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Simonetti V, Tomietto M, Comparcini D, Pastore F, Stefanizzi P, Tafuri S, Cicolini G. The community nurse's role on the promotion of papillomavirus vaccination among young students: A study protocol. Hum Vaccin Immunother 2024; 20:2314383. [PMID: 38356279 PMCID: PMC10877978 DOI: 10.1080/21645515.2024.2314383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
Vaccination is the principal strategy for primary prevention of infection by Human Papilloma Virus (HPV), which causes different pathological conditions, up to cancer, in both males and females. However, to date, knowledge among adolescents and their parents about the HPV vaccine is still low. The aim of this quasi-experimental, multicenter study is to assess the effectiveness of a digital educational intervention, conducted by a multidisciplinary health-care team including a Community Nurse, to increase adolescents' HPV vaccination uptake, their knowledge, self-efficacy, feelings and involvement in HPV vaccine decision-making, and parents' vaccination hesitancy. The study will be carried out among a population of students (and their parents), aged between 11 and 13, at secondary schools in Italy. Validated questionnaires will be administered to both students and parents at baseline (T0) and 3 months after a digital educational intervention (T1). The findings may be useful in evaluating and deepening a methodology for designing and implementing educational interventions, embedded in the school setting, that could promote the achievement of outcomes within the broader process of youth's health promotion.
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Affiliation(s)
- Valentina Simonetti
- Department of Medicine and Surgery, Casamassima, “LUM University” Giuseppe Degennaro, Bari, Italy
| | - Marco Tomietto
- Department of Nursing, Midwifery, and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Dania Comparcini
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Francesco Pastore
- Department of Biomedicine and Prevention, TorVergata University, Rome, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, Bari, Italy
| | - Giancarlo Cicolini
- Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), ”Aldo Moro” University of Bari, Bari, Italy
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2
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Fairer JJM, Playfor S, Sutherland AB, Tume LN. Is a UK multicentre trial of intravenous maintenance fluid volumes in critically ill children feasible? Intensive Crit Care Nurs 2024; 82:103624. [PMID: 38245495 DOI: 10.1016/j.iccn.2024.103624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Affiliation(s)
- Jane J M Fairer
- Staff Nurse in Paediatric Critical Care, Royal Manchester Children's Hospital, Manchester UK.
| | - Stephen Playfor
- Consultant Paediatric Intensivist, Royal Manchester Children's Hospital, Manchester UK.
| | - Adam B Sutherland
- Healthcare Quality & Safety, School of Pharmacy, Healthcare Quality & Safety, School of Life Sciences, University of Bradford.
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Bodker K, Freidin N, Arora N. A basic solution for a complex problem: does treatment of metabolic acidosis slow CKD progression? Curr Opin Nephrol Hypertens 2024; 33:304-310. [PMID: 38420899 DOI: 10.1097/mnh.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE OF THIS REVIEW Metabolic acidosis is frequently encountered in patients with chronic kidney disease (CKD), with increasing prevalence as kidney function worsens. Treating electrolyte disturbances is the sine qua non of Nephrologists, and alkali therapy to normalize serum bicarbonate levels and slow progression of kidney disease has been embedded in clinical practice guidelines for decades on the basis of animal models and controversial clinical trials. This review will critically appraise the literature base for this recommendation and determine whether the available evidence supports this common practice, which is a timely endeavor considering the impending demotion of metabolic acidosis treatment from recommendation to practice point in forthcoming KDIGO guidelines. RECENT FINDINGS Earlier, open-label, studies supporting the utility of sodium bicarbonate therapy to slow progression of chronic kidney disease have been challenged by more recent, blinded, studies failing to show benefit on CKD progression. This was further demonstrated in the absence of concomitant sodium administration with the hydrochloric acid binder veverimer, which failed to demonstrate benefit on renal death, end stage kidney disease or 40% reduction in estimated glomerular filtration rate in a large multicenter trial. SUMMARY The current body of literature does not support the routine treatment of metabolic acidosis in patients with CKD and the authors agree with the forthcoming KDIGO guidelines to de-emphasize this common practice.
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Affiliation(s)
| | | | - Nayan Arora
- University of Washington, Seattle, Washington, USA
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Chen ZW, Zhang XF, Tu ZM. Treatment measures for seasonal affective disorder: A network meta-analysis. J Affect Disord 2024; 350:531-536. [PMID: 38220102 DOI: 10.1016/j.jad.2024.01.028] [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: 08/16/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVE The purpose of this study was to assess the potential effectiveness of several mainstream therapies, including phototherapy, antidepressants, cognitive-behavioral therapy, and negative ion generators, in the treatment of Seasonal Affective Disorder (SAD). METHODS A systematic search of PubMed, Embase, Cochrane, and WOS databases was conducted from January 1975 to December 3, 2022. Randomized controlled trials meeting predefined selection criteria for the treatment of SAD using mainstream therapeutic approaches were identified. After reviewing abstracts, data were synthesized and categorized based on the type of intervention and the targeted disorder. RESULTS A total of 21 randomized controlled trials, involving 1037 participants, were included. The standardized mean difference of depression scores and corresponding 95 % confidence intervals were calculated to assess the efficacy of phototherapy for Seasonal Affective Disorder. The meta-analysis revealed that phototherapy was significantly more effective than other intervention groups or control therapies, with an effect size of 4.64(2.38,7.03). Subgroup analysis demonstrated that no factors could explain the significant heterogeneity observed. Phototherapy exhibited statistically significant mild to moderate therapeutic effects in alleviating depressive symptoms and can be considered as a clinical therapy for treating Seasonal Affective Disorder. However, the quality of evidence remains low, and further well-designed, larger sample size, and high-quality studies are needed to confirm the efficacy of phototherapy in treating Seasonal Affective Disorder. CONCLUSION In conclusion, our systematic review and meta-analysis indicate that bright light therapy is a promising first-line non-pharmacological treatment for Seasonal Affective Disorder (SAD), showing significant improvement in mood symptoms compared to placebo. The findings support the use of bright light therapy as an effective and well-tolerated intervention for SAD. However, further large-scale, multicenter randomized controlled trials with long-term follow-up are needed to assess the long-term efficacy and safety of different treatment approaches for SAD.
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Affiliation(s)
- Zuo-Wei Chen
- Yangtze University Medical School, Jingzhou, Hubei 434000, China
| | - Xin-Feng Zhang
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China; Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
| | - Zhe-Ming Tu
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China; Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China.
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Chiu CC. Letter to the Editor of Annals of Surgical Oncology Concerning "Safety and Efficacy of Oxaliplatin Pressurized Intraperitoneal Aerosolized Chemotherapy (PIPAC) in Colorectal and Appendiceal Cancer with Peritoneal Metastases: Results of a Multicenter Phase I Trial in the USA". Ann Surg Oncol 2024; 31:2405-2407. [PMID: 37971615 DOI: 10.1245/s10434-023-14595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/29/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
- Department of Medical Education and Research, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
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Langeslag JF, Onland W, Groenendaal F, de Vries LS, van Kaam AH, de Haan TR. Association Between Seizures and Neurodevelopmental Outcome at Two and Five Years in Asphyxiated Newborns With Therapeutic Hypothermia. Pediatr Neurol 2024; 153:152-158. [PMID: 38387280 DOI: 10.1016/j.pediatrneurol.2024.01.023] [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: 06/25/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE To investigate the association between the presence and severity of seizures in asphyxiated newborns and their neurodevelopmental outcome at ages two and five years. METHODS Retrospective data analysis from a prospectively collected multicenter cohort of 186 term-born asphyxiated newborns undergoing therapeutic hypothermia (TH) in 11 centers in the Netherlands and Belgium. Seizures were diagnosed by amplitude-integrated electroencephalography (EEG) and raw EEG signal reading up to 48 hours after rewarming. Neurodevelopmental outcome was assessed by standardized testing at age two and five years. Primary outcome was death or long-term neurodevelopmental impairment (NDI) including cerebral palsy. Associations were calculated using univariate and multivariate logistic regression analyses adjusting for Thompson score and a validated brain magnetic resonance imaging (MRI) score. RESULTS Seventy infants (38%) had seizures during TH or rewarming, and 44 (63%) of these needed two or more antiseizure medications (ASMs). Overall mortality was 21%. Follow-up data from 147 survivors were available for 137 infants (93%) at two and for 94 of 116 infants (81%) at five years. NDI was present in 26% at two and five years. Univariate analyses showed a significant association between seizures and death or NDI, but this was no longer significant after adjusting for Thompson and MRI score in the multivariate analysis; this was also true for severe seizures (need for two or more ASMs) or seizures starting during rewarming. CONCLUSION The presence or severity of seizures in newborns undergoing TH for hypoxic-ischemic encephalopathy was not independently associated with death or NDI up to age five years after adjusting for several confounders.
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Affiliation(s)
- Juliette F Langeslag
- Department of Neonatology, Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
| | - Wes Onland
- Department of Neonatology, Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
| | - Floris Groenendaal
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Brain Center, Utrecht, the Netherlands
| | - Linda S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Brain Center, Utrecht, the Netherlands
| | - Anton H van Kaam
- Department of Neonatology, Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
| | - Timo R de Haan
- Department of Neonatology, Amsterdam UMC Location University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands.
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Spratt DE, Dorff T, McKay RR, Lowentritt BH, Fallick M, Gatoulis SC, Flanders SC, Ross AE. Evaluating relugolix for the treatment of prostate cancer in real-world settings of care: the OPTYX study protocol. Future Oncol 2024; 20:727-738. [PMID: 38488039 DOI: 10.2217/fon-2023-0748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
OPTYX is a multi-center, prospective, observational study designed to further understand the actual experience of patients with advanced prostate cancer treated with relugolix (ORGOVYX®), an oral androgen deprivation therapy (ADT), by collecting clinical and patient-reported outcomes from routine care settings. The study aims to enroll 1000 consented patients with advanced prostate cancer from community, academic and government operated clinical practices across the USA. At planned timepoints, real-world data analysis on treatment patterns, adherence and safety as well as health outcomes and health-related quality-of-life (HRQOL) after treatment discontinuation will be published in scientific peer-reviewed journals and presented at relevant conferences. This study will provide real-world data for practitioners and researchers in their understanding of the safety and effectiveness of relugolix. Clinical Trial Registration: NCT05467176 (ClinicalTrials.gov).
