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  1. Article ; Online: Accelerating the Evolution of Severe Acute Respiratory Syndrome Coronavirus 2: A Risk of Combining Dexamethasone and Tocilizumab for Severe Coronavirus Disease 2019.

    Koeckerling, David / Barker, Joseph

    The Journal of infectious diseases

    2020  Volume 224, Issue 6, Page(s) 934–937

    Abstract: Emerging data from open-label randomized trials without placebo controls suggest potential mortality benefits for combining corticosteroids with the interleukin 6 receptor antagonist tocilizumab in severe coronavirus disease 2019. Conversely, dual ... ...

    Abstract Emerging data from open-label randomized trials without placebo controls suggest potential mortality benefits for combining corticosteroids with the interleukin 6 receptor antagonist tocilizumab in severe coronavirus disease 2019. Conversely, dual immunomodulation may weaken antiviral responses and delay viral clearance, allowing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to expand its population and accrue genetic diversity within individual hosts. Generating a pool of hosts with genetically diverse viral populations while introducing new selective pressures in the form of vaccination-induced immunity could accelerate the process of antigenic drift in SARS-CoV-2. However, clinical trials to date have largely disregarded viral outcomes, and data on viral kinetics in response to immunomodulation are scarce. Coadministration of antiviral agents with immunomodulation could serve as a potential strategy to aid viral clearance and reduce the risk of genetic diversification.
    MeSH term(s) Adrenal Cortex Hormones/pharmacology ; Antibodies, Monoclonal, Humanized/pharmacology ; Antiviral Agents/pharmacology ; COVID-19/drug therapy ; Dexamethasone/pharmacology ; Drug Combinations ; Humans ; Immunologic Factors ; SARS-CoV-2/drug effects
    Chemical Substances Adrenal Cortex Hormones ; Antibodies, Monoclonal, Humanized ; Antiviral Agents ; Drug Combinations ; Immunologic Factors ; Dexamethasone (7S5I7G3JQL) ; tocilizumab (I031V2H011)
    Language English
    Publishing date 2020-10-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiab328
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  2. Article ; Online: Re: 'Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis' by Tleyjeh et al.

    Koeckerling, David / Pan, Daniel / Barker, Joseph

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2021  Volume 27, Issue 8, Page(s) 1175–1176

    MeSH term(s) Antibodies, Monoclonal, Humanized/adverse effects ; Humans ; SARS-CoV-2 ; COVID-19 Drug Treatment
    Chemical Substances Antibodies, Monoclonal, Humanized ; tocilizumab (I031V2H011)
    Language English
    Publishing date 2021-02-05
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2021.01.025
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  3. Article ; Online: Effect of serial awake prone positioning on oxygenation in patients admitted to intensive care with COVID-19.

    Barker, Joseph / Pan, Daniel / Koeckerling, David / Baldwin, Alexander James / West, Raha

    Postgraduate medical journal

    2023  Volume 98, Issue 1159, Page(s) 360–364

    Abstract: Introduction: Awake prone positioning (APP) might benefit patients with COVID-19 by improving oxygenation, but it is unknown whether this improvement can be sustained with serial proning episodes.: Methods: We conducted a retrospective review of ... ...

    Abstract Introduction: Awake prone positioning (APP) might benefit patients with COVID-19 by improving oxygenation, but it is unknown whether this improvement can be sustained with serial proning episodes.
    Methods: We conducted a retrospective review of adults with COVID-19 admitted to one intensive care unit, in those who underwent APP and controls. Patients in both groups had type 1 respiratory failure requiring oxygen (but not initially intubated), confirmed SARS-CoV-2 PCR by nasopharyngeal swab and findings of multifocal ground-glass opacities on imaging. For the APP group, serial SpO2/FiO2 measurements were recorded after each proning episode.
    Results: Of 77 patients admitted, 50 (65%) were excluded because they had already been intubated. Another 7 (9%) had undergone APP prior to admission. Of the remaining 20, 10 underwent APP and 10 were controls. Patients in both groups had similar demographics, subsequent intubation and survival. Of those who underwent APP, SpO2/FiO2 was most likely to increase after the first episode (before median: 152, IQR 135-185; after: median 192, IQR 156-234, p=0.04). Half of participants (5) in the APP group were unable to tolerate more than two APP episodes.
    Conclusions: Most patients with COVID-19 admitted to the intensive care are not suitable for APP. Of those who are, many cannot tolerate more than two episodes. Improvements in SpO2/FiO2 secondary to APP are transient and most likely in the first episode. Our findings may explain why other studies have failed to show improvements in mortality from APP despite improvements in oxygenation.
    MeSH term(s) Adult ; Humans ; COVID-19/therapy ; SARS-CoV-2 ; Wakefulness ; Prone Position ; Critical Care/methods ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-08-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1136/postgradmedj-2020-139631
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  4. Article ; Online: Awake prone positioning for patients with covid-19.

