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Schauberger G, Groll A, Tutz G. Analysis of the importance of on-field covariates in the German Bundesliga. J Appl Stat 2017. [DOI: 10.1080/02664763.2017.1383370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Groll A, Hastie T, Tutz G. Selection of effects in Cox frailty models by regularization methods. Biometrics 2017; 73:846-856. [PMID: 28085181 PMCID: PMC6261611 DOI: 10.1111/biom.12637] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 11/28/2022]
Abstract
In all sorts of regression problems, it has become more and more important to deal with high-dimensional data with lots of potentially influential covariates. A possible solution is to apply estimation methods that aim at the detection of the relevant effect structure by using penalization methods. In this article, the effect structure in the Cox frailty model, which is the most widely used model that accounts for heterogeneity in survival data, is investigated. Since in survival models one has to account for possible variation of the effect strength over time the selection of the relevant features has to distinguish between several cases, covariates can have time-varying effects, time-constant effects, or be irrelevant. A penalization approach is proposed that is able to distinguish between these types of effects to obtain a sparse representation that includes the relevant effects in a proper form. It is shown in simulations that the method works well. The method is applied to model the time until pregnancy, illustrating that the complexity of the influence structure can be strongly reduced by using the proposed penalty approach.
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al Zakwani I, Gormezano NW, Kern D, Pereira OL, Esteves GCC, Sallum AM, Aikawa NE, Pereira RM, Silva CA, Bonfa E, Beckmann J, Bartholomä N, Foeldvari I, Bohnsack J, Milojevic D, Rabinovich C, Kingsbury D, Marzan K, Quartier P, Minden K, Chalom E, Horneff G, Venhoff N, Kuester RM, Dare J, Heinrich M, Kupper H, Kalabic J, Martini A, Brunner HI, Consolaro A, Horneff G, Burgos-Vargas R, Henneke P, Constantin T, Foeldvari I, Vojinovic J, Dehoorne J, Panaviene V, Susic G, Stanevica V, Kobusinska K, Zuber Z, Mouy R, Salzer U, Rumba-Rozenfelde I, Dolezalova P, Job-Deslandre C, Wulffraat N, Pederson R, Bukowski J, Hinnershitz T, Vlahos B, Martini A, Ruperto N, Janda A, Keskitalo P, Kangas S, Vähäsalo P, Valencia RAC, Martino D, Munro J, Ponsonby AL, Chiaroni-Clarke R, Meyer B, Allen RC, Boteanu AL, Akikusa JD, Craig JM, Saffrey R, Ellis JA, Davì S, Minoia F, Horne A, Wulffraat N, Wouters C, Wallace C, Corral SG, Uziel Y, Sterba G, Schneider R, Russo R, Ramanan AV, Schmid JP, Ozen S, Nichols KE, Miettunen P, Lovell DJ, Giraldo AS, Lehmberg K, Kitoh T, Khubchandani R, Ilowite NT, Henter JI, Grom AA, De Benedetti F, Behrens EM, Avcin T, Aricò M, Gámir MG, Martini A, Ruperto N, Cron RQ, Ravelli A, Grevich S, Lee P, Ringold S, Leroux B, Leahey H, Yuasa M, Mendoza AZ, Foster J, Sokolove J, Lahey L, Robinson W, Newson J, Stevens A, Shoop SJW, Hyrich KL, Verstappen SMM, Thomson W, Adrovic A, McDonagh JE, Beukelman T, Kimura Y, Natter M, Ilowite N, Mieszkalski K, Burrell G, Best B, Bristow H, Carr S, Dedeoglu R, Dennos A, Kaufmann R, Schanberg L, Parissenti I, Insalaco A, Taddio A, Mauro A, Pardeo M, Ricci F, Simonini G, Sahin S, Cattalini M, Montesano P, Parissenti I, Ricci F, Bonafini B, Medeghini V, Lancini F, Cattalini M, Gerbaux M, Lê PQ, Barut K, Goffin L, Badot V, La C, Caspers L, Willermain F, Ferster A, Ceci M, Licciardi F, Turco M, Santarelli F, Koka A, Montin D, Toppino C, Maggio MC, Alizzi C, Papia B, Vergara B, Corpora U, Messina L, Corsello G, Tsinti M, Oztunc F, Dermentzoglou V, Tziavas P, Tsitsami E, Perica M, Vidović M, Lamot L, Harjaček M, Bukovac LT, Çakan M, Ayaz NA, Kasapcopur O, Keskindemirci G, Miettunen P, Lang M, Laing C, Benseler S, Gerschman T, Luca N, Schmeling H, Dropol A, Taiani J, Rodriguez-Lozano AL, Johnson N, Rusted B, Nalbanti P, Trachana M, Pratsidou P, Pardalos G, Tzimouli V, Taparkou A, Stavrakidou M, Papachristou F, Rivas-Larrauri F, Kanakoudi-Tsakalidou F, Bale P, Robinson E, Palman J, Pilkington C, Ralph E, Gilmour K, Heard C, Wedderburn LR, Carlomagno R, de la Puente SG, Barrense-Dias Y, Gregory A, Amira D, Paolo S, Sylviane H, Michaël H, Panko N, Shokry S, Rakovska L, Pino S, Alves AGF, Diaz-Maldonado A, Guarnizo P, Torreggiani S, Cressoni P, Garagiola U, Di Landro G, Farronato G, Corona F, Filocamo G, Shenoi S, Giacomin MFDA, Bell S, Bhatti P, Nelson L, Mueller BA, Simon TA, Baheti A, Ray N, Guo Z, Ruperto N, Brunner HI, Farhat J, Hazra A, Stock T, Wang R, Mebus C, Alvey C, Lamba M, Krishnaswami S, Conte U, Wang M, Tzaribachev N, Braga ALF, Foeldvari I, Horneff G, Kingsbury D, Koskova E, Smolewska E, Vehe RK, Zuber Z, Martini A, Lovell D, Kubota T, Sallum AME, Shimizu M, Yasumura J, Nakagishi Y, Kizawa T, Yashiro M, Wakiguchi H, Yamatou T, Yamasaki Y, Takei S, Kawano Y, Campos LMDA, Nykvist UJ, Magnusson B, Wicksell R, Palmblad K, Olsson GL, Ziaee V, Modaressi M, Moradinejad MH, Seraya V, Zholobova E, Pereira LAA, Vitebskaya A, Moshe V, Amarilyo G, Harel L, Hashkes PJ, Mendelson A, Rabinowicz N, Reis Y, Uziel Y, Dāvidsone Z, Lichtenfels AJDFC, Lazareva A, Šantere R, Bērziņa D, Staņēviča V, Varnier GC, Consolaro A, Pilkington C, Maillard S, Ferrari C, Zaffarano S, Silva CA, Martini A, Ravelli A, Wienke J, Enders FB, van den Hoogen LL, Mertens JS, Radstake TR, Hotten HG, Fritsch R, de Jager W, Farhat SCL, Wedderburn L, Nistala K, Pilkington C, Prakken B, van Royen-Kerkhof A, van Wijk F, Alhemairi M, Muzaffer M, Van Dijkhuizen P, Deakin CT, Acar B, Simou S, Wedderburn LR, De Iorio M, Wu Q, Amin T, Simou S, Dossetter L, Wedderburn LR, Pilkington C, Campanilho-Marques R, Ozcakar ZB, Deakin C, Simou S, Wedderburn LR, Pilkington CA, Rosina S, Consolaro A, van Dijkhuizen P, Nistala K, Ruperto N, Pilkington C, Çakar N, Ravelli A, Soponkanaporn S, Simou S, Deakin CT, Wedderburn LR, Arıcı ZS, Tuğcu GD, Batu ED, Sönmez HE, Doğru-Ersöz D, Uncu N, Bilginer Y, Talim B, Kiper N, Özen S, Solyom A, Hügle B, Makay B, Magnusson B, Batu E, Mitchell J, Gür G, Kariminejad A, Hadipour F, Hadipour Z, Torcoletti M, Agostoni C, Di Rocco M, Tanpaiboon P, Superti-Furga A, Bonafé L, Arslan N, Özdel S, Guelbert N, Kostik M, Ehlert K, Grigelioniene G, Puri R, Ozen S, Schuchman E, Malagon C, Gomez P, Mosquera AC, Yalçınkaya F, Gonzalez T, Yepez R, Vargas C, Fernanda F, Lepri G, Ferrari A, Rigante D, Matucci-Cerinic M, Meini A, Moneta GM, Scott C, Caiello I, Marasco E, Nicolai R, Pardeo M, Bracaglia C, Insalaco A, Bracci-Laudiero L, De Benedetti F, Kopchak O, Kostik M, Brice N, Mushkin A, Maletin A, Makay B, Batu ED, Hügle B, Arslan N, Solyom A, Mitchell J, Schuchman E, Ozen S, Nourse P, Magnusson B, Malagon C, Gomez P, Mosquera C, Gonzalez T, Yepez R, Vargas C, Amorim RA, Len CA, Molina J, Lewandowski L, Moreira G, Santos FH, Fraga M, Keppeke L, Silva VM, Hirotsu C, Tufik S, Terreri MT, Braga VL, Fonseca MB, Arango C, Len CA, Fraga M, Schinzel V, Terreri MTR, Molina J, Len CA, Jorge L, Guerra L, Santos FH, Terreri MT, Mosquera AC, Junior EA, Fonseca MB, Braga VL, Len CA, Fraga M, Schinzel V, Terreri MTR, Alizzi C, Maggio MC, Castiglione MC, Malagon C, Tricarico A, Corsello G, Boulter E, Schultz A, Murray K, Falcini F, Lepri G, Stagi S, Bellucci E, Matucci-Cerinic M, Sakamoto AP, Grein IHR, Groot N, Pileggi G, Pinto NBF, de Oliveira AL, Wulffraat N, Chyzheuskaya I, Belyaeva L, Filonovich R, Khrustaleva H, Silva CA, Zajtseva L, Ilisson J, Pruunsild C, Kostik M, Kopchak O, Mushkin A, Maletin A, Gilliaux O, Corazza F, Lelubre C, Silva MFCD, Ferster A, Suárez RG, Morel Z, Espada G, Malagon C, C CSM, Lira L, Ladino M, Eraso R, Arroyo I, Lopes AS, Sztajnbok F, Silva C, Rose C, Russo GCS, Sallum AEM, Kozu K, Bonfá E, Saad-Magalhães C, Pereira RMR, Len CA, Terreri MT, Suri D, Didel S, Rawat A, Singh S, Maritsi D, Onoufriou MA, Vougiouka O, Tsolia M, Bosak EP, Vidović M, Lamot M, Lamot L, Harjaček M, Van