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Affiliation(s)
- Daniel E Spratt
- Radiation Oncology, UH Seidman Cancer Center/Case Western Reserve University, Cleveland, OH 441062, USA
| | - Tanya Dorff
- Medical Oncology, City of Hope, Duarte, CA 910103, USA
| | - Rana R McKay
- Medical Oncology, UC San Diego, La Jolla, CA 920374, USA
| | | | | | | | - Scott C Flanders
- Myovant Sciences Inc., Brisbane, CA & Sumitomo Pharma America Inc., Marlborough, MA 017528, USA
| | - Ashley E Ross
- Urology, Northwestern Medicine, Chicago, IL 60611, USA
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Filip P, Chiang H, Goldberg A, Khorsandi AS, Moonis G, Moody Antonio SA, Wanna G, Cosetti M. Challenges in the Management of Symptomatic Fallopian Canal Meningoceles: A Multicenter Case Series and Literature Review. Otol Neurotol 2024; 45:434-439. [PMID: 38478412 DOI: 10.1097/mao.0000000000004155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
OBJECTIVE To describe the presentations, the diagnosis, our treatment approaches, and the outcomes for 11 patients with fallopian canal meningocele (FCM). STUDY DESIGN MULTICENTER Retrospective case series. SETTING Tertiary referral centers. PATIENTS Patients (N = 11) with radiographically or intraoperatively identified, symptomatic FCM. INTERVENTIONS Surgical repair of cerebrospinal fluid (CSF) leak and meningocele versus observation. MAIN OUTCOME MEASURES Presentation (including symptoms, radiographic imaging, and comorbidities), management (including surgical approach, technique for packing, use of lumbar drain), clinical outcomes (control of CSF leak, meningitis, facial nerve function), and revision surgery. RESULTS Patients presented with spontaneous CSF leak (n = 7), conductive (N = 11) and sensorineural hearing loss (n = 3), nonpositional intermittent vertigo (n = 3), headaches (n = 4), and recurrent meningitis (n = 1). Risk factors in our series included obesity (n = 4), Chiari 1 malformation (n = 1), and head trauma (n = 2). Noncontrast computed tomography of the temporal bone and magnetic resonance imaging were positive for FCM in 10 patients. Eight patients were managed surgically via a transmastoid approach (n = 4), combined transmastoid and middle fossa (N = 3), or middle fossa alone (n = 1); three were managed conservatively with observation. Postoperative complications included worsened facial nerve palsy (n = 1), recurrent meningitis (n = 1), and persistent CSF leak that necessitated revision (n = 1). CONCLUSIONS Facial nerve meningoceles are rare with variable presentation, often including CSF otorrhea. Management can be challenging and guided by symptomatology and comorbidities. Risk factors for FCM include obesity and head trauma, and Chiari 1 malformation may present with nonspecific otologic symptoms, in some cases, meningitis and facial palsy. Layered surgical repair leads to high rates of success; however, this may be complicated by worsening facial palsy.
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Affiliation(s)
- Peter Filip
- Department of Otolaryngology-Head and Neck Surgery, The Mount Sinai Hospital
| | - Harry Chiang
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Allison Goldberg
- Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, VA
| | | | - Gul Moonis
- CUMC Division of Neuroradiology, Columbia University Medical Center, New York, NY
| | | | - George Wanna
- Department of Otolaryngology-Head and Neck Surgery, The Mount Sinai Hospital
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Avadhani R, Ziai WC, Thompson RE, Mould WA, Lane K, Nanni A, Iacobelli M, Sharrock MF, Sansing LH, Van Eldik LJ, Hanley DF. Clinical Trial Protocol for BEACH: A Phase 2a Study of MW189 in Patients with Acute Nontraumatic Intracerebral Hemorrhage. Neurocrit Care 2024; 40:807-815. [PMID: 37919545 PMCID: PMC10959780 DOI: 10.1007/s12028-023-01867-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/22/2023] [Indexed: 11/04/2023]
Abstract
Patients with acute spontaneous intracerebral hemorrhage (ICH) develop secondary neuroinflammation and cerebral edema that can further damage the brain and lead to increased risk of neurologic complications. Preclinical studies in animal models of acute brain injury have shown that a novel small-molecule drug candidate, MW01-6-189WH (MW189), decreases neuroinflammation and cerebral edema and improves functional outcomes. MW189 was also safe and well tolerated in phase 1 studies in healthy adults. The proof-of-concept phase 2a Biomarker and Edema Attenuation in IntraCerebral Hemorrhage (BEACH) clinical trial is a first-in-patient, multicenter, randomized, double-blind, placebo-controlled trial. It is designed to determine the safety and tolerability of MW189 in patients with acute ICH, identify trends in potential mitigation of neuroinflammation and cerebral edema, and assess effects on functional outcomes. A total of 120 participants with nontraumatic ICH will be randomly assigned 1:1 to receive intravenous MW189 (0.25 mg/kg) or placebo (saline) within 24 h of symptom onset and every 12 h for up to 5 days or until hospital discharge. The 120-participant sample size (60 per group) will allow testing of the null hypothesis of noninferiority with a tolerance limit of 12% and assuming a "worst-case" safety assumption of 10% rate of death in each arm with 10% significance and 80% power. The primary outcome is all-cause mortality at 7 days post randomization between treatment arms. Secondary end points include all-cause mortality at 30 days, perihematomal edema volume after symptom onset, adverse events, vital signs, pharmacokinetics of MW189, and inflammatory cytokine concentrations in plasma (and cerebrospinal fluid if available). Other exploratory end points are functional outcomes collected on days 30, 90, and 180. BEACH will provide important information about the utility of targeting neuroinflammation in ICH and will inform the design of future larger trials of acute central nervous system injury.
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Affiliation(s)
- Radhika Avadhani
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA
| | - Wendy C Ziai
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA
- Division of Neurocritical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Richard E Thompson
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - W Andrew Mould
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA
| | - Karen Lane
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA
| | - Angeline Nanni
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA
| | - Michael Iacobelli
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA
| | - Matthew F Sharrock
- Division of Neurocritical Care, Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren H Sansing
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging and Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Daniel F Hanley
- BIOS Clinical Trials Coordinating Center, Johns Hopkins School of Medicine, 750 East Pratt Street, 16th Floor, Baltimore, MD, 21202, USA.
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Chen R, Guo Y, Kuang Y, Zhang Q. Effects of home-based exercise interventions on post-stroke depression: A systematic review and network meta-analysis. Int J Nurs Stud 2024; 152:104698. [PMID: 38290424 DOI: 10.1016/j.ijnurstu.2024.104698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Post-stroke depression (PSD) is a common and persistent mental disorder that negatively impacts stroke outcomes. Exercise-based interventions have been shown to be an effective non-pharmacological treatment for improving depression in patients with mild stroke, but no reviews have yet synthesized the effects of home-based exercise on PSD. OBJECTIVE The purpose of this systematic review and network meta-analysis was to synthesize the available evidence to compare the effectiveness of different types of home-based exercise programs on PSD and identify the optimal home-based exercise modality to inform clinical decision-making for the treatment of PSD. METHODS PubMed, Embase, the Cochrane Library, CINAHL, and PsycINFO were systematically searched from their inception dates to March 7, 2023. We searched for randomized controlled trials (RCTs) of home-based exercise for PSD in adults aged 18 years and older. Only scores of depression retrieved directly post-treatment were included as the primary endpoint for the analysis. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2) was used to assess the quality of included studies. We conducted traditional pairwise meta-analysis for direct comparisons using Review Manager 5.4.1, followed by network meta-analysis using Stata 15.1 for both the network evidence plot and analysis. The surface under the cumulative ranking curve (SUCRA) was used to estimate the intervention hierarchy. The protocol was registered with PROSPERO under registration number CRD42022363784. RESULTS A total of 517 participants from nine RCTs were included. Based on the ranking probabilities, mind-body exercise was the most effective way in improving PSD (SUCRA: 90.4 %, Hedges' g: -0.59, 95 % confidence interval [CI]: -1.16 to -0.02), followed by flexibility/neuro-motor skills training (SUCRA: 42.9 %, Hedges' g: -0.10, 95 % CI: -0.70 to 0.49), and aerobic exercise (SUCRA: 39.3 %, Hedges' g: -0.07, 95 % CI: -0.81 to 0.67). We performed a subgroup analysis of mind-body exercise. In mind-body exercise interventions, Tai Chi was the most effective way to improve PSD (SUCRA: 99.4 %, Hedges' g: -0.94, 95 % CI: -1.28 to -0.61). CONCLUSIONS Our network meta-analysis that provides evidence with very low certainty indicates potential benefits of home-based exercise for alleviating PSD, with mind-body exercises, notably Tai Chi, showing promise as an effective treatment. However, further rigorous studies are needed to solidify these findings. Specifically, multicenter RCTs comparing specific exercises to no intervention are crucial, assessing not only efficacy but also dose, reach, fidelity, and long-term effects for real-world optimization.
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Affiliation(s)
- Rong Chen
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China
| | - Yijia Guo
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China
| | - Yashi Kuang
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China
| | - Qi Zhang
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China.
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Holden KI, Ebanks AH, Lally KP, Harting MT. The CDH Study Group: Past, Present, and Future. Eur J Pediatr Surg 2024; 34:162-171. [PMID: 38242150 DOI: 10.1055/s-0043-1778021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
The Congenital Diaphragmatic Hernia Study Group (CDHSG) is an international consortium of medical centers actively collecting and voluntarily contributing data pertaining to live born congenital diaphragmatic hernia (CDH) patients born and/or managed at their institutions. These data are aggregated to construct a comprehensive registry that participating centers can access to address specific clinical inquiries and track patient outcomes. Since its establishment in 1995, 147 centers have taken part in this initiative, including 53 centers from 17 countries outside the United States, with 95 current active centers across the globe. The registry has amassed data on over 14,000 children, resulting in the creation of over 75 manuscripts based on registry data to date. International, multicenter consortia enable health care professionals managing uncommon, complex, and diverse diseases to formulate evidence-based hypotheses and draw meaningful and generalizable conclusions for clinical inquiries. This review will explore the formation and structure of the CDHSG and its registry, outlining their functions, center participation, and the evolution of data collection. Additionally, we will provide an overview of the evidence generated by the CDHSG, with a particular emphasis on contributions post-2014, and look ahead to the future directions the study group will take in addressing CDH.
