000) compared to individuals with a positive IFN-gamma ELISpot/positive IL-2 ELISpot result (median = 24 hours; 20_130; p-value = 0.047). Combination of a M. tuberculosis specific IFN-gamma ELISpot with a M. tuberculosis specific IL-2 ELISpot significantly improved the identification of individuals with the highest risk of recent M. tuberculosis infection and is a promising method that should be explored to target tuberculosis preventive chemotherapy.
    Full-text · Article · Jul 2010 · PLoS ONE
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    ABSTRACT: Lower respiratory tract infections rank among the leading causes of morbidity and mortality worldwide. In clinical practice, especially in the care of severely ill patients, discrimination between tracheobronchial colonisation with potentially pathogenic microorganisms and infection is a common diagnostic challenge. While prompt antibiotic treatment is needed in critically ill patients with pneumonia, an inadequate use of antibiotics is the major cause for the emergence of drug-resistant microorganisms. The first part of this review provided a detailed overview of the currently available methods for the diagnosis of pulmonary infectious diseases. In the present second part of the manuscript, we focus upon methods and criteria for the differentiation between lower respiratory tract bacterial colonisation and lower respiratory tract infections, highlighting important pathogens.
    No preview · Article · May 2010 · Pneumologie
  • Alan Strassburg · Arne Luers · Klaus Dalhoff
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) predisposes for the acquisition of community-acquired pneumonia (CAP). To assess clinically and scientifically suggested disorders in innate immune response during acute phrase and resolution CAP (T2), we evaluated peripheral and pulmonary polymorphnuclear neutrophils (PMN), recovered by induced sputum, from CAP patients with and without COPD with regard to cell activation, interleukin-8 (CXCL-8) and CXCL-8 receptor expression, and apoptosis rate. At T1, COPD patients displayed significantly lower pulmonary PMN apoptosis rates, while total cell count, the amount of macrophages, and vital and necrotic neutrophils in sputum samples were similar between study groups. At T2, there were no differences between study groups or between pulmonary and peripheral compartment. While under systemic steroid treatment apoptosis rates of peripheral and pulmonary PMN at T1 were slightly decreased, there were no significant differences in intrapulmonary CXCL-8 levels. Regarding cell activation, no significant differences could be seen, neither in comparing study groups nor in pulmonary to peripheral PMN. Conclusion: Elucidating the pathology of suspected disorder in innate immune response, we found decreased apoptosis rates of pulmonary neutrophils in COPD at the peak of CAP indicating an increased inflammatory response, which is independent from anti-apoptotic cytokines such as CXCL-8, severity of disease and isolation of bacteria from sputum cultures.
    No preview · Article · Apr 2010 · The Clinical Respiratory Journal

  • No preview · Article · Feb 2010 · American Journal of Respiratory and Critical Care Medicine

