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Noben L, Lempersz C, van den Heuvel ER, Zhan Z, Vandenbussche FPHA, Coumans ABC, Haak MC, Vullings R, Oei SG, Clur SAB, van Laar JOEH. The electrical heart axis in fetuses with congenital heart disease, measured with non-invasive fetal electrocardiography. PLoS One 2022; 17:e0275802. [PMID: 36264863 PMCID: PMC9584524 DOI: 10.1371/journal.pone.0275802] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To determine if the electrical heart axis in different types of congenital heart defects (CHD) differs from that of a healthy cohort at mid-gestation. METHODS Non-invasive fetal electrocardiography (NI-fECG) was performed in singleton pregnancies with suspected CHD between 16 and 30 weeks of gestation. The mean electrical heart axis (MEHA) was determined from the fetal vectorcardiogram after correction for fetal orientation. Descriptive statistics were used to determine the MEHA with corresponding 95% confidence intervals (CI) in the frontal plane of all fetuses with CHD and the following subgroups: conotruncal anomalies (CTA), atrioventricular septal defects (AVSD) and hypoplastic right heart syndrome (HRHS). The MEHA of the CHD fetuses as well as the subgroups was compared to the healthy control group using a spherically projected multivariate linear regression analysis. Discriminant analysis was applied to calculate the sensitivity and specificity of the electrical heart axis for CHD detection. RESULTS The MEHA was determined in 127 fetuses. The MEHA was 83.0° (95% CI: 6.7°; 159.3°) in the total CHD group, and not significantly different from the control group (122.7° (95% CI: 101.7°; 143.6°). The MEHA was 105.6° (95% CI: 46.8°; 164.4°) in the CTA group (n = 54), -27.4° (95% CI: -118.6°; 63.9°) in the AVSD group (n = 9) and 26.0° (95% CI: -34.1°; 86.1°) in the HRHS group (n = 5). The MEHA of the AVSD and the HRHS subgroups were significantly different from the control group (resp. p = 0.04 and p = 0.02). The sensitivity and specificity of the MEHA for the diagnosis of CHD was 50.6% (95% CI 47.5% - 53.7%) and 60.1% (95% CI 57.1% - 63.1%) respectively. CONCLUSION The MEHA alone does not discriminate between healthy fetuses and fetuses with CHD. However, the left-oriented electrical heart axis in fetuses with AVSD and HRHS was significantly different from the control group suggesting altered cardiac conduction along with the structural defect. TRIAL REGISTRATION Clinical trial registration number: NL48535.015.14.
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Affiliation(s)
- L. Noben
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
- * E-mail:
| | - C. Lempersz
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
| | - E. R. van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Z. Zhan
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - F. P. H. A. Vandenbussche
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A. B. C. Coumans
- Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M. C. Haak
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - R. Vullings
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - S. G. Oei
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - S. A. B. Clur
- Department of Pediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - J. O. E. H. van Laar
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
- Department of Pediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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van Oostrum NHM, de Vet CM, Clur SB, van der Woude DAA, van den Heuvel ER, Oei SG, van Laar JOEH. Fetal myocardial deformation measured with two-dimensional speckle-tracking echocardiography: longitudinal prospective cohort study of 124 healthy fetuses. Ultrasound Obstet Gynecol 2022; 59:651-659. [PMID: 34558747 PMCID: PMC9321172 DOI: 10.1002/uog.24781] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Two-dimensional speckle-tracking echocardiography (2D-STE) is a promising technique which allows assessment of fetal cardiac function, and can be used in the evaluation of cardiac and non-cardiac diseases in pregnancy. However, reliable fetal reference values for deformation parameters measured using 2D-STE are needed before it can be introduced into clinical practice. This study aimed to obtain reference values for fetal global longitudinal strain (GLS) and GLS rate (GLSR) measured using 2D-STE and compare right and left ventricular values. METHODS This was a prospective longitudinal cohort study of uncomplicated pregnancies that underwent echocardiography every 4 weeks from inclusion at 18-21 weeks until delivery to obtain four-chamber loops of the fetal heart. Left and right ventricular GLS and GLSR were measured using 2D-STE at each examination. Using Bayesian mixed-effects models, reference values with lower and upper 5% prediction limits were calculated according to gestational age. Right and left ventricular GLS values according to gestational age were compared using the Wilcoxon signed-rank test. RESULTS A total of 592 left ventricular and 566 right ventricular GLS and GLSR measurements were obtained from 124 women with uncomplicated pregnancy and non-anomalous, appropriately grown fetuses. Reference values were obtained for both fetal ventricles according to gestational week. GLS and GLSR values of both ventricles increased (i.e. became less negative) significantly during pregnancy. Right ventricular GLS values were significantly higher (i.e. less negative) than the respective left ventricular values at every gestational week. CONCLUSIONS Reference values were obtained for fetal GLS and GLSR measured using 2D-STE. GLS and GLSR values increased significantly for both ventricles from the second trimester until delivery. GLS values were significantly higher for the right ventricle compared with the left ventricle. Future studies are needed to assess whether the obtained reference values are helpful in clinical practice in the assessment of pregnancy complications, such as fetal growth restriction or cardiac anomaly. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N. H. M. van Oostrum
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsGhent UniversityGhentBelgium
| | - C. M. de Vet
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
| | - S. B. Clur
- Department of Paediatric Cardiology, Emma Children's Hospital, Academic Medical CenterAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - D. A. A. van der Woude
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
| | - E. R. van den Heuvel
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Mathematics & Computer ScienceEindhoven University of TechnologyEindhovenThe Netherlands
| | - S. G. Oei
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
| | - J. O. E. H. van Laar
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
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Zhan Z, Bastide-Van Gemert SL, Wiersum M, Heineman KR, Hadders-Algra M, Heuvel ERVD. A comparison of statistical methods for age-specific reference values of discrete scales. COMMUN STAT-SIMUL C 2021. [DOI: 10.1080/03610918.2021.1977824] [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: 10/20/2022]
Affiliation(s)
- Z. Zhan
- Mathematics and Computer Science, Technische Universiteit Eindhoven, Eindhoven, Netherlands
| | | | - M. Wiersum
- Paediatrics, Universitair Medisch Centrum Groningen – UMCG, Groningen, Netherlands
| | - K. R. Heineman
- Paediatrics, Universitair Medisch Centrum Groningen – UMCG, Groningen, Netherlands
