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Brand A, Hornig C, Crayen C, Hamann A, Martineck S, Leistner DM, Dreger H, Sündermann S, Unbehaun A, Sherif M, Haghikia A, Bischoff S, Lueg J, Kühnle Y, Paul O, Squier S, Stangl K, Falk V, Landmesser U, Stangl V. Medical graphics to improve patient understanding and anxiety in elderly and cognitively impaired patients scheduled for transcatheter aortic valve implantation (TAVI). Clin Res Cardiol 2023:10.1007/s00392-023-02352-8. [PMID: 38117299 DOI: 10.1007/s00392-023-02352-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Anxiety and limited patient comprehension may pose significant barriers when informing elderly patients about complex procedures such as transcatheter aortic valve implantation (TAVI). OBJECTIVES We aimed to evaluate the utility of medical graphics to improve the patient informed consent (IC) before TAVI. METHODS In this prospective, randomized dual center study, 301 patients were assigned to a patient brochure containing medical graphics (Comic group, n = 153) or sham information (Control group, n = 148) on top of usual IC. Primary outcomes were patient understanding of central IC-related aspects and periprocedural anxiety assessed by the validated Spielberger State Trait Anxiety Inventory (STAI), both analyzed by cognitive status according to the Montreal Cognitive Assessment (MoCA). RESULTS Patient understanding was significantly higher in the Comic group [mean number of correct answers 12.8 (SD 1.2) vs. 11.3 (1.8); mean difference 1.5 (95% CI 1.2-1.8); p < 0.001]. This effect was more pronounced in the presence of cognitive dysfunction (MoCA < 26) [12.6 (1.2) in the Comic vs. 10.9 (1.6) in the Control group; mean difference 1.8 (1.4-2.2), p < 0.001]. Mean STAI score declined by 5.7 (95% CI 5.1-6.3; p < 0.001) in the Comic and 0.8 points (0.2-1.4; p = 0.015) in the Control group. Finally, mean STAI score decreased in the Comic group by 4.7 (3.8-5.6) in cognitively impaired patients and by 6.6 (95% CI 5.8 to 7.5) in patients with normal cognitive function (p < 0.001 each). CONCLUSIONS Our results prove beneficial effects for using medical graphics to inform elderly patients about TAVI by improving patient understanding and reducing periprocedural anxiety (DRKS00021661; 23/Oct/2020). Medical graphics entailed significant beneficial effects on the primary endpoints, patient understanding and periprocedural anxiety, compared to the usual patient informed consent (IC) procedure. Patient understanding of IC-related aspects was significantly higher in the Comic group, with a more pronounced benefit in patients with cognitive impairment (p for IC method and cognitive status < 0.001, respectively; p for IC method x MoCA category interaction = 0.017). There further was a significant decline of periprocedural anxiety in patients with and without cognitive impairment (p for IC method x measuring time point < 0.001; p for IC method x MoCA category x measuring time point interaction = 0.018).
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Affiliation(s)
- A Brand
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany.
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany.
| | - C Hornig
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - C Crayen
- Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - A Hamann
- Mintwissen-Science Communication Agency and Publishing House, Paulusstr. 11, 40237, Düsseldorf, Germany
| | | | - D M Leistner
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine, Goethe University Hospital, Universitäres Herz- und Gefässzentrum Frankfurt, Frankfurt am Main, 60590, Frankfurt, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhein-Main, Munich, Germany
| | - H Dreger
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| | - S Sündermann
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - A Unbehaun
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - M Sherif
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - A Haghikia
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| | - S Bischoff
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - J Lueg
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - Y Kühnle
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - O Paul
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - S Squier
- Brill Professor Emeritus of English and Women's, Gender and Sexuality Studies, The Pennsylvania State University, University Park, PA, 16802, USA
| | - K Stangl
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - V Falk
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - U Landmesser
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| | - V Stangl
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
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Kumari S, Moujaber T, Madsen I, Gao B, Provan P, Srirangan S, Bouantoun N, Kennedy C, Sharma R, Fereday S, Traficante N, Friedlander M, Brand A, Gourley C, Garsed D, Bowtell D, Balleine R, Harnett P, DeFazio A. 16P Response to taxanes in low-grade serous ovarian cancer patients and cell lines. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Steudel T, Mattig I, Romero Dorta E, Barzen G, Frumkin D, Laule N, Al Daas M, Spethmann S, Knebel F, Canaan-Kuhl S, Stangl K, Hahn K, Brand A. Echocardiographic assessment of left ventricular radial strain to differentiate cardiac amyloidosis from Fabry disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) wall thickening is a typical echocardiographic finding in infiltrative cardiomyopathies like cardiac amyloidosis (CA) and Fabry disease (FD). The discrimination of both infiltrative diseases remains challenging by standard as well as 2D speckle tracking echocardiography (2DSTE)-based analysis of longitudinal LV strain patterns. Over the recent years, a constant development in image quality and data processing provided better possibilities to analyse layer specific myocardial deformation indices. With regards to FD, specific layer LV strain patterns may be useful to rule-in FD in patients with suspected infiltrative cardiomyopathy.
Purpose
The aim of the present study was to investigate differences and the diagnostic value of layer specific 2D STE-based radial LV strain indices in CA and FD.
Methods
Next to standard parameters of a comprehensive echocardiographic assessment (Vivid E9 or E95, GE Vingmed, Horton, Norway, with an M5S 1.5–4.5MHz transducer), we retrospectively analysed the transmural radial LV strain (GSradial), the subendocardial radial LV strain (GSendo), the subepicardial radial LV strain (GSepi), and the strain gradient (GSendo − GSepi) (EchoPAC software, GE) in FD patients and CA patient from the amyloidosis registry at our study site. A Receiver operating curve (ROC) analysis was used to assess the diagnostic value of the respective LV strain values and the layer-specific strain gradient to discriminate FD and CA.
Results
A total of 38 FD and 40 CA patients were included in our analyses. In patients with FD, GSepi showed a marked impairment. LV radial and layer strain were significantly reduced in CA compared to FD patients [GSradial −12.0 (−16.2 to −9.9) in CA vs. −17.7 (−20.5 to −14.6) in FD; p<0.001); GSendo (−20.6 (−27.0 to −15.7) in CA vs. −30.0 (−32.0 to −25.6) in FD; p<0.001); and GSepi (−7.4 (−8.9 to −4.8) in CA vs. −9.1 (−11.86 to −7.6) in FD; p<0.001)]. The gradient of GSendo and GSepi was significantly lower in patients with CA compared to FD (−14.0±5.6 in CA vs. −19.4±4.3 in FD respectively; p<0.001). GSendo held the highest diagnostic accuracy to discriminate CA and FD (area under the curve [AUC] 0.83, 95% confidence interval [CI] 0.73–0.92). The layer-specific strain gradient GSendo − Gsepi showed an AUC of 0.79 (CI 0.69 to 0.89).
Conclusion
Layer-specific strain analysis demonstrated significantly reduced strain values in CA patients compared to FD. The analysis of GSendo held a high diagnostic accuracy to discriminate FD and CA in patients. The integration of layer-specific LV strain indices into the diagnostic work-up may improve the management of patients with an unclear thick heart pathology in future.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Alnylam Pharmaceuticals (Cambridge, MA, USA)
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Affiliation(s)
- T Steudel
- Charite University Hospital , Berlin , Germany
| | - I Mattig
- Charite University Hospital , Berlin , Germany
| | | | - G Barzen
- Charite University Hospital , Berlin , Germany
| | - D Frumkin
- Charite University Hospital , Berlin , Germany
| | - N Laule
- Charite University Hospital , Berlin , Germany
| | - M Al Daas
- Charite University Hospital , Berlin , Germany
| | - S Spethmann
- Charite University Hospital , Berlin , Germany
| | - F Knebel
- Charite University Hospital , Berlin , Germany
| | | | - K Stangl
- Charite University Hospital , Berlin , Germany
| | - K Hahn
- Charite University Hospital , Berlin , Germany
| | - A Brand
- Charite University Hospital , Berlin , Germany
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Mattig I, Steudel T, Romero Dorta E, Barzen G, Frumkin D, Laule N, Al-Daas M, Spethmann S, Stangl K, Knebel F, Canaan-Kuehl S, Hahn K, Brand A. New echocardiographic approaches to differentiate cardiac amyloidosis and Fabry disease: the right heart and mitral valve thickness. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Infiltrative cardiomyopathies such as cardiac amyloidosis (CA) and Fabry disease (FD) are associated with high cardiovascular morbidity and mortality. Diagnosis is often challenging as CA and FD may present similar cardiac phenotypes on standard echocardiographic imaging, especially in early stages of disease.
