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Johansen SU, Hansen T, Nordborg A, Meyer R, Goll R, Florholmen J, Jensen E. Plasma tryptophan pathway metabolites quantified by liquid chromatography-tandem mass spectrometry as biomarkers in neuroendocrine tumor patients. J Neuroendocrinol 2024; 36:e13372. [PMID: 38361341 DOI: 10.1111/jne.13372] [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: 09/25/2023] [Revised: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/17/2024]
Abstract
A good and accessible biomarker is of great clinical value in neuroendocrine tumor (NET) patients, especially considering its frequently indolent nature and long-term follow-up. Plasma chromogranin A (CgA) and 5-hydroxyindoleacetic acid (5-HIAA) are currently used as biomarkers in NET, but their sensitivity and specificity are restricted. 5-HIAA is the main metabolite of serotonin, an important neurotransmitter of the tryptophan pathway. The aim of this study is to estabish a sensitive and accurate method for the quantification of tryptophan pathway metabolites in plasma. We further aimed to evaluate its utility as a clinical tool in NET disease. We obtained plasma samples from NET patients and healthy controls recruited from the University Hospital of North Norway, Tromsø. Samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and eight metabolites of the tryptophan pathway were quantified. We included 130 NET patients (72/130 small intestinal [SI] NET, 35/130 pancreatic NET, 23/130 other origin) and 20 healthy controls. In the SI-NET group, 26/72 patients presented with symptoms of carcinoid syndrome (CS). We found that combining tryptophan metabolites into a serotonin/kynurenine pathway ratio improved diagnostic sensitivity (92.3%) and specificity (100%) in detecting CS patients from healthy controls compared with plasma 5-HIAA alone (sensitivity 84.6%/specificity 100%). Further, a clinical marker based on the combination of plasma serotonin, 5-HIAA, and 5OH-tryptophan, increased diagnostic capacity identifying NET patients with metastasized disease from healthy controls compared with singular plasma 5-HIAA, serotonin, or CgA. In addition, this marker was positive in 61% of curatively operated SI-NET patients compared with only 10% of healthy controls (p < .001). Our results indicate that simultaneous quantification of several tryptophan metabolites in plasma, using LC-MS/MS, may represent a clinically useful diagnostic tool in NET disease.
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Affiliation(s)
- S U Johansen
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - T Hansen
- Department of Biotechnology and Nanomedicine, SINTEF Industry, Trondheim, Norway
- Department of Pharmacy, UiT the Arctic University of Norway, Tromsø, Norway
| | - A Nordborg
- Department of Biotechnology and Nanomedicine, SINTEF Industry, Trondheim, Norway
| | - R Meyer
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - R Goll
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - J Florholmen
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - E Jensen
- Department of Pharmacy, UiT the Arctic University of Norway, Tromsø, Norway
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Titze U, Titze B, Hansen T, Barth PJ, Ali FA, Schneider F, Benndorf M, Sievert KD. Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas-A Feasibility Study. Cancers (Basel) 2024; 16:873. [PMID: 38473235 DOI: 10.3390/cancers16050873] [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: 01/30/2024] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND MRI-guided prostate biopsies from visible tumor-specific lesions (TBx) can be used to diagnose clinically significant carcinomas (csPCa) requiring treatment more selectively than conventional systematic biopsies (SBx). Ex vivo fluorescence confocal microscopy (FCM) is a novel technique that can be used to examine TBx prior to conventional histologic workup. METHODS TBx from 150 patients were examined with FCM on the day of collection. Preliminary findings were reported within 2 h of collection. The results were statistically compared with the final histology. RESULTS 27/40 (68%) of the csPCa were already recognized in the intraday FCM in accordance with the results of conventional histology. Even non-significant carcinomas (cisPCa) of the intermediate and high-risk groups (serum prostate-specific antigen (PSA) > 10 or 20 ng/mL) according to conventional risk stratifications were reliably detectable. In contrast, small foci of cisPCa were often not detected or were difficult to distinguish from reactive changes. CONCLUSION The rapid reporting of preliminary FCM findings helps to reduce the psychological stress on patients, and can improve the clinical management of csPCa. Additional SBx can be avoided in individual cases, leading to lower rates of complications and scarring in the future surgical area. Additional staging examinations can be arranged without losing time. FCM represents a promising basis for future AI-based diagnostic algorithms.
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Affiliation(s)
- Ulf Titze
- Department of Pathology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
| | - Barbara Titze
- Department of Pathology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
| | - Torsten Hansen
- Department of Pathology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
- MVZ for Histology, Cytology and Molecular Diagnostics Trier GmbH, 54296 Trier, Germany
| | - Peter J Barth
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, University of Münster, 48149 Münster, Germany
| | - Furat Abd Ali
- Department of Urology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
| | - Fried Schneider
- Department of Urology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
| | - Matthias Benndorf
- Department of Diagnostic and Interventional Radiology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
| | - Karl-Dietrich Sievert
- Department of Urology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany
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Jennings CS, Astin F, Prescott E, Hansen T, Gale Chris P, De Bacquer D. Illness perceptions and health literacy are strongly associated with health-related quality of life, anxiety, and depression in patients with coronary heart disease: results from the EUROASPIRE V cross-sectional survey. Eur J Cardiovasc Nurs 2023; 22:719-729. [PMID: 36351004 DOI: 10.1093/eurjcn/zvac105] [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: 02/23/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 10/12/2023]
Abstract
AIMS To (1) Describe the sociodemographic and risk factor profiles of a sample of patients with coronary disease, (2) Explore associations between illness perceptions and health literacy with sociodemographic characteristics and risk factors, health-related quality of life (HRQoL), anxiety, and depression. METHODS AND RESULTS Conducted as part of the ESC Prevention of CVD Project and EUROASPIRE V survey, patients were consecutively and retrospectively identified 6 months to 2 years after an acute event or elective procedure from 12 countries and interviewed. Three thousand four hundred and eight participants (76% male, mean age 64 years) were recruited, 16% were smokers, 38% obese, 60% physically inactive, and 41% hypertensive. Forty percent had attended cardiac rehabilitation. More threatening illness perceptions were associated with female gender (P < 0.0001), lower income (P < 0.0001), lower education (P = 0.02), obesity (P < 0.0001), sedentary behaviour (P < 0.0001), and diabetes (P < 0.0001). Poorer health literacy was associated with obesity (P = 0.02) and sedentary behaviour (P = 0.0001). Threatening illness perceptions were strongly associated with anxiety, depression, and poorer ratings of HRQoL after multivariable adjustment (all P < 0.001). Poor health literacy was associated with anxiety and depression (P < 0.0001) and poorer ratings of HRQoL (HeartQol scores P = 0.03). Results were consistent across regions of Europe, age, gender, and socio-economic strata. CONCLUSIONS Interventions like cardiac rehabilitation should be targeted at vulnerable groups given the strong associations between more threatening illness perceptions, lower health literacy, lower HRQoL, and higher levels of anxiety and depression. The delivery and content of these interventions should be accessible for those with low health literacy.
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Affiliation(s)
- C S Jennings
- Honorary Professor of Nursing and Interdisciplinary Relations, National Institute for Prevention and Cardiovascular Health, University of Galway, Croí Heart & Stroke Centre, Croí House, Moyola Lane, Newcastle, Galway, H91 FF68, Ireland
| | - F Astin
- Professor of Nursing, School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Horlock Building, Walton Hall, Milton Keynes, MK7 6AA, UK
| | - E Prescott
- Professor of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - T Hansen
- Zealand University Hospital, Denmark
| | - P Gale Chris
- Professor of Cardiovascular Medicine, Leeds Institute of Cardiovascular and Metabolic Medicine and Leeds Institute for Data Analytics, University of Leeds; Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Level 11, Worsely Building, Leeds, UK
| | - D De Bacquer
- Professor of Epidemiology, Research Methodology and Biostatistics, Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10-4K3, 9000 Gent, Belgium
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Abd Ali F, Sievert KD, Eisenblaetter M, Titze B, Hansen T, Barth PJ, Titze U. MRI-Guided Targeted and Systematic Prostate Biopsies as Prognostic Indicators for Prostate Cancer Treatment Decisions. Cancers (Basel) 2023; 15:3915. [PMID: 37568731 PMCID: PMC10416861 DOI: 10.3390/cancers15153915] [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: 06/27/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The standard procedure for the diagnosis of prostate carcinoma involves the collection of 10-12 systematic biopsies (SBx) from both lobes. MRI-guided targeted biopsies (TBx) from suspicious foci increase the detection rates of clinically significant (cs) PCa. We investigated the extent to which the results of the TBx predicted the tumor board treatment decisions. SBx and TBx were acquired from 150 patients. Risk stratifications and recommendations for interventional therapy (prostatectomy and radiotherapy) or active surveillance were established by interdisciplinary tumor boards. We analyzed how often TBx alone were enough to correctly classify the tumors as well as to indicate interventional therapy and how often the findings of SBx were crucial for therapy decisions. A total of 28/39 (72%) favorable risk tumors were detected in TBx, of which 11/26 (42%) very-low-risk tumors were not detected and 8/13 (62%) low-risk tumors were undergraded. A total of 36/44 (82%) intermediate-risk PCa were present in TBx, of which 4 (9%) were underdiagnosed as a favorable risk tumor. A total of 12/13 (92%) high-risk carcinomas were detected and correctly grouped in TBx. The majority of csPCa were identified by the sampling of TBx alone. The tumor size was underestimated in a proportion of ISUP grade 1 tumors. Systematic biopsy sampling is therefore indicated for the next AS follow-up in these cases.