| | - M. Hadders-Algra
- Obstetrics and Gynaecology, Universitair Medisch Centrum Groningen – UMCG, Groningen, Netherlands
| | - E. R. van den Heuvel
- Mathematics and Computer Science, Technische Universiteit Eindhoven, Eindhoven, Netherlands
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Affiliation(s)
- N. G. P. Den Teuling
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands
- Philips Research, Eindhoven, the Netherlands
| | - S. C. Pauws
- Philips Research, Eindhoven, the Netherlands
- Department Communication and Cognition, Tilburg University, Tilburg, the Netherlands
| | - E. R. van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands
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Moors S, Joshi R, Bullens LM, van Oostrum NHM, Regis M, van den Heuvel ER, Oei SG, van Laar JOEH, van der Hout-van der Jagt MB. A randomized controlled trial studying the effect of maternal hyperoxygenation on fetal heart rate in suspected fetal distress. Physiol Meas 2020; 41:115002. [PMID: 33049730 DOI: 10.1088/1361-6579/abc0b6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the effect of maternal hyperoxygenation on fetal heart rate (FHR) when applied for suspected fetal distress during the second stage of term labor. APPROACH A single-center randomized controlled trial was conducted in a tertiary care hospital in The Netherlands. Participants were included during the second stage of labor in case of an intermediary or abnormal FHR pattern. Patients were randomized to receive either 100% oxygen at 10 l/min until delivery, or conventional care without additional oxygen. The primary outcome was the change in FHR pattern before and after the onset of the study, measured as the change in depth and duration of FHR decelerations. Secondary outcome measures were features based on phase-rectified signal averaging (PRSA), baseline assignability, and deceleration characteristics of the FHR pattern. MAIN RESULTS Between March 2016 and April 2018, 117 women were included. The FHR pattern could be analyzed for 71 participants, the other 46 women delivered before the end of the post time-frame. A 2.3% reduction in depth and duration of FHR decelerations was found after maternal hyperoxygenation, compared to a 10% increase in the control group (p = 0.24). Maternal hyperoxygenation had a significantly positive effect on PRSA metrics, with a decrease in PRSA-acceleration capacity (p = 0.03) and PRSA-deceleration capacity (p = 0.02) in the intervention group compared to the control group. SIGNIFICANCE The difference in depth and duration of decelerations after the start of the study was not significantly different between both study groups. A statistically significant positive effect on PRSA-deceleration capacity and PRSA-acceleration capacity was found after maternal hyperoxygenation, which might be associated with a positive effect on neonatal outcome.
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Affiliation(s)
- S Moors
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands. Eindhoven MedTech Innovation Center (e/MTIC), Groene Loper 19, Eindhoven 5600 MB, The Netherlands. Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Raina P, Wolfson C, Kirkland S, Griffith LE, Balion C, Cossette B, Dionne I, Hofer S, Hogan D, van den Heuvel ER, Liu-Ambrose T, Menec V, Mugford G, Patterson C, Payette H, Richards B, Shannon H, Sheets D, Taler V, Thompson M, Tuokko H, Wister A, Wu C, Young L. Cohort Profile: The Canadian Longitudinal Study on Aging (CLSA). Int J Epidemiol 2019; 48:1752-1753j. [PMID: 31633757 PMCID: PMC6929533 DOI: 10.1093/ije/dyz173] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 12/03/2022] Open
Affiliation(s)
- Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, Hamilton, ON, Canada
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, ON, Canada
| | - Christina Wolfson
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Neuroepidemiology Research Unit, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Susan Kirkland
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging, Hamilton, ON, Canada
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, ON, Canada
| | - Cynthia Balion
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Benoȋt Cossette
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Isabelle Dionne
- Faculty of Physical Activity Sciences, Department of Kinanthropology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Scott Hofer
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - David Hogan
- Faculty of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Geriatric Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Medicine, Departments of Medicine, Clinical Neurosciences and Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Alberta Seniors Health, Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - E R van den Heuvel
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands, Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Verena Menec
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gerald Mugford
- Faculty of Medicine (Medicine and Psychiatry), The Health Sciences Centre, St John's, NL, Canada
| | - Christopher Patterson
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Hélène Payette
- Research Center on Aging, CIUSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Brent Richards
- Faculty of Medicine, Departments of Medicine (Endocrinology), Human Genetics, and Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - Harry Shannon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Debra Sheets
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Vanessa Taler
- School of Psychology, University of Ottawa, Ottawa, BC, Canada; School of Psychology, Bruyère Research Institute, Ottawa, ON, Canada
| | - Mary Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Holly Tuokko
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Andrew Wister
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Changbao Wu
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Lynne Young
- School of Nursing, Faculty of Human and Social Development, University of Victoria, Victoria, BC, Canada
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Raina P, Wolfson C, Kirkland S, Griffith LE, Balion C, Cossette B, Dionne I, Hofer S, Hogan D, van den Heuvel ER, Liu-Ambrose T, Menec V, Mugford G, Patterson C, Payette H, Richards B, Shannon H, Sheets D, Taler V, Thompson M, Tuokko H, Wister A, Wu C, Young L. Corrigendum to: Cohort Profile: The Canadian Longitudinal Study on Aging (CLSA). Int J Epidemiol 2019; 48:2066. [PMID: 31605135 PMCID: PMC6929521 DOI: 10.1093/ije/dyz221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vroom AJ, Timmermans A, Bongers MY, van den Heuvel ER, Geomini PMAJ, van Hanegem N. Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2019; 54:28-34. [PMID: 30693579 DOI: 10.1002/uog.20229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 12/25/2018] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE In women with postmenopausal bleeding, endometrial polyps are a frequent finding and the risk of a focal (pre)malignancy in a polyp is up to 6%. Because of this reported risk, the detection of polyps in these women, preferably by a minimally invasive method, is important. The aim of this systematic review was to assess the accuracy of saline contrast sonohysterography (SCSH) for diagnosis of endometrial polyps in women with postmenopausal bleeding. METHODS In August 2018, an electronic search was performed of MEDLINE, EMBASE and Web of Science databases to identify all diagnostic studies in which SCSH was used to detect endometrial polyps in postmenopausal women. Studies were included if SCSH was performed to detect endometrial polyps in women with postmenopausal bleeding and if detection of a polyp on hysteroscopy or diagnosis on histopathology was used as a reference standard. Two reviewers assessed methodological quality using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Two separate analyses were performed for each reference standard. Pooled sensitivity and specificity were calculated using the hierarchical summary receiver-operating characteristics (HSROC) model and HSROC curves were plotted. RESULTS After selection and quality assessment, five studies were included. Using 'polyps diagnosed with histopathology' as the reference standard, the pooled sensitivity of SCSH was 86.5% (95% CI, 63.6-100%) and the pooled specificity was 91.1% (95% CI, 63.2-100%). Using 'polyps seen on hysteroscopy' as the reference standard, the pooled sensitivity of SCSH was 85.1% (95% CI, 66.9-100%) and the pooled specificity was 84.5% (95% CI, 68.1-100%). Excluding the one study that included women in whom the SCSH examination was reported to be suboptimal, the pooled sensitivity increased to 90.7% (95% CI, 72.8-100%) using hysteroscopy as the reference standard. The sensitivity of hysteroscopy to detect polyps, as reported in two studies, was 81-98%. CONCLUSIONS Provided that the SCSH examination is of optimal quality, it can be considered as a method to stratify women with postmenopausal bleeding for further diagnostic workup and treatment with hysteroscopy. In women without suspicion of a polypoid lesion on SCSH, and with a benign endometrial sample, expectant management should be considered. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A J Vroom
- Department of Obstetrics and Gynecology, Maastricht UMC+, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
- Department of Gynecology and Obstetrics, Maxima Medisch Centrum, Veldhoven, The Netherlands
| | - A Timmermans
- Department of Gynecology, Amsterdam Medisch Centrum, Amsterdam, The Netherlands
| | - M Y Bongers
- Department of Obstetrics and Gynecology, Maastricht UMC+, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
- Department of Gynecology and Obstetrics, Maxima Medisch Centrum, Veldhoven, The Netherlands
| | - E R van den Heuvel
- Department of Stochastics W&I, Technische Universiteit, Eindhoven, The Netherlands
| | - P M A J Geomini
- Department of Gynecology and Obstetrics, Maxima Medisch Centrum, Veldhoven, The Netherlands
| | - N van Hanegem
- Department of Obstetrics and Gynecology, Maastricht UMC+, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
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Abstract
Objective: This study aimed to establish the determinants of perceived sleep quality over a longer period of time, taking into account the separate contributions of actigraphy-based sleep measures and self-reported sleep indices. Methods: Fifty participants (52 ± 6.6 years; 27 females) completed two consecutive weeks of home monitoring, during which they kept a sleep-wake diary while their sleep was monitored using a wrist-worn actigraph. The diary included questions on perceived sleep quality, sleep-wake information, and additional factors such as well-being and stress. The data were analyzed using multilevel models to compare a model that included only actigraphy-based sleep measures (model Acti) to a model that included only self-reported sleep measures to explain perceived sleep quality (model Self). In addition, a model based on the self-reported sleep measures and extended with nonsleep-related factors was analyzed to find the most significant determinants of perceived sleep quality (model Extended). Results: Self-reported sleep measures (model Self) explained 61% of the total variance, while actigraphy-based sleep measures (model Acti) only accounted for 41% of the perceived sleep quality. The main predictors in the self-reported model were number of awakenings during the night, sleep onset latency, and wake time after sleep onset. In the extended model, the number of awakenings during the night and total sleep time of the previous night were the strongest determinants of perceived sleep quality, with 64% of the variance explained. Conclusion: In our cohort, perceived sleep quality was mainly determined by self-reported sleep measures and less by actigraphy-based sleep indices. These data further stress the importance of taking multiple nights into account when trying to understand perceived sleep quality.
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Affiliation(s)
- M S Goelema
- a Personal Health Group , Philips Group Innovation Research , Eindhoven , The Netherlands.,b Department of Industrial Design , Eindhoven University of Technology , Eindhoven , The Netherlands
| | - M Regis
- a Personal Health Group , Philips Group Innovation Research , Eindhoven , The Netherlands.,c Department of Mathematics and Computer Science , Eindhoven University of Technology , Eindhoven , The Netherlands
| | - R Haakma
- a Personal Health Group , Philips Group Innovation Research , Eindhoven , The Netherlands
| | - E R van den Heuvel
- c Department of Mathematics and Computer Science , Eindhoven University of Technology , Eindhoven , The Netherlands
| | - P Markopoulos
- b Department of Industrial Design , Eindhoven University of Technology , Eindhoven , The Netherlands
| | - S Overeem
- b Department of Industrial Design , Eindhoven University of Technology , Eindhoven , The Netherlands.,d Sleep Medicine Center, Kempenhaeghe , Heeze , The Netherlands
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Islam MA, Habtewold TD, van Es FD, Quee PJ, van den Heuvel ER, Alizadeh BZ, Bruggeman R. Long-term cognitive trajectories and heterogeneity in patients with schizophrenia and their unaffected siblings. Acta Psychiatr Scand 2018; 138:591-604. [PMID: 30242827 PMCID: PMC6220939 DOI: 10.1111/acps.12961] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to assess the heterogeneity and stability of cognition in patients with a non-affective psychotic disorder and their unaffected siblings. In addition, we aimed to predict the cognitive subtypes of siblings by their probands. METHOD Assessments were conducted at baseline, 3 and 6 years in 1119 patients, 1059 siblings and 586 controls from the Genetic Risk and Outcome of Psychosis (GROUP) study. Group-based trajectory modeling was applied to identify trajectories and clustered multinomial logistic regression analysis was used for prediction modeling. A composite score of eight neurocognitive tests was used to measure cognitive performance. RESULTS Five stable cognitive trajectories ranging from severely altered to high cognitive performance were identified in patients. Likewise, four stable trajectories ranging from moderately altered to high performance were found in siblings. Siblings had a higher risk of cognitive alteration when patients' alteration was mild (OR = 2.21), moderate (OR = 5.70), and severe (OR = 10.07) compared with patients with intact cognitive function. The familial correlation coefficient between pairs of index patients and their siblings was 0.27 (P = 0.003). CONCLUSIONS The cognitive profiles identified in the current study might be suitable as endophenotypes and could be used in future genetic studies and predicting functional and clinical outcomes.
