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Jansen TL, Janssen M, Otto C, Vosters JLG, Niessink T. Raman spectroscopic analysis of joint capsule calcification of the fingers. Clin Rheumatol 2024; 43:1783-1784. [PMID: 38502410 DOI: 10.1007/s10067-024-06941-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Affiliation(s)
- T L Jansen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands
| | - M Janssen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands
| | - C Otto
- Personalized Diagnostics and Therapeutics, Technical Medicine Centre, University of Twente, Drienerlolaan 5, 7500AE, Enschede, the Netherlands
| | - J L G Vosters
- Department of Rheumatology, Meander Medical Centre, Amersfoort, the Netherlands
| | - T Niessink
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands.
- Personalized Diagnostics and Therapeutics, Technical Medicine Centre, University of Twente, Drienerlolaan 5, 7500AE, Enschede, the Netherlands.
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Niessink T, Janssen M, Giesen T, Efdé MN, Comarniceanu AC, Otto C, Jansen TL. The diagnostic accuracy of Raman spectroscopy integrated with polarized light microscopy for calcium pyrophosphate associated arthritis. Arthritis Care Res (Hoboken) 2024. [PMID: 38622108 DOI: 10.1002/acr.25350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND We studied the performance of integrated Raman Polarized light Microscopy (iRPolM) for the identification of calcium pyrophosphate (CPP) associated arthritis (CPPD) METHODS: This is a diagnostic accuracy study including 400 consecutive synovial fluid samples from a single hospital in the Netherlands. Accuracy measures were calculated against polarized light microscopy (PLM) and the 2023 ACR/EULAR criteria set for CPPD. RESULTS The interrater reliability between iRPolM and the 2023 ACR/EULAR criteria set for CPPD was strong (k = 0.88). The diagnostic performance of iRPolM compared to the 2023 ACR/EULAR criteria set was: sensitivity 86.0% (95%CI 73.3-94.2), specificity 99.1% (95%CI 97.5-99.8), positive likelihood ratio 100.33 (95%CI 32.3-311.3), negative likelihood ratio 0.14 (95%CI 0.07-0.28), positive predictive value 93.5% (95%CI 82.2-97.8), negative predictive value 98.0% (95%CI 82.2-97.8), and accuracy 97.5% (95%CI 95.5-98.8). We allowed rheumatologists to rate the certainty of their microscopic identification of CPP and found a large correspondence between iRPolM and a certain identification (κ = 0.87), while only 10% of the uncertain CPP identifications could be confirmed with iRPolM. We identified several novel particle types in synovial fluid analysis, including calcium carbonate crystals, deposited carotenoids, microplastics, and three types of Maltese cross birefringent objects. CONCLUSION iRPolM can easily identify CPP crystals with a strong diagnostic performance. PLM alone is not specific enough to reliably resolve complicated cases and the implementation of Raman spectroscopy in rheumatology practice can be of benefit to patients with suspected CPPD.
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Affiliation(s)
- Tom Niessink
- University of Twente, Enschede, the Netherlands
- VieCuri Medical Centre, Venlo, the Netherlands
| | | | | | | | | | - Cees Otto
- University of Twente, Enschede, the Netherlands
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Lucieer F, van der Lubbe M, van Stiphout L, Janssen M, Van Rompaey V, Devocht E, Perez-Fornos A, Guinand N, van de Berg R. Multi-frequency VEMPs improve detection of present otolith responses in bilateral vestibulopathy. Front Neurol 2024; 15:1336848. [PMID: 38450070 PMCID: PMC10915078 DOI: 10.3389/fneur.2024.1336848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024] Open
Abstract
Objective To investigate whether multi-frequency Vestibular Evoked Myogenic Potential (VEMP) testing at 500, 750, 1,000, and 2,000 Hz, would improve the detection of present dynamic otolith responses in patients with bilateral vestibulopathy (BV). Methods Prospective study in a tertiary referral center. BV patients underwent multi-frequency VEMP testing. Cervical VEMPs and ocular VEMPs were recorded with the Neuro-Audio system (v2010, Neurosoft, Ivanovo, Russia). The stimuli included air-conducted tone bursts of 500, 750, 1,000, and 2,000 Hz, at a stimulation rate of 13 Hz. Outcome measures included the percentage of present and absent VEMP responses, and VEMP thresholds. Outcomes were compared between frequencies and type of VEMPs (cVEMPs, oVEMPs). VEMP outcomes obtained with the 500 Hz stimulus, were also compared to normative values obtained in healthy subjects. Results Forty-nine BV patients completed VEMP testing: 47 patients completed cVEMP testing and 48 patients completed oVEMP testing. Six to 15 % more present VEMP responses were obtained with multifrequency testing, compared to only testing at 500 Hz. The 2,000 Hz stimulus elicited significantly fewer present cVEMP responses (right and left ears) and oVEMP responses (right ears) compared to the other frequencies (p ≤ 0.044). Using multi-frequency testing, 78% of BV patients demonstrated at least one present VEMP response in at least one ear. In 46% a present VEMP response was found bilaterally. BV patients demonstrated a significantly higher percentage of absent VEMP responses and significantly higher VEMP thresholds than healthy subjects, when corrected for age (p ≤ 0.002). Based on these results, a pragmatic VEMP testing paradigm is proposed, taking into account multi-frequency VEMP testing. Conclusion Multi-frequency VEMP testing improves the detection rate of present otolith responses in BV patients. Therefore, multi-frequency VEMPs should be considered when evaluation of (residual) otolith function is indicated.
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Affiliation(s)
- F. Lucieer
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - M. van der Lubbe
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - L. van Stiphout
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - M. Janssen
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - V. Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - E. Devocht
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - A. Perez-Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - N. Guinand
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - R. van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
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Niessink T, Giesen T, Efdé M, Comarniceanu A, Janssen M, Otto C, Jansen TL. Test characteristics of Raman spectroscopy integrated with polarized light microscopy for the diagnosis of acute gouty arthritis. Joint Bone Spine 2023; 90:105611. [PMID: 37442334 DOI: 10.1016/j.jbspin.2023.105611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES We studied the performance of Raman spectroscopy integrated with polarized light microscopy (iRPolM) as a next-generation technique for synovial fluid analysis in gout. METHODS This is a prospective study, including consecutive synovial fluid samples drawn from any peripheral swollen joint. Diagnostic accuracy was compared to the 2015 ACR/EULAR Gout classification criteria as a reference test and to polarized light microscopy (PLM) analysis by a rheumatologist. Synovial fluid was analysed with iRPolM after unblinding the PLM results. RESULTS Two hundred unselected consecutive patient samples were included in this study. Validation against clinical criteria: 67 patients were classified as gout according to 2015 ACR/EULAR classification criteria. Compared to the 2015 ACR/EULAR gout classification criteria, iRPolM had a sensitivity of 77.6% (95% CI: 65.8-86.9), specificity of 97.7% (95% CI: 93.5-99.5), positive predictive value (PPV) of 94.5% (95% CI: 84.9-98.2), negative predictive value (NPV) of 89.7% (95% CI: 84.7-93.1), an accuracy of 91.0% (95% CI: 86.2-94.6), a positive likelihood ratio of 34.4 (95% CI: 11.16-106.10) and a negative likelihood ratio of 0.23 (95% CI: 0.15-0.36). Validation against PLM: 55 samples were positive for MSU according to PLM. The interrater agreement between PLM and iRPolM was near perfect (к=0.90). The sensitivity of iRPolM to identify MSU in PLM-positive samples was 91.2% (95% CI: 80.7-97.1), the specificity was 97.6% (95% CI: 93.0-99.5), the PPV was 94.6% (95% CI: 85.0-98.2), NPV was 96.0% (95% CI: 91.2-98.2) and the accuracy was 95.6% (95% CI: 91.4-98.2). The positive likelihood ratio was 37.4 (95% CI: 12.20-114.71), and the negative likelihood ratio was 0.09 (95% CI: 0.04-0.21). CONCLUSION iRPolM is a promising next-generation diagnostic tool for rheumatology by diagnosing gout with high specificity, increased objectivity, and a sensitivity comparable to PLM.
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Affiliation(s)
- Tom Niessink
- Medical Cell BioPhysics Group, TechMed Centre, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands; Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands.
| | - Tanja Giesen
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - Monique Efdé
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - Antoaneta Comarniceanu
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - Cees Otto
- Medical Cell BioPhysics Group, TechMed Centre, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
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Janssen M, Siemer S. [Intervention planning in modern renal surgery]. Urologie 2023; 62:1133-1143. [PMID: 37698657 DOI: 10.1007/s00120-023-02188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Three-dimensional (3D) reconstruction in renal surgery offers significant benefits in planning of the operation itself, in patient education and training fellows. OBJECTIVE The goal was to study the possible application and use of 3D reconstruction in modern renal surgery. METHODS A literature search in PubMed using keywords "3D" and "renal surgery" within the last 10 years of publication was performed. RESULTS The search revealed 655 articles among them 53 reviews. Relevant for this article were 120 articles which included 14 reviews. The publication statistics showed a strong increase in the last 10 years which may reflect the increasing application and demand for 3D technology in the field of renal surgery. Especially in robot-assisted minimally invasive surgery applications, the use of 3D technology was studied more often. The technical standards are not yet uniform and 3D printing in complex renal surgery remains cost- and time-intensive. Nevertheless, the results of the pioneering clinical studies showed positive results, and 3D technology can be used not only in planning the operation, but in patient education and also the training of fellows and staff. A limitation to more complex cases seems to be sensible for this is still a costly tool. To identify complex cases in renal surgery, the established renometric scoring systems should be used more broadly in daily practice to identify patients who would profit most from this technique. CONCLUSION In complex renal surgery, 3D reconstruction and modelling is rational; furthermore, it can be useful in patient education and in training of fellows.
