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Köck A, Kofler J, Lemmens L, Suntinger M, Gehringer M, Auer F, Linke K, Riegler B, Winckler C, Berger G, Egger-Danner C. Hind feet position score: A novel trait to genetically reduce lameness incidence. JDS Commun 2024; 5:38-41. [PMID: 38223376 PMCID: PMC10785266 DOI: 10.3168/jdsc.2023-0414] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 01/16/2024]
Abstract
Lameness is an important health and welfare issue that causes considerable economic losses in dairy herds. The objective of this study was to investigate whether the hind feet position score (HFPS) can be used as an auxiliary trait for genetic evaluation of lameness. The HFPS is evaluated by visual scoring of the position of both the hind-digits to the mid-line of the cow's body. The higher the heel height of the lateral claw, the higher is the HFPS, and the higher is the risk for development of lameness. In total, 3,478 records from 1,064 Fleckvieh cows from 35 farms were obtained between September 1, 2021, and March 5, 2022. Data collection was carried out by the regional milk recording organizations. Hind feet position was scored visually by trained personnel during routine milk performance testing in the milking parlor using a 3-class scoring system: score 1 = 0° to <17° indicating a balanced heel height of both the medial and the lateral claw; score 2 = angle of 17° to 24°; score 3 = angle of >24°. After all cows had been milked, locomotion scoring was performed for each animal using a 5-class scoring system with locomotion scores ranging between 1 (normal) and 5 (severely lame). Using HFPS, sensitivity and specificity were 69.5% and 66.8%, respectively, for detecting lameness defined by locomotion score ≥2. For genetic analyses, a bivariate linear animal model was fitted with fixed effects of herd, parity, lactation stage, and classifier, and random effects of animal and permanent environment. Heritabilities for HFPS and locomotion score were 0.07 and 0.10, respectively, and the genetic correlation between the 2 traits studied was 0.80. These results suggest that the HFPS could be used for genetic evaluations to reduce lameness incidence in dairy cattle.
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Affiliation(s)
- A. Köck
- ZuchtData EDV-Dienstleistungen GmbH, Dresdner Str. 89/18, 1200 Vienna, Austria
| | - J. Kofler
- Department of Farm Animals and Veterinary Public Health, University Clinic for Ruminants, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
| | - L. Lemmens
- Department of Farm Animals and Veterinary Public Health, University Clinic for Ruminants, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria
| | - M. Suntinger
- ZuchtData EDV-Dienstleistungen GmbH, Dresdner Str. 89/18, 1200 Vienna, Austria
| | - M. Gehringer
- LKV-Austria, Dresdner Str. 89, 1200 Vienna, Austria
| | - F.J. Auer
- LKV-Austria, Dresdner Str. 89, 1200 Vienna, Austria
| | - K. Linke
- ZuchtData EDV-Dienstleistungen GmbH, Dresdner Str. 89/18, 1200 Vienna, Austria
| | - B. Riegler
- Department of Sustainable Agricultural Systems, Institute of Livestock Sciences, University of Natural Resources and Life Sciences, Vienna, 1180 Vienna, Austria
| | - C. Winckler
- Department of Sustainable Agricultural Systems, Institute of Livestock Sciences, University of Natural Resources and Life Sciences, Vienna, 1180 Vienna, Austria
| | - G. Berger
- Rinderzucht Austria, Dresdner Str. 89, 1200 Vienna, Austria
| | - C. Egger-Danner
- ZuchtData EDV-Dienstleistungen GmbH, Dresdner Str. 89/18, 1200 Vienna, Austria
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Maravic Z, Rawicka I, Lemmens L, Benedict A, Rakonczai P, Komlos K. Quality of life (QoL) in metastatic colorectal cancer (mCRC) in the real world: Final results of a European survey. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.136] [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: 11/14/2022] Open
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Maravic Z, Benedict À, Komlos K, Lemmens L, Rawicka I. Treatment of Metastatic Colorectal Cancer in the Real World (mCRC): Final Results from a European Survey. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.327] [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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Maravic Z, Rawicka I, Lemmens L, Bokros J, González de Pedro C, Stanisic Trenevski J, Méndez Otero M, Rial O, Ferro T. Survey on the Unmet Needs of Patients Living with mCRC – Learnings from an International Study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.022] [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] Open