  • No preview · Article · Feb 2010
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    ABSTRACT: Sarcoidosis is a multisystem granulomatous disease of unknown origin. Pathogenetic involvement of Mycobacterium tuberculosis has frequently been discussed in the aetiology of sarcoidosis; however, studies still remain contradictory. We addressed the question of mycobacterial involvement in the pathogenesis of sarcoidosis by analysing cellular immune responses to mycobacterial antigens. We examined the interferon (IFN)-gamma production by enzyme-linked immunospot in response to purified protein derivate (PPD) mycobacterial-specific antigen early secretory antigenic target (ESAT)-6 and culture filtrate protein (CFP)-10 by peripheral blood mononuclear cells (PBMCs) and bronchoalveolar-lavage mononuclear cells (BALMCs) of patients with pulmonary sarcoidosis, smear-negative tuberculosis and controls. Release of IFN-gamma in response to ex vivo contact with PPD, ESAT-6 or CFP-10 by BALMC and PBMC were comparable among patients with sarcoidosis and controls (PBMC P = 0.2326; BALMC P = 0.1767) and were less frequently observed in both groups compared to patients with tuberculosis (BALMC P < 0.05; PBMC P < 0.0001). Within PBMC, the immunophenotype of sarcoidosis patients differed from that of patients with tuberculosis, as well as from that of controls, while within BALMC it resembled that of patients with tuberculosis. In contrast to patients with tuberculosis, the frequency of mycobacteria-specific local and systemic immune responses is not elevated in patients with sarcoidosis when compared to controls. The immunophenotype represents the local resemblance of the granulomatous reaction underlying tuberculosis and sarcoidosis while showing systemical difference. These observations do not support a role of an infection with M. tuberculosis in the pathogenesis of sarcoidosis.
    No preview · Article · Oct 2009 · The Clinical Respiratory Journal
  • Strassburg A · Günther G · Sahly H · Lange C
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    ABSTRACT: Evaluation of rapid test device based on detection of antibodies against 6,16 and 38 kDa antigens of Mycobacterium tuberculosis Parvaneh Baghaei Shiva, Payam Tabarsi, Majid Marjani, Shokufe Dehghani, Mohammad Reza Masjedi. Mycobacteriology Research Center, National Research Center of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran Background: Serological assays for diagnosis of tuberculosis are very attrac- tive because they are inexpensive, non invasive and simple. Present study was conducted to evaluate the Tuberculosis rapid test device in Iran. Methods: The tuberculosis rapid test device based on detection of IgM, IgA and IgG antibodies against 6,16 and 38-kDa antigens of mycobacterium tuberculosis via chromatography was used in 96 cases of pulmonary and extra pulmonary TB. 54 patients other than TB were selected as control group. Tuberculin skin test was performed in two groups. None of patient s were immune deficient. All of them were evaluated concerning presence of BCG scar. Results: Tuberculosis rapid test was positive in 75 patients (78.1%) from case group and 15 from control group (27.8%). This difference was statistically mean- ingful (p-value < 0.001). TST was positive in 66 patients (68.8%) with tuberculosis and 10 (18.5%) among control group without any statistically difference. (p-value = 0.065). Sensitivity, specificity, Positive and negative predictive value of the tuberculosis rapid test for diagnosis of tuberculosis were 78.1%, 72.2%, 83.3% and 65% respectively. These parameters for TST were 31.3%, 81.5% 75% and 40% respectively. Comparison between TST and Rapid serologic assay Sensitivity Specificity PPV 1 NPV 2 TST 31.3% 81.5% 75% 40% Rapid serologic assay 78.1% 72.2% 83.3% 65% 1 PPV: Positive predictive value; 2 NPV: Negative predictive value. Conclusion: Tuberculosis rapid test has better sensitivity than TST and may be helpful in diagnosis of tuberculosis as a c omplementary test or in epidemiological investigations
    No preview · Conference Paper · Sep 2009
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    ABSTRACT: The rapid diagnosis of pulmonary tuberculosis (TB) is difficult when acid fast bacilli (AFB) cannot be detected in sputum smears. Following a proof of principle study, we examined in routine clinical practice whether individuals with sputum AFB smear-negative TB can be discriminated from those with latent TB infection by local immunodiagnosis with a Mycobacterium tuberculosis-specific enzyme-linked immunospot (ELISpot) assay. Subjects suspected of having active TB who were unable to produce sputum or with AFB-negative sputum smears were prospectively enrolled at Tuberculosis Network European Trialsgroup centers in Europe. ELISpot with early-secretory-antigenic-target-6 and culture-filtrate-protein-10 peptides was performed on peripheral blood mononuclear cells (PBMCs) and bronchoalveolar lavage mononuclear cells (BALMCs). M. tuberculosis-specific nucleic acid amplification (NAAT) was performed on bronchoalveolar lavage fluid. Seventy-one of 347 (20.4%) patients had active TB. Out of 276 patients who had an alternative diagnosis, 127 (46.0%) were considered to be latently infected with M. tuberculosis by a positive PBMC ELISpot result. The sensitivity and specificity of BALMC ELISpot for the diagnosis of active pulmonary TB were 91 and 80%, respectively. The BALMC ELISpot (diagnostic odds ratio [OR], 40.4) was superior to PBMC ELISpot (OR, 10.0), tuberculin skin test (OR, 7.8), and M. tuberculosis specific NAAT (OR, 12.4) to diagnose sputum AFB smear-negative TB. In contrast to PBMC ELISpot and tuberculin skin test, the BALMC ELISpot was not influenced by previous history of TB. Bronchoalveolar lavage ELISpot is an important advancement to rapidly distinguish sputum AFB smear-negative TB from latent TB infection in routine clinical practice.
    Full-text · Article · Aug 2009 · American Journal of Respiratory and Critical Care Medicine

  • No preview · Article · Mar 2009 · Pneumologie
  • A Strassburg · B Kalsdorf · R Hörster · G Günther · C Lange

    No preview · Article · Mar 2009 · Pneumologie
  • B Krummel · A Strassburg · M Ernst · B Eker · H Rath · W Wappler · A Glaewe · V Schoellhorn · C Lange

    No preview · Article · Mar 2009 · Pneumologie
  • A Strassburg · I Muenkel · K Dalhoff

    No preview · Article · Mar 2009 · Pneumologie
  • R Hörster · D Kirsten · K Gaede · C Jafari · A Strassburg · U Greinert · M Ernst · C Lange

    No preview · Article · Mar 2009 · Pneumologie
  • A. Strassburg · J. Rupp · F. Herth · H. Magnussen · P. Zabel · C. Lange