Nieuwenhove E, Liston A, Wouters C, Tahghighi F, Ziaee V, Raeeskarami SR, Aguiar F, Pereira S, Rodrigues M, Moura C, Rocha G, Guimarães H, Brito I, Aguiar F, Fonseca R, Rodrigues M, Brito I, Horneff G, Klein A, Minden K, Huppertz HI, Weller-Heinemann F, Kuemmerle-Deschner J, Haas JP, Hospach A, Menendez-Castro R, Huegle B, Haas JP, Swart J, Giancane G, Bovis F, Castagnola E, Groll A, Horneff G, Huppertz HI, Lovell DJ, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, Marafon DP, Ailioaie C, Tsitsami E, Kamphuis S, Herlin T, Doležalová P, Susic G, Flatø B, Sztajnbok F, Pistorio A, Martini A, Wulffraat N, Ruperto N, Gattorno M, Brucato A, Finetti M, Lazaros G, Maestroni S, Carraro M, Cumetti D, Carobbio A, Lorini M, Rimini A, Marcolongo R, Valenti A, Erre GL, Belli R, Gaita F, Sormani MP, Ruperto N, Imazio M, Martini A, Abinun M, Smith N, Rapley T, McErlane F, Kearsley-Fleet L, Hyrich KL, Foster H, Ruperto N, Lovell DJ, Tzaribachev N, Zeft A, Cimaz R, Stanevicha V, Horneff G, Bohnsack J, Griffin T, Carrasco R, Trachana M, Dare J, Foeldvari I, Vehe R, Bovis F, Simon T, Martini A, Brunner H, Verazza S, Davì S, Consolaro A, Insalaco A, Gerloni V, Cimaz R, Zulian F, Pastore S, Corona F, Conti G, Barone P, Cattalini M, Cortis E, Breda L, Olivieri AN, Civino A, Podda R, Rigante D, La Torre F, D’Angelo G, Jorini M, Gallizzi R, Maggio MC, Consolini R, De Fanti A, Alpigiani MG, Martini A, Ravelli A, Sozeri B, Kısaarslan AP, Gunduz Z, Dusunsel R, Dursun I, Poyrazoglu H, Kuchinskaya E, Abduragimova F, Kostik M, Sundberg E, Omarsdottir S, Klevenvall L, Erlandsson-Harris H, Basbozkurt G, Erdemli O, Simsek D, Yazici F, Karsioglu Y, Tezcaner A, Keskin D, Ozkan H, Acikel C, Ozen S, Demirkaya E, Orbán I, Sevcic K, Brodszky V, Kiss E, Tekko IA, Rooney M, McElnay J, Taggart C, McCarthy H, Donnelly RF, Abinun M, Slatter M, Nademi Z, Friswell M, Foster H, Jandial S, McErlane F, Flood T, Hambleton S, Gennery A, Cant A, Finetti M, Bovis F, Swart J, Doležalová P, Tsitsami E, Trachana M, Demirkaya E, Duong PN, Koné-Paut I, Vougiouka O, Marafon DP, Cimaz R, Filocamo G, Gamir ML, Stanevicha V, Sanner H, Carenini L, Wulffraat N, Martini A, Ruperto N, Topdemir M, Basbozkurt G, Karslioglu Y, Ozkan H, Acikel C, Demirkaya E, Gok F, Zholobova E, Tsurikova N, Ligostaeva E, Ramchurn NR, Friswell M, Kostareva O, Nikishina I, Arsenyeva S, Rodionovskaya S, Kaleda M, Alexeev D, Dursun ID, Sozeri B, Kısaarslan AP, Dusunsel R, Poyrazoglu H, Poyrazoglu H, Murias S, Barral E, Alcobendas R, Enriquez E, Remesal A, de Inocencio J, Castro TM, Lotufo SA, Freye T, Carlomagno R, Zumbrunn T, Bonhoeffer J, Schneider EC, Kaiser D, Hofer M, Hentgen V, Woerner A, Schwarz T, Klotsche J, Niewerth M, Horneff G, Haas JP, Hospach A, Huppertz HI, Ganser G, Minden K, Jeyaratnam J, ter Haar N, Kasapcopur O, Rigante D, Dedeoglu F, Baris E, Vastert S, Wulffraat N, Frenkel J, Hausmann JS, Lomax KG, Shapiro A, Durrant KL, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Leon K, Wei X, Laxer RM, Signa S, Rusmini M, Campione E, Chiesa S, Grossi A, Omenetti A, Caorsi R, Viglizzo G, Martini A, Ceccherini I, Gattorno M, Federici S, Frenkel J, Ozen S, Lachmann H, Finetti M, Martini A, Ruperto N, Gattorno M, Federici S, Vanoni F, Ozen S, Hofer M, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Gomes SM, Omoyinmi E, Arostegui JI, Gonzalez-Roca E, Eleftheriou D, Klein N, Brogan P, Volpi S, Santori E, Picco P, Pastorino C, Caorsi R, Rice G, Tesser A, Martini A, Crow Y, Candotti F, Gattorno M, Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Kasapcopur O, Damian LO, Lazea C, Sparchez M, Vele P, Muntean L, Albu A, Rednic S, Lazar C, Mendonça LO, Pontillo A, Kalil J, Castro FM, Barros MT, Pardeo M, Messia V, De Benedetti F, Insalaco A, Malighetti G, Gorio C, Ricci F, Parissenti I, Montesano P, Bonafini B, Medeghini V, Cattalini M, Giordano L, Zani G, Ferraro R, Vairo D, Giliani S, Cattalini M, Maggio MC, Luppino G, Corsello G, Fernandez MIG, Montesinos BL, Vidal AR, Gorospe JIA, Penades IC, Rafiq NK, Wynne K, Hussain K, Brogan PA, Ang E, Ng N, Kacar A, Gucenmez OA, Makay B, Unsal SE, Sahin Y, Barut K, Kutlu T, Cullu-Cokugras F, Sahin S, Adrovic A, Ayyildiz-Civan H, Kasapcopur O, Erkan T, Abdawani R, Al Zuhbi S, Abdalla E, Russo RA, Katsicas MM, Caorsi R, Minoia F, Viglizzo G, Grossi A, Chiesa S, Picco P, Ravelli A, Gattorno M, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Nada R, Tiewsoh K, Hawkins P, Rowczenio D, Singh S, Fingerhutova S, Franova J, Prochazkova L, Hlavackova E, Dolezalova P, Evrengül H, Yüksel S, Doğan M, Gürses D, Evrengül H, De Pauli S, Pastore S, Bianco AM, Severini GM, Taddio A, Tommasini A, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Sleptsova T, Alexeeva E, Savostyanov K, Pushkov A, Bzarova T, Valieva S, Denisova R, Isayeva K, Chistyakova E, Lomakina O, Soloshenko M, Kaschenko E, Kaneko U, Imai C, Saitoh A, Teixeira VA, Ramos FO, Costa M, Aviel YB, Fahoum S, Brik R, Özçakar ZB, Çakar N, Uncu N, Celikel BA, Yalcinkaya F, Schiappapietra B, Davi’ S, Mongini F, Giannone L, Bava C, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Lazarevic DS, Vojinovic J, Susic G, Basic J, Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Alongi A, Civino A, Quartulli L, Consolaro A, Martini A, Ravelli A, Januskeviciute G, van Dijkhuizen P, Muratore V, Giancane G, Schiappapietra B, Martini A, Ravelli A, Consolaro A, Groot N, van Dijk W, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Groot N, Kardolus A, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Suárez RG, Nordal EB, Rypdal VG, Berntson L, Ekelund M, Aalto K, Peltoniemi S, Zak M, Nielsen S, Glerup M, Herlin T, Arnstad ED, Fasth A, Rygg M, Duarte AC, Sousa S, Teixeira L, Cordeiro A, Santos MJ, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Coda A, Cassidy S, West K, Hendry G, Grech D, Jones J, Hawke F, Grewal DS, Coda A, Jones J, Grech D, Grewal DS, Foley C, Killeen O, MacDermott E, Veale D, Fearon U, Konukbay D, Demirkaya E, Tarakci E, Arman N, Barut K, Şahin S, Adrovic A, Kasapcopur O, Munro J, Consolaro A, Morgan E, Riebschleger M, Horonjeff J, Strand V, Bingham C, Collante MTM, Ganeva M, Stefanov S, Telcharova A, Mihaylova D, Saraeva R, Tzveova R, Kaneva R, Tsakova A, Temelkova K, Picarelli MMC, Danzmann LC, Barbé-Tuana F, Grun LK, Jones MH, Frković M, Ištuk K, Birkić I, Sršen S, Jelušić M, Smith N, Jandial S, Easton A, Quarmby R, Khubchandani R, Chan M, Rapley T, Foster H, Srp R, Kobrova K, Franova J, Fingerhutova S, Nemcova D, Hoza J, Uher M, Saifridova M, Linkova L, Dolezalova P, Charuvanij S, Leelayuwattanakul I, Pacharapakornpong T, Vallipakorn SAO, Lerkvaleekul B, Vilaiyuk S, Muratore V, Giancane G, Lanni S, Alongi A, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Alongi A, Bovis F, Minoia F, Davì S, Martini A, Ruperto N, Cron RQ, Ravelli A, Passarelli C, Pardeo M, Pisaneschi E, Novelli A, De Benedetti F, Bracaglia C, Bracaglia C, Marafon DP, Caiello I, de Graaf K, Guilhot F, Ferlin W, Davi’ S, Schulert G, Ravelli A, Grom AA, Nelson R, de Min C, De Benedetti F, Holzinger D, Kessel C, Fall N, Grom A, de Jager W, Vastert S, Strippoli R, Bracaglia C, Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Groll A, Tutz G. Variable selection in discrete survival models including heterogeneity. LIFETIME DATA ANALYSIS 2017; 23:305-338. [PMID: 26972989 DOI: 10.1007/s10985-016-9359-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/29/2016] [Indexed: 06/05/2023]
Abstract
Several variable selection procedures are available for continuous time-to-event data. However, if time is measured in a discrete way and therefore many ties occur models for continuous time are inadequate. We propose penalized likelihood methods that perform efficient variable selection in discrete survival modeling with explicit modeling of the heterogeneity in the population. The method is based on a combination of ridge and lasso type penalties that are tailored to the case of discrete survival. The performance is studied in simulation studies and an application to the birth of the first child.