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Affiliation(s)
- Md. A. Islam
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh
| | - T. D. Habtewold
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
| | - F. D. van Es
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
| | - P. J. Quee
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University Psychiatric Centre (UPC)KU LeuvenLeuvenBelgium
| | - E. R. van den Heuvel
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
- Department of Mathematics and Computer ScienceEindhoven University of TechnologyEindhovenThe Netherlands
| | - B. Z. Alizadeh
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
| | - R. Bruggeman
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- Department of Clinical and Developmental NeuropsychologyUniversity of GroningenGroningenThe Netherlands
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Bruins J, Jörg F, van den Heuvel ER, Bartels-Velthuis AA, Corpeleijn E, Muskiet FAJ, Pijnenborg GHM, Bruggeman R. The relation of vitamin D, metabolic risk and negative symptom severity in people with psychotic disorders. Schizophr Res 2018; 195:513-518. [PMID: 28927862 DOI: 10.1016/j.schres.2017.08.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/30/2017] [Accepted: 08/31/2017] [Indexed: 11/28/2022]
Affiliation(s)
- J Bruins
- Lentis Mental Health Institution, Hereweg 80, 9725 AG Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1 (CC72), 9713 GZ Groningen, The Netherlands.
| | - F Jörg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1 (CC72), 9713 GZ Groningen, The Netherlands; GGZ Friesland Mental Health Institution, Sixmastraat 2, 8932 PA Leeuwarden, The Netherlands.
| | - E R van den Heuvel
- Eindhoven University of Technology, Department of Mathematics and Computer Science, P.O. Box 513, MetaForum, 5600 MB Eindhoven, The Netherlands.
| | - A A Bartels-Velthuis
- Lentis Mental Health Institution, Hereweg 80, 9725 AG Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1 (CC72), 9713 GZ Groningen, The Netherlands.
| | - E Corpeleijn
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Hanzeplein 1 (CC72), 9713 GZ Groningen, The Netherlands.
| | - F A J Muskiet
- University of Groningen, University Medical Center Groningen, Department of Laboratory Medicine, Postbus 30.001 (EA40), 9700 RB Groningen, The Netherlands.
| | - G H M Pijnenborg
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology & Experimental Psychopathology, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands; GGZ Drenthe Mental Health Institution, Dennenweg 9, 9404 LA Assen, The Netherlands.
| | - R Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1 (CC72), 9713 GZ Groningen, The Netherlands.
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12
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Islam MA, Khan MFH, Quee PJ, Snieder H, van den Heuvel ER, Bruggeman R, Alizadeh BZ. Familial liability to psychosis is a risk factor for multimorbidity in people with psychotic disorders and their unaffected siblings. Eur Psychiatry 2017; 45:81-89. [PMID: 28750277 DOI: 10.1016/j.eurpsy.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/04/2017] [Revised: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Multimorbidity may impose an overwhelming burden on patients with psychosis and is affected by gender and age. Our aim is to study the independent role of familial liability to psychosis as a risk factor for multimorbidity. METHODS We performed the study within the framework of the Genetic Risk and Outcome of Psychosis (GROUP) project. Overall, we compared 1024 psychotic patients, 994 unaffected siblings and 566 controls on the prevalence of 125 lifetime diseases, and 19 self-reported somatic complaints. Multimorbidity was defined as the presence of two or more complaints/diseases in the same individual. Generalized linear mixed model (GLMM) were used to investigate the effects of gender, age (adolescent, young, older) and familial liability (patients, siblings, controls) and their interactions on multimorbidity. RESULTS Familial liability had a significant effect on multimorbidity of either complaints or diseases. Patients had a higher prevalence of multimorbidity of complaints compared to siblings (OR 2.20, 95% CI 1.79-2.69, P<0.001) and to controls (3.05, 2.35-3.96, P<0.001). In physical health multimorbidity, patients (OR 1.36, 95% CI 1.05-1.75, P=0.018), but not siblings, had significantly higher prevalence than controls. Similar finding were observed for multimorbidity of lifetime diseases, including psychiatric diseases. Significant results were observed for complaints and disease multimorbidity across gender and age groups. CONCLUSION Multimorbidity is a common burden, significantly more prevalent in patients and their unaffected siblings. Familial liability to psychosis showed an independent effect on multimorbidity; gender and age are also important factors determining multimorbidity.