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Affiliation(s)
- Furat Abd Ali
- Bielefeld University, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Department of Urology, 32756 Detmold, Germany; (F.A.A.); (K.-D.S.)
| | - Karl-Dietrich Sievert
- Bielefeld University, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Department of Urology, 32756 Detmold, Germany; (F.A.A.); (K.-D.S.)
| | - Michel Eisenblaetter
- Bielefeld University, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Department of Diagnostic and Interventional Radiology, 32756 Detmold, Germany;
| | - Barbara Titze
- Bielefeld University, Medical School and University Medical Center OWL, Department of Pathology, Klinikum Lippe Detmold, 32756 Detmold, Germany;
| | - Torsten Hansen
- MVZ for Histology, Cytology and Molecular Diagnostics Trier GmbH, 54296 Trier, Germany;
| | - Peter J. Barth
- University of Münster, Gerhard-Domagk-Institute of Pathology, Münster University Hospital, 48149 Münster, Germany;
| | - Ulf Titze
- Bielefeld University, Medical School and University Medical Center OWL, Department of Pathology, Klinikum Lippe Detmold, 32756 Detmold, Germany;
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Sievert KD, Hansen T, Titze B, Schulz B, Omran A, Abd Ali F, Titze U. Ex vivo Fluorescence Confocal Microscopy (FCM) of Perineal Prostate Biopsies (PPB) allows fast-track examination of MRI-guided targeted biopsies in routine diagnostics. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Fernandez G, Prastawa M, Scott R, Marami B, Shpalensky N, Madduri A, Cascetta K, Sawyer M, Chan M, Koll G, Malinowski D, De Angel R, Shtabsky A, Feliz A, Hansen T, Veremis B, Cordon-Cardo C, Zeineh J, Donovan M. Development and Validation of a Digital-Artificial Intelligent (AI) enabled Assay to predict early-stage breast cancer recurrence. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ritter D, Schwarz K, Knebel J, Hansen T, Zifle A, Fuchs A, Fautz R. P13-13 Development of a non-target strategy for evaluation of potential biological effects of inhalable aerosols generated during purposeful room conditioning using an in vitro inhalation model. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Drake C, Zobl W, Wehr M, Koschmann J, De Luca D, Kühne B, Vrieling H, Boei J, Hansen T, Escher S. P20-07 Transcriptome data to substantiate the assessment of similar mechanism of actions in a context of compound induced pulmonary fibrosis. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.673] [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: 10/14/2022]
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Nowak N, Sonnenschein N, Hansen T, Ritter D, Blümlein K, Escher S, Schwarz K. P17-10 Design and application of a physiologically based kinetic (PBK) model for uptake of airborne particulates. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.620] [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: 10/14/2022]
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Hansen T, Waldorff F, Andersen K, Stenager E. Homebased screening for cognitive impairment due to dementia. Eur Psychiatry 2022. [PMCID: PMC9566945 DOI: 10.1192/j.eurpsy.2022.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Dementia develops slowly and insidiously and causes cognitive impairment. The diagnosis is pivotal for relevant treatment and care. However, 50,000 people are estimated to have undiagnosed dementia in Denmark, while 36,000 are diagnosed. The municipalities offers a home visit to the population at the ages of 75 and 80 years to assess the need of care and prevent sickness. These home visits are well established and might offer an unused opportunity to detect cognitive impairment and dementia. Objectives To assess impaired cognition at home visits in order to initiate clinical examination for dementia. Methods A feasibility study with the use of Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q) (sensitivity 0.92, specificity 0.97) at home visits. It is expected to include 1000 participants without a dementia diagnosis at the ages of 75 and 80 years. Participants will be included in a period of 12 moths (in the year of 2022), in a number of municipalities. If the screening for cognitive impairment is positive, the participant is motivated for clinical examination at the general practitioner. Follow-up through registers and general practitioners. Results Preliminary results will be presented at the conference. Conclusions Assessment of cognition might give an opportunity to start medication and social support early in the elderly with impaired cognition and undiagnosed dementia. Disclosure No significant relationships.
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Spindler K, Callesen L, Andersen R, Pallisgaard N, Kramer S, Schlander S, Rafaelsen S, Boysen A, Jensen L, Jakobsen A, Hansen T. P-174 OPTIMISE: Optimization of treatment selection and follow-up in oligometastatic colorectal cancer – a ctDNA-guided phase II randomized approach with a run-in feasibility part. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.264] [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: 11/01/2022] Open
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Sievert KD, Hansen T, Titze B, Schulz B, Omran A, Brockkötter L, Gunnemann A, Titze U. Ex Vivo Fluorescence Confocal Microscopy (FCM) of Prostate Biopsies Rethought: Opportunities of Intraoperative Examinations of MRI-Guided Targeted Biopsies in Routine Diagnostics. Diagnostics (Basel) 2022; 12:diagnostics12051146. [PMID: 35626301 PMCID: PMC9140526 DOI: 10.3390/diagnostics12051146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM) can detect carcinoma foci in diagnostic biopsies intraoperatively. Methods: MRI-guided and systematic biopsies were identified in a dataset of our previously published study cohort. Detection rates of clinically relevant tumors were determined in both groups. A retrospective blinded trial was performed to determine how many tumors requiring intervention were detectable via FCM analysis of MRI-guided targeted biopsies alone. Results: MRI-guided targeted biopsies revealed tumors more frequently than systematic biopsies. Carcinomas in need of intervention were reliably represented in the MRI-guided biopsies and were identified in intraoperative FCM microscopy. Combined with serum PSA levels and clinical presentation, 91% of the carcinomas in need of intervention were identified. Conclusions: Intraoperative FCM analysis of MRI-guided biopsies is a promising approach for the efficient diagnosis of PCa. The method allows a timely assessment of whether a tumor disease requiring intervention is present and can reduce the psychological stress of the patient in the waiting period of the histological finding. Furthermore, this technique can lead to reduction of the total number of biopsies needed for the diagnosis of PCa.
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Affiliation(s)
- Karl-Dietrich Sievert
- Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (K.-D.S.); (A.O.); (L.B.); (A.G.)
| | - Torsten Hansen
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
| | - Barbara Titze
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
| | - Birte Schulz
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
| | - Ahmad Omran
- Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (K.-D.S.); (A.O.); (L.B.); (A.G.)
| | - Lukas Brockkötter
- Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (K.-D.S.); (A.O.); (L.B.); (A.G.)
| | - Alfons Gunnemann
- Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (K.-D.S.); (A.O.); (L.B.); (A.G.)
| | - Ulf Titze
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
- Correspondence: ; Tel.: +49-05231-72-3451
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Krämer H, Wassenberg M, Hansen T, Schänzer A, Kolodziej M, Geber C, Birklein F. P 79 L5 radiculopathy induces sensory changes in the neighboring, unaffected S1 fibers. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.110] [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: 11/03/2022]
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Jonigk D, Werlein C, Acker T, Aepfelbacher M, Amann KU, Baretton G, Barth P, Bohle RM, Büttner A, Büttner R, Dettmeyer R, Eichhorn P, Elezkurtaj S, Esposito I, Evert K, Evert M, Fend F, Gaßler N, Gattenlöhner S, Glatzel M, Göbel H, Gradhand E, Hansen T, Hartmann A, Heinemann A, Heppner FL, Hilsenbeck J, Horst D, Kamp JC, Mall G, Märkl B, Ondruschka B, Pablik J, Pfefferle S, Quaas A, Radbruch H, Röcken C, Rosenwald A, Roth W, Rudelius M, Schirmacher P, Slotta-Huspenina J, Smith K, Sommer L, Stock K, Ströbel P, Strobl S, Titze U, Weirich G, Weis J, Werner M, Wickenhauser C, Wiech T, Wild P, Welte T, von Stillfried S, Boor P. Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies? Virchows Arch 2022; 481:139-159. [PMID: 35364700 PMCID: PMC8975445 DOI: 10.1007/s00428-022-03319-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 01/08/2023]
Abstract
The use of autopsies in medicine has been declining. The COVID-19 pandemic has documented and rejuvenated the importance of autopsies as a tool of modern medicine. In this review, we discuss the various autopsy techniques, the applicability of modern analytical methods to understand the pathophysiology of COVID-19, the major pathological organ findings, limitations or current studies, and open questions. This article summarizes published literature and the consented experience of the nationwide network of clinical, neuro-, and forensic pathologists from 27 German autopsy centers with more than 1200 COVID-19 autopsies. The autopsy tissues revealed that SARS-CoV-2 can be found in virtually all human organs and tissues, and the majority of cells. Autopsies have revealed the organ and tissue tropism of SARS-CoV-2, and the morphological features of COVID-19. This is characterized by diffuse alveolar damage, combined with angiocentric disease, which in turn is characterized by endothelial dysfunction, vascular inflammation, (micro-) thrombosis, vasoconstriction, and intussusceptive angiogenesis. These findings explained the increased pulmonary resistance in COVID-19 and supported the recommendations for antithrombotic treatment in COVID-19. In contrast, in extra-respiratory organs, pathological changes are often nonspecific and unclear to which extent these changes are due to direct infection vs. indirect/secondary mechanisms of organ injury, or a combination thereof. Ongoing research using autopsies aims at answering questions on disease mechanisms, e.g., focusing on variants of concern, and future challenges, such as post-COVID conditions. Autopsies are an invaluable tool in medicine and national and international interdisciplinary collaborative autopsy-based research initiatives are essential.
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Affiliation(s)
- Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany.
| | | | - Till Acker
- Institute of Neuropathology, University Hospital Giessen and Marburg, Giessen, Germany
| | - Martin Aepfelbacher
- Institute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kerstin U Amann
- Department of Nephropathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Gustavo Baretton
- Department of Pathology, University Hospital Dresden, Dresden, Germany
| | - Peter Barth
- Gerhard Domagk Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Rainer M Bohle
- Department of Pathology, University Hospital Saarland Homburg, Homburg, Germany
| | - Andreas Büttner
- Institute of Forensic Medicine, University Medical Center Rostock, Rostock, Germany
| | - Reinhard Büttner
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - Reinhard Dettmeyer
- Department of Legal Medicine, University Hospital Giessen and Marburg, Giessen, Germany
| | - Philip Eichhorn
- Department of Pathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Sefer Elezkurtaj
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Irene Esposito
- Department of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Katja Evert
- Department of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Evert
- Department of Pathology, University Hospital Regensburg, Regensburg, Germany
| | - Falko Fend
- Department of Pathology, University Hospital Tübingen, Tübingen, Germany
| | - Nikolaus Gaßler
- Department of Pathology, University Hospital Jena, Jena, Germany
| | - Stefan Gattenlöhner
- Department of Pathology, University Hospital Giessen and Marburg, Giessen, Germany
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Göbel
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - Elise Gradhand
- Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt, Germany
| | - Torsten Hansen
- Department of Pathology, University Hospital OWL of the Bielefeld University, Campus Lippe, Detmold, Germany
| | - Arndt Hartmann
- Department of Pathology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Axel Heinemann
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank L Heppner
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany.,Cluster of Excellence, NeuroCure, Berlin, Germany
| | - Julia Hilsenbeck
- Department of Pathology, University Hospital Dresden, Dresden, Germany
| | - David Horst
- Department of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jan C Kamp
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Gita Mall
- Department of Legal Medicine, University Hospital Jena, Jena, Germany
| | - Bruno Märkl
- General Pathology and Molecular Diagnostics, University Hospital Augsburg, Augsburg, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jessica Pablik
- Department of Pathology, University Hospital Dresden, Dresden, Germany
| | - Susanne Pfefferle
- Institute of Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Quaas
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - Helena Radbruch
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christoph Röcken
- Department of Pathology, University Hospital Schleswig-Holstein, Kiel, Germany
| | | | - Wilfried Roth
- Department of Pathology, University Medical Center Mainz, Mainz, Germany
| | - Martina Rudelius
- Institute of Pathology, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Peter Schirmacher
- Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Julia Slotta-Huspenina
- Department of Pathology, TUM School of Medicine of Technical University of Munich, Munich, Germany
| | - Kevin Smith
- Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt, Germany
| | - Linna Sommer
- Department of Pathology, University Hospital Dresden, Dresden, Germany
| | - Konrad Stock
- Department of Nephrology, TUM School of Medicine of Technical University of Munich, Munich, Germany
| | - Philipp Ströbel
- Department of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Stephanie Strobl
- Department of Pathology, University Medical Center Mainz, Mainz, Germany
| | - Ulf Titze
- Department of Pathology, University Hospital OWL of the Bielefeld University, Campus Lippe, Detmold, Germany
| | - Gregor Weirich
- Department of Pathology, TUM School of Medicine of Technical University of Munich, Munich, Germany
| | - Joachim Weis
- Department of Neuropathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Martin Werner
- Institute for Surgical Pathology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Claudia Wickenhauser
- Department of Pathology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Thorsten Wiech
- Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Wild
- Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | | | - Peter Boor
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany. .,Department of Nephrology and Immunology, University Hospital RWTH Aachen, Aachen, Germany.
