1
|
Sasse A, Saeed NA, Oh P, Housri N, Knowlton CA, Hayman TJ, Peters GW, Campbell AM, Yang DX, Park HSM. Dose-Escalated vs. Conventional Hypofractionated Radiotherapy for Lung Cancer Patients in Predominantly Central Locations. Int J Radiat Oncol Biol Phys 2023; 117:e55. [PMID: 37785692 DOI: 10.1016/j.ijrobp.2023.06.768] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Hypofractionated radiation therapy (HFRT) is an increasingly utilized treatment option for patients with lung cancers unamenable to stereotactic body radiotherapy (SBRT). Conventional HFRT (C-HFRT) is often prescribed to 60 Gy in 15 fractions, which has a lower biologically effective dose (BED10 of 84.0) than SBRT. We compared outcomes of patients treated with a dose-escalated HFRT regimen (DE-HFRT, 72 Gy in 18 fractions, BED10 of 100.8) to those treated with C-HFRT. We aimed to evaluate local control (LC), overall survival (OS), and grade 3+ toxicity between patients who received C-HFRT vs. DE-HFRT as we hypothesized DE-HFRT may be superior/equivalent to C-HFRT. MATERIALS/METHODS A database was created of all patients at our institution who received either thoracic C-HFRT or DE-HFRT between 2013 and 2020. Baseline variables were compared by chi-square analysis and logistic regression. We analyzed the association between treatment regimens with LC and OS (log-rank test and Cox proportional hazards regression), as well as grade 3+ toxicity. RESULTS A total of 107 patients were included, among whom 55 (51.4%) received C-HFRT and 52 (48.6%) received DE-HFRT. Median age was 73, 88.8% of patients had non-small cell lung cancer, 81.3% received lung-only treatment, and 52.3% had an ultra-central tumor location (within 1 cm of proximal tracheobronchial tree, esophagus, or heart). Patients with DE-HFRT were more likely to have lung-only treatment (92.3% vs. 70.9%, p = 0.005) and stage I disease (47.1% vs 24.1%, p = 0.01) than those with C-HFRT, but had a similar proportion of ultra-central tumors (57.1% vs. 54.9%, p = 0.82). Patients with DE-HFRT had a non-statistically significant trend towards higher LC (2-year 81.0% vs. 72.3%, 3-year 77.3% vs 52.3%, HR 0.53 [95% CI 0.26-1.09], p = 0.09) and OS (2-year 61.3% vs. 44.8%, 3-year 44.9% vs 33.9%, HR 0.68 [95% CI 0.41-1.11], p = 0.13) compared to those with C-HFRT. Similar findings were noted among those with lung-only treatment. Among those with ultra-central tumors, patients with DE-HFRT had statistically significantly higher LC (2-year 86.6% vs 71.2%, 3-year 86.6% vs 42.2%, HR 0.26 [95% CI 0.08-0.84] p = 0.02) and a non-statistically significant trend towards higher OS (2-year 63.8% vs 40.0%, 3-year 46.2% vs 31.1% HR 0.55 [95% CI 0.28-1.09] p = 0.09) compared to those with C-HFRT. There was no statistically significant difference in grade 3+ toxicities between DE-HFRT and C-HFRT (15.4% vs. 10.9%, OR 1.48 [95% CI 0.47-4.61], p = 0.49). CONCLUSION We noted promising local control and overall survival for patients treated with 72 Gy in 18 fractions compared to 60 Gy in 15 fractions, especially among those with ultra-central tumors. Grade 3+ toxicities were not significantly higher for patients undergoing dose escalation. Hence, our findings suggest that DE-HFRT to the lung is a safe and effective treatment regimen for highly selected patients who cannot undergo SBRT.
Collapse
Affiliation(s)
- A Sasse
- Yale School of Medicine, New Haven, CT
| | - N A Saeed
- Yale University School of Medicine, New Haven, CT
| | - P Oh
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - N Housri
- Veterans Affairs, East Orange, NJ
| | | | - T J Hayman
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - G W Peters
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - A M Campbell
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - D X Yang
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - H S M Park
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| |
Collapse
|
2
|
Hedigan F, Sheridan H, Sasse A. Benefit of inhalation aromatherapy as a complementary treatment for stress and anxiety in a clinical setting – A systematic review. Complement Ther Clin Pract 2023; 52:101750. [PMID: 37031643 DOI: 10.1016/j.ctcp.2023.101750] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE The purpose of this systematic review is to ascertain the impact of inhalation aromatherapy on stress and anxiety in clinical settings. METHODS A search strategy was developed using various databases. Randomised Controlled Trials (RCTs) as well as single and double-blind pilot clinical studies (non-RCT) using inhalation aromatherapy with an essential oil blend or a single essential oil were examined. All studies included a control intervention and use of a validated measurement tool. The time period under review was years 2000-2021. Due to the high level of heterogeneity and element of bias, a narrative synthesis was conducted. RESULTS The search strategy initially retrieved 628 studies and through application of the selection criteria and the removal of duplicates, 76 studies were selected for review with a total of 6539 patients. In 42% of the RCTs, physiological measures including vital signs and/or salivary cortisol were used in addition to questionnaires. Over 70% of the studies reported a positive effect on anxiety levels in the aromatherapy intervention groups compared with the control. However, in many cases this is limited by the absence of safety data, imprecise reporting of plant species and dosage of essential oil. CONCLUSION Inhalation aromatherapy has the potential to reduce stress and anxiety with data emerging to further support this result across a wide modality of clinical treatments. However, there is a clear need for the development of standard protocols for research in this area, generating measurable results which will create the opportunity for more rigorous evidence-based outcomes.