    Barker, Joseph / Koeckerling, David / Mudalige, Nadeesha Lakmal / Oyefeso, Oluwatobiloba / Pan, Daniel

    BMJ (Clinical research ed.)

    2022  Volume 376, Page(s) o632

    MeSH term(s) COVID-19 ; Humans ; Patient Positioning ; Prone Position ; Wakefulness
    Language English
    Publishing date 2022-03-23
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.o632
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  5. Article ; Online: A need for prone position CPR guidance for intubated and non-intubated patients during the COVID-19 pandemic.

    Barker, Joseph / Koeckerling, David / West, Raha

    Resuscitation

    2020  Volume 151, Page(s) 135–136

    MeSH term(s) Betacoronavirus ; COVID-19 ; Cardiopulmonary Resuscitation/methods ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Critical Care/methods ; Critical Illness/therapy ; Female ; Humans ; Intensive Care Units ; Intubation, Intratracheal/methods ; Male ; Needs Assessment ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Patient Positioning ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Prone Position ; Reference Values ; SARS-CoV-2 ; United Kingdom
    Keywords covid19
    Language English
    Publishing date 2020-05-01
    Publishing country Ireland
    Document type Comparative Study ; Letter
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2020.04.029
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    Zs.A 1048: Show issues Location:
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  6. Article: Fighting liver fat.

    Koeckerling, David / Tomlinson, Jeremy W / Cobbold, Jeremy F

    Endocrine connections

    2020  Volume 9, Issue 7, Page(s) R173–R186

    Abstract: Non-alcoholic fatty liver disease is a chronic liver disease which is closely associated with components of the metabolic syndrome. Its high clinical burden results from the growing prevalence, inherent cardiometabolic risk and potential of progressing ... ...

    Abstract Non-alcoholic fatty liver disease is a chronic liver disease which is closely associated with components of the metabolic syndrome. Its high clinical burden results from the growing prevalence, inherent cardiometabolic risk and potential of progressing to cirrhosis. Patients with non-alcoholic fatty liver disease show variable rates of disease progression through a histological spectrum ranging from steatosis to steatohepatitis with or without fibrosis. The presence and severity of fibrosis are the most important prognostic factors in non-alcoholic fatty liver disease. This necessitates risk stratification of patients by fibrosis stage using combinations of non-invasive methods, such as composite scoring systems and/or transient elastography. A multidisciplinary approach to treatment is advised, centred on amelioration of cardiometabolic risk through lifestyle and pharmacological interventions. Despite the current lack of licensed, liver-targeted pharmacotherapy, several promising agents are undergoing late-phase clinical trials to complement standard management in patients with advanced disease. This review summarises the current concepts in diagnosis and disease progression of non-alcoholic liver disease, focusing on pragmatic approaches to risk assessment and management in both primary and secondary care settings.
    Language English
    Publishing date 2020-07-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2668428-7
    ISSN 2049-3614
    ISSN 2049-3614
    DOI 10.1530/EC-20-0174
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  7. Article ; Online: Patient-specific risk factors for reintervention following primary endovascular treatment of iliac artery disease.

    Koeckerling, David / Zielasek, Christian / Stähli, Patrick / Wohlfarth, Benny / Rosenov, Alexander / Helfenstein, Fabrice / Behrendt, Christian-Alexander / Baumgartner, Iris

    Journal of vascular surgery

    2023  Volume 79, Issue 4, Page(s) 847–855.e5

    Abstract: Objective: Predictive models for reintervention may guide clinicians to optimize selection, education, and follow-up of patients undergoing endovascular iliac revascularization. Although the impact of lesion- and device-related characteristics on iliac ... ...