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Affiliation(s)
- M Janssen
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
| | - S Siemer
- Klinik für Urologie und Kinderurologie, Universitätskliniken des Saarlandes, Homburg/Saar, Deutschland
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Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, Fuller A, Rosenthal A, Becce F, Bardin T, Ea HK, Filippou G, FitzGerald J, Iagnocco A, Lioté F, McCarthy GM, Ramonda R, Richette P, Sivera F, Andres M, Cipolletta E, Doherty M, Pascual E, Perez-Ruiz F, So A, Jansen TL, Kohler MJ, Stamp LK, Yinh J, Adinolfi A, Arad U, Aung T, Benillouche E, Bortoluzzi A, Dau J, Maningding E, Fang MA, Figus FA, Filippucci E, Haslett J, Janssen M, Kaldas M, Kimoto M, Leamy K, Navarro GM, Sarzi-Puttini P, Scirè C, Silvagni E, Sirotti S, Stack JR, Truong L, Xie C, Yokose C, Hendry AM, Terkeltaub R, Taylor WJ, Choi HK. The 2023 ACR/EULAR Classification Criteria for Calcium Pyrophosphate Deposition Disease. Arthritis Rheumatol 2023; 75:1703-1713. [PMID: 37494275 PMCID: PMC10543651 DOI: 10.1002/art.42619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/23/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score >56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
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Affiliation(s)
| | - Sara K Tedeschi
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lille, France
| | - Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts
| | - Amy Fuller
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Ann Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Hang Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Georgios Filippou
- Rheumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - John FitzGerald
- David Geffen School of Medicine, University of California, and Veterans Administration for Greater Los Angeles, Los Angeles, California
| | - AnnaMaria Iagnocco
- Academic Rheumatology Center, Università degli Studi di Torino, Turin, Italy
| | - Frédéric Lioté
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Service de Rhumatologie, AP-HP, Lariboisière Hospital, and Université Paris Cité, Faculté de Santé, Paris, France
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, and Mater Misericordiae University Hospital, Dublin, Ireland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain, and Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain
| | - Mariano Andres
- Department of Medicine, Rheumatology Section, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Eliseo Pascual
- Rheumatology Division, Cruces University Hospital, Bilbao, Spain
| | - Fernando Perez-Ruiz
- Arthritis Investigation Group, Biocruces-Bizkaia Health Research Institute, Spain, Department of Medicine, Medicine and Nursing School, University of the Basque Country, and Basque Country Rheumatology Society, Bilbao, Spain
| | - Alexander So
- Lausanne University Hospital, Lausanne, Switzerland
| | - Tim L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands, and Medical Cell BioPhysics Group, University of Twente, Enschede, The Netherlands
| | - Minna J Kohler
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Janeth Yinh
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | - Uri Arad
- Department of Rheumatology, Te Whatu Ora-Health New Zealand Waikato, Hamilton, New Zealand
| | - Thanda Aung
- Division of Rheumatology, University of California, Los Angeles
| | - Eva Benillouche
- Department of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, and Azienda Ospedaliera-Universitaria di Ferrara, Cona (FE), Italy
| | - Jonathan Dau
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston
| | | | - Meika A Fang
- David Geffen School of Medicine, University of California, and Veterans Administration for Greater Los Angeles, Los Angeles, California
| | - Fabiana A Figus
- Rheumatology Division, Local Health Unit (ASL), Turin-3, Collegno and Pinerolo, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Janine Haslett
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Marian Kaldas
- David Geffen School of Medicine, University of California, Los Angeles
| | - Maryann Kimoto
- David Geffen School of Medicine, University of California, Los Angeles
| | - Kelly Leamy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | | | - Carlo Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Ettore Silvagni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, and Azienda Ospedaliera-Universitaria di Ferrara, Cona (FE), Italy
| | - Silvia Sirotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - John R Stack
- School of Medicine and Medical Science, University College Dublin, and Mater Misericordiae University Hospital, Dublin, Ireland
| | - Linh Truong
- Division of Rheumatology, University of California, Los Angeles, California
| | - Chen Xie
- Division of Rheumatology, University of California, Los Angeles, California
| | - Chio Yokose
- Harvard Medical School, Boston, Massachusetts
| | - Alison M Hendry
- Department of Medicine, General Medicine and Rheumatology, Middlemore Hospital, Counties Manukau Health District, New Zealand
| | - Robert Terkeltaub
- San Diego Veterans Administration Healthcare Service, and University of California, San Diego
| | - William J Taylor
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Hyon K Choi
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
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7
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Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, Fuller A, Rosenthal A, Becce F, Bardin T, Ea HK, Filippou G, Fitzgerald J, Iagnocco A, Lioté F, McCarthy GM, Ramonda R, Richette P, Sivera F, Andrés M, Cipolletta E, Doherty M, Pascual E, Perez-Ruiz F, So A, Jansen TL, Kohler MJ, Stamp LK, Yinh J, Adinolfi A, Arad U, Aung T, Benillouche E, Bortoluzzi A, Dau J, Maningding E, Fang MA, Figus FA, Filippucci E, Haslett J, Janssen M, Kaldas M, Kimoto M, Leamy K, Navarro GM, Sarzi-Puttini P, Scirè C, Silvagni E, Sirotti S, Stack JR, Truong L, Xie C, Yokose C, Hendry AM, Terkeltaub R, Taylor WJ, Choi HK. The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease. Ann Rheum Dis 2023; 82:1248-1257. [PMID: 37495237 PMCID: PMC10529191 DOI: 10.1136/ard-2023-224575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score>56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
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Affiliation(s)
| | - Sara K Tedeschi
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lille, France
| | - Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amy Fuller
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Ann Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Hang-Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Georgios Filippou
- Rheumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - John Fitzgerald
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Veterans Administration for Greater Los Angeles, Los Angeles, California, USA
| | - AnnaMaria Iagnocco
- Academic Rheumatology Center, Università degli Studi di Torino, Turin, Italy
| | - Frédéric Lioté
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
- Université Paris Cité, Faculté de Santé, Paris, France
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain
- Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain
| | - Mariano Andrés
- Department of Medicine, Rheumatology Section, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Eliseo Pascual
- Rheumatology Division, Cruces University Hospital, Bilbao, Spain
| | - Fernando Perez-Ruiz
- Arthritis Investigation Group, Biocruces-Bizkaia Health Research Institute, Spain, Department of Medicine, Medicine and Nursing School, University of the Basque Country, and Basque Country Rheumatology Society, Bilbao, Spain
| | - Alexander So
- Lausanne University Hospital, Lausanne, Switzerland
| | - Tim L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands
- Medical Cell BioPhysics Group, University of Twente, Enschede, The Netherlands
| | - Minna J Kohler
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Janeth Yinh
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Uri Arad
- Department of Rheumatology, Te Whatu Ora-Health New Zealand Waikato, Hamilton, New Zealand
| | - Thanda Aung
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Eva Benillouche
- Department of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Azienda Ospedaliera-Universitaria di Ferrara (Cona FE), Cona FE, Italy
| | - Jonathan Dau
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Meika A Fang
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Veterans Administration for Greater Los Angeles, Los Angeles, California, USA
| | - Fabiana A Figus
- Rheumatology Division, Local Health Unit (ASL), Turin-3, Collegno and Pinerolo, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Janine Haslett
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Marian Kaldas
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Maryann Kimoto
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kelly Leamy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Geraldine M Navarro
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | | | - Carlo Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Ettore Silvagni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Azienda Ospedaliera-Universitaria di Ferrara (Cona FE), Cona FE, Italy
| | - Silvia Sirotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - John R Stack
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Linh Truong
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Chen Xie
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Chio Yokose
- Harvard Medical School, Boston, Massachusetts, USA
| | - Alison M Hendry
- Department of Medicine, General Medicine and Rheumatology, Middlemore Hospital, Counties Manukau Health District, Auckland, New Zealand
| | - Robert Terkeltaub
- San Diego Veterans Administration Healthcare Service, and University of California, San Diego, California, USA
| | - William J Taylor
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Hyon K Choi
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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Niessink T, Otto C, Janssen M, Jansen TL. Calcium carbonates are novel positive birefringent crystals in synovial fluid. Clin Rheumatol 2023; 42:635-636. [PMID: 36357629 DOI: 10.1007/s10067-022-06441-3] [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] [Received: 09/12/2022] [Revised: 10/27/2022] [Accepted: 11/05/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Tom Niessink
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands. .,Medical Cell BioPhysics Group, TechMed Centre, University of Twente, Drienerlolaan 5, 7500AE, Enschede, The Netherlands.
| | - Cees Otto
- Medical Cell BioPhysics Group, TechMed Centre, University of Twente, Drienerlolaan 5, 7500AE, Enschede, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands
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Kuipers-Dirven R, Janssen M, Hoekman J. Assessing university policies for enhancing societal impact of academic research: A multicriteria mapping approach. Research Evaluation 2022. [DOI: 10.1093/reseval/rvac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
While there is a prolific debate on evaluating the societal impact of academic research, so far little attention has been paid to assessing the design and implementation of suitable organizational strategies. This article argues that evaluation methods are needed which are both formative and sensitive to diverging views on what defines and constitutes societal impact. We use a participatory deliberation method, the Multicriteria Mapping (MCM) approach, to examine how stakeholders appraise the use of university policy options for enhancing societal impact, and understand on what basis they judge the performance of these options. Focusing on a large Dutch research-based university, we conduct 22 interviews with academics, management, and support staff as well as strategic policy officers to examine how they rank and discuss the expected performance of university policy options identified in previous literature. Our results show that interviewees base their scores on criteria related to policy options’ expected organizational output and external outcomes, as well as their practical and, to a lesser degree, cultural, and financial feasibility. The resulting rankings also point at contrasts in the perceived potential of policy options, with interviewees assigning priority to providing researchers with recognition and rewards for impact-based activities. We conclude by discussing how MCM can be used as a formative evaluation method to assess and select policies and inform decision-making that fit a university’s particular situation. Besides drawing lessons for the context of our illustrative case, we also reflect on the relevance of the evaluation method and our findings for other universities.
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Affiliation(s)
- Rosa Kuipers-Dirven
- Dialogic Innovatie en Interactie , Hooghiemstraplein 33-36 , Utrecht, 3514 AX, The Netherlands
- Innovation & Impact Centre TU Delft , Building 26.C, Van der Burghweg 1 , Delft, 2628 CS, The Netherlands
| | - Matthijs Janssen
- Dialogic Innovatie en Interactie , Hooghiemstraplein 33-36 , Utrecht, 3514 AX, The Netherlands
- Copernicus Institute of Sustainable Development, Utrecht University , Princetonlaan 8a , Utrecht, 3584 CB, The Netherlands
| | - Jarno Hoekman
- Copernicus Institute of Sustainable Development, Utrecht University , Princetonlaan 8a , Utrecht, 3584 CB, The Netherlands
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van der Weele L, Niessink T, Maas M, Don Griot P, Janssen M, Otto C, Jansen TL, Tas SW, de Vries N. Clinical image: synovitis of the metacarpophalangeal joints. Ann Rheum Dis 2022:ard-2022-223290. [DOI: 10.1136/ard-2022-223290] [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] [Received: 10/04/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
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11
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Sumpter NA, Takei R, Cadzow M, Topless RKG, Phipps-Green AJ, Murphy R, de Zoysa J, Watson H, Qasim M, Lupi AS, Abhishek A, Andrés M, Crișan TO, Doherty M, Jacobsson L, Janssen M, Jansen TL, Joosten LAB, Kapetanovic M, Lioté F, Matsuo H, McCarthy GM, Perez-Ruiz F, Riches P, Richette P, Roddy E, Stiburkova B, So A, Tausche AK, Torres RJ, Uhlig T, Major TJ, Stamp LK, Dalbeth N, Choi HK, Vazquez AI, Leask MP, Reynolds RJ, Merriman TR. Association of Gout Polygenic Risk Score With Age at Disease Onset and Tophaceous Disease in European and Polynesian Men With Gout. Arthritis Rheumatol 2022; 75:816-825. [PMID: 36281732 DOI: 10.1002/art.42393] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/19/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine whether a gout polygenic risk score (PRS) is associated with age at gout onset and tophaceous disease in European, East Polynesian, and West Polynesian men and women with gout. METHODS A 19-variant gout PRS was produced in 7 European gout cohorts (N = 4,016), 2 East Polynesian gout cohorts (N = 682), and 1 West Polynesian gout cohort (N = 490). Sex-stratified regression models were used to estimate the relationship between the PRS and age at gout onset and tophaceous disease. RESULTS The PRS was associated with earlier age at gout onset in men (β = -3.61 in years per unit PRS [95% confidence interval (95% CI) -4.32, -2.90] in European men; β = -6.35 [95% CI -8.91, -3.80] in East Polynesian men; β = -3.51 [95% CI -5.46, -1.57] in West Polynesian men) but not in women (β = 0.07 [95% CI -2.32, 2.45] in European women; β = 0.20 [95% CI -7.21, 7.62] in East Polynesian women; β -3.33 [95% CI -9.28, 2.62] in West Polynesian women). The PRS showed a positive association with tophaceous disease in men (odds ratio [OR] for the association 1.15 [95% CI 1.00, 1.31] in European men; OR 2.60 [95% CI 1.66, 4.06] in East Polynesian men; OR 1.53 [95% CI 1.07, 2.19] in West Polynesian men) but not in women (OR for the association 0.68 [95% CI 0.42, 1.10] in European women; OR 1.45 [95% CI 0.39, 5.36] in East Polynesian women). The PRS association with age at gout onset was robust to the removal of ABCG2 variants from the PRS in European and East Polynesian men (β = -2.42 [95% CI -3.37, -1.46] and β = -6.80 [95% CI -10.06, -3.55], respectively) but not in West Polynesian men (β = -1.79 [95% CI -4.74, 1.16]). CONCLUSION Genetic risk variants for gout also harbor risk for earlier age at gout onset and tophaceous disease in European and Polynesian men. Our findings suggest that earlier gout onset involves the accumulation of gout risk alleles in men but perhaps not in women, and that this genetic risk is shared across multiple ancestral groups.
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Affiliation(s)
- Nicholas A Sumpter
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, and Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Riku Takei
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Murray Cadzow
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Ruth K G Topless
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | | | - Rinki Murphy
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Janak de Zoysa
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Huti Watson
- Ngāti Porou Hauora Trust, Te Puia Springs, New Zealand
| | | | - Alexa S Lupi
- Department of Epidemiology and Biostatistics, Michigan State University, and The Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, Michigan
| | - Abhishek Abhishek
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK, and GlobalGoutGenetics Consortium
| | - Mariano Andrés
- GlobalGoutGenetics Consortium, and Department of Rheumatology, Alicante General University Hospital-ISABIAL, Miguel Hernandez University, Alicante, Spain
| | - Tania O Crișan
- GlobalGoutGenetics Consortium, and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK, and GlobalGoutGenetics Consortium
| | - Lennart Jacobsson
- GlobalGoutGenetics Consortium, and Department of Rheumatology & Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Matthijs Janssen
- GlobalGoutGenetics Consortium, and Complex Gout Expert Centre, Department of Rheumatology, Viecuri Medical Centre, Venlo, The Netherlands
| | - Tim L Jansen
- GlobalGoutGenetics Consortium, and Complex Gout Expert Centre, Department of Rheumatology, Viecuri Medical Centre, Venlo, The Netherlands
| | - Leo A B Joosten
- GlobalGoutGenetics Consortium, and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, and Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Meliha Kapetanovic
- GlobalGoutGenetics Consortium, and Lund University and Skåne University Hospital, Lund, Sweden
| | - Frédéric Lioté
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Hirotaka Matsuo
- GlobalGoutGenetics Consortium, and Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Saitama, Japan
| | - Geraldine M McCarthy
- GlobalGoutGenetics Consortium, and Mater Misericordiae University Hospital and University College, Dublin, Ireland
| | - Fernando Perez-Ruiz
- GlobalGoutGenetics Consortium, and Rheumatology Division, Osakidetza, OSI EE-Cruces, Cruces University Hospital, Barakaldo, Biocruces-Bizkaia Health Research Institute, Barakaldo, and the Medicine Department of the Medicine School of the University of the Basque Country, Leioa, Spain
| | - Philip Riches
- GlobalGoutGenetics Consortium, and IGC, University of Edinburgh, Scotland
| | - Pascal Richette
- GlobalGoutGenetics Consortium, and Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Cité, Paris, France
| | - Edward Roddy
- GlobalGoutGenetics Consortium, and School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Blanka Stiburkova
- GlobalGoutGenetics Consortium, and Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic, and Institute of Rheumatology, Prague, Czech Republic
| | - Alexander So
- GlobalGoutGenetics Consortium, and Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Anne-Kathrin Tausche
- GlobalGoutGenetics Consortium, and Division of Rheumatology, University Clinic Carl Gustav Carus at the TU Dresden, Dresden, Germany
| | - Rosa J Torres
- GlobalGoutGenetics Consortium, and Department of Biochemistry, La Paz University Hospital Health Research Institute (FIBHULP), IdiPaz, and Center for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Till Uhlig
- GlobalGoutGenetics Consortium, and Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Tanya J Major
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Lisa K Stamp
- GlobalGoutGenetics Consortium, and Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand, and GlobalGoutGenetics Consortium
| | - Hyon K Choi
- Clinical Epidemiology Unit, Massachusetts General Hospital, Boston
| | - Ana I Vazquez
- Department of Epidemiology and Biostatistics, Michigan State University, and The Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, Michigan
| | - Megan P Leask
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Richard J Reynolds
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Tony R Merriman
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and GlobalGoutGenetics Consortium
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Te Kampe R, Boonen A, Jansen TL, Elling JM, Flendrie M, van Eijk-Hustings Y, Janssen M, van Durme C, de Vries H. Development and usability of a web-based patient-tailored tool to support adherence to urate-lowering therapy in gout. BMC Med Inform Decis Mak 2022; 22:95. [PMID: 35392890 PMCID: PMC8991610 DOI: 10.1186/s12911-022-01833-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/28/2022] [Indexed: 01/09/2023] Open
Abstract
Background The aim of this study is to develop and assess usability of a web-based patient-tailored tool to support adherence to urate-lowering therapy (ULT) among gout patients in a clinical setting.
