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Nikoghosyan A, Lambert J. Low Consciousness in a Patient with Pancolitis. J Belg Soc Radiol 2024; 108:17. [PMID: 38371363 PMCID: PMC10870939 DOI: 10.5334/jbsr.3265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Teaching point: Lentiform fork sign is a rare finding on MRI of the brain, found in patients with metabolic acidosis, in a critically ill patient with low consciousness and renal failure, this sign can correspond to uremic encephalopathy.
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Affiliation(s)
- Ani Nikoghosyan
- Department Radiology, UZ Leuven, campus Gasthuisberg, Leuven, Belgium Herestraat 49/B, 3000 Leuven
| | - Julie Lambert
- Department Radiology, UZ Leuven, Campus Gasthuisberg, Leuven, Belgium Herestraat 49/B, 3000 Leuven
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McGettrick P, Tinago W, O'Brien J, Miles S, Lawler L, Garcia-Leon A, Mahon N, Lambert J, Sheehan G, Landay A, Sabin CA, Cotter AG, Mallon PWG. Distinct Inflammatory Phenotypes are associated with subclinical and clinical Cardiovascular disease in People living with HIV. J Infect Dis 2024:jiae007. [PMID: 38214571 DOI: 10.1093/infdis/jiae007] [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] [Received: 08/15/2023] [Revised: 12/28/2023] [Accepted: 01/05/2023] [Indexed: 01/13/2024] Open
Abstract
Despite inflammation being implicated in cardiovascular disease (CVD) in people with HIV (PWH), considerable heterogeneity within populations of PWH exists. Stratifying CVD risk based on inflammatory phenotype could play an important role. Using principal component analyses and unsupervised hierarchical clustering, we examined 38 biomarkers to identify inflammatory phenotypes in two independent cohorts of PWH. We identified three distinct inflammatory clusters present in both cohorts that associated with altered risk of both subclinical CVD (cohort 1) and prevalent clinical CVD (cohort 2) after adjusting for CVD risk factors. These data support precision medicine approaches to enhance CVD risk assessment in PWH.
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Affiliation(s)
- P McGettrick
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - W Tinago
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - J O'Brien
- Department of Radiology, University Hospital Limerick, Ireland
| | - S Miles
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - L Lawler
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Garcia-Leon
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - N Mahon
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - J Lambert
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - G Sheehan
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Landay
- Department of Internal Medicine, Rush University Medical Center, Chicago, United States of America
| | - C A Sabin
- Institute for Global Health, University College London, London, United Kingdom
| | - A G Cotter
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - P W G Mallon
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
- Department of Infectious Diseases, St. Vincent's University Hospital, Dublin, Ireland
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Demeuleneere A, Lambert J, Demeestere J, Lemmens R, Fourneau I, Houthoofd S, Schauwvlieghe PP, Jacob J, Cassiman C. A rare presentation of a common carotid artery occlusion. GMS Ophthalmol Cases 2023; 13:Doc20. [PMID: 38111470 PMCID: PMC10726582 DOI: 10.3205/oc000228] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Background A common carotid artery occlusion (CCAO) is very rare and the clinical features of CCAO have rarely been described. Since the blood supply of the eye and orbit is derived from the internal carotid artery, a CCAO may present with various ophthalmological symptoms, ranging from incidental findings to complete visual loss but also other neuro-ophthalmological abnormalities. Case report A 61-year-old woman presented with acute monocular vision loss and an elevation deficit of the right eye. Fluorescein angiography showed delayed filling of both the retinal and choroidal vasculature, without occlusion/embolisms of the retinal arteries. Vascular imaging showed a right CCAO. Conclusion CCAO has a variable presentation. In patients with acute unilateral visual loss a CCAO should be considered, especially when ocular motility deficits are present. Fluorescein angiography examination can aid in the localization and diagnosis of the vascular insult. Urgent referral for a systemic work-up is essential.
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Affiliation(s)
| | - Julie Lambert
- Radiology Department, University Hospitals Leuven, Belgium
| | | | - Robin Lemmens
- Neurology Department, University Hospitals Leuven, Belgium
| | - Inge Fourneau
- Vascular Surgery Department, University Hospitals Leuven, Belgium
| | | | | | - Julie Jacob
- Ophthalmology Department, University Hospitals Leuven, Belgium
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Melki GJ, Demeestere J, Laenen A, Bonne L, Claus E, Lambert J, Buyck PJ, Peluso J, Demaerel P, Lemmens R, Maleux G. Immediate and 90-Day Clinical Outcome of Patients with Acute Stroke Treated with the NeVa-Vesalio Mechanical Thrombectomy Device: A Retrospective Case Series. World Neurosurg 2023; 179:e212-e221. [PMID: 37611801 DOI: 10.1016/j.wneu.2023.08.053] [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: 04/13/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE The NeVa stent retriever is a newly designed mechanical thrombectomy device for the treatment of acute ischemic stroke caused by large vessel occlusion. We investigate the procedural characteristics and patients' clinical outcomes at discharge and at 90 days of follow-up. METHODS We retrospectively reviewed a cohort of 75 patients (median age, 74 years) treated with the NeVa device for acute large vessel occlusion stroke. Per pass modified Treatment in Cerebral Infarction (mTICI) scores, procedural complications, and clinical outcome parameters including the National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS) score, and mortality were analyzed, based on patients' electronic medical records. RESULTS Complete first pass effect was observed in 24 patients (32%). Vasospasm, repeated re-thrombosis, failure to advance the NeVa device through the microcatheter, and symptomatic intracranial hemorrhage were observed in 2, 1, 1, and 2 patient(s) respectively. The rate of complete (mTICI 2c-3) reperfusion was achieved in 61 patients (81.33%), with a median number of 2 passes (1-3). Median NIHSS score on admission, after 24 hours, and after 5-10 days or at discharge was 19 (15-23), 11 (4-19), and 3 (2-13.5), respectively. The number of patients with a functional mRS score (0-2) at 90 days follow-up was 29 (39%). CONCLUSIONS Endovascular stroke management with use of the NeVa-Vesalio stent retriever may be associated with a 90-day functional mRS score in nearly 40% of treated patients.
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Affiliation(s)
| | - Jelle Demeestere
- Department of Neurology, University Hospitals KU Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Department of Public Health and Primary Care, Leuven Biostatistics and Statistical Bioinformatics Centre, Leuven, Belgium
| | - Lawrence Bonne
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Eveline Claus
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Julie Lambert
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Pieter-Jan Buyck
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Jo Peluso
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Philippe Demaerel
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Robin Lemmens
- Department of Neurology, University Hospitals KU Leuven, Leuven, Belgium
| | - Geert Maleux
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium.
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Mardones ML, Lambert J, Wiedenmann J, Davies TW, Levy O, D'Angelo C. Artificial light at night (ALAN) disrupts behavioural patterns of reef corals. Mar Pollut Bull 2023; 194:115365. [PMID: 37579595 DOI: 10.1016/j.marpolbul.2023.115365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/16/2023]
Abstract
Increasing levels of Artificial Light At Night (ALAN) alter the natural diel cycles of organisms at global scale. ALAN constitutes a potential threat to the light-dependent functioning of symbiotic scleractinian corals, the habit-founders of warm, shallow water reefs. Here, we show that ALAN disrupts the natural diel tentacle expansion and contraction behaviour, a key mechanism for prey capture and nutrient acquisition in corals. We exposed four symbiotic scleractinian coral species to different ALAN treatments (0.4-2.5 μmol quanta m-2 s-1). Exposure to ALAN levels of 1.2 μmol quanta m-2 s-1 and above altered the normal tentacle expansion response in diurnal species (Stylophora pistillata and Duncanopsammia axifuga). The tentacle expansion pattern of nocturnal species (Montastraea cavernosa and Lobophyllia hemprichii) was less affected, which may indicate a greater capacity to tolerate ALAN exposure. The results of this work suggest that ALAN has the potential to affect nutrient acquisition mechanisms of symbiotic corals which may in turn result in changes in the coral community structure in shallow water reefs in ALAN-exposed areas.
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Affiliation(s)
- M L Mardones
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK
| | - J Lambert
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK
| | - J Wiedenmann
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK
| | - T W Davies
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, UK
| | - O Levy
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Israel; Israel The H. Steinitz Marine Biology Laboratory, The Interuniversity Institute for Marine Sciences of Eilat, Israel
| | - C D'Angelo
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK.
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Gonzalez-Cantero A, Boehncke WH, De Sutter J, Zamorano JL, Lambert J, Puig L. Statins and psoriasis: Position statement by the Psoriasis Task Force of the European Academy of Dermatology and Venerology. J Eur Acad Dermatol Venereol 2023; 37:1697-1705. [PMID: 37259959 DOI: 10.1111/jdv.19191] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Psoriasis is associated with an increased mortality risk, with cardiovascular disease being the leading excess cause (in a dose-response manner with psoriasis severity). Statins have demonstrated a reduction in all-cause mortality with no excess of adverse events among the general population. The underuse of interventions in cardiovascular prevention, such as statins, for patients with psoriasis may be the result of an insufficient evaluation. OBJECTIVES To provide the dermatologist with a tool for systematizing the treatment of dyslipidemia in psoriasis, which generally escapes the scope of dermatological practice, and to facilitate decision-making about the referral and treatment of patients. METHODS The Psoriasis Task Force of the European Academy of Dermatology and Venereology performed this two-phase study to achieve a consensus and create recommendations on the use of statin therapy in patients with psoriasis. The first phase included a systematic review to identify a list of outline concepts and recommendations according to guidelines. The second phase consisted in a two-round Delphi study to evaluate those recommendations not literally taken from guidelines. RESULTS A list of 47 concepts and recommendations to be followed by dermatologists involved in the treatment of patients with moderate-severe psoriasis was created. It included six main concepts about cardiovascular risk and psoriasis, six items related with the role of low-density lipoprotein cholesterol (LDL-c) and the benefits of statin treatment in psoriasis patients, eight recommendations about how cardiovascular risk should be assessed, three on the role of non-invasive cardiovascular imaging, three on LDL-c thresholds, eight key points related to statin prescription, 10 on statin treatment follow-up and three on patient referral to another specialist. CONCLUSIONS The application of this position statement (close final list of concepts and recommendations) will help dermatologists to manage dyslipidemia and help psoriasis patients to reduce their cardiovascular risk.