Collapse
|
3
|
Li C, Matsis P, Prescott-Whitaker G, Sasse A. Characteristics and Outcomes of Transcatheter Aortic Valve Implantation (TAVI) Patients in Wellington Regional Hospital (WRH). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.062] [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: 10/21/2022]
|
4
|
Mekhail A, Matsis P, Sasse A, Wilkins G, Galvin S. Percutaneous Repair of Left Ventricular Pseudoaneurysm With Amplatzer VSD Occluder - A Case Report. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.065] [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: 10/21/2022]
|
5
|
Borrie A, Goggin C, Ershad S, Robinson W, Sasse A. Non-invasive myocardial work: characterising the normal and ischaemic response to exercise. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Myocardial work and work efficiency are new parameters for assessing left ventricular function. They have been shown to have value in a range of clinical settings but have not previously been applied to exercise stress echocardiography.
Purpose
We aim to characterize the normal myocardial work and work efficiency response to exercise in a mixed population and determine if myocardial work could be used to identify patients with inducible ischaemia.
Methods
Patients were retrospectively enrolled from an existing database of exercise stress echocardiography. Inclusion criteria were a clinical indication of possible ischemia and technical suitability to calculate myocardial work. Exclusion criteria were abnormal baseline left ventricular function or inadequate image quality. Echocardiograms positive for ischaemia were defined by independent visual assessment and compared with angiographic findings where available. Myocardial work and work efficiency were calculated using a proprietary algorithm.
Results
A total of 177 patients met inclusion criteria, 117 were excluded leaving 40 normal and 20 positive tests for analysis. During normal exercise global work increased 54% and efficiency remained at 96%. Segmental work showed a basal to apical gradient which became more prominent at peak exercise. In patients with inducible ischaemia during exercise there was a significant difference in response; work decreased by 1.9% and efficiency dropped to 87%. Receiver operating characteristic curve for myocardial work had an area under the curve of 0.94. Youden's J statistic suggested an optimum cut point of a 25% increase in work to define a normal test.
Conclusion
During normal exercise myocardial work increased and efficiency remained unchanged, however during exercise induced ischaemia both myocardial work and efficiency decreased. We have demonstrated that myocardial work can be applied to stress echocardiography to identify ischemia but the utility of this remains uncertain. Further research compared to an objective measure of functional ischemia is needed.
Response to exercise
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- A Borrie
- Wellington Hospital, Wellington, New Zealand
| | - C Goggin
- Wellington Hospital, Wellington, New Zealand
| | - S Ershad
- Wellington Hospital, Wellington, New Zealand
| | - W Robinson
- Hutt Valley Hospital, Wellington, New Zealand
| | - A Sasse
- Wellington Hospital, Wellington, New Zealand
| |
Collapse
|
6
|
Van Beckhoven D, Florence E, De Wit S, Wyndham-Thomas C, Sasse A, Van Oyen H, Macq J. Incidence rate, predictors and outcomes of interruption of HIV care: nationwide results from the Belgian HIV cohort. HIV Med 2020; 21:557-566. [PMID: 32627351 PMCID: PMC7540395 DOI: 10.1111/hiv.12901] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 11/30/2022]
Abstract
Objectives We aimed to study the incidence rate, predictors and outcomes of HIV care interruption (HCI) in Belgium. Methods We analysed data for adult patients with at least two HIV care records in the Belgian HIV cohort between 1 January 2007 and 31 December 2016. An HCI episode was defined as 1 year without an HIV care record. The HCI incidence rate was analysed using Poisson regression, return to HIV care using a cumulative incidence function with death as a competing risk, and viral load (VL) status upon return to HIV care using logistic regression. Results We included 16 066 patients accounting for 78 625 person‐years of follow‐up. The incidence rate of HCI was 5.3/100 person‐years [95% confidence interval (CI) 5.1–5.4/100 person‐years]. The incidence of return to HIV care after HCI was estimated at 77.5% (95% CI 75.7–79.2%). Of those who returned to care, 43.7% had a VL ≤ 200 HIV‐1 RNA copies/mL, suggesting care abroad or suboptimal care (without an HIV‐related care record) in Belgium during the HCI, and 56.3% returned without controlled VL and were therefore considered as having experienced a real gap in HIV care; they represented 2.3/100 person‐years of follow‐up. Factors individually associated with HCI were no antiretroviral therapy (ART) uptake, lower age, injecting drug use, non‐Belgian nationality, male gender, not being a man who has sex with men, a shorter time since HIV diagnosis, no high blood pressure and CD4 count < 350 cells/µL. Conclusions This study highlights the need to investigate return to care and viral status at return, to better understand HCI. Identified predictors can help health care workers to target patients at higher risk of HCI for awareness and support.
