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Rezaeian P, Shufelt C, Wei J, Pacheco C, Cook-Wiens G, Berman D, Tamarappoo B, Thomson L, Nelson M, Anderson R, Petersen J, Handberg E, Pepine C, Merz CB. Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study. Am Heart J Plus 2024; 41:100390. [PMID: 38600957 PMCID: PMC11004063 DOI: 10.1016/j.ahjo.2024.100390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
Background Heart failure with preserved ejection fraction (HFpEF) is the most common cardiac complication in patients with coronary microvascular dysfunction (CMD), yet its underlying pathways remain unclear. Aortic pulse-wave velocity (aPWV) is an indicator of large artery stiffness and a predictor for cardiovascular disease. However, aPWV in CMD and HFpEF is not well characterized and may provide understanding of disease progression. Methods Among participants without obstructive coronary artery disease, we evaluated 51 women with suspected CMD and 20 women and men with evidence of HFpEF. All participants underwent aPWV measurement (SphygmoCor, Atcor Medical) with higher aPWV indicating greater vascular stiffness. Cardiac magnetic resonance imaging (CMRI) assessed left ventricular (LV) ejection fraction, CMD via myocardial perfusion reserve index (MPRI), and ventricular remodeling via LV mass-volume ratio. . Statistical analysis was performed using Wilcoxon rank sum tests, Pearson correlations and linear regression analysis. Results Compared to the suspected CMD group, the HFpEF participants were older (65 ± 12 vs 56 ± 11 yrs., p = 0.002) had higher BMI (31.0 ± 4.3 vs 27.8 ± 6.7 kg/m2, p = 0.013), higher aPWV (10.5 ± 2.0 vs 8.0 ± 1.6 m/s, p = 0.05) and lower MPRI (1.5 ± 0.3 vs1.8 ± 0.3, p = 0.02), but not remodeling. In a model adjusted for cardiovascular risk factors, the HFpEF group had a lower LVEF (estimate -4.78, p = 0.0437) than the suspected CMD group. Conclusions HFpEF participants exhibit greater arterial stiffness and lower myocardial perfusion reserve, with lower LVEF albeit not remodeling, compared to suspected CMD participants. These findings suggest arterial stiffness may contribute to progression from CMD to HFpEF. Prospective work is needed and ongoing.
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Affiliation(s)
- P. Rezaeian
- Torrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USA
| | - C.L. Shufelt
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - J. Wei
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - C. Pacheco
- Hôspital Pierre-Boucher, Centre Hospitalier de l'Université de Montréal, Université de Montreal, QC, Canada
| | - G. Cook-Wiens
- Torrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USA
| | - D. Berman
- Taper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - B. Tamarappoo
- Taper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - L.E. Thomson
- Taper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - M.D. Nelson
- The University of Texas at Arlington, Arlington, TX, USA
| | - R.D. Anderson
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - J. Petersen
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - E.M. Handberg
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - C.J. Pepine
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - C.N. Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
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Holme S, van Wijk R, Rasmussen AØ, Petersen J, Glenthøj A. Glucose phosphate isomerase deficiency demasked by whole-genome sequencing: a case report. J Med Case Rep 2024; 18:130. [PMID: 38539245 PMCID: PMC10976829 DOI: 10.1186/s13256-024-04466-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/16/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Glucose-6-phosphate isomerase deficiency is a rare genetic disorder causing hereditary nonspherocytic hemolytic anemia. It is the second most common glycolytic enzymopathy in red blood cells. About 90 cases are reported worldwide, with symptoms including chronic hemolytic anemia, jaundice, splenomegaly, gallstones, cholecystitis, and in severe cases, neurological impairments, hydrops fetalis, and neonatal death. CASE PRESENTATION This paper details the case of the first Danish patient diagnosed with glucose-6-phosphate isomerase deficiency. The patient, a 27-year-old white female, suffered from lifelong anemia of unknown origin for decades. Diagnosis was established through whole-genome sequencing, which identified two GPI missense variants: the previously documented variant p.(Thr224Met) and a newly discovered variant p.(Tyr341Cys). The pathogenicity of these variants was verified enzymatically. CONCLUSIONS Whole-genome sequencing stands as a potent tool for identifying hereditary anemias, ensuring optimal management strategies.
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Affiliation(s)
- Sissel Holme
- Danish Red Blood Cell Center, Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Richard van Wijk
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andreas Ørslev Rasmussen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jesper Petersen
- Danish Red Blood Cell Center, Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Andreas Glenthøj
- Danish Red Blood Cell Center, Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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3
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Gravholt EAE, Petersen J, Mottelson M, Nardo-Marino A, Rathe M, Olsen M, Holm C, Jørgensen FS, Birgens H, Glenthøj A. The Danish national haemoglobinopathy screening programme: Report from 16 years of screening in a low-prevalence, non-endemic region. Br J Haematol 2024; 204:329-336. [PMID: 37694757 DOI: 10.1111/bjh.19103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
The Danish national haemoglobinopathy screening programme seeks to determine parental haemoglobinopathy carrier state antenatally. In this retrospective register-based study, we evaluated the 16-year trajectory of this programme, utilising the Danish Red Blood Cell Centre's laboratory database, covering approximately 77% of the Danish population. During the study period, we observed a substantial increase in annual diagnostic examinations performed, from 389 in 2007 to 3030 in 2022. Women constituted 88% of these cases, aligning with the emphasis of the screening programme. Of these, 54% of women of reproductive age (15-40 years) and 10% of women >40 years were specified as pregnant. During our study period, 61 children were born with a severe haemoglobinopathy, out of which 23 children were born from mothers not residing in Denmark during their first trimester thus not included in the screening programme. Prenatal invasive testing was performed for 60 fetuses, identifying 12 with homozygous or compound heterozygous haemoglobinopathy. The Danish haemoglobinopathy screening programme has provided screening, information and reproductive choices for numerous families. During the study period, screening for haemoglobinopathies has been steadily increasing and is expected to continue to increase. Awareness of and adherence to the screening programme is subject of further investigation and optimisation.
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Affiliation(s)
| | - Jesper Petersen
- Danish Red Blood Cell Centre, Department of Haematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mathis Mottelson
- Danish Red Blood Cell Centre, Department of Haematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Amina Nardo-Marino
- Danish Red Blood Cell Centre, Department of Haematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mathias Rathe
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marianne Olsen
- Department of Paediatrics and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Charlotte Holm
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Finn Stener Jørgensen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Fetal Medicine Unit, Department of Gynaecology and Obstetrics, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Henrik Birgens
- Danish Red Blood Cell Centre, Department of Haematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Andreas Glenthøj
- Danish Red Blood Cell Centre, Department of Haematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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4
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Juhl AR, Helby J, Nardo-Marino A, Petersen J, Petersen EE, Jensen KN, Szecsi PB, Bratholm PS, Wang T, Glenthøj A. A Novel β-Globin Variant, Hb Raklev [β 75(E19) HBB:c.227T > A (Leu→Gln)]. Hemoglobin 2023; 47:140-144. [PMID: 37752804 DOI: 10.1080/03630269.2023.2262391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
We present a new hemoglobin variant, Hb Raklev, characterized by the substitution of leucine with glutamine at position 75 in the β-globin chain. This variant was discovered inadvertently during an HbA1c evaluation using high performance liquid chromatography in a symptomless 54-year-old Caucasian woman, with the same variant also identified in her 16-year-old daughter. Purification of the hemoglobin revealed possibly diminished 2,3-bisphosphoglycerate (2,3-BPG) sensitivity, which may result in heightened oxygen affinity. Notably, two variants have been previously documented at this location: the unstable Hb Atlanta and the high-affinity Hb Pasadena.
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Affiliation(s)
- Anne Rudbeck Juhl
- Department of Hematology, Danish Red Blood Cell Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jens Helby
- Department of Hematology, Danish Red Blood Cell Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Amina Nardo-Marino
- Department of Hematology, Danish Red Blood Cell Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jesper Petersen
- Department of Hematology, Danish Red Blood Cell Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Pal Bela Szecsi
- Department of Clinical Biochemistry, Holbæk Hospital, Holbæk, Denmark
| | - Palle S Bratholm
- Department of Clinical Biochemistry, Holbæk Hospital, Holbæk, Denmark
| | - Tobias Wang
- Zoophysiology, Department of Bioscience, Aarhus University, Aarhus, Denmark
| | - Andreas Glenthøj
- Department of Hematology, Danish Red Blood Cell Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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5
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Yuan X, Liu B, Cuevas P, Brunski J, Aellos F, Petersen J, Koehne T, Bröer S, Grüber R, LeBlanc A, Zhang X, Xu Q, Helms J. Linking the Mechanics of Chewing to Biology of the Junctional Epithelium. J Dent Res 2023; 102:1252-1260. [PMID: 37555395 PMCID: PMC10626588 DOI: 10.1177/00220345231185288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
The capacity of a tissue to continuously alter its phenotype lies at the heart of how an animal is able to quickly adapt to changes in environmental stimuli. Within tissues, differentiated cells are rigid and play a limited role in adapting to new environments; however, differentiated cells are replenished by stem cells that are defined by their phenotypic plasticity. Here we demonstrate that a Wnt-responsive stem cell niche in the junctional epithelium is responsible for the capability of this tissue to quickly adapt to changes in the physical consistency of a diet. Mechanical input from chewing is required to both establish and maintain this niche. Since the junctional epithelium directly attaches to the tooth surface via hemidesmosomes, a soft diet requires minimal mastication, and consequently, lower distortional strains are produced in the tissue. This reduced strain state is accompanied by reduced mitotic activity in both stem cells and their progeny, leading to tissue atrophy. The atrophied junctional epithelium exhibits suboptimal barrier functions, allowing the ingression of bacteria into the underlying connective tissues, which in turn trigger inflammation and mild alveolar bone loss. These data link the mechanics of chewing to the biology of tooth-supporting tissues, revealing how a stem cell niche is responsible for the remarkable adaptability of the junctional epithelium to different diets.