    Abstract Objective: Predictive models for reintervention may guide clinicians to optimize selection, education, and follow-up of patients undergoing endovascular iliac revascularization. Although the impact of lesion- and device-related characteristics on iliac restenosis and reintervention risk is well-defined, data on patient-specific risk factors are scarce and conflicting. This study aimed to explore the value of patient-related factors in predicting the need for clinically driven target-vessel revascularization (CD-TVR) in patients undergoing primary endovascular treatment of iliac artery disease.
    Methods: Consecutively enrolled patients undergoing endovascular revascularization for symptomatic iliac artery disease at a tertiary vascular referral center between January 2008 and June 2020 were retrospectively analyzed. Primary and secondary outcomes were CD-TVR occurrence within 24 months and time to CD-TVR, respectively. Patients who died or did not require CD-TVR within 24 months were censored at the date of death or at 730 days, respectively. Multiple imputation was used to account for missing data in primary analyses.
    Results: A total of 1538 iliac interventions were performed in 1113 patients (26% females; 68 years). CD-TVR occurred in 108 limbs (74 patients; 7.0%) with a median time to CD-TVR of 246 days. On multivariable analysis, increasing age was associated with lower likelihood of CD-TVR (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.50-0.83; P = .001) and decreased risk of CD-TVR at any given time (hazard ratio [HR], 0.66; 95% CI, 0.52-0.84; P = .001). Similarly, a lower likelihood of CD-TVR (OR, 0.75; 95% CI, 0.59-0.95; P = .017) and decreased risk of CD-TVR at any given time (HR, 0.73; 95% CI, 0.58-0.93; P = .009) were observed with higher glomerular filtration rates. Lastly, revascularization of common vs external iliac artery disease was associated with lower likelihood of CD-TVR (OR, 0.48; 95% CI, 0.24-0.93; P = .030) and decreased risk of CD-TVR at any given time (HR, 0.48; 95% CI, 0.25-0.92; P = .027). No associations were observed between traditional cardiovascular risk factors (sex, hypertension, higher low-density lipoprotein cholesterol, higher hemoglobin A1c, smoking) and CD-TVR.
    Conclusions: In this retrospective cohort study, younger age, impaired kidney function, and external iliac artery disease were associated with CD-TVR. Traditional markers of cardiovascular risk were not seen to predict reintervention.
    MeSH term(s) Female ; Humans ; Male ; Iliac Artery/diagnostic imaging ; Iliac Artery/surgery ; Retrospective Studies ; Treatment Outcome ; Endovascular Procedures/adverse effects ; Risk Factors ; Peripheral Arterial Disease/diagnostic imaging ; Peripheral Arterial Disease/therapy ; Peripheral Arterial Disease/etiology
    Language English
    Publishing date 2023-12-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605700-7
    ISSN 1097-6809 ; 0741-5214
    ISSN (online) 1097-6809
    ISSN 0741-5214
    DOI 10.1016/j.jvs.2023.12.012
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  8. Article ; Online: A comparative evaluation of calix[4]arene-1,3-crown-6 as a ligand for selected divalent cations of radiopharmaceutical interest.

    Bauer, David / Blumberg, Markus / Köckerling, Martin / Mamat, Constantin

    RSC advances

    2019  Volume 9, Issue 55, Page(s) 32357–32366

    Abstract: Metals, which form divalent cations, including the alkaline earth metals offer radionuclides like lead-203, lead-212, barium-131, and strontium-89, which are promising candidates for radiopharmaceutical applications. Besides, the heavy homologous ... ...

    Abstract Metals, which form divalent cations, including the alkaline earth metals offer radionuclides like lead-203, lead-212, barium-131, and strontium-89, which are promising candidates for radiopharmaceutical applications. Besides, the heavy homologous nuclides radium-223 and radium-224 - with similar properties to barium - are suitable alpha-emitters for targeted alpha-particle therapy. However, there is a lack of suitable chelation agents, especially for heavy group 2 metals. The macrocycle calix[4]arene-1,3-crown-6 seems to interact with these metals strongly. Therefore, this ligand and its coordination to the divalent cations of barium, strontium, and lead have been investigated. The complex formation was analyzed by NMR and UV/Vis titration experiments in acetonitrile, and stability constants were determined to be >4 with both methods. It was found that the stability of these complexes increase in the order strontium, barium, and lead. Additional to these investigations, X-ray crystallography, solvent-dependent
    Language English
    Publishing date 2019-10-10
    Publishing country England
    Document type Journal Article
    ISSN 2046-2069
    ISSN (online) 2046-2069
    DOI 10.1039/c9ra07293d
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  10. Article ; Online: A need for prone position CPR guidance for intubated and non-intubated patients during the COVID-19 pandemic

    Barker, Joseph / Koeckerling, David / West, Raha

    Resuscitation

    2020  Volume 151, Page(s) 135–136

    Keywords Emergency ; Emergency Medicine ; Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2020.04.029
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