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Affiliation(s)
- A Gonzalez-Cantero
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - W H Boehncke
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - J De Sutter
- Department of Cardiology, AZ Maria Middelares, Ghent, Belgium
| | - J L Zamorano
- Departamento de Cardiología, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - J Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Hammoudi N, Lehmann-Che J, Lambert J, Amoyel M, Maggiori L, Salfati D, Tran Minh ML, Baudry C, Asesio N, Poirot B, Lourenco N, Corte H, Allez M, Aparicio T, Gornet JM. Prognosis and molecular characteristics of IBD-associated colorectal cancer: Experience from a French tertiary-care center. Dig Liver Dis 2023; 55:1280-1287. [PMID: 36872200 DOI: 10.1016/j.dld.2023.02.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Little is known about the prognosis of colorectal cancer associated with inflammatory bowel disease (CRC-IBD) in a real-world cohort in France. METHODS We conducted a retrospective observational study including all patients presenting CRC-IBD in a French tertiary center. RESULTS Among 6510 patients, the rate of CRC was 0.8% with a median delay of 19.5 years after IBD diagnosis (median age 46 years, ulcerative colitis 59%, initially localized tumor 69%). There was a previous exposure to immunosuppressants (IS) in 57% and anti-TNF in 29% of the cases. A RAS mutation was observed in only 13% of metastatic patients. OS of the whole cohort was 45 months. OS and PFS of synchronous metastatic patients was 20.4 months and 8.5 months respectively. Among the patients with localized tumor those previously exposed to IS had a better PFS (39 months vs 23 months; p = 0.05) and OS (74 vs 44 months; p = 0.03). The IBD relapse rate was 4%. No unexpected chemotherapy side-effect was observed CONCLUSIONS: OS of CRC-IBD is poor in metastatic patients although IBD is not associated with under-exposure or increased toxicity to chemotherapy. Previous IS exposure may be associated with a better prognosis.
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Affiliation(s)
- N Hammoudi
- Université de Paris, INSERM U1160, EMiLy, Institut de Recherche Saint-Louis, Paris, France; Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - J Lehmann-Che
- Department of molecular oncology, Hôpital Saint-Louis, Université Paris Cité, Paris, France
| | - J Lambert
- Department of biostatistics, Hôpital Saint-Louis, APHP, Paris University, Paris, France. Hôpital Saint-Louis, Paris - France
| | - M Amoyel
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - L Maggiori
- Department of digestive surgery, Hôpital Saint-Louis, APHP, Université Paris Cité, Paris, France
| | - D Salfati
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - M L Tran Minh
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - C Baudry
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - N Asesio
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - B Poirot
- Department of molecular oncology, Hôpital Saint-Louis, Université Paris Cité, Paris, France
| | - N Lourenco
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - H Corte
- Department of digestive surgery, Hôpital Saint-Louis, APHP, Université Paris Cité, Paris, France
| | - M Allez
- Université de Paris, INSERM U1160, EMiLy, Institut de Recherche Saint-Louis, Paris, France; Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - T Aparicio
- Université de Paris, INSERM U1160, EMiLy, Institut de Recherche Saint-Louis, Paris, France; Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - J M Gornet
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France.
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Gousset S, Torta DM, Mouraux A, Lambert J, van den Broeke EN. Pinprick-induced gamma-band oscillations are not a useful electrophysiological marker of pinprick hypersensitivity in humans. Clin Neurophysiol 2023; 153:102-110. [PMID: 37473484 DOI: 10.1016/j.clinph.2023.06.018] [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: 02/25/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE This study aimed to investigate scalp gamma-band oscillations (GBOs) induced by mechanical stimuli activating skin nociceptors before and after the induction of mechanical hypersensitivity using high-frequency electrical stimulation (HFS) of the skin. METHODS In twenty healthy volunteers, we recorded the electroencephalogram during robot-controlled mechanical pinprick stimulation (512 mN) applied at the right ventral forearm before and after HFS. RESULTS HFS induced a significant increase in mechanical pinprick sensitivity, but this increased pinprick sensitivity was, at the group level, not accompanied by a significant increase in GBOs. Visual inspection of the individual data revealed that possible GBOs were present in eight out of twenty participants (40%) and the frequency of these GBOs varied substantially across participants. CONCLUSIONS Based on the low number of participants showing GBOs we question the (clinical) utility of mechanically-induced GBOs as an electrophysiological marker of pinprick hypersensitivity in humans. SIGNIFICANCE Mechanical pinprick-induced scalp GBOs are not useful for evaluating mechanical pinprick hypersensitivity in humans.
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Affiliation(s)
- S Gousset
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - D M Torta
- Health Psychology Group, University of Leuven (KUL), Leuven, Belgium
| | - A Mouraux
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - J Lambert
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - E N van den Broeke
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium; Health Psychology Group, University of Leuven (KUL), Leuven, Belgium.
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Lourenço A, Lee N, Charlwood F, Lambert J, Vera-Sánchez JA, Hussein M, Shipley D, Romano F, Lowe M, Clarke M, Lorentini S, Mazal A, Pettingell J, Palmans H, Thomas R. A portable primary-standard level graphite calorimeter for absolute dosimetry in clinical pencil beam scanning proton beams. Phys Med Biol 2023; 68:175005. [PMID: 37414003 DOI: 10.1088/1361-6560/ace50f] [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: 12/06/2022] [Accepted: 07/06/2023] [Indexed: 07/08/2023]
Abstract
Objective. To report the use of a portable primary standard level graphite calorimeter for direct dose determination in clinical pencil beam scanning proton beams, which forms part of the recommendations of the proposed Institute of Physics and Engineering in Medicine (IPEM) Code of Practice (CoP) for proton therapy dosimetry.Approach. The primary standard proton calorimeter (PSPC) was developed at the National Physical Laboratory (NPL) and measurements were performed at four clinical proton therapy facilities that use pencil beam scanning for beam delivery. Correction factors for the presence of impurities and vacuum gaps were calculated and applied, as well as dose conversion factors to obtain dose to water. Measurements were performed in the middle of 10 × 10 × 10 cm3homogeneous dose volumes, centred at 10.0, 15.0 and 25.0 g·cm-2depth in water. The absorbed dose to water determined with the calorimeter was compared to the dose obtained using PTW Roos-type ionisation chambers calibrated in terms of absorbed dose to water in60Co applying the recommendations in the IAEA TRS-398 CoP.Main results.The relative dose difference between the two protocols varied between 0.4% and 2.1% depending on the facility. The reported overall uncertainty in the determination of absorbed dose to water using the calorimeter is 0.9% (k= 1), which corresponds to a significant reduction of uncertainty in comparison with the TRS-398 CoP (currently with an uncertainty equal or larger than 2.0% (k= 1) for proton beams).Significance. The establishment of a purpose-built primary standard and associated CoP will considerably reduce the uncertainty of the absorbed dose to water determination and ensure improved accuracy and consistency in the dose delivered to patients treated with proton therapy and bring proton reference dosimetry uncertainty in line with megavoltage photon radiotherapy.
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Affiliation(s)
- A Lourenço
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - N Lee
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
| | - F Charlwood
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - J Lambert
- Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - J A Vera-Sánchez
- Centro de Protonterapia Quirónsalud, E-28223 Pozuelo de Alarcón, Madrid, Spain
| | - M Hussein
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - D Shipley
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
| | - F Romano
- Istituto Nazionale di Fisica Nucleare, Sezione di Catania, Via S Sofia 64, I-95123, Catania, Italy
| | - M Lowe
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - M Clarke
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - S Lorentini
- Protontherapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - A Mazal
- Centro de Protonterapia Quirónsalud, E-28223 Pozuelo de Alarcón, Madrid, Spain
| | - J Pettingell
- Rutherford Cancer Centre North East, Bedlington NE22 7FD, United Kingdom
| | - H Palmans
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - R Thomas
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- University of Surrey, Faculty of Engineering and Physical Science, Guildford GU2 7XH, United Kingdom
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Paulou F, Wegrzyn J, Rossel JB, Gonvers E, Antoniadis A, Kägi M, Wolmarans MR, Lambert J, Albrecht E. Analgesic efficacy of selective tibial nerve block versus partial local infiltration analgesia for posterior pain after total knee arthroplasty: a randomized, controlled, triple-blinded trial. Anaesth Crit Care Pain Med 2023; 42:101223. [PMID: 37030393 DOI: 10.1016/j.accpm.2023.101223] [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: 02/12/2023] [Revised: 02/28/2023] [Accepted: 03/19/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The adductor canal block provides pain relief on the anterior aspect of the knee after arthroplasty. Pain on the posterior aspect may be treated either by partial local infiltration analgesia of the posterior capsule or by a tibial nerve block. This randomized, controlled, triple-blinded trial tests the hypothesis that a tibial nerve block would provide superior analgesia compared to posterior capsule infiltration in patients scheduled for total knee arthroplasty under spinal anesthesia with an adductor canal block. METHODS Sixty patients were randomized to receive either infiltration of the posterior capsule by the surgeon with ropivacaine 0.2%, 25 mL, or a tibial nerve block with 10 mL of ropivacaine 0.5%. Sham injections were performed to guarantee proper blinding. The primary outcome was intravenous morphine consumption at 24 h. Secondary outcomes included intravenous morphine consumption, pain scores at rest and on movement, and different functional outcomes, measured at up to 48 h. When necessary, longitudinal analyses were performed with a mixed-effects linear model. RESULTS The median (interquartile range) of cumulative intravenous morphine consumption at 24 h was 12 mg (4-16) and 8 mg (2-14) in patients having the infiltration or the tibial nerve block respectively (p = 0.20). Our longitudinal model showed a significant interaction between group and time in favor of the tibial nerve block (p = 0.015). No significant differences were present between groups in the other above-mentioned secondary outcomes. CONCLUSION A tibial nerve block does not provide superior analgesia when compared to infiltration. However, a tibial nerve block might be associated with a slower increase in morphine consumption over time.