Methods The content of the tool was based on the Integrated Change (I-Change) model. This model combines various socio-cognitive theories and assumes behavioral change is a result of becoming aware of the necessity of change by integrating pre-motivational, motivational, and post-motivational factors. An expert group (five gout experts, three health services researchers, and one health behavior expert) was assembled that decided in three meetings on the tool’s specific content (assessments and personalized feedback) using information from preparatory qualitative studies and literature reviews. Usability was tested by a think aloud approach and validated usability questionnaires.
Results The I-Change Gout tool contains three consecutive sessions comprising 80 questions, 66 tailored textual feedback messages, and 40 tailored animated videos. Navigation through the sessions was determined by the patients’ intention to adapt suboptimal ULT adherence. After the sessions, patients receive an overview of the personalized advices and plans to support ULT adherence. Usability testing among 20 gout patients that (ever) used ULT and seven healthcare professionals revealed an overall score for the tool of 8.4 ± 0.9 and 7.7 ± 1.0 (scale 1–10). Furthermore, participants reported a high intention to use and/or recommend the tool to others. Participants identified some issues for further improvement (e.g. redundant questions, technical issues, and text readability). If relevant, these were subsequently implemented in the I-Change Gout tool, to allow further testing among the following participants. Conclusion This study provides initial support for the usability by patients and healthcare professionals of the I-Change Gout tool to support ULT adherence behavior.
Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01833-6.
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Affiliation(s)
- Ritch Te Kampe
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. .,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. .,Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands.
| | - Annelies Boonen
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Jan Mathis Elling
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Marcel Flendrie
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Yvonne van Eijk-Hustings
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Caroline van Durme
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,Centre Hospitalier Chrétien, Liège, Belgium
| | - Hein de Vries
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
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Pleshkov M, Rondas N, Lucieer F, van Stiphout L, Janssen M, Guinand N, Perez-Fornos A, Demkin V, van Rompaey V, Kingma H, van de Berg R. Reported thresholds of self-motion perception are influenced by testing paradigm. J Neurol 2022; 269:5755-5761. [PMID: 35294617 PMCID: PMC9553771 DOI: 10.1007/s00415-022-11032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/01/2021] [Accepted: 02/15/2022] [Indexed: 11/27/2022]
Abstract
Background/objective Different testing paradigms have been proposed to investigate perceptual self-motion thresholds. They can differ regarding the amount of possible motions that patients have to choose from. Objective of this study was to compare the two-option paradigm and twelve-option paradigm, to investigate whether reducing the choice options significantly influences the reported thresholds of self-motion perception of healthy subjects. Methods Thirty-three volunteers with no prior vestibular complaints were included and sequentially tested with both paradigms at a random sequence. Perceptual self-motion thresholds were measured using a hydraulic motion platform in the absence of external visual and auditory cues. The platform delivered twelve different movements: six translations and six rotations. Each subject had to report the correct type and direction of movements. Thresholds were determined by a double confirmation of the lowest threshold, in combination with a double rejection of the one-step lower stimulus. Perceptual self-motion thresholds of both paradigms were compared using the mixed model analysis. Results The twelve-option paradigm showed significantly higher reported thresholds for yaw rotations and translations left, right and down (p < 0.001), compared to the two-option paradigm. No statistical difference was found for rolls and translations up. No significant gender effect, learning effect and carry-over effect were present in any of the applied motion directions. Conclusion Reported thresholds of self-motion perception of healthy subjects are influenced by the testing paradigm. The twelve-option paradigm showed significantly higher thresholds than the two-option paradigm. Results obtained with each testing paradigm should, therefore, be compared to paradigm-specific normative data. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11032-y.
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Affiliation(s)
- M. Pleshkov
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands
- Faculty of Physics, Tomsk State University, Tomsk, Russia
| | - N. Rondas
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - F. Lucieer
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands
| | - L. van Stiphout
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands
| | - M. Janssen
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands
- School for Public Health and Primary Care (CAPHRI), Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - N. Guinand
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - A. Perez-Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - V. Demkin
- Faculty of Physics, Tomsk State University, Tomsk, Russia
| | - V. van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine and Health Sciences, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - H. Kingma
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands
| | - R. van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands
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14
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Te Kampe R, Boonen A, Jansen T, Janssen M, de Vries H, van Durme C. Development of a patient decision aid for the initiation of urate-lowering therapy in gout patients. RMD Open 2022; 8:rmdopen-2021-001979. [PMID: 35185008 PMCID: PMC8860083 DOI: 10.1136/rmdopen-2021-001979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/23/2022] [Indexed: 11/04/2022] Open
Abstract
Aim Shared decision-making improves patients’ experiences with care, satisfaction with management decisions and possibly health outcomes. This study describes the development of a decision aid (DA) that supports patients with gout and their physicians in a face-to-face clinical setting to (a) decide whether or not to (re)start urate-lowering therapy (ULT) and (b) agree on the preferred ULT. Methods Recommendations of the International Patient Decision Aid Standards group guided the development. A steering group of experts in gout and health services research specified the scope. Nominal group technique meetings were organised in which patients ranked the importance of preidentified potential characteristics/attributes of ULT and discussed further needs regarding the DA. A literature search was conducted to collect evidence on gout outcomes with and without ULT. Subsequently, the DA prototype was designed and adjusted using feedback from the steering group and results of cognitive debriefing interviews among five gout patients. Results The final DA consists of six pages. First, the DA clarifies the decision at stake and describes gout including its risk factors, the role of lifestyle and treatment of flares. Next, risk of future flares with and without ULT in relation to serum uric acid levels is described and visualised. Relevant attributes of ULT are presented in an option grid distinguishing first-line and second-line ULT. Finally, patients’ believes and preferences are explicitly addressed before making the shared decision. Conclusion This study provides initial support for usability of a DA for gout patients eligible for starting ULT.
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Affiliation(s)
- Ritch Te Kampe
- Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Annelies Boonen
- Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Tim Jansen
- Rheumatology, VieCuri Medical Centre, Venlo, Netherlands
| | | | - Hein de Vries
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Health Promotion, Maastricht University, Maastricht, Limburg, Netherlands
| | - Caroline van Durme
- Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, Netherlands
- Rheumatology, Centre Hospitalier Chrétien, Liege, Belgium
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Niessink T, Ringoot J, Janssen M, Otto C, Jansen T. Titanium dioxide particles detected by Raman Spectroscopy in synovial fluid from a swollen ankle. Arthritis Rheumatol 2022; 74:1069. [PMID: 35133081 PMCID: PMC9322402 DOI: 10.1002/art.42078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | - Cees Otto
- University of Twente, Enschede, Netherlands
| | - Tim Jansen
- University of Twente, Enschede, Netherlands.,VieCuri Medisch Centrum, Venlo, Netherlands
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Zeuschner P, Greguletz L, Meyer I, Janssen M, Wagenpfeil G, Stöckle M, Siemer S, Saar M. Longitudinal comparison of open vs. robot-assisted partial nephrectomy: Is the robot better from the start? Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00433-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: 11/04/2022]
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van de Laar CJ, Janssen CA, Janssen M, Oude Voshaar MAH, AL MJ, van de Laar MAFJ. Model-based cost-effectiveness analyses comparing combinations of urate lowering therapy and anti-inflammatory treatment in gout patients. PLoS One 2022; 17:e0261940. [PMID: 35089941 PMCID: PMC8797232 DOI: 10.1371/journal.pone.0261940] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives
To assess the cost-effectiveness of various combinations of urate lowering therapy (ULT) and anti-inflammatory treatment in the management of newly diagnosed gout patients, from the Dutch societal perspective.
Methods
A probabilistic patient-level simulation estimating costs and quality-adjusted life years (QALYs) comparing gout and hyperuricemia treatment strategies was performed. ULT options febuxostat, allopurinol and no ULT were considered. Flare treatments naproxen, colchicine, prednisone, and anakinra were considered. A Markov Model was constructed to simulate gout disease. Health states were no flare, and severe pain, mild pain, moderate pain, or no pain in the presence of a flare. Model input was derived from patient level clinical trial data, meta-analyses or from previously published health-economic evaluations. The results of probabilistic sensitivity analyses were presented using incremental cost-effectiveness ratios (ICERs), and summarized using cost-effectiveness acceptability curves (CEACs). Scenario analyses were performed.
Results
The ICER for allopurinol versus no ULT was €1,381, when combined with naproxen. Febuxostat yielded the highest utility, but also the highest costs (€4,385 vs. €4,063 for allopurinol), resulting in an ICER of €25,173 when compared to allopurinol. No ULT was not cost-effective, yielding the lowest utility. For the gout flare medications, comparable effects on utility were achieved. Combined with febuxostat, naproxen was the cheapest option (€4,404), and anakinra the most expensive (€4,651). The ICER of anakinra compared to naproxen was €818,504. Colchicine and prednisone were dominated by naproxen.
Conclusion
Allopurinol and febuxostat were both cost-effective compared to No ULT. Febuxostat was cost-effective in comparison with allopurinol at higher willingness-to-pay thresholds. For treating gout flares, colchicine, naproxen and prednisone offered comparable health economic implications, although naproxen was the favoured option.
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Affiliation(s)
| | - Carly A. Janssen
- Transparency in Healthcare BV, Hengelo, the Netherlands
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Martijn A. H. Oude Voshaar
- Transparency in Healthcare BV, Hengelo, the Netherlands
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
| | - Maiwenn J. AL
- Institute for Medical Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Mart A. F. J. van de Laar
- Transparency in Healthcare BV, Hengelo, the Netherlands
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
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O'Sullivan S, Janssen M, Holzinger A, Nevejans N, Eminaga O, Meyer CP, Miernik A. Explainable artificial intelligence (XAI): closing the gap between image analysis and navigation in complex invasive diagnostic procedures. World J Urol 2022; 40:1125-1134. [PMID: 35084542 PMCID: PMC8791809 DOI: 10.1007/s00345-022-03930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
Literature review Cystoscopy is the gold standard for initial macroscopic assessments of the human urinary bladder to rule out (or diagnose) bladder cancer (BCa). Despite having guidelines, cystoscopic findings are diverse and often challenging to classify. The extent of the false negatives and false positives in cystoscopic diagnosis is currently unknown. We suspect that there is a certain degree of under-diagnosis (like the failure to detect malignant tumours) and over-diagnosis (e.g. sending the patient for unnecessary transurethral resection of bladder tumors with anesthesia) that put the patient at risk. Conclusions XAI robot-assisted cystoscopes would help to overcome the risks/flaws of conventional cystoscopy. Cystoscopy is considered a less life-threatening starting point for automation than open surgical procedures. Semi-autonomous cystoscopy requires standards and cystoscopy is a good procedure to establish a model that can then be exported/copied to other procedures of endoscopy and surgery. Standards also define the automation levels—an issue for medical product law. These cystoscopy skills do not give full autonomy to the machine, and represent a surgical parallel to ‘Autonomous Driving’ (where a standard requires a human supervisor to remain in the ‘vehicle’). Here in robotic cystoscopy, a human supervisor remains bedside in the ‘operating room’ as a ‘human‐in‐the‐loop’ in order to safeguard patients. The urologists will be able to delegate personal- and time-consuming cystoscopy to a specialised nurse. The result of automated diagnostic cystoscopy is a short video (with pre-processed photos from the video), which are then reviewed by the urologists at a more convenient time.