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Affiliation(s)
- X. Yuan
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - B. Liu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - P. Cuevas
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J. Brunski
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - F. Aellos
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J. Petersen
- Department of Orthodontics, University of Leipzig Medical Center, Saxony, Germany
| | - T. Koehne
- Department of Orthodontics, University of Leipzig Medical Center, Saxony, Germany
| | - S. Bröer
- Institute of Pharmacology and Toxicology, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - R. Grüber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - A. LeBlanc
- Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - X. Zhang
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Q. Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - J.A. Helms
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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6
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Terrones-Campos C, Ledergerber B, Forbes N, Smith AG, Petersen J, Helleberg M, Lundgren J, Specht L, Vogelius IR. Prediction of Radiation-induced Lymphopenia following Exposure of the Thoracic Region and Associated Risk of Infections and Mortality. Clin Oncol (R Coll Radiol) 2023; 35:e434-e444. [PMID: 37149425 DOI: 10.1016/j.clon.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/08/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
AIMS Large blood volumes are irradiated when the heart is exposed to radiation. The mean heart dose (MHD) may be a good surrogate for circulating lymphocytes exposure. We investigated the association between MHD and radiation-induced lymphopenia and explored the impact of the end-of-radiation-therapy (EoRT) lymphocyte count on clinical outcomes. MATERIALS AND METHODS In total, 915 patients were analysed: 303 patients with breast cancer and 612 with intrathoracic tumours: oesophageal cancer (291), non-small cell lung cancer (265) and small cell lung cancer (56). Heart contours were generated using an interactive deep learning delineation process and an individual dose volume histogram for each heart was obtained. A dose volume histogram for the body was extracted from the clinical systems. We compared different models analysing the effect of heart dosimetry on the EoRT lymphocyte count using multivariable linear regression and assessed goodness of fit. We published interactive nomograms for the best models. The association of the degree of EoRT lymphopenia with clinical outcomes (overall survival, cancer treatment failure and infection) was investigated. RESULTS An increasing low dose bath to the body and MHD were associated with a low EoRT lymphocyte count. The best models for intrathoracic tumours included dosimetric parameters, age, gender, number of fractions, concomitant chemotherapy and pre-treatment lymphocyte count. Models for patients with breast cancer showed no improvement when adding dosimetric variables to the clinical predictors. EoRT lymphopenia grade ≥3 was associated with decreased survival and increased risk of infections among patients with intrathoracic tumours. CONCLUSION Among patients with intrathoracic tumours, radiation exposure to the heart contributes to lymphopenia and low levels of peripheral lymphocytes after radiotherapy are associated with worse clinical outcomes.
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Affiliation(s)
- C Terrones-Campos
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - B Ledergerber
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - N Forbes
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A G Smith
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - J Petersen
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - M Helleberg
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J Lundgren
- Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - L Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - I R Vogelius
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Yildirim Y, Reuter L, Odah S, Petersen J, Pahrmann C, Reichenspurner H, Pecha S. Nanotechnological Coating Reduces Bacterial Growth on Vascular Prostheses: An In Vitro Bioluminescence Imaging Study. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- Y. Yildirim
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - L. Reuter
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - S. Odah
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | | | - C. Pahrmann
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | | | - S. Pecha
- University Heart and Vascular Center Hamburg, Hamburg, Deutschland
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8
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Nardo‐Marino A, Glenthøj A, Brewin JN, Petersen J, Braunstein TH, Kurtzhals JAL, Williams TN, Rees DC. The significance of spleen size in children with sickle cell anemia. Am J Hematol 2022; 97:1520-1528. [PMID: 36054667 PMCID: PMC9827862 DOI: 10.1002/ajh.26703] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 01/31/2023]
Abstract
It is well established that splenic dysfunction occurs in early childhood in sickle cell anemia (SCA), although the determinants and consequences of splenic injury are not fully understood. In this study, we examined spleen size and splenic function in 100 children with SCA aged 0-16 years at King's College Hospital in London. Spleen size was assessed by abdominal ultrasound (US) and splenic function by pitted red blood cells (PIT counts). In our cohort, 5.6% of children aged 6-10 years and 19.4% of children aged 11-16 years had no visible spleen on US (autosplenectomy). Splenomegaly was common in all age groups, with 28% of children overall having larger spleens than the average for their age. Only one child had a PIT count suggesting preserved splenic function. We found no correlation between hemoglobin F levels and spleen size, nor was there any difference in spleen size between children treated with or without hydroxyurea. Although there was a trend toward increased spleen length in children with co-inherited α-thalassemia, this did not reach statistical significance. Finally, we found a strong association between erythrocyte deformability measured with oxygen gradient ektacytometry, spleen size, and PIT counts. In conclusion, our results do not agree with the general perception that most children with SCA undergo autosplenectomy within the first decade of life and indicate that loss of erythrocyte deformability contributes to loss of splenic filtration capacity in SCA, as well as phenotypical variations in spleen size.
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Affiliation(s)
- Amina Nardo‐Marino
- Danish Centre for Haemoglobinopathies, Department of HaematologyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark,Department of Immunology and Microbiology, Centre for Medical ParasitologyUniversity of CopenhagenCopenhagenDenmark,Department of Haematological MedicineKing's College HospitalLondonUnited Kingdom,Comprehensive Cancer Centre, School of Cancer and Pharmaceutical SciencesKing's College LondonLondonUnited Kingdom
| | - Andreas Glenthøj
- Danish Centre for Haemoglobinopathies, Department of HaematologyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - John N. Brewin
- Department of Haematological MedicineKing's College HospitalLondonUnited Kingdom,Comprehensive Cancer Centre, School of Cancer and Pharmaceutical SciencesKing's College LondonLondonUnited Kingdom
| | - Jesper Petersen
- Danish Centre for Haemoglobinopathies, Department of HaematologyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Thomas H. Braunstein
- Core Facility for Integrated Microscopy, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Jørgen A. L. Kurtzhals
- Department of Immunology and Microbiology, Centre for Medical ParasitologyUniversity of CopenhagenCopenhagenDenmark,Department of Clinical MicrobiologyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Thomas N. Williams
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya,Department of Surgery and CancerInstitute of Global Health Innovation, Imperial College LondonLondonUnited Kingdom
| | - David C. Rees
- Department of Haematological MedicineKing's College HospitalLondonUnited Kingdom,Comprehensive Cancer Centre, School of Cancer and Pharmaceutical SciencesKing's College LondonLondonUnited Kingdom
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Petersen J, Butt JH, Yafasova A, Torp-Pedersen C, Soerensen R, Kruuse C, Vinding NE, Gundlund A, Koeber L, Fosboel EL, Oestergaard L. Prognosis and antithrombotic practice patterns in recurrent and transient atrial fibrillation following acute coronary syndrome: a nationwide study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.379] [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: 11/12/2022] Open
Abstract
Abstract
Background
First-time detected atrial fibrillation (AF) during acute coronary syndrome (ACS) aggravates the prognosis and increases the risk of ischemic stroke. In this setting, AF may present as brief and transient or with recurrent episodes after discharge. However, data on the association between transient or recurrent AF and ischemic stroke in patients with ACS are sparse. Further, despite being associated with ischemic stroke, first-time detected AF patients have been reported with low oral anticoagulation (OAC) rates.
Purpose
To examine the associated rate of ischemic stroke and mortality in ACS survivors with transient or recurrent AF and to assess the antithrombotic practice patterns one year after ACS.
Methods
Using data from Danish nationwide registries, we identified all patients with first-time ACS, without known AF prior to ACS, from 2000–2017 who were alive one year after ACS discharge (index date). According to a grace period between ACS discharge and one year after ACS discharge, patients were categorized into: i) no AF; ii) first-time detected AF during ACS admission without AF recurrence (transient AF); and iii) first-time detected AF during ACS admission with a subsequent recurrent AF episode (recurrent AF). Patients who developed AF during the grace period were excluded. Patients were followed from one year post ACS discharge, and two-year rates of ischemic stroke and mortality were compared using multivariable adjusted Cox proportional hazards analysis. Further, we assessed the prescribed OAC rates in a three-month period following the index date.
Results
We included 116,793 patients surviving one year post ACS discharge: 111,708 (95.6%) without AF (64.9% male, median age 64 years), 2,671 (2.3%) with transient AF (58.0% male, median age 74 years), and 2,414 (2.1%) with recurrent AF (55.2% male, median age 76 years). The cumulative two-year incidence of ischemic stroke was 0.9%, 1.5%, and 2.3% for patients without AF, transient AF, and recurrent AF, respectively (Figure 1). The cumulative two-year incidence of mortality was 7.4%, 12.1%, and 20.3% for patients without AF, transient AF, and recurrent AF, respectively (Figure 1). Compared to those without AF, the adjusted two-year rates of outcomes were as follows: ischemic stroke: HR 1.15 (95% CI: 0.81–1.61) for patients with transient AF and HR 1.50 (95% CI: 1.14–1.98) for patients with recurrent AF; mortality: HR 0.98 (95% CI: 0.87–1.10) for patients with transient AF and HR 1.35 (95% CI: 1.23–1.49) for patients with recurrent AF (Figure). We identified that 20.9% for transient AF and 42.2% for recurrent AF were prescribed OAC therapy in the three-month period after one year.
Conclusion
In patients surviving one year after ACS with first-time detected AF, a recurrent AF episode was associated with an increased long-term rate of ischemic stroke and mortality, while transient AF yielded no statistically difference as compared with patients without AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Petersen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - J H Butt
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - A Yafasova
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | | | - R Soerensen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - C Kruuse
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - N E Vinding
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - A Gundlund
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - E L Fosboel
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - L Oestergaard
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
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10
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Tas A, Fosboel E, Butt J, Weeke P, Kristensen S, Burcharth J, Vinding N, Petersen J, Koeber L, Vester-Andersen M, Gundlund A. Perioperative atrial fibrillation in major emergency abdominal surgery: does it affect postoperative outcome? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.520] [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: 11/15/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) in relation to surgery remains a clinical challenge. Major emergency abdominal surgery (e.g. ileus, perforation) is associated with postoperative complications and mortality. However, the prevalence and impact of perioperative AF in this setting is not well examined.
Purpose
We compared 30-days and 1-year outcomes (i.e. hospitalization of any causes, AF-related hospitalization, thromboembolic events and all-cause mortality) in patients who did and did not develop perioperative AF (POAF) in relation to their major emergency abdominal surgery.