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von Stillfried S, Bülow RD, Röhrig R, Meybohm P, Boor P, Böcker J, Schmidt J, Tholen P, Majeed R, Wienströer J, Weis J, Bremer J, Knüchel R, Breitbach A, Cacchi C, Freeborn B, Wucherpfennig S, Spring O, Braun G, Römmele C, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Hirschbühl K, Wittmann M, Kling E, Kröncke T, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Mahlke N, Esposito I, Crudele G, Seidl M, Amann KU, Coras R, Hartmann A, Eichhorn P, Haller F, Lange F, Schmid KW, Ingenwerth M, Rawitzer J, Theegarten D, Birngruber CG, Wild P, Gradhand E, Smith K, Werner M, Schilling O, Acker T, Gattenlöhner S, Stadelmann C, Metz I, Franz J, Stork L, Thomas C, Zechel S, Ströbel P, Wickenhauser C, Fathke C, Harder A, Ondruschka B, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Glatzel M, Krasemann S, Matschke J, Jonigk D, Werlein C, Schirmacher P, Domke LM, Hartmann L, Klein IM, Schwab C, Röcken C, Friemann J, Langer D, Roth W, Strobl S, Rudelius M, Stock KF, Weichert W, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weirich G, Barth P, Wardelmann E, Schnepper A, Evert K, Büttner A, Manhart J, Nigbur S, Bittmann I, Fend F, Bösmüller H, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Kurz F, Vogt N. Intracranial hemorrhage in COVID-19 patients during extracorporeal membrane oxygenation for acute respiratory failure: a nationwide register study report. Crit Care 2022; 26:83. [PMID: 35346314 PMCID: PMC8958804 DOI: 10.1186/s13054-022-03945-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/04/2022] [Indexed: 12/22/2022] Open
Abstract
Background In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID). Methods The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites. Findings The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency. Interpretation Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-03945-x.
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von Stillfried S, Bülow RD, Röhrig R, Boor P, Böcker J, Schmidt J, Tholen P, Majeed R, Wienströer J, Weis J, Bremer J, Knüchel R, Breitbach A, Cacchi C, Freeborn B, Wucherpfennig S, Spring O, Braun G, Römmele C, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Hirschbühl K, Wittmann M, Kling E, Kröncke T, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Mahlke N, Esposito I, Crudele G, Seidl M, Amann KU, Coras R, Hartmann A, Eichhorn P, Haller F, Lange F, Schmid KW, Ingenwerth M, Rawitzer J, Theegarten D, Birngruber CG, Wild P, Gradhand E, Smith K, Werner M, Schilling O, Acker T, Gattenlöhner S, Stadelmann C, Metz I, Franz J, Stork L, Thomas C, Zechel S, Ströbel P, Wickenhauser C, Fathke C, Harder A, Ondruschka B, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Glatzel M, Krasemann S, Matschke J, Jonigk D, Werlein C, Schirmacher P, Domke LM, Hartmann L, Klein IM, Schwab C, Röcken C, Friemann J, Langer D, Roth W, Strobl S, Rudelius M, Stock KF, Weichert W, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weirich G, Barth P, Wardelmann E, Evert K, Büttner A, Manhart J, Nigbur S, Bittmann I, Fend F, Bösmüller H, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Kurz F, Vogt N. First report from the German COVID-19 autopsy registry. Lancet Reg Health Eur 2022; 15:100330. [PMID: 35531493 PMCID: PMC9073019 DOI: 10.1016/j.lanepe.2022.100330] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Autopsies are an important tool in medicine, dissecting disease pathophysiology and causes of death. In COVID-19, autopsies revealed e.g., the effects on pulmonary (micro)vasculature or the nervous system, systemic viral spread, or the interplay with the immune system. To facilitate multicentre autopsy-based studies and provide a central hub supporting autopsy centres, researchers, and data analyses and reporting, in April 2020 the German COVID-19 Autopsy Registry (DeRegCOVID) was launched. Methods The electronic registry uses a web-based electronic case report form. Participation is voluntary and biomaterial remains at the respective site (decentralized biobanking). As of October 2021, the registry included N=1129 autopsy cases, with 69271 single data points including information on 18674 available biospecimens gathered from 29 German sites. Findings In the N=1095 eligible records, the male-to-female ratio was 1·8:1, with peaks at 65-69 and 80-84 years in males and >85 years in females. The analysis of the chain of events directly leading to death revealed COVID-19 as the underlying cause of death in 86% of the autopsy cases, whereas in 14% COVID-19 was a concomitant disease. The most common immediate cause of death was diffuse alveolar damage, followed by multi-organ failure. The registry supports several scientific projects, public outreach and provides reports to the federal health authorities, leading to legislative adaptation of the German Infection Protection Act, facilitating the performance of autopsies during pandemics. Interpretation A national autopsy registry can provide multicentre quantitative information on COVID-19 deaths on a national level, supporting medical research, political decision-making and public discussion. Funding German Federal Ministries of Education and Research and Health. Hintergrund: Obduktionen sind ein wichtiges Instrument in der Medizin, um die Pathophysiologie von Krankheiten und Todesursachen zu untersuchen. Im Rahmen von COVID-19 wurden durch Obduktionen z.B. die Auswirkungen auf die pulmonale Mikrovaskulatur, das Nervensystem, die systemische Virusausbreitung, und das Zusammenspiel mit dem Immunsystem untersucht. Um multizentrische, auf Obduktionen basierende Studien zu erleichtern und eine zentrale Anlaufstelle zu schaffen, die Obduktionszentren, Forscher sowie Datenanalysen und -berichte unterstützt, wurde im April 2020 das deutsche COVID-19-Autopsieregister (DeRegCOVID) ins Leben gerufen. Methoden: Das elektronische Register verwendet ein webbasiertes elektronisches Fallberichtsformular. Die Teilnahme ist freiwillig und das Biomaterial verbleibt am jeweiligen Standort (dezentrales Biobanking). Im Oktober 2021 umfasste das Register N=1129 Obduktionsfälle mit 69271 einzelnen Datenpunkten, die Informationen über 18674 verfügbare Bioproben enthielten, die von 29 deutschen Standorten gesammelt wurden. Ergebnisse: In den N=1095 ausgewerteten Datensätzen betrug das Verhältnis von Männern zu Frauen 1,8:1 mit Spitzenwerten bei 65-69 und 80-84 Jahren bei Männern und >85 Jahren bei Frauen. Die Analyse der Sequenz der unmittelbar zum Tod führenden Ereignisse ergab, dass in 86 % der Obduktionsfälle COVID-19 die zugrunde liegende Todesursache war, während in 14 % der Fälle COVID-19 eine Begleiterkrankung war. Die häufigste unmittelbare Todesursache war der diffuse Alveolarschaden, gefolgt von Multiorganversagen. Das Register unterstützt mehrere wissenschaftliche Projekte, die Öffentlichkeitsarbeit und liefert Berichte an die Bundesgesundheitsbehörden, was zu einer Anpassung des deutschen Infektionsschutzgesetzes führte und die Durchführung von Obduktionen in Pandemien erleichtert. Interpretation: Ein nationales Obduktionsregister kann multizentrische quantitative Informationen über COVID-19-Todesfälle auf nationaler Ebene liefern und damit die medizinische Forschung, die politische Entscheidungsfindung und die öffentliche Diskussion unterstützen. Finanzierung: Bundesministerien für Bildung und Forschung und für Gesundheit.
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Titze U, Sievert KD, Titze B, Schulz B, Schlieker H, Madarasz Z, Weise C, Hansen T. Ex Vivo Fluorescence Confocal Microscopy in Specimens of the Liver: A Proof-of-Concept Study. Cancers (Basel) 2022; 14:590. [PMID: 35158859 PMCID: PMC8833349 DOI: 10.3390/cancers14030590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
Ex vivo Fluorescence Confocal Microscopy (FCM) is a technique providing high-resolution images of native tissues. The method is increasingly used in surgical settings in areas of dermatology and urology. Only a few publications exist about examinations of tumors and non-neoplastic lesions of the liver. We report on the application of FCM in biopsies, surgical specimens and autopsy material (33 patients, 39 specimens) of the liver and compare the results to conventional histology. Our preliminary examinations indicated a perfect suitability for tumor diagnosis (ĸ = 1.00) and moderate/good suitability for the assessment of inflammation (ĸ = 0.4-0.6) with regard to their severity and localization. Macro-vesicular steatosis was reliably detected, micro-vesicular steatosis tended to be underestimated. Cholestasis and eosinophilic granules in granulocytes were not represented in the scans. The tissue was preserved as native material and maintained its quality for downstream histological, immunohistological and molecular examinations. In summary, FCM is a material sparing method that provides rapid feedback to the clinician about the presence of tumor, the degree of inflammation and structural changes. This can lead to faster therapeutic decisions in the management of liver tumors, treatment of hepatitis or in liver transplant medicine.
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Affiliation(s)
- Ulf Titze
- Institute of Pathology, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany; (B.T.); (B.S.); (T.H.)
| | - Karl-Dietrich Sievert
- Department of Urology, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany;
| | - Barbara Titze
- Institute of Pathology, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany; (B.T.); (B.S.); (T.H.)
| | - Birte Schulz
- Institute of Pathology, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany; (B.T.); (B.S.); (T.H.)
| | - Heiko Schlieker
- Department of Gastroenterology, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany;
| | - Zsolt Madarasz
- Department of General Surgery, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany;
| | - Christian Weise
- Department of Pediatrics, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany;
| | - Torsten Hansen
- Institute of Pathology, Campus Lippe, University Hospital OWL of the University of Bielefeld, 32756 Detmold, Germany; (B.T.); (B.S.); (T.H.)