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Affiliation(s)
- S O'Sullivan
- Department of Urology, University Hospital of Münster (UKM), Muenster, Germany.
| | - M Janssen
- Department of Urology, University Hospital of Münster (UKM), Muenster, Germany
| | - Andreas Holzinger
- Human-Centered AI Lab, Institute for Medical Informatics/Statistics, Medical University of Graz, Graz, Austria
- xAI Lab, Alberta Machine Intelligence Institute, University of Alberta, Edmonton, Canada
| | - Nathalie Nevejans
- AI Responsible Chair, Research Center in Law, Ethics and Procedures, Faculty of Law of Douai, University of Artois, Arras, France
| | - O Eminaga
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
- Center for Artificial Intelligence in Medicine and Imaging, Stanford University School of Medicine, Stanford, CA, USA
| | - C P Meyer
- Urology Clinic, Ruhr‑University of Bochum, Bochum, Germany
| | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Freiburg, Germany
- RaVeNNA 4Pi-Consortium of the German Federal Ministry of Education and Research (BMBF), Freiburg, Germany
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Peeters IR, Oude Voshaar AMH, Moses A, Jansen TLTA, Flendrie M, van Herwaarden N, Janssen M. [Gout: an overview of diagnostics and treatment]. Ned Tijdschr Geneeskd 2022; 166:D6311. [PMID: 35138742] [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: 06/14/2023]
Abstract
Gout is characterized by acute arthritis due to the deposition of urate crystals in joints in a state of hyperuricemia. Gout is a clinical diagnosis and can be confirmed with a joint aspiration to examine the synovial fluid with a polarized light microscopy. If a joint aspiration is not feasible or inconclusive, ultrasound or Dual Energy Computed Tomography (DECT) can be considered. Pharmacological treatment of gout consists of treating acute flares with anti-inflammatory drugs and, if indicated, of urate lowering therapies (ULT). (Inter)national rheumatology guidelines recommend the use of ULT indefinite by a treat-to-target approach, but there is discussion whether (certain) patients might also be treated by a treat-to-avoid-symptoms approach. Two large Dutch trials are comparing these strategies in gout patients. Most gout patients have cardiovascular and metabolic comorbidities and therefore an indication for cardiovascular risk assessment.
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Affiliation(s)
- Iris Rose Peeters
- Sint Maartenskliniek, afd. Reumatologie, Nijmegen
- Contact: Iris Rose Peeters
| | | | - Anusha Moses
- Universiteit van Twente, afd. MedicalCellBiophysics, TechMed Centre, Enschede
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Bolton SJ, Levin SM, Guillot T, Li C, Kaspi Y, Orton G, Wong MH, Oyafuso F, Allison M, Arballo J, Atreya S, Becker HN, Bloxham J, Brown ST, Fletcher LN, Galanti E, Gulkis S, Janssen M, Ingersoll A, Lunine JL, Misra S, Steffes P, Stevenson D, Waite JH, Yadav RK, Zhang Z. Microwave observations reveal the deep extent and structure of Jupiter's atmospheric vortices. Science 2021; 374:968-972. [PMID: 34709937 DOI: 10.1126/science.abf1015] [Citation(s) in RCA: 4] [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] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- S J Bolton
- Southwest Research Institute, San Antonio, TX, USA
| | - S M Levin
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - T Guillot
- Université Côte d'Azur, Observatoire de la Côte d'Azur, Centre National de la Recherche Scientifique, Laboratoire Lagrange, Nice, France
| | - C Li
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Y Kaspi
- Weizmann Institute of Science, Rehovot, 76100, Israel
| | - G Orton
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - M H Wong
- Carl Sagan Center for Research, SETI Institute, Mountain View, CA, USA
| | - F Oyafuso
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - M Allison
- Goddard Institute for Space Studies, New York, NY, USA.,Department of Astronomy, Columbia University, New York, NY 10027, USA
| | - J Arballo
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - S Atreya
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - H N Becker
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - J Bloxham
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA 02138, USA
| | - S T Brown
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - L N Fletcher
- School of Physics and Astronomy, University of Leicester, Leicester LE1 7RH, UK
| | - E Galanti
- Weizmann Institute of Science, Rehovot, 76100, Israel
| | - S Gulkis
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - M Janssen
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - A Ingersoll
- Department of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - J L Lunine
- Department of Astronomy, Cornell University, Ithaca, NY, USA
| | - S Misra
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - P Steffes
- Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - D Stevenson
- Department of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - J H Waite
- Southwest Research Institute, San Antonio, TX, USA
| | - R K Yadav
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Z Zhang
- Department of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
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Bouman K, Groothuis J, Doorduin J, van Alfen N, ten Cate FU, van den Heuvel F, Nijveldt R, van Tilburg W, Buckens S, Dittrich A, Draaisma J, Janssen M, Kamsteeg E, van Kleef E, Smeitink J, van Tienen F, Smeets H, van Engelen B, Erasmus C, Voermans N. CONGENITAL MUSCULAR DYSTROPHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Te Kampe R, Jansen TL, van Durme C, Janssen M, Petersen G, Boonen A. Outcomes of Care Among Patients With Gout in Europe: A Cross-sectional Survey. J Rheumatol 2021; 49:312-319. [PMID: 34329184 DOI: 10.3899/jrheum.210009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess health- and patient-centered outcomes in gout across Europe, and explore patient-, care-, and country-level characteristics associated with these outcomes. METHODS Patients with self-reported physician-diagnosed gout from 14 European countries completed an online survey. Multivariable mixed-effect logistic and linear regressions were computed for health outcomes (gout flare recurrence) and patient-centered outcomes (patient satisfaction with current medication, and unaddressed goals), accounting for clustering within countries. The role of patient-, care-, and country-level factors was explored. RESULTS Participants included 1029 patients, predominantly diagnosed by a general practitioner (GP). One or more gout flares were reported by 70% of patients and ≥ 3 flares by 32%. Gout patients reported 1.1 ± 1.2 unaddressed goals, and 80% were satisfied with current medication. Patients with ≥ 3 and ≥ 1 flares were less likely to be treated with urate-lowering therapy (ULT) (OR 0.52, 95% CI 0.39-0.70 and OR 0.38, 95% CI 0.28-0.53, respectively), but more likely to have regular physician visits (OR 2.40, 95% CI 1.79-3.22 and OR 1.77, 95% CI 1.30-2.41). Three or more gout flares were also associated with lower satisfaction (OR 0.39, 95% CI 0.28-0.56) and more unaddressed goals (β 0.36, 95% CI 0.19-0.53). Notwithstanding, the predicted probability of being satisfied was still between 57% and 75% among patients with ≥ 3 flares but who were not receiving ULT. Finally, patients from wealthier and Northern European countries more frequently had ≥ 3 gout flares. CONCLUSION Across Europe, many patients with gout remain untreated despite frequent reported flares. Remarkably, a substantial proportion of them were still satisfied with gout management. A better understanding of patients' satisfaction and its role in physicians' gout management decisions is warranted to improve quality of care and gout outcomes across Europe.
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Affiliation(s)
- Ritch Te Kampe
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Tim L Jansen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Caroline van Durme
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Matthijs Janssen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Gudula Petersen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
| | - Annelies Boonen
- The data collection for this study was funded by Grünenthal GmbH. R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, and Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; T.L. Jansen, MD, PhD, M. Janssen, MD, PhD, Department of Rheumatology, VieCuri Medical Center, Venlo, the Netherlands; C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands, and Centre Hospitalier Chrétien, Liège, Belgium; G. Petersen, PhD, Grünenthal GmbH, Aachen, Germany; A. Boonen, Professor, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. GP is a full-time employee in the department of Governmental Affairs & Patient Centricity at Grünenthal GmbH. Address correspondence to R. te Kampe, Department of Rheumatology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. . Accepted for publication May 28, 2021
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te Kampe R, Boonen A, Jansen T, Elling JM, Flendrie M, Van Eijk-Hustings Y, Janssen M, Van Durme C, De Vries H. AB0915-PARE DEVELOPMENT AND USABILITY OF A WEB-BASED PATIENT-TAILORED TOOL TO SUPPORT ADHERENCE TO URATE-LOWERING THERAPY IN GOUT PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Adherence to prescribed urate-lowering therapy (ULT) among gout patients is considered to be among the poorest of all chronic conditions. eHealth programs can be a possible opportunity to foster ULT adherence.Objectives:This study describes the development and usability evaluation of a web-based tool to support ULT adherence among gout patients, specifically designed for a complement to usual care.Methods:The Integrated Change (I-Change) model was used as theoretical basis for the development. The model combines various socio-cognitive theories and differentiates between three phases: a pre-motivational, a motivational, and a post-motivational phase. In practices, the I-Change gout tool contains three sessions, following the three phases of the I-Change model. Patients receive tailored feedback based on their answers in the form of animated videos and text messages after each session, and are prompted to set specific goals and action plans for their ULT adherence. The content and development of the I-Change gout tool was determined along an iterative process within a steering group of clinicians and researchers, supported by patient interviews and gout specific literature related to key aspects of medication adherence behavior. A cross-sectional mixed methods design was used to test usability of the support tool consisting of a think aloud method and a usability questionnaire.Results:The steering group decided on the content of the three sessions of the I-Change gout tool. Depending on the intention to change ULT adherence behavior patients were navigated through the I-Change gout tool, patients with a low intention go through all 3 sessions and patients with a high intention go through the pre- and post-motivational session (figure 1). In total, the I-Change gout tool contains three sessions with 80 questions, 66 tailored textual feedback messages, and 40 tailored animated videos.Figure 1.Flowchart of the computer-tailored I-Change gout tool for urate-lowering therapy adherence.Twenty gout patients and seven healthcare professionals participated in the usability tests. The program end score rating for the gout tool was on average 8.4±0.9 (range 6-10) for patients and 7.7±1.0 (range 6-9) for healthcare professionals. Furthermore, participants reported a high intention to use and/or recommend the program in the future. Yet, participants identified some issues for further improvement of the systems user-friendliness by addressing barriers (e.g. more explicitly navigation) and weaknesses (e.g. technical and health literacy). The I-Change gout tool was updated according suggestions of improvements of the participants.Conclusion:This study provides initial support for the usability by patients and healthcare professionals of a ULT adherence I-Change gout tool. Further studies need to be conducted to assess its efficacy and (cost-) effectiveness in daily practice.Disclosure of Interests:None declared
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Zaidi F, Narang RK, Phipps-Green A, Gamble GG, Tausche AK, So A, Riches P, Andres M, Perez-Ruiz F, Doherty M, Janssen M, Joosten LAB, Jansen TL, Kurreeman F, Torres RJ, McCarthy GM, Miner JN, Stamp LK, Merriman TR, Dalbeth N. Systematic genetic analysis of early-onset gout: ABCG2 is the only associated locus. Rheumatology (Oxford) 2021; 59:2544-2549. [PMID: 31998961 DOI: 10.1093/rheumatology/kez685] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/12/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine whether serum urate-associated genetic variants are associated with early-onset gout. METHODS Participants with gout in the Genetics of Gout in Aotearoa study with available genotyping were included (n = 1648). Early-onset gout was defined as the first presentation of gout <40 years of age. Single nucleotide polymorphisms (SNPs) for the 10 loci most strongly associated with serum urate were genotyped. Allelic association of the SNPs with early-onset gout was tested using logistic regression in an unadjusted model and in a model adjusted for sex, body mass index, tophus presence, flare frequency, serum creatinine and highest serum urate. The analysis was also done in two replication cohorts: Eurogout (n = 704) and Ardea (n = 755), and data were meta-analysed. RESULTS In the Genetics of Gout in Aotearoa study, there were 638 (42.4%) participants with early-onset gout. The ABCG2 rs2231142 gout risk T-allele was present more frequently in participants with early-onset gout compared with the later-onset group. For the other SNPs tested, no differences in risk allele number were observed. In the allelic association analysis, the ABCG2 rs2231142 T-allele was associated with early-onset gout in unadjusted and adjusted models. Analysis of the replication cohorts confirmed the association of early-onset gout with the ABCG2 rs2231142 T-allele, but not with other serum urate-associated SNPs. In the meta-analysis, the odds ratio (95% CI) for early-onset gout for the ABCG2 rs2231142 T-allele was 1.60 (1.41, 1.83). CONCLUSION In contrast to other serum urate-raising variants, the ABCG2 rs2231142 T-allele is strongly associated with early-onset gout.