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Affiliation(s)
- F Paulou
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - J Wegrzyn
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - J B Rossel
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - E Gonvers
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - A Antoniadis
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Kägi
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M R Wolmarans
- Department of Anaesthesia, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - J Lambert
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - E Albrecht
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
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Lambert J, Demeestere J, Dewachter B, Cockmartin L, Wouters A, Symons R, Boomgaert L, Vandewalle L, Scheldeman L, Demaerel P, Lemmens R. Performance of Automated ASPECTS Software and Value as a Computer-Aided Detection Tool. AJNR Am J Neuroradiol 2023; 44:894-900. [PMID: 37500286 PMCID: PMC10411841 DOI: 10.3174/ajnr.a7956] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND PURPOSE ASPECTS quantifies early ischemic changes in anterior circulation stroke on NCCT but has interrater variability. We examined the agreement of conventional and automated ASPECTS and studied the value of computer-aided detection. MATERIALS AND METHODS We retrospectively collected imaging data from consecutive patients with acute ischemic stroke with large-vessel occlusion undergoing thrombectomy. Five raters scored conventional ASPECTS on baseline NCCTs, which were also processed by RAPID software. Conventional and automated ASPECTS were compared with a consensus criterion standard. We determined the agreement over the full ASPECTS range as well as dichotomized, reflecting thrombectomy eligibility according to the guidelines (ASPECTS 0-5 versus 6-10). Raters subsequently scored ASPECTS on the same NCCTs with assistance of the automated ASPECTS outputs, and agreement was obtained. RESULTS For the total of 175 cases, agreement among raters individually and the criterion standard varied from fair to good (weighted κ = between 0.38 and 0.76) and was moderate (weighted κ = 0.59) for the automated ASPECTS. The agreement of all raters individually versus the criterion standard improved with software assistance, as did the interrater agreement (overall Fleiss κ = 0.15-0.23; P < .001 and .39 to .55; P = .01 for the dichotomized ASPECTS). CONCLUSIONS Automated ASPECTS had agreement with the criterion standard similar to that of conventional ASPECTS. However, including automated ASPECTS during the evaluation of NCCT in acute stroke improved the agreement with the criterion standard and improved interrater agreement, which could, therefore, result in more uniform scoring in clinical practice.
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Affiliation(s)
- J Lambert
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Departments of Imaging and Pathology (J.L., B.D., P.D.)
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
| | - J Demeestere
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - B Dewachter
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Departments of Imaging and Pathology (J.L., B.D., P.D.)
| | - L Cockmartin
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
| | - A Wouters
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - R Symons
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Imelda Hospital (R.S.), Bonheiden, Belgium
| | - L Boomgaert
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
| | - L Vandewalle
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - L Scheldeman
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - P Demaerel
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Departments of Imaging and Pathology (J.L., B.D., P.D.)
| | - R Lemmens
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
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Chapelle V, Lambert J, Deom T, Tessier E, Amouroux D, Silvestre F. Early-life exposure to methylmercury induces reversible behavioral impairments and gene expression modifications in one isogenic lineage of mangrove rivulus fish Kryptolebias marmoratus. Aquat Toxicol 2023; 258:106474. [PMID: 36893699 DOI: 10.1016/j.aquatox.2023.106474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Methylmercury (MeHg) is a ubiquitous bioaccumulative neurotoxicant present in aquatic ecosystems. It is known to alter behaviors, sensory functions and learning abilities in fish and other vertebrates. Developmental and early-life stages exposure to MeHg can lead to brain damage with immediate consequences on larvae behavior, but may also induce long term effects in adults after a detoxification period. However, very little is known about developmental origin of behavioral impairment in adults due to early exposure to MeHg. The aim of this study is to assess whether early-life MeHg exposure induces immediate and/or delayed effects on behaviors, related genes expression and DNA methylation (one of epigenetic mechanisms). To reach this goal, newly hatched larvae of mangrove rivulus fish, Kryptolebias marmoratus, were exposed to two sub-lethal concentrations of MeHg (90 μg/L and 135 µg/L) for 7 days, and immediate and delayed effects were assessed respectively in 7 dph (days post-hatching) and 90 dph fish. This species naturally produces isogenic lineages due to its self-fertilizing reproduction system, which is unique among vertebrates. It allows to study how environment stressors can influence organism's phenotype while minimizing genetic variability. As results, both MeHg exposures are associated with a decreased foraging efficiency and thigmotaxis, and a dose-dependent reduction in larvae locomotor activity. Regarding molecular analysis in larvae whole bodies, both MeHg exposures induced significant decreased expression of DNMT3a, MAOA, MeCP2 and NIPBL, and significant increase of GSS, but none of those genes underwent methylation changes in targeted CpGs. None of significant behavioral and molecular impairments observed in 7-dph larvae were found in 90-dph adults, which highlight a distinction between immediate and delayed effects of developmental MeHg exposure. Our results suggest implications of aminergic system and its neurotransmitters, redox/methylation trade-off and possibly other epigenetic mechanisms in MeHg neurotoxicity underlying behavioral alterations in rivulus.
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Affiliation(s)
- V Chapelle
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium.
| | - J Lambert
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium
| | - T Deom
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium
| | - E Tessier
- Université de Pau et des Pays de L'Adour, E2S UPPA, CNRS, Institut des Sciences Analytiques et de Physicochimie pour l'Environnement et les Matériaux, Pau, France
| | - D Amouroux
- Université de Pau et des Pays de L'Adour, E2S UPPA, CNRS, Institut des Sciences Analytiques et de Physicochimie pour l'Environnement et les Matériaux, Pau, France
| | - F Silvestre
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium
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Dietvorst S, Devriendt K, Lambert J, Boogaerts A, Van Den Bogaert K, Buyse G, Van Calenbergh F. NID1-related autosomal dominant Dandy-Walker malformation with occipital cephalocele in three generations. Eur J Med Genet 2023; 66:104713. [PMID: 36702440 DOI: 10.1016/j.ejmg.2023.104713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/18/2022] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
The combination of Dandy-Walker malformation and occipital cephalocele is a rare autosomal dominant condition, known as ADDWOC, and caused by mutations in NID1 or LAMC1. We present a three-generation family with variable manifestations of Dandy-Walker malformation and occipital cephalocele. They all have normal psychomotor development and lack neurological manifestations. Mutation analysis revealed a likely pathogenic missense variant in NID1 (c.3336T > G, p.Asn1112Lys), affecting an amino acid residue crucial in the nidogen/laminin interaction.
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Affiliation(s)
| | | | | | | | | | - Gunnar Buyse
- Department of Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
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Soenen R, Stove C, Capobianco A, De Schutter H, Dobbelaere M, Mahjor T, Follens M, Lambert J, Grine L. 146 Promising tools to facilitate the implementation of TDM of biologics in clinical practice. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.156] [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: 11/19/2022]
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Miglianico M, Thériault R, Lavoie B, Labelle P, Joussemet M, Veilleux M, Lambert J, Bertrand-Dubois D. Pratiques cliniques inspirées par la recherche en psychologie positive. Psychologie Française 2022. [DOI: 10.1016/j.psfr.2022.06.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Lambert J. Tick Borne Infections in the EU:A New Epidemic in the Face of Global Warming. Ir Med J 2022; 115:594. [PMID: 35696127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- J Lambert
- Mater Misericordiae University Hospital, Eccles St, Dublin 7
- Rotunda Hospital Dublin, Parnell Square E, Rotunda, Dublin 1
- UCD School of Medicine, Belfield, Dublin 4
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Reich K, Iversen L, Puig L, Lambert J, Mrowietz U, Kaplan Saday K, Warren RB. Long‐term efficacy and safety of brodalumab in moderate‐to‐severe plaque psoriasis: a post hoc pooled analysis of AMAGINE‐2 and ‐3. J Eur Acad Dermatol Venereol 2022; 36:1275-1283. [DOI: 10.1111/jdv.18068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - L. Iversen
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - L. Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Autonomous University of Barcelona Barcelona Spain
| | - J. Lambert
- Department of Dermatology Ghent University Ghent Belgium
| | - U. Mrowietz
- Department of Dermatology University Medical Center Schleswig‐Holstein Kiel Germany
| | | | - R. B. Warren
- Dermatology Centre Salford Royal NHS Foundation Trust Manchester NIHR Biomedical Research Centre University of Manchester United Kingdom
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18
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Lambert J, Leutenegger AL, Janno AS, Baudot A. Suivi temporel de clusters identifiés à partir de réseaux de patients. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.023] [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] Open
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Van Loon A, Mortelmans D, Siozopoulou V, Ogunjimi B, Jansens H, Lambert J, Aerts O. A first case of “Covid toes” from a viral vector‐based COVID‐19 vaccine. J Eur Acad Dermatol Venereol 2022; 36:e400-e402. [DOI: 10.1111/jdv.17948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- A. Van Loon
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
| | - D. Mortelmans
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
| | - V. Siozopoulou
- Department of Pathology University Hospital Antwerp (UZA) and University of Antwerp Antwerp Belgium
| | - B. Ogunjimi
- Department of Pediatrics University Hospital Antwerp (UZA) and University of Antwerp Antwerp Belgium
| | - H. Jansens
- Department of Laboratory Medicine University Hospital Antwerp (UZA) and University of Antwerp Antwerp Belgium
| | - J. Lambert
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
| | - O. Aerts
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
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20
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Cook H, Lambert J, Thomas R, Palmans H, Hussein M, Clark CH, Royle G, Pettingell J, Lourenço A. Development of a heterogeneous phantom to measure range in clinical proton therapy beams. Phys Med 2022; 93:59-68. [PMID: 34968893 DOI: 10.1016/j.ejmp.2021.11.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE In particle therapy, determination of range by measurement or calculation can be a significant source of uncertainty. This work investigates the development of a bespoke Range Length Phantom (RaLPh) to allow independent determination of proton range in tissue. This phantom is intended to be used as an audit device. METHOD RaLPh was designed to be compact and allows different configurations of tissue substitute slabs, to facilitate measurement of range using radiochromic film. Fourteen RaLPh configurations were tested, using two types of proton fluence optimised water substitutes, two types of bone substitute, and one lung substitute slabs. These were designed to mimic different complex tissue interfaces. Experiments were performed using a 115 MeV mono-energetic scanning proton beam to investigate the proton range for each configuration. Validation of the measured film ranges was performed via Monte Carlo simulations and ionisation chamber measurements. The phantom was then assessed as an audit device, by comparing film measurements with Treatment Planning System (TPS) predicted ranges. RESULTS Varying the phantom slab configurations allowed for measurable range differences, and the best combinations of heterogeneous material gave agreement between film and Monte Carlo on average within 0.2% and on average within 0.3% of ionisation chamber measurements. Results against the TPS suggest a material density override is currently required to enable the phantom to be an audit device. CONCLUSION This study found that a heterogeneous phantom with radiochromic film can provide range verification as part of a dedicated audit for clinical proton therapy beams.