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5
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Lemmens L, Kos S, Beijer C, Braat DDM, Jonker MA, Nelen WLDM, Wetzels AMM. Optimization of laboratory procedures for intrauterine insemination: survey of methods in relation to clinical outcome. Andrology 2018; 6:707-713. [PMID: 29959833 DOI: 10.1111/andr.12510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/31/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a wide practice variation of used methods and outcomes in IUI in fertility laboratories. Standardization of the IUI procedure is important for reducing inconsistency among laboratories in counseling infertile couples and in pregnancy results. The aim of the study was to evaluate the currently used laboratory procedures of IUI in Dutch fertility laboratories and their effect on IUI pregnancy results. Additionally, the methods for semen analysis (SA) were evaluated, as SA is related to IUI in terms of inseminated sperm number and IUI counseling. MATERIAL AND METHODS This questionnaire survey study was sent to laboratories participating in the Dutch external quality control program for semen analysis (SKML) and consisted of 46 questions concerning laboratory management, methods for semen analysis and IUI, and clinical results. The results were analyzed using univariable and multivariable logistic regression models. RESULTS A total of 52 laboratories (out of 99) provided information on used methodologies for SA or laboratory procedures of IUI and the organization of the laboratory. A wide variability was confirmed in used methods for both SA and IUI. Evaluation of pregnancy results obtained during 3 years (2013-2015) showed that specific used laboratory methods have a significant effect on the probability of becoming pregnant. DISCUSSION AND CONCLUSION Important to remark is that in this survey study cycle-specific data, including variables of the individual couples (age, stimulation protocol, etc), were not included and may have effects on the results. The reported results provide an overview of the current practice performance; however, the organization of fertility laboratories is changing rapidly. The use of standardized methods in IUI is important for optimizing the performance of care and improving pregnancy results. The knowledge on used procedures, however, is limited, and further research on factors involving SA and the IUI procedure is necessary.
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Affiliation(s)
- L Lemmens
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - S Kos
- Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, The Netherlands
| | - C Beijer
- Department of Clinical Chemistry, Atalmedial, Medical Diagnostic Centre, Amsterdam, The Netherlands
| | - D D M Braat
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - M A Jonker
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - W L D M Nelen
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - A M M Wetzels
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
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Lemmens L, Kos S, Beijer C, Braat DDM, Nelen WLDM, Wetzels AMM. Techniques used for IUI: is it time for a change? Hum Reprod 2018; 32:1835-1845. [PMID: 28854719 DOI: 10.1093/humrep/dex223] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/04/2017] [Indexed: 12/29/2022] Open
Abstract
STUDY QUESTION Are the guidelines for the technical aspects of IUI (WHO, 2010) still in accordance with the current literature? SUMMARY ANSWER In general, the laboratory guidelines of the World Health Organization (WHO) are a suitable protocol, although the evidence is not always conclusive and some changes are advisable. WHAT IS KNOWN ALREADY Lack of standardization of the technical procedures required for IUI might result in inter-laboratory variation in pregnancy rates. Most centers still use their own materials and methods even though some guidelines are available. STUDY DESIGN, SIZE, DURATION A structural review focusing on the association between pregnancy rates and the procedures of semen collection (e.g. ejaculatory abstinence, collection place), semen processing (e.g. preparation method, temperature during centrifugation/storage), insemination (e.g. timing of IUI, bed rest after IUI) and the equipment used. PARTICIPANTS/MATERIALS, SETTING, METHODS A literature search was performed in Medline and the Cochrane library. When no adequate studies of the impact of a parameter on pregnancy results were found, its association with sperm parameters was reviewed. MAIN RESULTS AND THE ROLE OF CHANCE For most variables, the literature review revealed a low level