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Groll A, Kim K, Bhatia H, Zhang JC, Wang JH, Shen ZM, Cai L, Dutta J, Li Q, Meng LJ. Hybrid Pixel-Waveform (HPWF) Enabled CdTe Detectors for Small Animal Gamma-Ray Imaging Applications. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2017; 1:3-14. [PMID: 28516169 PMCID: PMC5431752 DOI: 10.1109/tns.2016.2623807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This paper presents the design and preliminary evaluation of small-pixel CdTe gamma ray detectors equipped with a hybrid pixel-waveform (HPWF) readout system for gamma ray imaging applications with additional discussion on CZT due to its similarity. The HPWF readout system utilizes a pixelated anode readout circuitry which is designed to only provide the pixel address. This readout circuitry works in coincidence with a high-speed digitizer to sample the cathode waveform which provides the energy, timing, and depth-of-interaction (DOI) information. This work focuses on the developed and experimentally evaluated prototype HPWF-CdTe detectors with a custom CMOS pixel-ASIC to readout small anode pixels of 350 μm in size, and a discrete waveform sampling circuitry to digitize the signal waveform induced on the large cathode. The intrinsic timing, energy, and spatial resolution were experimentally evaluated in this paper in conjunction with methods for depth of interaction (DOI) partitioning of the CdTe crystal. While the experimental studies discussed in this paper are primarily for evaluating HPWF detectors for small animal PET imaging, these detectors could find their applications for ultrahigh-resolution SPECT and other imaging modalities.
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Meid AD, Groll A, Schieborr U, Walker J, Haefeli WE. How can we define and analyse drug exposure more precisely to improve the prediction of hospitalizations in longitudinal (claims) data? Eur J Clin Pharmacol 2016; 73:373-380. [PMID: 28013365 DOI: 10.1007/s00228-016-2184-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/16/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Risk prediction models can be powerful tools to support clinical decision-making, to help targeting interventions, and, thus, to improve clinical and economic outcomes, provided that model performance is good and sensitivity and specificity are well balanced. Drug utilization as a potential risk factor for unplanned hospitalizations has recently emerged as a meaningful predictor variable in such models. Drug treatment is a rather unstable (i.e. time-dependent) phenomenon and most drug-induced events are concentration-dependent and therefore individual drug exposure will likely modulate the risk. This especially applies to longitudinal monitoring of appropriate drug treatment within claims data as another promising application for prediction models. METHODS AND RESULTS To guide future research towards this direction, we firstly reviewed current risk prediction models for unplanned hospitalizations that explicitly included information on drug utilization and were surprised to find that these models rarely attempted to consider dose and frequent modulators of drug clearance such as interactions with co-medication or co-morbidities. As another example, they often presumed class effects where in fact, differences between active moieties were well established. In addition, the study designs and statistical risk analysis disregarded the fact that medication and risk modulators and, thus, adverse events can vary over time. In a simulation study, we therefore evaluated the potential benefit of time-dependent Cox models over standard binary regression approaches with a fixed follow-up period. CONCLUSIONS Longitudinal drug information could be utilized much more efficiently both by precisely estimating individual drug exposure and by applying more refined statistical methodology to account for time-dependent drug utilization patterns.
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Swart J, Giancane G, Bovis F, Castagnola E, Groll A, Horneff G, Huppertz HI, Lovell D, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, De Benedetti F, Ailioaie L, Tsitsami E, Kamphuis S, Herlin T, Dolezalova P, Susic G, Flato B, Sztajnbok F, Pistorio A, Martini A, Wulffraat N, Ruperto N. OP0217 Adjudication of Infections in The Pharmacovigilance in Juvenile Idiopathic Arthritis Patients (Pharmachild) Treated with Biologic Agents and/or Methotrexate. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meid AD, Quinzler R, Groll A, Wild B, Saum KU, Schöttker B, Heider D, König HH, Brenner H, Haefeli WE. Longitudinal evaluation of medication underuse in older outpatients and its association with quality of life. Eur J Clin Pharmacol 2016; 72:877-85. [DOI: 10.1007/s00228-016-2047-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/15/2016] [Indexed: 11/29/2022]
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Groll A, George J, Vargas P, La Rivière P, Meng LJ. Element Mapping in Organic Samples Utilizing a Benchtop X-Ray Fluorescence Emission Tomography (XFET) System. IEEE TRANSACTIONS ON NUCLEAR SCIENCE 2015; 62:2310-2317. [PMID: 26705368 PMCID: PMC4686274 DOI: 10.1109/tns.2015.2465380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
X-ray fluorescence computed tomography (XFCT) is an emerging imaging modality that maps the three-dimensional distribution of elements, generally metals, in ex vivo specimens and potentially in living animals and humans. Building on our previous synchrotron-based work, we experimentally explored the use of a benchtop X-ray fluorescence computed tomography system for mapping trace-metal ions in biological samples. This system utilizes a scanning pencil-beam to stimulate the object and then relies on a detection system, with single or multiple slit apertures placed in front of position-sensitive X-ray detectors, to collect the fluorescence X-rays and to form 3-D elemental map without the need for tomographic imaging reconstruction. The technique was used to generate images of the elemental distributions of a triple-tube phantom and an osmium-stained zebrafish.
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Herbst M, Gazendam R, Reimnitz D, Sawalle-Belohradsky J, Groll A, Schlegel PG, Belohradsky B, Renner E, Klepper J, Grimbacher B, Kuijpers T, Liese J. Chronic Candida albicans Meningitis in a 4-Year-Old Girl with a Homozygous Mutation in the CARD9 Gene (Q295X). Pediatr Infect Dis J 2015; 34:999-1002. [PMID: 25933095 DOI: 10.1097/inf.0000000000000736] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A 4-year-old Turkish girl of consanguineous parents was hospitalized for the evaluation of headaches and recurrent febrile episodes of unknown origin. Her medical history was unremarkable except for a few episodes of uncomplicated oral thrush. Meningitis was diagnosed, and Candida albicans was the only pathogen identified by polymerase chain reaction and culture. Despite systemic antifungal multidrug therapy, a prolonged course of 16 months of therapy was necessary to clear C. albicans from the cerebrospinal fluid. Molecular genetic analysis revealed a homozygous caspase recruitment domain 9 (CARD9) mutation (Q295X), which was reported to predispose to chronic mucocutaneous candidiasis. Immunologic workup excluded predisposing B-cell and T-cell defects. In addition, T cells producing interleukin-17 were repeatedly measured within the normal range. Analyses of neutrophils demonstrated normal nicotinamide adenine dinucleotide phosphate oxidase activity in response to various stimuli including Staphylococcus aureus and C. albicans. Additional neutrophilic functional testing, however, showed a decreased cytotoxicity to nonopsonized C. albicans, indicating an impaired killing mechanism against Candida spp. independent from the production of reactive oxygen species by the nicotinamide adenine dinucleotide phosphate oxidase system. Because this defect was only demonstrated in the absence of opsonins, it might especially predispose to chronic C. albicans infections in the central nervous system where opsonin concentrations are usually low. We, therefore, suggest that due to an additional neutrophil dependent defect CARD9 deficiency predisposes not only to chronic mucocutaneous candidiasis, but also to invasive chronic Candida infections, especially of the central nervous system.