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Affiliation(s)
- H Cook
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom.
| | - J Lambert
- Medical Physics Department, The Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - R Thomas
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - H Palmans
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - M Hussein
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - C H Clark
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Radiotherapy Physics, University College London Hospital, NW1 2BU, United Kingdom; Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, HA6 2RN, United Kingdom
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - J Pettingell
- Medical Physics Department, The Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - A Lourenço
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
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van Ee I, Deprez E, Egeberg A, Augustin M, Conrad C, Corazza V, Donati L, Lambert J, Lăpădatu R, Meyer A, Paul C, Penzer-Hick R, Stephen K, van der Zon J, Bewley A. Freedom from disease in psoriasis: a Delphi consensus definition by patients, nurses and physicians. J Eur Acad Dermatol Venereol 2021; 36:403-412. [PMID: 34816508 PMCID: PMC9303201 DOI: 10.1111/jdv.17829] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
Background Physician‐reported clinical outcome and quality of life (QoL) measures are currently used to assess outcomes and direct treatment of plaque psoriasis. However, people with psoriasis may have different criteria for judging treatment success. Objectives To build a unified consensus on the definition of ‘freedom from disease’ from a European stakeholder group, including people with psoriasis, dermatologists and nurses. Methods The modified Delphi consensus methodology was used to define ‘freedom from disease’, with a consensus group consisting of people with psoriasis, nurses and dermatologists. This methodology involved people with psoriasis during the entire process and consisted of a 15‐member Facilitating Consensus Panel to drive the programme content and a larger Voting Consensus Panel to vote on defining ‘freedom from disease’. The Facilitating Panel agreed on disease domains, and aspects of each domain were put forward to the Voting Consensus Panel to establish relative importance. Following two voting rounds, a meeting was held to agree on a final consensus statement. Results The Facilitating Panel consisted of six patient advocacy group representatives, three specialist nurses and six dermatologists. Voting rounds 1 and 2 were completed by 166 and 130 respondents from the Voting Consensus Panel, respectively. The outputs from both rounds of voting were similar, focusing on normality of living, symptom control, and a relationship of mutual respect and trust between the individual with psoriasis and their healthcare professional. The consensus statement emphasizes that ‘freedom from disease’ is multifaceted and includes the following domains ‘management of clinical symptoms’, ‘psychosocial elements’, ‘QoL and well‐being’, ‘treatment’ and ‘healthcare team support’. ‘Freedom from disease’ means all aspects are addressed. Conclusions Freedom from disease in psoriasis is a multicomponent concept including five main domains. This diverse and multifaceted patient perspective will help us to improve understanding of the outcomes of treatment interventions in people with psoriasis.
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Affiliation(s)
- I van Ee
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - E Deprez
- Ghent University Hospital, Ghent, Belgium
| | - A Egeberg
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M Augustin
- IVDP Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - C Conrad
- Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - V Corazza
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - L Donati
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - J Lambert
- Ghent University Hospital, Ghent, Belgium
| | - R Lăpădatu
- Associaţia Pacienţilor cu Afecţiuni Autoimune (APAA), Bucharest, Romania
| | - A Meyer
- Deutscher Psoriasis Bund e.V. (DPB), Hamburg, Germany
| | - C Paul
- Paul Sabatier University, Toulouse, France.,Centre Hospitalier Universitaire, Toulouse, France
| | | | | | - J van der Zon
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - A Bewley
- Barts Health NHS Trust & Queen Mary University, London, UK
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Patch S, Nguyen C, Cohilis M, Lambert J, Souris K, Janssens G, Labarbe R, Ono S, Lynch T. Thermoacoustic Range Verification During Pencil Beam Delivery of a Clinical Plan to an Abdominal Imaging Phantom. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Grine L, Hilhorst N, Michels N, Abbeddou S, De Henauw S, Lambert J. 243 Interim Results of the MANGO Trial: Modified Intermittent Fasting in Psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.248] [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: 11/29/2022]
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Soenen R, Grine L, Schots L, Lanssens S, Temmerman L, Thomas D, Lambert J. LB814 Therapeutic drug monitoring: The way towards individualized Secukinumab dosing in Psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Nicholas O, Saplaouros A, Lambert J, Fegan G, Hugtenburg R, Gwynne S. PO-1241 Optimising splenic dose with PBT and VMAT for distal oesophageal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07692-1] [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: 10/20/2022]
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Patch S, Nguyen C, Labarbe R, Janssens G, Lambert J, Cohilis M, Souris K, Ono S, Lynch T. OC-0205 Thermoacoustic Range Verification During Delivery of a Clinical Plan to a Abdominal Imaging Phantom. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Westeel V, Bourdon M, Cortot AB, Debieuvre D, Toffart AC, Acquadro M, Arnould B, Lambert J, Cotte FE, Gaudin AF, Lemasson H. Management of lung cancer patients' quality of life in clinical practice: a Delphi study. ESMO Open 2021; 6:100239. [PMID: 34388690 PMCID: PMC8363823 DOI: 10.1016/j.esmoop.2021.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/18/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The assessment of health-related quality of life (HRQoL) has seen exponential growth in oncology clinical trials. However, the measurement of HRQoL has yet to be optimised in routine clinical practice. This study aimed at exploring the operationalisation of HRQoL in clinical practice with the goal of reaching a consensus from a panel of physicians. MATERIALS AND METHODS Physicians involved in the management of lung cancer patients in France were recruited to participate in a Delphi study. The study involved three rounds of iterated queries to gain consensus on management aspects of HRQoL, including timing of discussion on HRQoL, which specific domains of HRQoL should be discussed, and what was the most appropriate method of assessment. The threshold adopted for consensus was at least 70% agreement among physicians. A scientific committee reviewed results following each round of the Delphi study. RESULTS A representative panel of 60 physicians participated in this study. Consensus was obtained for HRQoL management at all time points in the patient care pathway. Panellists agreed that HRQoL discussions should occur during routine visits and hospitalisation. The involvement of patients' relatives was also recognised as important, except when discussing side-effects and involvement of a multidisciplinary team. There was a lack of consensus on a systematic assessment for all patients at each visit and no consensus on how HRQoL should be measured in clinical practice. CONCLUSIONS HRQoL discussions are considered an integral part in the management of lung cancer patients, and are deemed key to success in patient-physician interaction. Further research is required to harmonise how best to implement HRQoL assessment.