Purpose
Our study focuses on right ventricular (RV) two-dimensional speckle tracking imaging and mitral valve thickness as diagnostic strategies to discriminate CA from FD. Here, we report preliminary data of our study registry of CA and FD patients.
Methods
We retrospectively screened patients with diagnosed CA or with genetically confirmed FD from our study registry. Global and free wall RV strain and mitral leaflet thickening in both groups were analysed using 2D speckle tracking echocardiography and linear measurements from a parastenal long axis view, respectively (Vivid E9 or E95, GE Vingmed, Horton, Norway, M5S 1.5–4.5MHz transducer). The diagnostic accuracy for discriminating CA and FD in both groups was evaluated using receiver operating characteristic (ROC) curve analysis.
Results
A total of 33 FD and 27 CA patients, including 17 patients with wild-type transthyretin-related (ATTR) CA, 8 patients with hereditary ATTR CA, one patient with light chain CA, and one patient with AA CA, were included. RV function was significantly reduced in CA compared to FD patients as measured by global longitudinal RV strain (−13.6±5.1 in CA vs. −18.4±3.9 in FD, p<0.001) and free wall longitudinal RV strain (−17.5±5.7 in CA vs. −21.3±4.4 in FD, p=0.005). Significantly lower longitudinal RV strain was observed in the basal to mid ventricular region in CA compared to FD patients, while RV apical strain was not significantly different between the two groups. RV global longitudinal strain had the highest diagnostic accuracy of strain analyses (area under the curve [AUC] 0.79, 95% confidence interval [CI] 0.66–0.93) to discriminate CA from FD. Additional measurement of the mitral valve in mid diastole in the parasternal long axis view revealed a significantly thickened leaflet in CA patients (4.6±1.2 mm in CA vs. 2.9±1.0 mm in FD, p<0.001) corresponding to an AUC of 0.84 (95% CI 0.72–0.96) in ROC analysis.
Conclusion
Global longitudinal RV strain was significantly reduced in CA patients while the mitral valve leaflets were significantly thickened compared to FD patients. Therefore, both parameters may be useful to discriminate CA from FD in the echocardiographic workup of patients with unclear left ventricular wall thickening.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Alnylam Pharmaceuticals (Cambridge, MA, USA)
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Affiliation(s)
- I Mattig
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - T Steudel
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | | | - G Barzen
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - D Frumkin
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - N Laule
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - M Al-Daas
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - S Spethmann
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - K Stangl
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - F Knebel
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | | | - K Hahn
- Charite Universitatsmedizin Berlin , Berlin , Germany
| | - A Brand
- Charite Universitatsmedizin Berlin , Berlin , Germany
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Brand A, Crayen C, Hamann A, Martineck S, Gao L, Brand H, Squier S, Stangl K, Kendel F, Stangl V. Informed Consent before coronary angiography and percutaneous coronary intervention from the patient’s perspective: A picture is worth a thousand words. IJC Heart & Vasculature 2022; 41:101076. [PMID: 35800041 PMCID: PMC9254333 DOI: 10.1016/j.ijcha.2022.101076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Affiliation(s)
- A. Brand
- Charité – Universitätsmedizin Berlin, Department of Cardiology and Angiology, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
- Corresponding author at: Charité – Universitätsmedizin Berlin, Department of Cardiology and Angiology, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | - C. Crayen
- Freie Universität Berlin, Department of Education and Psychology, Habelschwerdter Allee 45, 14195 Berlin, Germany
| | - A. Hamann
- mintwissen – science communication agency and publishing house, Paulusstr. 11, 40237 Düsseldrof, Germany
| | - S. Martineck
- Sophia Martineck, Kollwitzstraße 52, 10405 Berlin, Germany
| | - L. Gao
- Charité – Universitätsmedizin Berlin, Department of Nephrology and Medical Intensive Care, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - H. Brand
- Charité – Universitätsmedizin Berlin, Institute of Gender in Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
| | - S.M. Squier
- The Pennsylvania State University, Brill Professor Emeritus of English and Women’s, Gender and Sexuality Studies, University Park, and Freie Universität Berlin, Einstein Visiting Fellow, PA 16802, United States
| | - K. Stangl
- Charité – Universitätsmedizin Berlin, Department of Cardiology and Angiology, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - F. Kendel
- Charité – Universitätsmedizin Berlin, Institute of Gender in Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
| | - V. Stangl
- Charité – Universitätsmedizin Berlin, Department of Cardiology and Angiology, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
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Zheng Q, Bertran A, Brand A, van Schaik CC, van de Ruitenbeek SJS, Smant G, Goverse A, Sterken MG. Comparative Transcriptome Analysis Reveals the Specific Activation of Defense Pathways Against Globodera pallida in Gpa2 Resistant Potato Roots. Front Plant Sci 2022; 13:909593. [PMID: 35783958 PMCID: PMC9248836 DOI: 10.3389/fpls.2022.909593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Cyst nematodes are considered a dominant threat to yield for a wide range of major food crops. Current control strategies are mainly dependent on crop rotation and the use of resistant cultivars. Various crops exhibit single dominant resistance (R) genes that are able to activate effective host-specific resistance to certain cyst nematode species and/or populations. An example is the potato R gene Gpa2, which confers resistance against the potato cyst nematode (PCN), Globodera pallida population D383. Activation of Gpa2 results in a delayed resistance response, which is characterized by a layer of necrotic cells formed around the developing nematode feeding structure. However, knowledge about the Gpa2-induced defense pathways is still lacking. Here, we uncover the transcriptional changes and gene expression network induced upon Gpa2 activation in potato roots infected with G. pallida. To this end, in vitro-grown Gpa2-resistant potato roots were infected with the avirulent population D383 and virulent population Rookmaker. Infected root segments were harvested at 3 and 6 dpi and sent for RNA sequencing. Comparative transcriptomics revealed a total of 1,743 differentially expressed genes (DEGs) upon nematode infection, of which 559 DEGs were specifically regulated in response to D383 infection. D383-specific DEGs associated with Gpa2-mediated defense mainly relates to calcium-binding activity, salicylic acid (SA) biosynthesis, and systemic acquired resistance (SAR). These data reveal that cyst nematode resistance in potato roots depends on conserved downstream signaling pathways involved in plant immunity, which are also known to contribute to R genes-mediated resistance against other pathogens with different lifestyles.
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Sukarta OCA, Zheng Q, Slootweg EJ, Mekken M, Mendel M, Putker V, Bertran A, Brand A, Overmars H, Pomp R, Roosien J, Boeren S, Smant G, Goverse A. GLYCINE-RICH RNA-BINDING PROTEIN 7 potentiates effector-triggered immunity through an RNA recognition motif. Plant Physiol 2022; 189:972-987. [PMID: 35218353 PMCID: PMC9157115 DOI: 10.1093/plphys/kiac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
The activity of intracellular plant nucleotide-binding leucine-rich repeat (NB-LRR) immune receptors is fine-tuned by interactions between the receptors and their partners. Identifying NB-LRR interacting proteins is therefore crucial to advance our understanding of how these receptors function. A co-immunoprecipitation/mass spectrometry screening was performed in Nicotiana benthamiana to identify host proteins associated with the resistance protein Gpa2, a CC-NB-LRR immune receptor conferring resistance against the potato cyst nematode Globodera pallida. A combination of biochemical, cellular, and functional assays was used to assess the role of a candidate interactor in defense. A N. benthamiana homolog of the GLYCINE-RICH RNA-BINDING PROTEIN7 (NbGRP7) protein was prioritized as a Gpa2-interacting protein for further investigations. NbGRP7 also associates in planta with the homologous Rx1 receptor, which confers immunity to Potato Virus X. We show that NbGRP7 positively regulates extreme resistance by Rx1 and cell death by Gpa2. Mutating the NbGRP7 RNA recognition motif (RRM) compromises its role in Rx1-mediated defense. Strikingly, ectopic NbGRP7 expression is likely to impact the steady-state levels of Rx1, which relies on an intact RRM. Our findings illustrate that NbGRP7 is a pro-immune component in effector-triggered immunity by regulating Gpa2/Rx1 function at a posttranscriptional level.
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Affiliation(s)
- Octavina C A Sukarta
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Qi Zheng
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Erik J Slootweg
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Mark Mekken
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Melanie Mendel
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Vera Putker
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - André Bertran
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Anouk Brand
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Hein Overmars
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Rikus Pomp
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Jan Roosien
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University & Research, Wageningen, The Netherlands
| | - Geert Smant
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
| | - Aska Goverse
- Laboratory of Nematology, Wageningen University & Research, Wageningen, The Netherlands
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Jasaityte R, Bajraktarevic R, Blaschke-Waluga D, Seeland U, Regitz-Zagrosek V, Stangl K, Knebel F, Stangl V, Brand A. Association of myocardial work indices with controlled arterial hypertension, age, weight and conventional echocardiographic parameters in women. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Objective
By incorporating myocardial deformation and afterload, novel echocardiographic myocardial work indices appear to be advantageous over the load-dependent left ventricular (LV) strain. As such, these indices might provide a better and load-independent estimation of LV function in patients with chronically increased afterload. To date, however, little is known about the relation of these indices to clinical and conventional echocardiographic parameters.
