TY - JOUR A1 - Balakirski, Galina A1 - Kotliar, Konstantin A1 - Pauly, Karolin J. A1 - Krings, Laura K. A1 - Rübben, Albert A1 - Baron, Jens M. A1 - Schmitt, Laurenz T1 - Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience JF - Dermatologic Surgery N2 - BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients. The available data on complications after dermatologic surgery have improved over the past years. Particularly, additional risk factors have been identified for surgical site infections (SSI). Purulent surgical sites, older age, involvement of head, neck, and acral regions, and also the involvement of less experienced surgeons have been reported to increase the risk of the SSI after dermatologic surgeries.1 In general, the incidence of SSI after skin surgery is considered to be low.1,2 However, antibiotics in dermatologic surgeries, especially in the perioperative setting, seem to be overused,3,4 particularly regarding developing antibiotic resistances and side effects. Immunosuppression has been recommended to be taken into consideration as an additional indication for antibiotic prophylaxis to prevent SSI after skin surgery in special cases.5,6 However, these recommendations do not specify the exact dermatologic surgeries, and were not specifically developed for dermatologic surgery patients and treatments, but adopted from other surgical fields.6 According to the survey conducted on American College of Mohs Surgery members in 2012, 13% to 29% of the surgeons administered antibiotic prophylaxis to immunocompromised patients to prevent SSI while performing dermatologic surgery on noninfected skin,3 although this was not recommended by Journal of the American Academy of Dermatology Advisory Statement. Indeed, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. However, it is possible that due to the insufficient evidence on the risk of SSI occurrence in this patient group, dermatologic surgeons tend to overuse perioperative antibiotic prophylaxis. To make specific recommendations on the use of antibiotic prophylaxis in immunosuppressed patients in the field of skin surgery, more information about the incidence of SSI after dermatologic surgery in these patients is needed. The aim of this study was to fill this data gap by investigating whether there is an increased risk of SSI after skin surgery in immunocompromised patients compared with immunocompetent patients. Y1 - 2018 U6 - http://dx.doi.org/10.1097/DSS.0000000000001615 IS - 44 (12) SP - 1525 EP - 1536 PB - Wolters Kluwer ER - TY - JOUR A1 - Conzen, Catharina A1 - Albanna, Walid A1 - Weiss, Miriam A1 - Kürten, David A1 - Vilser, Walthard A1 - Kotliar, Konstantin A1 - Zäske, Charlotte A1 - Clusmann, Hans A1 - Schubert, Gerrit Alexander T1 - Vasoconstriction and Impairment of Neurovascular Coupling after Subarachnoid Hemorrhage: a Descriptive Analysis of Retinal Changes JF - Translational Stroke Research N2 - Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5–14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C). Data was acquired using a Retinal Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and NVC using flicker-light excitation. Diameter of retinal vessels—central retinal arteriolar and venular equivalent—was significantly reduced in the acute phase (p < 0.001) with gradual improvement in group B (p < 0.05). Arterial NVC of group A was significantly impaired with diminished dilatation (p < 0.001) and reduced area under the curve (p < 0.01) when compared to group C. Group B showed persistent prolonged latency of arterial dilation (p < 0.05). Venous NVC was significantly delayed after SAH compared to group C (A p < 0.001; B p < 0.05). To our knowledge, this is the first clinical study to document retinal vasoconstriction and impairment of NVC in patients with SAH. Using non-invasive RVA as a translational approach, characteristic patterns of compromise were detected for the arterial and venous compartment of the neurovascular unit in a time-dependent fashion. Recruitment will continue to facilitate a correlation analysis with clinical course and outcome. Y1 - 2018 U6 - http://dx.doi.org/10.1007/s12975-017-0585-8 SN - 1868-601X IS - 9 SP - 284 EP - 293 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Albanna, Walid A1 - Kotliar, Konstantin A1 - Lüke, Jan Niklas A1 - Alpdogan, Serdar A1 - Conzen, Catharina A1 - Lindauer, Ute A1 - Clusmann, Hans A1 - Hescheler, Jürgen A1 - Vilser, Walthard A1 - Schneider, Toni A1 - Schubert, Gerrit Alexander T1 - Non-invasive evaluation of neurovascular coupling in the murine retina by dynamic retinal vessel analysis JF - Plos one N2 - Background Impairment of neurovascular coupling (NVC) was recently reported in the context of subarachnoid hemorrhage and may correlate with disease severity and outcome. However, previous techniques to evaluate NVC required invasive procedures. Retinal vessels may represent an alternative option for non-invasive assessment of NVC. Methods A prototype