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Affiliation(s)
- V Westeel
- Unité de Méthodologie et de Qualité de Vie en Cancérologie, Centre Hospitalier Universitaire de Besançon, UMR1098, Université de Franche-Comté, Besançon, France
| | - M Bourdon
- Institut de Cancérologie de l'Ouest, Nantes, Angers, France; UMR INSERM 1246 SPHERE, Université de Nantes, Université de Tours, Tours, France
| | - A B Cortot
- University of Lille, Centre Hospitalier Universitaire de Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-UMR-S 1277-Canther, Lille, France
| | - D Debieuvre
- GHRMSA-Hôpital Emile Muller, Mulhouse, France
| | - A-C Toffart
- Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - M Acquadro
- Patient Centred Outcomes, ICON plc, Lyon, France
| | - B Arnould
- Patient Centred Outcomes, ICON plc, Lyon, France
| | - J Lambert
- Patient Centred Outcomes, ICON plc, Lyon, France.
| | - F-E Cotte
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | - A-F Gaudin
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | - H Lemasson
- Bristol-Myers Squibb, Rueil-Malmaison, France
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Mahil S, Yates M, Langan S, Yiu Z, Tsakok T, Dand N, Mason K, McAteer H, Meynell F, Coker B, Vincent A, Urmston D, Vesty A, Kelly J, Lancelot C, Moorhead L, Bachelez H, Bruce I, Capon F, Contreras C, Cope A, De La Cruz C, Di Meglio P, Gisondi P, Hyrich K, Jullien D, Lambert J, Marzo‐Ortega H, McInnes I, Naldi L, Norton S, Puig L, Sengupta R, Spuls P, Torres T, Warren R, Waweru H, Weinman J, Griffiths C, Barker J, Brown M, Galloway J, Smith C. Risk-mitigating behaviours in people with inflammatory skin and joint disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey. Br J Dermatol 2021; 185:80-90. [PMID: 33368145 PMCID: PMC9214088 DOI: 10.1111/bjd.19755] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. OBJECTIVES We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. METHODS Online surveys were completed by individuals with psoriasis (globally) or rheumatic and musculoskeletal diseases (RMDs) (UK only) between 4 May and 7 September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterized international variation in a mixed-effects model. RESULTS Of 3720 participants (2869 psoriasis, 851 RMDs) from 74 countries, 2262 (60·8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term 'shielding'). A greater proportion of those receiving targeted therapies (biologics and Janus Kinase inhibitors) reported shielding compared with those receiving no systemic therapy [adjusted odds ratio (OR) 1·63, 95% confidence interval (CI) 1·35-1·97]. The association between targeted therapy and shielding was preserved when standard systemic therapy was used as the reference group (OR 1·39, 95% CI 1·23-1·56). Shielding was associated with established risk factors for severe COVID-19 [male sex (OR 1·14, 95% CI 1·05-1·24), obesity (OR 1·37, 95% CI 1·23-1·54), comorbidity burden (OR 1·43, 95% CI 1·15-1·78)], a primary indication of RMDs (OR 1·37, 95% CI 1·27-1·48) and a positive anxiety or depression screen (OR 1·57, 95% CI 1·36-1·80). Modest differences in the proportion shielding were observed across nations. CONCLUSIONS Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk-mitigation strategies and may help inform updated public health guidelines as the pandemic continues.
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29
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Bahti A, Telfah A, Lambert J, Hergenröder R, Suter D. Optimal control pulses for subspectral editing in low field NMR. J Magn Reson 2021; 328:106993. [PMID: 34029798 DOI: 10.1016/j.jmr.2021.106993] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/14/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
Low field NMR is an inexpensive and low footprint technique to obtain physical, chemical, electronic and structural information on small molecules, but suffers from poor spectral dispersion, especially when applied to the analysis of mixtures. Subspectral editing employing optimal control pulses is a suitable approach to cope with the severe signal superpositions in complex mixture spectra at low field. In this contribution, the use of optimal control pulses is demonstrated to be feasible at a field strength as low as 0.5 T. The optimal control pulse shapes were calculated using the Krotov algorithm. Downsizing the complexity of the algorithm from exponential to polynomial is shown to be possible by using a system approach with each system corresponding to a (small) molecule. In this way compound selective excitation pulses can be calculated. The signals of substructures of the cyclopentenone molecule were excited using optimal control pulses calculated by the Krotov algorithm demonstrating the feasibility of subspectral editing. Likewise, for a mixture of benzoic acid and alanine, editing of the signals of either benzoic acid or alanine employing optimal control pulses was shown to be possible. The obtained results are very promising and can be extended to the targeted analysis of complex mixtures such as biofluids or metabolic samples at low field strengths opening access for benchtop NMR to point of care settings.
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Affiliation(s)
- A Bahti
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany; Experimental Physics III, TU Dortmund University, 44227 Dortmund, Germany.
| | - A Telfah
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany
| | - J Lambert
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany
| | - R Hergenröder
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany.
| | - D Suter
- Experimental Physics III, TU Dortmund University, 44227 Dortmund, Germany
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30
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Mahil SK, Yates M, Yiu ZZN, Langan SM, Tsakok T, Dand N, Mason KJ, McAteer H, Meynell F, Coker B, Vincent A, Urmston D, Vesty A, Kelly J, Lancelot C, Moorhead L, Bachelez H, Capon F, Contreras CR, De La Cruz C, Di Meglio P, Gisondi P, Jullien D, Lambert J, Naldi L, Norton S, Puig L, Spuls P, Torres T, Warren RB, Waweru H, Weinman J, Brown MA, Galloway JB, Griffiths CM, Barker JN, Smith CH. Describing the burden of the COVID-19 pandemic in people with psoriasis: findings from a global cross-sectional study. J Eur Acad Dermatol Venereol 2021; 35:e636-e640. [PMID: 34145643 PMCID: PMC8447018 DOI: 10.1111/jdv.17450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S K Mahil
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - M Yates
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Centre for Rheumatic Diseases, King's College London, London, UK
| | - Z Z N Yiu
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - S M Langan
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Faculty of Epidemiology, and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - T Tsakok
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - N Dand
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Health Data Research UK, London, UK
| | - K J Mason
- Centre for Rheumatic Diseases, King's College London, London, UK.,School of Medicine, Keele University, Keele, UK
| | - H McAteer
- The Psoriasis Association, Northampton, UK
| | - F Meynell
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - B Coker
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - A Vincent
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - D Urmston
- The Psoriasis Association, Northampton, UK
| | - A Vesty
- The Psoriasis Association, Northampton, UK
| | - J Kelly
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - C Lancelot
- International Federation of Psoriasis Associations (IFPA), Bromma, Sweden
| | - L Moorhead
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - H Bachelez
- Department of Dermatology, AP-HP Hôpital Saint-Louis, Paris, France.,INSERM U1163, Imagine Institute for Human Genetic Diseases, Université de Paris, Paris, France
| | - F Capon
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - C R Contreras
- Catedra de Dermatologia, Hospital de Clinicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, San Lorenzo, Paraguay
| | | | - P Di Meglio
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - P Gisondi
- Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - D Jullien
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, University of Lyon, Lyon, France.,Groupe de Recherche sur le Psoriasis (GrPso) de la Société Française de Dermatologie, Paris, France
| | - J Lambert
- Department of Dermatology, Ghent University, Ghent, Belgium
| | - L Naldi
- Centro Studi GISED, Bergamo, Italy
| | - S Norton
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Spuls
- Department of Dermatology, Amsterdam Public Health/Infection and Immunology, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - T Torres
- Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal
| | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - H Waweru
- International Federation of Psoriasis Associations (IFPA), Bromma, Sweden
| | - J Weinman
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - M A Brown
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Centre for Rheumatic Diseases, King's College London, London, UK
| | - J B Galloway
- Centre for Rheumatic Diseases, King's College London, London, UK.,Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - C M Griffiths
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - J N Barker
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - C H Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
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31
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Connellan D, Diffley K, McCabe J, Cotter A, McGinty T, Sheehan G, Ryan K, Cullen W, Lambert J, Callaly E, Kyne L. 484 CHANGING PRACTICES OF DECISION MAKING REGARDING DO-NOT-ATTEMPT-CARDIOPULMONARY-RESUSCITATION ORDERS AMID THE COVID-19 PANDEMIC. Age Ageing 2021. [PMCID: PMC8344931 DOI: 10.1093/ageing/afab117.07] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The COVID-19 pandemic has brought the decision-making process regarding cardiopulmonary resuscitation into focus. This study aims to analyse Do-Not-Attempt CPR (DNACPR) documentation in older hospitalised patients before and during the COVID-19 pandemic.
Methods
This was a retrospective repeated cross-sectional study. Data including co-morbidities and resuscitation status was collected on 300 patients with COVID-19 hospitalised from March 1st to May 31 s t 2020. DNACPR documentation rates in patients aged ≥65 years with a diagnosis of COVID-19 were compared to those without COVID-19 admitted during the same period. Pre-COVID-19 pandemic DNACPR documentation rates were also examined. Factors associated with DNACPR order instatement during the first wave of the COVID-19 pandemic were identified.
Results
Of 300 COVID-19-positive patients, 28% had a DNACPR order documented during their admission. 50% of DNAR orders were recorded within 24 hours of a positive swab result for SARS-CoV-2. Of 131 patients aged 65 years or over within the cohort admitted with COVID-19, 60.3% had a DNACPR order compared to 25.4% of 130 patients ≥65 without COVID-19 (p < 0.0001). During a comparable time period pre-pandemic, 15.4% of 130 older patients had a DNACPR order in place (p < 0.0001). Independent associations with DNACPR order documentation included increasing age (Odds Ratio [O.R.] 1.12; 95% CI 1.05-1.21); nursing home resident status (O.R. 3.57; 95% CI 1.02-12.50); frailty (O.R. 3.34; 95% CI 1.16-9.61) and chronic renal impairment (O.R. 5.49; 1.34-22.47). The case-fatality-rate of older patients with COVID-19 was 29.8% versus 5.4% without COVID-19. Of older COVID-19-positive patients, 39.2% were referred to palliative care services and 70.2% survived.
Conclusion
The COVID-19 pandemic has prompted more widespread and earlier decision-making regarding resuscitation status. Although case-fatality-rates were higher for older hospitalised patients with COVID-19, many older patients survived the illness. Advance care planning should be prioritised in all patients and should remain clinical practice despite the pandemic.