Purpose
Our aim was to evaluate the relationship between myocardial work indices and age, weight, conventional echocardiographic parameters, and the presence of previously defined well-controlled arterial hypertension (AH) in women without cardiovascular diseases.
Methods
We retrospectively analyzed echocardiographic data of women, included to the BEFRI (BErlin Female RIsk evaluation) trial. Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW) and Global Work Efficiency (GWE) were calculated using commercially available software based on noninvasive pressure-strain loops. Mulitvariate analysis of covariance was applied to investigate the relation of myocardial work indices with the above mentioned variables.
Results
A total of 224 women were included in the final analysis. 155 of them were normotensive and 69 had controlled AH. Women with AH were significantly older (67 ± 12 y. vs. 54 ± 13 y, p < 0.05), had higher blood pressure (136 ± 10/77 ± 6 mmHg vs. 121 ± 7/70 ± 6 mmHg, p < 0.05), higher body mass index (28 ± 5 kg/m² vs. 24 ± 4 kg/m², p < 0.05), thicker LV walls (septum: 12 ± 2 mm vs. 9 ± 1 mm; posterior wall: 11 ± 1 mm vs. 9 ± 1 mm, p < 0.05 for both), higher left atrial volume index (35 ± 8 ml/m² vs. 29 ± 5 ml/m², p < 0.05) and longer IVRT (103 ± 27 ms vs. 85 ± 24 ms, p < 0.05). LV ejection fraction, LV internal dimensions and TAPSE were within a normal range and did not differ between groups. Patients with AH showed lower global longitudinal strain (GLS) (19 ± 3% vs. 20 ± 2%, p < 0.05), higher GWI and GCW (2214 ± 285 mmHg% vs. 2045 ± 244 mmHg%, 2445 ± 316 mmHg% vs. 2256 ± 272 mmHg%; p < 0.05 for both) (Fig. 1), whereas GWW and GWE did not differ significantly (112 ± 59 mmHg% vs 101 ± 51 mmHg% and 95 ± 3% vs. 95 ± 2%). In the multivariate analysis GWI and GCW, but not GWW or GWE, were significantly positively associated with the presence of AH (s. Table). Besides that, GWI and GCW were positively related to LVEF and LVEDD. GWW showed negative relation to LVEF and a positive relation with IVRT. GWE was positively related to LVEF, and negatively to IVRT. None of the indices was significantly related to age.
Conclusion
We have defined the relationship of various myocardial work indices with weight, conventional echocardiographic parameters, and the presence of AH. The higher GWI and GCW in patients with AH might suggest higher energetic expenditure of myocardium due to increased afterload. The prognostic impact of these findings remains to be defined. Abstract Table.
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Affiliation(s)
- R Jasaityte
- Immanuel Clinic Bernau Heart Centre Brandenburg, Bernau, Germany
| | - R Bajraktarevic
- Charité – Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, berlin, Germany
| | - D Blaschke-Waluga
- Charité – Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, berlin, Germany
| | - U Seeland
- German Center for Cardiovascular Research, Berlin, Germany
| | - V Regitz-Zagrosek
- Charité - University Medicine Berlin, Institute of Gender in Medicine, Berlin, Germany
| | - K Stangl
- Charité – Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, berlin, Germany
| | - F Knebel
- Charité – Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, berlin, Germany
| | - V Stangl
- Charité – Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, berlin, Germany
| | - A Brand
- Charité – Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, berlin, Germany
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Brand A, Romero Dorta E, Blaschke-Waluga D, Wolf A, Stangl K, Seeland U, Regitz-Zagrosek V, Knebel F, Dreger H, Stangl V. Phasic left atrial strain to predict diastolic dysfunction development in women: results from the prospective Berlin Female Risk Evaluation (BEFRI) follow up trial. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Supported by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research)
OnBehalf
BEFRI
Background/Introduction: During the past few years, left atrial strain (LAS) has been identified to be significantly associated with left ventricular diastolic dysfunction (DD). However, the predictive value of LAS reductions on the course of DD in patients without or mild DD has so far not been investigated.
Purpose
To assess the predictive impact of phasic left atrial strain (LAS) reductions on the development of left ventricular (LV) diastolic function in women with normal (DD0) or mildly impaired diastolic function in a longitudinal study design.
Methods
We reinvited 449 participants of the Berlin Female Risk Evaluation (BEFRI) study for follow-up examinations. A comprehensive clinical and echocardiographic assessment comprising the analysis of phasic LAS was performed in 256 participants. The diagnostic and predictive value of LAS analysis was assessed and compared with standard echocardiographic DD parameters using receiver operating characteristic (ROC) curve analyses and a multivariate logistic regression model.
Results
After a mean time interval of 6.8 years, subjects with DD0 at baseline investigation and a worsening of diastolic function of at least one stage according to recent ASE / EACVI recommendations (DD_progress) showed a significantly reduced baseline LA reservoir strain (LASr) and conduit strain (LAScd) [LASr 28.1% (6.9) in DD_progress vs. 41.9% (8.5) in DD0 at follow up; and LAScd -13.2% (5.0) in DD_progress vs. -25.4% (9.1) in DD0 at follow up; p < 0.001 respectively]. With an area under the curve (AUC) of 0.89 [95% confidence interval (CI) 0.83-0.94], and 0.85 (95% CI 0.80-0.90), LASr and LAScd showed the highest discriminative value to predict DD_progress while the echocardiographic standard DD parameter left atrial volume index (LAVI) featured a limited predictive diagnostic accuracy [AUC of 0.65 (95%CI 0.52-0.72)]. In a multivariate logistic regression model controlling for age, BMI, and other standard echocardiographic DD parameters including LAVI, only LASr and LAScd remained significantly associated with DD_progress over time.
Conclusions
In addition to improving the diagnostic accuracy of the current DD algorithm, the analysis of phasic LAS reductions may be useful to predict the development of DD in previously healthy women.
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Affiliation(s)
- A Brand
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
| | - E Romero Dorta
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
| | - D Blaschke-Waluga
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
| | - A Wolf
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
| | - K Stangl
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
| | - U Seeland
- Charite - Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - V Regitz-Zagrosek
- Charité - Universitätsmedizin Berlin, Institute of Gender in Medicine, Berlin, Germany
| | - F Knebel
- Sana Klinikum Lichtenberg , Clinical of Internal Medicine II - Cardiology, Berlin, Germany
| | - H Dreger
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
| | - V Stangl
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology , Berlin, Germany
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Frumkin D, Knebel F, Stangl K, Mattig I, Laule N, Canaan-Kuehl S, Brand A. Comparative analysis of phasic left atrial strain and left ventricular posterolateral strain to discriminate Fabry cardiomyopathy from other forms of left ventricular hypertrophy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
“Classic” echocardiographic signs of Fabry cardiomyopathy (FC), such as left ventricular hypertrophy (LVH) and posterolateral strain deficiency (PLSD) have a low diagnostic accuracy in clinical practice.
Purpose
Our aim was to evaluate the diagnostic accuracy of phasic left atrial strain impairment compared to PLSD to discriminate FC from other forms of LVH.
Methods
40 patients with LVH due to bioptically and genetically confirmed FC or with LVH due to other causes, defined by exclusion of storage diseases, such as Amyloidosis or FC, by myocardial biopsy, were retrospectively analysed. Standard echocardiographic views (Vivid E9, GE, Vingmed, Horton) were used to analyse left atrial (LA) reservoir, conduit, and contraction strain using 2D speckle tracking echocardiography (2DSTE; EchoPAC software, GE) as well as the PLSD, obtained by the mean of deformation values in basal posterior and lateral segments in a 17-segment model. Receiver operating characteristic (ROC) curve analysis and a logistic regression model were performed to assess the diagnostic accuracy of LA and LV strain impairment.