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Al Ahmad J, Norman S, Tierney M, Hansen T, Lee A, Shetty P, Yeung A, Danson E, Nguyendang T, Owensby D. 10 Years of ST Elevation Myocardial Infarctions (STEMIs) in the Illawarra Shoalhaven Local Health District (ISLHD) – Patient Demographics. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.554] [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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von Stillfried S, Freeborn B, Windeck S, Boor P, Böcker J, Schmidt J, Tholen P, Röhrig R, Majeed R, Wienströer J, Bremer J, Weis J, Knüchel R, Breitbach A, Bülow RD, Cacchi C, Wucherpfennig S, Märkl B, Claus R, Dhillon C, Schaller T, Sipos E, Spring O, Braun G, Römmele C, Kling E, Kröncke T, Wittmann M, Hirschbühl K, Heppner FL, Meinhardt J, Radbruch H, Streit S, Horst D, Elezkurtaj S, Quaas A, Göbel H, Friemann J, Hansen T, Titze U, Lorenzen J, Reuter T, Woloszyn J, Baretton G, Hilsenbeck J, Meinhardt M, Pablik J, Sommer L, Holotiuk O, Meinel M, Esposito I, Crudele G, Seidl M, Mahlke N, Hartmann A, Haller F, Eichhorn P, Lange F, Amann KU, Coras R, Ingenwerth M, Rawitzer J, Schmid KW, Theegarten D, Gradhand E, Smith K, Wild P, Birngruber CG, Schilling O, Werner M, Acker T, Gattenlöhner S, Franz J, Metz I, Stadelmann C, Stork L, Thomas C, Zechel S, Ströbel P, Fathke C, Harder A, Wickenhauser C, Glatzel M, Matschke J, Krasemann S, Dietz E, Edler C, Fitzek A, Fröb D, Heinemann A, Heinrich F, Klein A, Kniep I, Lohner L, Möbius D, Ondruschka B, Püschel K, Schädler J, Schröder AS, Sperhake JP, Aepfelbacher M, Fischer N, Lütgehetmann M, Pfefferle S, Jonigk D, Werlein C, Domke LM, Hartmann L, Klein I, Schirmacher P, Schwab C, Röcken C, Langer D, Roth W, Strobl S, Rudelius M, Delbridge C, Kasajima A, Kuhn PH, Slotta-Huspenina J, Weichert W, Weirich G, Stock K, Barth P, Schnepper A, Wardelmann E, Evert K, Evert M, Büttner A, Manhart J, Nigbur S, Bösmüller H, Fend F, Granai M, Klingel K, Warm V, Steinestel K, Umathum VG, Rosenwald A, Vogt N, Kurz F. [Update on collaborative autopsy-based research in German pathology, neuropathology, and forensic medicine]. Pathologie (Heidelb) 2022; 43:101-105. [PMID: 36114379 PMCID: PMC9483541 DOI: 10.1007/s00292-022-01117-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Autopsies are a valuable tool for understanding disease, including COVID-19. MATERIALS AND METHODS The German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs. RESULTS The NATON consortium's interconnected, collaborative autopsy research is enabled by an unprecedented collaboration of 138 individuals at more than 35 German university and non-university autopsy centers through which pathology, neuropathology, and forensic medicine autopsy data including data on biomaterials are collected in DeRegCOVID and tissue-based research and methods development are conducted. More than 145 publications have now emerged from participating autopsy centers, highlighting various basic science and clinical aspects of COVID-19, such as thromboembolic events, organ tropism, SARS-CoV‑2 detection methods, and infectivity of SARS-CoV-2 at autopsy. CONCLUSIONS Participating centers have demonstrated the high value of autopsy and autopsy-derived data and biomaterials to modern medicine. The planned long-term continuation and further development of the registry and network, as well as the open and participatory design, will allow the involvement of all interested partners.
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Affiliation(s)
- Saskia von Stillfried
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Benita Freeborn
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Svenja Windeck
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
| | - Peter Boor
- Institut für Pathologie, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Medizinische Klinik II (Nephrologie und Immunologie), Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland ,Elektronenmikroskopische Einrichtung, Universitätsklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Deutschland
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Hansen T, Norman S, Al AJ, Tierney M, Nguyendang T, Yeung A, Danson E, Owensby D, Lee A, Shetty P. Single Centre Experience of Primary PCI: 10-Year Procedural Outcomes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.624] [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: 10/16/2022]
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Kjaersgaard Andersen R, Loft IC, Hansen T, Hjalgrim H, Rostgaard K, Banasik K, Bruun M, Nielsen K, Dinh KM, Sørensen E, Burgdorff K, Erikstrup C, Ullum H, Saunte DM, Pedersen OB, Jemec GBE. Incidence and remission rates of self-reported hidradenitis suppurativa - A prospective cohort study conducted in Danish blood donors. J Eur Acad Dermatol Venereol 2021; 36:717-725. [PMID: 34862994 DOI: 10.1111/jdv.17857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND A large discrepancy between physician-diagnosed and self-reported Hidradenitis suppurativa (HS) exists. Knowledge regarding incidence and remission rates of self-reported HS is missing, but may help bridge the gap in understanding between these two phenotypes. OBJECTIVES To determine the incidence and remission rates of self-reported HS, and to what degree these are affected by sex, smoking and BMI. METHODS A prospective cohort of 23 930 Danish blood donors. Information on self-reported HS, symptom-localisation, sex, age, BMI and smoking status was collected at baseline and study termination. Self-reported HS fulfilled clinical obligatory diagnostic criteria. Cox proportional hazards regression analyses were conducted for both incidence and remission rates providing a hazard ratio (HR) of risk for each variable in the regression. RESULTS Incidence rate of self-reported HS was 10.8/1000 person-years (95% confidence interval (CI): 9.9-11.7), decreasing as a function of numbers of areas affected. Female BMI points above 25 (HR = 1.11, 95% CI: 1.09-1.13), male BMI points above 25 (HR = 1.07, 95% CI: 1.04-1.11), active smoking (HR = 1.72, 95% CI: 1.15-2.57), male sex (HR = 0.55, 95% CI: 0.45-0.67) and years of age above 25 (HR = 0.97, 95% CI: 0.96-0.97) were all statistically associated with the development of self-reported HS. Remission rate of self-reported HS was 256.7/1000 person-years (95% CI: 223.9-292.6), decreasing as a function of numbers of affected areas. Symptoms in ≥3 areas (HR = 0.54, 95% CI: 0.34-0.85), active smoking (HR = 0.49, 95% CI: 0.32-0.76) and female weight loss (every percentage drop in BMI: HR = 1.07, 95% CI: 1.05-1.11) all significantly affected the remission rate. CONCLUSIONS Both incidence and remission rates of self-reported HS are high, indicating that many with self-reported HS are unlikely to be diagnosed, as they to a higher degree experience mild transient HS symptoms.
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Affiliation(s)
| | - I C Loft
- Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
| | - T Hansen
- Danish Headache Center, Department of Neurology, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - H Hjalgrim
- Department of Epidemiology Research, Centre for Cancer Research, Danish Cancer Society, Statens Serum Institut, Copenhagen, Denmark
| | - K Rostgaard
- Department of Epidemiology Research, Centre for Cancer Research, Danish Cancer Society, Statens Serum Institut, Copenhagen, Denmark
| | - K Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - K Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - K M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - E Sørensen
- Statens Serum Institute, Copenhagen, Denmark
| | - K Burgdorff
- Statens Serum Institute, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - H Ullum
- Statens Serum Institute, Copenhagen, Denmark
| | - D M Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
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22
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Titze U, Hansen T, Brochhausen C, Titze B, Schulz B, Gunnemann A, Rocco B, Sievert KD. Diagnostic Performance of Ex Vivo Fluorescence Confocal Microscopy in the Assessment of Diagnostic Biopsies of the Prostate. Cancers (Basel) 2021; 13:cancers13225685. [PMID: 34830839 PMCID: PMC8616222 DOI: 10.3390/cancers13225685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Fluorescence confocal microscopy (FCM) is a novel micro-imaging technique providing optical sections of examined tissue. In this study, we compare intraoperative diagnoses from the real-time application of FCM in pre-therapeutic prostate biopsies with the final diagnoses from conventional histology. We found FCM to be an effective tool for the timely assessment of prostate biopsies enabling reliable real-time diagnosis of prostate cancer in patients requiring therapy. Abstract Background: Fluorescence confocal microscopy (FCM) is a novel micro-imaging technique providing optical sections of examined tissue. The method has been well established for the diagnosis of tumors in dermatological specimens. Methods: We compare intraoperative diagnoses of the real-time application of FCM in pre-therapeutic prostate biopsies (35 patients, total number of biopsy specimens: n = 438) with the findings of conventional histology. Results: Prostate carcinoma was reliably diagnosed in all patients. Depending on scan quality and experience of the examiner, smaller lesions of well differentiated carcinoma (ISUP1) could not be consistently differentiated from reactive changes. Furthermore, in some cases there was difficulty to distinguish ISUP grade 2 from ISUP grade 1 tumors. ISUP grades 3–5 were reliably detected in FCM. Conclusions: Despite some limitations, FCM seems to be an effective tool for the timely assessment of prostate biopsies enabling reliable diagnosis of prostate cancer in patients requiring therapy.
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Affiliation(s)
- Ulf Titze
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
- Correspondence: ; Tel.: +49-05231-72-3451
| | - Torsten Hansen
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
| | - Christoph Brochhausen
- Institute of Pathology, University of Regensburg, 93053 Regensburg, Germany;
- Central Biobank Regensburg, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Barbara Titze
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
| | - Birte Schulz
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (T.H.); (B.T.); (B.S.)
| | - Alfons Gunnemann
- Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (A.G.); (K.-D.S.)
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Karl-Dietrich Sievert
- Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; (A.G.); (K.-D.S.)