Collapse
Affiliation(s)
| | - E Florence
- Institute of Tropical Medicine, Antwerp, Belgium
| | - S De Wit
- Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - A Sasse
- Sciensano, Brussels, Belgium
| | - H Van Oyen
- Sciensano, Brussels, Belgium.,University of Ghent, Ghent, Belgium
| | - J Macq
- Université Catholique de Louvain, Brussels, Belgium
| | | |
Collapse
|
7
|
Li C, Borrie A, Sasse A. 512 Management and Outcomes of Patients Presenting With “Not Low Risk” EDACS Chest Pain, With Negative or Static Troponins. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.519] [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]
|
8
|
Li C, Borrie A, Sasse A. A033 Management and Outcomes of Patients Presenting With “Not Low Risk” EDACS Chest Pain, With Negative or Static Troponins. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.05.038] [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]
|
9
|
Sasse A, Carmo R. Sorafenib for advanced hepatocellular carcinoma (HCC) in the public health setting in Brazil: a cost-effectiveness analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
10
|
Borrie A, Goggin C, Robinson W, Sasse A. Can Non-Invasive Global Myocardial Work Index Calculation Improve Exercise Stress Echocardiography? Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
11
|
Mahon B, Sasse A, Stewart R. P5454The development and validation of a clinical priority system score for cardiac surgery used throughout New Zealand. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5454] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Mahon
- Capital & Coast District Health Board, Cardiothoracic Surgery, Wellington, New Zealand
| | - A Sasse
- Capital & Coast District Health Board, Cardiology, Wellington, New Zealand
| | - R Stewart
- Auckland District Health Board, Cardiology, Auckland, New Zealand
| |
Collapse
|
12
|
Kristono G, Holley A, Sasse A, Harding S, Larsen P. Neutrophil-Lymphocyte Ratio as a Prognostic Marker in Acute Myocardial Infarction. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
Kostkova P, Brewer H, de Lusignan S, Fottrell E, Goldacre B, Hart G, Koczan P, Knight P, Marsolier C, McKendry RA, Ross E, Sasse A, Sullivan R, Chaytor S, Stevenson O, Velho R, Tooke J. Who Owns the Data? Open Data for Healthcare. Front Public Health 2016; 4:7. [PMID: 26925395 PMCID: PMC4756607 DOI: 10.3389/fpubh.2016.00007] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [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: 10/31/2015] [Accepted: 01/14/2016] [Indexed: 11/13/2022] Open
Abstract
Research on large shared medical datasets and data-driven research are gaining fast momentum and provide major opportunities for improving health systems as well as individual care. Such open data can shed light on the causes of disease and effects of treatment, including adverse reactions side-effects of treatments, while also facilitating analyses tailored to an individual's characteristics, known as personalized or "stratified medicine." Developments, such as crowdsourcing, participatory surveillance, and individuals pledging to become "data donors" and the "quantified self" movement (where citizens share data through mobile device-connected technologies), have great potential to contribute to our knowledge of disease, improving diagnostics, and delivery of -healthcare and treatment. There is not only a great potential but also major concerns over privacy, confidentiality, and control of data about individuals once it is shared. Issues, such as user trust, data privacy, transparency over the control of data ownership, and the implications of data analytics for personal privacy with potentially intrusive inferences, are becoming increasingly scrutinized at national and international levels. This can be seen in the recent backlash over the proposed implementation of care.data, which enables individuals' NHS data to be linked, retained, and shared for other uses, such as research and, more controversially, with businesses for commercial exploitation. By way of contrast, through increasing popularity of social media, GPS-enabled mobile apps and tracking/wearable devices, the IT industry and MedTech giants are pursuing new projects without clear public and policy discussion about ownership and responsibility for user-generated data. In the absence of transparent regulation, this paper addresses the opportunities of Big Data in healthcare together with issues of responsibility and accountability. It also aims to pave the way for public policy to support a balanced agenda that safeguards personal information while enabling the use of data to improve public health.
Collapse
Affiliation(s)
- Patty Kostkova
- Department of Computer Science, University College London (UCL) , London , UK
| | - Helen Brewer
- Parliamentary Office of Science and Technology , London , UK
| | - Simon de Lusignan
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, and Royal College of General Practitioners Research and Surveillance Centre , London , UK
| | | | - Ben Goldacre
- Faculty of Population Health Sciences, University College London (UCL) , London , UK
| | - Graham Hart
- London School of Hygiene & Tropical Medicine , London , UK