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Walsh TJ, Skiada A, Cornely OA, Roilides E, Ibrahim A, Zaoutis T, Groll A, Lortholary O, Kontoyiannis DP, Petrikkos G. Development of new strategies for early diagnosis of mucormycosis from bench to bedside. Mycoses 2015; 57 Suppl 3:2-7. [PMID: 25475924 DOI: 10.1111/myc.12249] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Early diagnosis and initiation of amphotericin B (AmB) for treatment of mucormycosis increases survival from approximately 40% to 80%. The central objective of a new study of the European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology (ISHAM) Zygomycosis Working Group is to improve the clinical and laboratory diagnosis of mucormycosis. The diagnostic tools generated from this study may help to significantly improve survival from mucormycosis worldwide. The study has three major objectives: to conduct a prospective international registration of patients with mucormycosis using a well-established global network of centres; to construct a predictive risk model for patients at risk for mucormycosis; and to establish an international archive of specimens of tissues, fluids, and organisms linked from the patients enrolled into the registry that will be used for development of leading edge molecular, proteomic, metabolic and antigenic systems for mucormycosis.
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Welsch S, Hense HW, Groll A, Fröhlich B, Goletz G, Wältermann M, Jürgens H. [Adherence to Long-term Follow-up in Paediatric Oncology--Results of a Monocentric Analysis]. KLINISCHE PADIATRIE 2015; 227:144-50. [PMID: 25811744 DOI: 10.1055/s-0034-1398629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cured paediatric-oncology patients frequently present with health problems even years after treatment. Hence long-term follow-up (LTFU) is essential. This analysis tries to identify factors that influence regular LTFU attendance. STUDY POPULATION Between 1991 and 2010, 2 153 children and adolescents were treated at Muenster University Department of Paediatric Hematology and Oncology (UKM). 1 708 patients with permanent residence in Germany and completed therapy have been included into this analysis. METHODS Patients were reviewed for the duration and regularity of LTFU at UKM. Prospective analyses with postponed starting-points have been conducted as well as descriptive analyses to validate correlations. Prospective data were evaluated by Kaplan-Meier-Analyses, the analysis of multivariate correlations by Cox Proportional Hazard Model. RESULTS 2 years after the end of therapy 83% of the patients were still in LTFU. After 5 and 10 years this percentage decreased to 67 and 42%. Patients diagnosed after the year 2000 and younger patients attended LTFU for a longer period (p<0,005). There were no significant gender differences. Statutory insured patients stayed longer in LTFU than private health insured (p<0,005). The multivariate examination showed only small differences between systemic diseases and solid tumours. The residential distance had no significant influence. CONCLUSIONS Younger, more recently treated and statutory insured patients showed a significantly longer LTFU.
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Ruhnke M, Groll A, Ullmann A, Denning D. Burden of serious fungal infections in Germany. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Tutz G, Groll A. Likelihood-Based Boosting in Binary and Ordinal Random Effects Models. J Comput Graph Stat 2013. [DOI: 10.1080/10618600.2012.694769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Groll A, Tutz G. Regularization for generalized additive mixed models by likelihood-based boosting. Methods Inf Med 2012; 51:168-77. [PMID: 22378253 DOI: 10.3414/me11-02-0021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 10/20/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE With the emergence of semi- and nonparametric regression the generalized linear mixed model has been extended to account for additive predictors. However, available fitting methods fail in high dimensional settings where many explanatory variables are present. We extend the concept of boosting to generalized additive mixed models and present an appropriate algorithm that uses two different approaches for the fitting procedure of the variance components of the random effects. METHODS The main tool developed is likelihood-based componentwise boosting that enforces variable selection in generalized additive mixed models. In contrast to common procedures they can be used in high-dimensional settings where many covariates are available and the form of the influence is unknown. The complexity of the resulting estimators is determined by information criteria. The performance of the methods is investigated in simulation studies for binary and Poisson responses with comparisons to alternative approaches and it is applied to clinical real world data. RESULTS Simulations show that the proposed methods are considerably more stable and more accurate in estimating the regression function than the conventional approach, especially when a large number of predictors is available. The methods also produce reasonable results in applications to real data sets, which is illustrated by the Multicenter AIDS Cohort Study. CONCLUSIONS The boosting algorithm allows to extract relevant predictors in generalized additive mixed models. It works in high-dimensional settings and is very stable.
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Skiada A, Pagano L, Groll A, Zimmerli S, Dupont B, Lagrou K, Lass-Florl C, Bouza E, Klimko N, Gaustad P, Richardson M, Hamal P, Akova M, Meis J, Rodriguez-Tudela JL, Roilides E, Mitrousia-Ziouva A, Petrikkos G. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect 2011; 17:1859-67. [DOI: 10.1111/j.1469-0691.2010.03456.x] [Citation(s) in RCA: 470] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Rüping MJGT, Vehreschild JJ, Groll A, Lass-Flörl C, Ostermann H, Ruhnke M, Cornely OA. Current issues in the clinical management of invasive aspergillosis--the AGIHO, DMykG, ÖGMM and PEG web-based survey and expert consensus conference 2009. Mycoses 2011; 54:e557-68. [PMID: 21518025 DOI: 10.1111/j.1439-0507.2010.01989.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objectives of this study were to identify unsolved issues in the management of invasive aspergillosis, identify controversies and achieve consensus. The German Speaking Mycological Society (Deutschsprachige Mykologische Gesellschaft, DMykG) invited other German infectious diseases (ID) and mycological societies to submit unsolved issues concerning the diagnosis and treatment of invasive aspergillosis. Based on these contributions, a digital web-based questionnaire of 12 questions on Aspergillus spp. was designed to be completed by experts of the participating societies. Controversial results were identified by a mathematical model and were discussed at a consensus conference during the 43rd Annual Meeting of the DMykG in Cologne, Germany. Forty-two individuals completed the questionnaire. Analysis showed a strong consensus on effective preventive measures, choice of antifungal agents for pre-emptive, empiric and targeted treatment, as well as the evaluation of early chest CT control scans as a measure of treatment response assessment. Opinions on the indication for a pulmonary biopsy of a halo sign in high-risk neutropenic patients and on the role of Aspergillus spp. PCR as well as galactomannan from serum in the assessment of treatment duration diverged in spite of discussion such that a consensus could not be reached. Using a recently published two-step approach - web-based survey plus classical panel discussion - expert consensus was achieved on 10 of 12 questions concerning the diagnosis and treatment of invasive aspergillosis.