Methods
We crosslinked data from Danish nationwide registries and identified all patients who underwent major emergency abdominal surgery (2000–2018) and discharged alive. Patients who developed POAF during hospitalization were matched in a 1:3 ratio on age, sex, year of surgery and category of surgery with those without POAF. Starting follow up at discharge, we examined the rates of outcomes at 30-days and 1-year post-discharge. The cumulative incidences and ratios of outcomes were assessed with the Aalen Johanson estimator together with Kaplan-Meier estimator and multivariable Cox regression analysis, respectively.
Results
We identified 891 patients with POAF and 64,914 patients without POAF. The matched cohort were composed of 889 patients with POAF and 2667 patients without POAF with a median age of 79 years [25th-75th percentile; 72–84 years] and 45.2% males. In general, patients with POAF had higher comorbid burden compared with patients without POAF. The cumulative incidences of a hospitalization of any cause after 30-days post-discharge were 31.2% and 22.3% in patients with and without POAF, respectively. The corresponding numbers for AF-related hospitalization were 20.8% and 1.2%, respectively. In adjusted analyses, POAF was associated with a significantly higher risk of hospitalization of any causes together with AF-related hospitalization (Figure 1 and 2).
The cumulative incidences of a thromboembolic event after 30-days post-discharge were 2.2% and 0.9% in patients with and without POAF, respectively. The corresponding numbers for all-cause mortality were 9.7% and 3.2%, respectively. In adjusted analyses, POAF was associated with a significantly higher risk of a thromboembolic event together with all-cause mortality within 30-days of follow up as well as 1-year of follow up. However, the results regarding thromboembolic events did not reach statistical significance after 1-year of follow up (Figure 1 and 2).
Conclusions
Perioperative atrial fibrillation in relation to major emergency abdominal surgery was associated with higher 30-days and 1-year rates of hospitalizations of any causes, atrial fibrillation related hospitalization, a thromboembolic event and all-cause mortality. These findings suggest that perioperative atrial fibrillation is a strong prognostic marker of increased morbidity following major emergency abdominal surgery.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Tas
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - E Fosboel
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Butt
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - P Weeke
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - S Kristensen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Burcharth
- Herlev-Gentofte University Hospital, Department of Surgucal Gastroenterology , Gentofte , Denmark
| | - N Vinding
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - J Petersen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - M Vester-Andersen
- Herlev-Gentofte University Hospital, Department of Anesthesiology , Gentofte , Denmark
| | - A Gundlund
- Herlev-Gentofte University Hospital, Department of Cardiology , Gentofte , Denmark
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Wild C, Lang F, Gerhäuser AS, Schmidt MW, Kowalewski KF, Petersen J, Kenngott HG, Müller-Stich BP, Nickel F. Telestration with augmented reality for visual presentation of intraoperative target structures in minimally invasive surgery: a randomized controlled study. Surg Endosc 2022; 36:7453-7461. [PMID: 35266048 PMCID: PMC9485092 DOI: 10.1007/s00464-022-09158-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
AIMS In minimally invasive surgery (MIS), intraoperative guidance has been limited to verbal communication without direct visual guidance. Communication issues and mistaken instructions in training procedures can hinder correct identification of anatomical structures on the MIS screen. The iSurgeon system was developed to provide visual guidance in the operating room by telestration with augmented reality (AR). METHODS Laparoscopic novices (n = 60) were randomized in two groups in a cross-over design: group 1 trained only with verbal guidance first and then with additional telestration with AR on the operative screen and vice versa for group 2. Training consisted of laparoscopic basic training and subsequently a specifically designed training course, including a porcine laparoscopic cholecystectomy (LC). Outcome included time needed for training, performance with Global Operative Assessment of Laparoscopic Skills (GOALS), and Objective Structured Assessment of Technical Skills (OSATS) score for LC, complications, and subjective workload (NASA-TLX questionnaire). RESULTS Telestration with AR led to significantly faster total training time (1163 ± 275 vs. 1658 ± 375 s, p < 0.001) and reduced error rates. LC on a porcine liver was performed significantly better (GOALS 21 ± 5 vs. 18 ± 4, p < 0.007 and OSATS 67 ± 11 vs. 61 ± 8, p < 0.015) and with less complications (13.3% vs. 40%, p < 0.020) with AR. Subjective workload and stress were significantly reduced during training with AR (33.6 ± 12.0 vs. 30.6 ± 12.9, p < 0.022). CONCLUSION Telestration with AR improves training success and safety in MIS. The next step will be the clinical application of telestration with AR and the development of a mobile version for remote guidance.
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Affiliation(s)
- C Wild
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - F Lang
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - A S Gerhäuser
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - M W Schmidt
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - K F Kowalewski
- Department of Urology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - J Petersen
- German Cancer Research Center, 69120, Heidelberg, Germany
| | - H G Kenngott
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - B P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
| | - F Nickel
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
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Klotz S, Ketels G, Petersen J, Stock S, Girdauskas E. Interdisciplinary and cross-sectoral perioperative care model in cardiac surgery: Implementation in the setting of minimally-invasive heart valve surgery (increase) – Study protocol for a randomized controlled trial. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ahmad-Nielsen EB, Szecsi PB, Bratholm PS, Petersen J, Glenthøj A. Hb Kalundborg [β79(EF3)Asp→Glu; HBB: c.240C>a], a Possible Low-affinity Hemoglobin Variant Detected during Hb A 1c Measurement. Hemoglobin 2022; 46:124-128. [PMID: 35920343 DOI: 10.1080/03630269.2022.2079520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A previously unknown hemoglobin (Hb) variant was detected during measurement of glycosylated Hb (Hb A1c) after the introduction of a new high performance liquid chromatography (HPLC) apparatus. Subsequent DNA sequencing revealed a heterozygous single nucleotide substitution at codon 79 (C>A) on the β-globin gene changing an amino acid [β79(EF3)Asp→Glu; HBB: c.240C>A]. The new Hb variant was named Hb Kalundborg after the place of origin of the proband. Heterozygosity for this mutation appears to have no clinical significance in itself except for a possibly slightly lower oxygen affinity. However, it interferes with Hb A1c measurement by HPLC, causing a falsely high Hb A1c concentration when using the G11 apparatus with clinical implications possibly to follow.
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Affiliation(s)
- Emil B Ahmad-Nielsen
- Department of Hematology, Danish Center for Hemoglobinopathies, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Pal B Szecsi
- Department of Clinical Biochemistry, Holbaek Hospital, Holbaek, Denmark
| | - Palle S Bratholm
- Department of Clinical Biochemistry, Holbaek Hospital, Holbaek, Denmark
| | - Jesper Petersen
- Department of Hematology, Danish Center for Hemoglobinopathies, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Andreas Glenthøj
- Department of Hematology, Danish Center for Hemoglobinopathies, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Karlsson LK, Mottelson MN, Helby J, Petersen J, Glenthøj A. Acquired Spherocytosis in the Setting of Myelodysplasia. Leuk Res Rep 2022; 17:100332. [PMID: 35720514 PMCID: PMC9198317 DOI: 10.1016/j.lrr.2022.100332] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/22/2022] [Accepted: 05/30/2022] [Indexed: 11/15/2022] Open
Abstract
Hereditary spherocytosis (HS) is the most prevalent red blood cell (RBC) membrane disorder. We report a rare case of acquired SPTB spherocytosis coinciding with a myelodysplastic syndrome associated U2AF1 mutation, neither found in germline DNA. The diagnosis was confirmed by Eosin-5-Maleimide binding assay and Next Generation Sequencing (NGS). The patient recovered quickly after splenectomy, which confirms that his myelodysplastic syndrome (MDS)-associated U2AF1 mutation did not affect the clinical picture. This case highlights the essence of thoroughly examining the etiology of hemolytic indices, despite bone marrow morphology and myeloid gene panel supporting a diagnosis of MDS with single line dysplasia.
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Affiliation(s)
| | | | | | | | - Andreas Glenthøj
- Corresponding author at: Department of Hematology Copenhagen University Hospital - Rigshospitalet Blegdamsvej 9 DK - 2100 Copenhagen Denmark.
