Papers by Michael Schirmer
NIR news, 2021
New developments in instrumentation and data analysis have further improved the perspectives of h... more New developments in instrumentation and data analysis have further improved the perspectives of hyperspectral imaging in clinical use. Thus, hyperspectral imaging can be considered as “Next Generation Imaging” for future clinical research. As a contactless, non-invasive method with short process times of just a few seconds, it quantifies predefined substance classes. Results of hyperspectral imaging may support the detection of carcinomas and the classification of different tissue structures as well as the assessment of tissue blood flow. Taken together, this method combines the principle of spectroscopy with imaging using conventional visual cameras. Compared to other optical imaging methods, hyperspectral imaging also analyses deeper layers of tissue.
Praktische Rheumatologie, 2012
Frontiers in Medicine, Sep 28, 2022
Nuclear medicine techniques allow important insights not only into oncologic, neurologic, and inf... more Nuclear medicine techniques allow important insights not only into oncologic, neurologic, and infectious conditions, but also for the assessment of rheumatic diseases. This review provides a brief, update on the potential role of nuclear imaging in rheumatology, especially on F-fluorodeoxyglucose (FDG) positron emission tomography for the diagnosis of giant cell arteritis and other large vessel arteritis according to international recommendations. Besides, the potential role of this and other nuclear imaging techniques for the rheumatologic practice are summarized. With F-fluoride as tracer for positron emission tomography, a new option for bone scintigraphy comes up, whereas the use of a semiquantitative sialoscintigraphy is no more supported for classification of Sjögren's syndrome according to current recommendations. Other techniques are used for di erent organ manifestations in systemic rheumatic diseases like for myocardial infarction and apoplectic insult.
Rheumatology International, Sep 8, 2017
Rheumatology International, Aug 2, 2019
Frontiers in Medicine, Feb 22, 2022
Background: It is well established that patients with inflammatory joint diseases (IJD) have an i... more Background: It is well established that patients with inflammatory joint diseases (IJD) have an increased cardiovascular (CV) mortality and morbidity. According to the 2016 EULAR recommendations on CV risk management, rheumatologists should ensure appropriate management of CV risk in rheumatoid arthritis (RA) and other IJDs. The aim was to assess the CV risk and CV disease in Middle-European patients with IJD. Methods: A retrospective chart review was performed for CV risk factors and CV disease in outpatients of a rheumatology outpatient clinic. CV risk was assessed according to the 2016 European Guidelines on CV disease prevention and also using 2 other approaches to compare the results with data from Norwegian and Spanish cohorts. Results: Out of 432 patients, the prevalence of CV disease reached from 8.7% in spondyloarthritis (SpA) and 12.8% in psoriatic arthritis (PsA) to 18.7% in patients with RA. The number of CV risk factors did not differ between patients with RA, SpA, PsA, and non-inflammatory rheumatic disease (NIRD) (with 1.68 ± 0.13, 1.70 ± 0.13, 2.04 ± 0.16, and 1.78 ± 0.34, respectively). CV risk assessment could be performed in 82 patients after exclusion because of missing data and age. Stratification according to ESC guidelines showed low in 50%, moderate in 12.2%, high in 20.7%, and very high CV risk in 17.1% of patients aged between 40 and 65 years. CV risk in the Middle-European patients with IJD was higher than in the German general population (p = 0.004), and similar to the Norwegian patients with IJD, although patients with Middle-European PsA were at higher risk than the Norwegian patients (p = 0.045). Compared to the Spanish patients, Middle-European patients with IJD were more likely assigned to the high-to a very high-risk group (34.2 vs. 16.2%, p < 0.001), especially in RA disease (49.1 vs. 21%, respectively, p < 0.001). Discussion: High prevalence of established CV disease together with high CV risk in patients with IJD urges for increased vigilance for CV risk factors followed by appropriate interaction by the treating physicians. The prospective use of an international CV risk assessment tool will allow not only estimation of the individual CV risk but also provide data for direct comparisons with the general population and other international cohorts.
Frontiers in Medicine
ObjectiveTo review the current knowledge on bone health in patients with hemophilia A and the und... more ObjectiveTo review the current knowledge on bone health in patients with hemophilia A and the underlying pathogenetic mechanisms.Data SourcesOriginal research articles, meta-analyses, and scientific reviews.Data SynthesisAlready in childhood, patients with hemophilia A are prone to low bone mineral density, leading to osteopenia and/or osteoporosis. Initially associated with the life style of hemophilia, today we are faced with accumulating evidence that coagulation factor VIII is involved directly or indirectly in bone physiology.ConclusionUnderstanding the role of factor VIII and the mechanisms of decreased bone mineral density in hemophilia A is critically important, especially as non-factor replacement therapies are available, and treatment decisions potentially impact bone health.