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Adams NG, Adekambi T, Afeltra J, Aguado J, Aires de Sousa M, Akiyoshi K, Al Hasan M, Ala-Kokko T, Albert M, Alfandari S, Allen D, Allerberger F, Almyroudis N, Alp E, Amin R, Anderson-Berry A, Andes DR, Andremont A, Andreu A, Angelakis M, Antachopoulos C, Antoniadou A, Arabatzis M, Arlet G, Arnez M, Arnold C, Asensio A, Asseray N, Ausiello C, Avni T, Ayling R, Baddour L, Baguelin M, Bányai K, Barbour A, Basco LK, Bauer D, Bayston R, Beall B, Becker K, Behr M, Bejon P, Belliot G, Benito-Fernandez J, Benjamin D, Benschop K, Berencsi G, Bergeron MG, Bernard K, Berner R, Beyersmann J, Bille J, Bizzini A, Bjarnsholt T, Blanc D, Blanco J, Blot S, Bohnert J, Boillat N, Bonomo R, Bonten M, Bordon JM, Borel N, Boschiroli ML, Bosilkovski M, Bosso JA, Botelho-Nevers E, Bou G, Bretagne S, Brouqui P, Brun-Buisson C, Brunetto M, Bucher H, Buchheidt D, Buckling A, Bulpa P, Cambau E, Canducci F, Cantón R, Capobianchi M, Carattoli A, Carcopino X, Cardona-Castro N, Carling PC, Carrat F, Castilla J, Castilletti C, Cavaco L, Cavallo R, Ceccherini-Silberstein F, Centrón D, Chappuis F, Charrel R, Chen M, Chevaliez S, Chezzi C, Chomel B, Chowers M, Chryssanthou E, Ciammaruconi A, Ciccozzi M, Cid J, Ciofu O, Cisneros D, Ciufolini MG, Clark C, Clarke SC, Clayton R, Clementi M, Clemons K, Cloeckaert A, Cloud J, Coenye T, Cohen Bacri S, Cohen R, Coia J, Colombo A, Colson P, Concerse P, Cordonnier C, Cormican M, Cornaglia G, Cornely O, Costa S, Cots F, Craxi A, Creti R, Crnich C, Cuenca Estrella M, Cusi MG, d'Ettorre G, da Cruz Lamas C, Daikos G, Dannaoui E, De Barbeyrac B, De Grazia S, de Jager C, de Lamballerie X, de Marco F, del Palacio A, Delpeyroux F, Denamur E, Denis O, Depaquit J, Deplano A, Desenclos JC, Desjeux P, Deutch S, Di Luca D, Dianzani F, Diep B, Diestra K, Dignani C, Dimopoulos G, Divizia M, Doi Y, Dornbusch HJ, Dotis J, Drancourt M, Drevinek P, Dromer F, Dryden M, Dubreuil L, Dubus JC, Dumitrescu O, Dumke R, DuPont H, Edelstein M, Eggimann P, Eis-Huebinger AM, El Atrouni WI, Entenza J, Ergonul O, Espinel-Ingroff A, Esteban J, Etienne J, Fan XG, Fenollar F, Ferrante P, Ferrieri P, Ferry T, Feuchtinger T, Finegold S, Fingerle V, Fitch M, Fitzgerald R, Flori P, Fluit A, Fontana R, Fournier PE, François M, Francois P, Freedman DO, Friedrich A, Gallego L, Gallinella G, Gangneux JP, Gannon V, Garbarg-Chenon A, Garbino J, Garnacho-Montero J, Gatermann S, Gautret P, Gentile G, Gerlich W, Ghannoum M, Ghebremedhin B, Ghigo E, Giamarellos-Bourboulis E, Girgis R, Giske C, Glupczynski Y, Gnarpe J, Gomez-Barrena E, Gorwitz RJ, Gosselin R, Goubau P, Gould E, Gradel K, Gray J, Gregson D, Greub G, Grijalva CG, Groll A, Groschup M, Gutiérrez J, Hackam DG, Hall WA, Hallett R, Hansen S, Harbarth S, Harf-Monteil C, Hasanjani RMR, Hasler P, Hatchette T, Hauser P, He Q, Hedges A, Helbig J, Hennequin C, Herrmann B, Hezode C, Higgins P, Hoesli I, Hoiby N, Hope W, Houvinen P, Hsu LY, Huard R, Humphreys H, Icardi M, Imoehl M, Ivanova K, Iwamoto T, Izopet J, Jackson Y, Jacobsen K, Jang TN, Jasir A, Jaulhac B, Jaureguy F, Jefferies JM, Jehl F, Johnstone J, Joly-Guillou ML, Jonas M, Jones M, Joukhadar C, Kahl B, Kaier K, Kaiser L, Kato H, Katragkou A, Kearns A, Kern W, Kerr K, Kessin R, Kibbler C, Kimberlin D, Kittang B, Klaassen C, Kluytmans J, Ko WC, Koh WJ, Kostrzewa M, Kourbeti I, Krause R, Krcmery V, Krizova P, Kuijper E, Kullberg BJ, Kumar G, Kunin CM, La Scola B, Lagging M, Lagrou K, Lamagni T, Landini P, Landman D, Larsen A, Lass-Floerl C, Laupland K, Lavigne JP, Leblebicioglu H, Lee B, Lee CH, Leggat P, Lehours P, Leibovici L, Leon L, Leonard N, Leone M, Lescure X, Lesprit P, Levy PY, Lew D, Lexau CA, Li SY, Li W, Lieberman D, Lina B, Lina G, Lindsay JA, Livermore D, Lorente L, Lortholary O, Lucet JC, Lund B, Lütticken R, MacLeod C, Madhi S, Maertens J, Maggi F, Maiden M, Maillard JY, Maira-Litran T, Maltezou H, Manian FA, Mantadakis E, Maragakis L, Marcelin AG, Marchaim D, Marchetti O, Marcos M, Markotic A, Martina B, Martínez J, Martinez JL, Marty F, Maurin M, McGee L, Mediannikov O, Meersseman W, Megraud F, Meletiadis J, Mellmann A, Meyer E, Meyer W, Meylan P, Michalopoulos A, Micol R, Midulla F, Mikami Y, Miller RF, Miragaia M, Miriagou V, Mitchell TJ, Miyakis S, Mokrousov I, Monecke S, Mönkemüller K, Monno L, Monod M, Morales G, Moriarty F, Morosini I, Mortensen E, Mubarak K, Mueller B, Mühlemann K, Muñoz Bellido JL, Murray P, Muscillo M, Mylotte J, Naessens A, Nagy E, Nahm MH, Nassif X, Navarro D, Navarro F, Neofytos D, Nes I, Ní Eidhin D, Nicolle L, Niederman MS, Nigro G, Nimmo G, Nordmann P, Nougairède A, Novais A, Nygard K, Oliveira D, Orth D, Ortiz JR, Osherov N, Österblad M, Ostrosky-Zeichner L, Pagano L, Palamara AT, Pallares R, Panagopoulou P, Pandey P, Panepinto J, Pappas G, Parkins M, Parola P, Pasqualotto A, Pasteran F, Paul M, Pawlotsky JM, Peeters M, Peixe L, Pepin J, Peralta G, Pereyre S, Perfect JR, Petinaki E, Petric M, Pettigrew M, Pfaller M, Philipp M, Phillips G, Pichichero M, Pierangeli A, Pierard D, Pigrau C, Pilishvili T, Pinto F, Pistello M, Pitout J, Poirel L, Poli G, Poppert S, Posfay-Barbe K, Pothier P, Poxton I, Poyart C, Pozzetto B, Pujol M, Pulcini C, Punyadeera C, Ramirez M, Ranque S, Raoult D, Rasigade JP, Re MC, Reilly JS, Reinert R, Renaud B, Rice L, Rich S, Richet H, Rigouts L, Riva E, Rizzo C, Robotham J, Rodicio MR, Rodriguez J, Rodriguez-Bano J, Rogier C, Roilides E, Rolain JM, Rooijakkers S, Rooney P, Rossi F, Rotimi V, Rottman M, Roux V, Ruhe J, Russo G, Sadowy E, Sagel U, Said SI, Saijo M, Sak B, Sa-Leao R, Sanders EAM, Sanguinetti M, Sarrazin C, Savelkoul P, Scheifele D, Schmidt WP, Schønheyder H, Schönrich G, Schrenzel J, Schubert S, Schwarz K, Schwarz S, Sefton A, Segondy M, Seifert H, Seng P, Senneville E, Sexton D, Shafer RW, Shalit I, Shankar N, Shata TM, Shields J, Sibley C, Sicinschi L, Siljander T, Simitsopoulou M, Simoons-Smit AM, Sissoko D, Sjögren J, Skiada A, Skoczynska A, Skov R, Slack M, Sogaard M, Sola C, Soriano A, Sotto A, Sougakoff W, Sougakoff W, Souli M, Spelberg B, Spelman D, Spiliopoulou I, Springer B, Stefani S, Stein A, Steinbach WJ, Steinbakk M, Strakova L, Strenger V, Sturm P, Sullivan P, Sutton D, Symmons D, Tacconelli E, Tamalet C, Tang JW, Tang YW, Tattevin P, Thibault V, Thomsen RW, Thuny F, Tong S, Torres C, Townsend R, Tristan A, Trouillet JL, Tsai HC, Tsitsopoulos P, Tuerlinckx D, Tulkens P, Tumbarello M, Tureen J, Turnidge JD, Turriziani O, Tutuian R, Uçkay I, Upton M, Vabret A, Vamvakas EC, van den Boom D, Van Eldere J, van Leeuwen W, van Strijp J, Van Veen S, Vandamme P, Vandenesch F, Vayssier M, Velin D, Venditti M, Venter M, Venuti A, Vergnaud G, Verheij T, Verhofstede C, Viscoli C, Vizza CD, Vogel U, Waller A, Wang YF, Warn P, Warris A, Wauters G, Weidmann M, Weill FX, Weinberger M, Welch D, Wellinghausen N, Wheat J, Widmer A, Wild F, Willems R, Willinger B, Winstanley C, Witte W, Wolff M, Wong F, Wootton M, Wyllie D, Xu W, Yamamoto S, Yaron S, Yildirim I, Zaoutis T, Zazzi M, Zbinden R, Zehender GG, Zemlickova H, Zerbini ML, Zhang L, Zhang Y, Zhao YD, Zhu Z, Zimmerli W. ACKNOWLEDGEMENT OF REVIEWERS. Clin Microbiol Infect 2011. [DOI: 10.1111/j.1469-0691.2010.03428.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dornbusch H, Groll A, Walsh T. Diagnosis of invasive fungal infections in immunocompromised children. Clin Microbiol Infect 2010; 16:1328-34. [DOI: 10.1111/j.1469-0691.2010.03336.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Groll A. Neues aus der Welt der Antimykotika. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Groll A, Maddison P, Arrieta A. Micafungin – Overview of Safety in Pediatric Patients. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Groll A, Seibel NL, Walsh TJ, Arnold L, Arrieta A. Micafungin – Overview of Efficacy in Pediatric Patients. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Walsh TJ, Petraitis V, Petraitiene R, Solomon J, Bacher JD, Greene L, Cotton M, Groll A, Roilides E, Avila N, Pyrgos V, Shoham S. Diagnostic imaging of experimental invasive pulmonary aspergillosis. Med Mycol 2009; 47 Suppl 1:S138-45. [PMID: 19253145 DOI: 10.1080/13693780802665879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Pulmonary infiltrates in neutropenic hosts with invasive aspergillosis are caused by organism-mediated tissue injury, vascular invasion, and hemorrhagic infarction. Ultrafast computed tomography (UFCT) scanning reproducibly measures these lesions in experimental invasive pulmonary aspergillosis in persistently neutropenic rabbits. The pulmonary lesion score from UFCT scanning is a useful outcome variable for measuring differences in efficacy of antifungal compounds alone and in combination, as well as the virulence of different strains and species of Aspergillus. Several studies demonstrate that the course of pulmonary lesions treated with amphotericin B, lipid formulations of amphotericin B, triazoles, echinocandins, and combination therapy measured by serial UFCT scans correlate with those measured by survival, histopathological resolution of lesions, microbiological clearance of Aspergillus fumigatus, and resolution of galactomannan index. We further developed a multidimensional volumetric imaging (MDVI) method for analysis of the volume of pulmonary infiltrates over time in response to antifungal therapy. Volumetric data by MDVI correlate with UFCT pulmonary lesion scores and validated biological endpoints. A recent pilot clinical study demonstrated the applicability of MDVI to human pulmonary fungal infections. MDVI also improves objectivity of radiological assessment of therapeutic response to antifungal therapy and merits more extensive evaluation in patients with invasive aspergillosis, as well as other fungal and bacterial pneumonias.