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Affiliation(s)
- Kylie I Holden
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, Texas, United States
- Center for Surgical Trials and Evidence-based Practice (CSTEP), University of Texas McGovern Medical School, Houston, Texas, United States
| | - Ashley H Ebanks
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, Texas, United States
- Center for Surgical Trials and Evidence-based Practice (CSTEP), University of Texas McGovern Medical School, Houston, Texas, United States
| | - Kevin P Lally
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, Texas, United States
- Center for Surgical Trials and Evidence-based Practice (CSTEP), University of Texas McGovern Medical School, Houston, Texas, United States
| | - Matthew T Harting
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, Texas, United States
- Center for Surgical Trials and Evidence-based Practice (CSTEP), University of Texas McGovern Medical School, Houston, Texas, United States
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Martinez Aguirre-Betolaza A, Cacicedo J, Castañeda-Babarro A. Creatine Supplementation and Resistance Training in Patients With Breast Cancer (CaRTiC Study): Protocol for a Randomized Controlled Trial. Am J Clin Oncol 2024; 47:161-168. [PMID: 38018533 DOI: 10.1097/coc.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Creatine supplementation is an effective ergogenic nutrient for athletes, as well as for people starting a health or fitness program. Resistance training has previously been identified as an important method of increasing muscle mass and strength, especially in people with cancer to avoid sarcopenia. The potential of creatine supplementation for adaptations produced by resistance training in patients with cancer is still unknown. The primary aim of this study is to evaluate the effectiveness of a supervised resistance training program intervention with and without creatine supplementation in patients with breast cancer. METHODS Is a multicentre, randomized, blind, placebo-controlled study. Patients will be randomly assigned to a control group and 2 experimental groups. The first training resistance group (RG) will perform resistance training, while the second experimental resistance-creatine group will perform the same resistance training as the RG and will also receive a 5 g/d creatine supplementation during the intervention. RG participants will follow the same daily dosing protocol, but in their case, with dextrose/maltodextrin. Resistance training will be a 16-week supervised workout that will consist of a series of resistance exercises (leg press, knee extension, knee bends, chest press, sit-ups, back extensions, pull-ups, and shoulder press) that involve the largest muscle groups, performed 3 times a week on nonconsecutive days. Both the RG and the resistance-creatine group will receive a supplement of soluble protein powder (20 to 30 g) daily. CONCLUSION This intervention will help to better understand the potential of nonpharmacological treatment for improving strength and well-being values in patients with breast cancer with and without creatine supplementation.
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Affiliation(s)
| | - Jon Cacicedo
- Department of Radiation Oncology, Group for Radiology and Physical Medicine in Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
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13
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Davis CH, Augustinus S, de Graaf N, Wellner UF, Johansen K, Andersson B, Beane JD, Björnsson B, Busch OR, Gleeson EM, van Santvoort HC, Tingstedt B, Williamsson C, Keck T, Besselink MG, Koerkamp BG, Pitt HA. Impact of Neoadjuvant Therapy for Pancreatic Cancer: Transatlantic Trend and Postoperative Outcomes Analysis. J Am Coll Surg 2024; 238:613-621. [PMID: 38224148 DOI: 10.1097/xcs.0000000000000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
BACKGROUND The introduction of modern chemotherapy a decade ago has led to increased use of neoadjuvant therapy (NAT) in patients with pancreatic ductal adenocarcinoma (PDAC). A recent North American study demonstrated increased use of NAT and improved operative outcomes in patients with PDAC. The aims of this study were to compare the use of NAT and short-term outcomes in patients with PDAC undergoing pancreatoduodenectomy (PD) among registries from the US and Canada, Germany, the Netherlands, and Sweden. STUDY DESIGN Databases from 2 multicenter (voluntary) and 2 nationwide (mandatory) registries were queried from 2018 to 2020. Patients undergoing PD for PDAC were compared based on the use of upfront surgery vs NAT. Adoption of NAT was measured in each country over time. Thirty-day outcomes, including the composite measure (ideal outcomes), were compared by multivariable analyses. Sensitivity analyses of patients undergoing vascular resection were performed. RESULTS Overall, 11,402 patients underwent PD for PDAC with 33.7% of patients receiving NAT. The use of NAT increased steadily from 28.3% in 2018 to 38.5% in 2020 (p < 0.0001). However, use of NAT varied widely by country: the US (46.8%), the Netherlands (44.9%), Sweden (11.0%), and Germany (7.8%). On multivariable analysis, NAT was significantly (p < 0.01) associated with reduced rates of serious morbidity, clinically relevant pancreatic fistulae, reoperations, and increased ideal outcomes. These associations remained on sensitivity analysis of patients undergoing vascular resection. CONCLUSIONS NAT before PD for pancreatic cancer varied widely among 4 Western audits yet increased by 26% during 3 years. NAT was associated with improved short-term outcomes.
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Affiliation(s)
- Catherine H Davis
- From the Department of Surgery, Baylor Scott & White Health, Dallas, TX (Davis)
| | - Simone Augustinus
- Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands (Augustinus, de Graaf, Busch, Besselink)
| | - Nine de Graaf
- Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands (Augustinus, de Graaf, Busch, Besselink)
| | - Ulrich F Wellner
- DGAV StuDoQ/Pancreas and Clinic of Surgery, UKSH Campus, Lübeck, Germany (Wellner, Keck)
| | - Karin Johansen
- Departments of Surgery and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden (Johansen, Björnsson, Tingstedt, Williamsson)
| | - Bodil Andersson
- Departments of Surgery and Clinical Sciences Lund, Lund University, Lund, Sweden (Andersson)
- Skåne University Hospital, Lund, Sweden (Andersson)
| | - Joal D Beane
- Department of Surgery, The Ohio State University, Columbus, OH (Beane)
| | - Bergthor Björnsson
- Departments of Surgery and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden (Johansen, Björnsson, Tingstedt, Williamsson)
| | - Olivier R Busch
- From the Department of Surgery, Baylor Scott & White Health, Dallas, TX (Davis)
| | - Elizabeth M Gleeson
- Department of Surgery, University of North Carolina, Chapel Hill, NC (Gleeson)
| | - Hjalmar C van Santvoort
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, St. Antonius Hospital Nieuwegein, Utrecht, the Netherlands (van Santvoort)
| | - Bobby Tingstedt
- Departments of Surgery and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden (Johansen, Björnsson, Tingstedt, Williamsson)
| | - Caroline Williamsson
- Departments of Surgery and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden (Johansen, Björnsson, Tingstedt, Williamsson)
| | - Tobias Keck
- DGAV StuDoQ/Pancreas and Clinic of Surgery, UKSH Campus, Lübeck, Germany (Wellner, Keck)
| | - Marc G Besselink
- From the Department of Surgery, Baylor Scott & White Health, Dallas, TX (Davis)
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands (Koerkamp)
| | - Henry A Pitt
- Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ (Pitt)
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14
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Laakso JT, Oehlandt H, Kivekäs I, Harju T, Jero J, Sinkkonen ST. Balloon Eustachian Tuboplasty-A Feasible Double-Blinded Sham Surgery Randomized Clinical Trial Protocol to Study Efficacy. Laryngoscope 2024; 134:1874-1881. [PMID: 37776248 DOI: 10.1002/lary.31092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
INTRODUCTION Balloon Eustachian tuboplasty (BET) is used to treat obstructive Eustachian tube dysfunction (OETD) and recurrent otitis media with effusion (OME). However, there are no indisputable evidence of its efficacy. Here, we present a multicenter, double-blinded, randomized, placebo-controlled trial (MDRCT) design to evaluate the efficacy of BET, and the results of a pilot trial with 3- and 12-months' follow-up. MATERIAL AND METHODS This was a prospective MDRCT. For a pilot study, OETD (n = 10) and OME (n = 5) patients were recruited and followed. Detailed inclusion and exclusion criteria were used. Participants were randomized at beginning of the operation to active or sham surgery. All procedures were performed under local anesthesia. Controls were performed in double-blinded manner (both patient and physician), at 3 and 12 months after the procedure. RESULTS Altogether, 20 ears were treated and followed for 12 months, including 14 active BETs and 6 sham surgeries. Both the active and sham surgery were performed under local anesthesia without problems or deviations from the protocol. There were no differences in the preoperative symptoms (ETDQ-7) or objective measures (tympanometry, Valsalva and Toynbee maneuvers, tubomanometry, Eustachian tube score) between active and sham surgery arms. During follow-up, we noticed largely similar reduction in subjective symptoms and improvement in Eustachian tube score both in active and sham surgery arms. CONCLUSIONS The pilot study demonstrates that our MDRCT protocol is feasible, and that blinded RCTs are dearly needed to objectively measure the efficacy of BET. LEVEL OF EVIDENCE 2 Laryngoscope, 134:1874-1881, 2024.
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Affiliation(s)
- Juha T Laakso
- Department of Otorhinolaryngology-Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Heidi Oehlandt
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Ilkka Kivekäs
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Teemu Harju
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Jussi Jero
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Saku T Sinkkonen
- Department of Otorhinolaryngology-Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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15
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Franzone JP, Mackow N, van Duin D. Current treatment options for pneumonia caused by carbapenem-resistant Acinetobacter baumannii. Curr Opin Infect Dis 2024; 37:137-143. [PMID: 38179988 PMCID: PMC10922681 DOI: 10.1097/qco.0000000000001001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to briefly summarize the challenges associated with the treatment of pneumonia caused by carbapenem-resistant Acinetobacter baumannii (CRAB), discuss its carbapenem-resistance, and review the literature supporting the current treatment paradigm and therapeutic options. RECENT FINDINGS In a multicenter, randomized, and controlled trial the novel β-lactam-β-lactamase inhibitor sulbactam-durlobactam was compared to colistin, both in addition to imipenem-cilastatin. The drug met the prespecified criteria for noninferiority for 28-day all-cause mortality while demonstrating higher clinical cure rates in the treatment of CRAB pneumonia. In an international, randomized, double-blind, placebo controlled trial colistin monotherapy was compared to colistin combined with meropenem. In this trial, combination therapy was not superior to monotherapy in the treatment of drug-resistant gram-negative organisms including CRAB pneumonia. SUMMARY CRAB pneumonia is a preeminent public health threat without an agreed upon first line treatment strategy. Historically, there have been drawbacks to available treatment modalities without a clear consensus on the first-line treatment regimen. CRAB pneumonia is a top priority for the continued development of antimicrobials, adjuvant therapies and refinement of current treatment strategies.