Frontiers in Immunology, 2022
Earlier studies have recommended routine childhood immunization in patients with propionic acidem... more Earlier studies have recommended routine childhood immunization in patients with propionic acidemia (PA); however, the literature presents insufficient data on the response to vaccines, notably specific IgG concentrations and avidity maturation, after measles, mumps, rubella (MMR), and diphtheria/tetanus (DiphtTe) vaccinations in this population. In patients with PA, cellular and humoral changes of the immune system (e.g. a decreased CD4+ T cell count, with a reversal of CD4/CD8 T cell ratio, a deficient gamma-globulin fraction, and in one case a decreased lymphocyte blastogenesis) have been reported. Former reports also detected pancytopenias accompanying febrile infections in PA patients. In the current study, we analyzed vaccine-specific IgG concentrations and avidity maturation after MMR and DiphtTe vaccinations in 10 patients with PA. Compared to gender and age matched controls, all 10 had protective IgG concentrations for at least one tested antigen, and in 6 out of 10 patient...
Rheumatology, 2021
Objective To describe the development of an Environmental contextual factors (EF) Item Set (EFIS)... more Objective To describe the development of an Environmental contextual factors (EF) Item Set (EFIS) accompanying the disease specific Assessment of SpondyloArthritis international Society Health Index (ASAS HI). Method First, a candidate item pool was developed by linking items from existing questionnaires to 13 EF previously selected for the International Classification of Functioning, Disability and Health (ICF) /ASAS Core Set. Second, using data from two international surveys, which contained the EF item pool as well as the items from the ASAS HI, the number of EF items was reduced based on the correlation between the item and the ASAS HI sum score combined with expert opinion. Third, the final English EFIS was translated into 15 languages and cross-culturally validated. Results The initial item pool contained 53 EF addressing four ICF EF chapters: products and technology (e1), support and relationship (e3), attitudes (e4) and health services (e5). Based on 1754 responses of axial ...
Archives of Rheumatology & Arthritis Research, 2020
In the general population, the prevalence of fibromyalgia (FM) is estimated as high as 1.8% [1]. ... more In the general population, the prevalence of fibromyalgia (FM) is estimated as high as 1.8% [1]. Rheumatologists, neurologists, psychiatrists, and other disciplines may be involved to cover the full spectrum of a biopsychosocial model to care for these patients. With high health-care use for up to 10 years before diagnosis [2], FM is considered as an ongoing challenge: (1) different criteria are used for diagnosis-sometimes even without any objective biomarker included, (2) outcome criteria are not widely used in clinical practice and (3) new and promising therapeutic concepts and strategies are missing. An interdisciplinary team last updated the EULAR management recommendations in 2016, recognizing the need of further updates after 5 years [3]. This personal "opinion" summarizes some aspects considered important for the management of FM in clinical routine (Figure 1).
Arthritis und Rheuma, 2013
Rheumatology International, Dec 16, 2015
PubMed, Nov 1, 2012
Giant-cell arteritis (GCA) is the most common form of vasculitis in patients over 50 years old. L... more Giant-cell arteritis (GCA) is the most common form of vasculitis in patients over 50 years old. Loss of vision is the most common severe complication but involvement of extracranial arteries including the aorta is more frequent than previously assumed. The role of dendritic and T-cells indicates the presence of an antibody but a clear association with underlying infections has not yet been demonstrated. Even if the inflammation parameters in blood are mostly increased in the diagnosis of GCA, specific laboratory tests for the diagnosis of GCA are not available. Of the imaging procedures ultrasonography, magnetic resonance imaging and (18)F-fluorodeoxyglucose positron emission tomography can be useful to localize and estimate the extent of vascular involvement. Glucocorticoids are still the standard therapy of GCA, whereby the cumulative dose can possibly be reduced by additional methotrexate. In addition acetylsalicylic acid is recommended as prophylaxis against cardiovascular and cerebrovascular events as well as prophylaxis and therapy of accompanying osteoporosis.