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Groll A. Traitement des infections fongiques invasives en pédiatrie. Med Mal Infect 2007; 37 Suppl 2:12-3. [DOI: 10.1016/s0399-077x(07)80054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Altiner A, Sielk M, Düllmann A, Fiegen J, Groll A, Stock K, Wilm S, Brockmann S. Auswirkungen des GMG (GKV-Modernisierungs-Gesetz) auf hausärztliche Verordnungen am Beispiel des akuten Hustens. ACTA ACUST UNITED AC 2004. [DOI: 10.1055/s-2004-820384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Walsh TJ, Groll A, Hiemenz J, Fleming R, Roilides E, Anaissie E. Infections due to emerging and uncommon medically important fungal pathogens. Clin Microbiol Infect 2004; 10 Suppl 1:48-66. [PMID: 14748802 DOI: 10.1111/j.1470-9465.2004.00839.x] [Citation(s) in RCA: 374] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The emergence of less common but medically important fungal pathogens contributes to the rate of morbidity and mortality, especially in the increasingly expanding population of immunocompromised patients. These pathogens include septate filamentous fungi (e.g., Fusarium spp., Scedosporium spp., Trichoderma spp.), nonseptate Zygomycetes, the endemic dimorphic pathogen Penicillium marneffei, and non-Cryptococcus, non-Candida pathogenic yeast (e.g., Trichosporon spp.). The medical community is thus called upon to acquire an understanding of the microbiology, epidemiology and pathogenesis of these previously uncommon pathogens in order to become familiar with the options for prevention and treatment.
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Cooper MA, Groll A. A case of chronic pancreatic insufficiency due to valproic acid in a child. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2001; 15:127-30. [PMID: 11240383 DOI: 10.1155/2001/687087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 14-year-old child treated with valproic acid over several years for a seizure disorder developed abdominal pain with radiological evidence of acute pancreatitis. The association with valproic acid was not recognized, and the child continued to take the drug. The patient eventually developed steatorrhea and weight loss that improved with pancreatic enzyme replacement. Radiological evaluation showed an atrophic pancreas. Without evidence of other etiological factors, valproic acid by itself appeared to be the cause of chronic pancreatitis with exocrine pancreatic insufficiency in this patient.
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Walsh TJ, Roden M, Roilides E, Groll A. Concepts in design of comparative clinical trials of antifungal therapy in neutropenic patients. Int J Antimicrob Agents 2000; 16:151-6. [PMID: 11053799 DOI: 10.1016/s0924-8579(00)00242-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Fundamental to the successful implementation of antifungal compounds in neutropenic patients is the appropriate design of comparative clinical trials investigating their safety and efficacy. The key elements of comparative clinical trial design include issues of enrollment, stratification, randomization, blinding, administration of study drugs, monitoring of drug toxicity, definitions, and key statistical elements of end points, sample size, and tools for data analysis. The initial selection of compounds and the timing of initiation of antifungal therapy in comparative clinical trials are predicated to a large degree on the in vitro and in vivo activities, plasma pharmacokinetics, profiles of safety and toxicity of the study drugs. Phase I and II studies have a critical role in designing comparative clinical trials of antifungal therapy by providing data on safety, tolerance, and plasma pharmacokinetics of the investigational agent. As new antifungal agents are developed in response to the challenge of invasive fungal infections in immunocompromised patients with cancer, thoughtfully designed and carefully implemented clinical trials will be essential in determining the future utility of these promising compounds.
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Böhler T, Bäumler C, Herr I, Groll A, Kurz M, Debatin KM. Activation of the CD95 system increases with disease progression in human immunodeficiency virus type 1-infected children and adolescents. Pediatr Infect Dis J 1997; 16:754-9. [PMID: 9271036 DOI: 10.1097/00006454-199708000-00005] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Increased apoptosis in infected as well as noninfected cells has been invoked in CD4+ T helper cell depletion during HIV-1 infection. A strong increase in the expression of CD95 (APO-1/Fas) and CD95 ligand, key regulators of apoptosis in normal T cells, has previously been described in freshly isolated T cells from HIV-1-positive children when compared with healthy age-matched controls. We also found an increase in spontaneous as well as specific CD95-mediated apoptosis in CD4+ and CD8+ T cells from these patients. However, the relationship of these findings to disease progression in children with HIV infection is not known. MEASUREMENTS AND SUBJECTS: We studied expression of CD95 and CD95 ligand as well as sensitivity towards spontaneous and anti-CD95-triggered apoptosis of T cells in 33 HIV-1-positive children and adolescents in different disease stages. RESULTS Loss of CD4+ T cells in vivo was paralleled by an increase in the percentage of CD95 high T cells and an increase in anti-CD95-induced apoptosis of CD4+ T cells. CD95L mRNA was constantly up-regulated in T cells from patients in intermediate disease stages whereas patients with normal CD4 counts and patients with advanced T cell loss showed CD95 ligand-mRNA levels in or slightly above the range of normal controls. CONCLUSIONS Disturbed regulation of the CD95 system may play an important role in the development of immunodeficiency during the course of HIV infection in children.
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Poenaru D, Roblin N, Bird M, Duce S, Groll A, Pietak D, Spry K, Thompson J. The Pediatric Bowel Management Clinic: initial results of a multidisciplinary approach to functional constipation in children. J Pediatr Surg 1997; 32:843-8. [PMID: 9200083 DOI: 10.1016/s0022-3468(97)90633-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The multifactorial nature of functional constipation in children suggests that a multidisciplinary management approach may be effective. The authors tested this hypothesis in a newly created pediatric Bowel Management Clinic (BMC). Detailed data were collected prospectively on all patients seen in the clinic over the first 16 months. Both quantitative and qualitative analyses were performed to describe the index population and to demonstrate the impact of the intervention. Satisfaction with care in the clinic was measured using the Measure of Processes of Care tool, then compared with a normative sample. One hundred fourteen patients, all previously treated unsuccessfully for constipation, were referred to a team comprised of a physician, nurse practitioner, nurse educator, dietitian, and psychosocial nurse specialist. The mean age was 5.4 years with equal gender distribution. Between the first and last visits recorded, several variables including stool consistency and frequency, soiling frequency, abdominal pain, rectal pain, and rectal bleeding all showed statistically significant (P < .05) improvement. Qualitative data analysis showed the significant psychosocial impact of constipation on patients and their families. In the Measures of Processes of Care questionnaire, scores for the BMC were higher than normal on all scales except in provision of information. A multidisciplinary approach to functional constipation leads to both patient and parent satisfaction and significant short-term improvement. Further studies will examine the long-term impact of the clinic.
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Shiro H, Meluleni G, Groll A, Muller E, Tosteson TD, Goldmann DA, Pier GB. The pathogenic role of Staphylococcus epidermidis capsular polysaccharide/adhesin in a low-inoculum rabbit model of prosthetic valve endocarditis. Circulation 1995; 92:2715-22. [PMID: 7586377 DOI: 10.1161/01.cir.92.9.2715] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The capsular polysaccharide/adhesin (PS/A) antigen of Staphylococcus epidermidis was required to produce endocarditis in a rabbit model in which infection resulted from hematogenous spread of bacteria from a contaminated catheter in the jugular vein. However, many prosthetic valve endocarditis (PVE) infections probably result from direct contamination of the valve with small numbers of bacteria during surgery. The role of PS/A in this situation was evaluated by modifying a rabbit model of endocarditis to partially mimic PVE. METHODS AND RESULTS A Teflon catheter was contaminated with graded inocula of either PS/A-positive S epidermidis strain M187sp11 or the PS/A-negative, isogenic strain M187sn3 and inserted into the left ventricle through the aortic valve. The PS/A-positive strain had a 50% infectious dose of 1.1 x 10(2) cfu (95% CI, 3.3 to 3.7 x 10(3)) compared with 8.5 x 10(4) cfu of the PS/A-negative strain (95% CI, 8.6 x 10(3) to 8.5 x 10(5)). The odds for developing endocarditis were estimated to be 42 times higher for any given inoculum level of the PS/A-positive strain (P = .1). When the PS/A-positive strain was adherent to a catheter surface it survived in rabbit blood, whereas under the same conditions the PS/A-negative strain was killed approximately 90% in 1 hour. CONCLUSIONS Direct contamination of an intraventricular foreign body by low levels of PS/A-positive S epidermidis results in endocarditis in rabbits, but at suitably high doses PS/A-negative strains have sufficient virulence to infect cardiac vegetations. PS/A enhances but is not absolutely required for bacterial virulence in a rabbit model of PVE.