    No preview · Article · Dec 2008 · Pneumologie
  • A Strassburg · J Rupp · F J F Herth · H Magnussen · P Zabel · C Lange
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    ABSTRACT: Lower respiratory tract infections rank among the most important illnesses in medicine. However, the identification of a causative microbiological agent is often difficult. Pulmonary infections must be differentiated from non-infectious causes of pulmonary diseases with similar symptoms and infiltrates on chest imaging. Among the important novel developments ranks the analysis of serum procalcitonin for a better identification and treatment monitoring of bacterial pneumonias compared to conventional tests and a simple scoring system, like the CRB-65/CURB score, for a rapid risk stratification. A rational diagnostic approach is necessary to identify causative microorganisms of pulmonary infectious diseases depending on the severity of the illness, the exposition and predisposition of the patient. In addition to the classical microbiological methods, rapid test systems for the identification of microorganisms are becoming increasingly important. The first part of this review gives a detailed survey of the methods for the diagnosis of pulmonary infectious diseases. In the second part of the manuscript, we will focus on special pulmonary infectious diseases.
    No preview · Article · Oct 2008 · Pneumologie
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    ABSTRACT: The purpose of this study was to investigate the association of central sleep apnea (CSA) and baroreflex sensitivity (BRS) after acute myocardial infarction. Both, CSA and blunted BRS have been shown to be independent predictors for cardiovascular mortality in patients with heart failure. But in contrast to BRS, which has been extensively studied in the setting of AMI, the incidence of CSA in patients recovering from AMI is thus far unknown. As previous reports suggested a potential role of sleep apnoea in augmenting reflex autonomic modulation, we hypothesized that there is a strong interrelation between CSA and BRS. Seventeen male patients in the subacute phase of a first uncomplicated ST-segment elevation AMI and eight healthy male controls without evidence of coronary artery disease underwent polysomnography with simultaneous beat-to-beat ECG- and blood-pressure recordings. Sleep stage specific spontaneous BRS was calculated from blood pressure and RR-interval fluctuations by using the time domain sequential technique. AMI patients revealed to have a higher incidence and longer duration of central apnoeas in all sleep stages, light sleep, deep sleep and dream sleep. There were no significant sleep stage specific differences regarding BRS between groups, however, AMI patients with central sleep apnea exhibited blunted BRS which was inversely correlated to incidences of central apnea in all sleep stages. Our findings suggest a direct relationship between impaired BRS and repetitive occurrence of CSA by inverse correlation in all sleep stages in the subacute phase of AMI. Thus, reflex cardiac autonomic nervous control, being represented by the BRS, may be the link between CSA and prognosis.
    No preview · Article · Jul 2008 · International journal of cardiology
  • A Strassburg · C Jafari · M Ernst · W Lotz · C Lange
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    ABSTRACT: Immunocompromised patients with acid-fast bacilli (AFB) smear-negative active pulmonary tuberculosis (pTB) often present with nonspecific clinical symptoms and findings. T-cell interferon-gamma release assays (TIGRA) performed on whole blood (using ELISA) or peripheral blood mononuclear cells (using enzyme-linked immunospot assay (ELISPOT)) are more sensitive for the diagnosis of Mycobacterium tuberculosis (MTB) infection than the tuberculin skin test (TST), but cannot distinguish active from latent MTB infection. The present authors report a 38-yr-old female presenting with a 3-week history of malaise, dyspnoea, fevers and coughing, who had received immunosuppressive therapies over 8 months for mixed connective tissue disease. Chest radiograph and thoracic computed tomography showed ground glass opacities in both lower lobes. The TST-induration was 0 mm and AFBs or MTB nucleic acid was not detected on sputum and bronchial secretions. However, TIGRAs performed on peripheral blood cells were reactive. A high frequency of MTB-specific T-cells compatible with the immunodiagnosis of active pTB was detected among bronchoalveolar lavage cells using ELISPOT. Antituberculous therapy was initiated 18 days before MTB was discovered on sputum cultures. Detection of Mycobacterium tuberculosis-specific T-cells in the bronchoalveolar lavage using enzyme-linked immunospot assay is a promising tool for the diagnosis of active pulmonary tuberculosis in immunocompromised patients with negative acid-fast bacilli smears.
    No preview · Article · Jun 2008 · European Respiratory Journal

Publication Stats

264 Citations
61.15 Total Impact Points


  • 2007-2010
    • Research Center Borstel
      • Division of Clinical Infectious Diseases
      Borstel, Lower Saxony, Germany
  • 2007-2008
    • Universitätsklinikum Schleswig - Holstein
      Kiel, Schleswig-Holstein, Germany