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Arnold S, Wallmeier P, Schubach F, Ihorst G, Aries P, Bergner R, Bremer JP, Görl N, Hellmich B, Henes J, Hoyer B, Kangowski A, Kötter I, Metzler C, Müller-Ladner U, Schaier M, Schönermark U, Thiel J, Unger L, Venhoff N, Weinmann-Menke J, Petersen J, Iking-Konert C, Lamprecht P. AB0622 The Joint Vasculitis Registry in German-speaking countries (GeVas) – subgroup analysis of 113 GPA-patients. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundGranulomatosis with polyangiitis (GPA) is the second most frequent vasculitis in Germany with an annual incidence of 34 per million and a prevalence of 210 per million [1]. GPA is characterized by its chronic course, frequent relapses, significant overall morbidity and mortality, and substantial socio-economic impact. Multiorgan involvement affecting the respiratory tract, kidney, and other organs is common. Limited variants also occur [2]. So far, prospective long-term observational data on the disease course of GPA are missing in Germany. Therefore, the Joint Vasculitis Registry in German-speaking countries (GeVas) has been established to follow the course of patients recently diagnosed with vasculitis or a change of their treatment due to a relapse (inception cohort). The GeVas registry allows long-term follow-up of a substantial cohort of vasculitis patients in a multicenter setting.ObjectivesTo present the first data on the follow-up of newly diagnosed and relapsing GPA enrolled in the GeVas registry.MethodsGeVas is a prospective, web-based, multicenter, clinician-driven registry for the documentation of organ manifestations, damage, long-term outcomes, and therapy regimens in various types of vasculitis. Recruitment started in June 2019. By January 2022, 17 centers in Germany were initiated and started enrolling patients. Meanwhile, more than 350 patients have been documented in the registry. Sites in Austria and the German-speaking cantons of Switzerland will be integrated soon [3].ResultsBy mid-October 2021, the participating centers included 113 patients with GPA. The majority of patients were PR3-ANCA positive and affected by general symptoms, ENT, lung, renal, and neurological involvement. Patients commonly received cyclophosphamide or rituximab in combination with glucocorticoids for the induction of remission. Fewer patients received methotrexate or other immunosuppressants. Patient characteristics and therapy are summarized in Table 1.Table 1.Patient characteristics (n = 113). *Unless otherwise specified.CategoryFeaturen (%)*AgeAge (years); median [range]60 [51 - 70]GenderMale61 (54.0)Female52 (46.0)Reason for inclusion in the registryNewly diagnosed vasculitis57 (51.4)Relapse56 (49.6)ANCA statusPR3-ANCA99 (87.6)MPO-ANCA4 (3.6)ANCA negative9 (7.9)Organ manifestationGeneral symptoms86 (76.1)ENT69 (61.1)Lung/chest66 (58.4)Renal35 (31.0)Cardiovascular7 (6.2)GI3 (2.7)Neurological27 (23.9)TherapyGlucocorticoid102 (90.3)Rituximab56 (49.6)Cyclophosphamide37 (32.7)Methotrexate and other immunosuppressants, respectively26 (23.0) and 19 (16.8), respectivelyConclusionHere, we present the first interim analysis of the GeVas registry. Clinical manifestations of GPA reported herein show less frequent renal involvement in comparison with a recent report from another European registry (POLVAS) and an UK study [4, 5]. This is potentially related to the predominance of recruiting rheumatology centers thus far. By contrast, respiratory tract involvement is more frequent and PR3-ANCA less common in Japan [5]. Further data are prospectively documented and a follow up analysis is in progress.References[1]Hellmich B, et al. New insights into the epidemiology of ANCA-associated vasculitides in Germany: results from a claims data study. Rheumatology 2021;60:4868-73.[2]Kitching AR, et al. ANCA-associated vasculitis. Nat Rev Dis Primers 2020;6:71.[3]Iking-Konert C, et al. The Joint Vasculitis Registry in German-speaking countries (GeVas) – a prospective, multicenter registry for the follow-up of long-term outcomes in vasculitis. BMC Rheumatol 2021;5:40.[4]Wójcik K, et al. Clinical characteristics of Polish patients with ANCA-asscoiated vasculitides – retrospective analysis of POLVAS registry. Clin Rheumatol 2019;38:2553-63.[5]Furuta S, et al. Comparison of the phenotype and outcome of granulomatosis with polyangiitis between UK and Japanese cohorts. J Rheumatol 2017;44:216-22.AcknowledgementsGeVas was supported by unrestricted grants by: DGRh, John Grube Foundation, Vifor and Roche PharmaDisclosure of InterestsSabrina Arnold: None declared, Pia Wallmeier: None declared, Fabian Schubach: None declared, Gabriele Ihorst: None declared, Peer Aries: None declared, Raoul Bergner Consultant of: VIFOR, Jan Philip Bremer: None declared, Norman Görl: None declared, Bernhard Hellmich: None declared, Jörg Henes: None declared, Bimba Hoyer: None declared, Antje Kangowski: None declared, Ina Kötter: None declared, Claudia Metzler: None declared, Ulf Müller-Ladner: None declared, Matthias Schaier: None declared, Ulf Schönermark: None declared, Jens Thiel: None declared, Leonore Unger: None declared, Nils Venhoff Speakers bureau: Roche and Vifor: speaker honoraries, Consultant of: Roche and Vifor: advisory boards, Grant/research support from: John-Grube Research Award 2021, Julia Weinmann-Menke: None declared, Jana Petersen: None declared, Christof Iking-Konert Speakers bureau: Lecture fees from: Chugai, GSK, Roche, and Vifor, Consultant of: Consulting fees from: Chugai, GSK, Roche, and Vifor, Grant/research support from: Research grants for GeVas: Roche, Vifor, DGRh, John Grube Foundation, Peter Lamprecht Speakers bureau: Chugai, GSK, Roche, and Vifor, Consultant of: Chugai, GSK, Roche, and Vifor, Grant/research support from: DGRh, John Grube Foundation, Roche, and Vifor
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Wallmeier P, Arnold S, Schubach F, Ihorst G, Aries P, Bergner R, Bremer JP, Görl N, Hellmich B, Henes J, Hoyer B, Kangowski A, Kötter I, Magnus T, Metzler C, Müller-Ladner U, Schaier M, Schönermark U, Thiel J, Unger L, Venhoff N, Weinmann-Menke J, Petersen J, Lamprecht P, Iking-Konert C. POS0800 THE JOINT VASCULITIS REGISTRY IN GERMAN-SPEAKING COUNTRIES (GeVas) – SUBGROUP ANALYSIS OF 131 GCA-PATIENTS REFERENCES:. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe most frequent form of vasculitis in elderly people is giant cell arteritis (GCA) with an annual incidence rate less than 10 per 100,000 persons over the age of 50. Like most vasculitides, GCA is characterized by chronicity and relapses, leading to significant overall morbidity and higher mortality in a subset of patients with aortic involvement and dissection. Most studies carried out so far have been retrospective, used monocentric study designs and small patient cohorts. Therefore, the Joint Vasculitis Registry in German-speaking countries (GeVas) has been established to record patients, who have been recently diagnosed with vasculitis or who have changed their treatment due to a relapse (inception cohort). The GeVas-Registry allows a long-term follow-up of a substantial cohort of vasculitis patients in a prospective and multicenter manner.ObjectivesTo describe the subgroup of GCA and its characteristics within the GeVas registry.MethodsGeVas is a prospective, web-based, multicenter, clinician-driven registry for the documentation of organ manifestations, damage, long-term outcomes, and therapy regimens in various types of vasculitis. Recruitment started in June 2019. By January 2022, 17 centers in Germany were initiated and have begun enrolling patients. Meanwhile, more than 350 patients have been documented in the registry. Sites in Austria and the German-speaking cantons of Switzerland will be integrated soon (1).ResultsBy mid-October 2021, the participating centers recruited 131 GCA patients into the registry. 21.7% of patients (n=28) were enrolled in the registry due to relapse, and 78.3% (n=101) due to a first-time diagnosis. In accordance with long-standing epidemiology data, the majority of patients (67,2%), were female (n=88), and 32.8% (n=43) were male. Mean age was 74 years (max. 92y, min. 52y). The most frequently recorded organ manifestations in GCA patients addressed cranial and ophthalmic symptoms, and the cardiovascular system. However, vascular lung/chest involvement was also observed in 3% of cases (n=4). Out of the 131 patients, 97.7% (n=128) received immunosuppressive therapy, three refused to take any medication. An equal number of patients were treated with glucocorticoid (GC) therapy. While about two equal parts were treated by stable long term oral GC therapy (47,7%, n=62) or by i.v. pulse therapy followed by tapering (49,2%, n=64), only about 2.3% (n=3) were treated by oral GC therapy with intermittent i.v. pulses. 48.5% (n=63) of patients received tocilizumab as additional immunosuppressive therapy, 19.2% (n=25) methotrexate, and 18.5% (n=24) cyclophosphamide i.v. pulses.ConclusionIn June 2019, we successfully established the prospective multicenter vasculitis registry GeVAS. It describes the first systematically recorded prospective GCA cohort in German-speaking countries. Its characteristics correspond to those that can be expected from the literature, with some unexpected finding e.g. the high proportion of patients treated with cyclosphosphamid, probably reflecting a sicker patient population with e.g. aortic or central nervous involvement. After 2.5 years of follow-up documentation, the first long-term results will be systematically evaluated and interpreted. The newly acquired data on disease manifestation, diagnostics and therapy regimens will provide important insights into the treatment of GCA patients in Germany and may generate further research goals.ReferencesTrial registration: German Clinical Trials Register (Deutsches Register Klinischer Studien): DRKS00011866. Registered 10 May 2019. 3[1]C Iking-Konert; P Wallmeier; S Arnold; S Adler; K de Groot; B Hellmich; B Hoyer; K Holl-Ulrich; Ihorst; M Kaufmann; I Kötter; U Müller-Ladner; T Magnus; J. Rech; H. Schulze-Koops; N. Venhoff; T. Wiech; P. Villiger; F. Schubach; P. Lamprecht. The Joint Vasculitis Registry in German-speaking countries (GeVas) – a prospective, multicenter registry for the follow-up of long-term outcomes in vasculitis. BMC Rheumatol. 2021 Jul 31;5(1):40. doi: 10.1186/s41927-021-00206-2.AcknowledgementsGeVas was supported by unrestricted grants by: DGRh, John Grube Foundation, Vifor and Roche PharmaDisclosure of InterestsPia Wallmeier: None declared, Sabrina Arnold: None declared, Fabian Schubach: None declared, Gabriele Ihorst: None declared, Peer Aries: None declared, Raoul Bergner Consultant of: Advisory Board VIFOR, Grant/research support from: John-Grube Research Award 2021, Jan Philip Bremer: None declared, Norman Görl: None declared, Bernhard Hellmich: None declared, Jörg Henes: None declared, Bimba Hoyer: None declared, Antje Kangowski: None declared, Ina Kötter: None declared, Tim Magnus: None declared, Claudia Metzler: None declared, Ulf Müller-Ladner: None declared, Matthias Schaier: None declared, Ulf Schönermark: None declared, Jens Thiel: None declared, Leonore Unger: None declared, Nils Venhoff Speakers bureau: Roche and Vifor, Consultant of: Roche and Vifor, Grant/research support from: John-Grube Research Award 2021, Julia Weinmann-Menke: None declared, Jana Petersen: None declared, Peter Lamprecht Speakers bureau: Lecture fees from: Chugai, GSK, Roche, Consultant of: Consulting & lecture fees from: Chugai, GSK, Roche, and Vifor., Grant/research support from: Research grants for GeVas: DGRh, John Grube Foundation, Roche, and Vifor, Christof Iking-Konert Speakers bureau: lecture fees from: Chugai, GSK, Roche, and Vifor., Consultant of: Consulting fees from: Chugai, GSK, Roche, and Vifor., Grant/research support from: Research grants for GeVas: DGRh, John Grube Foundation, Roche, and Vifor;
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Ismaili D, Gurr K, Horvath A, Yuan L, Lemoine MD, Schulz C, Sani J, Petersen J, Reichenspurner H, Kirchhof P, Jespersen T, Eschenhagen T, Hansen A, Koivumaki JT, Christ T. Regulation of APD and force by Na+/Ca2+ exchanger in hiPSC-cardiomyocytes. Europace 2022. [DOI: 10.1093/europace/euac053.625] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): BMBF
Introduction
Human induced pluripotent stem cell-derived cardiomyocytes (HiPSC-CM) are an emerging, powerful tool to study human cardiac physiology, pharmacology and toxicology, to model cardiovascular diseases or even to use for cardiac repair. Understanding the similarities and differences between hiPSC-CM and adult human cardiomyocytes is critical for their use. Here we focus on sodium calcium exchanger (NCX) who plays a crucial role in the Ca2+-homeostasis in the mammalian heart. Importantly, alterations in NCX expression in human heart are associated with various cardiac pathologies such as heart failure or arrhythmias. In order to investigate whether hiPSC-CM could serve as model for adult human heart NCX we measured the properties of NCX in hiPSC-CM and human ventricular tissue. Rat ventricular tissue was used for comparison.