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Affiliation(s)
- M A Islam
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh.
| | - M F H Khan
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P J Quee
- University Psychiatric Centre (UPC), KU Leuven, campus Kortenberg, Leuven, Belgium
| | - H Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - E R van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R Bruggeman
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - B Z Alizadeh
- University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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13
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Verberne CJ, Zhan Z, van den Heuvel ER, Oppers F, de Jong AM, Grossmann I, Klaase JM, de Bock GH, Wiggers T. Survival analysis of the CEAwatch multicentre clustered randomized trial. Br J Surg 2017; 104:1069-1077. [PMID: 28376235 DOI: 10.1002/bjs.10535] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/30/2016] [Accepted: 02/08/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The CEAwatch randomized trial showed that follow-up with intensive carcinoembryonic antigen (CEA) monitoring (CEAwatch protocol) was better than care as usual (CAU) for early postoperative detection of colorectal cancer recurrence. The aim of this study was to calculate overall survival (OS) and disease-specific survival (DSS). METHODS For all patients with recurrence, OS and DSS were compared between patients detected by the CEAwatch protocol versus CAU, and by the method of detection of recurrence, using Cox regression models. RESULTS Some 238 patients with recurrence were analysed (7·5 per cent); a total of 108 recurrences were detected by CEA blood test, 64 (55·2 per cent) within the CEAwatch protocol and 44 (41·9 per cent) in the CAU group (P = 0·007). Only 16 recurrences (13·8 per cent) were detected by patient self-report in the CEAwatch group, compared with 33 (31·4 per cent) in the CAU group. There was no significant improvement in either OS or DSS with the CEAwatch protocol compared with CAU: hazard ratio 0·73 (95 per cent 0·46 to 1·17) and 0·78 (0·48 to 1·28) respectively. There were no differences in survival when recurrence was detected by CT versus CEA measurement, but both of these methods yielded better survival outcomes than detection by patient self-report. CONCLUSION There was no direct survival benefit in favour of the intensive programme, but the CEAwatch protocol led to a higher proportion of recurrences being detected by CEA-based blood test and reduced the number detected by patient self-report. This is important because detection of recurrence by blood test was associated with significantly better survival than patient self-report, indirectly supporting use of the CEAwatch protocol.
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Affiliation(s)
- C J Verberne
- Departments of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Z Zhan
- Departments of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - E R van den Heuvel
- Departments of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - F Oppers
- Departments of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - A M de Jong
- Departments of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - I Grossmann
- Departments of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Department of Gastrointestinal Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - J M Klaase
- Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands
| | - G H de Bock
- Departments of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - T Wiggers
- Departments of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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14
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San Giorgi MRM, van den Heuvel ER, Tjon Pian Gi REA, Brunings JW, Chirila M, Friedrich G, Golusinski W, Graupp M, Horcasitas Pous RA, Ilmarinen T, Jackowska J, Koelmel JC, Ferran Vilà F, Weichbold V, Wierzbicka M, Dikkers FG. Age of onset of recurrent respiratory papillomatosis: a distribution analysis. Clin Otolaryngol 2016; 41:448-53. [PMID: 26460806 DOI: 10.1111/coa.12565] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Distribution of age of onset of recurrent respiratory papillomatosis (RRP) is generally described to be bimodal, with peaks at approximately 5 years and 30 years. This assumption has never been scientifically confirmed, and authors tend to refer to an article that does not describe distribution. Knowledge of the distribution of age of onset is important for virological and epidemiological comprehension. The objective of this study was to determine the distribution of age of onset of RRP in a large international sample. DESIGN Cross-sectional distribution analysis. PARTICIPANTS Laryngologists from 12 European hospitals provided information on date of birth and date of onset of all their RRP patients treated between 1998 and 2012. Centers that exclusively treated either patients with juvenile onset RRP or patients with adult onset RRP, or were less accessible for one of these groups, were excluded to prevent skewness. MAIN OUTCOME MEASURES A mixture model was implemented to describe distribution of age of onset. The best fitting model was selected using the Bayesian information criterion. RESULTS Six hundred and thirty-nine patients were included in the analysis. Age of onset was described by a three component mixture distribution with lognormally distributed components. Recurrent respiratory papillomatosis starts at three median ages 7, 35 and 64 years. CONCLUSIONS Distribution of age of onset of RRP shows three peaks. In addition to the already adopted idea of age peaks at paediatric and adult age, there is an additional peak around the age of 64.
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Affiliation(s)
- M R M San Giorgi
- Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Cancer Research Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E R van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R E A Tjon Pian Gi
- Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Cancer Research Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J W Brunings
- Department of Otorhinolaryngology/Head & Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M Chirila
- Department of Otorhinolaryngology/Head & Neck Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - G Friedrich
- Department of Phoniatrics, Speech and Swallowing, Ear, Nose and Throat University Hospital, Medical University of Graz, Graz, Austria
| | - W Golusinski
- Department of Otorhinolaryngology, Greater Poland Cancer Centre, Poznań, Poland
| | - M Graupp
- Department of Phoniatrics, Speech and Swallowing, Ear, Nose and Throat University Hospital, Medical University of Graz, Graz, Austria
| | - R A Horcasitas Pous
- Pediatric Otolaryngology, Hospital Infantil del Estado de Chihuahua, Chihuahua, Mexico
| | - T Ilmarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - J Jackowska
- Department of Otolaryngology - Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - J C Koelmel
- Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Klinikum-Stuttgart, Stuttgart, Germany
| | - F Ferran Vilà
- Consulta d'ORL, foniatria i logopèdia, Hosp. Gral de Catalunya (Sant Cugat del Vallès), Barcelona, Spain
| | - V Weichbold
- Department for Hearing Speech and Voice Disorders, Medical University Innsbruck, Innsbruck, Austria
| | - M Wierzbicka
- Department of Otolaryngology - Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - F G Dikkers
- Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .,Cancer Research Center Groningen, University of Groningen, Groningen, The Netherlands.