of evidence, a limited number of studies and/or an inadequate outcome measure. Moreover, the comparison of procedures (i.e. semen preparation technique, time interval between semen, collection, processing and IUI) revealed no consensus about their results. It was not possible to develop an evidence-based, optimal IUI treatment protocol. LIMITATIONS, REASONS FOR CAUTION The included studies exhibited a lack of standardization in inclusion criteria and methods used. WIDER IMPLICATIONS OF THE FINDINGS This review emphasizes the need for more knowledge about and standardization of assisted reproduction technologies. Our literature search indicates that some of the recommendations in the laboratory guidelines could be adapted to improve standardization, comfort, quality control and to cut costs. STUDY FUNDING/COMPETING INTEREST(S) The Dutch Foundation for Quality Assessment in Medical Laboratories (SKML), Nijmegen, The Netherlands. S.K. and W.N. have no conflicts of interest to disclose. C.B. and A.W. are members of the board of the SKML. With a grant from SKML, L.L. was paid for her time to perform the research and write the publication. D.B. received grants from Merck Serono, Ferring and MSD, outside the submitted work. REGISTRATION NUMBER N/A.
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Affiliation(s)
- L Lemmens
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - S Kos
- Department of Clinical Chemistry, Maasstad Hospital Rotterdam, PO Box 9100, 3007 AC Rotterdam, The Netherlands
| | - C Beijer
- Department of Clinical Chemistry, Atalmedial, Medical Diagnostic Centre, PO Box 69641, 1060 CR Amsterdam, The Netherlands
| | - D D M Braat
- Department of Obstetrics and Gynaecology, Radboud University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - W L D M Nelen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - A M M Wetzels
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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Lemmens L, Buist Y, Lette M, Stoop A, Baan C, de Bruin S. IMPROVING EARLY DETECTION INITIATIVES: PERSPECTIVES OF PROFESSIONALS IN THE NETHERLANDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.401] [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: 11/13/2022] Open
Affiliation(s)
- L. Lemmens
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
| | - Y. Buist
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
| | - M. Lette
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
- VU University Medical Centre, Amsterdam, Netherlands,
| | - A. Stoop
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
- VU University Medical Centre, Amsterdam, Netherlands,
| | - C. Baan
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
- University of Tilburg, Tilburg, Netherlands
| | - S. de Bruin
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
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Lette M, Stoop A, Lemmens L, Buist Y, Baan C, de Bruin S. AGING IN PLACE WITH FORMAL AND INFORMAL CARE: OLDER PEOPLE’S NEEDS AND PREFERENCES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.400] [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: 11/12/2022] Open
Affiliation(s)
- M. Lette
- VU University Medical Centre, Amsterdam, Netherlands,
| | - A. Stoop
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
| | - L. Lemmens
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
| | - Y. Buist
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
| | - C. Baan
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
- Tilburg University, Tilburg, Netherlands
| | - S. de Bruin
- National Institute for Public Health and the Environment, Bilthoven, Netherlands,
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Abstract
To date, there are no phase III trial data that can guide healthcare professionals in managing toxicities of epidermal growth factor receptor inhibitors (EGFRIs). This exploratory survey assessed the similarities and differences in nursing management of EGFRI-related toxicities across 10 European countries. A questionnaire that was sent to ten nurses who specialize in the treatment of patients with EGFRI asked about the prevention and treatment of acneiform rash, dry skin/eczema, fissures, paronychia, and pyogenic granuloma. Responses from seven nurses showed that overall (with the exception of rash), treatment differed markedly between countries in the management of dermatologic toxicities. These substantial differences across the European hospitals surveyed suggest that it might be worthwhile to develop treatment algorithms by conducting a consensus conference or a follow-up survey with several assessments and a larger sample.