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Affiliation(s)
- John P. Franzone
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Natalie Mackow
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David van Duin
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
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16
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Vine J, Berlin N, Moskowitz A, Berg KM, Liu X, Balaji L, Donnino MW, Grossestreuer AV. Corticosteroids to Reduce Inflammation in Severe Pancreatitis (CRISP) protocol and statistical analysis plan: a prospective, multicentre, double-blind, randomized, placebo controlled clinical trial. Contemp Clin Trials 2024; 139:107486. [PMID: 38431131 DOI: 10.1016/j.cct.2024.107486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/29/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Acute pancreatitis is a common disease which, in its severe form, is associated with significant morbidity and mortality. Currently, there is no specific therapy known to attenuate organ failure in severe pancreatitis and treatment consists primarily of supportive care. Corticosteroids have been shown to be beneficial in disease processes associated with systemic inflammation and could potentially improve outcomes in severe acute pancreatitis. METHODS The Corticosteroids to Reduce Inflammation in Severe Pancreatitis (CRISP) trial is a multi-centre, double-blind, randomized, placebo-controlled clinical trial that aims to determine the impact of corticosteroids versus placebo on organ injury in patients with severe acute pancreatitis. Patients are randomized to receive 100 mg of hydrocortisone parenterally versus matching placebo every 8 h for 3 days. Clinical and laboratory data are collected at the time of study enrollment, at 24, 48 and 72 h. The primary end-point for the trial is the difference in 72-h change in the Sequential Organ Failure Assessment (SOFA) score between hydrocortisone and placebo groups. Additional key secondary outcomes include ventilator free days and 28-day mortality. DISCUSSION This study will add to the evidence base in the treatment of severe acute pancreatitis. The results will inform clinical practice and future studies in the field. Trial registration number The trial is registered on clinicaltrials.gov (NCT05160506). It was posted on December 16th, 2021. The study protocol was approved by the Beth Israel Deaconess Medical Center Committee on Clinical Investigation (CCI) (protocol 2021 P-000803).
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Affiliation(s)
- Jacob Vine
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA
| | - Noa Berlin
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA; Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA
| | - Ari Moskowitz
- Division of Critical Care Medicine, Montefiore Medical Center, the Bronx, NY, USA; Bronx Center for Critical Care Outcomes and Resuscitation Research, the Bronx, New York, NY, USA
| | - Katherine M Berg
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA
| | - Xiaowen Liu
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA
| | - Lakshman Balaji
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA
| | - Michael W Donnino
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA
| | - Anne V Grossestreuer
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Rosenberg 2, Boston, MA 02215, USA.
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17
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Azam AS, Tsang YW, Thirlwall J, Kimani PK, Sah S, Gopalakrishnan K, Boyd C, Loughrey MB, Kelly PJ, Boyle DP, Salto-Tellez M, Clark D, Ellis IO, Ilyas M, Rakha E, Bickers A, Roberts ISD, Soares MF, Neil DAH, Takyi A, Raveendran S, Hero E, Evans H, Osman R, Fatima K, Hughes RW, McIntosh SA, Moran GW, Ortiz-Fernandez-Sordo J, Rajpoot NM, Storey B, Ahmed I, Dunn JA, Hiller L, Snead DRJ. Digital pathology for reporting histopathology samples, including cancer screening samples - definitive evidence from a multisite study. Histopathology 2024; 84:847-862. [PMID: 38233108 DOI: 10.1111/his.15129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024]
Abstract
AIMS To conduct a definitive multicentre comparison of digital pathology (DP) with light microscopy (LM) for reporting histopathology slides including breast and bowel cancer screening samples. METHODS A total of 2024 cases (608 breast, 607 GI, 609 skin, 200 renal) were studied, including 207 breast and 250 bowel cancer screening samples. Cases were examined by four pathologists (16 study pathologists across the four speciality groups), using both LM and DP, with the order randomly assigned and 6 weeks between viewings. Reports were compared for clinical management concordance (CMC), meaning identical diagnoses plus differences which do not affect patient management. Percentage CMCs were computed using logistic regression models with crossed random-effects terms for case and pathologist. The obtained percentage CMCs were referenced to 98.3% calculated from previous studies. RESULTS For all cases LM versus DP comparisons showed the CMC rates were 99.95% [95% confidence interval (CI) = 99.90-99.97] and 98.96 (95% CI = 98.42-99.32) for cancer screening samples. In speciality groups CMC for LM versus DP showed: breast 99.40% (99.06-99.62) overall and 96.27% (94.63-97.43) for cancer screening samples; [gastrointestinal (GI) = 99.96% (99.89-99.99)] overall and 99.93% (99.68-99.98) for bowel cancer screening samples; skin 99.99% (99.92-100.0); renal 99.99% (99.57-100.0). Analysis of clinically significant differences revealed discrepancies in areas where interobserver variability is known to be high, in reads performed with both modalities and without apparent trends to either. CONCLUSIONS Comparing LM and DP CMC, overall rates exceed the reference 98.3%, providing compelling evidence that pathologists provide equivalent results for both routine and cancer screening samples irrespective of the modality used.
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Affiliation(s)
- Ayesha S Azam
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Yee-Wah Tsang
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Peter K Kimani
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Shatrughan Sah
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Clinton Boyd
- Belfast Health and Social Care Trust, Belfast, UK
| | - Maurice B Loughrey
- Belfast Health and Social Care Trust, Belfast, UK
- Queen's University, Belfast, UK
| | - Paul J Kelly
- Belfast Health and Social Care Trust, Belfast, UK
| | | | | | - David Clark
- Nottingham University Hospital NHS Trust, Nottingham, UK
| | - Ian O Ellis
- Nottingham University Hospital NHS Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
| | - Mohammad Ilyas
- Nottingham University Hospital NHS Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
| | - Emad Rakha
- Nottingham University Hospital NHS Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
| | - Adam Bickers
- Northern Lincolnshire and Goole NHS Foundation Trust, Scunthorpe, UK
| | - Ian S D Roberts
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Maria F Soares
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Abi Takyi
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Emily Hero
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Harriet Evans
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Rania Osman
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Khunsha Fatima
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Rhian W Hughes
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | | | | | - Nasir M Rajpoot
- Computer Science Department, University of Warwick, Coventry, UK
| | - Ben Storey
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Imtiaz Ahmed
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Janet A Dunn
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Louise Hiller
- Warwick Medical School, University of Warwick, Coventry, UK
| | - David R J Snead
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Computer Science Department, University of Warwick, Coventry, UK
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18
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Iliopoulos I, Mastropietro CW, Flores S, Cheung E, Amula V, Radman M, Kwiatkowski D, Puente BN, Buckley JR, Allen KY, Loomba R, Karki KB, Chiwane S, Cashen K, Piggott K, Kapileshwarkar Y, Gowda KMN, Badheka A, Raman R, Zang H, Costello JM. Pulmonary Atresia with Intact Ventricular Septum: Midterm Outcomes from a Multicenter Cohort. Pediatr Cardiol 2024; 45:847-857. [PMID: 35751685 DOI: 10.1007/s00246-022-02954-5] [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: 03/18/2022] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
Contemporary multicenter data regarding midterm outcomes for neonates with pulmonary atresia with intact ventricular septum are lacking. We sought to describe outcomes in a contemporary multicenter cohort, determine factors associated with end-states, and evaluate the effect of right ventricular coronary dependency and coronary atresia on transplant-free survival. Neonates treated during 2009-2019 in 19 United States centers were reviewed. Competing risks analysis was performed to determine cumulative risk of each end-state, and multivariable regression analyses were performed to identify factors associated with each end-state and transplant-free survival. We reviewed 295 patients. Median tricuspid valve Z-score was - 3.06 (25%, 75%: - 4.00, - 1.52). Final end-state was biventricular repair for 45 patients (15.2%), one-and-a half ventricle for 16 (5.4%), Fontan for 75 (25.4%), cardiac transplantation for 29 (9.8%), and death for 54 (18.3%). Seventy-six patients (25.7%) remained in mixed circulation. Cumulative risk estimate of death was 10.9%, 16.1%, 16.9%, and 18.8% at 1, 6 months, 1 year, and 5 years, respectively. Tricuspid valve Z-score was inversely, and coronary atresia positively associated with death or transplantation [odds ratio (OR) = 0.46, (95% confidence interval (CI) = 0.29-0.75, p < 0.001) and OR = 3.75 (95% CI 1.46-9.61, p = 0.011), respectively]. Right ventricular coronary dependency and left coronary atresia had a significant effect on transplant-free survival (log-rank p < 0.001). In a contemporary multicenter cohort of patients with PAIVS, consisting predominantly of patients with moderate-to-severe right ventricular hypoplasia, we observed favorable survival outcomes. Right ventricular coronary dependency and left, but not right, coronary atresia significantly worsens transplant-free survival.