Methods
HiPSC-CM were differentiated from a healthy iPSC line and dissociated from engineered heart tissue (EHT). Adult human and rat cardiomyocytes were digested from ventricular samples. We measured NCX current by the whole-cell patch clamp technique at 37 °C. Standard sharp microelectrodes were used to record action potentials (AP). Contractile force in human and rat ventricular samples was measured isometrically. A video-optical contractility test system was used to measure force in EHT. SEA0400 (10 µM) was used to block NCX.
Results
NCX currents could be measured in every hiPSC-CM. The NCX current densities in hiPSC-CM were larger than in human ventricular cardiomyocytes (3.2±0.2 pA/pF n=28 vs. 1.3±0.2 pA/pF n=15, p<0.05), but lower than reported for rat left ventricular cardiomyocytes using the same protocol. SEA0400 shortened APD90 markedly in EHT (264.1±24.9 ms to 191±31.6 ms, n=4) and to a lesser extent in rat ventricular tissue (54.4±3.9 ms to 48.9±4.2 ms, n=7). Shortening in human left ventricular preparations was tiny (320±22.1 ms to 305.5±20.3 ms, n=6) and not different from time-matched controls (TMC). Resting membrane potential, action potential amplitude and upstroke velocity were not affected neither in EHT nor in left ventricular preparations (rat and human). Force was significantly increased by NCX block in rat ventricle (by 31±5.4%, n=18) and EHT (by 20.8±3.9%, n=4), but in human left ventricular preparations there was only a tendency to attenuate spontaneous run-down (-3.7±4.3% n=8 with SEA vs. -6.2±3.7% n=12 in TMC).
Conclusion
HiPSC-CM possess NCX in the physiological range. HiPSC-CM show NCX-effects on APD and force as predicted from rat ventricle and in full accordance with cardiac physiology. Lack of NCX effect in human adult ventricles that had been already reported previously needs further investigations.
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Affiliation(s)
- D Ismaili
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - K Gurr
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - A Horvath
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - L Yuan
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - MD Lemoine
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - C Schulz
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - J Sani
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - J Petersen
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - H Reichenspurner
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - P Kirchhof
- University Heart & Vascular Center Hamburg, Department of Cardiology, Hamburg, Germany
| | - T Jespersen
- University of Copenhagen, Department of Biomedical Sciences, Copenhagen, Denmark
| | - T Eschenhagen
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - A Hansen
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
| | - JT Koivumaki
- Tampere University, BioMediTech, Faculty of Medicine and Health Technology, Tampere, Finland
| | - T Christ
- University Medical Center Hamburg Eppendorf, Institute of Experimental Pharmacology and Toxicology, Hamburg, Germany
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Smith A, Petersen J, Wahlstedt I, Risumlund S, Felter M, Hansen V, Vogelius I. PD-0065 Corrective-annotation auto-completion enables faster organ contouring. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02735-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sjölin M, Vogelius I, K N, Jensen G, Bak M, Kjær-Kristoffersen F, Nøttrup T, Friborg J, Hansen V, Petersen J. PO-1634 QA of dose originating from deformable image registration of planning CT to CBCT on the Ethos system. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03598-8] [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: 10/18/2022]
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20
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Forbes N, Smith A, Petersen J, Terrones-Campos C, Reekie J, Darkner S, Specht L, Vogelius I. MO-0716 Radiotherapy exposure and association with observed cardiovascular toxicity in over 5000 patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02414-8] [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: 10/18/2022]
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21
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Jensen S, Erichsen T, Jensen M, Balling P, Petersen J, Poulsen P, Muren L. PO-1572 Development of deformable 3D anthropomorphic dosimetry systems for proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03536-8] [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: 10/18/2022]
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22
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Nardo-Marino A, Braunstein TH, Petersen J, Brewin JN, Mottelson MN, Williams TN, Kurtzhals JAL, Rees DC, Glenthøj A. Automating Pitted Red Blood Cell Counts Using Deep Neural Network Analysis: A New Method for Measuring Splenic Function in Sickle Cell Anaemia. Front Physiol 2022; 13:859906. [PMID: 35480040 PMCID: PMC9037235 DOI: 10.3389/fphys.2022.859906] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
The spleen plays an important role in the body’s defence against bacterial infections. Measuring splenic function is of interest in multiple conditions, including sickle cell anaemia (SCA), where spleen injury occurs early in life. Unfortunately, there is no direct and simple way of measuring splenic function, and it is rarely assessed in clinical or research settings. Manual counts of pitted red blood cells (RBCs) observed with differential interference contrast (DIC) microscopy is a well-validated surrogate biomarker of splenic function. The method, however, is both user-dependent and laborious. In this study, we propose a new automated workflow for counting pitted RBCs using deep neural network analysis. Secondly, we assess the durability of fixed RBCs for pitted RBC counts over time. We included samples from 48 children with SCA and 10 healthy controls. Cells were fixed in paraformaldehyde and examined using an oil-immersion objective, and microscopy images were recorded with a DIC setup. Manual pitted RBC counts were performed by examining a minimum of 500 RBCs for pits, expressing the proportion of pitted RBCs as a percentage (%PIT). Automated pitted RBC counts were generated by first segmenting DIC images using a Zeiss Intellesis deep learning model, recognising and segmenting cells and pits from background. Subsequently, segmented images were analysed using a small ImageJ macro language script. Selected samples were stored for 24 months, and manual pitted RBC counts performed at various time points. When comparing manual and automated pitted RBC counts, we found the two methods to yield comparable results. Although variability between the measurements increased with higher %PIT, this did not change the diagnosis of asplenia. Furthermore, we found no significant changes in %PIT after storing samples for up to 24 months and under varying temperatures and light exposures. We have shown that automated pitted RBC counts, produced using deep neural network analysis, are comparable to manual counts, and that fixed samples can be stored for long periods of time without affecting the %PIT. Automating pitted RBC counts makes the method less time consuming and results comparable across laboratories.
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Affiliation(s)
- Amina Nardo-Marino
- Centre for Haemoglobinopathies, Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Thomas H Braunstein
- Core Facility for Integrated Microscopy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Petersen
- Centre for Haemoglobinopathies, Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - John N Brewin
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Mathis N Mottelson
- Centre for Haemoglobinopathies, Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas N Williams
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Institute of Global Health Innovation, Faculty of Medicine, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Jørgen A L Kurtzhals
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - David C Rees
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Andreas Glenthøj
- Centre for Haemoglobinopathies, Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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23
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von Stuelpnagel CC, Petersen J, Augustin M, Sommer R. [Dermatological care of elderly people with psoriasis before and after entering a nursing home : A qualitative analysis from the perspective of medical providers]. Hautarzt 2022; 73:627-633. [PMID: 35482046 PMCID: PMC9047578 DOI: 10.1007/s00105-022-04989-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
Hintergrund Demografische Veränderungen bewirken einen steilen Anstieg der Anzahl der über 65-Jährigen. Damit verbunden ist die Zunahme der Anzahl pflegebedürftiger, multimorbid Erkrankter. National wie auch international gibt es keine Informationen insbesondere zur Versorgung von Psoriasiserkrankten im Setting Pflegeheim und zur Frage, wie diese durch den Eintritt in ein Pflegeheim beeinflusst wird. Fragestellung Ziel war es, anhand von Interviews bzw. Fokusgruppen die Ergebnisse vorausgehender Routinedatenanalysen zur Versorgung Psoriasiserkrankter in Pflegeheimen mit medizinischen Versorgern (Dermatologen, Allgemeinmediziner, Pflegedienstleitungen und Pflegekräfte) zu diskutieren, Schwierigkeiten der Versorgung aufzudecken und abschließend Handlungsempfehlungen für eine zukunftsfähige gerontodermatologische Versorgung abzuleiten. Material und Methoden Durchgeführt wurden qualitative Leitfaden-gestützte Interviews und Fokusgruppen mit Dermatologen (n = 5), Allgemeinmedizinern (n = 7), Pflegekräften (n = 7) und Pflegedienstleitungen (n = 2). Die Daten wurden inhaltsanalytisch ausgewertet. Ergebnisse Die Auswertung ergab insgesamt 344 Aussagen, die insgesamt 14 Hauptkategorien zugeordnet werden konnten. Die Ergebnisse zeigen, dass für die Versorgungsqualität von Menschen mit Hautkrankheiten, insbesondere Psoriasis, in Pflegeinrichtungen ein Verbesserungsbedarf besteht. Dieser zeigt sich sowohl auf ärztlicher als auch auf pflegerischer Ebene. Laut der Versorger (N = 21) kann dies insbesondere durch eine verstärkte digitale Versorgung, dermatologische Schulungen für Hausärzte und Pflegefachkräfte sowie engere Kooperationen zwischen den einzelnen Disziplinen adressiert werden. Schlussfolgerung Digitale Pflegekonsile, aber auch eine spezifische Leitlinie zur „Haut des alternden Menschen“ können von Nutzen sein, um die dermatologische Versorgungssituation im Pflegeheim zu verbessern und somit das Wohlbefinden der Betroffenen zu steigern.