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Affiliation(s)
- Faseeh Zaidi
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
| | - Ravi K Narang
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
| | | | - Greg G Gamble
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
| | | | - Alexander So
- Department of Medicine, Service of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Philip Riches
- Rheumatology and Bone Disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Mariano Andres
- Department of Medicine, Sección de Reumatología, Hospital General Universitario de Alicante, Alicante, Spain
| | - Fernando Perez-Ruiz
- Rheumatology Division, Hospital Universitario Cruces, Baracaldo, Biscay, Spain
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Fina Kurreeman
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rosa J Torres
- Department of Biochemistry, La Paz University Hospital Health Research Institute (FIBHULP), IdiPaz, Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Geraldine M McCarthy
- Department of Rheumatology, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
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Reding R, Chardot C, Paul K, Veyckemans F, Obbergh LV, Clety SCD, Detaille T, Clapuyt P, Saint-Martin C, Janssen M, Lerut J, Sokal E, Otte JB. Living-Related Liver Transplantation in Children at Saint-Luc University Clinics : A Seven Year Experience in 77 Recipients. Acta Chir Belg 2020. [DOI: 10.1080/00015458.2001.12098576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- R. Reding
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Chr. Chardot
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - K. Paul
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - F. Veyckemans
- Pediatric Liver Transplant Program. Departments of Anaesthesiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - L. Van Obbergh
- Pediatric Liver Transplant Program. Departments of Anaesthesiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - S. Clement De Clety
- Pediatric Liver Transplant Program. Departments of Intensive Care, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Th. Detaille
- Pediatric Liver Transplant Program. Departments of Intensive Care, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Ph. Clapuyt
- Pediatric Liver Transplant Program. Departments of Radiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - Chr. Saint-Martin
- Pediatric Liver Transplant Program. Departments of Radiology, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - M. Janssen
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - J. Lerut
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - E. Sokal
- Pediatric Liver Transplant Program. Departments of Pediatrics, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
| | - J.-B. Otte
- Pediatric Liver Transplant Program. Departments of Surgery, Saint-Luc University Clinics, Universite catholique de Louvain, Brussels, Belgium
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Te Kampe R, Janssen M, van Durme C, Jansen TL, Boonen A. Sex Differences in the Clinical Profile Among Patients With Gout: Cross-sectional Analyses of an Observational Study. J Rheumatol 2020; 48:286-292. [PMID: 32611671 DOI: 10.3899/jrheum.200113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Research findings in gout result predominantly from studies about men and might not be generalizable to women. To improve insight into sex differences in gout, our study compared clinical characteristics and comorbidities of female and male patients with gout, and explored the influence of menopause on these differences. METHODS Data from patients referred to 2 rheumatology clinics and diagnosed with gout were used. Clinical characteristics and comorbidities of each sex were compared univariately. Sex difference in comorbidities were further explored in multivariate logistic regression analyses adjusting for age, BMI, smoking, and alcohol consumption in both the total group and in those with gout onset ≥ 55 years (as a surrogate for menopausal state). RESULTS There were 954 patients, including 793 (83%) men, included. Women were on average older (65 vs 62 yrs), were more often obese (54% vs 36%), had a higher serum uric acid (sUA) level (0.53 vs 0.49 mmol/L), used diuretics more often (60% vs 30%), and consumed alcohol less frequently (47% vs 72%). Additionally, women more frequently had reduced renal function (64% vs 31%), hypertension (78% vs 56%), heart failure (23% vs 12%), and type 2 diabetes (39% vs 17%; all P < 0.05). In those with gout onset ≥ 55 years, differences in comorbidities were less pronounced and disappeared after adjusting for lifestyle. CONCLUSION Our study confirmed sex differences in clinical characteristics and comorbidities among newly diagnosed patients with gout, and revealed that sex differences in comorbidities among those with gout onset beyond the age of female menopause were strongly attenuated and fully explained by lifestyle.
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Affiliation(s)
- Ritch Te Kampe
- R. te Kampe, MSc, Department of Internal Medicine, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht University, Department of Rheumatology, VieCuri Medical Center;
| | - Matthijs Janssen
- M. Janssen, MD, PhD, T.L. Jansen, MD, PhD, Department of Rheumatology, VieCuri Medical Center
| | - Caroline van Durme
- C. van Durme, MD, Department of Internal Medicine, Maastricht University Medical Center, the Netherlands, Centre Hospitalier Chrétien, Liège, Belgium
| | - Tim L Jansen
- M. Janssen, MD, PhD, T.L. Jansen, MD, PhD, Department of Rheumatology, VieCuri Medical Center
| | - Annelies Boonen
- A. Boonen, Prof, MD, PhD, Department of Internal Medicine, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands
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Prudhomme T, Beauval J, Lesourd M, Roumiguié M, Decaestecker K, Vignolini G, Campi R, Serni S, Territo A, Gausa L, Tugcu V, Sahin S, Alcaraz A, Musquera M, Stockle M, Janssen M, Fornara P, Mohammed N, Kamar N, Sallusto F, Breda A, Doumerc N. Robotic-assisted kidney transplantation in obese recipients compared to non-obese recipients: The European experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33559-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: 10/23/2022] Open
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Lambriks LJG, van Hoof M, Debruyne JA, Janssen M, Chalupper J, van der Heijden KA, Hof JR, Hellingman CA, George ELJ, Devocht EMJ. Evaluating hearing performance with cochlear implants within the same patient using daily randomization and imaging-based fitting - The ELEPHANT study. Trials 2020; 21:564. [PMID: 32576247 PMCID: PMC7310427 DOI: 10.1186/s13063-020-04469-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background Prospective research in the field of cochlear implants is hampered by methodological issues and small sample sizes. The ELEPHANT study presents an alternative clinical trial design with a daily randomized approach evaluating individualized tonotopical fitting of a cochlear implant (CI). Methods A single-blinded, daily-randomized clinical trial will be implemented to evaluate a new imaging-based CI mapping strategy. A minimum of 20 participants will be included from the start of the rehabilitation process with a 1-year follow-up period. Based on a post-operative cone beam CT scan (CBCT), mapping of electrical input will be aligned to natural place-pitch arrangement in the individual cochlea. The CI’s frequency allocation table will be adjusted to match the electrical stimulation of frequencies as closely as possible to corresponding acoustic locations in the cochlea. A randomization scheme will be implemented whereby the participant, blinded to the intervention allocation, crosses over between the experimental and standard fitting program on a daily basis, and thus effectively acts as his own control, followed by a period of free choice between both maps to incorporate patient preference. With this new approach the occurrence of a first-order carryover effect and a limited sample size is addressed. Discussion The experimental fitting strategy is thought to give rise to a steeper learning curve, result in better performance in challenging listening situations, improve sound quality, better complement residual acoustic hearing in the contralateral ear and be preferred by recipients of a CI. Concurrently, the suitability of the novel trial design will be considered in investigating these hypotheses. Trial registration ClinicalTrials.gov: NCT03892941. Registered 27 March 2019.
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Affiliation(s)
- L J G Lambriks
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands.
| | - M van Hoof
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J A Debruyne
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - M Janssen
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J Chalupper
- Advanced Bionics European Research Centre (AB ERC), Hannover, Germany
| | - K A van der Heijden
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - J R Hof
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - C A Hellingman
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - E L J George
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
| | - E M J Devocht
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center, Maastricht, The Netherlands
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Te Kampe R, van Durme C, Janssen M, van Eijk-Hustings Y, Boonen A, Jansen TL. Comparative Study of Real-Life Management Strategies in Gout: Data From Two Protocolized Gout Clinics. Arthritis Care Res (Hoboken) 2020; 72:1169-1176. [PMID: 31150161 DOI: 10.1002/acr.23995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/28/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare outcomes of 2 gout clinics that implemented different treatment strategies. METHODS Patients newly diagnosed with gout and a follow-up of 9-15 months were included. Co-primary outcomes were the proportion of patients reaching a serum uric acid (UA) ≤0.36 mmoles/liter and free of flares. Secondary outcomes were the proportion of patients requiring treatment intensification and experiencing adverse events. One clinic adopted a strict serum UA (≤0.30 mmoles/liter target) strategy, with early addition of a uricosuric to allopurinol, and the other clinic adopted a patient-centered (PC) strategy emphasizing a shared decision based on serum UA and patient satisfaction with gout control. Independent t-tests or chi-square tests were used to test differences in outcomes, and logistic regressions were used to adjust the effect of the treatment center on outcomes for confounders. RESULTS In total, 126 and 86 patients had a follow-up mean ± SD of 11.3 ± 1.8 versus 11.1 ± 1.9 months. In the UA strategy, 105 of 126 patients (83%) compared to 63 of 86 (74%) in the PC strategy (P = 0.10) reached the threshold of ≤0.36 mmoles/liter; and 58 of 126 (46%) versus 31 of 86 (36%) were free of flares (P = 0.15). In the UA strategy, 76 of 126 patients (60%) were on allopurinol monotherapy compared to 63 of 86 (73%) in the PC strategy (P = 0.05), yet the number of adverse events was not different (n = 25 [20%] versus n = 20 [23%]; P = 0.55). Adjusting for confounders did not substantially change these associations. CONCLUSION A strict UA strategy resulted in a nonsignificantly higher proportion of patients reaching a serum UA ≤0.36 mmoles/liter and being free of flares. This result was accomplished with significantly more therapy intensification. The small sample size plays a role in the significance of results.
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Affiliation(s)
- R Te Kampe
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - C van Durme
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - M Janssen
- VieCuri Medical Centre, Venlo, The Netherlands
| | | | - A Boonen
- Maastricht University Medical Centre, Maastricht, The Netherlands
| | - T L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands
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Jansen TL, Janssen M. Lessons and pitfalls from the 2020 Gout Clinical Practice Guideline presented in Atlanta at the ACR 2019. Clin Rheumatol 2020; 39:2011-2016. [DOI: 10.1007/s10067-020-05070-y] [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] [Received: 01/05/2020] [Revised: 02/23/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022]
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31
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Klück V, Jansen TLTA, Janssen M, Comarniceanu A, Efdé M, Tengesdal IW, Schraa K, Cleophas MCP, Scribner CL, Skouras DB, Marchetti C, Dinarello CA, Joosten LAB. Dapansutrile, an oral selective NLRP3 inflammasome inhibitor, for treatment of gout flares: an open-label, dose-adaptive, proof-of-concept, phase 2a trial. Lancet Rheumatol 2020; 2:e270-e280. [PMID: 33005902 PMCID: PMC7523621 DOI: 10.1016/s2665-9913(20)30065-5] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
SUMMARY BACKGROUND Gout flares are driven by interleukin (IL)-1β. Dapansutrile inhibits the NLRP3 inflammasome and subsequent activation of IL-1β. In this study we aimed to investigate the safety and efficacy of orally administered dapansutrile in patients with a gout flare. METHODS In this open-label, proof-of-concept, phase 2a trial, adult patients (aged 18-80 years) with a monoarticular monosodium urate crystal-proven gout flare were enrolled at an outpatient clinic in the Netherlands and sequentially assigned using a dose-adaptive design to receive 100 mg/day, 300 mg/day, 1000 mg/day, or 2000 mg/day oral dapansutrile for 8 days. The coprimary outcomes were change in patient-reported target joint pain from baseline to day 3 and from baseline to day 7, assessed in the per-protocol population (all patients who received at least 80% of the study drug and had no major protocol deviations). Safety was assessed in the intention-to-treat population. This trial is registered with the EU Clinical Trials Register, EudraCT 2016-000943-14, and is completed. FINDINGS Between May 18, 2017, and Jan 21, 2019, 144 patients were assessed for eligibility, of whom 34 were enrolled and 29 were included in the per-protocol population (three patients were excluded due to receiving <80% of study drug and two had major protocol deviations): eight patients received 100 mg/day, seven received 300 mg/day, six received 1000 mg/day, and eight received 2000 mg/day. Between baseline and day 3, there was a mean reduction in patient-reported target joint pain of 52·4% (SD 32·94; p=0∙016) for the 100 mg/day group, 68·4% (34·29; p=0∙016) for the 300 mg/day group, 55·8% (44·90; p=0∙063) for the 1000 mg/day group, and 57·6% (38·72; p=0∙016) for the 2000 mg/day group. At day 7, there was a mean reduction of 82·1% (22·68; p=0∙031) for the 100 mg/day group, 84·2% (16·33; p=0∙016) for the 300 mg/day group, 68·9% (34·89; p=0∙031) for the 1000 mg/day group, and 83·9% (15·44; p=0∙008) for the 2000 mg/day group, compared to baseline. 25 (73·5%) of 34 patients reported a total of 45 treatment-emergent adverse events, most of which were metabolism and nutrition disorders (17 [37·8%]) and gastrointestinal disorders (ten [22·2%]). Two serious adverse events occurred during the study, admission to hospital because of worsening of gout flare at day 3, and admission to hospital because of coronary stenosis 18 days after the patient received their last dose; these were considered moderate in severity and unrelated to the study drug. INTERPRETATION Dapansutrile is a specific NLRP3 inflammasome inhibitor with a satisfactory safety profile and efficacy in the reduction of target joint pain in this study. Future studies are needed to confirm the clinical potential of dapansutrile.