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Affiliation(s)
- D Connellan
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - K Diffley
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - J McCabe
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - A Cotter
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - T McGinty
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - G Sheehan
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - K Ryan
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - W Cullen
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - J Lambert
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - E Callaly
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - L Kyne
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
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32
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Bommier C, Ruggiu M, Monegier A, Zucca E, Thieblemont C, Lambert J. ENDPOINTS IN MARGINAL ZONE LYMPHOMAS: A SYSTEMATIC REVIEW REVEALS WIDE HETEROGENEITY ACROSS TRIALS AND CALLS FOR STANDARDIZATION. Hematol Oncol 2021. [DOI: 10.1002/hon.27_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C Bommier
- Hôpital Saint Louis Onco‐hematology department U1153 Inserm ‐ ECSTRRA Team Paris France
| | - M Ruggiu
- Hôpital Saint Louis Hematopoietic stem cell transplant Paris France
| | - A Monegier
- Hôpital Saint Louis, Statistics and Bioinformatics Paris France
| | - E Zucca
- Ospedale Regionale di Bellinzona e Valli, IELSG Bellinzona Switzerland
| | | | - J Lambert
- Hôpital Saint Louis, Statistics and Bioinformatics Inserm U1153 ECSTRRA Team Paris France
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33
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Lambert JLW, Segaert S, Ghislain PD, Hillary T, Nikkels A, Willaert F, Lambert J, Speeckaert R. Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 1). J Eur Acad Dermatol Venereol 2021; 34:1654-1665. [PMID: 32735076 PMCID: PMC7496083 DOI: 10.1111/jdv.16684] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 02/02/2020] [Accepted: 05/15/2020] [Indexed: 12/18/2022]
Abstract
Background Impressive progress in new therapeutic options has been made for psoriasis. Treatments include topical steroids, phototherapy, conventional, synthetic disease‐modifying drugs and an expanding list of biologics. Objective The primary objective of this work was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis). Methods Evidence‐based recommendations were formulated using a quasi‐Delphi methodology after a systematic search of the literature and a consensus procedure involving 8 psoriasis experts. Results In this part, the use of systemic treatment in different age groups, during pregnancy, in metabolic syndrome, in patients with mental health problems, in different psoriasis subtypes and in previously systemically treated patients treatment is discussed. Conclusion Guidance on therapeutic choice in specific clinical situations in psoriasis is provided in order to facilitate the decision‐making in clinical practice.
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Affiliation(s)
- J L W Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - P D Ghislain
- Dermatology, Cliniques Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - T Hillary
- Dermatology, University Hospital Leuven, Leuven, Belgium
| | - A Nikkels
- Dermatology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - F Willaert
- Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - J Lambert
- Dermatology, University Hospital of Antwerp, Antwerp, Belgium
| | - R Speeckaert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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34
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Van Gerven L, Qian Z, Starovoyt A, Jorissen M, Meulemans J, van Loon J, De Vleeschouwer S, Lambert J, Bex M, Vander Poorten V. Endoscopic, Endonasal Transsphenoidal Surgery for Tumors of the Sellar and Suprasellar Region: A Monocentric Historical Cohort Study of 369 Patients. Front Oncol 2021; 11:643550. [PMID: 34026618 PMCID: PMC8138557 DOI: 10.3389/fonc.2021.643550] [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: 12/18/2020] [Accepted: 04/06/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The endoscopic endonasal transsphenoidal approach (EETA) is an established technique for the resection of a large variety of benign sellar and suprasellar lesions, mostly pituitary adenomas. It has clear advantages over the microscopic approach, like a superior close-up view of the relevant anatomy and the tumor-gland interface, an enlarged working angle, as well as an increased panoramic vision inside the surgical area. We have been performing the EETA for over a decade, and this study will focus on perioperative and postoperative outcomes and complications and their association with the learning curve. MATERIAL AND METHODS All patients in our tertiary referral center (n = 369) undergoing an EETA for a lesion of the sellar and suprasellar region between January 1st 2008 and December 31st 2018 were included, and data were retrospectively retrieved from the electronic patient records. RESULTS Median follow-up after surgery was 55 months. Pituitary adenomas (n = 322) were the most frequent pathology. Headache (43.4%) and loss of vision (29.3%) were the most common presenting symptoms. Median procedure duration was significantly longer during the initial 5 years (106 versus 79 minutes; p <0.0001), but incidence of peri- and postoperative CSF leaks in the early years was not significantly higher. Knosp grade >2 was associated with perioperative CSF leak (p =0.002), and perioperative CSF leak was associated with postoperative CSF leak (p <0.001). Almost all cases of meningitis were preceded by a postoperative CSF leak. In 22.4% of patients, tumor recurrence required additional therapy. Perioperative (iatrogenic) mortality was 0.8%. The overall hospital stay decreased over time from an average of 7 to 5 days, and the case load increased yearly (p =0.015). CONCLUSION The EETA is an excellent technique with complication rates comparable to or even lower than those in large microsurgical series in the literature. EETA has a significant learning curve affecting the procedure duration. Throughout the first 10 years following the transition from the microscopic approach to the EETA in our cohort, the caseload increased and hospital stay was reduced, while no increase in peri- and postoperative complications was observed.
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Affiliation(s)
- Laura Van Gerven
- Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Leuven, Belgium
| | - Zhen Qian
- Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anastasiya Starovoyt
- Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Leuven, Belgium
| | - Mark Jorissen
- Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jeroen Meulemans
- Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Johannes van Loon
- Neurosciences, Research Group Experimental Neurosurgery and Neuroanatomy and Leuven Brain Institute, Leuven, Belgium
| | - Steven De Vleeschouwer
- Neurosciences, Research Group Experimental Neurosurgery and Neuroanatomy and Leuven Brain Institute, Leuven, Belgium
| | - Julie Lambert
- Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Marie Bex
- Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Vincent Vander Poorten
- Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
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35
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Luger T, Dirschka T, Eyerich K, Gollnick H, Gupta G, Lambert J, Micali G, Ochsendorf F, Ständer S, Traidl-Hoffmann C. Developments and challenges in dermatology: an update from the Interactive Derma Academy (IDeA) 2019. J Eur Acad Dermatol Venereol 2021; 34 Suppl 7:3-18. [PMID: 33315305 DOI: 10.1111/jdv.17009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 01/09/2023]
Abstract
The 2019 Interactive Derma Academy (IDeA) meeting was held in Lisbon, Portugal, 10-12 May, bringing together leading dermatology experts from across Europe, the Middle East and Asia. Over three days, the latest developments and challenges in relation to the pathophysiology, diagnosis, evaluation and management of dermatological conditions were presented, with a particular focus on acne, atopic dermatitis (AD) and actinic keratosis (AK). Interesting clinical case studies relating to these key topics were discussed with attendees to establish current evidence-based best practices. Presentations reviewed current treatments, potential therapeutic approaches and key considerations in the management of acne, AK and AD, and discussed the importance of the microbiome in these conditions, as well as the provision of patient education/support. It was highlighted that active treatment is not always required for AK, depending on patient preferences and clinical circumstances. In addition to presentations, two interactive workshops on the diagnosis and treatment of sexually transmitted infections/diseases (STIs/STDs) presenting to the dermatology clinic, and current and future dermocosmetics were conducted. The potential for misdiagnosis of STIs/STDs was discussed, with dermoscopy and/or reflectance confocal microscopy suggested as useful diagnostic techniques. In addition, botulinum toxin was introduced as a potential dermocosmetic, and the possibility of microbiome alteration in the treatment of dermatological conditions emphasized. Furthermore, several challenges in dermatology, including the use of lasers, the complexity of atopic dermatitis, wound care, use of biosimilars and application of non-invasive techniques in skin cancer diagnosis were reviewed. In this supplement, we provide an overview of the presentations and discussions from the fourth successful IDeA meeting, summarizing the key insights shared by dermatologists from across the globe.
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Affiliation(s)
- T Luger
- Department of Dermatology, University of Münster, Münster, Germany
| | - T Dirschka
- Centroderm Clinic, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Unit of Dermatology, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - H Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke University, Magdeburg, Germany
| | - G Gupta
- University Department of Dermatology, Edinburgh, UK
| | - J Lambert
- Department of Dermatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Ochsendorf
- Department of Dermatology, Frankfurt University Hospital, Frankfurt/Main, Germany
| | - S Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Münster, Germany
| | - C Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Augsburg, Germany
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Demaerel V, Vermeulen F, Desmet L, Lambert J. A 2-Year-Old Boy With an Unusual Bacterial Meningitis and Multiple Brain Abscesses. J Pediatric Infect Dis Soc 2021; 10:207-209. [PMID: 31675071 DOI: 10.1093/jpids/piz076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/08/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Victor Demaerel
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - François Vermeulen
- Department of Paediatrics, University Hospitals KU Leuven, Leuven, Belgium
| | - Lars Desmet
- Department of Critical Care Medicine, University Hospitals KU Leuven, Leuven, Belgium
| | - Julie Lambert
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
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Affiliation(s)
- Jan Vynckier
- Jan Vynckier, MD, Stroke Research Physician, Department of Neurology, Inselspital, Bern, Switzerland;
| | - Jelle Demeestere
- Jelle Demeestere, MD, Consultant Neurologist; Julie Lambert, MD, Consultant Neuroradiologist, Department of Neurology and Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Julie Lambert
- Jelle Demeestere, MD, Consultant Neurologist; Julie Lambert, MD, Consultant Neuroradiologist, Department of Neurology and Department of Radiology, University Hospitals Leuven, Leuven, Belgium
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Pereira MP, Ziehfreund S, Rueth M, Ewering T, Legat FJ, Lambert J, Elberling J, Misery L, Brenaut E, Papadavid E, Garcovich S, Evers AWM, Halvorsen JA, Szepietowski JC, Reich A, Gonçalo M, Lvov A, Bobko S, Serra-Baldrich E, Wallengren J, Savk E, Leslie T, Ständer S, Zink A. Google search trends for itch in Europe: a retrospective longitudinal study. J Eur Acad Dermatol Venereol 2021; 35:1362-1370. [PMID: 33295009 DOI: 10.1111/jdv.17077] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/10/2020] [Accepted: 10/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Itch is a common symptom in the general population. Affected individuals often do not seek medical consultation and rely on Internet searches to obtain information regarding their itch. OBJECTIVES The aim of this study was to attain insights into common concerns of the general population regarding itch can by analysing itch-related Internet search behaviour. METHODS Google AdWords Keyword Planner was used to assess search volumes for itch-related terms in 15 European countries between September 2014 and August 2018. All identified keywords were qualitatively categorized. Itch-related terms were descriptively analysed and are shown as number of searches/100 000 inhabitants. RESULTS The search volume for the keyword 'itch' per 100 000 inhabitants was highest in Northern Europe, followed by Eastern, Central and Southern Europe. In 4/15 countries, itch was searched for more often in the autumn/winter months compared to in the spring/summer months. Most itch-related terms were related to dermatological conditions such as inflammatory skin diseases (e.g. psoriasis, atopic dermatitis), allergic or immunologic conditions (e.g. urticaria), and infectious diseases or infestations (e.g. scabies). In terms of body location, genitoanal itch dominated the searches. Symptoms and signs related to itch, possible non-dermatological aetiologies, and treatment options were also among the most searched terms. CONCLUSIONS These analyses provided for the first time insights into the search behaviour patterns related to itch across Europe. People from Northern and Eastern Europe are more likely to seek online information regarding itch. Causes for the itch, especially dermatological conditions, and genitoanal itch are the most important concerns for Internet users. This unconventional and inexpensive method identifies medical needs of people beyond the medical setting, including people who do not seek medical consultation. Accordingly, the data could be used to guide public health interventions and manage respective inhabitants' medical needs.