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Groll A, Hörlin A, Lang C, Jäger G, Jacobi G. [Neurological complications in infectious endocarditis]. KLINISCHE PADIATRIE 1995; 207:19-23. [PMID: 7885013 DOI: 10.1055/s-2008-1046503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Despite considerable progress in both diagnostic studies and therapeutic management serious complications of infectious endocarditis have become rather more common. Next to intracardiac complications arterial embolization to the central nervous system is the second most common life-threatening event, which might lead to infarction, hemorrhage, mycotic aneurysm and/or metastatic infection with a wide spectrum of neurological symptoms and an overall very poor prognosis. The most effective prevention of neurological complications is the early diagnosis of infectious endocarditis with isolation of the infecting agent and adequate antimicrobial chemotherapy in combination with well-timed cardiosurgical measures. Computed tomography and cerebral angiography is mandatory in any patient with neurological symptoms to check the need for a neurosurgical intervention as well as in patients assigned for anticoagulation for cardiac reasons.
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Feagan BG, McDonald JW, Rochon J, Laupacis A, Fedorak RN, Kinnear D, Saibil F, Groll A, Archambault A, Gillies R. Low-dose cyclosporine for the treatment of Crohn's disease. The Canadian Crohn's Relapse Prevention Trial Investigators. N Engl J Med 1994; 330:1846-51. [PMID: 8196727 DOI: 10.1056/nejm199406303302602] [Citation(s) in RCA: 170] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Long-term corticosteroid therapy for Crohn's disease is associated with important types of morbidity, such as osteoporosis. Safe and effective alternative treatments are required. Although a short-term benefit of cyclosporine in active Crohn's disease has been suggested, the long-term safety and efficacy of this treatment have not been established. METHODS We conducted a randomized, double-blind, placebo-controlled evaluation of the effect of 18 months of low-dose cyclosporine treatment on the course of Crohn's disease. Adult patients whose disease had been active within the previous two years were randomly assigned to receive cyclosporine (151 patients) or placebo (154 patients) in addition to their usual therapy. Randomization was stratified according to center and score on the Crohn's Disease Activity Index (193 patients had scores of 150 or less, and 112 had scores greater than 150). The primary outcome measure was clinically important worsening of Crohn's disease, defined as a 100-point increase in the Crohn's Disease Activity Index from the patient's base-line value. Secondary outcomes were the use of prednisone and 5-amino-salicylates, mean score on the Crohn's Disease Activity Index and mean quality-of-life score, and the need for surgery. RESULTS The condition of more patients worsened with cyclosporine than with placebo (91 of 151, or 60.3 percent, vs. 80 of 154, or 51.9 percent; P = 0.10). The median time to worsening of disease in patients receiving cyclosporine was 338 days, as compared with 492 days in patients receiving placebo (P = 0.25; relative risk, 1.22; 95 percent confidence interval, 0.86 to 1.72). Analyses of the mean Crohn's Disease Activity Index and quality-of-life scores and of the use of prednisone and 5-aminosalicylates also failed to demonstrate benefit. CONCLUSIONS In our patient population, the addition of low-dose cyclosporine to conventional treatment for Crohn's disease did not improve symptoms or reduce requirements for other forms of therapy.
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Groll A, Shah P, Menzel C, Just G, Schneider M, Hübner K. Invasive mycosis in post-mortem findings. J Infect 1994. [DOI: 10.1016/s0163-4453(94)96001-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Irvine EJ, Feagan B, Rochon J, Archambault A, Fedorak RN, Groll A, Kinnear D, Saibil F, McDonald JW. Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn's Relapse Prevention Trial Study Group. Gastroenterology 1994; 106:287-96. [PMID: 8299896 DOI: 10.1016/0016-5085(94)90585-1] [Citation(s) in RCA: 484] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND/AIMS Quality of life (QOL), a subjective index of health perception and function, embraces physical, social, and emotional performance but has not had a prominent role in clinical trials of inflammatory bowel disease (IBD). To test the robustness of the Inflammatory Bowel Disease Questionnaire (IBDQ), a disease-specific QOL index, this study assessed its validity, reliability, and responsiveness during a multicenter trial. METHODS Three hundred five patients with stable Crohn's disease received cyclosporin or placebo for 18 months. IBDQ and dimensional scores (bowel, social, systemic, and emotional) were correlated with disease activity (Crohn's disease activity index [CDAI] and Harvey-Bradshaw index). Concordance of IBDQ scores was tested in 280 stable subjects. Linear regression evaluated change in IBDQ scores over time. RESULTS IBDQ scores correlated highly with CDAI (r = -0.67; P < 0.0001). The reliability coefficient for IBDQ score was 0.70 vs. 0.66 for CDAI and 0.55 for Harvey-Bradshaw index. Regression line slopes of IBDQ scores were significantly different in patients who deteriorated from those who remained stable ([b] < 0.15; P < 0.0001). QOL scores were lower in patients who required surgery. CONCLUSIONS The IBDQ is a valid reliable assessment tool that reflects important changes in the health status of patients with IBD. The IBDQ is a robust measure of therapeutic efficacy and should be used in future clinical trials in IBD.
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87
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Nowak-Göttl U, Groll A, Kreuz WD, Brand M, Breddin HK, von Loewenich V, Kornhuber B. [Treatment of disseminated intravascular coagulation with antithrombin III concentrate in children with verified infection]. KLINISCHE PADIATRIE 1992; 204:134-40. [PMID: 1614177 DOI: 10.1055/s-2007-1025338] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Consumption coagulopathy in childhood is still a serious problem. Besides treatment of the underlying diseases therapy of consumption coagulopathy was performed with heparin and nowadays with substitution of coagulation factors, especially antithrombin III concentrate, alone or in combination with heparin. We performed administration of AT III concentrates only, without additional heparin treatment in children with proven septicaemia (preterm infants n = 21, children beyond the newborn period n = 18). Antithrombin III, platelet count, fibrinogen, PT, aPTT and TT were assayed. These coagulation parameters turned to be normal 48 hours after normalisation of the antithrombin III plasma level-AT III increased to normal values within 24 hours after the initial substitution in all children. Lethal outcome was not observed after sole administration of AT III as well as no other side effects have been seen. In summary, these data indicate that consumption coagulopathy in childhood can be managed successfully with early substitution of AT III concentrate.
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88
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Groll A, Renz S, Gerein V, Schwabe D, Katschan G, Schneider M, Hübner K, Kornhuber B. Fatal haemoptysis associated with invasive pulmonary aspergillosis treated with high-dose amphotericin B and granulocyte-macrophage colony-stimulating factor (GM-CSF). Mycoses 1992; 35:67-75. [PMID: 1435849 DOI: 10.1111/j.1439-0507.1992.tb00822.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Opportunistic pulmonary infections are a leading cause of morbidity and mortality in patients with chemotherapeutically treated neoplasias. With increasingly aggressive cytotoxic regimens causing prolonged neutropenia, the risk of systemic mycoses and in particular of invasive pulmonary aspergillosis has increased. We review the case of a 10-year-old child suffering from relapsed lymphoblastic leukaemia and from high-dose amphotericin B-treated invasive pulmonary aspergillosis acquired during long-standing neutropenia in the initial phase of remission induction chemotherapy. The patient died in remission after GM-CSF-induced bone marrow recovery and clinical and radiological improvement with stable plasmatic coagulation and normal thrombocyte count. Peracute massive pulmonary bleeding caused by the simultaneous arrosion of a greater pulmonary artery and a lobar bronchus by a liquefactive fungal focus was responsible. In patients with chemotherapeutically induced neutropenia and invasive aspergillosis, bone marrow recovery may lead to the liquefaction of pulmonary foci, and, in view of the well-known vasotropic nature of the infection, to a potentially lethal arrosion bleeding. With the emerging use of colony-stimulating factors for shortening and overcoming neutropenia, this so far rare complication may become of increasing importance.