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Affiliation(s)
| | | | - Matthijs Janssen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Antoaneta Comarniceanu
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Monique Efdé
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Isak W Tengesdal
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Kiki Schraa
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Maartje C P Cleophas
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Curtis L Scribner
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Damaris B Skouras
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Carlo Marchetti
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Charles A Dinarello
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands (V Klück MD, K Schraa BSc, M C P Cleophas PhD, Prof C A Dinarello MD, Prof L A B Joosten PhD); Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands (T L Th A Jansen PhD, M Janssen PhD, A Comarniceanu MD, M Efdé MD); Olatec Therapeutics, New York, NY, USA (C L Scribner MD, D B Skouras MBA); Department of Medicine, University of Colorado, Aurora, CO, USA (I W Tengesdal MSc, C Marchetti PhD, Prof C A Dinarello); and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania (Prof L A B Joosten)
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Trebuch LM, Oyserman BO, Janssen M, Wijffels RH, Vet LEM, Fernandes TV. Impact of hydraulic retention time on community assembly and function of photogranules for wastewater treatment. Water Res 2020; 173:115506. [PMID: 32006806 DOI: 10.1016/j.watres.2020.115506] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 08/02/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 06/10/2023]
Abstract
Photogranules are dense, spherical agglomerates of cyanobacteria, microalgae and non-phototrophic microorganisms that have considerable advantages in terms of harvesting and nutrient removal rates for light driven wastewater treatment processes. This ecosystem is poorly understood in terms of the microbial community structure and the response of the community to changing abiotic conditions. To get a better understanding, we investigated the effect of hydraulic retention time (HRT) on photogranule formation and community assembly over a period of 148 days. Three laboratory bioreactors were inoculated with field samples from various locations in the Netherlands and operated in sequencing batch mode. The bioreactors were operated at four different HRTs (2.00, 1.00, 0.67, 0.33 days), while retaining the same solid retention time of 7 days. A microbial community with excellent settling characteristics (95-99% separation efficiency) was established within 2-5 weeks. The observed nutrient uptake rates ranged from 24 to 90 mgN L-1 day-1 and from 3.1 to 5.4 mgP L-1 day-1 depending on the applied HRT. The transition from single-cell suspension culture to floccular agglomeration to granular sludge was monitored by microscopy and 16S/18S sequencing. In particular, two important variables for driving aggregation and granulation, and for the structural integrity of photogranules were identified: 1. Extracellular polymeric substances (EPS) with high protein to polysaccharide ratio and 2. specific microorganisms. The key players were found to be the cyanobacteria Limnothrix and Cephalothrix, the colony forming photosynthetic eukaryotes within Chlamydomonadaceae, and the biofilm producing bacteria Zoogloea and Thauera. Knowing the makeup of the microbial community and the operational conditions influencing granulation and bioreactor function is crucial for successful operation of photogranular systems.
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Affiliation(s)
- L M Trebuch
- Department of Aquatic Ecology, Netherlands Institute of Ecology (NIOO-KNAW), Droevendaalsesteeg 10, 6708 PB, Wageningen, the Netherlands; Bioprocess Engineering, AlgaePARC Wageningen University, P.O. Box 16, 6700 AA, Wageningen, the Netherlands.
| | - B O Oyserman
- Department of Microbial Ecology, Netherlands Institute of Ecology (NIOO-KNAW), Droevendaalsesteeg 10, 6708 PB, Wageningen, the Netherlands; Bioinformatics Group, Wageningen University, Wageningen, the Netherlands
| | - M Janssen
- Bioprocess Engineering, AlgaePARC Wageningen University, P.O. Box 16, 6700 AA, Wageningen, the Netherlands
| | - R H Wijffels
- Bioprocess Engineering, AlgaePARC Wageningen University, P.O. Box 16, 6700 AA, Wageningen, the Netherlands; Faculty of Biosciences and Aquaculture, Nord University, N-8049, Bodø, Norway
| | - L E M Vet
- Department of Terrestrial Ecology, Netherlands Institute of Ecology (NIOO-KNAW), Droevendaalsesteeg 10, 6708 PB, Wageningen, the Netherlands
| | - T V Fernandes
- Department of Aquatic Ecology, Netherlands Institute of Ecology (NIOO-KNAW), Droevendaalsesteeg 10, 6708 PB, Wageningen, the Netherlands
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Wrigley R, Phipps-Green AJ, Topless RK, Major TJ, Cadzow M, Riches P, Tausche AK, Janssen M, Joosten LAB, Jansen TL, So A, Harré Hindmarsh J, Stamp LK, Dalbeth N, Merriman TR. Pleiotropic effect of the ABCG2 gene in gout: involvement in serum urate levels and progression from hyperuricemia to gout. Arthritis Res Ther 2020; 22:45. [PMID: 32164793 PMCID: PMC7069001 DOI: 10.1186/s13075-020-2136-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 02/20/2020] [Indexed: 12/13/2022] Open
Abstract
Background The ABCG2 Q141K (rs2231142) and rs10011796 variants associate with hyperuricaemia (HU). The effect size of ABCG2 rs2231142 on urate is ~ 60% that of SLC2A9, yet the effect size on gout is greater. We tested the hypothesis that ABCG2 plays a role in the progression from HU to gout by testing for association of ABCG2 rs2231142 and rs10011796 with gout using HU controls. Methods We analysed 1699 European gout cases and 14,350 normouricemic (NU) and HU controls, and 912 New Zealand (NZ) Polynesian (divided into Eastern and Western Polynesian) gout cases and 696 controls. Association testing was performed using logistic and linear regression with multivariate adjusting for confounding variables. Results In Europeans and Polynesians, the ABCG2 141K (T) allele was associated with gout using HU controls (OR = 1.85, P = 3.8E− 21 and ORmeta = 1.85, P = 1.3E− 03, respectively). There was evidence for an effect of 141K in determining HU in European (OR = 1.56, P = 1.7E− 18) but not in Polynesian (ORmeta = 1.49, P = 0.057). For SLC2A9 rs11942223, the T allele associated with gout in the presence of HU in European (OR = 1.37, P = 4.7E− 06), however significantly weaker than ABCG2 rs2231142 141K (PHet = 0.0023). In Western Polynesian and European, there was epistatic interaction between ABCG2 rs2231142 and rs10011796. Combining the presence of the 141K allele with the rs10011796 CC-genotype increased gout risk, in the presence of HU, 21.5-fold in Western Polynesian (P = 0.009) and 2.6-fold in European (P = 9.9E− 06). The 141K allele of ABCG2 associated with increased gout flare frequency in Polynesian (Pmeta = 2.5E− 03). Conclusion These data are consistent with a role for ABCG2 141K in gout in the presence of established HU.
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Affiliation(s)
- Rebekah Wrigley
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | | | - Ruth K Topless
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | - Tanya J Major
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | - Murray Cadzow
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | - Philip Riches
- Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Anne-Kathrin Tausche
- Department of Rheumatology, University Clinic "Carl-Gustav-Carus", Dresden, Germany
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine and Radboud Institute of Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Alexander So
- Laboratory of Rheumatology, University of Lausanne, CHUV, Nestlé 05-5029, 1011, Lausanne, Switzerland
| | | | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand.
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Klück V, van Deuren RC, Cavalli G, Shaukat A, Arts P, Cleophas MC, Crișan TO, Tausche AK, Riches P, Dalbeth N, Stamp LK, Hindmarsh JH, Jansen TLTA, Janssen M, Steehouwer M, Lelieveld S, van de Vorst M, Gilissen C, Dagna L, Van de Veerdonk FL, Eisenmesser EZ, Kim S, Merriman TR, Hoischen A, Netea MG, Dinarello CA, Joosten LA. Rare genetic variants in interleukin-37 link this anti-inflammatory cytokine to the pathogenesis and treatment of gout. Ann Rheum Dis 2020; 79:536-544. [PMID: 32114511 DOI: 10.1136/annrheumdis-2019-216233] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Gout is characterised by severe interleukin (IL)-1-mediated joint inflammation induced by monosodium urate crystals. Since IL-37 is a pivotal anti-inflammatory cytokine suppressing the activity of IL-1, we conducted genetic and functional studies aimed at elucidating the role of IL-37 in the pathogenesis and treatment of gout. METHODS Variant identification was performed by DNA sequencing of all coding bases of IL37 using molecular inversion probe-based resequencing (discovery cohort: gout n=675, controls n=520) and TaqMan genotyping (validation cohort: gout n=2202, controls n=2295). Predictive modelling of the effects of rare variants on protein structure was followed by in vitro experiments evaluating the impact on protein function. Treatment with recombinant IL-37 was evaluated in vitro and in vivo in a mouse model of gout. RESULTS We identified four rare variants in IL37 in six of the discovery gout patients; p.(A144P), p.(G174Dfs*16), p.(C181*) and p.(N182S), whereas none emerged in healthy controls (Fisher's exact p-value=0.043). All variants clustered in the functional domain of IL-37 in exon 5 (p-value=5.71×10-5). Predictive modelling and functional studies confirmed loss of anti-inflammatory functions and we substantiated the therapeutic potential of recombinant IL-37 in the treatment of gouty inflammation. Furthermore, the carrier status of p.(N182S)(rs752113534) was associated with increased risk (OR=1.81, p-value=0.031) of developing gout in hyperuricaemic individuals of Polynesian ancestry. CONCLUSION Here, we provide genetic as well as mechanistic evidence for the role of IL-37 in the pathogenesis of gout, and highlight the therapeutic potential of recombinant IL-37 for the treatment of gouty arthritis.
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Affiliation(s)
- Viola Klück
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosanne C van Deuren
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Giulio Cavalli
- Internal Medicine and Clinical Immunology, Vita-Salute San Raffaele University, Milan, Italy.,Department of Medicine, University of Colorado Denver, Denver, Colorado, USA
| | - Amara Shaukat
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Peer Arts
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology and the University of South Australia, Adelaide, South Australia, Australia
| | - Maartje C Cleophas
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tania O Crișan
- Department of Medical Genetics, Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Anne-Kathrin Tausche
- Department of Internal Medicine, Section of Rheumatology, University Clinic Carl Gustav Carus, Dresden, Saxonia, Germany
| | - Philip Riches
- Rheumatology and Bone Disease, University of Edinburgh, Edinburgh, UK
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Lisa K Stamp
- Department of Medicine, Otago University, Christchurch, Canterbury, New Zealand
| | - Jennie Harré Hindmarsh
- Te Rangawairua o Paratene Ngata Research Centre, Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti, New Zealand
| | - Tim L Th A Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Marloes Steehouwer
- Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stefan Lelieveld
- Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maartje van de Vorst
- Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christian Gilissen
- Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lorenzo Dagna
- Internal Medicine and Clinical Immunology, Vita-Salute San Raffaele University, Milan, Italy
| | - Frank L Van de Veerdonk
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elan Z Eisenmesser
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver, Denver, Colorado, USA
| | - SooHyun Kim
- Laboratory of Cytokine Immunology, Konkuk University, Seoul, Korea (the Republic of)
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Alexander Hoischen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Genomics and Immunoregulation, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Charles A Dinarello
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Medicine, University of Colorado Denver, Denver, Colorado, USA
| | - Leo Ab Joosten
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands .,Department of Medical Genetics, Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, Romania
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Allessie D, Janssen M, Ubacht J, Cunningham S, van der Harst G. The consequences of blockchain architectures for the governance of public services: A case study of the movement of excise goods under duty exemptions. IP 2019. [DOI: 10.3233/ip-190151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- D. Allessie
- Gartner Consulting – 1101 BH Amsterdam, NL, The Netherlands
| | - M. Janssen
- Faculty of Technology, Policy and Management –
| | - J. Ubacht
- Faculty of Technology, Policy and Management –
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Bursill D, Taylor WJ, Terkeltaub R, Kuwabara M, Merriman TR, Grainger R, Pineda C, Louthrenoo W, Edwards NL, Andrés M, Vargas-Santos AB, Roddy E, Pascart T, Lin CT, Perez-Ruiz F, Tedeschi SK, Kim SC, Harrold LR, McCarthy G, Kumar N, Chapman PT, Tausche AK, Vazquez-Mellado J, Gutierrez M, da Rocha Castelar-Pinheiro G, Richette P, Pascual E, Fisher MC, Burgos-Vargas R, Robinson PC, Singh JA, Jansen TL, Saag KG, Slot O, Uhlig T, Solomon DH, Keenan RT, Scire CA, Biernat-Kaluza E, Dehlin M, Nuki G, Schlesinger N, Janssen M, Stamp LK, Sivera F, Reginato AM, Jacobsson L, Lioté F, Ea HK, Rosenthal A, Bardin T, Choi HK, Hershfield MS, Czegley C, Choi SJ, Dalbeth N. Gout, Hyperuricemia, and Crystal-Associated Disease Network Consensus Statement Regarding Labels and Definitions for Disease Elements in Gout. Arthritis Care Res (Hoboken) 2019; 71:427-434. [PMID: 29799677 DOI: 10.1002/acr.23607] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 05/22/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The language currently used to describe gout lacks standardization. The aim of this project was to develop a consensus statement on the labels and definitions used to describe the basic disease elements of gout. METHODS Experts in gout (n = 130) were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach consensus on the labeling and definitions for the basic disease elements of gout. Disease elements and labels in current use were derived from a content analysis of the contemporary medical literature, and the results of this analysis were used for item selection in the Delphi exercise and face-to-face consensus meeting. RESULTS There were 51 respondents to the Delphi exercise and 30 attendees at the face-to-face meeting. Consensus agreement (≥80%) was achieved for the labels of 8 disease elements through the Delphi exercise; the remaining 3 labels reached consensus agreement through the face-to-face consensus meeting. The agreed labels were monosodium urate crystals, urate, hyperuric(a)emia, tophus, subcutaneous tophus, gout flare, intercritical gout, chronic gouty arthritis, imaging evidence of monosodium urate crystal deposition, gouty bone erosion, and podagra. Participants at the face-to-face meeting achieved consensus agreement for the definitions of all 11 elements and a recommendation that the label "chronic gout" should not be used. CONCLUSION Consensus agreement was achieved for the labels and definitions of 11 elements representing the fundamental components of gout etiology, pathophysiology, and clinical presentation. The Gout, Hyperuricemia, and Crystal-Associated Disease Network recommends the use of these labels when describing the basic disease elements of gout.