Results
FC was confirmed in 20 patients by genetic testing and myocardial biopsy. In the LVH group, 12 patients were classified to have hypertrophic cardiomyopathy, two had hypertensive heart disease, and six expressed the pattern of LV hypertrophy combined with borderline myocarditis. LV septum thickness (15.8mm±3.4 in FC; 17.9mm±4.3 in LVH) and left atrial volume index (LAVI) (36.7ml/m2±11.3 in FC; 45.7ml/m2±16.3 in LVH) as well as LVEF (54.2%± 9.8 in FC; 52.5%±7.7 in LVH,) were not statistically different between groups. LV filling parameters such as E/A (1.2±0.5 in FC; 1.2±0.7 in LVH) and E/e' (11.0±4.9 in FC; 13.2±5.3 in LVH) showed a slightly more advanced impairment in the LVH group.
Global and regional LV function was not different between groups (LVGLS −13.8±3.7% in FC and −12.8±3.7% in LVH; PLSD −10.7±5.2% in FC and −8.85±3.9% in LVH; p-value?). LA reservoir strain (LASr) and LA conduit strain (LAScd) were significantly impaired in FC compared to the LVH group (LASr 14,6±2.5% in FC and 26.3±8.5% in LVH, p<0.01; LAScd −5.9±2.6% in FC and −15.8±4.7% in LVH, p<0.01). In ROC analysis, LASr, with an area under the curve (AUC) of 0.81 (95% CI 0.64–0.97) and LAScd with an AUC of 0.85 (95% CI 0.71–0.99), respectively, showed the highest diagnostic accuracy to discriminate FC. PLSD, in contrast, held a low diagnostic accuracy with an AUC of only 0.47 (95% CI 0.27–0.68).
Conclusion
A substantially higher diagnostic accuracy could be shown for LASr and LAScd impairment in discriminating FD and other forms of LVH compared to PLSD. The echocardiographic assessment of phasic LA strain may help to identify FC in patients with unclear LVH.
Funding Acknowledgement
Type of funding sources: None. ROC analysisRepresentative examples
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Affiliation(s)
- D Frumkin
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - F Knebel
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - K Stangl
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - I Mattig
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - N Laule
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - S Canaan-Kuehl
- Charite - Campus Virchow-Klinikum (CVK), Berlin, Germany
| | - A Brand
- Charite - Campus Mitte (CCM), Berlin, Germany
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Brand A, Gao L, Dreger H, Hamann A, Crayen C, Brand H, Squier SM, Stangl K, Kendel F, Stangl V. Effects of medical graphic narratives (patient comic) on Patient Reported Outcome Measures (PROMs) in patients undergoing coronary angiography and PCI. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Increasing evidence suggests that patients scheduled for invasive cardiac procedures such as coronary angiography / PCI feel insufficiently informed about the planned procedure.
Purpose
To improve the Patient Informed Consent (IC) before coronary angiography by using “medical graphic narratives” (patient comic) that illustrate central IC-related aspects in a simple and understandable manner.
Methods
A patient comic illustrating central steps of the procedure, risks, treatment alternatives and behavioural measures was created in collaboration with professional scientific visual communicators. In a randomised, controlled, prospective trial, we included 121 patients undergoing coronary angiography/PCI. Patients were randomised to a group that was informed about the procedure using the usual Patient IC approach (official consent form and conversation with physician; Control group) or a group that additionally obtained a patient comic for reading (graphic illustrations of central IC aspects based on the official consent form; Comic group). Patient Reported Outcome Measures (PROMs), i.e. satisfaction with and perceived quality of the patient IC, were tested in both groups comparing single items of the Client Satisfaction Questionnaire-8 (CSQ-8) and self-designed single items in both IC groups. Differences were compared using the Fisher's exact test. A p-value <0.05 was considered statistically significant.
Results
PROMs showed significant benefits in favour of the Comic group: Quality of the patient IC was perceived to be “very good” in 45.0% of the Comic group compared to 24.9% of patients in the Control group (p=0.023). Only 23.0% of the patients in the Control group, compared to 40.0% in the Comic group, stated that the IC procedure completely met their expectations (p=0.012). 57.4% in the Control group and 76.7% in the Comic group stated that all of their questions were satisfactorily adressed before the procedure (p=0.015). 43.3% in the Comic group, in contrast to 18.0% in the Control group, declared to feel “very satisfied” with the obtained IC procedure (p=0.002). The acceptance of the patient comic was very high: no patient (0%) expressed feelings of not being taken seriously by reading the patient comic.
Conclusions
Our data confirm pronounced limitations of the usual Patient IC practice before coronary angiography. The use of a patient comic that narratively illustrates central steps of the procedure positively impacts on patient-centered endpoints and significantly improves the patient IC procedure.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Friede Springer Herz Stiftung
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Affiliation(s)
- A Brand
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, Berlin, Germany
| | - L Gao
- Charite Universitatsmedizin Berlin, Department of Nephrology, Berlin, Germany
| | - H Dreger
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, Berlin, Germany
| | - A Hamann
- mintwissen – science communication agency and publishing house, Berlin, Germany
| | - C Crayen
- Freie Universität, Department of Education and Psychology, Berlin, Germany
| | - H Brand
- Charité - Universitätsmedizin Berlin, Institute of Gender in Medicine, Berlin, Germany
| | - S M Squier
- The Pennsylvania State University, English and Women's, Gender and Sexuality Studies, Pennsylvania, United States of America
| | - K Stangl
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, Berlin, Germany
| | - F Kendel
- Charité - Universitätsmedizin Berlin, Institute of Gender in Medicine, Berlin, Germany
| | - V Stangl
- Charité - Universitätsmedizin Berlin, Campus Mitte, Department of Cardiology and Angiology, Berlin, Germany
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Frumkin D, Pietron M, Kind A, Leistner D, Krackhardt F, Laule M, Brand A, Knebel F, Lembcke A, Landmesser U, Stangl K, Dreger H. Long-term morphological appearance of transcatheter valves left in the ascending aorta after valve dislocation during transcatheter aortic valve implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Transcatheter valve embolization and migration (TVEM) is a potential complication of transcatheter aortic valve implantation (TAVI) (1). Registries suggest low incidence but clinical relevance due to increased acute and mid-term mortality with the majority embolizing in the aorta. However, there is little data on potential late complications such as leaflet and stent thrombosis or aortic wall alterations by migrated valves.
Purpose
The aim of our study was to analyze the incidence and clinical characteristics of TVEM in a large single center cohort of TAVI patients and to examine dislocated valves by ECG-gated computed tomography (CT).
Methods and results
Between July 2009 and May 2020, 40 TVEM occurred in 3387 TAVI procedures performed in our center (1.18%). TVEM was defined according to Valve Academic Research Consortium-2 (VARC-2) criteria (3). Majority of TVEM were left in the ascending aorta (31 ascending, 3 arch, 1 descending aorta). 90% of TVEM occurred with a self-expanding valve (SEV), with no difference between older and newer valve generations, 10% with a ballon-expandable valve. Analyzing a TAVI sample cohort (n=200), horizontal aorta (p<0.001, OR 11.7, 95% CI: [3.9:34.8]), defined as aortic angulation >48°(4), as well as the use of SEV (p<0.001, OR 12.8, 95% CI: [3.1:53.9]) were identified as a predisposing risk factor for TVEM. OR in SEV was severely increased when isolating the analysis for patients with horizontal aorta only (p=0.003, OR 23.75, 95% CI: [2.8:129]). No other predisposing risk factors were identified in this cohort. Out of 35 patients still alive, 6 patients were willing to participate in our imaging sub-study. CT exams were performed on average 47 months after TAVI (IQR 50 months [25%Q: 16.8, 75%Q: 72.8]). We detected no leaflet or stent thrombosis, yet CT identified pin protrusions in the aorta in 3 out of 6 patients.
Conclusions
TVEM is a rare complication of TAVI. TVEM was significantly associated to the use of self-expanding valves and the presence of horizontal aorta. CT did detect pin protrusions in several cases which could bear the possible risk of perforation but showed no signs of long-term damage.