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Affiliation(s)
- Ilias Iliopoulos
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Cardiac Intensive Care, The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229, USA.
| | - Christopher W Mastropietro
- Division of Critical Care, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA
| | - Saul Flores
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Eva Cheung
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York, New York, NY, USA
| | - Venugopal Amula
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Monique Radman
- Division of Critical Care, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - David Kwiatkowski
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Lucille Packard Children's Hospital, Palo Alto, CA, USA
| | - Bao Nguyen Puente
- Division of Cardiac Critical Care, Children's National Health System, Washington, DC, USA
| | - Jason R Buckley
- Division of Cardiology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
| | - Kiona Y Allen
- Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rohit Loomba
- Department of Pediatrics, Chicago Medical School, Advocate Children's Hospital, Chicago, IL, USA
| | - Karan B Karki
- Division of Cardiology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Saurabh Chiwane
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Louis University, Cardinal Glennon Children's Hospital, Saint Louis, MO, USA
| | - Katherine Cashen
- Department of Pediatrics, Central Michigan University, Children's Hospital of Michigan, Detroit, MI, USA
| | - Kurt Piggott
- Division of Critical Care, LSU Health Sciences, Children's Hospital, New Orleans, LA, USA
| | | | | | - Aditya Badheka
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Rahul Raman
- Department of Pediatrics, Mercy Medical Center, Des Moines, IA, USA
| | - Huaiyu Zang
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John M Costello
- Division of Cardiology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA
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19
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Van Gent JM, Kaminski CW, Praestholm C, Pivalizza EG, Clements TW, Kao LS, Stanworth S, Brohi K, Cotton BA. Empiric Cryoprecipitate Transfusion in Patients with Severe Hemorrhage: Results from the US Experience in the International CRYOSTAT-2 Trial. J Am Coll Surg 2024; 238:636-643. [PMID: 38146823 DOI: 10.1097/xcs.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND Hypofibrinogenemia has been shown to predict massive transfusion and is associated with higher mortality in severely injured patients. However, the role of empiric fibrinogen replacement in bleeding trauma patients remains controversial. We sought to determine the effect of empiric cryoprecipitate as an adjunct to a balanced transfusion strategy (1:1:1). STUDY DESIGN This study is a subanalysis of patients treated at the single US trauma center in a multicenter randomized controlled trial. Trauma patients (more than 15 years) were eligible if they had evidence of active hemorrhage requiring emergent surgery or interventional radiology, massive transfusion protocol (MTP) activation, and received at least 1 unit of blood. Transfer patients, those with injuries incompatible with life, or those injured more than 3 hours earlier were excluded. Patients were randomized to standard MTP (STANDARD) or MTP plus 3 pools of cryoprecipitate (CRYO). Primary outcomes included all-cause mortality at 28 days. Secondary outcomes were transfusion requirements, intraoperative and postoperative coagulation laboratory values, and quality-of-life measures (Glasgow outcome score-extended). RESULTS Forty-nine patients (23 in the CRYO group and 26 in the STANDARD group) were enrolled between May 2021 and October 2021. Time to randomization was similar between groups (14 vs 24 minutes, p = 0.676). Median time to cryoprecipitate was 41 minutes (interquartile range 37 to 48). There were no differences in demographics, arrival physiology, laboratory values, or injury severity. Intraoperative and ICU thrombelastography values, including functional fibrinogen, were similar between groups. There was no benefit to CRYO with respect to post-emergency department transfusions (intraoperative and ICU through 24 hours), complications, Glasgow outcome score, or mortality. CONCLUSIONS In this study of severely injured, bleeding trauma patients, empiric cryoprecipitate did not improve survival or reduce transfusion requirements. Cryoprecipitate should continue as an "on-demand" addition to a balanced transfusion strategy, guided by laboratory values and should not be given empirically.
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Affiliation(s)
- Jan-Michael Van Gent
- From the Departments of Surgery (Van Gent, Kaminski, Praestholm, Clements, Kao, Cotton)
| | - Carter W Kaminski
- From the Departments of Surgery (Van Gent, Kaminski, Praestholm, Clements, Kao, Cotton)
| | - Caroline Praestholm
- From the Departments of Surgery (Van Gent, Kaminski, Praestholm, Clements, Kao, Cotton)
| | - Evan G Pivalizza
- Anesthesiology (Pivalizza), McGovern Medical School, Houston, TX
| | - Thomas W Clements
- From the Departments of Surgery (Van Gent, Kaminski, Praestholm, Clements, Kao, Cotton)
| | - Lillian S Kao
- From the Departments of Surgery (Van Gent, Kaminski, Praestholm, Clements, Kao, Cotton)
- The Center for Translational Injury Research, Houston, TX (Kao, Cotton)
| | | | - Karim Brohi
- Department of Haematology, University of Oxford, UK (Brohi)
| | - Bryan A Cotton
- From the Departments of Surgery (Van Gent, Kaminski, Praestholm, Clements, Kao, Cotton)
- The Center for Translational Injury Research, Houston, TX (Kao, Cotton)
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20
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Inamasu J, Akiyama T, Akaji K, Inaba M, Nishimoto M, Kojima A, Terao S, Hayashi T, Mizutani K, Toda M. Aneurysmal subarachnoid hemorrhage occurring during sleep: Clinical characteristics and risk factors. J Stroke Cerebrovasc Dis 2024; 33:107591. [PMID: 38266691 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (aSAH) is known to be triggered by several specific human activities. Sleep, by contrast, has not been considered a triggering activity for aSAH, and clinical characteristics of patients who sustain aSAH during sleep have rarely been reported in the literature. METHODS This is a retrospective analysis on the data acquired through a multicenter aSAH registry. Between January 2019 and December 2021, a total of 732 aSAH patients had been registered into our database. After excluding 109 patients whose activities at aSAH onset had been unidentifiable, the remaining 623 aSAH patients were dichotomized to 59 patients who sustained aSAH during sleep (Sleep group) and 564 patients who sustained aSAH during daytime activities (Awake group). Two-group comparison of demographic variables and multivariate logistic regression analysis were performed to clarify their clinical characteristics and identify potential risk factors. RESULTS The Sleep group exhibited significantly higher frequencies of diabetes (15.5 % vs. 6.4 %, p = 0.01) and antiplatelet use (13.8 % vs. 4.6 %, p=0.004) than the Awake group. Furthermore, multivariate logistic regression analysis showed that diabetes (OR, 3.051; 95 % CI, 1.281-7.268; p = 0.012) and antiplatelet use (OR, 3.640; 95 % CI, 1.422-9.316; p = 0.007) were correlated with aSAH occurring during sleep. There were no significant inter-group differences in the patient outcomes evaluated at discharge. CONCLUSION The current results indicate that risk factors may exist for aSAH occurring during sleep. Further investigations on how comorbidities such as diabetes, antiplatelet use and sleep apnea affect human hemodynamic and hemostatic parameters during sleep is warranted to better understand those relationships.
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Affiliation(s)
- Joji Inamasu
- Department of Neurosurgery, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi, Utsunomiya 321-0974, Japan.
| | - Takenori Akiyama
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazunori Akaji
- Department of Neurosurgery, Mihara Memorial Hospital, Isesaki, Japan
| | - Makoto Inaba
- Department of Neurosurgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Masaaki Nishimoto
- Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Atsuhiro Kojima
- Department of Neurosurgery, Saitama City Hospital, Saitama, Japan
| | - Satoshi Terao
- Department of Neurosurgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Takuro Hayashi
- Department of Neurosurgery, NHO Tokyo Medical Center, Tokyo, Japan
| | - Katsuhiro Mizutani
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Toda
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
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21
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Pletch A, Lidor A. GERD after Bariatric Surgery: A Review of the Underlying Causes and Recommendations for Management. Curr Gastroenterol Rep 2024; 26:99-106. [PMID: 38353898 DOI: 10.1007/s11894-024-00919-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE OF REVIEW GERD after bariatric surgery is an ongoing concern for bariatric surgeons and their patients. This paper reviews the association of persistent or de novo GERD after multiple types of bariatric surgery, and focuses on the work up and management of GERD after SG. RECENT FINDINGS Two recent large, multicenter randomized clinical trials have shown stronger associations between SG and GERD compared to RYGB. A large group of internationally recognized bariatric surgeons collaborated on 72 consensus statements to help guide the bariatric community on the subject of redo surgeries after SG, including as it pertains to GERD. We present an algorithm that consolidates the best-practices recommendations of the work-up and management of GERD after sleeve gastrectomy, and mention areas of persistent controversy where future research is warranted.
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Affiliation(s)
- Alison Pletch
- Department of Surgery, University at Buffalo, 100 High Street, Buffalo, NY, D35014203, USA.
| | - Anne Lidor
- Division of Minimally Invasive Surgery, Department of Surgery, University of Wisconsin, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53726, USA
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22
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Minga I, Kwak E, Hussain K, Wathen L, Gaznabi S, Singh L, Macrinici V, Wang CH, Singulane C, Addetia K, Sarswat N, Slivnick J, Pursnani A. Prevalence of valvular heart disease in cardiac amyloidosis and impact on survival. Curr Probl Cardiol 2024; 49:102417. [PMID: 38280494 DOI: 10.1016/j.cpcardiol.2024.102417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Limited data exists on the prognostic impact of valvular heart disease in cardiac amyloidosis (CA). We therefore sought to define the prevalence of valvular disease in patients with CA and assess the effects of significant valve disease on survival. METHODS This multi-center retrospective cohort study included consecutive patients with confirmed transthyretin (TTR) or light chain (AL) amyloidosis. Echocardiographic data closest to the date of amyloid diagnosis was reviewed, and severity was graded according to ASE guidelines. Kaplan-Meier survival analysis was performed to compare survival between patients with moderate or greater valve disease against those with mild or less disease. RESULTS We included 345 patients (median age 76 years; 73 % men; 110 AL, 235TTR). The median survival for the total patient cohort with cardiac amyloidosis was 2.92 years, with 30 % of patients surviving at five years after their diagnosis. Median survival comparing AL vs ATTR was 2.58 years vs 2.82 years (p = 0.67) The most common valvular abnormalities in the total cohort were mitral (62 %) and tricuspid (66 %).regurgitation There was a statistically significant difference in median survival between patients with no or mild MR compared to those with moderate or severe MR (2.92 years vs 3.35 years, p = 0.0047) (Fig. 5). There was a statistically significant difference in median survival in patients with no or mild TR compared to those with moderate or severe TR (3.35 years vs 2.3 years, p = 0.015). CONCLUSION Our study demonstrates a significant prevalence of mitral and tricuspid regurgitation in CA, with patients with moderate to severe MR and TR having a poorer prognosis.