| | - Phil Koczan
- University College London Partners (UCLP) , London , UK
| | | | - Corinne Marsolier
- Cisco Consulting Services, Life Sciences, Health and Care , Paris , France
| | - Rachel A McKendry
- The London Centre for Nanotechnology and Division of Medicine, University College London (UCL) , London , UK
| | - Emma Ross
- Chatham House Centre on Global Health Security , London , UK
| | - Angela Sasse
- Department of Computer Science, University College London (UCL) , London , UK
| | - Ralph Sullivan
- Health Informatics Group, Royal College of General Practitioners , London , UK
| | | | | | - Raquel Velho
- Department of Science and Technology Studies, UCL , London , UK
| | - John Tooke
- School of Life and Medical Sciences, UCL , London , UK
| |
Collapse
|
14
|
Hofstra LM, Sauvageot N, Albert J, Alexiev I, Garcia F, Struck D, Van de Vijver DAMC, Åsjö B, Beshkov D, Coughlan S, Descamps D, Griskevicius A, Hamouda O, Horban A, Van Kasteren M, Kolupajeva T, Kostrikis LG, Liitsola K, Linka M, Mor O, Nielsen C, Otelea D, Paraskevis D, Paredes R, Poljak M, Puchhammer-Stöckl E, Sönnerborg A, Staneková D, Stanojevic M, Van Laethem K, Zazzi M, Zidovec Lepej S, Boucher CAB, Schmit JC, Wensing AMJ, Puchhammer-Stockl E, Sarcletti M, Schmied B, Geit M, Balluch G, Vandamme AM, Vercauteren J, Derdelinckx I, Sasse A, Bogaert M, Ceunen H, De Roo A, De Wit S, Echahidi F, Fransen K, Goffard JC, Goubau P, Goudeseune E, Yombi JC, Lacor P, Liesnard C, Moutschen M, Pierard D, Rens R, Schrooten Y, Vaira D, Vandekerckhove LPR, Van den Heuvel A, Van Der Gucht B, Van Ranst M, Van Wijngaerden E, Vandercam B, Vekemans M, Verhofstede C, Clumeck N, Van Laethem K, Beshkov D, Alexiev I, Lepej SZ, Begovac J, Kostrikis L, Demetriades I, Kousiappa I, Demetriou V, Hezka J, Linka M, Maly M, Machala L, Nielsen C, Jørgensen LB, Gerstoft J, Mathiesen L, Pedersen C, Nielsen H, Laursen A, Kvinesdal B, Liitsola K, Ristola M, Suni J, Sutinen J, Descamps D, Assoumou L, Castor G, Grude M, Flandre P, Storto A, Hamouda O, Kücherer C, Berg T, Braun P, Poggensee G, Däumer M, Eberle J, Heiken H, Kaiser R, Knechten H, Korn K, Müller H, Neifer S, Schmidt B, Walter H, Gunsenheimer-Bartmeyer B, Harrer T, Paraskevis D, Hatzakis A, Zavitsanou A, Vassilakis A, Lazanas M, Chini M, Lioni A, Sakka V, Kourkounti S, Paparizos V, Antoniadou A, Papadopoulos A, Poulakou G, Katsarolis I, Protopapas K, Chryssos G, Drimis S, Gargalianos P, Xylomenos G, Lourida G, Psichogiou M, Daikos GL, Sipsas NV, Kontos A, Gamaletsou MN, Koratzanis G, Sambatakou H, Mariolis H, Skoutelis A, Papastamopoulos V, Georgiou O, Panagopoulos P, Maltezos E, Coughlan S, De Gascun C, Byrne C, Duffy M, Bergin C, Reidy D, Farrell G, Lambert J, O'Connor E, Rochford A, Low J, Coakely P, O'Dea S, Hall W, Mor O, Levi I, Chemtob D, Grossman Z, Zazzi M, de Luca A, Balotta C, Riva C, Mussini C, Caramma I, Capetti A, Colombo MC, Rossi C, Prati F, Tramuto F, Vitale F, Ciccozzi M, Angarano G, Rezza G, Kolupajeva T, Vasins O, Griskevicius A, Lipnickiene V, Schmit JC, Struck D, Sauvageot N, Hemmer R, Arendt V, Michaux C, Staub T, Sequin-Devaux C, Wensing AMJ, Boucher CAB, van de Vijver DAMC, van Kessel A, van Bentum PHM, Brinkman K, Connell BJ, van der Ende ME, Hoepelman IM, van Kasteren M, Kuipers M, Langebeek N, Richter C, Santegoets RMWJ, Schrijnders-Gudde L, Schuurman R, van de Ven BJM, Åsjö B, Kran AMB, Ormaasen V, Aavitsland P, Horban A, Stanczak JJ, Stanczak GP, Firlag-Burkacka E, Wiercinska-Drapalo A, Jablonowska E, Maolepsza E, Leszczyszyn-Pynka M, Szata W, Camacho R, Palma C, Borges F, Paixão T, Duque V, Araújo F, Otelea D, Paraschiv S, Tudor AM, Cernat R, Chiriac C, Dumitrescu F, Prisecariu LJ, Stanojevic M, Jevtovic D, Salemovic D, Stanekova D, Habekova M, Chabadová Z, Drobkova T, Bukovinova P, Shunnar A, Truska P, Poljak M, Lunar M, Babic D, Tomazic J, Vidmar L, Vovko T, Karner P, Garcia F, Paredes R, Monge S, Moreno S, Del Amo J, Asensi V, Sirvent JL, de Mendoza C, Delgado R, Gutiérrez F, Berenguer J, Garcia-Bujalance S, Stella N, de Los Santos I, Blanco JR, Dalmau D, Rivero M, Segura F, Elías MJP, Alvarez M, Chueca N, Rodríguez-Martín C, Vidal C, Palomares JC, Viciana I, Viciana P, Cordoba J, Aguilera A, Domingo P, Galindo MJ, Miralles C, Del Pozo MA, Ribera E, Iribarren JA, Ruiz L, de la Torre J, Vidal F, Clotet B, Albert J, Heidarian A, Aperia-Peipke K, Axelsson M, Mild M, Karlsson A, Sönnerborg A, Thalme A, Navér L, Bratt G, Karlsson A, Blaxhult A, Gisslén M, Svennerholm B, Bergbrant I, Björkman P, Säll C, Mellgren Å, Lindholm A, Kuylenstierna N, Montelius R, Azimi F, Johansson B, Carlsson M, Johansson E, Ljungberg B, Ekvall H, Strand A, Mäkitalo S, Öberg S, Holmblad P, Höfer M, Holmberg H, Josefson P, Ryding U. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe. Clin Infect Dis 2015; 62:655-663. [PMID: 26620652 PMCID: PMC4741360 DOI: 10.1093/cid/civ963] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [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: 06/08/2015] [Accepted: 11/06/2015] [Indexed: 11/13/2022] Open
Abstract
Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors. Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.