Funding Acknowledgement
Type of funding sources: None. Representative CT images after TVEM
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Affiliation(s)
- D Frumkin
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - M Pietron
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - A Kind
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - D Leistner
- Charite - Campus Benjamin Franklin, Berlin, Germany
| | - F Krackhardt
- Charite - Campus Virchow-Klinikum (CVK), Berlin, Germany
| | - M Laule
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - A Brand
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - F Knebel
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - A Lembcke
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - U Landmesser
- Charite - Campus Benjamin Franklin, Berlin, Germany
| | - K Stangl
- Charite - Campus Mitte (CCM), Berlin, Germany
| | - H Dreger
- Charite - Campus Mitte (CCM), Berlin, Germany
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Brand A, De Angelis V, Vuk T, Garraud O, Lozano M, Politis D. Review of indications for immunoglobulin (IG) use: Narrowing the gap between supply and demand. Transfus Clin Biol 2021; 28:96-122. [DOI: 10.1016/j.tracli.2020.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Schofield P, Gough K, Pascoe M, Bergin R, White K, Mileshkin L, Bernshaw D, Kinnane N, Jackson M, Do V, Brand A, Aranda S, Cheuk R, Drosdowsky A, Penberthy S, Juraskova I. A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial – ANZGOG 1102. Gynecol Oncol 2020; 159:785-793. [DOI: 10.1016/j.ygyno.2020.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/08/2020] [Indexed: 12/01/2022]
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Amburgey SM, Miller DAW, Brand A, Dietrich A, Campbell Grant EH. Knowing your limits: estimating range boundaries and co‐occurrence zones for two competing plethodontid salamanders. Ecosphere 2019. [DOI: 10.1002/ecs2.2727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- S. M. Amburgey
- Department of Ecosystem Sciences and Management The Pennsylvania State University University Park Pennsylvania 16802 USA
- Intercollege Graduate Ecology Program The Pennsylvania State University University Park Pennsylvania 16802 USA
| | - D. A. W. Miller
- Department of Ecosystem Sciences and Management The Pennsylvania State University University Park Pennsylvania 16802 USA
| | - A. Brand
- USGS Patuxent Wildlife Research Center SO Conte Anadromous Fish Research Center Turners Falls Massachusetts 01376 USA
| | - A. Dietrich
- USGS Patuxent Wildlife Research Center Laurel Maryland 20708 USA
| | - E. H. Campbell Grant
- USGS Patuxent Wildlife Research Center SO Conte Anadromous Fish Research Center Turners Falls Massachusetts 01376 USA
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Lindner A, Brand A. GPS- and stopwatch-determined running speeds of horses differ. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hogervorst EK, Rosseel PMJ, van de Watering LMG, Brand A, Bentala M, van der Meer BJM, van der Bom JG. Prospective validation of the EuroSCORE II risk model in a single Dutch cardiac surgery centre. Neth Heart J 2018; 26:540-551. [PMID: 30232783 PMCID: PMC6220016 DOI: 10.1007/s12471-018-1161-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objective The EuroSCORE I was one of the most frequently used pre-operative risk models in cardiac surgery. In 2011 it was replaced by its successor the EuroSCORE II. This study aims to validate the EuroSCORE II and to compare its performance with the EuroSCORE I in a Dutch hospital. Methods The EuroSCORE II was prospectively validated in 2,296 consecutive cardiac surgery patients between 1 April 2012 and 1 January 2014. Receiver operating characteristic curves on in-hospital mortality were plotted for EuroSCORE I and EuroSCORE II, and the area under the curve was calculated to assess discriminative power. Calibration was assessed by comparing observed versus expected mortality. Additionally, analyses were performed in which we stratified for type of surgery and for elective versus emergency surgery. Results The observed mortality was 2.4% (55 patients). The discriminative power of the EuroSCORE II surpassed that of the EuroSCORE I (area under the curve EuroSCORE II 0.871, 95% confidence interval (CI) 0.832–0.911; area under the curve additive EuroSCORE I 0.840, CI 0.798–0.882; area under the curve logistic EuroSCORE I 0.761, CI 0.695–0.828). Both the additive and the logistic EuroSCORE I overestimated mortality (predictive mortality additive EuroSCORE I median 5.0%, inter-quartile range 3.0–8.0%; logistic EuroSCORE I 10.7%, inter-quartile range 5.8–13.9), while the EuroSCORE II underestimated mortality (median 1.6%, inter-quartile range 1.0–3.5). In most stratified analyses the EuroSCORE II performed better. Conclusion Our results show that the EuroSCORE II produces a valid risk prediction and outperforms the EuroSCORE I in elective cardiac surgery patients.
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Affiliation(s)
- E K Hogervorst
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands. .,Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands. .,Department of Anaesthesiology, University of Groningen, Groningen, The Netherlands. .,University Medical Centre Groningen, Groningen, The Netherlands.
| | - P M J Rosseel
- Department of Anaesthesia and Intensive Care, Amphia Hospital, Breda, The Netherlands
| | - L M G van de Watering
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.,Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands
| | - A Brand
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.,Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands
| | - M Bentala
- Department of Anaesthesia and Intensive Care, Amphia Hospital, Breda, The Netherlands
| | - B J M van der Meer
- Department of Anaesthesia and Intensive Care, Amphia Hospital, Breda, The Netherlands.,TIAS, Tilburg University, Tilburg, The Netherlands
| | - J G van der Bom
- Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.,Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
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Nagle C, Crosbie E, Brand A, Obermair A, Oehler M, Quinn M, Leung Y, Spurdle A, Webb P. The association between diabetes, comorbidities, body mass index and all-cause and cause-specific mortality among women with endometrial cancer. Gynecol Oncol 2018; 150:99-105. [DOI: 10.1016/j.ygyno.2018.04.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/04/2018] [Accepted: 04/06/2018] [Indexed: 01/10/2023]
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Kouskouti C, Evangelatos N, Brand A, Kainer F. Maternal sepsis in the era of genomic medicine. Arch Gynecol Obstet 2017; 297:49-60. [PMID: 29103195 DOI: 10.1007/s00404-017-4584-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 10/26/2017] [Indexed: 12/23/2022]
Abstract
PURPOSE Maternal sepsis remains one of the leading causes of direct and indirect maternal mortality both in high- and low-income environments. In the last two decades, systems biology approaches, based on '-omics' technologies, have started revolutionizing the diagnosis and management of the septic syndrome. The scope of this narrative review is to present an overview of the basic '-omics' technologies, exemplified by cases relevant to maternal sepsis. METHODS Narrative review of the new '-omics' technologies based on a detailed review of the literature. RESULTS After presenting the main 'omics' technologies, we discuss their limitations and the need for integrated approaches that encompass research efforts across multiple '-omics' layers in the '-omics' cascade between the genome and the phenome. CONCLUSIONS Systems biology approaches are revolutionizing the research landscape in maternal sepsis. There is a need for increased awareness, from the side of health practitioners, as a requirement for the effective implementation of the new technologies in the research and clinical practice in maternal sepsis.
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Affiliation(s)
- C Kouskouti
- Department of Obstetrics and Perinatal Medicine, Klinik Hallerwiese, St. Johannis-Mühlgasse 19, 90419, Nuremberg, Germany.