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Affiliation(s)
- Iva Minga
- University of Chicago Medical Center, Chicago, IL, United States.
| | - Esther Kwak
- Medical College of Milwaukee Medical Center, Milwaukee, IL, United States
| | - Kifah Hussain
- Northshore University HealthSystem, Evanston, IL, United States
| | - Lucas Wathen
- Northshore University HealthSystem, Evanston, IL, United States
| | | | - Lavisha Singh
- Northshore University HealthSystem, Evanston, IL, United States
| | | | - Chi-Hsiung Wang
- Northshore University HealthSystem, Evanston, IL, United States
| | | | - Karima Addetia
- University of Chicago Medical Center, Chicago, IL, United States
| | - Nitasha Sarswat
- University of Chicago Medical Center, Chicago, IL, United States
| | - Jeremy Slivnick
- University of Chicago Medical Center, Chicago, IL, United States
| | - Amit Pursnani
- Northshore University HealthSystem, Evanston, IL, United States
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23
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Yu L, Zhao X, Long Q, Li S, Zhang H, Teng Z, Chen J, Zhang Y, You X, Guo Z, Zeng Y. Association between a changeable lifestyle, sedentary behavior, and suicide risk: A systematic review and meta-analysis. J Affect Disord 2024; 350:974-982. [PMID: 38266927 DOI: 10.1016/j.jad.2024.01.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Suicide and self-injury have become increasingly serious public health crises. Yet current evidence about the association between sedentary behavior (SB) and suicide is inconclusive. We explore the relationship between SB and suicide behavior to provide intervention measures to change the risk factors of the latter. METHODS We searched PubMed, Embase, Cochrane Library, and Web of Science from database inception to September 10, 2023. Adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) were used as effect measures. Subgroup analysis was conducted based on gender, regions and countries, age, and study type. RESULTS A total of 13 studies were included. According to the meta-analysis of suicide type, compared with individuals without sedentary behavior, individuals with sedentary behavior have a higher risk of suicide attempt (OR = 1.23, 95%CI: 1.15-1.37, p < 0.001), suicide ideation (OR = 1.47, 95%CI:1.28-1.68, p < 0.001) and suicide plan (OR = 1.30, 95%CI:1.16-1.44, p < 0.001). We conducted multiple subgroup analyses for different suicidal behaviors. The analysis found that SB can increase the risk of suicide attempt in different subgroups of different genders, different research centers, Africa, and adolescents; SB can increase the risk of suicide ideation in the subgroups of different genders and ages, different research centers, Asia and Africa; SB can increase the risk of suicide plan in the subgroups of different genders, multi-center study, Africa, and adolescents. LIMITATIONS Future research should focus on objective SB measurement and explore its dose-response relation and time limit. CONCLUSION A sedentary lifestyle is associated with suicide behavior risk, with varying effects across age groups and regions, as evidenced in both single-center and multi-center studies.
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Affiliation(s)
- Ling Yu
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Xinling Zhao
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Qing Long
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Shujun Li
- Department of Student Affairs Office, Suizhou Vocational & Technical College, Suizhou City, Hubei Province, China
| | - Huaxia Zhang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Zhaowei Teng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Jian Chen
- Department of Gastroenterology, Nanchong Central Hospital, Nanchong, Sichuan Province, China
| | - Yunqiao Zhang
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Xu You
- Department of Psychiatry, Honghe Second People's Hospital, Honghe, Yunnan Province, China
| | - Zeyi Guo
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
| | - Yong Zeng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
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Crescioli E, Riis JØ, Weinreich UM, Jensen JUS, Poulsen LM, Brøchner AC, Lange T, Perner A, Klitgaard TL, Schjørring OL, Rasmussen BS. Long-term cognitive and pulmonary functions following a lower versus a higher oxygenation target in the HOT-ICU and HOT-COVID trials: A protocol update. Acta Anaesthesiol Scand 2024; 68:575-578. [PMID: 38272985 DOI: 10.1111/aas.14379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND The Handling Oxygenation Targets in the Intensive Care Unit (HOT-ICU) trial was a multicentre, randomised, parallel-group trial of a lower oxygenation target (arterial partial pressure of oxygen [PaO2 ] = 8 kPa) versus a higher oxygenation target (PaO2 = 12 kPa) in adult ICU patients with acute hypoxaemic respiratory failure; the Handling Oxygenation Targets in coronavirus disease 2019 (HOT-COVID) tested the same oxygenation targets in patients with confirmed COVID-19. In this study, we aim to evaluate the long-term effects of these oxygenation targets on cognitive and pulmonary function. We hypothesise that a lower oxygenation target throughout the ICU stay may result in cognitive impairment, whereas a higher oxygenation target may result in impaired pulmonary function. METHODS This is the updated protocol and statistical analysis plan of two pre-planned secondary outcomes, the long-term cognitive function, and long-term pulmonary function, in the HOT-ICU and HOT-COVID trials. Patients enrolled in both trials at selected Danish sites and surviving to 1 year after randomisation are eligible to participate. A Repeatable Battery for the Assessment of Neuropsychological Status score and a full-body plethysmography, including diffusion capacity for carbon monoxide, will be obtained. The last patient is expected to be included in the spring of 2024. CONCLUSION This study will provide important information on the long-term effects of a lower versus a higher oxygenation target on long-term cognitive and pulmonary functions in adult ICU patients with acute hypoxaemic respiratory failure.
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Affiliation(s)
- Elena Crescioli
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jens Østergaard Riis
- Department of Neurology and Neurosurgery, Aalborg University Hospital, Aalborg, Denmark
| | - Ulla Møller Weinreich
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Jens Ulrik Staehr Jensen
- Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | | | - Anne Craveiro Brøchner
- Department of Anaesthesia and Intensive Care, Kolding Hospital, University of Southern Denmark, Kolding, Denmark
| | - Theis Lange
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anders Perner
- Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Lass Klitgaard
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
| | - Olav Lilleholt Schjørring
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Bodil Steen Rasmussen
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Hirt-Minkowski P, Schaub S. Urine CXCL10 as a biomarker in kidney transplantation. Curr Opin Organ Transplant 2024; 29:138-143. [PMID: 38235748 PMCID: PMC10919271 DOI: 10.1097/mot.0000000000001135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE OF REVIEW Urine CXCL10 is a promising biomarker for posttransplant renal allograft monitoring but is currently not widely used for clinical management. RECENT FINDINGS Large retrospective studies and data from a prospective randomized trial as well as a prospective cohort study demonstrate that low urine CXCL10 levels are associated with a low risk of rejection and can exclude BK polyomavirus replication with high certainty. Urine CXCL10 can either be used as part of a multiparameter based risk assessment tool, or as an individual biomarker taking relevant confounders into account. A novel Luminex-based CXCL10 assay has been validated in a multicenter study, and proved to be robust, reproducible, and accurate. SUMMARY Urine CXCL10 is a well characterized inflammation biomarker, which can be used to guide performance of surveillance biopsies. Wide implementation into clinical practice depends on the availability of inexpensive, thoroughly validated assays with approval from regulatory authorities.
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Affiliation(s)
| | - Stefan Schaub
- Clinic for Transplantation Immunology and Nephrology
- HLA-Diagnostic and lmmunogenetics, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
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26
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White BR, Adepoju TE, Fisher HB, Shinohara RT, Vandekar S. Spatial nonstationarity of image noise in widefield optical imaging and its effects on cluster-based inference for resting-state functional connectivity. J Neurosci Methods 2024; 404:110076. [PMID: 38331258 PMCID: PMC10940215 DOI: 10.1016/j.jneumeth.2024.110076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Resting-state functional connectivity (RSFC) analysis with widefield optical imaging (WOI) is a potentially powerful tool to develop imaging biomarkers in mouse models of disease before translating them to human neuroimaging with functional magnetic resonance imaging (fMRI). The delineation of such biomarkers depends on rigorous statistical analysis. However, statistical understanding of WOI data is limited. In particular, cluster-based analysis of neuroimaging data depends on assumptions of spatial stationarity (i.e., that the distribution of cluster sizes under the null is equal at all brain locations). Whether actual data deviate from this assumption has not previously been examined in WOI. NEW METHOD In this manuscript, we characterize the effects of spatial nonstationarity in WOI RSFC data and adapt a "two-pass" technique from fMRI to correct cluster sizes and mitigate spatial bias, both parametrically and nonparametrically. These methods are tested on multi-institutional data. RESULTS AND COMPARISON WITH EXISTING METHODS We find that spatial nonstationarity has a substantial effect on inference in WOI RSFC data with false positives much more likely at some brain regions than others. This pattern of bias varies between imaging systems, contrasts, and mouse ages, all of which could affect experimental reproducibility if not accounted for. CONCLUSIONS Both parametric and nonparametric corrections for nonstationarity result in significant improvements in spatial bias. The proposed methods are simple to implement and will improve the robustness of inference in optical neuroimaging data.
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Affiliation(s)
- Brian R White
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Division of Cardiology, Department of Pediatrics, USA.
| | - Temilola E Adepoju
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Division of Cardiology, Department of Pediatrics, USA
| | - Hayden B Fisher
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Division of Cardiology, Department of Pediatrics, USA
| | - Russell T Shinohara
- University of Pennsylvania, Perelman School of Medicine, Department of Biostatistics, Epidemiology, and Informatics, USA; University of Pennsylvania, Center for Biomedical Image Computing and Analysis, Department of Radiology, USA; University of Pennsylvania, Penn Statistics in Imaging and Visualization Endeavor, Department of Biostatistics, Epidemiology, and Informatics, USA
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27
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Goltstein LCMJ, Grooteman KV, Bernts LHP, Scheffer RCH, Laheij RJF, Gilissen LPL, Schrauwen RWM, Talstra NC, Zuur AT, Braat H, Hadithi M, Brouwer JT, Nagengast WB, Oort FA, Tenthof van Noorden J, Kievit W, van Geenen EJM, Drenth JPH. Standard of Care Versus Octreotide in Angiodysplasia-Related Bleeding (the OCEAN Study): A Multicenter Randomized Controlled Trial. Gastroenterology 2024; 166:690-703. [PMID: 38158089 DOI: 10.1053/j.gastro.2023.12.020] [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: 06/13/2023] [Revised: 10/18/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND & AIMS Gastrointestinal angiodysplasias are vascular anomalies that may result in transfusion-dependent anemia despite endoscopic therapy. An individual patient data meta-analysis of cohort studies suggests that octreotide decreases rebleeding rates, but component studies possessed a high risk of bias. We investigated the efficacy of octreotide in reducing the transfusion requirements of patients with angiodysplasia-related anemia in a clinical trial setting. METHODS The study was designed as a multicenter, open-label, randomized controlled trial. Patients with angiodysplasia bleeding were required to have had at least 4 red blood cell (RBC) units or parental iron infusions, or both, in the year preceding randomization. Patients were allocated (1:1) to 40-mg octreotide long-acting release intramuscular every 28 days or standard of care, including endoscopic therapy. The treatment duration was 1 year. The primary outcome was the mean difference in the number of transfusion units (RBC + parental iron) between the octreotide and standard of care groups. Patients who received at least 1 octreotide injection or followed standard of care for at least 1 month were included in the intention-to-treat analyses. Analyses of covariance were used to adjust for baseline transfusion requirements and incomplete follow-up. RESULTS We enrolled 62 patients (mean age, 72 years; 32 men) from 17 Dutch hospitals in the octreotide (n = 31) and standard of care (n = 31) groups. Patients required a mean number of 20.3 (standard deviation, 15.6) transfusion units and 2.4 (standard deviation, 2.0) endoscopic procedures in the year before enrollment. The total number of transfusions was lower with octreotide (11.0; 95% confidence interval [CI], 5.5-16.5) compared with standard of care (21.2; 95% CI, 15.7-26.7). Octreotide reduced the mean number of transfusion units by 10.2 (95% CI, 2.4-18.1; P = .012). Octreotide reduced the annual volume of endoscopic procedures by 0.9 (95% CI, 0.3-1.5). CONCLUSIONS Octreotide effectively reduces transfusion requirements and the need for endoscopic therapy in patients with angiodysplasia-related anemia. CLINICALTRIALS gov, NCT02384122.