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23
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Hansen T. Citizen initiative: www.covid19data.no. Eur J Public Health 2021. [PMCID: PMC8574827 DOI: 10.1093/eurpub/ckab164.487] [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
Norway confirmed its first case of Coronavirus on the 26th of February 2020. As the number of infections continued to increase, the Norwegian Institute of Public Health started releasing daily reports on the 9th of March 2020. Public interest peaked with Norway locking down on the 12th of March. Local transmissions and outbreaks generated a growing demand for more granular data than the county-based level reported released by public health officials. The absence of detailed data created a market for some media outlets to release district-level situation reports behind paywalls (Aftenposten). Others implemented daily Corona-trackers on their front page by sourcing information from Norway's 358 municipalities (VG). While public authorities were tracking local infections and media published their results, none of the actors released detailed information in a complete, timely and accessible manner. Covid19data.no was launched as a citizen initiative on the 16th of April 2020 to provide historic and daily updated data for all municipalities and districts in Norway. The launch included daily updated dashboards and the release of all data in a cleaned, granular and machine-readable format. Soon, other citizens began contributing to the project, adding to the already existing list of data sources. The citizen initiative was launched 2 months before the Norwegian Institute of Public Health began releasing similar detailed data. Citizen dashboards can represent a valuable addition to public reporting, but also represent new challenges: How can you trust data and dashboards from a non-official actor? How do you keep data updated when running the dashboard on a voluntary basis? How are metrics and visualizations decided when creators have no experience with public health and epidemics? How do multiple collaborators effectively work together when they have never met before? This presentation will focus on the role of citizen initiatives, their challenges and opportunities.
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24
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Drake C, Zobl W, Wehr M, Kühne B, Vrieling H, Boei J, Hansen T, Escher S. Transcriptome Data to Substantiate the Assessment of Similar Mechanism of Actions in a Read-Across Context -a Case Study on Volatile Diketones. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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25
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Kaltschmidt B, Fitzek ADE, Schaedler J, Förster C, Kaltschmidt C, Hansen T, Steinfurth F, Windmöller BA, Pilger C, Kong C, Singh K, Nierhaus A, Wichmann D, Sperhake J, Püschel K, Huser T, Krüger M, Robson SC, Wilkens L, Schulte Am Esch J. Hepatic Vasculopathy and Regenerative Responses of the Liver in Fatal Cases of COVID-19. Clin Gastroenterol Hepatol 2021; 19:1726-1729.e3. [PMID: 33516952 PMCID: PMC7844358 DOI: 10.1016/j.cgh.2021.01.044] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 02/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infects the nasopharynx and lungs and causes coronavirus disease-2019 (COVID-19). It may impact the heart, brain, kidney, and liver.1 Although functional impairment of the liver has been correlated with worse clinical outcomes, little is known about the pathophysiology of hepatic injury and repair in COVID-19.2,3 Histologic evaluation has been limited to small numbers of COVID-19 cases with no control subjects2,4 and demonstrated largely heterogeneous patterns of pathology.2,3.
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Affiliation(s)
- Barbara Kaltschmidt
- Department of Cell Biology, Faculty of Biology, University of Bielefeld, Bielefeld, Germany
| | - Antonia D E Fitzek
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Schaedler
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Förster
- Institute of Pathology, KRH Hospital Nordstadt, affiliated with the University Hospital of the University of Bielefeld, Campus Bielefeld-Bethel, Hannover, Germany
| | - Christian Kaltschmidt
- Department of Cell Biology, Faculty of Biology, University of Bielefeld, Bielefeld, Germany
| | - Torsten Hansen
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Klinikum Lippe, Detmold, Germany
| | - Fabian Steinfurth
- Department of General and Visceral Surgery, University Hospital OWL of the University of Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Beatrice A Windmöller
- Department of Cell Biology, Faculty of Biology, University of Bielefeld, Bielefeld, Germany
| | - Christian Pilger
- Biomolecular Photonics, Faculty of Physics, University of Bielefeld, Bielefeld, Germany
| | - Cihang Kong
- Biomolecular Photonics, Faculty of Physics, University of Bielefeld, Bielefeld, Germany
| | - Kashika Singh
- Department of General and Visceral Surgery, University Hospital OWL of the University of Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Axel Nierhaus
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominic Wichmann
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Sperhake
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Huser
- Biomolecular Photonics, Faculty of Physics, University of Bielefeld, Bielefeld, Germany
| | - Martin Krüger
- Department of Internal Medicine and Gastroenterology, University Hospital OWL of the University of Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Simon C Robson
- Center for Inflammation Research, Department of Anesthesia and Division of Gastroenterology, Departement of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Ludwig Wilkens
- Institute of Pathology, KRH Hospital Nordstadt, affiliated with the University Hospital of the University of Bielefeld, Campus Bielefeld-Bethel, Hannover, Germany
| | - Jan Schulte Am Esch
- Department of General and Visceral Surgery, University Hospital OWL of the University of Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany.
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26
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Talley NJ, Walker MM, Jones M, Keely S, Koloski N, Cameron R, Fairlie T, Burns G, Shah A, Hansen T, Harris G, Holtmann G. Letter: budesonide for functional dyspepsia with duodenal eosinophilia-randomised, double-blind, placebo-controlled parallel-group trial. Aliment Pharmacol Ther 2021; 53:1332-1333. [PMID: 34029411 DOI: 10.1111/apt.16396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- N J Talley
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia
| | - M M Walker
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia
| | - M Jones
- NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.,Department of Psychology, Macquarie University, Ryde, NSW, Australia
| | - S Keely
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia
| | - N Koloski
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.,Department of Psychology, Macquarie University, Ryde, NSW, Australia.,Department of Gastroenterology, Princess Alexander Hospital, Woolloongabba, Qld, Australia
| | - R Cameron
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia
| | - T Fairlie
- Department of Gastroenterology, Princess Alexander Hospital, Woolloongabba, Qld, Australia
| | - G Burns
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia
| | - A Shah
- NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.,Department of Gastroenterology, Princess Alexander Hospital, Woolloongabba, Qld, Australia.,School of Medicine, University of Queensland, St Lucia, Qld, Australia
| | - T Hansen
- Department of Psychology, Macquarie University, Ryde, NSW, Australia
| | - G Harris
- University of Newcastle, Newcastle, NSW, Australia.,NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia
| | - G Holtmann
- NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.,Department of Gastroenterology, Princess Alexander Hospital, Woolloongabba, Qld, Australia.,School of Medicine, University of Queensland, St Lucia, Qld, Australia
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27
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Hansen T, Titze U, Kulamadayil-Heidenreich NSA, Glombitza S, Tebbe JJ, Röcken C, Schulz B, Weise M, Wilkens L. First case of postmortem study in a patient vaccinated against SARS-CoV-2. Int J Infect Dis 2021; 107:172-175. [PMID: 33872783 PMCID: PMC8051011 DOI: 10.1016/j.ijid.2021.04.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 01/06/2023] Open
Abstract
A previously symptomless 86-year-old man received the first dose of the BNT162b2 mRNA COVID-19 vaccine. He died 4 weeks later from acute renal and respiratory failure. Although he did not present with any COVID-19-specific symptoms, he tested positive for SARS-CoV-2 before he died. Spike protein (S1) antigen-binding showed significant levels for immunoglobulin (Ig) G, while nucleocapsid IgG/IgM was not elicited. Acute bronchopneumonia and tubular failure were assigned as the cause of death at autopsy; however, we did not observe any characteristic morphological features of COVID-19. Postmortem molecular mapping by real-time polymerase chain reaction revealed relevant SARS-CoV-2 cycle threshold values in all organs examined (oropharynx, olfactory mucosa, trachea, lungs, heart, kidney and cerebrum) except for the liver and olfactory bulb. These results might suggest that the first vaccination induces immunogenicity but not sterile immunity.
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Affiliation(s)
- Torsten Hansen
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, Detmold, Germany.
| | - Ulf Titze
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, Detmold, Germany
| | - Nidhi Su Ann Kulamadayil-Heidenreich
- Department of Internal Medicine, Gastroenterology and Infectious Medicine, University Hospital OWL of the University of Bielefeld, Campus Lippe, Detmold, Germany
| | - Sabine Glombitza
- Institute of Pathology, KRH Hospital Nordstadt, Hannover, Germany
| | - Johannes Josef Tebbe
- Department of Internal Medicine, Gastroenterology and Infectious Medicine, University Hospital OWL of the University of Bielefeld, Campus Lippe, Detmold, Germany
| | - Christoph Röcken
- Institute of Pathology of the University of Schleswig-Holstein, Campus Kiel, Germany
| | - Birte Schulz
- Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, Detmold, Germany
| | - Michael Weise
- Department of Internal Medicine, Gastroenterology and Infectious Medicine, University Hospital OWL of the University of Bielefeld, Campus Lippe, Detmold, Germany
| | - Ludwig Wilkens
- Institute of Pathology, KRH Hospital Nordstadt, Hannover, Germany
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28
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Titze U, Hansen T, Titze B, Schulz B, Gunnemann A, Rocco B, Sievert KD. Feasibility study for ex vivo fluorescence confocal microscopy (FCM) on diagnostic prostate biopsies. Quant Imaging Med Surg 2021; 11:1322-1332. [PMID: 33816171 DOI: 10.21037/qims-20-895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Fluorescence confocal microscopy (FCM) is a novel micro-imaging technique providing optical sections of examined tissue. The method has been well established for the diagnosis of tumours in dermatological specimens. Preliminary results found good feasibility when this technique was used to examine prostate cancer (PCa) specimens. Methods We report on the application of FCM in magnet resonance imaging (MRI)-fused prostate biopsies (10 patients, total number of biopsy specimens: n=121) and compare the results to conventional histology. Results Specific structures of the prostatic tissue were very well represented in the FCM images comparable to conventional histology. Prostate carcinoma was diagnosed with good sensitivity (79/68%) and high specificity (100%) by two pathologists with substantial/almost perfect levels of agreement with the results of conventional histology (kappa 0.79/0.86). Depending on the quality of the scans, malignant lesions of 1.8 mm and more in diameter were reliably diagnosed. Smaller lesions were rated as suspect for malignancy, but could not be consistently differentiated from reactive changes. Optimal image qualities were achieved in focus depths of up to 50 µm, whereas deeper scans led to insufficient representation of cytological features. Pre-treatment with acridine orange (AO) did not alter immunoreactivity of the tissue or its feasibility for fluorescence in situ hybridization (FISH) analyses and adequate amounts of DNA could be extracted for further polymerase chain reaction (PCR)-based examinations. Conclusions FCM seems to be a promising tool for the timely diagnosis in cases of PCa in patients requiring therapy. In particular, this technique is a material-sparing method that conserves the biopsies as unfixed material for further analysis such as molecular tumour companion diagnosis.