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15
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Dlabac-de Lange JJ, Bais L, van Es FD, Visser BGJ, Reinink E, Bakker B, van den Heuvel ER, Aleman A, Knegtering H. Efficacy of bilateral repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: results of a multicenter double-blind randomized controlled trial. Psychol Med 2015; 45:1263-1275. [PMID: 25354751 DOI: 10.1017/s0033291714002360] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Few studies have investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) treatment for negative symptoms of schizophrenia, reporting inconsistent results. We aimed to investigate whether 10 Hz stimulation of the bilateral dorsolateral prefrontal cortex during 3 weeks enhances treatment effects. METHOD A multicenter double-blind randomized controlled trial was performed in 32 patients with schizophrenia or schizo-affective disorder, and moderate to severe negative symptoms [Positive and Negative Syndrome Scale (PANSS) negative subscale ⩾15]. Patients were randomized to a 3-week course of active or sham rTMS. Primary outcome was severity of negative symptoms as measured with the Scale for the Assessment of Negative Symptoms (SANS) and the PANSS negative symptom score. Secondary outcome measures included cognition, insight, quality of life and mood. Subjects were followed up at 4 weeks and at 3 months. For analysis of the data a mixed-effects linear model was used. RESULTS A significant improvement of the SANS in the active group compared with sham up to 3 months follow-up (p = 0.03) was found. The PANSS negative symptom scores did not show a significant change (p = 0.19). Of the cognitive tests, only one showed a significant improvement after rTMS as compared with sham. Finally, a significant change of insight was found with better scores in the treatment group. CONCLUSIONS Bilateral 10 Hz prefrontal rTMS reduced negative symptoms, as measured with the SANS. More studies are needed to investigate optimal parameters for rTMS, the cognitive effects and the neural basis.
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Affiliation(s)
- J J Dlabac-de Lange
- University of Groningen,University Medical Center Groningen,Department of Psychiatry,Hanzeplein 1,Groningen,The Netherlands
| | - L Bais
- University of Groningen,University Medical Center Groningen,Department of Neuroscience and BCN Neuroimaging Center,Antonius Deusinglaan 2,Groningen,The Netherlands
| | - F D van Es
- University of Groningen,University Medical Center Groningen,Department of Psychiatry,Hanzeplein 1,Groningen,The Netherlands
| | - B G J Visser
- University of Groningen,University Medical Center Groningen,Department of Psychiatry,Hanzeplein 1,Groningen,The Netherlands
| | - E Reinink
- Lentis Research,Center for Mental Health,Hereweg 80,Groningen,The Netherlands
| | - B Bakker
- Lentis Research,Center for Mental Health,Hereweg 80,Groningen,The Netherlands
| | - E R van den Heuvel
- University of Groningen,University Medical Center Groningen,Department of Epidemiology,Hanzeplein 1,Groningen,The Netherlands
| | - A Aleman
- University of Groningen,University Medical Center Groningen,Department of Neuroscience and BCN Neuroimaging Center,Antonius Deusinglaan 2,Groningen,The Netherlands
| | - H Knegtering
- University of Groningen,University Medical Center Groningen,Department of Psychiatry,Hanzeplein 1,Groningen,The Netherlands
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16
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Blok JL, Boersma M, Terra JB, Spoo JR, Leeman FWJ, van den Heuvel ER, Huizinga J, Jonkman MF, Horváth B. Surgery under general anaesthesia in severe hidradenitis suppurativa: a study of 363 primary operations in 113 patients. J Eur Acad Dermatol Venereol 2015; 29:1590-7. [PMID: 25589154 DOI: 10.1111/jdv.12952] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/04/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Treatment of hidradenitis suppurativa (HS) is a difficult undertaking, especially as there is no consensus on what surgical technique is preferred. At our centre severe HS (Hurley II/III) is operated under general anaesthesia, mostly with the STEEP procedure. OBJECTIVES To investigate characteristics, surgical outcomes and patient satisfaction of HS patients who underwent deroofing or STEEP under general anaesthesia. METHODS A clinical records-based retrospective analysis was conducted of all patients who had surgery under general anaesthesia between 1999 and 2013. Patient satisfaction was retrospectively investigated with questionnaires. RESULTS A total of 482 operations (363 primary operations and 119 re-operations) were performed during the study period. The proportion of women in the included population was 68%. The median diagnostic delay (patient's and doctor's delay) was 6.5 years. Relapses occurred after 29.2% of primary operations. Women had higher relapse rates than men [odds ratio 2.85 (1.07;7.61)]. Hypergranulation of the wound was the most common complication and occurred in 7% of all operations. The median score patients attributed to the medical effect of surgery was eight of 10 (zero corresponding to very dissatisfied and 10 to very satisfied). CONCLUSION The diagnostic delay in HS is long due to a lack of knowledge in both patients and health care professionals, indicating that there is a need for education. Deroofing and the STEEP are effective surgical procedures in severe cases of HS and lead to a relatively high patient satisfaction. The postoperative relapse risk is higher in women. Prospective studies are required for the development of clear guidelines on the appropriate choice of surgery.
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Affiliation(s)
- J L Blok
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M Boersma
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J B Terra
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J R Spoo
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - F W J Leeman
- Department of Dermatology, Antonius Hospital, Sneek, The Netherlands
| | - E R van den Heuvel
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J Huizinga
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M F Jonkman
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - B Horváth
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Apeldoorn SY, Sterk B, van den Heuvel ER, Schoevers RA, Islam MA, Bruggeman R, Cahn W, deHaan L, Kahn RS, Meijer CJ, Myin-Germeys I, van Os J, Wiersma D. Factors contributing to the duration of untreated psychosis. Schizophr Res 2014; 158:76-81. [PMID: 25043913 DOI: 10.1016/j.schres.2014.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 01/28/2014] [Revised: 05/25/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Shortening the duration of untreated psychosis (DUP) - with the aim of improving the prognosis of psychotic disorders - requires an understanding of the causes of treatment delay. Current findings concerning several candidate risk factors of a longer DUP are inconsistent. Our aim was to identify factors contributing to DUP in a large sample that represents the treated prevalence of non-affective psychotic disorders. METHOD Patients with a non-affective psychotic disorder were recruited from mental health care institutes from 2004 to 2008. Of the 1120 patients enrolled, 852 could be included in the present analysis. Examined candidate factors were gender, educational level, migration status, premorbid adjustment and age at onset of the psychotic disorder. DUP was divided into five ordinal categories: less than one month, one month to three months, three months to six months, six months to twelve months and twelve months and over. An ordinal logistic regression analysis was used to identify the risk factors of a longer DUP. RESULTS Median DUP was less than one month (IQR 2). The factors migration status (p=0.028), age at onset of the psychotic disorder (p=0.003) and gender (p=0.034) were significantly associated with DUP in our analysis. CONCLUSION First generation immigrant patients, patients with an early onset of their psychotic disorder and male patients seem at risk of a longer DUP. These findings can assist in designing specific interventions to shorten treatment delay.