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Lemmens L. 1745 Nursing management of liver enzyme elevations (LEEs) in cancer patients receiving oral antiangiogenic tyrosine kinase inhibitors (TKIs). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30753-5] [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: 10/22/2022]
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Lemmens L, Van Steijn J, Wojtasik A. 73 Nursing Management of Patients Taking Everolimus – an Oral MTor Inhibitor. Eur J Oncol Nurs 2012. [DOI: 10.1016/s1462-3889(12)70087-x] [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: 10/28/2022]
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Lemmens L. P117 Management of epidermal growth factor receptor (EGFR) inhibitor-related skin toxicities across Europe. Eur J Oncol Nurs 2010. [DOI: 10.1016/s1462-3889(10)70179-4] [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: 11/30/2022]
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Lemmens L, van Zelm R, Borel Rinkes I, van Hillegersberg R, Kerkkamp H. Clinical and organizational content of clinical pathways for digestive surgery: a systematic review. Dig Surg 2009; 26:91-9. [PMID: 19252405 DOI: 10.1159/000206142] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [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: 12/10/2022]
Abstract
BACKGROUND/AIMS Oncology surgery of the gastrointestinal tract is complex and infamous for its high complication rates. One of the methods for implementing interventions to optimize the patients' condition and to enhance postoperative outcome is the development and implementation of a clinical pathway. The aim of this study was to analyze the content, i.e. the interventions of clinical pathways for digestive surgery and their effects on postoperative outcome measures. METHODS We performed a systematic review to study clinical pathways in hospital care for adult patients undergoing elective surgery of the stomach, esophagus, pancreas, liver, colon or rectum. The MEDLINE, EMBASE and CINAHL literature databases were searched. RESULTS The most common interventions in the clinical pathways in this review were defined in the pre- and postoperative phase and included: nutritional management, pain management, mobilization, education and discharge planning. The primary aim of these interventions was to enhance postoperative recovery. CONCLUSION Clinical pathways for digestive surgery contain specific interventions to improve postoperative outcome. Most of these interventions are in accordance with the Enhanced Recovery After Surgery (ERAS) protocol, which is an evidence-based protocol for care after colon resections. They result in reduced length of stay without compromising other postoperative outcome measures.
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Affiliation(s)
- L Lemmens
- Department of Perioperative and Emergency Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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Rutgeerts P, Lemmens L, Van Assche G, Noman M, Borghini-Fuhrer I, Goedkoop R. Treatment of active Crohn's disease with onercept (recombinant human soluble p55 tumour necrosis factor receptor): results of a randomized, open-label, pilot study. Aliment Pharmacol Ther 2003; 17:185-92. [PMID: 12534402 DOI: 10.1046/j.1365-2036.2003.01414.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.7] [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: 12/17/2022]
Abstract
BACKGROUND Monoclonal antibodies to the pro-inflammatory cytokine tumour necrosis factor-alpha have shown efficacy in treating Crohn's disease, but can be immunogenic. Soluble tumour necrosis factor-binding proteins are being studied as potential alternative anti-tumour necrosis factor agents in Crohn's disease. AIM To investigate the safety and efficacy of onercept, a recombinant form of the natural human soluble p55 tumour necrosis factor receptor, in the treatment of patients with active Crohn's disease. METHODS In a pilot study, 12 patients with active Crohn's disease were randomized to receive onercept at either 11.7 or 50 mg three times weekly for 2 weeks. Patients were followed up for 6 months after the end of treatment. RESULTS The Crohn's disease activity index decreased rapidly during treatment in both groups. Seven responses (Crohn's disease activity index decrease of 100 points) were observed over the first 6 weeks of the study, including five remissions (Crohn's disease activity index decrease of 150 points). Improvement was sustained for 2-4 months after stopping treatment. Treatment was well tolerated. No patients developed antibodies to onercept. CONCLUSIONS Neutralizing the activity of tumour necrosis factor-alpha with its soluble p55 receptor may be valuable in the treatment of patients with Crohn's disease. Larger placebo-controlled trials are indicated.