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Affiliation(s)
- C C von Stuelpnagel
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - J Petersen
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - R Sommer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
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24
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Von Stumm M, Petersen J, Pausch J, Holst T, Gross TS, Sinn M, Reichenspurner H, Girdauskas E. Valvular Cardiomyopathy Persists Postoperatively in Aortic Regurgitation Patients: Data from cMRI-Based Cohort Study. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Von Stumm
- Deutsches Herzzentrum München, München, Deutschland
| | | | - J. Pausch
- Department of Cardiovascular Surgery, University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - T. Holst
- Universitäres Herzzentrum Hamburg GmbH Abteilung für Herzchirurgie und Gefäßchirurgie, Hamburg, Deutschland
| | - T.M. Sequeira Gross
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - M. Sinn
- Hamburg, Hamburg, Deutschland
| | | | - E. Girdauskas
- Department of Cardiovascular Surgery, University Heart Center, Augsburg, Deutschland
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25
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Stolfa P, Petersen J, Alassar Y, Reichenspurner H, Pecha S. Predictors of Rhythm Outcome in Patients Undergoing Concomitant AF Ablation: A Single-Center Experience of More than 1,000 Patients. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- P. Stolfa
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - J. Petersen
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - Y. Alassar
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - H. Reichenspurner
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
| | - S. Pecha
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herzchirurgie, Hamburg, Deutschland
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26
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Pecha S, Yildirim Y, Petersen J, Tönnis T, Kirchhof P, Reichenspurner H. Minimally Invasive Epicardial Left-Ventricular Lead Implantation and Simultaneous Left Atrial Appendage Clipping. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S. Pecha
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - Y. Yildirim
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - J. Petersen
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - T. Tönnis
- Kardiologie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - P. Kirchhof
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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27
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Yildirim Y, Yildirim S, Petersen J, Alassar Y, Sinning C, Conradi L, Reichenspurner H, Pecha S. Left-Atrial Strain Predicts Rhythm Outcome in Patients with Persistent Atrial Fibrillation Undergoing Left-Atrial Cryoablation during Minimally Invasive Endoscopic Mitral Valve Repair. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Y. Yildirim
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - S. Yildirim
- Kardiologie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - J. Petersen
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - Y. Alassar
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - C. Sinning
- Kardiologie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - L. Conradi
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - S. Pecha
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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28
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Petersen J, Meißner V, Wosgien K, Vettorazzi E, Blankenberg S, Conradi L, Girdauskas E, Reichenspurner H. Physical and Mental Recovery in Patients with Severe Aortic Valve Stenosis at Low-to-Intermediate Risk: SAVR versus TAVR. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - V. Meißner
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - K. Wosgien
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Deutschland
| | - E. Vettorazzi
- Department of Medical Biometry and Epidemiology, Hamburg, Deutschland
| | | | | | - E. Girdauskas
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Augsburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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29
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Holst T, Petersen J, Waschki B, Sinning C, Rybczynski M, Reichenspurner H, Girdauskas E. Evaluation of Exercise Capacity after Aortic Valve Surgery for Aortic Regurgitation in Nonelderly Patients: Repair versus Replacement. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T. Holst
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - J. Petersen
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - B. Waschki
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - C. Sinning
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - M. Rybczynski
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Kardiologie, Hamburg, Deutschland
| | - H. Reichenspurner
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - E. Girdauskas
- Klinik für herz- und thoraxchirurgie, Universitätsklinikum Augsburg, Augsburg, Deutschland
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30
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Backer V, Aanaes K, Hansen S, Petersen J, von Buchwald C. Global airways – a novel Standard Tests for Asthma, allergic Rhinitis, and chronic Rhinosinusitis (STARR-15). Rhinology 2021; 60:63-72. [DOI: 10.4193/rhin21.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Global airway disease, with symptoms from both upper and lower airways, is a challenging problem for clinicians. Our goal is to design one single standard test for the awareness of global airway diseases to be used in clinical setting. Material and Methods: During 2019, rhinologists and pulmonologists generated a pool of items based on literature, patient-reported outcome measures and clinical experience. The items were administered to 206 patients with known asthma, CRS, allergic rhinitis, or a combination thereof. The patients also completed the Asthma Control Questionnaire (ACQ-5) and the Sino-Nasal Outcome Test (SNOT-22). Using a mix of clinical knowledge and data-driven methods a global airways questionnaire was developed. Results: Mean ACQ score was highest in patients with all three, whereas the highest SNOT-22 score was observed in patients with CRS and asthma. After the development process, analysis of responses from 206 patients to 44 items on a new global airway’s questionnaire led to identification of 15 items that form the STARR-15 questionnaire with three underlying domains (an allergic rhinitis sub-factor, a CRS sub-factor and an asthma sub-factor). Conclusion: STARR-15 represents the first global airways questionnaire, to be used when examining patients with upper and lower airways symptoms. Future analyses are warranted to evaluate the clinical and psychometric properties of STARR-15.
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31
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Nardo-Marino A, Petersen J, Brewin JN, Birgens H, Williams TN, Kurtzhals JAL, Rees DC, Glenthøj A. Oxygen gradient ektacytometry does not predict pain in children with sickle cell anaemia. Br J Haematol 2021; 197:609-617. [PMID: 34859420 PMCID: PMC7613550 DOI: 10.1111/bjh.17975] [Citation(s) in RCA: 6] [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] [Received: 08/22/2021] [Accepted: 11/15/2021] [Indexed: 01/29/2023]
Abstract
The loss of red blood cell (RBC) deformability in sickle cell anaemia (SCA) is considered the primary factor responsible for episodes of acute pain and downstream progressive organ dysfunction. Oxygen gradient ektacytometry (Oxygenscan) is a recently commercialised functional assay that aims to describe the deformability of RBCs in SCA at differing oxygen tensions. So far, the Oxygenscan has been evaluated only by a small number of research groups and the validity and clinical value of Oxygenscan-derived biomarkers have not yet been fully established. In this study we examined RBC deformability measured with the Oxygenscan in 91 children with SCA at King's College Hospital in London. We found a significant correlation between Oxygenscan-derived biomarkers and well-recognised modifiers of disease severity in SCA: haemoglobin F and co-inherited α-thalassaemia. We failed, however, to find any independent predictive value of the Oxygenscan in the clinical outcome measure of pain, as well as other important parameters such as hydroxycarbamide treatment. Although the Oxygenscan remains an intriguing tool for basic research, our results question whether it provides any additional information in predicting the clinical course in children with SCA, beyond measuring known markers of disease severity.
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Affiliation(s)
- Amina Nardo-Marino
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.,Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Jesper Petersen
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - John N Brewin
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Henrik Birgens
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Thomas N Williams
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Medicine, Imperial College London, London, United Kingdom
| | - Jørgen A L Kurtzhals
- Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - David C Rees
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom.,School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Andreas Glenthøj
- Department of Haematology, Centre for Haemoglobinopathies, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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32
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Glenthøj A, Brieghel C, Nardo‐Marino A, Wijk R, Birgens H, Petersen J. Facilitating EMA binding test performance using fluorescent beads combined with next‐generation sequencing. eJHaem 2021; 2:716-728. [PMID: 35845192 PMCID: PMC9176113 DOI: 10.1002/jha2.277] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022]
Abstract
The eosin‐5′‐maleimide (EMA) binding test is widely used as diagnostic test for hereditary spherocytosis (HS), one of the most common haemolytic disorders in Caucasian populations. We recently described the advantages of replacing the use of healthy control blood samples with fluorescent beads in a modified EMA binding assay. In this study we further explore this novel approach. We performed targeted next‐generation sequencing, modified EMA binding test and osmotic gradient ektacytometry on consecutive individuals referred to our laboratory on the suspicion of HS. In total, 33 of 95 carried a (likely) pathogenic variant, and 24 had variants of uncertain significance (VUS). We identified a total 79 different (likely) pathogenic variants and VUS, including 43 novel mutations. Discarding VUS and recessive mutations in STPA1, we used the occurrence of (likely) pathogenic variants to generate a diagnostic threshold for our modified EMA binding test. Twenty‐one of 23 individuals with non‐SPTA1 (likely) pathogenic variants had EMA ≥ 43.6 AU, which was the optimal threshold in receiver operating characteristic (ROC) analysis. Accuracy was excellent at 93.4% and close to that of osmotic gradient ektacytometry (98.7%). In conclusion, we were able to simplify the EMA‐binding test by using rainbow beads as reference and (likely) pathogenic variants to define an accurate cut‐off value.
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Affiliation(s)
- Andreas Glenthøj
- Centre for Haemoglobinopathies Department of Haematology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Christian Brieghel
- Centre for Haemoglobinopathies Department of Haematology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Amina Nardo‐Marino
- Centre for Haemoglobinopathies Department of Haematology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Richard Wijk
- Central Diagnostic Laboratory‐Research University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Henrik Birgens
- Centre for Haemoglobinopathies Department of Haematology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Jesper Petersen
- Centre for Haemoglobinopathies Department of Haematology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
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33
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Reid A, Klein A, Lin D, Abbate A, Luis SA, Petersen J, Portman M, Winnowski D, Malinowski A, Marden L, Paolini JF, Martin D. RESONANCE Registry: rationale and design of the retrospective and prospective longitudinal, observational registry in pediatric and adult patients with recurrent pericarditis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3173] [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
Annually in the United States (US), an estimated 80–90,000 patients are diagnosed with acute pericarditis and 15–30% experience recurrent pericarditis (RP), resulting in increased morbidity and reduced health-related quality of life (HRQoL). Treatment options include non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine. Corticosteroids (CS) are often added to the treatment plan in RP despite CS-associated adverse events and inherent potentiation of recurrence with long-term treatment. A recent Phase 3 clinical trial RHAPSODY (NCT03737110) demonstrated efficacy and safety of rilonacept, an interleukin-1 α and β cytokine trap, in patients with RP. RHAPSODY data helped support FDA approval of the first therapy for RP. With the emergence of this targeted therapy, there is increased interest to learn more about this disease with the goal to better inform treatment and management decisions and improve long-term outcomes.
Purpose
RESONANCE Registry aims to evaluate the natural history of RP by collecting retrospective and prospective, longitudinal physician- and patient-reported outcomes data in real-world clinical practice across the US.
Methods
RP patients with active disease (recurrence within 3 years) will have both retrospective and prospective data collected (Figure 1) for as long as their RP is managed up to 5 years. For patients with inactive disease (no recurrence within 3 years), data collection will be retrospective (Figure 2). Up to 500 patients in the US are planned for enrollment at pediatric and adult medical centers, with the potential for expansion to European sites. Additionally, patients will be recruited through a novel, internet-based technology platform and screened for eligibility at a “decentralized” trial site. The registry will include variables obtained from health records, including baseline characteristics and medical history, as well as patient reported outcome (PRO) measures collected every 3 months. The RESONANCE protocol is designed to include a broad population of pediatric and adult patients, regardless of etiology or treatment course, including patients treated with rilonacept. Data will be analyzed to understand disease heterogeneity, variability in treatment and management, and impact on HRQoL. The protocol and Case Report Forms (CRFs) were developed in collaboration with physicians, patients, and patient advocates.