Collapse
Affiliation(s)
- L Marije Hofstra
- Luxembourg Institute of Health, Luxembourg.,Department of Virology, University Medical Center Utrecht, The Netherlands
| | | | - Jan Albert
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Federico Garcia
- Complejo Hospitalario Universitario de Granada, Instituto de Investigación IBS Granada; on behalf of Cohorte de Adultos de la Red de Investigación en SIDA, Spain
| | | | | | | | - Danail Beshkov
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Diane Descamps
- AP-HP Groupe hospitalier Bichat-Claude Bernard, IAME INSERM UMR 1137, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | | | | | | | | | | | | | - Kirsi Liitsola
- Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland
| | - Marek Linka
- National Reference Laboratory for HIV/AIDS, National Institute of Public Health, Prague, Czech Republic
| | - Orna Mor
- National HIV Reference Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Dan Otelea
- National Institute for Infectious Diseases "Prof. dr. Matei Bals", Bucharest, Romania
| | | | | | - Mario Poljak
- Faculty of Medicine, Slovenian HIV/AIDS Reference Centre, University of Ljubljana, Slovenia
| | | | - Anders Sönnerborg
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Van Beckhoven D, Florence E, Ruelle J, Deblonde J, Verhofstede C, Callens S, Vancutsem E, Lacor P, Demeester R, Goffard JC, Sasse A. Good continuum of HIV care in Belgium despite weaknesses in retention and linkage to care among migrants. BMC Infect Dis 2015; 15:496. [PMID: 26530500 PMCID: PMC4631021 DOI: 10.1186/s12879-015-1230-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/19/2015] [Indexed: 01/06/2023] Open
Abstract
Background The Belgian HIV epidemic is largely concentrated among men who have sex with men and Sub-Saharan Africans. We studied the continuum of HIV care of those diagnosed with HIV living in Belgium and its associated factors. Methods Data on new HIV diagnoses 2007–2010 and HIV-infected patients in care in 2010–2011 were analysed. Proportions were estimated for each sequential stage of the continuum of HIV care and factors associated with attrition at each stage were studied. Results Of all HIV diagnosed patients living in Belgium in 2011, an estimated 98.2 % were linked to HIV care, 90.8 % were retained in care, 83.3 % received antiretroviral therapy and 69.5 % had an undetectable viral load (<50 copies/ml). After adjustment for sex, age at diagnosis, nationality and mode of transmission, we found lower entry into care in non-Belgians and after preoperative HIV diagnoses; lower retention in non-Belgians and injecting drug users; higher retention in men who have sex with men and among those on ART. Younger patients had lower antiretroviral therapy uptake and less viral suppression; those with longer time from diagnosis had higher ART uptake and more viral suppression; Sub-Saharan Africans on ART had slightly less viral suppression. Conclusions The continuum of HIV care in Belgium presents low attrition rates over all stages. The undiagnosed HIV-infected population, although not precisely estimated, but probably close to 20 % based on available survey and surveillance results, could be the weakest stage of the continuum of HIV care. Its identification is a priority along with improving the HIV care continuum of migrants. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1230-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- D Van Beckhoven
- Epidemiology of Infectious Diseases Unit, Scientific Institute of Public Health, Rue J. Wytsman 14, 1050, Brussels, Belgium.
| | - E Florence
- Department of Clinical Sciences, Instituut Tropische Geneeskunde, Antwerp, Belgium.
| | - J Ruelle
- Institute of Experimental and Clinical Research (IREC), Unit of Medical Microbiology (MBLG), Université Catholique de Louvain, Brussels, Belgium.
| | - J Deblonde
- Epidemiology of Infectious Diseases Unit, Scientific Institute of Public Health, Rue J. Wytsman 14, 1050, Brussels, Belgium.
| | - C Verhofstede
- AIDS Reference Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium.
| | - S Callens
- Department of Internal Medicine, Universitair Ziekenhuis Gent, Ghent, Belgium.
| | - E Vancutsem
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium.
| | - P Lacor
- Department of Internal Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium.
| | - R Demeester
- Department of Internal Medicine and Infectious Diseases, CHU de Charleroi, Charleroi, Belgium.
| | - J-C Goffard
- Service of Internal Medicine, Hôpital Erasme, Brussels, Belgium.
| | - A Sasse
- Epidemiology of Infectious Diseases Unit, Scientific Institute of Public Health, Rue J. Wytsman 14, 1050, Brussels, Belgium.