| | - N Evangelatos
- Intensive Care Medicine Unit, Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University, Nuremberg, Germany.,UNU-MERIT (Maastricht Economic and Social Research Institute on Innovation and Technology), Maastricht University, Boschstraat 24, 6211 AX, Maastricht, The Netherlands
| | - A Brand
- Public Health Genomics, Department International Health, Maastricht University, Duboisdomain 30, 6229 GT, Maastricht, The Netherlands.,Professorial Fellow, UNU-MERIT (Maastricht Economic and Social Research Institute on Innovation and Technology), Maastricht University, Boschstraat 24, 6211 AX, Maastricht, The Netherlands.,Dr. TMA Pai Endowed Chair Public Health Genomics, Manipal University, Madhav Nagar, Manipal, Karnataka, 576104, India
| | - F Kainer
- Department of Obstetrics and Perinatal Medicine, Klinik Hallerwiese, St. Johannis-Mühlgasse 19, 90419, Nuremberg, Germany
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20
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Brand A, Claas FHJ, Bontrop RE, de Vries RRP. Obituary: Prof Johannes Joseph van Rood (1926-2017). Vox Sang 2017. [DOI: 10.1111/vox.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Brand
- Jon van Rood Center for Transfusion Science; Leiden The Netherlands
- Department of Immunohematology and Blood Transfusion; LUMC; Leiden The Netherlands
| | - F. H. J. Claas
- Department of Immunohematology and Blood Transfusion; LUMC; Leiden The Netherlands
| | - R. E. Bontrop
- Biomedical Primate Research Centre; Rijswijk The Netherlands
| | - R. R. P. de Vries
- Department of Immunohematology and Blood Transfusion; LUMC; Leiden The Netherlands
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Bontrop RE, Brand A, Claas FHJ. Prof. Dr. Johannes Joseph van Rood (1926-2017). HLA 2017. [PMCID: PMC5639368 DOI: 10.1111/tan.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- R. E. Bontrop
- Biomedical Primate Research Centre Rijswijk; Rijswijk The Netherlands
| | - A. Brand
- Jon van Rood National Center for Clinical Transfusion Science; Leiden The Netherlands
| | - F. H. J. Claas
- Department of Immunohematology; LUMC; Leiden The Netherlands
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Brand A, Claas F, Voogt P, Wasser M, Eernisse J. Alloimmunization after Leukocyte-Depleted Multiple Random
Donor Platelet Transfusions. Vox Sang 2017. [DOI: 10.1159/000461792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Novotny V, Kanhai H, Overbeeke M, Schlaman-Nijp A, Harvey M, Brand A. Misleading Results in the Determination of Haemolytic Disease of the Newborn Using Antibody Titration and ADCC in a Woman with Anti-Lu^b. Vox Sang 2017. [DOI: 10.1159/000462163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kanhai H, BeBennebroek Gravenhorst J, van Kamp I, Meerman R, Brand A, Dohmen-Feld M, Ruys J. Management of Severe Hemolytic Disease with Ultrasound-Guided Intravascular Fetal Transfusions. Vox Sang 2017. [DOI: 10.1159/000461197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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McGee J, Bookman M, Harter P, Marth C, McNeish I, Moore K, Poveda A, Hilpert F, Hasegawa K, Bacon M, Gatsonis C, Brand A, Kridelka F, Berek J, Ottevanger N, Levy T, Silverberg S, Kim BG, Hirte H, Okamoto A, Stuart G, Ochiai K. Fifth Ovarian Cancer Consensus Conference: individualized therapy and patient factors. Ann Oncol 2017; 28:702-710. [DOI: 10.1093/annonc/mdx010] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Indexed: 12/13/2022] Open
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Wang R, Brand A, Achan A, Sharma R. Ganglioglioma arising in an ovarian cystic teratoma. Pathology 2017. [DOI: 10.1016/j.pathol.2016.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Man J, Khoo C, Gao B, Fereday S, Hung J, Group A, Harnett P, Bowtell D, Brand A, Defazio A. Lymph node dissection in early epithelial ovarian cancer (EOC) – Results from a population based study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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van Hout F, Hogervorst EK, Rosseel PMJ, van der Bom JG, Bentala M, Brand A, van der Meer NJM, van de Watering LMG. The independent effect of a platelet transfusion on bleeding and adverse outcomes in cardiac surgery. J Cardiothorac Vasc Anesth 2016. [DOI: 10.1053/j.jvca.2016.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bank I, Wiersum-Osselton JC, Van Walraven SM, Netelenbos T, Fechter M, Marijt-van der Kreek T, Bär BMAM, Van der Bom JG, Brand A. Donors' health state the year after peripheral haematopoietic progenitor cell collection: A prospective follow-up study in related and unrelated donors compared to first-time platelet donors. J Clin Apher 2016; 31:523-528. [PMID: 26812941 DOI: 10.1002/jca.21444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/09/2015] [Indexed: 11/10/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF) mobilized peripheral haematopoietic progenitor cells collected by apheresis (HPC-A) are the most common source used for allogeneic hematopoietic stem cell transplantation (HSCT). Retrospective short and long-term donor follow-up studies show very low risks of serious complications and do not report compelling evidence of increased cancer occurrence. Some studies reported a prolonged period of leucopenia without an obvious association with infectious complications. However, beyond the first few weeks after the procedure a relationship between events is elusive. We therefore evaluated medical service utilization by prospectively recruited HPC-A donors and first-time platelet apheresis donors for comparison for 1 year after donation. Data were prospectively collected using questionnaires and by medical record review. A total of 215 HPC-A donors (111 unrelated donors and 104 related donors) and 96 first-time platelet donors consented to participation in the study. Follow-up was available for 202 (96%): questionnaires were returned by 74% and records from nonstudy contacts were available for 94% of donors. During the 1-year follow-up, 94 of the donors who returned questionnaires sought medical attention for diagnostic evaluation and/or treatment: 41% of HPC-A donors and 40% of platelet donors. Medical service utilization the first year after HPC-A donation is similar to that after first-time platelet donation. The occurrence of serious medical conditions in both related and unrelated HPC-A donors underscores the importance of participation in long-term follow-up in large cohorts. The findings in this relatively small cohort contribute to evidence on the safety of G-CSF mobilization and HPC-A. J. Clin. Apheresis 31:523-528, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- I Bank
- Sanquin - LUMC Jon J. Van Rood Centre for Clinical Transfusion Research, Leiden, the Netherlands.,Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, the Netherlands
| | - J C Wiersum-Osselton
- Donor Services Unit, Sanquin Blood Supply, Leiden, the Netherlands.,TRIP Hemovigilance and Biovigilance Office, Leiden, the Netherlands
| | - S M Van Walraven
- TRIP Hemovigilance and Biovigilance Office, Leiden, the Netherlands.,Europdonor Foundation, Leiden, the Netherlands
| | - T Netelenbos
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, the Netherlands
| | - M Fechter
- Europdonor Foundation, Leiden, the Netherlands
| | | | - B M A M Bär
- Stem Cell Donor Bank Europdonor Nijmegen, Nijmegen, the Netherlands
| | - J G Van der Bom
- Sanquin - LUMC Jon J. Van Rood Centre for Clinical Transfusion Research, Leiden, the Netherlands
| | - A Brand
- Sanquin - LUMC Jon J. Van Rood Centre for Clinical Transfusion Research, Leiden, the Netherlands.,Europdonor Foundation, Leiden, the Netherlands
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Tavilla G, Bruggemans EF, Gielen CLI, Brand A, van den Hout WB, Klautz RJM, van Hilten JA. Multicentre randomized clinical trial to investigate the cost-effectiveness of an allogeneic single-donor fibrin sealant after coronary artery bypass grafting (FIBER Study). Br J Surg 2015; 102:1338-47. [PMID: 26265447 DOI: 10.1002/bjs.9877] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 04/02/2015] [Accepted: 05/18/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Reduction of blood transfusion in cardiac surgery is an important target. The aim of this study was to investigate the cost-effectiveness of the use of CryoSeal®, an allogeneic single-donor fibrin sealant, in patients undergoing coronary artery bypass grafting (CABG). METHODS This randomized clinical study involved seven cardiac surgery centres in the Netherlands. Patients undergoing elective isolated CABG with the use of at least one internal thoracic artery (ITA) graft were assigned randomly to receive either CryoSeal® (5 ml per ITA bed) or no CryoSeal®. Primary efficacy endpoints were units of transfused red blood cells, fresh frozen plasma and platelet concentrates, and duration of intensive care unit stay. Secondary efficacy endpoints were 48-h blood loss, reoperation for bleeding, mediastinitis, 30-day mortality and duration of hospital stay. RESULTS Between March 2009 and January 2012, 1445 patients were randomized. The intention-to-treat (ITT) population comprised 1436 patients; the per-protocol (PP) population 1292. In both the ITT and the PP analysis, no significant difference between the treatment groups was observed for any of the primary and secondary efficacy endpoints. In addition, no significant difference between the groups was seen in the proportion of transfused patients. Estimated CryoSeal® costs were €822 (95 per cent c.i. €808 to €836) per patient, which translated to €72,000 per avoided transfusion (unbounded 95 per cent c.i.). CONCLUSION The use of the fibrin sealant CryoSeal® did not result in health benefits. Combined with the high cost per avoided transfusion, this study does not support the implementation of routine CryoSeal® use in elective isolated CABG. REGISTRATION NUMBER NTR1386 ( http://www.trialregister.nl).
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Affiliation(s)
- G Tavilla
- Departments of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - E F Bruggemans
- Departments of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - C L I Gielen
- Departments of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - A Brand
- Centre of Clinical Transfusion Research, Sanquin Blood Supply, Leiden, The Netherlands
| | - W B van den Hout
- Departments of Medical Decision-Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - R J M Klautz
- Departments of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - J A van Hilten
- Centre of Clinical Transfusion Research, Sanquin Blood Supply, Leiden, The Netherlands
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Affiliation(s)
- A Brand
- Department of Immunohaematology, Leiden University Hospital, The Netherlands
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Röckel A, Brand A, Bechinger W, Heidland A. Effects of acute haemodialysis-induced changes in sodium balance upon experimentally hypertensive rats. Contrib Nephrol 2015; 19:139-47. [PMID: 6991209 DOI: 10.1159/000428772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In two-kidney Goldblatt hypertensive, spontaneously hypertensive, and normotensive control rats, the activity of the renin-angiotensin system was tested during variation of sodium balance. Acute, exactly calculable and selective changes in total body sodium were achieved by haemodialysing conscious rats, using dialysates with high and low sodium contents. The activity of the renin-angiotensin system was evaluated by blood pressure response to angiogtensin II blockade (saralasin bolus injection; 25 micrograms/kg b.w., i.v.) and plasma renin activity. During sodium-depletion, blood pressure maintenance became renin-dependent; sodium-loading caused a decrease of renin-angiotensin activity in renovascular hypertension. A weak direct correlation between depressor response to saralasin and the plasma renin activity could be established in the different sodium-depleted and sodium-loaded states.