Conclusions
Registries utilize real-world data to fill knowledge gaps in the management of less common diseases such as RP. The RESONANCE Registry is the first RP registry designed to collect data across a broad range of patients regardless of treatment. The registry will also serve as a connection point for physicians to further educate and empower patients with information about their disease. In addition, PRO data may enable greater insights into the understanding of the burden of RP from the patient's perspective.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Kiniksa Pharmaceuticals
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Affiliation(s)
- A Reid
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - A Klein
- Cleveland Clinic, Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Cleveland, United States of America
| | - D Lin
- Abbott Northwestern Hospital, Minneapolis Heart Institute, Minneapolis, United States of America
| | - A Abbate
- Virginia Commonwealth University, VCU Pauley Heart Center, Richmond, United States of America
| | - S A Luis
- Mayo Clinic, Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Rochester, United States of America
| | - J Petersen
- Swedish Medical Center, Seattle, United States of America
| | - M Portman
- Seattle Children's Hospital, Seattle, United States of America
| | - D Winnowski
- Pericarditis Alliance, Albany, United States of America
| | - A Malinowski
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - L Marden
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - J F Paolini
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
| | - D Martin
- Kiniksa Pharmaceuticals Corp., Lexington, United States of America
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Sprenger J, Petersen J, Neumann N, Reichenspurner H, Russ D, Detter C, Schlaefer A. Tracking heart surface features to determine myocardial contrast agent enrichment. Current Directions in Biomedical Engineering 2021. [DOI: 10.1515/cdbme-2021-1012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Fluorescent cardiac imaging can be applied for intraoperative quality control after a coronary bypass grafting surgery to ensure the myocardial perfusion by evaluating the increasing contrast agent enrichment in the heart. The motion due to the beating heart impedes the interpretation of the contrast agent enrichment in the vessels and leads to noisy enrichment curves. We propose tracking of the heart surface features to compensate for the motion of the beating heart and thereby improve the analysis of the contrast agent enrichment. Furthermore, we propose a vessel segmentation pipeline for a local evaluation of contrast agent enrichment directly in the vessels.
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Affiliation(s)
- J. Sprenger
- Institute of Medical Technology and Intelligent Systems, Hamburg University of Technology, Hamburg , Germany
| | - J. Petersen
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg , Germany
| | - N. Neumann
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Hamburg , Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg , Germany
| | - D. Russ
- Institut für Lasertechnologien in der Medizin und Meßtechnik, University of Ulm, Ulm , Germany
| | - C. Detter
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg , Germany
| | - A. Schlaefer
- Institute of Medical Technology and Intelligent Systems, Hamburg University of Technology, Hamburg , Germany
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Stangerup I, Petersen J, Glenthøj A. Hb A 2-Calderdale [δ2(NA2)His→Asn; HBD: c.7C>A] and Misdiagnosis of Type 2 Diabetes Mellitus Due to Interference with Hb A 1c When Using Cation Exchange High Performance Liquid Chromatography: A Case Report. Hemoglobin 2021; 45:207-209. [PMID: 34309459 DOI: 10.1080/03630269.2021.1954945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Hb A2-Calderdale variant [δ2(NA2)His→Asn, HBD: c.7C>A] was described as a novel variant in 2014. However, a high performance liquid chromatography (HPLC) peak was never identified indicating that this fraction could be 'hiding' somewhere else in the chromatogram. In this case report, we present evidence that the physiochemical properties of Hb A2-Calderdale resemble those of Hb A1c, resulting in a coelution in variant mode on the Tosoh G8 but not the Tosoh G11. This coelution results in an overestimation of Hb A1c and can potentially cause misdiagnosis of type 2 diabetes mellitus (T2DM).
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Affiliation(s)
- Ida Stangerup
- Department of Clinical Biochemistry, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jesper Petersen
- Department of Hematology, Danish Center for Hemoglobinopathies, Copenhagen, Denmark
| | - Andreas Glenthøj
- Department of Hematology, Danish Center for Hemoglobinopathies, Copenhagen, Denmark
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Augustin M, Garbe C, Hagenström K, Petersen J, Pereira MP, Ständer S. Prevalence, incidence and presence of comorbidities in patients with prurigo and pruritus in Germany: A population-based claims data analysis. J Eur Acad Dermatol Venereol 2021; 35:2270-2276. [PMID: 34192369 DOI: 10.1111/jdv.17485] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND There are currently no published population-based data on prurigo and pruritus epidemiology in Germany. OBJECTIVES We present the prevalence, incidence and comorbidity frequency of prurigo and pruritus in Germany. METHODS This was a retrospective healthcare research study based on anonymized routine data from the German health insurance company DAK-Gesundheit. Evaluations were carried out for 2 006 003 adults who were insured as of 31 December 2010. Prurigo and pruritus diagnoses were based on International Classification of Diseases, Tenth Revision, German Modification (ICD-10-GM) codes. RESULTS Prevalence was determined to be 0.21% (adjusted for sex and age 0.19%) for prurigo and 2.21% (adjusted 2.14%) for pruritus in 2010. The adjusted rates extrapolated to the total German population in 2010 show that 130 685 adults would have received a prurigo diagnosis and 1 461 024 a diagnosis of pruritus. In 2011, incidence of new prurigo and pruritus cases was 0.13% (adjusted 0.12%, extrapolated 77 263 cases) and 1.51% (adjusted 1.46%, extrapolated 978 885), respectively. Adults with prurigo suffered most frequently from hypertension (35.16%), hyperlipidaemia (24.95%) and depression (21.97%); all were reported more frequently in patients with prurigo compared with the general population (P < 0.001). Similarly, adults with pruritus suffered most frequently from hypertension (31.28%), hyperlipidaemia (23.52%) and depression (18.91%) compared with patients without pruritus (P < 0.001). CONCLUSIONS Our data show that prurigo is a relatively rare but significant disease and that pruritus is frequent and very variable in appearance, and both have a high comorbidity burden.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Garbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Hagenström
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - J Petersen
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M P Pereira
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
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Pacheco C, AlBadri A, Anderson R, Petersen J, Marpuri S, Cook-Wiens G, Pepine C, Mancini G, Merz CB, Wei J. Coronary atheroma burden predicts flow reserve in women with ischemia and nonobstructive coronary artery disease. Am Heart J Plus 2021; 6:100027. [PMID: 38560556 PMCID: PMC10976284 DOI: 10.1016/j.ahjo.2021.100027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 04/04/2024]
Abstract
Background Women with signs and symptoms of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD) with reduced coronary flow reserve (CFR), and compensatory coronary remodeling. Angiographic measurements of epicardial coronary anatomy (AMCA) may improve understanding of relations between CFR and atherosclerosis. We investigated AMCA and CFR in women evaluated for CMD. Methods Women consecutively enrolled in the Women's Ischemia Syndrome Evaluation CVD Continuation (NCT00832702) were included. All underwent clinically indicated coronary function testing measuring CFR. AMCA included coronary angiographic atheroma burden (AB), percent diameter stenosis (PDS), and tapering reference diameter Z score (RDZ), derived for the left main and left anterior descending coronary epicardial segments. Results The 51 women were aged 55.8 ± 10.8 years, with 19(38%) hypertensive, 10(20.4%) hyperlipidemic, 4(7.8%) diabetic, 13(25.5%) prior smokers, and mean CFR 3.0 ± 0.8. Both average and maximal AB negatively correlated with CFR (r = -0.30 and -0.31, with p = 0.04 for both), as did average and maximal PDS (r = -0.38 and -0.41 with p = 0.009 and p = 0.005) while average RDZ was directly related (r = 0.37, p = 0.01). Multiple linear regression analyses revealed that both average PDS (Units of CFR -0.03 95% CI: -0.06, -0.002, p = 0.023) and maximal PDS (-0.04 95% CI -0.07, -0.01, p = 0.007) were negatively related to CFR. Conclusions Measures of epicardial coronary atheroma burden, size and tapering are related to CFR, suggesting that atherosclerotic anatomical findings may contribute to or be a consequence of CMD, with further work is needed to investigate these measures as treatment targets.
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Affiliation(s)
- C. Pacheco
- Hôpital Pierre-Boucher, Centre Hospitalier de l'Université de Montréal, Université de Montreal, QC, Canada
| | - A. AlBadri
- Emory University, Atlanta, GA, United States of America
| | - R.D. Anderson
- University of Florida, Gainesville, FL, United States of America
| | - J. Petersen
- University of Florida, Gainesville, FL, United States of America
| | - S. Marpuri
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - G. Cook-Wiens
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - C.J. Pepine
- University of Florida, Gainesville, FL, United States of America
| | | | - C.N. Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - J. Wei
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
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Nottmeier C, Liao N, Simon A, Decker MG, Luther J, Schweizer M, Yorgan T, Kaucka M, Bockamp E, Kahl-Nieke B, Amling M, Schinke T, Petersen J, Koehne T. Wnt1 Promotes Cementum and Alveolar Bone Growth in a Time-Dependent Manner. J Dent Res 2021; 100:1501-1509. [PMID: 34009051 PMCID: PMC8649456 DOI: 10.1177/00220345211012386] [Citation(s) in RCA: 6] [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: 11/24/2022] Open
Abstract
The WNT/β-catenin signaling pathway plays a central role in the biology
of the periodontium, yet the function of specific extracellular WNT
ligands remains poorly understood. By using a
Wnt1-inducible transgenic mouse model targeting
Col1a1-expressing alveolar osteoblasts,
odontoblasts, and cementoblasts, we demonstrate that the WNT ligand
WNT1 is a strong promoter of cementum and alveolar bone formation in
vivo. We induced Wnt1 expression for 1, 3, or 9 wk in
Wnt1Tg mice and analyzed them at the age of 6 wk and 12 wk.