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Affiliation(s)
- Lia C M J Goltstein
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Karina V Grooteman
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lucas H P Bernts
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Robert C H Scheffer
- Department of Gastroenterology and Hepatology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Robert J F Laheij
- Department of Gastroenterology and Hepatology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Lennard P L Gilissen
- Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands
| | - Ruud W M Schrauwen
- Department of Gastroenterology, Bernhoven Hospital, Uden, the Netherlands
| | - Nynke C Talstra
- Department of Gastroenterology, Bernhoven Hospital, Uden, the Netherlands
| | - Abraham T Zuur
- Department of Gastroenterology, Tjongerschans, Heerenveen, the Netherlands
| | - Henri Braat
- Department of Gastroenterology, Gelre Hospital, Apeldoorn, the Netherlands
| | - Muhammed Hadithi
- Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, the Netherlands
| | - Johannes T Brouwer
- Department of Gastroenterology, Reinier de Graaf Gasthuis, Delft, the Netherlands
| | - Wouter B Nagengast
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands
| | - Frank A Oort
- Department of Gastroenterology, Rijnstate Hospital, Arnhem, the Netherlands
| | | | - Wietske Kievit
- Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Erwin J M van Geenen
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Avitzur Y, Pahl E, Venick R. The Development of the International Intestinal Failure Registry and an Overview of its Results. Eur J Pediatr Surg 2024; 34:172-181. [PMID: 37973155 PMCID: PMC10920018 DOI: 10.1055/a-2212-6874] [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: 10/25/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Pediatric intestinal failure (IF) is a rare disease that represents an evolving field in pediatric gastroenterology and surgery. With only a limited number of multicenter collaborations, much of the research in pediatric IF is often confined to single-center reports with small sample sizes. This has resulted in challenges in data interpretation and left many knowledge gaps unanswered. Over the past two decades, five large multicenter collaborations, primarily from North America and Europe, have published their findings. Apart from one ongoing European adult and pediatric registry, these relatively large-scale efforts have been concluded.In 2018, the International Intestinal Failure Registry (IIFR) was initiated by the International Intestinal Rehabilitation and Transplant Association to continue these efforts and answer some of the knowledge gaps in pediatric IF. The IIFR goals are to prospectively assess the natural history of children diagnosed with IF and creating a worldwide platform to facilitate benchmarking and evidence-based interventions in pediatric IF. A pilot phase involving 204 enrolled patients was initiated in 2018 to assess the feasibility of an international IF registry and refine the study protocol and data collection forms. Following the successful completion of this phase, the current phase of the IIFR was launched in 2021. As of May 2023, the registry includes 362 prospectively followed children from 26 centers worldwide. This review provides an overview of the development, structure, and challenges of the IIFR, as well as the main findings from both the pilot and current phase.
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Affiliation(s)
- Yaron Avitzur
- Division of Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Center, Group for Improvement of Intestinal Function and Treatment, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eric Pahl
- Registry Data Analyst and Administrator, International Intestinal Rehabilitation and Transplant Association, The Transplantation Society, Montreal, Quebec, Canada
| | - Robert Venick
- Graduate Research Fellow, Health Informatics, University of Iowa, Iowa City, Iowa, United States
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Mattel Children's Hospital, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, United States
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Kraake S, Pabst A, Wiese B, Moor L, König HH, Hajek A, Kaduszkiewicz H, Scherer M, Stark A, Wagner M, Maier W, Werle J, Weyerer S, Riedel-Heller SG, Stein J. Profiles of met and unmet care needs in the oldest-old primary care patients with depression - results of the AgeMooDe study. J Affect Disord 2024; 350:618-626. [PMID: 38244789 DOI: 10.1016/j.jad.2024.01.138] [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: 06/07/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Unmet care needs have been associated with an increased risk of depression in old age. Currently, the identification of profiles of met and unmet care needs associated with depressive symptoms is pending. Therefore, this exploratory study aimed to identify profiles of care needs and analyze associated factors in oldest-old patients with and without depression. METHODS The sample of 1092 GP patients aged 75+ years is based on the multicenter study "Late-life depression in primary care: needs, health care utilization and costs (AgeMooDe)". Depression (i.e. clinically meaningful depressive symptoms) was determined using the Geriatric Depression Scale (GDS) (cutoff score ≥ 4). Needs of patients were assessed using the Camberwell Assessment of Need for the Elderly (CANE). Associated sociodemographic and clinical factors were examined, and latent class analysis identified the need profiles. RESULTS The main result of the study indicates three need profiles: 'no needs', 'met physical needs', and 'unmet social needs'. Members of the 'met physical needs' (OR = 3.5, 95 %-CI: 2.5-4.9) and 'unmet social needs' (OR = 17.4, 95 %-CI: 7.7-39.7) profiles were significantly more likely to have depression compared to members of the 'no needs' profile. LIMITATIONS Based on the cross-sectional design, no conclusions can be drawn about the causality or direction of the relationships between the variables. CONCLUSIONS The study results provide important insights for the establishment of needs-based interventions for GPs. Particular attention should be paid to the presence of unmet social needs in the oldest-old GP patients with underlying depressive symptoms.
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Affiliation(s)
- Sophia Kraake
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Birgitt Wiese
- Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Lilia Moor
- Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany
| | - Martin Scherer
- Institute of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Stark
- Institute of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health und Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
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Abi Mosleh K, Lind R, Salame M, Jawad MA, Ghanem M, Hage K, Abu Dayyeh BK, Kendrick M, Teixeira AF, Ghanem OM. Comparative multicenter analysis of sleeve gastrectomy, gastric bypass, and duodenal switch in patients with BMI ≥70kg/m 2: a 2-year follow-up. Surg Obes Relat Dis 2024; 20:399-405. [PMID: 38151416 DOI: 10.1016/j.soard.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 10/25/2023] [Accepted: 11/04/2023] [Indexed: 12/29/2023]
Abstract
Patients undergoing metabolic and bariatric surgery (MBS) with body mass index (BMI) ≥ 70 kg/m2 are considered a high-risk group. There is limited literature to guide surgeons on the perioperative safety as well as the different procedural outcomes of MBS in this cohort. Our aim is to compare the safety profiles, early- and medium-term outcomes of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) in patients with BMI ≥ 70 kg/m2. A total of 156 patients with BMI ≥ 70kg/m2 underwent MBS (SG = 40, RYGB = 40, and DS = 76). Mean baseline BMI was 75.5 kg/m2. Total weight loss (%TWL) at 24 months was highest in the DS group compared to RYGB (40.6% versus 33.8%, P value = .03) and SG (40.6% versus 28.5%, P value = .006). There was no significant difference in %TWL between RYGB and SG (33.8% versus 28.5%, P value = .20). The 30-day complication rates were similar [SG (7.5%), RYGB (10%), and DS (9.2%) (P value = 1.0)]. There was one reported leak (DS). The 30-day mortality was zero. MBS is safe and effective in patients with BMI ≥ 70 kg/m2. All procedures had comparable safety profiles and complication rates. While DS achieved the highest %TWL at 24 months, similar comorbidity resolution rates among the procedures attenuate its clinical significance.
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Affiliation(s)
| | - Romulo Lind
- Weight Loss and Bariatric Surgery Institute, Orlando Health, Orlando, Florida, USA
| | - Marita Salame
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Muhammad A Jawad
- Weight Loss and Bariatric Surgery Institute, Orlando Health, Orlando, Florida, USA
| | - Muhammad Ghanem
- Weight Loss and Bariatric Surgery Institute, Orlando Health, Orlando, Florida, USA
| | - Karl Hage
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Barham K Abu Dayyeh
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Andre F Teixeira
- Weight Loss and Bariatric Surgery Institute, Orlando Health, Orlando, Florida, USA
| | - Omar M Ghanem
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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Badhwar V, Pereda D, Khaliel FH, Poffo R, Darehzereshki A, Mehaffey JH, Yan TD, Melnitchouk S, Geirsson A, Arghami A, Navia JL, Raikar GV, Weber AC, Ramzy D, Černý Š, Vojáček J, Smith RL, Bonatti J, Thourani VH, Wei LM. Outcomes following initial multicenter experience with robotic aortic valve replacement: Defining a path forward. J Thorac Cardiovasc Surg 2024; 167:1244-1250. [PMID: 38246340 DOI: 10.1016/j.jtcvs.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Affiliation(s)
- Vinay Badhwar
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.