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Affiliation(s)
- Ulf Titze
- Department of Pathology, Klinikum Lippe GmbH, Detmold, Germany
| | - Torsten Hansen
- Department of Pathology, Klinikum Lippe GmbH, Detmold, Germany
| | - Barbara Titze
- Department of Pathology, Klinikum Lippe GmbH, Detmold, Germany
| | - Birte Schulz
- Department of Pathology, Klinikum Lippe GmbH, Detmold, Germany
| | | | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
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29
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Obura M, Beulens JWJ, Slieker R, Koopman ADM, Hoekstra T, Nijpels G, Elders P, Dekker JM, Koivula RW, Kurbasic A, Laakso M, Hansen TH, Ridderstråle M, Hansen T, Pavo I, Forgie I, Jablonka B, Ruetten H, Mari A, McCarthy MI, Walker M, McDonald TJ, Perry MH, Pearson ER, Franks PW, 't Hart LM, Rutters F. Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time: An IMI-DIRECT study. Diabet Med 2021; 38:e14428. [PMID: 33067862 DOI: 10.1111/dme.14428] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/10/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022]
Abstract
AIM To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. METHODS We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. RESULTS At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1-4. Participants in Subgroups 2-4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13-0.58), Subgroup 3 (β = 0.30; 95% CI 0.10-0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04-0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months. CONCLUSIONS Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.
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Affiliation(s)
- M Obura
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - J W J Beulens
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - R Slieker
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, The Netherlands
| | - A D M Koopman
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T Hoekstra
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
| | - G Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - P Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J M Dekker
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - R W Koivula
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
| | - A Kurbasic
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
| | - M Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Finland
| | - T H Hansen
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - M Ridderstråle
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - I Pavo
- Eli Lilly Regional Operations GmbH, Vienna, Austria
| | - I Forgie
- Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK
| | - B Jablonka
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - H Ruetten
- Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany
| | - A Mari
- Institute of Biomedical Engineering, National Research Council, Padova, Italy
| | - M I McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - M Walker
- Institute of Cellular Medicine (Diabetes), Newcastle University, Newcastle upon Tyne, UK
| | - T J McDonald
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School and Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - M H Perry
- Department of Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - E R Pearson
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - P W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), University of Oxford, Oxford, UK
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - L M 't Hart
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Molecular Epidemiology Section, Leiden University Medical Centre, Leiden, The Netherlands
| | - F Rutters
- Epidemiology and Data Science, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
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30
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Hansen T, Titze U, Trachte F, Maschuw K, Hiller W, Tebbe JJ. [Uncommon tumor of the gastric wall]. Pathologe 2020; 42:328-332. [PMID: 33355706 DOI: 10.1007/s00292-020-00886-6] [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] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
We report on a 72-year-old male patient suffering from weight loss, diarrhea, and epigastric pain. By means of endosonographic ultrasound, a well-circumscribed tumor mass was found in the gastric wall, suggesting a gastrointestinal stromal tumor (GIST). Biopsies were taken and processed for standard histopathological analysis. The microscopy revealed uniform, small, round cells with central nuclei and prominent cell borders embedded in vascularized stroma. Immunohistochemistry demonstrated the expression of actin, but showed negativity for cytokeratin, CD34, CD117, DOG‑1, desmin, and CD45. The tumor was diagnosed as a gastral glomus tumor. The diagnosis was confirmed in the wedge resection specimen. Gastral glomus tumors are rare intramural tumors of the stomach. GIST and neuroendocrine tumor (NET) present the main differential diagnoses. Especially with regard to the epithelioid variant of GIST, clear separation can be difficult. Besides standard histological examination, immunohistochemistry and molecular analysis can be helpful since gastral glomus tumors do not obtain c‑Kit- or PDGFRα mutations. Based on the fact that this tumor most commonly shows a benign biological behavior, the prognosis of gastral glomus tumors is favorable.
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Affiliation(s)
- T Hansen
- Institut für Pathologie, Klinikum Lippe GmbH, Röntgenstraße 18, 32756, Detmold, Deutschland.
| | - U Titze
- Institut für Pathologie, Klinikum Lippe GmbH, Röntgenstraße 18, 32756, Detmold, Deutschland
| | - F Trachte
- Klinik für Gastroenterologie und Infektiologie, Klinikum Lippe GmbH, Detmold, Deutschland
| | - K Maschuw
- Klinik für Allgemein- und Viszeralchirurgie, Klinikum Lippe GmbH, Detmold, Deutschland
| | - W Hiller
- Klinik für Allgemein- und Viszeralchirurgie, Klinikum Lippe GmbH, Detmold, Deutschland
| | - J J Tebbe
- Klinik für Gastroenterologie und Infektiologie, Klinikum Lippe GmbH, Detmold, Deutschland
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31
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Hansen T, Keiler A, Brochhausen C, Schulz B, Stege H. Uncommon finding of a "black node" in a patient with malignant melanoma and arthroplasty: A case report. Clin Case Rep 2020; 8:3098-3101. [PMID: 33363888 PMCID: PMC7752487 DOI: 10.1002/ccr3.3337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 06/21/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022] Open
Abstract
Postarthroplasty lymphadenopathy should be kept in mind particularly in patients with tumor (eg, melanoma) with a long-term history of total joint replacement therapy. Microscopy is mandatory in establishing diagnosis and is thus helpful for therapy.
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Affiliation(s)
- Torsten Hansen
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Andreas Keiler
- Clinic of DermatologyUniversity of RegensburgRegensburgGermany
| | - Christoph Brochhausen
- Klinikum Lippe DetmoldInstitute of PathologyUniversity of RegensburgRegensburgGermany
| | - Birte Schulz
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Helger Stege
- Clinic of DermatologyUniversity of RegensburgRegensburgGermany
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Lindsø Andersen P, Kjaersgaard Andersen R, Jemec GBE, Ullum H, Erikstrup C, Nielsen KR, Bruun MT, Hjalgrim H, Sørensen E, Burgdorf KS, Dinh KM, Banasik K, Hansen T, Saunte DM, Pedersen OB. Superficial fungal infections and patients with hidradenitis suppurativa: a study under the Danish Blood Donor Study. Clin Exp Dermatol 2020; 46:571-573. [PMID: 33006774 DOI: 10.1111/ced.14468] [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] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- P Lindsø Andersen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
| | | | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - H Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - C Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - K R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - M T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - H Hjalgrim
- Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - E Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K S Burgdorf
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - K Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- Danish Headache Center, Department of Neurology, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - D M Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - O B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Naestved, Denmark
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Kott K, Hansen T, De Dreu M, Vernon S, Kim T, Yang J, Fazekas De St Groth B, McGuire H, Figtree G. Circulating immune cell profiles detected by mass cytometry differ significantly between patients with predominantly calcified and predominantly non-calcified coronary atherosclerosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Inflammation is now a well-established component of the pathophysiology of coronary artery disease (CAD), but it is unknown whether atherosclerosis is associated with a distinct circulating immune cell profile. Mass cytometry time-of-flight (CYTOF) is a new precision technology which can be used to assess leukocyte populations comprehensively.
Purpose
To determine if patients with calcified and non-calcified (soft) coronary plaque have distinct circulating immune cell profiles when compared to healthy controls, and to assess whether this could be used to detect sub-clinical CAD.
Methods
Patients referred for a CT coronary angiogram were recruited; blood samples were collected and peripheral blood mononuclear cells (PBMCs) were isolated. Imaging data was analysed using a modified Gensini scoring system which incorporated plaque composition, with higher weighting given to soft plaque. The modified Gensini scores were then used to further segregate into calcified-predominant and soft-predominant disease groups. CYTOF analysis was performed on the PBMCs, with groups as outlined in Table 1.
Results
Age was significantly higher in the CAD+ group, but all other demographic features and risk factors did not differ between groups. Patients with predominantly calcified disease showed an increase in memory CD8 T cells (p=0.004), an increase in CD 39+ CD4 T cells (p=0.028), and a decrease in naïve CD8 T cells (p=0.005), which suggests an accumulated memory response in more quiescent disease. Patients with predominantly soft-plaque disease have higher pro-inflammatory monocyte populations (p=0.013) and proliferative CD4 T cell populations (p=0.011), suggesting acute innate and adaptive responses to biologically active plaque.
Conclusions
This pilot study has shown that further study should be pursued into the utility of CYTOF to identify sub-clinical CAD through differences in peripheral circulating immune cell profiles.
Figure 1
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): National Health and Medical Research Council of Australia, Heart Research Australia
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Affiliation(s)
- K.A Kott
- Royal North Shore Hospital, Department of Cardiology, Sydney, Australia
| | - T Hansen
- University of Sydney, Kolling Institute of Medical Research, Northern Clinical School, Sydney, Australia
| | - M De Dreu
- University of Sydney, School of Pathology, Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre, Sydney, Australia
| | - S.T Vernon
- Royal North Shore Hospital, Department of Cardiology, Sydney, Australia
| | - T Kim
- University of Sydney, School of Mathematics and Statistics, Sydney, Australia
| | - J.J Yang
- University of Sydney, School of Mathematics and Statistics, Sydney, Australia
| | - B Fazekas De St Groth
- University of Sydney, School of Pathology, Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre, Sydney, Australia
| | - H McGuire
- University of Sydney, School of Pathology, Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre, Sydney, Australia
| | - G.A Figtree
- University of Sydney, Kolling Institute of Medical Research, Northern Clinical School, Sydney, Australia
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Windsor JW, Buie M, Coward S, Gearry R, Hansen T, King JA, Kotze P, Ma C, Ng S, Panaccione N, Panaccione R, Quan J, Seow C, Underwood F, Kaplan GG. A28 RELATIVE RATES OF ULCERATIVE COLITIS TO CROHN’S DISEASE: PARALLEL EPIDEMIOLOGIES IN NEWLY VS. HIGHLY INDUSTRIALIZED COUNTRIES. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Inflammatory bowel disease (IBD) first presents in a population as cases of ulcerative colitis (UC) followed by cases of Crohn’s disease (CD). Newly industrialized countries (NIC) show a prallel epidemiology of IBD to highly industrialized countries (HIC) in the previous century; one marker of this is the relative incidence/prevalence rates of UC to CD, which approximates 1 over time.
Aims
Provide evidence for the UC:CD ratio as a proxy for disease penatrance in a population.
Methods
Systematic review of MedLine and Embase for studies reporting incidence or prevalence of UC and CD. Log-linear regression (by region and NIC/HIC [2019 United Nations definitions]) was used to calculate average annual percent change (AAPC) and associated 95% confidence intervals (CI). Data were plotted on an online, interactive map to show trends (link provided).
Results
We extracted data from 218 studies compising population-level data from 69 countries. We found negative AAPCs as the prevalence ratio of UC:CD significantly decreased over time in East Asia, West Asia, North Europe, and South Europe; 6/12 global regions displayed significantly decreasing incidence ratios. No AAPC was found to be significantly increasing (Table 1). When examing HIC/NIC, we found a significant effect of NIC on the UC:CD prevalence ratio after 2000 (AAPC:−3.83;95%CI:−6.28,−1.31) while HIC regions remained stable (AAPC:2.14;95%CI:−1.40,5.82). Looking at all available data, both HICs and NICs show significantly decreasing UC:CD prevalence ratios (HIC:AAPC:−3.72;95% CI:−4.46,−2.97; NIC:AAPC:−2.62;95%CI:−4.13,−1.08).