| | | |
Collapse
|
16
|
Sasse A, Florence E, Pharris A, De Wit S, Lacor P, Van Beckhoven D, Deblonde J, Delforge ML, Fransen K, Goffard JC, Legrand JC, Moutschen M, Piérard D, Ruelle J, Vaira D, Vandercam B, Van Ranst M, Van Wijngaerden E, Vandekerckhove L, Verhofstede C. Late presentation to HIV testing is overestimated when based on the consensus definition. HIV Med 2015. [PMID: 26222266 PMCID: PMC5034831 DOI: 10.1111/hiv.12292] [Citation(s) in RCA: 18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objectives In 2011, a consensus was reached defining “late presenters” (LPs) as individuals presenting for care with a CD4 count < 350 cells/μL or with an AIDS‐defining event, regardless of CD4 count. However, a transient low CD4 count is not uncommon in recent infections. The objective of this study was to investigate how measurements of late presentation change if the clinical stage at the time of diagnosis is taken into account. Methods Case surveillance data for newly diagnosed patients in Belgium in 1998–2012 were analysed, including CD4 count at diagnosis, the presence of AIDS‐defining events, and recent infections (< 6 months) as reported by clinicians in the case of acute illness or a recent negative test. First, proportions of LPs were calculated according to the consensus definition. Secondly, LPs were reclassified as “nonlate” if infections were reported as recent. Results A total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men (MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition (P < 0.001). The proportion of patients misclassified as LPs increased significantly over time: 5% in MSM in 1998 vs. 41% in 2012. Conclusions This study suggests that low CD4 counts in recent infections may lead to overestimation of late presentation when applying the consensus definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered.
Collapse
Affiliation(s)
- A Sasse
- Scientific Institute of Public Health, Brussels, Belgium
| | - E Florence
- Instituut Tropische Geneeskunde Antwerpen, Antwerp, Belgium
| | - A Pharris
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - S De Wit
- CHU Saint-Pierre, Brussels, Belgium
| | - P Lacor
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - J Deblonde
- Scientific Institute of Public Health, Brussels, Belgium
| | - M-L Delforge
- Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - K Fransen
- Instituut Tropische Geneeskunde Antwerpen, Antwerp, Belgium
| | - J-C Goffard
- Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - D Piérard
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - J Ruelle
- Université Catholique de Louvain, Brussels, Belgium
| | - D Vaira
- CHU de Liège, Liege, Belgium
| | - B Vandercam
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - M Van Ranst
- Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | | | | |
Collapse
|
17
|
Ershad S, Harding S, Larsen P, Sasse A, Al-Sinan A. Adverse outcomes following coronary artery bypass grafting surgery post acute coronary syndrome: Wellington hospital population. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.124] [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: 12/01/2022]
|
18
|
Wilkins B, Gudex F, Sasse A. Measures of frailty in elderly patients considered for cardiac surgery and comparison of 30-day outcomes in both medical and surgical treatment groups. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.117] [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]
|
19
|
Howard C, Holley A, Sasse A, Harding S, Larsen P. Is the incidence of high on treatment platelet reactivity (HOTPR) reduced in acute coronary syndrome (ACS) patients treated with ticagrelor? Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
20
|
|
21
|
Wolbinski M, Morgan A, Larsen P, Sasse A. 3D echo mitral valve reconstruction - validity of a novel software application. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.04.251] [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]
|
22
|
Abstract
A total of 1055 nucleotide sequences obtained from HIV patients diagnosed in 2008 and 2009 in Belgium were included in this prevalence study. The study population is a group of patients whose visit was considered by the clinician as the first contact with a Belgian AIDS reference centre or with another clinical centre experienced in HIV care. Prevalences of surveillance drug resistance mutations (SDRM) of 11·7% (47/394) and 11·0% (73/661) were observed in 2008 and 2009, respectively. The highest level of SDRM was observed towards nucleoside reverse transcriptase inhibitors (NRTIs) (7·8%), followed by the non-nucleoside reverse transcriptase inhibitors (NNRTIs) (4·2%) and Protease inhibitors (PIs) (2·3%). A potential clinical impact of the SDRM was demonstrated when using the current first-line therapy. A particularly high prevalence of SDRM was observed among intravenous drug users (IDUs) (29·4%). Reanalysis and comparing the data from previous Belgian studies using similar interpretation algorithms could not reveal a significant trend in SDRM prevalence over the last 5 years.
Collapse
|
23
|
Bass M, Chen-Xu M, Sasse A, La Flamme A, Larsen P, Harding S. Stimulation of platelet toll-like receptors results in marked platelet activation that is partially inhibited by prasugrel but not aspirin. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.04.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
24
|
Smith G, Gudex F, Willox G, Sasse A, Ruygrok P, Chataline A, Stewart R. Cognitive Impairment in Elderly Patients Evaluated for Cardiac Surgery. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.04.075] [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]
|
25
|
Gudex F, Willox G, Smith G, Chataline A, Ruygrok P, Stewart R, Sasse A. Clinical Frailty Assessment and Formal Frailty Testing—Clinical Decision Making in Severe Coronary and Valvular Heart Disease. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
26
|
Willox G, Gudex F, Smith G, Ruygrok P, Chateleine A, Stewart R, Sasse A. Evaluation of Tests for Frailty in Elderly Patients Accepted for Cardiac Surgery Compared to Those Managed Conservatively. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.04.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
27
|
Verbrugge R, Deblonde J, Beckhoven DV, Sasse A. P3.252 STI Surveillance Within the General Population and in AIDS Reference Centres (ARC) in Belgium: Circumstances of HIV Testing in Patients Diagnosed with an STI. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0708] [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]
|
28
|
Van Beckhoven D, Buvé A, Ruelle J, Seyler L, Sasse A. A national cohort of HIV-infected patients in Belgium: design and main characteristics. Acta Clin Belg 2013. [PMID: 23189540 DOI: 10.2143/acb.67.5.2062686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Belgium, individual laboratory and treatment data of all HIV-infected patients seen in the 9 AIDS Reference Centres and 7 AIDS Reference Laboratories are collected prospectively since 2006. We present here an analysis of patients recorded in the cohort database between 1st of January 2006 and 31st of December 2008. During that period, 11982 patients were under medical follow-up in Belgium. Sixty-one percent of the patients were male and the median age was 39.8 at the time of first recorded viral load. Among the patients whose nationality or probable mode of transmission was recorded, nearly half (48.0%) were Belgian and 38.3% originated from Sub-Saharan Africa; heterosexual contacts were reported in the majority of cases (56.0%) followed by homosexual contacts (35.3%). A total of 145 deaths were reported. Around three quarters of the patients were on ART. The median CD4 cell count rose from 470 cells/mm3 in 2006 to 501 cells/mm3 in 2008. This cohort enabled us to obtain comprehensive information on the numbers and characteristics of HIV-infected patients currently being followed up in Belgium, and on trends in antiretroviral therapy and biological results. This will serve for planning purposes, evaluation of access to care and as a source of information for further studies.