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Affiliation(s)
- P Rutgeerts
- University Hospital Gasthuisberg, Leuven, Belgium. PaulRutgeerts.uz.kuleuven.ac.be
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Matthyssens LE, Van Hee R, Van Osselaer GE, Lemmens L. Giant diverticulum of the colon: report of two new cases and review of the literature. Int Surg 2003; 88:34-40. [PMID: 12731729] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Diverticulosis coli affects more than one in three individuals older than 65 in the Western world. Giant diverticulum of the colon is an extremely rare complication of diverticular disease; only 113 cases, mostly situated in the colon sigmoideum, have been reported in the world literature. Two new cases of giant diverticulum of the colon sigmoideum, with totally different clinical presentation, diagnosis, and management, are reported-one being the cause of chronic anemia and the other presenting as an acute abdomen. Based on a review of the literature, an update on symptomatology, diagnosis, pathogenesis, and therapeutical options of this rare disorder is provided.
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Affiliation(s)
- L E Matthyssens
- Academic Surgical Center Stuivenberg, ACZA, Stuivenberg General Hospital, Antwerp, Belgium
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D'Haens G, Swijsen C, Noman M, Lemmens L, Ceuppens J, Agbahiwe H, Geboes K, Rutgeerts P. Etanercept in the treatment of active refractory Crohn's disease: a single-center pilot trial. Am J Gastroenterol 2001; 96:2564-8. [PMID: 11569676 DOI: 10.1111/j.1572-0241.2001.04705.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [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: 12/11/2022]
Abstract
OBJECTIVES Etanercept, an injectable tumor necrosis factor (TNF) receptor fusion protein, binds and inactivates human TNF and is used in active rheumatoid arthritis. Blocking TNF with monoclonal antibodies has also been beneficial in Crohn's disease. We attempted to determine the efficacy and safety of etanercept for induction of clinical, endoscopic, and histological improvement in patients with moderate to severe Crohn's disease despite standard treatment. METHODS Ten patients with active Crohn's disease were treated with etanercept (25 mg s.c.) twice per week for 12 wk. Background therapy was kept stable during the trial. Crohn's disease activity index (CDAI), Inflammatory Bowel Disease Questionnaire, and C-reactive protein levels were measured at weeks 0, 2, 4, 8, and 12. Colonoscopies were performed before and after therapy in responders; endoscopic biopsies were scored for inflammation. RESULTS At week 2 after the start, a clinical response (deltaCDAI > or = 70) was observed in 6/10 patients (median = 305 [294-418] to 166 [107-392]), with reduction in serum C-reactive protein levels (median = 17.2 [6.8-67.2] to 9.1 [0.9-17.2] mg/dl). Colonoscopies showed a reduction in inflammatory lesions in the four patients who attained remission (CDAI < 150), whereas the inflammatory score of the biopsies did not decrease significantly. No moderate or severe adverse events were observed. CONCLUSIONS Etanercept may be effective in Crohn's disease refractory to standard therapy.