Conclusions
In some HICs (eg. Canada), the UC:CD incidence ratio was <1 in the earliest available data (1966), explaining the stable AAPC in North America (AAPC:−0.24;95%CI:−1.12,0.65). However, in NICs (eg. Southern Asia), the AAPC is rapidly decreasing (AAPC:−24.68;95%CI:−37.85,−8.71) as areas like Sri Lanka rapidly fall from an incidence ratio of 7.5 (2007) to 2.8 (2012), mimicking trends in IBD epidimeology of HICs in the previous century.
Funding Agencies
None
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Affiliation(s)
- J W Windsor
- Medicine, University of Calgary, Calgary, AB, Canada
| | - M Buie
- Medicine, University of Calgary, Calgary, AB, Canada
| | - S Coward
- University of Calgary, Calgary, AB, Canada
| | - R Gearry
- University of Otago, Christchurch, New Zealand
| | - T Hansen
- Medicine, University of Calgary, Calgary, AB, Canada
| | - J A King
- University of Calgary, Calgary, AB, Canada
| | - P Kotze
- Catholic University of Paraná, Curitiba, Brazil
| | - C Ma
- University of Calgary, Calgary, AB, Canada
| | - S Ng
- Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - N Panaccione
- Medicine, University of Calgary, Calgary, AB, Canada
| | | | - J Quan
- Medicine, University of Calgary, Calgary, AB, Canada
| | - C Seow
- Medicine, University of Calgary, Calgary, AB, Canada
| | - F Underwood
- Medicine, University of Calgary, Calgary, AB, Canada
| | - G G Kaplan
- Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Hansen T, Baraty B, Lu C, Tanyingoh D, Maaser C, Novak KL. A248 WHAT IS THE MINIMUM TRAINING STANDARD FOR POINT OF CARE INTESTINAL ULTRASOUND? A SINGLE CENTER, PROSPECTIVE, OBSERVATIONAL STUDY TO DEFINE TRAINING STANDARDS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Higher demands for colonoscopy and magnetic resonance imaging (MRI) for long term disease monitoring can be expected as the prevalence of IBD continues to rise in Canada. As resources are perpetually constrained, timely access to effective monitoring strategies important to direct care are increasingly compromised. Intestinal ultrasound provides a cost-effective solution to these challenges. Intestinal ultrasound (IUS) is a patient-centered, accurate modality used during clinic by non-radiologists to enhance clinical decision making. Minimum IUS training standards have yet to be established.
Aims
The aim of this study is to report a single operator IUS performance characteristics after completion of 4 weeks of training with 100 completed supervised scans.
Methods
A single center, prospective, observational study over 4 years utilizing a convenience sample of patients presenting to the inflammatory bowel disease (IBD) clinic at the University of Calgary. A single operator compared IUS to gold standard (either colonoscopy, or alternative cross-sectional imaging) with sensitivity, specificity, positive and negative predictive value calculated for each year. Joinpoint regression was performed to analyze the trend for sensitivity and specificity over the study period.
Results
A total of 235 IUS were performed on 235 individuals diagnosed with IBD between 2013 and 2016. There were individuals with 26 ulcerative colitis and 209 persons diagnosed with Crohn’s disease. There was a non-significant increase in sensitivity and specificity point estimates over the 4 year period (Table 1). The sensitivity, specificity, positive predictive value, and accuracy of IUS in 2016 were 100% (95% CI: 81%-100%), 92% (95% CI: 62%-100%), 94% (95% CI: 72%-99%) and 97% (95% CI: 8%-100%) respectively.
Conclusions
IUS provision by a gastroenterologist having completed 100 supervised scans during training within an expert center is sufficient, resulting in high accuracy. Although there is some improvement over time, the trend towards improvement over time is not significant. This study provides evidence to inform IUS training programs with a minimum training standard benchmark, imperative with expanding demand and development of new expert centers.
Funding Agencies
None
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Affiliation(s)
- T Hansen
- University of Calgary, Calgary, AB, Canada
| | - B Baraty
- Gastroenterology, University of Calgary, Calgary AB, AB, Canada
| | - C Lu
- Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - D Tanyingoh
- Gastroenterology, University of Calgary, Calgary AB, AB, Canada
| | - C Maaser
- Hospital Luneberg, Luneberg, Germany
| | - K L Novak
- Gastroenterology, University of Calgary, Calgary AB, AB, Canada
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Cavaglià M, Gaudio S, Hansen T, Staats K, Szczepańczyk M, Zanolin M. Improving the background of gravitational-wave searches for core collapse supernovae: a machine learning approach. Mach Learn : Sci Technol 2020. [DOI: 10.1088/2632-2153/ab527d] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Based on the prior O1–O2 observing runs, about 30% of the data collected by Advanced LIGO and Virgo in the next observing runs are expected to be single-interferometer data, i.e. they will be collected at times when only one detector in the network is operating in observing mode. Searches for gravitational-wave signals from supernova events do not rely on matched filtering techniques because of the stochastic nature of the signals. If a Galactic supernova occurs during single-interferometer times, separation of its unmodelled gravitational-wave signal from noise will be even more difficult due to lack of coherence between detectors. We present a novel machine learning method to perform single-interferometer supernova searches based on the standard LIGO-Virgo coherent WaveBurst pipeline. We show that the method may be used to discriminate Galactic gravitational-wave supernova signals from noise transients, decrease the false alarm rate of the search, and improve the supernova detection reach of the detectors.
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37
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Kott K, Vernon S, Hansen T, de Dreu M, Kim T, Yang J, Fazekas De St Groth B, McGuire H, Figtree G. 302 Circulating Immune Cell Profiles Detected by Mass Cytometry Differ Significantly between Patients with Predominantly Calcified and Predominantly Non-Calcified Coronary Atherosclerosis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Georges H, Bishop J, Van Campen H, Barfield J, Hansen T. 102 A delay in maternal zygotic transition may lead to early embryonic loss in poor-quality bovine blastocysts. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Increased genetic potential and performance of dairy cows has coincided with a decline in fertility. Early embryonic mortality accounts for 75-80% of this decline in fertility, costing the industry over $1.28 trillion worldwide. Despite advancements in assisted reproductive technologies and embryo transfer, many transferred embryos do not survive past Day 24 of gestation, suggesting flaws in embryo selection for transfer. It was hypothesised that visually lower-quality IVF Day 7 blastocysts were developmentally delayed as a result of altered mitotic signalling and were at higher risk of embryo mortality. To identify potential causes for early embryo mortality in IVF embryos, RNA-Seq was performed on 6 categories of Day 7 blastocysts: stages (S) 5 (early), 6 (full), and 7 (expanded), with quality scores (Q) of 1 or 2. Oocytes were matured, fertilized by routine procedure, and cultured for 7 days. Blastocysts were classified and graded, separated into the six categories, and subjected to Pronase digestion of the zona pellucida. From three biological replicates of each blastocyst group, RNA was extracted and submitted for RNA-sequencing. Secondary bioinformatics and analyses were performed using R to determine differentially expressed genes. When S7.Q1 blastocysts were compared to other categories, 55 genes were consistently differentially expressed (P<0.05) in S5.Q1 or 2 and S6.Q2. Of these 55 genes, 15 were significantly upregulated (>1.5 fold change), and 40 were downregulated (<−1.5 fold change). The nine most common upregulated genes in S5.Q1 or 2 and S6.Q2, compared with S7.Q1, were BTG4, ARGFX, GPC4, BOC, CNTNAP2, NR3C2, CCDC7, and PHYHIPL. The five most common downregulated genes included MUC1, HSD3B1, ADAM19, EVPL, and TGM1. The EVPL and TGM1 proteins are associated with cell barrier permeability, and a lack of TGM1 has been shown to cause neonatal death in mice. Therefore, early embryo mortality may begin with decreased EVPL and TGM1, limiting cell permeability and communication between blastomeres. This limited communication might delay gene expression in the embryo at the 4- to 8-cell stage, delaying the maternal zygotic transition (MZT), in spite of continued cell division. This explanation is supported by the observed increase in ARGFX and BTG4 mRNA. Normally, stored maternal BTG4 mRNA becomes translated during the MZT and degrades maternal mRNA. The increase of BTG4 mRNA in poor-quality embryos may reflect delayed translation of BTG4 and delayed MZT. The mRNA transcripts increased in poor-quality blastocysts may be excess maternal mRNA not yet degraded, like BTG4. The decreased mRNA transcripts observed may be indicative of zygotic genes which have not yet been transcribed. For instance, MUC1 is necessary for proper embryo implantation, and HSD3B1 converts placental pregnenolone to progesterone and produces a precursor to oestradiol. The delayed transcription of both MUC1 and HSD3B1 may impair maternal recognition of pregnancy, implantation, and communication to the maternal endometrium via oestradiol, thereby causing embryo mortality.
This research was supported by USDA NNF 2016-38420-25289 and Zoetis Inc.
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Hansen T, Bubb K, McGuire H, Kim T, Vernon S, Kott K, Yang J, Kassiou M, Figtree G. 001 The Utility of the P2X7 Receptor as a Diagnostic and Therapeutic Target in Atherosclerosis and Efficacy of a Novel P2X7 Receptor Antagonist. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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40
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Davis T, Desouza C, Bain S, Gondolf T, Hansen T, Holst I, Rea R, Seufert J. 563 The Effect of Once-Weekly Semaglutide on MACE and Blood Pressure by Race and Ethnicity: SUSTAIN 6 Post Hoc Analysis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.570] [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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41
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Hansen T, Nilsson M, Lindholm D, Sundström J, Hedberg J. Normal radiological lymph node appearance in the thorax. Dis Esophagus 2019; 32:1-6. [PMID: 30561570 DOI: 10.1093/dote/doy120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 04/17/2018] [Revised: 10/18/2018] [Indexed: 12/11/2022]
Abstract
Modern treatment of esophageal cancer is multimodal and highly dependent on a detailed diagnostic assessment of clinical stage, which includes nodal stage. Clinical appraisal of nodal stage is highly dependent on knowledge of normal radiological appearance, information of which is scarce. We aimed to describe lymph node appearance on computed tomography (CT) investigations in a randomly selected cohort of healthy subjects. In a sample of the Swedish Cardiopulmonary bioimage study, which investigates a sample of the Swedish population aged 50-64 years, the CT scans of 426 subjects were studied in detail concerning intrathoracic node stations relevant in clinical staging of esophageal cancer. With stratification for sex, the short axis of visible lymph nodes was measured and the distribution of lymph node sizes was calculated as well as proportion of patients with visible nodes above 5 and 10 millimeters for each station. Probability of having any lymph node station above 5 and 10 millimeters was calculated with a logistic regression model adjusted for age and sex. In the 214 men (aged: 57.3 ± 4.1 years) and 212 women (aged: 57.8 ± 4.4 years) included in this study, a total of 309 (72.5%) had a lymph node with a short axis of 5 mm or above was seen in at least one of the node stations investigated. When using 10 mm as a cutoff, nodes were visible in 29 (6.81%) of the subjects. Men had higher odds of having any lymph node with short axis 5 mm or above (OR 3.03 95% CI 1.89-4.85, P < 0.001) as well as 10 mm or above (OR 2.31 95% CI 1.02-5.23, P = 0.044) compared to women. Higher age was not associated with propensity for lymph nodes above 5 or 10 millimeters in this sample. We conclude that, in a randomly selected cohort of patients between 50 and 64 years, almost 10% of the men and 4% of the women had lymph nodes above 10 millimeters, most frequently in the subcarinal station (station 107). More than half of the patients had nodes above 5 millimeters on CT and men were much more prone to have this finding. The probability of finding lymph nodes in specific stations relevant of esophageal cancer is now described.