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Affiliation(s)
- M P Pereira
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Rueth
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - T Ewering
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - F J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium
| | - J Elberling
- Department of Dermatology, University Hospital Gentofte, Copenhagen, Denmark
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - E Brenaut
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - E Papadavid
- Department of Dermatology and Venereology, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - S Garcovich
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A W M Evers
- Department of Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - J A Halvorsen
- Department of Dermatology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - A Reich
- Department of Dermatology, University of Rzeszów, Rzeszów, Poland
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Lvov
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - S Bobko
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | | | - J Wallengren
- Department of Clinical Sciences Lund, Dermatology and Venereology, Lund University, Lund, Sweden.,Skane University Hospital, Lund, Sweden
| | - E Savk
- Department of Dermatology, Aydin Adnan Menderes University, Aydın, Turkey
| | | | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Ward TL, Raybould SJ, Mondal A, Lambert J, Patel B. Predicting the length of stay at admission for emergency general surgery patients a cohort study. Ann Med Surg (Lond) 2021; 62:127-130. [PMID: 33520208 PMCID: PMC7819802 DOI: 10.1016/j.amsu.2021.01.011] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Predicting length of stay (LOS) is beneficial to patients and the health service. When a prolonged LOS is predicted, it gives the opportunity for focused therapies and allocation of resources to reduce this period. In emergency general surgery (EGS) there has been limited investigation of variables that may be important predictors of LOS. This study examines social characteristics alongside measures of severity of acute illness and co-morbidities in an adult EGS population to establish their contribution to LOS. Methods Data were collected prospectively from patients at admission including medical variables, demographics, and therapeutic requirements. The length of hospital admission was measured, and multiple regression analysis was used to identify variables which predicted the LOS. Results Data were collected from 105 patients. The regression model gave an R2 of 0.34, p = 0.0006. Barthal index (measure of independence in activities of daily living) was a significant predictor of LOS [logworth 1.649, p0.02243]. Housing status and Level of social support both correlated in one-way analysis with LOS. Conclusion There are non-surgical variables, measurable at admission which are of significant value in predicting LOS of EGS patients. This warrants further investigation through a larger study to better quantify the contributions of these variables, and establish potential early interventions to reduce the LOS. Barthal Index is a significant predictor of length of stay at admission for patients admitted under EGS. Unstable housing and a lack of social support independently correlate with a longer length of stay. It may be possible to intervene at admission to reduce the length of stay for patients admitted under EGS.
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Affiliation(s)
- T L Ward
- Barts and the London SMD, Dept. Surgery and Surgical Skills, Barts Cancer Institute, London, UK
| | - S J Raybould
- St Helen's and Knowsley Teaching Hospitals, Department of Anaesthetics, Prescot, UK
| | - A Mondal
- Barts and the London SMD, Dept. Surgery and Surgical Skills, Barts Cancer Institute, London, UK
| | - J Lambert
- Homerton University Hospitals Foundation Trust, Department of Surgery, Homerton Row, London, E9 6SR, UK
| | - B Patel
- Barts and the London SMD, Dept. Surgery and Surgical Skills, Barts Cancer Institute, London, UK.,Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, E1 1FR, UK
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Sterkens A, Lambert J, Bervoets A. Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options. Clin Exp Med 2021; 21:215-230. [PMID: 33386567 DOI: 10.1007/s10238-020-00673-w] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [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: 06/29/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
Patients suffering from alopecia areata (AA) can lose hair in focal regions, the complete scalp, including eyelashes and eyebrows, or even the entire body. The exact pathology is not yet known, but the most described theory is a collapse of the immune privilege system, which can be found in some specific regions of the body. Different treatment options, local and systemic, are available, but none of them have been proven to be effective in the long term as well for every treatment there should be considered for the possible side effects. In many cases, treated or non-treated, relapse often occurs. The prognosis is uncertain and is negatively influenced by the subtypes alopecia totalis and alopecia universalis and characteristics such as associated nail lesions, hair loss for more than 10 years and a positive familial history. The unpredictable course of the disease also makes it a mental struggle and AA patients are more often associated with depression and anxiety compared to the healthy population. Research into immunology and genetics, more particularly in the field of dendritic cells (DC), is recommended for AA as there is evidence of the possible role of DC in the treatment of other autoimmune diseases such as multiple Sclerosis and cancer. Promising therapies for the future treatment of AA are JAK-STAT inhibitors and PRP.
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Affiliation(s)
- A Sterkens
- Department of Dermatology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium.
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - A Bervoets
- Department of Dermatology, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium
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Benajiba L, Lambert J, La Selva R, Cochereau D, Baroudjian B, Roux J, Le Goff J, Basset-Seguin N, Pages C, Battistella M, Delyon J, Lebbé C. Évolution clinique et prise en charge thérapeutique du sarcome de Kaposi classique et endémique. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nicholas O, Selby A, Lambert J, Hugtenburg R, Gwynne S. PO-1471: Dosimetric comparison of neoadjuvant proton beam therapy vs VMAT in distal oesophageal cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01489-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ralki M, Serrien A, Lambert J, Leys M, Nackaerts K. Brown-Séquard Syndrome in a Desmoplastic Malignant Mesothelioma Patient: A Rare Complication. Clin Lung Cancer 2020; 22:e552-e554. [PMID: 33229302 DOI: 10.1016/j.cllc.2020.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/09/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Mike Ralki
- Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, Belgium.
| | - Anouk Serrien
- Department of Neurology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Julie Lambert
- Department of Radiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Mathias Leys
- Department of Pneumology, AZ Groeninge Hospital, Kortrijk, Belgium
| | - Kristiaan Nackaerts
- Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, Belgium
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Severyns T, Kirchgesner J, Lambert J, Thieblemont C, Amiot A, Abitbol V, Treton X, Cazals-Hatem D, Malamut G, Coppo P, Galicier L, Walter-Petrich A, Deau-Fischer B, Besson C, Aparicio T, Beaugerie L, Allez M, Gornet JM. Prognosis of Lymphoma in Patients With Known Inflammatory Bowel Disease: A French Multicentre Cohort Study. J Crohns Colitis 2020; 14:1222-1230. [PMID: 32161943 DOI: 10.1093/ecco-jcc/jjaa048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS The prognosis of lymphoma that occurs in patients with inflammatory bowel disease [IBD] is poorly known. METHODS A multicentre retrospective cohort analysis was done in seven French tertiary centres from 1999 to 2019. Only lymphoma occurring in patients with previous established diagnosis of IBD were analysed. The primary outcome was progression-free survival at 3 years. RESULTS A total of 52 patients [male 65%, Crohn's disease 79%, median age 48.3 years, median duration of IBD 10.1 years] were included, of whom 37 had been previously exposed to immunosuppressants and/or biologics for at least 3 months and 20 had primary intestinal lymphomas. The lymphoma histological types were: diffuse large B cell lymphomas [N = 17], Hodgkin lymphomas [N = 17], indolent B cell lymphomas [N = 12], and others including T cell lymphomas, mantle cell lymphomas, and unclassifiable B cell lymphoma [N = 6]. The median follow-up after lymphoma was 5.1 years (interquartile range [IQR] 4-7.8). Progression-free survival at 3 years was 85% in the overall population (95% confidence interval [CI] 75%-96%) with no significant difference between the exposed and unexposed group, 79% for patients exposed to immunosuppressants and/or biologics [95% CI 67%-94%], and 83% for patients diagnosed with primary intestinal lymphoma [95% CI 67%-100%]. No relapse of IBD has been observed during chemotherapy. The IBD relapse rate at the end of the last chemotherapy cycle was 23% at 3 years [95% CI 11%-39%] in the overall population. CONCLUSIONS In this large cohort, the prognosis for lymphomas occurring in IBD appears to be good and similar to what is expected, irrespective of the exposure to biologics and/or immunosuppressants.