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Affiliation(s)
- S Y Apeldoorn
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, the Netherlands; Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, the Netherlands.
| | - B Sterk
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, the Netherlands; Department of Psychiatry, University Medical Centre Nijmegen, the Netherlands
| | - E R van den Heuvel
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, the Netherlands
| | - R A Schoevers
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, the Netherlands
| | - M A Islam
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, the Netherlands; Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, the Netherlands
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18
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Bolster MAJ, Zöphel OT, van den Heuvel ER, Ruettermann M. Cubital tunnel syndrome: a comparison of an endoscopic technique with a minimal invasive open technique. J Hand Surg Eur Vol 2014; 39:621-5. [PMID: 23877730 DOI: 10.1177/1753193413498547] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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] [Indexed: 02/03/2023]
Abstract
Both open and endoscopic methods for ulnar nerve decompression have been described. The purpose of this study is to compare the 6-month results of a minimal invasive open technique with an endoscopic technique. We treated 60 patients with unilateral ulnar neuropathy at the elbow, employing both techniques. Six months postoperative we found no differences in treatment effect on pain and disability scores between both groups, but both techniques resulted in an early postoperative relief of symptoms and good patient satisfaction.
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Affiliation(s)
- M A J Bolster
- Department of Plastic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
| | - O T Zöphel
- Department of Plastic Surgery, Medical Spectrum Twente, Enschede, The Netherlands
| | - E R van den Heuvel
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - M Ruettermann
- Department of Plastic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
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19
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Quee PJ, Alizadeh BZ, Aleman A, van den Heuvel ER. Cognitive subtypes in non-affected siblings of schizophrenia patients: characteristics and profile congruency with affected family members. Psychol Med 2014; 44:395-405. [PMID: 23659373 DOI: 10.1017/s0033291713000809] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although cognitive subtypes have been suggested in schizophrenia patients, similar analyses have not been carried out in their non-affected siblings. Subtype classification may provide more insight into genetically driven variation in cognitive function. We investigated cognitive subtypes in siblings. METHOD Cluster analyses were performed in 654 non-affected siblings, on a cognitive battery that included tests of attention, intellectual function and episodic memory. Resulting subtypes in the siblings were analyzed for cognitive, demographic and clinical characteristics and compared with those of their probands. RESULTS Three sibling subtypes of cognitive function were distinguished: 'normal', 'mixed' and 'impaired'. Normal profile siblings (n = 192) were unimpaired on cognitive tests, in contrast to their proband (n = 184). Mixed profile siblings (n = 228) and their probands (n = 222) had a more similar performance pattern. Impaired profile siblings had poorer functional outcomes (n = 234) and their profile was almost identical to that of their proband (n = 223). Probands with cognitively impaired siblings could be distinguished from other schizophrenia patients by their own cognitive performance. They also had poorer clinical characteristics, including achievement of symptomatic remission. CONCLUSIONS Unaffected siblings of patients with schizophrenia are heterogeneous with respect to cognitive function. The poorer the cognitive profile of the sibling, the higher the level of correspondence with the proband. The sibling's cognitive subtype was predictive for disease course in the proband. Distinguishing cognitive subtypes of unaffected siblings may be of relevance for genetic studies.
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Affiliation(s)
- P J Quee
- Department of Psychiatry and Rob Giel Research Center, University of Groningen, University Medical Center Groningen, The Netherlands
| | - B Z Alizadeh
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - A Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, The Netherlands
| | - E R van den Heuvel
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
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20
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den Dekker MAM, Takashima R, van den Heuvel ER, van den Dungen JJAM, Tio RA, Oudkerk M, Vliegenthart R. Relationship between epicardial adipose tissue and subclinical coronary artery disease in patients with extra-cardiac arterial disease. Obesity (Silver Spring) 2014; 22:72-8. [PMID: 23804361 DOI: 10.1002/oby.20547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/25/2013] [Accepted: 06/03/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Epicardial adipose tissue (EAT) and mediastinal adipose tissue (MAT) are linked to coronary artery disease (CAD). The association between EAT, MAT, and severity of CAD in known extra-cardiac arterial disease was investigated. DESIGN AND METHODS Sixty-five cardiac asymptomatic patients (mean age 65 ± 8 years, 69% male) with peripheral arterial disease, carotid stenosis, or aortic aneurysm underwent coronary computed tomography angiography. Patients were divided into non-significant (<50% stenosis, N = 35), single vessel (N = 15) and multi-vessel CAD (N = 15). EAT and MAT were quantified on computed tomography images using volumetric software. RESULTS Subgroups did not significantly differ by age, gender, or cardiovascular risk factors. Median EAT was 99.5, 98.0, and 112.0 cm(3) (P = 0.38) and median MAT was 66.0, 90.0, and 81.0 cm(3) (P = 0.53) for non-significant, single vessel, and multi-vessel CAD, respectively. In age- and gender-adjusted analysis, only EAT was significantly associated with CAD (odds ratio [OR] 1.12 [95% confidence interval, 1.01-1.25] per 10 cm(3) increase in EAT; P = 0.04). This remained in multivariate-adjusted analysis (OR 1.21 [1.04-1.39]; P = 0.01). CONCLUSIONS In patients with known extra-cardiac arterial disease, CAD is correlated with EAT, but not with MAT. These results suggest that EAT has a local effect on coronary atherosclerosis, apart from the endocrine effect of visceral fat.