Micro–computed tomography (CT) analyses of the mandibles revealed a
1.8-fold increased bone volume after 1 and 3 wk of
Wnt1 expression and a 3-fold increased bone
volume after 9 wk of Wnt1 expression compared to
controls. In addition, the alveolar ridges were higher in Wnt1Tg mice
as compared to controls. Nondecalcified histology demonstrated
increased acellular cementum thickness and cellular cementum volume
after 3 and 9 wk of Wnt1 expression. However, 9 wk of
Wnt1 expression was also associated with
periodontal breakdown and ectopic mineralization of the pulp. The
composition of this ectopic matrix was comparable to those of cellular
cementum as demonstrated by quantitative backscattered electron
imaging and immunohistochemistry for noncollagenous proteins. Our
analyses of 52-wk-old mice after 9 wk of Wnt1
expression revealed that Wnt1 expression affects
mandibular bone and growing incisors but not molar teeth, indicating
that Wnt1 influences only growing tissues. To further
investigate the effect of Wnt1 on cementoblasts, we
stably transfected the cementoblast cell line (OCCM-30) with a vector
expressing Wnt1-HA and performed proliferation as
well as differentiation experiments. These experiments demonstrated
that Wnt1 promotes proliferation but not
differentiation of cementoblasts. Taken together, our findings
identify, for the first time, Wnt1 as a critical
regulator of alveolar bone and cementum formation, as well as provide
important insights for harnessing the WNT signal pathway in
regenerative dentistry.
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Affiliation(s)
- C Nottmeier
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany.,Department of Orthodontics, University of Leipzig Medical Center, Leipzig, Germany
| | - N Liao
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany.,Department of Orthodontics, College of Stomatology, North China University of Science and Technology, Tangshan, China
| | - A Simon
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany
| | - M G Decker
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany
| | - J Luther
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - M Schweizer
- ZMNH, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Yorgan
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - M Kaucka
- Max Planck Institute for Evolutionary Biology, Plön, Germany
| | - E Bockamp
- Institute for Translational Immunology and Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - B Kahl-Nieke
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany
| | - M Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - T Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - J Petersen
- Department of Orthodontics, University of Leipzig Medical Center, Leipzig, Germany.,Department of Osteology and Biomechanics, University Medical Center Hamburg, Hamburg, Germany
| | - T Koehne
- Department of Orthodontics, University Medical Center Hamburg, Hamburg, Germany.,Department of Orthodontics, University of Leipzig Medical Center, Leipzig, Germany
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Petersen J, Hutchinson C, Zinser G, Holtsche M, Thode M, Kahle B. Vaskuläre Malformationen – Anamnese und Klinik als wichtiges Werkzeug auf dem Weg zur Diagnose. Phlebologie 2021. [DOI: 10.1055/a-1391-9786] [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: 10/21/2022]
Abstract
ZusammenfassungVaskuläre Malformationen sind eine heterogene Gruppe von embryonalen Gefäßfehlbildungen, welche als venöse, arterielle, lymphatische oder kombinierte Anomalien auftreten können 1
2
3
4. Typischerweise sind diese bereits bei Geburt vorhanden. VMF sind äußerst variabel im klinischen Erscheinungsbild, je nachdem welche Gefäße betroffen sind.Bei vorwiegend lymphatischen Malformationen steht die Schwellung der betroffenen Körperregion im Vordergrund 5. Kapilläre Malformationen treten in der Regel als Naevus flammeus in Erscheinung. Die Erweiterung von Kapillargefäßen führt zu einer permanenten lividen Rötung im Hautniveau des betroffenen Areals.Dieser Fall beschreibt einen Patienten mit einer ausgedehnten kombinierten venös-kapillären und lymphatischen Malformation mit Betonung des Gesichts, des Rückens und der unteren Extremität. Aufgrund der auffälligen Schwellung der Unterlippe wurde er mit der Verdachtsdiagnose eines Melkersson-Rosenthal-Syndroms in unserer Ambulanz vorstellig.
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Affiliation(s)
- J. Petersen
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - C. Hutchinson
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - G. Zinser
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - M. Holtsche
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - M. Thode
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
| | - Birgit Kahle
- Klinik für Dermatologie, Venerologie und Allergologie, UKSH Campus Lübeck
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Handlos Grauslund J, Holmström MO, Jørgensen NG, Klausen U, Weis-Banke SE, El Fassi D, Schöllkopf C, Clausen MB, Gjerdrum LMR, Breinholt MF, Kjeldsen JW, Hansen M, Koschmieder S, Chatain N, Novotny GW, Petersen J, Kjær L, Skov V, Met Ö, Svane IM, Hasselbalch HC, Andersen MH. Therapeutic Cancer Vaccination With a Peptide Derived From the Calreticulin Exon 9 Mutations Induces Strong Cellular Immune Responses in Patients With CALR-Mutant Chronic Myeloproliferative Neoplasms. Front Oncol 2021; 11:637420. [PMID: 33718228 PMCID: PMC7952976 DOI: 10.3389/fonc.2021.637420] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/18/2021] [Indexed: 12/12/2022] Open
Abstract
Background The calreticulin (CALR) exon 9 mutations that are identified in 20% of patients with Philadelphia chromosome negative chronic myeloproliferative neoplasms (MPN) generate immunogenic antigens. Thus, therapeutic cancer vaccination against mutant CALR could be a new treatment modality in CALR-mutant MPN. Methods The safety and efficacy of vaccination with the peptide CALRLong36 derived from the CALR exon 9 mutations was tested in a phase I clinical vaccination trial with montanide as adjuvant. Ten patients with CALRmut MPN were included in the trial and received 15 vaccines over the course of one year. The primary end point was evaluation of safety and toxicity of the vaccine. Secondary endpoint was assessment of the immune response to the vaccination epitope (www.clinicaltrials.gov identifier NCT03566446). Results Patients had a median age of 59.5 years and a median disease duration of 6.5 years. All patients received the intended 15 vaccines, and the vaccines were deemed safe and tolerable as only two grade three AE were detected, and none of these were considered to be related to the vaccine. A decline in platelet counts relative to the platelets counts at baseline was detected during the first 100 days, however this did not translate into neither a clinical nor a molecular response in any of the patients. Immunomonitoring revealed that four of 10 patients had an in vitro interferon (IFN)-γ ELISPOT response to the CALRLong36 peptide at baseline, and four additional patients displayed a response in ELISPOT upon receiving three or more vaccines. The amplitude of the immune response increased during the entire vaccination schedule for patients with essential thrombocythemia. In contrast, the immune response in patients with primary myelofibrosis did not increase after three vaccines. Conclusion Therapeutic cancer vaccination with peptide vaccines derived from mutant CALR with montanide as an adjuvant, is safe and tolerable. The vaccines did not induce any clinical responses. However, the majority of patients displayed a marked T-cell response to the vaccine upon completion of the trial. This suggests that vaccines directed against mutant CALR may be used with other cancer therapeutic modalities to enhance the anti-tumor immune response.
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Affiliation(s)
- Jacob Handlos Grauslund
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Morten Orebo Holmström
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Nicolai Grønne Jørgensen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Uffe Klausen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Stine Emilie Weis-Banke
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Daniel El Fassi
- Department of Hematology, Copenhagen University Hospital, Herlev, Denmark.,Department of Medicine, Copenhagen University, Copenhagen, Denmark
| | - Claudia Schöllkopf
- Department of Hematology, Copenhagen University Hospital, Herlev, Denmark
| | - Mette Borg Clausen
- Department of Hematology, Copenhagen University Hospital, Herlev, Denmark
| | | | | | - Julie Westerlin Kjeldsen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Morten Hansen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Steffen Koschmieder
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Nicolas Chatain
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Guy Wayne Novotny
- Department of Hematology, Copenhagen University Hospital, Herlev, Denmark
| | - Jesper Petersen
- Department of Hematology, Copenhagen University Hospital, Herlev, Denmark
| | - Lasse Kjær
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Vibe Skov
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Özcan Met
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark.,Institute for Immunology and Microbiology, Copenhagen University, Copenhagen, Denmark
| | - Inge Marie Svane
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | | | - Mads Hald Andersen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev, Denmark.,Institute for Immunology and Microbiology, Copenhagen University, Copenhagen, Denmark
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Glenthøj A, Samson M, Toft N, Diness BR, Askj R N, Vojdeman FJ, Birgens H, Sørensen MB, Petersen J. [The Danish screening programme for haemoglobinopathies]. Ugeskr Laeger 2021; 183:V07200536. [PMID: 33491643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The prevalence of people in Denmark descending from areas with a high prevalence of haemoglobinopathies is approximately one tenth and increasing. Since 1995, the Danish Health Authority has recommended haemoglobinopathy screening of pregnant women with ethnic roots outside Northern Europe. Partners of pregnant haemoglobinopathy carriers are also tested. Carrier state in both parents leads to genetic counselling, and prenatal diagnostics of the foetus (chorionic villus biopsy or amniocentesis) is offered, which can lead to abortion and/or preimplantation genetic screening for future pregnancies, as discussed in this review.
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Petersen J, Yildirim Y, Tönnis T, Reichenspurner H, Pecha S. Transvenous Lead Extraction in Patients with Grownup Congenital Heart Disease. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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43
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Petersen J, Grammatika-Pavlidou N, Bork NI, Reichenspurner H, Nikolaev VO, Girdauskas E, Molina CE. Differential β-Adrenergic Signaling and Camp Dynamics in Left and Right Ventricles from Patients with Valve Disease. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Böning H, Petersen J, Sinning C, Yildirim S, Yildirim Y, Reichenspurner H, Pecha S. Echocardiographic Evaluation of Different LAA Closure Techniques during Concomitant Surgical AF Ablation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Petersen J, Castro L, Bengaard AK, Pecha S, Steenpass A, Meyer C, Reichenspurner H, Jespersen T, Eschenhagen T, Christ T. IK,ACh Does Not Mediate Negative Inotropy and Antiarrhythmic Action of Muscarinic Receptor Activation in Human Atrium. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Petersen J, Gebauer A, Böning H, Chokair F, Girdauskas E, Conradi L, Reichenspurner H, Pecha S. Rhythm Outcome after Cryoablation and LAA Clipping during Minimally Invasive Mitral Valve Surgery Using 3D Endoscopy. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pecha S, Petersen J, Hakmi S, Yildirim Y, Tönnis T, Reichenspurner H. Safety and Efficacy of Transvenous Laser Lead Extraction in Octogenarians. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Holst T, Petersen J, Waschki B, Rybczynski M, Reichenspurner H, Girdauskas E. Patient-Reported Outcomes after Aortic Valve Surgery in Nonelderly Patients. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yildirim Y, Petersen J, Tönnis T, Reichenspurner H, Pecha S. Hybrid Transvenous Lead Extraction during Valvular Endocarditis Surgery. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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