Collapse
Affiliation(s)
- D Van Beckhoven
- O.D. Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium.
| | | | | | | | | | | |
Collapse
|
29
|
Macedo LT, Sasse A. Prevention Strategies for Chemotherapy Induced Hand-Foot Syndrome: A Meta-Analysis of Prospective Randomised Trials. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34141-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
30
|
Sasse A, Nourani C, Reis L. Low-Dose Dethylstilbestrol in Castration-Resistant Prostate Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33488-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
31
|
Chen-Xu M, Johnston L, Holley A, Sasse A, Larsen P, Harding S. Comparison of the Multiplate and VerifyNow Assays for Monitoring Residual Platelet Reactivity after Clopidogrel. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
32
|
Shi B, Ferrier K, Sasse A, Harding S, Larsen P. ECG Markers of Arrhythmogeneic Substrate and Structural Heart Disease. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.03.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
33
|
Michel J, Mundell D, Boga T, Sasse A. Early Experience of Dabigatran Use in a Wellington Population. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.03.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
34
|
Morgan A, Webber M, Harding S, Scully A, Sexton J, Johnson L, Larsen P, Sasse A. Strain and Pacing Study; Role of Pacing Lead Placement in LV Contraction. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.03.071] [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: 11/17/2022]
|
35
|
Lou P, Morgan A, Harding S, Matsis P, Sasse A. Patent Foramen Ovale Closure: The Wellington Experience 2009–2012. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.417] [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]
|
36
|
Verbrugge R, Van Beckhoven D, Sasse A. P1-S2.34 STI-Surveillance within AIDS Reference Centres in Belgium - high consistent STI incidence among HIV-positive Men having Sex with Men, 2008-2009. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
37
|
Zhang Z, Ranchord A, Webber M, Simmonds M, Matsis P, Aitken A, Sasse A, Luo D, Harding S. Same-day Discharge Following Elective PCI – 10 Year Single Center Experience. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.03.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
38
|
|
39
|
Harding S, Johnston L, Michel J, Ramanathan A, La Flamme A, Sasse A, Larsen P. High on Treatment Platelet Reactivity is Common and Differs Among Ethnic Groups. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.088] [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: 11/27/2022]
|
40
|
Zhang Z, Ranchord A, Webber M, Simmonds M, Matsis P, Aitken A, Sasse A, Luo D, Harding S. Same-day Discharge Following Elective PCI—10 Year Single Centre Experience. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
41
|
Bredehorn-Mayr T, Marquardt L, Sasse A, Issa H, Duncker GIW. PKP bei Keratektasie im Säuglingsalter – Fallbericht. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1267559] [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: 10/19/2022]
|
42
|
Stewart RAH, Hamer A, Mahon B, Ruygrok P, Kang N, Sasse A, Fisher R, Luke R, Barber A, Naden R. Comparison of a New Clinical Score with Individual Clinician Judgement for Assigning Priority for Heart Valve Surgery. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.04.068] [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]
|
43
|
Savage EJ, van de Laar MJ, Gallay A, van der Sande M, Hamouda O, Sasse A, Hoffmann S, Diez M, Borrego MJ, Lowndes CM, Ison C. Lymphogranuloma venereum in Europe, 2003-2008. ACTA ACUST UNITED AC 2009; 14. [PMID: 20003898 DOI: 10.2807/ese.14.48.19428-en] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lymphogranuloma venereum, caused by the L serovars of Chlamydia trachomatis, emerged in Europe in 2003 and a series of outbreaks were reported in different countries. The infection presents as a severe proctitis in men who have sex with men, many of whom are co-infected with HIV and other sexually transmitted infections. This paper reviews the number of cases reported over a five year period, from 2003 to 2008, from countries that were part of the European Surveillance of Sexually Transmitted Infections (ESSTI) network. Reports were received from Belgium, Denmark, France, Germany, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom. It appears that after five years the characteristics of the patients infected has overall remained unchanged, although the total number of cases has increased and more countries in Europe have now identified cases of LGV.