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Affiliation(s)
- T Severyns
- Service de Gastroentérologie, Hôpital Saint Louis, Université de Paris, Paris, France
| | - J Kirchgesner
- Service de Gastroentérologie, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - J Lambert
- Service de Biostatistiques et Information Médicale, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - C Thieblemont
- Service d'Hémato-oncologie, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - A Amiot
- Service de Gastroentérologie, Hôpital Henri Mondor, UPEC, Créteil, France
| | - V Abitbol
- Service de Gastroentérologie, Hôpital Cochin, Université de Paris, Paris, France
| | - X Treton
- Service de Gastroentérologie, Hôpital Beaujon, Université de Paris, Clichy La Garenne, France
| | - D Cazals-Hatem
- Département de Pathologie, Hôpital Beaujon, Université de Paris, Clichy La Garenne. France
| | - G Malamut
- Service de Gastroentérologie, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - P Coppo
- Service d'Hématologie, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - L Galicier
- Service d'Immunohématologie, Hôpital Saint Louis, Université de Paris, Paris, France
| | - A Walter-Petrich
- Service de Biostatistiques et Information Médicale, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - B Deau-Fischer
- Service d'Hématologie, Hôpital Cochin, Université de Paris, Paris, France
| | - C Besson
- Service d'Hématologie-Oncologie, Centre Hospitalier de Versailles, Université Versailles Saint Quentin en Yvelines, Université de Paris-Saclay, Le Chesnay, France
| | - T Aparicio
- Service de Gastroentérologie, Hôpital Saint Louis, Université de Paris, Paris, France
| | - L Beaugerie
- Service de Gastroentérologie, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - M Allez
- Service de Gastroentérologie, Hôpital Saint Louis, Université de Paris, Paris, France
| | - J M Gornet
- Service de Gastroentérologie, Hôpital Saint Louis, Université de Paris, Paris, France
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Westeel V, Bourdon M, Cortot A, Debieuvre D, Toffart A, Acquadro M, Arnould B, Lambert J, Cotte FE, Gaudin AF, Lemasson H. 1569P Integrating patients’ quality of life (QoL) into clinical practice: A Delphi method-based consensus among French physicians managing lung cancer patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lambert JLW, Segaert S, Ghislain PD, Hillary T, Nikkels A, Willaert F, Lambert J, Speeckaert R. Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 2). J Eur Acad Dermatol Venereol 2020; 34:1914-1923. [PMID: 32791572 PMCID: PMC7496856 DOI: 10.1111/jdv.16683] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 02/02/2020] [Accepted: 05/15/2020] [Indexed: 12/16/2022]
Abstract
Background Psoriasis patients carry an increased risk for associated comorbidities. Dermatologists have to be aware of the effects of systemic treatments not only on psoriasis but also on co‐occurring diseases. In case of other coexisting inflammatory diseases, the right psoriasis treatment may improve both disorders. For infectious and malignant disorders, some treatments have to be avoided as they may be harmful. Objective The primary objective of this project was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis). Methods Evidence‐based recommendations were formulated using a quasi‐Delphi methodology after a systematic search of the literature and a consensus procedure involving eight psoriasis experts. Results Recommendations are given on the use of systemic treatment in psoriatic arthritis, inflammatory bowel disease, demyelinating disorders, hepatitis B and C, HIV and cancer. Conclusion This expert opinion is a practical guide for dermatologists when handling psoriasis patients with these specific conditions.
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Affiliation(s)
- J L W Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - P D Ghislain
- Dermatology, Cliniques Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - T Hillary
- Dermatology, University Hospital Leuven, Leuven, Belgium
| | - A Nikkels
- Dermatology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - F Willaert
- Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - J Lambert
- Dermatology, University Hospital of Antwerp, Antwerp, Belgium
| | - R Speeckaert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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Speeckaert R, Lambert J, Delbaere L, Lesseliers T, van Geel N. The reliability of the Self-Assessment Cutaneous Inflammatory Disease Extent Score (SA-CIDES) and the rule of hands to assess the involved body surface area in psoriasis and eczema. Br J Dermatol 2020; 184:171-173. [PMID: 32730683 DOI: 10.1111/bjd.19430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022]
Affiliation(s)
- R Speeckaert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - J Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - L Delbaere
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - T Lesseliers
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - N van Geel
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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van den Broeke EN, de Hemptinne P, Mercken M, Torta DM, Lambert J, Mouraux A. Central sensitization of nociceptive pathways demonstrated by robot-controlled pinprick-evoked brain potentials. Clin Neurophysiol 2020; 131:2491-2498. [PMID: 32709556 DOI: 10.1016/j.clinph.2020.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/27/2020] [Accepted: 06/06/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to assess the effect of central sensitization, induced by high frequency electrical stimulation of the skin (HFS), on pinprick-evoked brain potentials (PEPs) using robot-controlled mechanical pinprick stimulation and a stimulus evaluation task. METHODS In 16 healthy volunteers HFS was applied to the right volar forearm. Robot- controlled pinprick stimuli (64 mN) were applied before and 20 minutes after HFS to the skin surrounding the area onto which HFS was applied. During pinprick stimulation, the EEG was recorded and the quality of perception and perceived intensity of the pinprick stimuli was collected. RESULTS After HFS, the skin surrounding the site at which HFS was delivered showed increased mechanical pinprick sensitivity. Both the early-latency negative peak of PEPs and the later-latency peak were significantly increased after HFS. CONCLUSIONS This study shows increased PEPs after HFS when they are elicited by a robot-controlled mechanical pinprick stimulator and participants are engaged in a stimulus evaluation task during pinprick stimulation. SIGNIFICANCE This is the first study that shows a significant increase of both PEP peaks, and therefore, it provides a preferred setup for assessing the function of mechanical nociceptive pathways in the context of central sensitization.
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Affiliation(s)
- E N van den Broeke
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium.
| | - P de Hemptinne
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - M Mercken
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - D M Torta
- Faculty of Psychology and Educational Sciences, Health Psychology Group, University of Leuven, 3000 Leuven, Belgium
| | - J Lambert
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - A Mouraux
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
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Pyl J, Aerts O, Siozopoulou V, Lambert J, Dendooven E, Poschet K, Dandelooy J. Bullous fixed drug eruption following Human Papilloma Virus vaccination. J Eur Acad Dermatol Venereol 2020; 34:e697-e698. [DOI: 10.1111/jdv.16377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 11/26/2022]
Affiliation(s)
- J. Pyl
- Antwerp University Hospital (UZA) Antwerp Belgium
| | - O. Aerts
- Antwerp University Hospital (UZA) Antwerp Belgium
- Antwerp University Antwerp Belgium
| | | | - J. Lambert
- Antwerp University Hospital (UZA) Antwerp Belgium
- Antwerp University Antwerp Belgium
| | - E. Dendooven
- Antwerp University Hospital (UZA) Antwerp Belgium
- Antwerp University Antwerp Belgium
| | - K. Poschet
- GasthuisZusters Antwerpen Wilrijk Belgium
| | - J. Dandelooy
- Antwerp University Hospital (UZA) Antwerp Belgium
- GasthuisZusters Antwerpen Wilrijk Belgium
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Strober B, Menter A, Leonardi C, Gordon K, Lambert J, Puig L, Photowala H, Longcore M, Zhan T, Foley P. Efficacy of risankizumab in patients with moderate-to-severe plaque psoriasis by baseline demographics, disease characteristics and prior biologic therapy: an integrated analysis of the phase III UltIMMa-1 and UltIMMa-2 studies. J Eur Acad Dermatol Venereol 2020; 34:2830-2838. [PMID: 32320088 PMCID: PMC7818271 DOI: 10.1111/jdv.16521] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 01/21/2020] [Accepted: 03/31/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Risankizumab is a humanized IgG monoclonal antibody that selectively inhibits interleukin-23 through binding the p19 subunit. In Phase 3 trials, risankizumab demonstrated superior efficacy compared with adalimumab and ustekinumab in patients with moderate-to-severe plaque psoriasis. Here, we evaluated the impact of baseline characteristics on efficacy of risankizumab compared with ustekinumab in patients with moderate-to-severe plaque psoriasis. METHODS This analysis included all patients initially randomized to risankizumab or ustekinumab from the replicate, double-blinded, randomized, placebo-controlled phase 3 trials, UltIMMa-1 (NCT02684370) and UltIMMa-2 (NCT02684357). Patients received either risankizumab (150 mg) or ustekinumab (weight-based; 45 or 90 mg per label) at weeks 0, 4, 16, 28 and 40. Efficacy was assessed as the proportion of patients achieving ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) at weeks 16 and 52 by baseline patient demographics, disease characteristics and prior biologic exposure. Mean per cent improvement in PASI was calculated by body weight and body mass index at week 52. Missing efficacy data were imputed as non-responders for categorical variables and last observation carried forward for continuous variables. Logistic regression analyses assessed for interactions between treatment and five independent variables (age, sex, weight, baseline PASI score and presence of psoriatic arthritis) at both weeks 16 and 52. RESULTS Baseline patient demographics, disease characteristics and prior biologic exposure were similar between patients randomized to risankizumab (n = 598) and ustekinumab (n = 199). At weeks 16 and 52, risankizumab demonstrated superior efficacy compared with ustekinumab across these patient characteristics (P < 0.01). Logistic regression analyses demonstrated that risankizumab was superior to ustekinumab at weeks 16 and 52 in all models tested (P < 0.0001 for all). CONCLUSIONS Risankizumab demonstrated consistent and superior efficacy compared with ustekinumab regardless of patient demographics, disease characteristics or prior biologic exposure.
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Affiliation(s)
- B Strober
- Yale University, New Haven, CT, USA.,Central Connecticut Dermatology Research, Cromwell, CT, USA
| | - A Menter
- Baylor Scott and White, Dallas, TX, USA
| | - C Leonardi
- Central Dermatology, Richmond Heights, MO, USA
| | - K Gordon
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - L Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - T Zhan
- AbbVie, Inc., North Chicago, IL, USA
| | - P Foley
- St. Vincent's Hospital Melbourne, Probity Medical Research, Skin Health Institute, The University of Melbourne, Melbourne, VIC, Australia
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