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Affiliation(s)
- David Bursill
- University of Auckland, Auckland, New Zealand, and Adelaide Medical School, University of Adelaide, South Australia, Australia
| | - William J Taylor
- University of Otago, Wellington, and Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Robert Terkeltaub
- Veterans Affairs Medical Center and University of California, San Diego
| | - Masanari Kuwabara
- Toranomon Hospital, Tokyo, Japan, and University of Colorado Denver, Aurora
| | | | - Rebecca Grainger
- University of Otago, Wellington, and Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Carlos Pineda
- Instituto Nacional Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | | | | | - Mariano Andrés
- Hospital Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain
| | | | | | - Tristan Pascart
- Lille Catholic University and Saint-Philibert Hospital, Lomme, France
| | | | - Fernando Perez-Ruiz
- University of the Basque Country, Biscay, and Cruces University Hospital and Biocruces Health Research Institute, Baracaldo, Spain
| | - Sara K Tedeschi
- Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts
| | - Seoyoung C Kim
- Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts
| | - Leslie R Harrold
- Corrona, LLC, Waltham, and University of Massachusetts Medical School, Worcester
| | - Geraldine McCarthy
- Mater Misericordiae University Hospital and University College, Dublin, Ireland
| | | | | | - Anne-Kathrin Tausche
- University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | | | | | | | - Pascal Richette
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Eliseo Pascual
- Hospital Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain
| | - Mark C Fisher
- Harvard Medical School and Massachusetts General Hospital Boston
| | - Ruben Burgos-Vargas
- Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Philip C Robinson
- University of Queensland School of Medicine and Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Jasvinder A Singh
- Veterans Affairs Medical Center, Birmingham, and University of Alabama at Birmingham
| | | | | | - Ole Slot
- Rigshospitalet Glostrup, Glostrup, Denmark
| | | | - Daniel H Solomon
- Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Carlo Alberto Scire
- University of Ferrara, Ferrara, and Italian Society for Rheumatology, Milan, Italy
| | | | - Mats Dehlin
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | | | | | | | - Anthony M Reginato
- Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
| | | | - Frédéric Lioté
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Hang-Korng Ea
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Ann Rosenthal
- Medical College of Wisconsin and the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee
| | - Thomas Bardin
- Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Hyon K Choi
- Harvard Medical School and Massachusetts General Hospital Boston
| | | | - Christine Czegley
- Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Sung Jae Choi
- University of California, San Diego, and Korea University Ansan Hospital, Ansan, South Korea
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Prudhomme T, Beauval J, Lesourd M, Roumiguié M, Decaestecker K, Siena G, Serni S, Territo A, Gausa L, Tugcu V, Alcaraz A, Musquera M, Stockle M, Janssen M, Fornara P, Mohammed N, Kamar N, Sallusto F, Breda A, Doumerc N. Comparaison de la transplantation rénale cœlioscopique robot-assistée de donneur vivant entre receveurs obèses et non-obèses : une série internationale de 169 transplantations. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wegberg van A, Zweers-van Essen H, Smeitink J, Saris C, Janssen M. MITOCHONDRIAL DISEASES. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.081] [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: 10/25/2022]
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Bursill D, Taylor WJ, Terkeltaub R, Abhishek A, So AK, Vargas-Santos AB, Gaffo AL, Rosenthal A, Tausche AK, Reginato A, Manger B, Sciré C, Pineda C, van Durme C, Lin CT, Yin C, Albert DA, Biernat-Kaluza E, Roddy E, Pascual E, Becce F, Perez-Ruiz F, Sivera F, Lioté F, Schett G, Nuki G, Filippou G, McCarthy G, da Rocha Castelar Pinheiro G, Ea HK, Tupinambá HDA, Yamanaka H, Choi HK, Mackay J, ODell JR, Vázquez Mellado J, Singh JA, Fitzgerald JD, Jacobsson LTH, Joosten L, Harrold LR, Stamp L, Andrés M, Gutierrez M, Kuwabara M, Dehlin M, Janssen M, Doherty M, Hershfield MS, Pillinger M, Edwards NL, Schlesinger N, Kumar N, Slot O, Ottaviani S, Richette P, MacMullan PA, Chapman PT, Lipsky PE, Robinson P, Khanna PP, Gancheva RN, Grainger R, Johnson RJ, Te Kampe R, Keenan RT, Tedeschi SK, Kim S, Choi SJ, Fields TR, Bardin T, Uhlig T, Jansen T, Merriman T, Pascart T, Neogi T, Klück V, Louthrenoo W, Dalbeth N. Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. Ann Rheum Dis 2019; 78:1592-1600. [PMID: 31501138 DOI: 10.1136/annrheumdis-2019-215933] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [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: 06/23/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout. METHODS A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions. RESULTS The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus). CONCLUSION Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.
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Affiliation(s)
- David Bursill
- Department of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - William J Taylor
- Department of Medicine, University of Otago, Wellington, New Zealand.,Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Robert Terkeltaub
- Department of Rheumatology, UCSD/ VA Medical Center, San Diego, California, USA
| | - Abhishek Abhishek
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Alexander K So
- Department of Musculoskeletal Medicine, Service de RMR, Lausanne, Switzerland
| | - Ana Beatriz Vargas-Santos
- Department of Internal Medicine, Rheumatology Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Angelo Lino Gaffo
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ann Rosenthal
- Division of Rheumatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Translational Research Unit, Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
| | - Anne-Kathrin Tausche
- Department of Rheumatology, University Hospital 'Carl Gustav Carus' of the Technical University Dresden, Dresden, Germany
| | - Anthony Reginato
- Division of Rheumatology, The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
| | - Bernhard Manger
- Rheumatology and Immunology, Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Carlo Sciré
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Carlos Pineda
- Department of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Caroline van Durme
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ching-Tsai Lin
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Congcong Yin
- Department of Immunology and Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Daniel Arthur Albert
- Department of Rheumatology, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire, USA
| | - Edyta Biernat-Kaluza
- Outpatient Rheumatology Clinic, Nutritional and Lifestyle Medicine Centre, ORLIK, Warsaw, Poland
| | - Edward Roddy
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Eliseo Pascual
- Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland
| | - Fernando Perez-Ruiz
- Rheumatology Division, Cruces University Hospital, Baracaldo, Spain.,Department of Medicine, University of the Basque Country, Biscay, Spain.,Investigation Group for Arthritis, Biocruces Health Research Institute, Baracaldo, Spain
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain
| | - Frédéric Lioté
- Department of Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, Paris, France.,Department of Rhumatologie, INSERM UMR-1132 and Université Paris Diderot, Paris, France
| | - Georg Schett
- Department of Internal Medicine III, Friedrich-Alexander University Erlangen-Nürnberg and Universitatsklinikum Erlangen, Erlangen, Germany
| | - George Nuki
- Insititute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Geraldine McCarthy
- Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Hang-Korng Ea
- Department of Rheumatology, Hôpital Lariboisière, Paris, France
| | | | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.,School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Hyon K Choi
- Section of Rheumatology and Clinical Epidemiology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James Mackay
- President and CEO, Aristea Therapeutics, San Diego, California, USA
| | - James R ODell
- Division of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Janitzia Vázquez Mellado
- Department of Rheumatology, Hospital General de Mexico and Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jasvinder A Singh
- Department of Medicine at School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.,Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - John D Fitzgerald
- Department of Medicine/Rheumatology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Leo Joosten
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Leslie R Harrold
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Chief Scientific Officer, Corrona, LLC, Southborough, Massachusetts, USA
| | - Lisa Stamp
- Department of Medicine, Otago University, Christchurch, New Zealand
| | - Mariano Andrés
- Department of Rheumatology, Hospital Universitario de Alicante, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain
| | - Marwin Gutierrez
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional Rehabilitación, México City, México
| | - Masanari Kuwabara
- Division of Renal Diseases and Hypertension, University of Colorado Denver School of Medicine, Aurora, Colorado, USA.,Department of Cardiology, Toranomon Hospital, Minato-ku, Japan
| | - Mats Dehlin
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Michael Doherty
- Department of Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Michael S Hershfield
- Division of Rheumatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael Pillinger
- Department of Rheumatology/Medicine, New York University School of Medicine, New York City, New York, USA
| | | | - Naomi Schlesinger
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Nitin Kumar
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Detroit, Michigan, USA
| | - Ole Slot
- Department of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spinal Disorders, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Sebastien Ottaviani
- Department of Rheumatology, Bichat-Claude Bernard Hospital, University of Sorbonne Paris Cité, Paris, France
| | - Pascal Richette
- Service de Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France
| | - Paul A MacMullan
- Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada
| | - Peter T Chapman
- Department of Rheumatology, Immunology and Allergy, Canterbury District Health Board, Christchurch, New Zealand
| | - Peter E Lipsky
- CEO and CMO, AMPEL BioSolutions, LLC, Charlottesville, Virginia, USA
| | - Philip Robinson
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Puja P Khanna
- Department of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rada N Gancheva
- Clinic of Rheumatology, University Hospital 'St. Ivan Rilski', Sofia, Bulgaria
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, Wellington, New Zealand.,Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA
| | - Ritch Te Kampe
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert T Keenan
- Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sara K Tedeschi
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Arthritis Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Seoyoung Kim
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sung Jae Choi
- Division of Rheumatology, Department of Internal Medicine, Korea University Medical College, Ansan, South Korea
| | - Theodore R Fields
- Weill Cornell Medical College, Hospital for Special Surgery, New York City, New York, USA
| | - Thomas Bardin
- Department of Rheumatology, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France
| | - Till Uhlig
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Tim Jansen
- Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Tony Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lomme, France
| | - Tuhina Neogi
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Viola Klück
- Department of Internal Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Janssen CA, Oude Voshaar MAH, Vonkeman HE, Jansen TLTA, Janssen M, Kok MR, Radovits B, van Durme C, Baan H, van de Laar MAFJ. Anakinra for the treatment of acute gout flares: a randomized, double-blind, placebo-controlled, active-comparator, non-inferiority trial. Rheumatology (Oxford) 2019; 58:5270863. [PMID: 30602035 DOI: 10.1093/rheumatology/key402] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy and safety of anakinra in treating acute gout flares in a randomized, double-blind, placebo-controlled, active comparator, non-inferiority (NI) trial. METHODS Patients with a crystal-proven acute gout flare were randomized (1: 1) to treatment with anakinra or treatment as usual (free choice: either colchicine, naproxen or prednisone). The primary end point was the change in pain between baseline and the averaged pain score on days 2-4 measured on a five-point rating scale. NI of anakinra would be established if the upper bound of the 95% CI of the numeric difference in changed pain scores between treatment groups did not exceed the NI limit of 0.4 in favour of treatment as usual, in the per-protocol (PP) and intention-to-treat (ITT) populations, assessed in an analysis of covariance model. Secondary outcomes included safety assessments, improvement in pain, swelling, tenderness and treatment response after 5 days, assessed using linear mixed models and binary logistic regression models. RESULTS Forty-three patients received anakinra and 45 treatment as usual. Anakinra was non-inferior (mean difference; 95% CI) to treatment as usual in both the PP (-0.13; -0.44, 0.18) and ITT (-0.18; -0.44, 0.08) populations. No unexpected or uncommon (serious) adverse events were observed in either treatment arm. Analyses of secondary outcomes showed that patients in both groups reported similar significant reductions in their gout symptoms. CONCLUSION Efficacy of anakinra was shown to be non-inferior to treatment as usual for the treatment of acute gout flares, suggesting that anakinra is an effective treatment alternative for acute gout flares. TRIAL REGISTRATION Het Nederlands Trial Register, www.trialregister.nl, NTR5234.
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Affiliation(s)
- Carly A Janssen
- Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, The Netherlands
| | - Martijn A H Oude Voshaar
- Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, The Netherlands
| | - Harald E Vonkeman
- Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, The Netherlands
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Ensche, The Netherlands
| | - Tim L Th A Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
- Department of Rheumatology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Marc R Kok
- Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands
| | - Bea Radovits
- Department of Rheumatology, Bernhoven Hospital, Uden, The Netherlands
| | - Caroline van Durme
- Department of Rheumatology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Hetty Baan
- Department of Rheumatology and Clinical Immunology, ZiekenhuisGroep Twente, Almelo, The Netherlands
| | - Mart A F J van de Laar
- Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, The Netherlands
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Ensche, The Netherlands
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Jansen TLTA, Janssen M. Gout lessons from 2018: CARES, a direct comparison of febuxostat vs allopurinol, and CANTOS, IL1 blocker for cardiovascular risk minimisation. Clin Rheumatol 2018; 38:263-265. [PMID: 30542798 DOI: 10.1007/s10067-018-4396-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 11/29/2022]
Abstract
In the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial conducted by White et al. (March 29 issue from NEJM), all-cause mortality and cardiovascular mortality are found to be higher among patients randomly assigned to febuxostat compared to allopurinol, but significant flaws are a clear lack of treat to target strategy with more powered treatment in the febuxostat arm, dysbalance with cardiovascular risk factors selectively in again the febuxostat arm, and discontinuation of the trial regimen in over 50% of patients with discontinuation of follow-up in about 45%. With these flaws, conclusions such as febuxostat-associated higher mortality are potentially if not probably incorrect, and thus febuxostat to be used not as first-line therapy may well be an invalid consequence? The paper here describes potential lessons to be taken.