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Abstract
INTRODUCTION This article is part of a Focus Theme of Methods of Information in Medicine on Health Record Banking. BACKGROUND Healthcare is often ineffective and costs are steadily rising. This is in a large part due to the inaccessibility of medical and health data stored in multiple silos. Furthermore, in most cases molecular differences between individuals that result in different susceptibilities to drugs and diseases as well as targeted interventions cannot be taken into account. Technological advances in genome sequencing and the interaction of 'omics' data with environmental data on one hand and mobile health on the other, promise to generate the longitudinal health data that will form the basis for a more personalized, precision medicine. OBJECTIVES For this new medicine to become a reality, however, millions of personal health data sets have to be aggregated. The value of such aggregated personal data has been recognized as a new asset class and many commercial entities are competing for this new asset (e.g. Google, Facebook, 23andMe, PatientsLikeMe). The primary source and beneficiary of personal health data is the individual. As a collective, society should be the beneficiary of both the economic and health value of these aggregated data and (health) information. METHODS We posit that empowering citizens by providing them with a platform to safely store, manage and share their health-related data will be a necessary element in the transformation towards a more effective and efficient precision medicine. Such health data platforms should be organized as cooperatives that are solely owned and controlled by their members and not by shareholders. Members determine which data they want to share for example with doctors or to contribute to research for the benefit of their health and that of society. Members will also decide how the revenues generated by granting third parties access to the anonymized data that they agreed to share, should be invested in research, information or education. RESULTS Currently no functional Health Data Cooperatives exist yet. The relative success of health data repositories such as 23andme and PatientsLikeMe indicates that citizens are willing to participate in research even if - and in contrast to the cooperative model - the commercial value of these data does not go back to the collective of users. CONCLUSIONS In the Health Data Cooperative model, the citizens with their data would take the center stage in the healthcare system and society would benefit from the health-related and financial benefits that aggregation of these data brings.
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Affiliation(s)
- E Hafen
- Ernst Hafen, Institute of Molecular Systems Biology, ETH Zurich, 8093 Zurich, Switzerland, E-mail:
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Milne R, La Vecchia C, Van Steen K, Hahn S, Buchholz M, Costello E, Esposito I, Hoheisel JD, Lange B, Lopez-Bigas N, Michalski CW, Real FX, Brand A, Malats N. EU Pancreas: an integrated European platform for pancreas cancer research--from basic science to clinical and public health interventions for a rare disease. Public Health Genomics 2014; 16:305-12. [PMID: 24503591 DOI: 10.1159/000355937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Large-scale international collaboration is essential to decipher relevant information in the context of omics-scale interrogations in cancer research. This is even more important for rare and fatal diseases like pancreas cancer (PC). METHODS The COST Action BM1204 is a unique platform to facilitate the collaboration of a broad range of European and international PC multidisciplinary research groups in order to: (1) integrate knowledge and experience in a multidisciplinary way 'from cell to society', (2) promote the application of uniform study tools and protocols, (3) foster their optimal use by early-stage researchers, (4) enhance the mobility and training of researchers, and (5) disseminate the results produced to the broader society. RESULTS This Action will develop novel interdisciplinary tools for collaborative research to improve our understanding of PC and its prevention, diagnosis and treatment. It also aims to answer questions related to the etiology, early detection, evidence-based and personalized treatment, and health management for PC. Furthermore, the Action will contribute to new insights into PC personalized medicine and beyond as well as to the understanding of complex and rare diseases taking PC as a best practice example. The Action aims at attracting young scholars across a range of disciplines in collaboration with more experienced researchers and enhancing active European participation in the international scenario of PC research. CONCLUSION The ultimate aim is to foster PC research in Europe and to coordinate this effort with other international initiatives to reduce disease mortality.
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Affiliation(s)
- R Milne
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
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Rieber N, Wecker I, Neri D, Fuchs K, Schäfer I, Brand A, Pfeiffer M, Lang P, Bethge W, Amon O, Handgretinger R, Hartl D. Extracorporeal photopheresis increases neutrophilic myeloid-derived suppressor cells in patients with GvHD. Bone Marrow Transplant 2014; 49:545-52. [DOI: 10.1038/bmt.2013.236] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 12/13/2013] [Accepted: 12/13/2013] [Indexed: 11/09/2022]
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Taruscio D, Morciano C, Laricchiuta P, Mincarone P, Palazzo F, Leo CG, Sabina S, Guarino R, Auld J, Sejersen T, Gavhed D, Ritchie K, Hilton-Boon M, Manson J, Kanavos PG, Tordrup D, Tzouma V, Le Cam Y, Senecat J, Filippini G, Minozzi S, Del Giovane C, Schünemann H, Meerpohl JJ, Prediger B, Schell L, Stefanov R, Iskrov G, Miteva-Katrandzhieva T, Serrano-Aguilar P, Perestelo-Perez L, Trujillo-Martín MM, Pérez-Ramos J, Rivero-Santana A, Brand A, van Kranen H, Bushby K, Atalaia A, Ramet J, Siderius L, Posada M, Abaitua-Borda I, Ferreira V, Hens-Pérez M, Manzanares FJ. RARE-Bestpractices: a platform for sharing best practices for the management of rare diseases. Orphanet J Rare Dis 2014. [PMCID: PMC4249596 DOI: 10.1186/1750-1172-9-s1-o14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rieber N, Brand A, Neri D, Hall T, Schäfer I, Hansmann S, Kümmerle-Deschner J, Hartl D. PW02-042 - Induction of MDSC in Muckle-Wells syndrome. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952133 DOI: 10.1186/1546-0096-11-s1-a183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cases M, Furlong LI, Albanell J, Altman RB, Bellazzi R, Boyer S, Brand A, Brookes AJ, Brunak S, Clark TW, Gea J, Ghazal P, Graf N, Guigó R, Klein TE, López-Bigas N, Maojo V, Mons B, Musen M, Oliveira JL, Rowe A, Ruch P, Shabo A, Shortliffe EH, Valencia A, van der Lei J, Mayer MA, Sanz F. Improving data and knowledge management to better integrate health care and research. J Intern Med 2013; 274:321-8. [PMID: 23808970 PMCID: PMC4110348 DOI: 10.1111/joim.12105] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- M Cases
- Research Programme on Biomedical Informatics (GRIB), IMIM, DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
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Brand A. Public health genomics and personalized healthcare. Clin Ther 2013. [DOI: 10.1016/j.clinthera.2013.07.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bradley MT, Brand A. ALPHA VALUES AS A FUNCTION OF SAMPLE SIZE, EFFECT SIZE, AND POWER: ACCURACY OVER INFERENCE 1. Psychol Rep 2013. [DOI: 10.2466/03.49.pr0.112.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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de Viron S, Malats N, Van der Heyden J, Van Oyen H, Brand A. Environmental and Genomic Factors as well as Interventions Influencing Smoking Cessation: A Systematic Review of Reviews and a Proposed Working Model. Public Health Genomics 2013; 16:159-73. [DOI: 10.1159/000351453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 04/18/2013] [Indexed: 11/19/2022] Open
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van der Lugt NM, van Kampen A, Walther FJ, Brand A, Lopriore E. Outcome and management in neonatal thrombocytopenia due to maternal idiopathic thrombocytopenic purpura. Vox Sang 2013; 105:236-43. [DOI: 10.1111/vox.12036] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 02/20/2013] [Accepted: 02/22/2013] [Indexed: 11/29/2022]
Affiliation(s)
- N. M. van der Lugt
- Division of Neonatology; Department of Pediatrics; Willem-Alexander Children's Hospital; Leiden University Medical Center; Leiden; The Netherlands
| | - A. van Kampen
- Division of Neonatology; Department of Pediatrics; Willem-Alexander Children's Hospital; Leiden University Medical Center; Leiden; The Netherlands
| | - F. J. Walther
- Division of Neonatology; Department of Pediatrics; Willem-Alexander Children's Hospital; Leiden University Medical Center; Leiden; The Netherlands
| | - A. Brand
- Department of Immunohematology; Leiden University Medical Center; Leiden; The Netherlands
| | - E. Lopriore
- Division of Neonatology; Department of Pediatrics; Willem-Alexander Children's Hospital; Leiden University Medical Center; Leiden; The Netherlands
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Abstract
Tables of alpha values as a function of sample size, effect size, and desired power were presented. The tables indicated expected alphas for small, medium, and large effect sizes given a variety of sample sizes. It was evident that sample sizes for most psychological studies are adequate for large effect sizes defined at .8. The typical alpha level of .05 and desired power of 90% can be achieved with 70 participants in two groups. It was perhaps doubtful if these ideal levels of alpha and power have generally been achieved for medium effect sizes in actual research, since 170 participants would be required. Small effect sizes have rarely been tested with an adequate number of participants or power. Implications were discussed.