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Affiliation(s)
- M A M den Dekker
- Center for Medical Imaging - North East Netherlands and Departments of Radiology Epidemiology Vascular Surgery and Cardiology University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Wessel SW, Chen Y, Maitra A, van den Heuvel ER, Slomp AM, Busscher HJ, van der Mei HC. Adhesion forces and composition of planktonic and adhering oral microbiomes. J Dent Res 2013; 93:84-8. [PMID: 24186560 DOI: 10.1177/0022034513511822] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The oral microbiome consists of a planktonic microbiome residing in saliva and an adhering microbiome (the biofilm adhering to oral hard and soft tissues). Here we hypothesized that possible differences in microbial composition of the planktonic and adhering oral microbiome on teeth can be related to the forces by which different bacterial species are attracted to the tooth surface. The relative presence of 7 oral bacterial species in saliva and biofilm collected from 10 healthy human volunteers was determined twice in each volunteer by denaturing-gradient-gel electrophoresis. Analysis of both microbiomes showed complete separation of the planktonic from the adhering oral microbiome. Next, adhesion forces of corresponding bacterial strains with saliva-coated enamel surfaces were measured by atomic force microscopy. Species that were found predominantly in the adhering microbiome had significantly higher adhesion forces to saliva-coated enamel (-0.60 to -1.05 nN) than did species mostly present in the planktonic microbiome (-0.40 to -0.55 nN). It is concluded that differences in composition of the planktonic and the adhering oral microbiome are due to small differences in the forces by which strains adhere to saliva-coated enamel, providing an important step in understanding site- and material-specific differences in the composition of biofilms in the oral cavity.
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Affiliation(s)
- S W Wessel
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Bantema-Joppe EJ, van den Heuvel ER, de Munck L, de Bock GH, Smit WGJM, Timmer PR, Dolsma WV, Jansen L, Schröder CP, Siesling S, Langendijk JA, Maduro JH. Impact of primary local treatment on the development of distant metastases or death through locoregional recurrence in young breast cancer patients. Breast Cancer Res Treat 2013; 140:577-85. [PMID: 23912958 DOI: 10.1007/s10549-013-2650-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 07/20/2013] [Indexed: 11/30/2022]
Abstract
In this study, we tested the hypothesis whether breast conserving therapy (BCT) compared with mastectomy is associated with a negative outcome in terms of distant metastases or death (DMD) and investigated the relation between locoregional recurrence (LRR) and DMD in young breast cancer (BC) patients. This study included a consecutive series of 536 patients ≤40 years of age at diagnosis with pathological T1N0-3M0 BC, treated between 1989 and 2005. A multistate survival model was used to evaluate the influences of local treatment and LRR on DMD, adjusted for potential prognostic factors. Patients were treated with mastectomy (N = 213) or BCT (N = 323). Median age at diagnosis was 36.3 years, with a median follow-up of 9.0 years. The 10-year actuarial cumulative incidence of DMD was 30.6 % after mastectomy and 26.3 % after BCT (P = 0.04). In total, 81 (15 %) LRRs were observed. After BCT, patients had a threefold higher risk of LRR than after mastectomy (HR 2.9; 95 % CI 1.6-5.3). Patients with LRR had a higher risk of DMD compared with patients without LRR (HR 5.5; 95 % CI 2.1-14.5). However, BCT was not negatively associated with DMD-after-LRR (HR 0.47; 95 % CI 0.2-1.1, BCT vs mastectomy). In conclusion, although LRR significantly affected DMD, the increased risk of LRR after BCT compared with mastectomy did not lead to a worse DMD outcome in BC patients ≤40 years of age.
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Affiliation(s)
- E J Bantema-Joppe
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands
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Tjon Pian Gi REA, Ilmarinen T, van den Heuvel ER, Aaltonen LM, Andersen J, Brunings JW, Chirila M, Dietz A, Ferran Vilà F, Friedrich G, de Gier HHW, Golusinski W, Graupp M, Hantzakos A, Horcasitas R, Jackowska J, Koelmel JC, Lawson G, Lindner F, Remacle M, Sittel C, Weichbold V, Wierzbicka M, Dikkers FG. Safety of intralesional cidofovir in patients with recurrent respiratory papillomatosis: an international retrospective study on 635 RRP patients. Eur Arch Otorhinolaryngol 2013; 270:1679-87. [PMID: 23377227 DOI: 10.1007/s00405-013-2358-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/10/2013] [Indexed: 12/27/2022]
Abstract
Intralesional use of cidofovir (Vistide(®)) has been one of the mainstays of adjuvant therapy in patients with recurrent respiratory papillomatosis (RRP) since 1998. In 2011, a communication provided by the producer of cidofovir addressed very serious side effects concerning its off-label use. As this was a general warning, it was inconclusive whether this would account for its use in RRP. The aim of this study is to determine whether nephrotoxic, neutropenic, or oncogenic side effects have occurred after intralesional use of cidofovir in patients with RRP. Update of recent developments in RRP, a multicentre questionnaire and a multicentre retrospective chart review. Sixteen hospitals from eleven countries worldwide submitted records of 635 RRP patients, of whom 275 were treated with cidofovir. RRP patients received a median of three intralesional injections (interquartile range 2-6). There were no statistical differences in occurrence of neutropenia or renal dysfunction before and after cidofovir. There was no statistical difference in occurrence of upper airway and tracheal malignancies between the cidofovir and the non-cidofovir group. In this retrospective patient chart review, no clinical evidence was found for more long-term nephrotoxicity, neutropenia or laryngeal malignancies after the administration of intralesional cidofovir in RRP patients.
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Affiliation(s)
- R E A Tjon Pian Gi
- Department of Otorhinolaryngology Head and Neck Surgery, University of Groningen, University Medical Center Groningen, PO box 30001, 9700 RB Groningen, The Netherlands.
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