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Kort RSS, Tuininga YS, Bosker HA, Janssen M, Tukkie R. Telemonitoring with an implantable loop recorder in outpatient heart failure care : One year follow-up report from a prospective observational Dutch multicentre study. Neth Heart J 2018; 27:46-51. [PMID: 30511332 PMCID: PMC6311161 DOI: 10.1007/s12471-018-1198-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction In the care of heart failure patients, telemonitoring is receiving growing attention. The main purpose of this study was to determine the effect of continuous telemonitoring with an implantable loop recorder (ILR, Reveal XT), a novel strategy in the management of stable heart failure patients without a cardiac implantable device. Furthermore, little is known about the incidence of subclinical arrhythmias in this specific group of patients. Materials and Methods Stable heart failure patients, New York Heart Association Class II and III, without recent hospitalisation or upcoming intervention, were included. After implantation of the ILR there was regular contact with the research nurse on a pre-specified basis. Clinic visits and telephonic interviews were alternated for a minimum of 1 year. Parallel visits to their treating physician continued according to standard care. The treating physician was blinded for the ILR findings, accept for pre-specified, significant arrhythmic events. Results Thirty patients were included and followed for a median duration of 12 months. In 13 patients, data from the loop recorder led to therapeutic changes. One patient received a pacemaker. Eight patients developed atrial fibrillation, all subclinical, with a mean burden of 65.8 ± 173.2 min/day. Conclusion The use of an ILR could potentially impact patient management. Additional study is needed in different patient populations (e. g. higher risk groups) to assess if an ILR could also impact on endpoints such as heart failure hospitalisation.
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Affiliation(s)
- R S S Kort
- Department of Cardiology, Spaarne Gasthuis, Haarlem, The Netherlands.
| | - Y S Tuininga
- Department of Cardiology, Deventer Hospital, Deventer, The Netherlands
| | - H A Bosker
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - M Janssen
- Department of Cardiology, Spaarne Gasthuis, Haarlem, The Netherlands
| | - R Tukkie
- Department of Cardiology, Spaarne Gasthuis, Haarlem, The Netherlands
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Gerlag DM, Safy M, Maijer KI, Tang MW, Tas SW, Starmans-Kool MJF, van Tubergen A, Janssen M, de Hair M, Hansson M, de Vries N, Zwinderman AH, Tak PP. Effects of B-cell directed therapy on the preclinical stage of rheumatoid arthritis: the PRAIRI study. Ann Rheum Dis 2018; 78:179-185. [PMID: 30504445 PMCID: PMC6352407 DOI: 10.1136/annrheumdis-2017-212763] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/31/2022]
Abstract
Objectives We explored the effects of B-cell directed therapy in subjects at risk of developing autoantibodypositive rheumatoid arthritis (RA), who never experienced inflammatory arthritis before, and explored biomarkers predictive of arthritis development. Methods Individuals positive for both anti-citrullinated peptide antibodies and rheumatoid factor but without arthritis were included in a randomised, double-blind, placebo-controlled study to receive a single infusion of 1000 mg rituximab or placebo. Results Eighty-one individuals received treatment and were followed up for a mean of 29.0 (0–54) months, during which 30/81 (37%) individuals developed arthritis. The observed risk of developing arthritis in the placebo-treated group was 40%, which was decreased by 55% (HR 0.45, 95% CI 0.154 to 1.322) in the rituximab-treated group at 12 months. Rituximab treatment caused a delay in arthritis development of 12 months compared with placebo treatment at the point when 25% of the subjects had developed arthritis (p<0.0001). Erythrocyte sedimentation rate and the presence of anti-citrullinated α-enolase peptide 1 at baseline were significant predictors of arthritis development. Conclusions A single infusion of 1000 mg rituximab significantly delays the development of arthritis in subjects at risk of developing RA, providing evidence for the pathogenetic role of B cells in the earliest, prearthritis stage of autoantibody positive RA.
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Affiliation(s)
- Danielle M Gerlag
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands.,Department of Epidemiology and Bioinformatics, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Mary Safy
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Karen I Maijer
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Man Wai Tang
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Sander W Tas
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | | | - Astrid van Tubergen
- Division of Rheumatology, Department of Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Maria de Hair
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Monika Hansson
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niek de Vries
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | | | - Paul P Tak
- Department of Clinical immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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Oortwijn W, Baltussen R, Janssen M. Priority setting: towards evidence-informed deliberative processes. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.810] [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)
- W Oortwijn
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - R Baltussen
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - M Janssen
- Radboud University Medical Centre, Nijmegen, Netherlands
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van Boxtel W, Lütje S, van Engen- van Grunsven I, Verhaegh G, Schalken J, Janssen M, Nagarajah J, Gotthardt M, van Herpen C. 68Ga-PSMA-PET/CT imaging for locally advanced, recurrent and metastatic adenoid cystic carcinoma and salivary duct carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy294.006] [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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Ohlmann C, Roger Z, Rüssel C, Hellmis E, Suttmann H, Janssen M, Hübner A, Dahm J, Gleißner J, Scheffler M, Feyerabend S, Telle J, Klier J. Abiraterone acetate plus prednisone and LHRH therapy versus abiraterone acetate plus prednisone while sparing LHRH therapy in patients with progressive, metastatic and chemotherapy-naïve, castration-resistant prostate cancer: Results from the SPARE-trial (NCT02077634). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.019] [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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Disveld IJM, Fransen J, Rongen GA, Kienhorst LBE, Zoakman S, Janssens HJEM, Janssen M. Crystal-proven Gout and Characteristic Gout Severity Factors Are Associated with Cardiovascular Disease. J Rheumatol 2018; 45:858-863. [PMID: 29657151 DOI: 10.3899/jrheum.170555] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Our aim was to examine the prevalence of cardiovascular disease (CVD) in patients with crystal-proven gout compared to arthritis controls. Further, we analyzed the association between characteristic gout severity factors and CVD to provide further support for a pathogenetic relationship between gout and CVD. METHODS Patients with arthritis referred for diagnosis were consecutively included in the Gout Arnhem-Liemers cohort. Joint fluid analysis was performed in all referred patients; controls were negative for crystals. Patients' characteristics and different manifestations of CVD and gout severity factors (disease duration, attack frequency, tophi, affected joints, high serum urate acid level, joint damage) were collected. Gout patients were compared with controls for the prevalence of CVD. In addition, the association between characteristic gout severity factors and presence of CVD was analyzed. RESULTS Data from 700 gout patients and 276 controls were collected. CVD was present in 47% (95% CI 44%-51%) and 24% (95% CI 19%-29%) of gout patients and controls, respectively. Corrected for confounders, gout was still strongly associated with an increased prevalence of CVD compared to controls (OR 3.39, 95% CI 2.37-4.84). In patients with gout, disease duration ≥ 2 years, oligo- or polyarthritis, serum urate acid > 0.55 mmol/l at presentation, and joint damage were independently (p < 0.05) associated with prevalent CVD. CONCLUSION Crystal-proven gout was strongly associated with an increased prevalence of CVD. In patients with gout, characteristic gout severity factors were associated with CVD.
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Affiliation(s)
- Iris J M Disveld
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital
| | - Jaap Fransen
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital
| | - Gerard A Rongen
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital
| | - Laura B E Kienhorst
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital
| | - Sahel Zoakman
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital
| | - Hein J E M Janssens
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital
| | - Matthijs Janssen
- From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands. .,I.J. Disveld, MD, Department of Rheumatology, Rijnstate Hospital; J. Fransen, PhD, Department of Rheumatology, Radboud University Medical Centre; G.A. Rongen, Professor, Department of Internal Medicine, and Department of Pharmacology and Toxicology, Radboud University Medical Centre; L.B. Kienhorst, MD, LLM, Department of Dermatology, University Medical Centre Utrecht; S. Zoakman, MD, Department of Rheumatology, Rijnstate Hospital; H.J. Janssens, MD, PhD, Department of Primary and Community Care, Radboud University Medical Centre; M. Janssen, MD, PhD, Department of Rheumatology, Rijnstate Hospital.
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Bolton SJ, Adriani A, Adumitroaie V, Allison M, Anderson J, Atreya S, Bloxham J, Brown S, Connerney JEP, DeJong E, Folkner W, Gautier D, Grassi D, Gulkis S, Guillot T, Hansen C, Hubbard WB, Iess L, Ingersoll A, Janssen M, Jorgensen J, Kaspi Y, Levin SM, Li C, Lunine J, Miguel Y, Mura A, Orton G, Owen T, Ravine M, Smith E, Steffes P, Stone E, Stevenson D, Thorne R, Waite J, Durante D, Ebert RW, Greathouse TK, Hue V, Parisi M, Szalay JR, Wilson R. Jupiter's interior and deep atmosphere: The initial pole-to-pole passes with the Juno spacecraft. Science 2018; 356:821-825. [PMID: 28546206 DOI: 10.1126/science.aal2108] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/01/2017] [Indexed: 11/02/2022]
Abstract
On 27 August 2016, the Juno spacecraft acquired science observations of Jupiter, passing less than 5000 kilometers above the equatorial cloud tops. Images of Jupiter's poles show a chaotic scene, unlike Saturn's poles. Microwave sounding reveals weather features at pressures deeper than 100 bars, dominated by an ammonia-rich, narrow low-latitude plume resembling a deeper, wider version of Earth's Hadley cell. Near-infrared mapping reveals the relative humidity within prominent downwelling regions. Juno's measured gravity field differs substantially from the last available estimate and is one order of magnitude more precise. This has implications for the distribution of heavy elements in the interior, including the existence and mass of Jupiter's core. The observed magnetic field exhibits smaller spatial variations than expected, indicative of a rich harmonic content.
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Affiliation(s)
- S J Bolton
- Southwest Research Institute, San Antonio, TX 78238, USA.
| | - A Adriani
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, 00133 Rome, Italy
| | - V Adumitroaie
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - M Allison
- Goddard Institute for Space Studies, New York, NY 10025, USA
| | - J Anderson
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - S Atreya
- University of Michigan, Ann Arbor, MI 48109, USA
| | - J Bloxham
- Harvard University, Cambridge, MA 02138, USA
| | - S Brown
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - J E P Connerney
- Space Research Corporation, Annapolis, MD 21403, USA.,NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - E DeJong
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - W Folkner
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - D Gautier
- Laboratoire d'Études Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris, 92195 Meudon, France
| | - D Grassi
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, 00133 Rome, Italy
| | - S Gulkis
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - T Guillot
- Université Côte d'Azur, Observatoire de la Côte d'Azur, Laboratoire Lagrange CNRS, 06304 Nice, France
| | - C Hansen
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - W B Hubbard
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - L Iess
- Sapienza University of Rome, 00185 Rome, Italy
| | - A Ingersoll
- California Institute of Technology, Pasadena, CA 91125, USA
| | - M Janssen
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - J Jorgensen
- National Space Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Y Kaspi
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - S M Levin
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - C Li
- California Institute of Technology, Pasadena, CA 91125, USA
| | - J Lunine
- Cornell University, Ithaca, NY 14853, USA
| | - Y Miguel
- Université Côte d'Azur, Observatoire de la Côte d'Azur, Laboratoire Lagrange CNRS, 06304 Nice, France
| | - A Mura
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, 00133 Rome, Italy
| | - G Orton
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - T Owen
- Institute for Astronomy, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - M Ravine
- Malin Space Science Systems, San Diego, CA 92121, USA
| | - E Smith
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - P Steffes
- Center for Space Technology and Research, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - E Stone
- California Institute of Technology, Pasadena, CA 91125, USA
| | - D Stevenson
- California Institute of Technology, Pasadena, CA 91125, USA
| | - R Thorne
- Department of Atmospheric and Oceanic Sciences, University of California, Los Angeles, CA 90095, USA
| | - J Waite
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - D Durante
- Sapienza University of Rome, 00185 Rome, Italy
| | - R W Ebert
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - T K Greathouse
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - V Hue
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - M Parisi
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - J R Szalay
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - R Wilson
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
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Rongen GA, van Ingen I, Kok M, Vonkeman H, Janssen M, Jansen TL. Vasodilator function worsens after cessation of tumour necrosis factor inhibitor therapy in patients with rheumatoid arthritis only if a flare occurs. Clin Rheumatol 2018; 37:909-916. [DOI: 10.1007/s10067-017-3961-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 12/14/2017] [Accepted: 12/18/2017] [Indexed: 11/27/2022]
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50
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Janssen M, Harlaar J, Koopman H, de Groot I. Unraveling upper extremity performance in DMD: a biophysical model. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.500] [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: 10/18/2022]
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