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Affiliation(s)
| | - A. Brand
- Kings College: Institute of Psychiatry
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Lal JA, Malogajski J, Verweij SP, de Boer P, Ambrosino E, Brand A, Ouburg S, Morré SA. Chlamydia trachomatis infections and subfertility: opportunities to translate host pathogen genomic data into public health. Public Health Genomics 2013; 16:50-61. [PMID: 23548718 DOI: 10.1159/000346207] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Chlamydia trachomatis (CT) infections in women can result in tubal pathology (TP). Worldwide 10-15% of all couples are subfertile, meaning they did not get pregnant after 1 year. Part of the routine subfertility diagnostics is the Chlamydia Antibody Test (CAT) to decide for laparoscopy or not in order to diagnose TP. The CAT positive and negative predictive value is such that many unneeded laparoscopies are done and many TP cases are missed. Addition of host genetic markers related to infection susceptibility and severity could potentially improve the clinical management of couples who suffer from subfertility. In the present study, the potential translational and clinical value of adding diagnostic host genetic marker profiles on the basis of infection and inflammation to the current clinical management of subfertility was investigated. This review provides an overview of the current state of the art of host genetic markers in relation to CT infection, proposes a new clinical diagnostic approach, and investigates how the Learning-Adapting-Leveling model (LAL, a public health genomic (PHG) model) can be of value and provide insight to see whether these host genetic markers can be translated into public health. This review shows that the preliminary basis of adding host genetic marker profiles to the current diagnostic procedures of subfertility is present but has to be further developed before implementation into health care can be achieved. CT infection is an example in the field of PHG with potential diagnostic to be taken up in the future in the field of subfertility diagnosis with a time line for integration to be dependent on enhanced participation of many stakeholders in the field of PHG which could be advanced through the LAL model.
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Affiliation(s)
- J A Lal
- Institute for Public Health Genomics, Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, The Netherlands
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Panzer S, Engelbrecht S, Cole-Sinclair MF, Wood EM, Wendel S, Biagini S, Zhu Z, Lefrère JJ, Andreu G, Zunino T, Cabaud JJ, Rouger P, Garraud O, Janetzko K, Müller-Steinhardt M, van der Burg P, Brand A, Agarwal P, Triyono T, Gharehbaghian A, Manny N, Zelig O, Takeshita A, Yonemura Y, Fujihara H, Nollet KE, Ohto H, Han KS, Nadarajan VS, Berlin G, Sandler SG, Strauss RG, Reesink HW. Education in transfusion medicine for medical students and doctors. Vox Sang 2013; 104:250-72. [PMID: 23409732 DOI: 10.1111/j.1423-0410.2012.1661.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Panzer
- Department for Blood Group Serology and Transfusion MedicineMedical University Vienna, Vienna, Austria.
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Wiersum-Osselton J, Van Tilborgh-De Jong A, Zijlker-Jansen P, Van de Watering L, Brand A, Van Der Bom J, Schipperus M. Variabilité de l’incidence des effets indésirables receveur entre hôpitaux : est-ce qu’un nombre important de déclarations indique une meilleure sécurité transfusionnelle ? Transfus Clin Biol 2012. [DOI: 10.1016/j.tracli.2012.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wiersum-Osselton JC, Faber JC, Politis C, Brand A, van der Bom JG, Schipperus MR. Quality validation of data in national haemovigilance systems in Europe: report of a survey on current state of practice. Vox Sang 2012; 104:214-7. [PMID: 23061879 DOI: 10.1111/j.1423-0410.2012.01659.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
European Union member states must have national haemovigilance reporting of serious adverse reactions and events. We sent national competent authorities an email questionnaire about data validation. Responses were received from 23/27 countries. Nine previously had no national haemovigilance system. In 13 (57%), the serious adverse reactions and events can be verified. Coverage of blood establishments is documented in 20 systems (87%) and of hospitals in 15 systems (65%). Although all member states have implemented haemovigilance systems, there are currently wide variations in data quality assurance, not allowing comparisons between countries.
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Affiliation(s)
- J C Wiersum-Osselton
- TRIP (Transfusion Reactions in Patients) Dutch National Hemovigilance Office, The Hague, The Netherlands.
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Hendriks J, Zwart JJ, Briët E, Brand A, van Roosmalen J. The clinical benefit of blood transfusion: a hypothetical experiment based on a nationwide survey of severe maternal morbidity. Vox Sang 2012; 104:234-9. [PMID: 23061811 DOI: 10.1111/j.1423-0410.2012.01654.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND It is beyond doubt that blood transfusion services have added to the decline in maternal mortality in high-resource countries. To quantify the clinical benefit of red blood cell (RBC) transfusion in obstetric care, we performed a hypothetical experimental study using data from a prospective nationwide cohort of women giving birth in the Netherlands. STUDY DESIGN AND METHODS Data were abstracted from a nationwide cohort study on severe maternal morbidity, including obstetric haemorrhage requiring 4 or more units of RBC, to obtain an observed and a hypothetical control group consisting of the same women. In the hypothetical control group, we simulated a situation where RBC transfusion was unavailable and estimated how many of these women would have died in that situation. A questionnaire survey asked experts in major (obstetric) haemorrhage to choose a critical minimal number of RBC transfusions at which a woman with obstetric haemorrhage would have died if RBC transfusion was not available. Maternal mortality rate per 100,000 maternities [maternal mortality ratios (MMR)] and relative risk were calculated for the observed and hypothetical group. RESULTS The observed MMR was 13 per 100,000 maternities. According to 47 responding experts, the median number of RBC units without which a woman would have most probably died was nine, resulting in a hypothetical MMR of 87 per 100,000 maternities (relative risk 6·5; 95% confidence interval 4·2-10·0). CONCLUSIONS It can be expected that unavailability of RBC transfusion in obstetric care increases the risk of maternal death 6.5-fold. Blood transfusion thus largely contributes to the decline of MMR and would also be an important pillar of improving quality of care in resource-poor settings.
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Affiliation(s)
- J Hendriks
- Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands
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Ypma PF, Kerkhoffs JLH, van Hilten JA, Middelburg RA, Coccoris M, Zwaginga JJ, Beckers EM, Fijnheer R, van der Meer PF, Brand A. The observation of bleeding complications in haemato-oncological patients: stringent watching, relevant reporting. Transfus Med 2012; 22:426-31. [PMID: 23036067 DOI: 10.1111/j.1365-3148.2012.01193.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 08/30/2012] [Accepted: 09/06/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND The reported percentage of haemato-oncological patients experiencing bleeding complications is highly variable, ranging from 5 to 70%, posing a major problem for comparison of clinical platelet transfusion trials using bleeding complications as a primary endpoint. In a pilot study we assessed the impact of the design of scoring of bleeding on the percentage of patients with WHO grade 2 or higher bleeding grades. STUDY DESIGN AND METHODS We performed a prospective, observational study using a rigorous bleeding observation system in thrombocytopenic patients with haemato-oncological disorders. Endpoints of the study were the percentage of patients and days with bleeding WHO grade ≥ 2 comparing designs in which skin bleeding represent a continuation of a previous bleed or a new bleed. RESULTS In four participating hospitals 64 patients suffering 870 evaluable thrombocytopenic days (platelet count < 80 × 10(9) L(-1)) were included. At least one episode of bleeding grade ≥ 2 occurred in 36 patients (56%). Most grade 2 bleeding complications occurred mucocutaneously. The percentage of days with bleeding of grade ≥ 2 was 16% but decreases to 8% when only newly developed skin bleeding was included. CONCLUSION Rigorous daily observation results in a bleeding incidence that is comparable to recent reportings applying the same method. The results of this study show that censoring for stable skin bleeding has a profound effect on bleeding incidence per day. The clinical relevance of rigorous or clinically judged bleeding scores as an endpoint remains to be defined.
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Affiliation(s)
- P F Ypma
- Department of Haematology, HAGA Teaching Hospital Den Haag, The Hague, The Netherlands.
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Abstract
Reactive arthritis (ReA) is an autoimmune seronegative spondyloarthropathy that occurs in response to a urogenital or enteric infection. Several studies have reported a link between ReA and HIV infection. We report a case of an HIV-1-infected patient diagnosed with a disabling ReA who failed to respond to conventional therapy but whose symptoms resolved rapidly after starting antiretroviral therapy (ART). Clinicians may not be cognizant to this phenomenon and so this case report serves to remind clinicians that initiation of antiretroviral therapy should be considered in HIV-infected patients with ReA who are refractory to standard therapy.
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Affiliation(s)
- C Scott
- HIV and Sexual Health Directorate, Chelsea & Westminster Hospital, London, UK.
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