Rheumatology International, Aug 20, 2018
In 2011 EULAR first published recommendations for the potential role of nurses in the management ... more In 2011 EULAR first published recommendations for the potential role of nurses in the management of patients with rheumatic diseases. To perform a literature update for the role of nurses in the management of chronic inflammatory arthritis (CIA) from 2010 to 2018. A systematic literature review (SLR) was performed according to the PRISMA guidelines, in accordance with the search strategies and eligibility criteria of the EULAR taskforce. The eligibility criteria were "inflammatory arthritis", "interventions undertaken by nurses" and "relevant outcomes to answer the research questions". Exclusion criteria were in itself contradictory outcomes, insufficient data, consideration if they did not clearly distinguish between nurses and health professionals or focused on chronic other than rheumatic diseases. Systematic reviews were classified as descriptive and excluded. Quality of selected trials was determined according to Oxford-levels of evidence 2009. A total of 48 articles and 10 abstracts were identified fulfilling the eligibility and exclusion criteria. Recommendation 1 has been well established in Europe so far. New evidence strengthens the recommendation 3, and-at least in part-recommendation 6. High evidence strengthens recommendation 4, especially for outpatients with low and stable disease activity. Some new evidence also exists for recommendations 7 and 8. This SLR reveals new evidence for the role of nurses in managing CIA patients since 2010, especially for RA-patients with low disease activity or in remission.
Clinical Rheumatology, Nov 11, 2009
To define relevant disease parameters and their respective limits indicating the initiation of TN... more To define relevant disease parameters and their respective limits indicating the initiation of TNF-αblockers in individual patients. Subsequently, to analyze retrospectively patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS), who started TNF-α inhibition in 2006. Points to consider, regarded relevant for individual treatment decisions as well as their assessment methods, were ascertained by experts' consensus applying the Delphi technique. Subsequently , these parameters' thresholds with respect to the initiation of a TNF-α-blocker were identified. Thereafter, the rheumatologists representing 12 centres all over Austria agreed to retrospectively analyze their patients started on a TNF-α-blocker in 2006. Experts' opinion regarding disease parameters relevant to initiate TNF-αblockers in RA patients only slightly differed from those applied in clinical trials, but the parameters' threshold values were considerably lower. For PsA patients, some B. F. Leeb (*) : B. Rintelen
Rheumatology International, Jun 1, 1998
Bioengineering
Bone analyses using mid-infrared spectroscopy are gaining popularity, especially with handheld sp... more Bone analyses using mid-infrared spectroscopy are gaining popularity, especially with handheld spectrometers that enable on-site testing as long as the data quality meets standards. In order to diagnose Staphylococcus epidermidis in human bone grafts, this study was carried out to compare the effectiveness of the Agilent 4300 Handheld Fourier-transform infrared with the Perkin Elmer Spectrum 100 attenuated-total-reflectance infrared spectroscopy benchtop instrument. The study analyzed 40 non-infected and 10 infected human bone samples with Staphylococcus epidermidis, collecting reflectance data between 650 cm−1 and 4000 cm−1, with a spectral resolution of 2 cm−1 (Agilent 4300 Handheld) and 0.5 cm−1 (Perkin Elmer Spectrum 100). The acquired spectral information was used for spectral and unsupervised classification, such as a principal component analysis. Both methods yielded significant results when using the recommended settings and data analysis strategies, detecting a loss in bone...
Wiener klinische Wochenschrift
The Austrian and International Rheumatology World is deeply saddened by the loss of Winfried Gran... more The Austrian and International Rheumatology World is deeply saddened by the loss of Winfried Graninger on 30 May 2023. Professor Graninger became the first chairman of the newly founded Division of Rheumatology at the University of Graz in 2003, a position that he held for 18 years and that he used to shape the world of rheumatology in many respects.
Biology
Glaciers are dwindling archives, releasing animal mummies preserved in the ice for centuries due ... more Glaciers are dwindling archives, releasing animal mummies preserved in the ice for centuries due to climate changes. As preservation varies, residual soft tissues may differently expand the biological information content of such mummies. DNA studies have proven the possibility of extracting and analyzing DNA preserved in skeletal residuals and sediments for hundreds or thousands of years. Paleoradiology is the method of choice as a non-destructive tool for analyzing mummies, including micro-computed tomography (micro-CT) and magnetic resonance imaging (MRI). Together with radiocarbon dating, histo-anatomical analyses, and DNA sequencing, these techniques were employed to identify a 350-year-old Austrian Ardea purpurea glacier mummy from the Ötztal Alps. Combining these techniques proved to be a robust methodological concept for collecting inaccessible information regarding the structural organization of the mummy. The variety of methodological approaches resulted in a distinct pictu...
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Papers by Michael Schirmer