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Affiliation(s)
| | - M Nilsson
- Department of Medical Sciences, and Uppsala University, Uppsala
| | - D Lindholm
- Division of Surgery, CLINTEC, Karolinska Institutet and Department of Upper Abdominal Surgery, Division of Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - J Sundström
- Division of Surgery, CLINTEC, Karolinska Institutet and Department of Upper Abdominal Surgery, Division of Cancer, Karolinska University Hospital, Stockholm, Sweden
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Kanters J, Ghouse J, Skov M, Isaksen J, Christiansen M, Graff C, Grarup N, Have CT, Linneberg A, Hansen T, Olesen M. Genetical component of the QT interval is associated with increased mortality in the general population. J Electrocardiol 2019. [DOI: 10.1016/j.jelectrocard.2019.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Desouza C, Bain SC, Gondolf T, Hansen T, Holst I, Rea RR, Seufert J. P6271The effect of semaglutide once weekly on MACE and blood pressure by race and ethnicity: SUSTAIN 6 post hoc analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In SUSTAIN 6, subcutaneous semaglutide once weekly added to standard of care significantly reduced major adverse cardiovascular events (MACE: non-fatal myocardial infarction, non-fatal stroke or death) vs placebo over 2 years in T2D subjects.
Purpose
Assess the effect of semaglutide vs placebo on MACE and blood pressure (BP) by race and ethnicity in a post hoc analysis of SUSTAIN 6.
Methods
Subjects were randomised to semaglutide 0.5 mg, 1.0 mg or volume-matched placebo. Data for the two semaglutide-dose groups were pooled and compared to the pooled placebo groups. Time-to-event data were analysed with a Cox proportional hazards model. Changes from baseline to week 104 were analysed using analysis of covariance. The interaction between treatment and subgroup was added to the models.
Results
Overall, 3,297 patients received treatment. Subgroups included Caucasian, Asian, Black/African American, Other (race), and Hispanic, non-Hispanic (ethnicity). Mean baseline characteristics were similar across subgroups (age 64.7 years, HbA1c 8.7%, diabetes duration 14.2 years). Time to composite MACE and individual components were improved with semaglutide across all subgroups. Semaglutide affected BP similarly across race and ethnicity, except for systolic BP in Black/African American subjects (Table).
Race Ethnicity Caucasian Asian Black/African American Other Interaction p-value Hispanic Non-Hispanic Interaction p-value Semaglutide (n) 1,384 121 108 35 256 1,392 Placebo (n) 1,352 152 113 32 254 1,395 MACE and individual outcomes MACE HR [95% CI] 0.76 [0.58; 1.00] 0.58 [0.25; 1.34] 0.72 [0.23; 2.28] 0.46 [0.08; 2.50] 0.8793 0.67 [0.33; 1.36] 0.74 [0.57; 0.96] 0.7978 CV death HR [95% CI] 0.98 [0.63; 1.50] 0.32 [0.04; 2.85] 1.01 [0.06; 16.20] n/a† 0.8089 0.79 [0.31; 2.00] 1.00 [0.63; 1.59] 0.6521 Non-fatal MI HR [95% CI] 0.69 [0.45; 1.07] 0.97 [0.36; 2.60] 1.37 [0.31; 6.12] 0.31 [0.03; 3.00] 0.6637 0.65 [0.18; 2.31] 0.74 [0.50; 1.10] 0.8562 Non-fatal stroke HR [95% CI] 0.70 [0.42; 1.16] 0.31 [0.04; 2.77] n/a‡ n/a‡ 0.9176 0.73 [0.16; 3.27] 0.60 [0.36; 0.99] 0.7995 Blood pressure at week 104 Systolic BP* ETD (mmHg) [95% CI] −1.92 [−3.09; −0.74] −4.98 [−8.61; 1.35] 4.47 [0.15; 8.79] −11.02 [−18.45; −3.60] 0.0008 −3.22 [−5.93; −0.51] −1.81 [−2.98; −0.64] 0.3489 Diastolic BP* ETD (mmHg) [95% CI] 0.36 [−0.32; 1.04] −1.31 [−3.43; 0.80] −0.07 [−2.56; 2.43] −3.41 [−7.73; 0.92] 0.1871 −0.18 [−1.75; 1.39] 0.16 [−0.52; 0.83] 0.6981 *Treatment difference between semaglutide and placebo (pooled 0.5 and 1.0 mg values for each treatment group) at week 104. †No events in the placebo group; ‡No events in the semaglutide group. BP, blood pressure; CI, confidence interval; ETD, estimated treatment difference; HR, hazard ratio; MACE, major adverse cardiovascular event; MI, myocardial infarction.
Conclusion
Overall there was no evidence of a differential effect of semaglutide on risk reduction in MACE and its components and on BP across race and ethnicity subgroups in this post hoc analysis.
Acknowledgement/Funding
Novo Nordisk A/S
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Affiliation(s)
- C Desouza
- University of Nebraska Medical Center, Omaha, United States of America
| | - S C Bain
- Swansea University, School of Medicine, Swansea, United Kingdom
| | | | - T Hansen
- Novo Nordisk A/S, Søborg, Denmark
| | - I Holst
- Novo Nordisk A/S, Søborg, Denmark
| | - R R Rea
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | - J Seufert
- University of Freiburg Medical Center, Faculty of Medicine, Freiburg, Germany
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Hansen T, Constantin C, Weber M, Titze U, Hartmann F. [Bronchoalveolar lavage in hairy cell leukemia with pulmonary infiltration]. Pathologe 2019; 40:529-533. [PMID: 30937513 DOI: 10.1007/s00292-019-0586-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We report a 78-year-old male patient suffering from hairy cell leukemia, presenting clinically mainly with dyspnea. Radiology exhibited bilateral ground-glass shadows. In order to prevent pneumonia as a possible side effect due to conventional chemotherapy, it was decided to first treat the patient with rituximab; however, dyspnea persisted. Therefore, bronchoscopy was performed and specimens were sampled for both histological examination and bronchoalveolar lavage (BAL) analysis. BAL showed lymphocytosis (28.7%), and by means of immunocytochemistry a few CD79a+ B‑lymphocytes as well as lymphoid cells positive for the hairy cell marker DBA44 were observed. In addition, molecular study revealed the BRAF V600E mutation. Thus, the findings of BAL were interpreted as lung infiltration by hairy cell leukemia. This result was confirmed by histology. Following a therapy switch to cladribine, a significant improvement was reached. Pulmonary infiltrates by hairy cell leukemia were rarely described. This case represents the first report of hairy cell leukemia diagnosed by means of BAL. It may be difficult to clearly separate between lymphoma infiltration of the lung and medicamentous pneumonitis, but this differential diagnosis can be supported by morphological methods.
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Affiliation(s)
- T Hansen
- Institut für Pathologie, Klinikum Lippe GmbH, Detmold und Lemgo, Röntgenstraße 18, 32756, Detmold, Deutschland.
| | - C Constantin
- Klinik für Onkologie und Hämatologie, Klinikum Lippe GmbH, Detmold und Lemgo, Lemgo, Deutschland
| | - M Weber
- Klinik für Pneumologie, Schlaf- und Beatmungsmedizin, Klinikum Lippe GmbH, Detmold und Lemgo, Lemgo, Deutschland
| | - U Titze
- Institut für Pathologie, Klinikum Lippe GmbH, Detmold und Lemgo, Röntgenstraße 18, 32756, Detmold, Deutschland
| | - F Hartmann
- Klinik für Onkologie und Hämatologie, Klinikum Lippe GmbH, Detmold und Lemgo, Lemgo, Deutschland
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Rankins E, Hansen T, Van Camp D, Weir-Chouinard J, Warren L, Wickens C. Effect of crude protein on fiber digestibility of a warm-season forage-based diet in mature horses. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.075] [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: 10/26/2022]
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Nour D, Allahwala U, Hansen T, Muthukrishna N, Choong C, Hansen P, Bhindi R. Comparison of Aortic Gradient Assessment Modalities in Balloon Aortic Valvuloplasty; is there a Correlation Between Echocardiograpic and Invasively Obtained Aortic Gradients? Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hansen T, Cooney L, Bobel J, Rankins E, Willemse E, Adkin A, Warren L. 469 Soluble fiber in equine diets alters fecal characteristics. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Hansen
- University of Florida,Gainesville, FL, United States
| | - L Cooney
- University of Florida,Gainesville, FL, United States
| | - J Bobel
- University of Florida,Gainesville, FL, United States
| | - E Rankins
- University of Florida,Gainesville, FL, United States
| | - E Willemse
- University of Florida,Gainesville, FL, United States
| | - A Adkin
- University of Florida,Gainesville, FL, United States
| | - L Warren
- University of Florida,Gainesville, FL, United States
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Hansen T, Bobel J, Rankins E, Vasco C, Sanchez L, Warren L. PSI-16 Exploring the relationship between digesta retention time in the equine gastrointestinal tract and compartment models. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Hansen
- University of Florida,Gainesville, FL, United States
| | - J Bobel
- University of Florida,Gainesville, FL, United States
| | - E Rankins
- University of Florida,Gainesville, FL, United States
| | - C Vasco
- University of Florida,Gainesville, FL, United States
| | - L Sanchez
- Large Animal Clinical Sciences University of Florida,Gainesville, FL, United States
| | - L Warren
- University of Florida,Gainesville, FL, United States
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Jennings C, De Bacquer D, Prescott E, Hansen T, Gale C, Astin F. MS03.3 Factors Influencing Patients’ Self-reported Lifestyle Changes and Medication Adherence Following an Acute Cardiac Event In 12 Countries: A Specialist Study Within the Euroaspire V (EAV) Survey. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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