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89
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Holtmann L, Buse K, Kuper G, Groll A, Hesse H, Kr�tzig E. Photoconductivity and light-induced absorption in KNbO3:Fe. ACTA ACUST UNITED AC 1991. [DOI: 10.1007/bf00323439] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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90
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Groll A, Schneider M, Gaida BJ, Hübner K. [Infectious endocarditis from the morphologic viewpoint: on the pathology and clinical aspects of 97 autopsy cases]. MEDIZINISCHE KLINIK (MUNICH, GERMANY : 1983) 1991; 86:59-70. [PMID: 2030661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In continuous autopsy material between 1978 and 1987 an infectious endocarditis was present in 97 cases of 8745 postmortem examinations. Hospital acquired or iatrogenic infections were at the top of the list with 60% contribution and intravasal devices, cardiovascular or abdominal surgery acting as predominant entrance spots of the infection. In community acquired disease the portal of entry could not be ascertained in most of the cases. The spectrum of causative organisms showed staphylococcus aureus in first position (37%), followed by enterococci (20%), candida (12%) and gram-negative rods (10%). Streptococcus viridans could be isolated in only one case. The majority of patients already had cardiac valve lesions before the onset of infection (48%), immune-defence tangent illnesses (47%) and/or were treated immunosuppressively (14%). In many of the patients, however, no predisposing factors could be established. Factors determining the clinical outcome were - independent of the localization - the local destruction (47%), purulent and non-purulent myocarditis (58%), fresh myocardial infarction (17%) and embolization to various organs (76%), whereby the central nervous system was affected to a high degree (43%). Only 39% of the analyzed cases were discovered at lifetime; especially mural (n = 10) and tricuspidal (n = 9) infections were overlooked. In spite of highly suspicious infection parameters, blood-cultures were drawn from only 59% of the patients; however, an antibiotic therapy had been given to 85%. Only through an early diagnosis before serious complications set in, the poor prognosis of infectious endocarditis can be improved by specific chemotherapy and well-timed surgical measures.
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91
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Groll A, Schneider M, Althoff PH, Falkenbach A, Helm EB, Keul HG, Schleiblinger S, Hübner K. [The morphology and clinical significance of pathologic changes of the adrenals and hypophysis in AIDS]. Dtsch Med Wochenschr 1990; 115:483-8. [PMID: 2156663 DOI: 10.1055/s-2008-1065035] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A semiquantitative morphometric technique (point counting) was applied to the pituitary and adrenals taken at necropsy from 130 AIDS patients (4 women, 126 men, mean age 39 [22-71] years) to ascertain the nature, extent and location of the pathological lesions. Abnormalities were found in 32% of the pituitaries and 76% of the adrenals. Only 17 patients had normal findings in both organs. The predominant lesions were due to opportunistic infections or infiltration by Kaposi's sarcoma or non-Hodgkin lymphoma. The commonest finding was necrotizing cytomegalovirus adrenalitis (n = 68); in one third of the cases this had caused severe destructive lesions involving over 50% of the parenchyma. The almost total destruction of the adrenals noted in some cases suggests that cytomegalovirus adrenalitis may run a progressive course; its clinical significance has hitherto been underestimated.
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92
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Nguyen KT, Pace R, Groll A. CT appearance of annular pancreas: a case report. Can Assoc Radiol J 1989; 40:322-3. [PMID: 2598079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We report here the computed tomographic appearance of an annular pancreas complicated by chronic pancreatitis.
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93
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Groll A, Shah PM. [Teichoic acid antibody assay in infections of the bones and joints caused by Staphylococcus aureus]. Unfallchirurg 1989; 92:414-8. [PMID: 2508226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
For detecting antibodies against the teichoic acids of Staphylococcus aureus (SA), a commercially available Ouchterlony double-diffusion procedure kit was chosen. Thirteen of 26 patients with chronic SA osteomyelitis, 2 of 2 with SA spondylitis and 5 of 6 with arthritis had a positive assay (58%) in contrast to 8 of 24 patients of the control groups (33%). High titers correlated well with the extent and duration of antigen presentation in the bloodstream for cells of representing the specific immunity. Localized infections with minor antigenemia elicited a detectable but weak antibody response.
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94
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Haworth AC, Manley PN, Groll A, Pace R. Bile duct carcinoma and biliary tract dysplasia in chronic ulcerative colitis. Arch Pathol Lab Med 1989; 113:434-6. [PMID: 2705876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of chronic ulcerative colitis with a moderately differentiated adenocarcinoma of the common hepatic duct is described. Throughout the entire biliary tree, there was extensive epithelial dysplasia associated with changes of primary sclerosing cholangitis. The development of primary sclerosing cholangitis in the biliary tract of patients with ulcerative colitis appears to precede dysplasia and may be a marker of patients at risk for developing biliary tract carcinomas.
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95
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Falk S, Enzensberger W, Fischer PA, Just G, Laubenberger C, Helm EB, Stille W, Schlote W, Groll A, Hübner K. [Clinical aspects and pathologico-anatomic findings in AIDS patients with Cryptococcus neoformans meningoencephalitis]. DER NERVENARZT 1988; 59:553-8. [PMID: 3185845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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96
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Young ID, Clark RN, Manley PN, Groll A, Simon JB. Response to steroids in Budd-Chiari syndrome caused by idiopathic granulomatous venulitis. Gastroenterology 1988; 94:503-7. [PMID: 3335322 DOI: 10.1016/0016-5085(88)90444-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A 31-yr-old man presented with the Budd-Chiari syndrome. A liver biopsy specimen demonstrated noncaseating centrilobular granulomas and an idiopathic necrotizing granulomatous venulitis involving hepatic vein radicles with superimposed thrombotic occlusion. High-dose prednisone therapy produced dramatic clinical improvement with resolution of the hepatomegaly, ascites, and portal hypertension and normalization of the hepatic venous angiogram. A repeat liver biopsy specimen showed resolution of the venulitis and disappearance of the hepatic vein thrombosis. Idiopathic granulomatous venulitis that is reversible with prednisone therapy should be considered in the differential diagnosis of the Budd-Chiari syndrome.
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97
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Leddin DJ, Paterson WG, DaCosta LR, Dinda PK, Depew WT, Markotich J, McKaigney JP, Groll A, Beck IT. Indium-111-labeled autologous leukocyte imaging and fecal excretion. Comparison with conventional methods of assessment of inflammatory bowel disease. Dig Dis Sci 1987; 32:377-87. [PMID: 3829880 DOI: 10.1007/bf01296291] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study was designed to evaluate the role of 111In-labeled leukocyte imaging and fecal excretion in the assessment of inflammatory bowel disease. We compared these tests to various indices of disease activity in Crohn's disease, to Truelove's grading in ulcerative colitis, and to endoscopy, x-ray, and pathology in both diseases. Eleven controls, 16 patients with Crohn's disease, 13 with ulcerative colitis, and 3 with other types of acute bowel inflammation were studied (positive controls). Indium scanning was performed at 1, 4, and 24 hr. Fourteen of 16 patients with active Crohn's disease had positive scans but in only five was localization accurate. One patient had inactive ulcerative colitis, and the scan was negative. Of 12 patients with active ulcerative colitis, 10 had positive scans but disease localization was accurate in only four. Disease extent was correctly defined in 1 of the 3 Positive Controls. There was no significant difference in the accuracy of scanning at 1, 4, or 24 hr. 111In fecal excretion was significantly higher in patients with inflammatory bowel disease than in controls, and there was correlation between 111In fecal excretion and most of the indices of disease activity in Crohn's disease. In ulcerative colitis, 111In fecal excretion did not correlate with Truelove's grading but reflected colonoscopic assessment of severity. In conclusion, 111In-labeled leukocyte scanning lacks sensitivity with respect to disease extent, but fecal excretion of 111In correlates well with disease severity as determined by other methods.
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98
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Groll A, Simon JB, Wigle RD, Taguchi K, Todd RJ, Depew WT. Cimetidine prophylaxis for gastrointestinal bleeding in an intensive care unit. Gut 1986; 27:135-40. [PMID: 3485068 PMCID: PMC1433215 DOI: 10.1136/gut.27.2.135] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The efficacy of cimetidine in the prevention of gastrointestinal haemorrhage in a general intensive care unit was evaluated in 221 patients by a placebo controlled double blind randomised study. Criteria for bleeding were (i) haematemesis or gastric aspirate greater than 50 ml fresh blood, (ii) melaena or fresh blood per rectum with an upper source verified by endoscopy if the gastric aspirate was clear, (iii) a fall in haemoglobin level greater than 2 g/dl in a 24 hour period associated with either 4+ occult blood in stools, or coffee ground gastric drainage of at least 100 ml. The drug and placebo groups were similar for age, sex, duration of study and risk factors. One hundred and fourteen received cimetidine and 107 placebo. Only 8% of the patients bled with no significant difference between the two groups (6/114 cimetidine, 11/107 placebo; p = 0.16). There was no correlation between the frequency of bleeding and either the number of risk factors per patient or the duration of intensive care unit stay. Thirteen patients died in each study group, resulting in overall mortality of 12%. The low incidence of haemorrhage, the lack of statistical benefit from cimetidine and the similar mortality all argue against the routine use of this drug in intensive care unit patients.
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Abstract
Thirty-four patients with short stature of undetermined cause and no gastrointestinal symptoms underwent jejunal biopsy for exclusion of coeliac disease. Eight had subtotal or severe partial villous atrophy and seven showed a significant acceleration in height and weight velocity after the introduction of a gluten-free diet. Short stature by itself, in the complete absence of gastrointestinal symptoms, is an indication for jejunal biopsy, particularly if bone age is delayed by more than 4 years and/or there are associated haematological abnormalities.
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100
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Springer DJ, Groll A. Poisoning with enteric-coated acetylsalicylic acid complicating gastric outlet obstruction. CANADIAN MEDICAL ASSOCIATION JOURNAL 1980; 122:1032-4. [PMID: 7370884 PMCID: PMC1801734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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