Collapse
Affiliation(s)
- E J Savage
- Health Protection Agency, Centre for Infections, HIV and STI Department, London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
Belgium is currently experiencing an upward trend in the number of new HIV diagnoses characterised by a continuous increase in the number of cases among men who have sex with men (MSM). Based on surveillance data, in the past decade the yearly number of newly diagnosed HIV cases in MSM increased more than threefold, from 101 cases diagnosed in 1999 to 332 cases in 2008. During this period, the majority of new HIV infections in MSM were diagnosed among Belgian citizens (72%), followed by other European nationalities (13%). The increase in HIV diagnoses does not reflect an increase in HIV testing since the number of tests performed nationwide remained remarkably stable over time. The steady increase in the number of newly diagnosed HIV cases among MSM, and the high proportion of MSM among HIV-positive patients co-infected with other sexually transmitted infections (STI) (95.6% in 2008) indicate increases in unsafe sex practices in this group. Development of behavioural surveillance and more qualitative research on reasons for unsafe sex are needed in order to develop more effective prevention strategies.
Collapse
Affiliation(s)
- A Sasse
- Scientific Institute of Public Health, Brussels, Belgium.
| | | |
Collapse
|
45
|
|
46
|
Defraye A, Crucitti T, Ducoffre G, Mak R, Sasse A. [Incidence of Neisseria gonorrhoeae infections in Belgium: trends 2000-2006]. Rev Med Brux 2009; 30:93-98. [PMID: 19517905] [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: 05/27/2023]
Abstract
In Belgium, three registration systems collect epidemiological information on N. gonorrhoeae infections. The descriptive analysis of the data presented in this article allows describing the epidemiology of N. gonorrhoeae infections in Belgium in terms of trends in time, describing the characteristics of the patients, and providing information on resistance to antibiotics. The results on the incidence of N. gonorrhoeae infections show an important increase since the year 2000, and this increase is even more pronounced between 2005 and 2006. The majority of the patients reside in big cities, mainly in the district of Antwerp and in the Brussels-Capital region. Among the N. gonorrhoeae specimens that were sent to the reference laboratory, the proportion of specimens resistant to ciprofloxacine increases each year; this proportion reaches 61.4% in 2006. The increase in the incidence of N. gonorrhoeae infections and in antimicrobial resistance is also observed in other European countries. The increase in incidence may be partly related to the important increase of resistance to ciprofloxacine. It is very important to continue the surveillance of antimicrobial resistance, to adapt treatment in function of the recent evolutions and to inform physicians at a regular basis. The results show that homo- and bisexual men are most at risk for N. gonorrhoeae infections. The prevention campaigns for sexually transmitted infections and screening policy have to be reinforced, particularly among homo- and bisexual men.
Collapse
Affiliation(s)
- A Defraye
- Institut scientifique de Santé publique, Section Epidémiologie, Bruxelles.
| | | | | | | | | |
Collapse
|
47
|
Sasse A, Colindres P, Brewer M. Effect of Natural and Synthetic Antioxidants on the Oxidative Stability of Cooked, Frozen Pork Patties. J Food Sci 2009; 74:S30-5. [DOI: 10.1111/j.1750-3841.2008.00979.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
48
|
Sasse A, Vincent A, Galand M, Ryckmans P, Liesnard C. High HIV prevalence among patients choosing anonymous and free testing in Belgium, 1990-2002. Int J STD AIDS 2007; 17:817-20. [PMID: 17212858 DOI: 10.1258/095646206779307504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
From 1990 through 2002, 25,250 anonymous and free HIV tests were performed at a testing site, which carried out the majority (85%) of anonymous testing in Belgium. During the same period, approximately 7.3 million confidential tests were registered nationwide. The rate of new HIV infections diagnosed at the anonymous testing site was 11.1/1000 tests; it was significantly higher than the rate observed among confidential tests (relative risk = 7.41; P < 0.0001). New HIV cases diagnosed through anonymous testing include a higher proportion of young adults (42.0% versus 32.5% in confidential testing; P < 0.001) and a higher proportion of men who have sex with men (32.7% vs. 25.9% in confidential testing; P < 0.02). Anonymous and free HIV testing was particularly sought by persons with higher infection risk, and efficiently contributed to HIV diagnosis in this population. Anonymous and free testing should be and remain an accessible alternative integrated in HIV testing policies.
Collapse
Affiliation(s)
- A Sasse
- Scientific Institute of Public Health, Brussels, Belgium.
| | | | | | | | | |
Collapse
|
49
|
Abstract
Dissection of the common carotid artery is a rare but important complication of Marfan's syndrome. The following case describes a patient with formation of an intimal flap of the common carotid artery who had suffered from an aortic dissection years before.
Collapse
Affiliation(s)
- J U Harrer
- Neurologische Klinik, Universitätsklinikum der RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | | | | |
Collapse
|
50
|
Schickel J, Beetz C, Frömmel C, Heide G, Sasse A, Hemmerich P, Deufel T. Unexpected pathogenic mechanism of a novel mutation in the coding sequence of SPG4 (spastin). Neurology 2006; 66:421-3. [PMID: 16476945 DOI: 10.1212/01.wnl.0000196468.01815.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors report a nucleotide substitution (c.1216A>G) in SPG4 (spastin) causing hereditary spastic paraplegia. This apparent missense mutation in the ATPase domain confers aberrant, in-frame splicing and results in destabilization of mutated transcript. Mutated protein is deficient in microtubule-severing activity but, unlike neighboring mutations, shows regular subcellular localization. The authors' data point to haploinsufficiency rather than a dominant negative effect as the disease-causing mechanism for this mutation.
Collapse
Affiliation(s)
- J Schickel
- Institut für Klinische Chemie und Laboratoriumsdiagnostik, Universitätsklinikum, Friedrich-Schiller Universität, Jena, Germany
| | | | | | | | | | | | | |
Collapse
|