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Affiliation(s)
- G D'Haens
- Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium
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D'Haens G, Lemmens L, Geboes K, Vandeputte L, Van Acker F, Mortelmans L, Peeters M, Vermeire S, Penninckx F, Nevens F, Hiele M, Rutgeerts P. Intravenous cyclosporine versus intravenous corticosteroids as single therapy for severe attacks of ulcerative colitis. Gastroenterology 2001; 120:1323-9. [PMID: 11313301 DOI: 10.1053/gast.2001.23983] [Citation(s) in RCA: 288] [Impact Index Per Article: 12.5] [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] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Cyclosporine has been effective in patients with steroid-refractory attacks of ulcerative colitis (UC). We investigated the effects of intravenous (IV) cyclosporine as single IV therapy (without glucocorticosteroids) for severe UC and compared these with the response to glucocorticosteroids. METHODS Patients with a severe attack of UC were randomized to treatment with IV cyclosporine, 4 mg x kg(-1) x day(-1), or with methylprednisolone, 40 mg/day, in a randomized, double-blind, controlled trial. After 8 days, patients who had a response received the same medication orally in combination with azathioprine. Patients were followed up clinically, endoscopically, and by scintigraphy. Renal function was assessed using urinary inulin clearances. Endpoints were clinical improvement, discharge from the hospital, and remission up to 12 months after intravenous therapy. RESULTS Thirty patients were included. After 8 days, 8 of 15 patients (53%) who received methylprednisolone had a response to therapy vs. 9 of 14 (64%) receiving cyclosporine. In nonresponders, 3 of 7 methylprednisolone patients and 1 of 3 cyclosporine patients improved when both treatments were combined. No serious drug-related toxicity was observed with either treatment. At 12 months, 7 of 9 patients (78%) initially controlled with cyclosporine maintained their remission vs. 3 of 8 (37%) initially treated with methylprednisolone. No clinically significant decrease of renal function was observed. CONCLUSIONS Cyclosporine monotherapy is an effective and safe alternative to glucocorticosteroids in patients with severe attacks of UC.
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Affiliation(s)
- G D'Haens
- Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
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Abstract
The CT and MRI findings in a case of chondrosarcoma of the hyoid bone are reported. Although chondrosarcoma is the second most common primary malignant bone tumor, only 10 % of chondrosarcomas occur in the head and neck region. The hyoid bone is a rare site of involvement with only seven cases reported previously.
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Affiliation(s)
- A Demeyere
- Department of Radiology, Imeldaziekenhuis Bonheiden, Imeldalaan 9, B-2820 Bonheiden, Belgium
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Abstract
The classical indication for obesity surgery, in terms of excess weight, included only patients with an excess weight of 100% or 45 kg. This review challenges this classic indication. Sixty-four out of 170 patients treated with a biliopancreatic diversion had an excess weight below 80%. The specific weight-related complications, reoperations and results are compared with patients above 80% excess weight. The different groups are comparable in complications and results.
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Affiliation(s)
- L Lemmens
- Antwerp Medical Center, Antwerp, 2000, Belgium
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20
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Verhille R, Lemmens L, De Somer F, Schillebeeckx J. Cervical intervertebral disc calcification in children: case report. J Belge Radiol 1991; 74:109-10. [PMID: 2061270] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We present the case of an 8-year-old male with intervertebral disc calcification at C2-C3. This uncommon entity has a very striking clinical and radiographic appearance. The course is mostly benign and therefore only needs conservative treatment.
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Affiliation(s)
- R Verhille
- Department of Radiology, Imeldaziekenhuis, Bonheiden, Belgium
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Lemmens L, Hougardy G. [Porphyria and psychiatric manifestations. Apropos of a case]. Acta Psychiatr Belg 1990; 90:100-11. [PMID: 1670392] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Porphyrias is a group of metabolic diseases with different clinical aspects. However, the following case suggests that psychodynamic assumptions might be considered to explain a part of the symptomatology.
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Affiliation(s)
- L Lemmens
- Service-adjoint, Psychologie médicale, CHU de Liège
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Saubier EC, Lemmens L, Partensky C, Allantaz F. [Leiomyosarcoma of the duodenum. A new case and review of the literature (author's transl)]. J Chir (Paris) 1981; 118:473-81. [PMID: 7026581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
The purgative activities of 18 different dihydroxyanthracene derivatives, including free anthraquinones and anthrones, were investigated by determining their influence on the water, sodium and potassium absorption in the gastrointestinal tract by direct injection of the solutions in Tyrode to the rat colon in situ. The extent of the solubility of the compounds has also been assessed. The 1,8-dihydroxyanthracene structure seemed to be the best for hydragogue effect. Rhein-anthraquinone and -anthrone were the most active compounds tested.
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