of an adapted retinal vessel analyzer was used to assess retinal vessel diameter in mice. Dynamic vessel analysis (DVA) included an application of monochromatic flicker light impulses in predefined frequencies for evaluating NVC. All retinae were harvested after DVA and electroretinograms were performed. Results A total of 104 retinal scans were conducted in 21 male mice (90 scans). Quantitative arterial recordings were feasible only in a minority of animals, showing an emphasized reaction to flicker light impulses (8 mice; 14 scans). A characteristic venous response to flicker light, however, could observed in the majority of animals. Repeated measurements resulted in a significant decrease of baseline venous diameter (7 mice; 7 scans, p < 0.05). Ex-vivo electroretinograms, performed after in-vivo DVA, demonstrated a significant reduction of transretinal signaling in animals with repeated DVA (n = 6, p < 0.001). Conclusions To the best of our knowledge, this is the first non-invasive study assessing murine retinal vessel response to flicker light with characteristic changes in NVC. The imaging system can be used for basic research and enables the investigation of retinal vessel dimension and function in control mice and genetically modified animals. Y1 - 2018 U6 - http://dx.doi.org/10.1371/journal.pone.0204689 VL - 13 IS - 10 PB - PLOS CY - San Francisco ER - TY - JOUR A1 - Albanna, Walid A1 - Lüke, Jan Niklas A1 - Schubert, Gerrit Alexander A1 - Dibué-Adjei, Maxine A1 - Kotliar, Konstantin A1 - Hescheler, Jürgen A1 - Clusmann, Hans A1 - Steiger, Hans-Jakob A1 - Hänggi, Daniel A1 - Kamp, Marcel A. A1 - Schneider, Toni A1 - Neumaier, Felix T1 - Modulation of Ca v 2.3 channels by unconjugated bilirubin (UCB) – Candidate mechanism for UCB-induced neuromodulation and neurotoxicity JF - Molecular and Cellular Neuroscience Y1 - 2019 U6 - http://dx.doi.org/10.1016/j.mcn.2019.03.003 SN - 1044-7431 VL - 96 IS - 4 SP - 35 EP - 46 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Kodomskoi, Leonid A1 - Kotliar, Konstantin A1 - Schröder, Andreas A1 - Weiss, Michael A1 - Hille, Konrad T1 - Suture-Probe Canaloplasty as an Alternative to Canaloplasty using the iTrack™ Microcatheter JF - Journal of Glaucoma Y1 - 2019 U6 - http://dx.doi.org/10.1097/IJG.0000000000001321 SN - 1057-0829 IS - Epub ahead of print PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Attar, Mandana Hossein Zadeh A1 - Merk, Hans F. A1 - Kotliar, Konstantin A1 - Wurpts, Gerda A1 - Röseler, Stefani A1 - Moll-Slodowy, Silke A1 - Plange, Johann A1 - Baron, Jens Malte A1 - Balakirski, Galina T1 - The CD63 basophil activation test as a diagnostic tool for assessing autoimmunity in patients with chronic spontaneous urticaria JF - European Journal of Dermatology Y1 - 2019 U6 - http://dx.doi.org/10.1684/ejd.2019.3680 VL - 29 IS - 6 SP - 614 EP - 618 ER - TY - JOUR A1 - Ramoshaba, Nthai E. A1 - Huisman, Hugo W. A1 - Lammertyn, Leandi A1 - Kotliar, Konstantin A1 - Schutte, Aletta E. A1 - Smith, Wayne T1 - Retinal microvasculature and masked hypertension in young adults: the African-PREDICT study JF - Hypertension Research N2 - Masked hypertension is known to induce microvascular complications. However, it is unclear whether early microvascular changes are already occurring in young, otherwise healthy adults. We therefore investigated whether retinal microvascular calibers and acute responses to a flicker stimulus are related to masked hypertension. We used the baseline data of 889 participants aged 20–30 years who were taking part in the African Prospective study on the Early Detection and Identification of Cardiovascular Disease and Hypertension. Clinic and 24-h ambulatory blood pressure were measured. The central retinal artery equivalent (CRAE) and central retinal vein equivalent were calculated from fundus images, and retinal vessel dilation was determined in response to flicker light-induced provocation. A smaller CRAE was observed in those with masked hypertension vs. those with normotension (157.1 vs. 161.2 measuring units, P < 0.001). In forward multivariable-adjusted regression analysis, only CRAE was negatively related to masked hypertension [adjusted R² = 0.267, β = −0.097 (95% CI = −0.165; −0.029), P = 0.005], but other retinal microvascular parameters were not associated with masked hypertension. In multivariable logistic regression analyses, masked hypertension [OR = 2.333, (95% CI = 1.316; 4.241), P = 0.004] was associated with a narrower CRAE. In young healthy adults, masked hypertension was associated with retinal arteriolar narrowing, thereby reflecting early microvascular alterations known to predict cardiovascular outcomes in later life. Y1 - 2020 U6 - http://dx.doi.org/10.1038/s41440-020-0487-0 SN - 1348-4214 IS - 43 SP - 1231 EP - 1238 PB - Springer Nature CY - Osaka ER - TY - JOUR A1 - Malan, Leone A1 - Hamer, Mark A1 - Känel, Roland von A1 - Kotliar, Konstantin A1 - Wyk, Roelof D. van A1 - Lambert, Gavin W. A1 - Vilser, Walthard A1 - Ziemssen, Tjalf A1 - Schlaich, Markus P. A1 - Smith, Wayne A1 - Magnusson, Martin A1 - Wentzel, Annemarie A1 - Myburgh, Carlien E. A1 - Steyn, Hendrik S. A1 - Malan, Nico T. T1 - Delayed retinal vein recovery responses indicate both non-adaptation to stress as well as increased risk for stroke: the SABPA study JF - Cardiovascular Journal of Africa Y1 - 2020 U6 - http://dx.doi.org/10.5830/CVJA-2020-031 SN - 1680-0745 VL - 26 IS - 31 SP - 1 EP - 12 PB - Clinics Cardive Publishing CY - Durbanville ER - TY - JOUR A1 - Smith, Wayne A1 - Kotliar, Konstantin A1 - Lammertyn, Leandi A1 - Ramoshaba, Nthai E. A1 - Vilser, Walthard A1 - Huisman, Hugo W. A1 - Schutte, Aletta E. T1 - Retinal vessel caliber and caliber responses in true normotensive black and white adults: The African-PREDICT study JF - Microvascular Research N2 - Purpose Globally, a detrimental shift in cardiovascular disease risk factors and a higher mortality level are reported in some black populations. The retinal microvasculature provides early insight into the pathogenesis of systemic vascular diseases, but it is unclear whether retinal vessel calibers and acute retinal vessel functional responses differ between young healthy black and white adults. Methods We included 112 black and 143 white healthy normotensive adults (20–30 years). Retinal vessel calibers (central retinal artery and vein equivalent (CRAE and CRVE)) were calculated from retinal images and vessel caliber responses to flicker light induced provocation (FLIP) were determined. Additionally, ambulatory blood pressure (BP), anthropometry and blood samples were collected. Results The groups displayed similar 24 h BP profiles and anthropometry (all p > .24). Black participants demonstrated a smaller CRAE (158 ± 11 vs. 164 ± 11 MU, p < .001) compared to the white group, whereas CRVE was similar (p = .57). In response to FLIP, artery maximal dilation was greater in the black vs. white group (5.6 ± 2.1 vs. 3.3 ± 1.8%; p < .001). Conclusions Already at a young age, healthy black adults showed narrower retinal arteries relative to the white population. Follow-up studies are underway to show if this will be related to increased risk for hypertension development. The reason for the larger vessel dilation responses to FLIP in the black population is unclear and warrants further investigation. Y1 - 2020 U6 - http://dx.doi.org/10.1016/j.mvr.2019.103937 SN - 0026-2862 VL - 128 IS - Article 103937 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Streese, Lukas A1 - Kotliar, Konstantin A1 - Deiseroth, Arne A1 - Infanger, Denis A1 - Gugleta, Konstantin A1 - Schmaderer, Christoph A1 - Hanssen, Henner T1 - Retinal endothelial function in cardiovascular risk patients: A randomized controlled exercise trial JF - Scandinavian Journal of Medicine and Science in Sports N2 - The aim of this study was to investigate, for the first time, the effects of high-intensity interval training (HIIT) on retinal microvascular endothelial function in cardiovascular (CV) risk patients. In the randomized controlled trial, middle-aged and previously sedentary patients with increased CV risk (aged 58 ± 6 years) with ≥ two CV risk factors were randomized into a 12-week HIIT (n = 33) or control group (CG, n = 36) with standard physical activity recommendations. A blinded examiner measured retinal endothelial function by flicker light-induced maximal arteriolar (ADmax) and venular (VDmax) dilatation as well as the area under the arteriolar (AFarea) and venular (VFarea) flicker curve using a retinal vessel analyzer. Standardized assessments of CV risk factors, cardiorespiratory fitness, and retinal endothelial function were performed before and after HIIT. HIIT reduced body mass index, fat mass, and low-density lipoprotein and increased muscle mass and peak oxygen uptake (VO2peak). Both ADmax (pre: 2.7 ± 2.1%, post: 3.0 ± 2.2%, P = .018) and AFarea (pre: 32.6 ± 28.4%*s, post: 37.7 ± 30.6%*s, P = .016) increased after HIIT compared with CG (ADmax, pre: 3.2 ± 1.8%, post: 2.9 ± 1.8%, P = .254; AFarea, pre: 41.6 ± 28.5%*s, post: 37.8 ± 27.0%*s, P = .186). Venular function remained unchanged after HIIT. There was a significant association between ∆-change VO2peak and ∆-changes ADmax and AFarea (P = .026, R² = 0.073; P = .019, R² = 0.081, respectively). 12-weeks of HIIT improved retinal endothelial function in middle-aged patients with increased CV risk independent of the reduction in classical CV risk factors. Exercise has the potential to reverse or at least postpone progression of small vessel disease in older adults with increased CV risk under standard medication. Dynamic retinal vessel analysis seems to be a sensitive tool to detect treatment effects of exercise interventions on retinal microvascular endothelial function in middle-aged individuals with increased CV risk. Y1 - 2020 U6 - http://dx.doi.org/10.1111/sms.13560 SN - 1600-0838 VL - 30 IS - 2 SP - 272 EP - 280 PB - Wiley CY - Oxford ER -