| | - Daniel Pereda
- Department of Cardiovascular Surgery, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Feras H Khaliel
- Division of Cardiac Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Robinson Poffo
- Department of Cardiovascular Surgery, Hospital Moriah, Sao Paulo, Brazil
| | - Ali Darehzereshki
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa
| | - J Hunter Mehaffey
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa
| | - Tristan D Yan
- Department of Cardiothoracic Surgery, The Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Arnar Geirsson
- Division of Cardiac, Thoracic and Vascular Surgery, New York-Presbyterian Columbia University Medical Center, New York, NY
| | - Arman Arghami
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Jose L Navia
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Florida, Weston, Fla
| | - Goya V Raikar
- Division of Cardiothoracic Surgery, Medical College of Wisconsin, Pleasant Prairie, Wis
| | - Alberto C Weber
- Department of Cardiovascular Surgery, Herzzentrum Hislanden, Zurich, Switzerland
| | - Danny Ramzy
- Division of Cardiac Surgery, McGovern Medical School, UTHealth, Houston, Tex
| | - Štěpán Černý
- Department of Cardiac Surgery, University Hospital Motol, Prague, Czech Republic
| | - Jan Vojáček
- Department of Cardiac Surgery, University Hospital, Hradec Kralove, Czech Republic
| | - Robert L Smith
- Division of Cardiac Surgery, Baylor Scott & White Health, Plano, Tex
| | - Johannes Bonatti
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Vinod H Thourani
- Department of Cardiothoracic Surgery, Piedmont Healthcare, Atlanta, Ga
| | - Lawrence M Wei
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa
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Niu C, Zhu K, Zhang J, Joshi U, Liu H, Zahid S, Jadhav N, Okolo PI. Analysis of immune-related adverse events in gastrointestinal malignancy patients treated with immune checkpoint inhibitors. Int J Cancer 2024; 154:1261-1271. [PMID: 38083969 DOI: 10.1002/ijc.34813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 02/07/2024]
Abstract
Immune checkpoint inhibitors are becoming an increasingly common treatment for advanced gastrointestinal cancer, but the possibility of immune-related adverse events has raised concerns. This study aimed to evaluate the risks of immune-related adverse events between patients who received immune checkpoint inhibitors and those who received chemotherapy among different types of gastrointestinal cancer. The study utilized data from the multicenter TriNetX database in the United States covering the period between 2015 and 2022. Hazard ratios and 95% confidence intervals were used to describe the relative hazard of immune-related adverse events based on comparing time-to-event rates. Our study revealed that the incidence of immune-related adverse events was significantly higher in patients who received immune checkpoint inhibitors and chemotherapy compared to those who received chemotherapy only in treating gastrointestinal cancer. CTLA-4 inhibitors tended to have a higher rate of immune-related adverse events compared to PD-1/PD-L1 inhibitors. Our study found a lower mortality rate among patients who developed immune-related adverse events compared to those who did not after propensity score matching (HR, 0.661; 95% CI 0.620-0.704; p < .01). We provide important real-world data on the incidence and impact of immune-related adverse events in patients with advanced gastrointestinal cancer treated with immune checkpoint inhibitors. Our study's results support clinicians in making informed decisions about the potential benefits and risks of immune checkpoint inhibitor therapy for patients with gastrointestinal cancer.
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Affiliation(s)
- Chengu Niu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Kaiwen Zhu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Jing Zhang
- Harbin Medical University, Harbin, China
| | - Utsav Joshi
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Hongli Liu
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Salman Zahid
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Nagesh Jadhav
- Internal Medicine Residency Program, Rochester General Hospital, Rochester, New York, USA
| | - Patrick I Okolo
- Division of Gastroenterology, Rochester General Hospital, Rochester, New York, USA
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33
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Hönig M, Altomare D, Caprioglio C, Collij L, Barkhof F, Van Berckel B, Scheltens P, Farrar G, Battle MR, Theis H, Giehl K, Bischof GN, Garibotto V, Molinuevo JLL, Grau-Rivera O, Delrieu J, Payoux P, Demonet JF, Nordberg AK, Savitcheva I, Walker Z, Edison P, Stephens AW, Gismondi R, Jessen F, Buckley CJ, Gispert JD, Frisoni GB, Drzezga A. Association Between Years of Education and Amyloid Burden in Patients With Subjective Cognitive Decline, MCI, and Alzheimer Disease. Neurology 2024; 102:e208053. [PMID: 38377442 DOI: 10.1212/wnl.0000000000208053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/13/2023] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES Higher-educated patients with Alzheimer disease (AD) can harbor greater neuropathologic burden than those with less education despite similar symptom severity. In this study, we assessed whether this observation is also present in potential preclinical AD stages, namely in individuals with subjective cognitive decline and clinical features increasing AD likelihood (SCD+). METHODS Amyloid-PET information ([18F]Flutemetamol or [18F]Florbetaben) of individuals with SCD+, mild cognitive impairment (MCI), and AD were retrieved from the AMYPAD-DPMS cohort, a multicenter randomized controlled study. Group classification was based on the recommendations by the SCD-I and NIA-AA working groups. Amyloid PET images were acquired within 8 months after initial screening and processed with AMYPYPE. Amyloid load was based on global Centiloid (CL) values. Educational level was indexed by formal schooling and subsequent higher education in years. Using linear regression analysis, the main effect of education on CL values was tested across the entire cohort, followed by the assessment of an education-by-diagnostic-group interaction (covariates: age, sex, and recruiting memory clinic). To account for influences of non-AD pathology and comorbidities concerning the tested amyloid-education association, we compared white matter hyperintensity (WMH) severity, cardiovascular events, depression, and anxiety history between lower-educated and higher-educated groups within each diagnostic category using the Fisher exact test or χ2 test. Education groups were defined using a median split on education (Md = 13 years) in a subsample of the initial cohort, for whom this information was available. RESULTS Across the cohort of 212 individuals with SCD+ (M(Age) = 69.17 years, F 42.45%), 258 individuals with MCI (M(Age) = 72.93, F 43.80%), and 195 individuals with dementia (M(Age) = 74.07, F 48.72%), no main effect of education (ß = 0.52, 95% CI -0.30 to 1.58), but a significant education-by-group interaction on CL values, was found (p = 0.024) using linear regression modeling. This interaction was driven by a negative association of education and CL values in the SCD+ group (ß = -0.11, 95% CI -4.85 to -0.21) and a positive association in the MCI group (ß = 0.15, 95% CI 0.79-5.22). No education-dependent differences in terms of WMH severity and comorbidities were found in the subsample (100 cases with SCD+, 97 cases with MCI, 72 cases with dementia). DISCUSSION Education may represent a factor oppositely modulating subjective awareness in preclinical stages and objective severity of ongoing neuropathologic processes in clinical stages.
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Affiliation(s)
- Merle Hönig
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Daniele Altomare
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Camilla Caprioglio
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Lyduine Collij
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Frederik Barkhof
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Bart Van Berckel
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Philip Scheltens
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Gill Farrar
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Mark R Battle
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Hendrik Theis
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Kathrin Giehl
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Gerard N Bischof
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Valentina Garibotto
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - José Luis L Molinuevo
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Oriol Grau-Rivera
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Julien Delrieu
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Pierre Payoux
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Jean Francois Demonet
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Agneta K Nordberg
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Irina Savitcheva
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Zuzana Walker
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Paul Edison
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Andrew W Stephens
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Rossella Gismondi
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Frank Jessen
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Christopher J Buckley
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Juan Domingo Gispert
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Giovanni B Frisoni
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
| | - Alexander Drzezga
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne (M.H., H.T., K.G., G.N.B., A.D.), University of Cologne; Institute of Neuroscience and Medicine (INM-2) (M.H., K.G., A.D.), Molecular Organization of the Brain, Forschungszentrum Jülich, Germany; Neurology Unit (D.A.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE) (D.A.), University of Geneva; Geneva Memory Center (D.A., C.C., G.B.F.), Geneva University Hospitals, Switzerland; Amsterdam UMC (L.C., F.B., B.V.B., P.S.), Location VUmc, Radiology; Amsterdam Neuroscience (L.C., F.B., B.V.B., P.S.), Brain Imaging, the Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing (F.B.), University College London; GE Healthcare (G.F., M.R.B., C.J.B.), Pharmaceutical Diagnostics, Amersham, United Kingdom; Department of Neurology (H.T.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany; Division of Nuclear Medicine and Molecular Imaging (V.G.), Diagnostic Department, University Hospitals of Geneva; Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTLab) (V.G.), Faculty of Medicine, Department of Radiology, University of Geneva; Center for Biomedical Imaging (CIBM) (V.G.), Geneva, Switzerland; Barcelonaβeta Brain Research Center (BBRC) (J.L.L.M., O.G.-R., J.D.G.), Pasqual Maragall Foundation, Barcelona, Spain; Gérontopôle (J.D., P.P., J.F.D.), Department of Geriatrics, Toulouse University Hospital; Maintain Aging Research Team (J.D.), CERPOP, Inserm, Université Paul Sabatier, Toulouse; ToNIC (P.P.), Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Center for Alzheimer Research (A.K.N.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; Theme Inflammation and Aging (A.K.N.), Karolinska University Hospital, Stockholm; Medical Radiation Physics and Nuclear Medicine (I.S.), Karolinska University Hospital, Sweden; Division of Psychiatry (Z.W.), University College London, London and Essex Partnership University NHS Foundation Trust; Department of Brain Sciences (P.E.), Imperial College London, United Kingdom; Life Molecular Imaging (A.W.S., R.G.), Berlin; Department of Psychiatry (F.J.), Faculty of Medicine and University Hospital Cologne, University of Cologne; and German Center for Neurodegenerative Diseases (DZNE) (F.J., A.D.), Bonn-Cologne, Germany
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Budge J, Carrell T, Yaqub M, Wafa H, Waltham M, Pilecka I, Kelly J, Murphy C, Palmer S, Wang Y, Clough RE. The ARIA trial protocol: a randomised controlled trial to assess the clinical, technical, and cost-effectiveness of a cloud-based, ARtificially Intelligent image fusion system in comparison to standard treatment to guide endovascular Aortic aneurysm repair. Trials 2024; 25:214. [PMID: 38528619 DOI: 10.1186/s13063-023-07710-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/06/2023] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Endovascular repair of aortic aneurysmal disease is established due to perceived advantages in patient survival, reduced postoperative complications, and shorter hospital lengths of stay. High spatial and contrast resolution 3D CT angiography images are used to plan the procedures and inform device selection and manufacture, but in standard care, the surgery is performed using image-guidance from 2D X-ray fluoroscopy with injection of nephrotoxic contrast material to visualise the blood vessels. This study aims to assess the benefit to patients, practitioners, and the health service of a novel image fusion medical device (Cydar EV), which allows this high-resolution 3D information to be available to operators at the time of surgery. METHODS The trial is a multi-centre, open label, two-armed randomised controlled clinical trial of 340 patient, randomised 1:1 to either standard treatment in endovascular aneurysm repair or treatment using Cydar EV, a CE-marked medical device comprising of cloud computing, augmented intelligence, and computer vision. The primary outcome is procedural time, with secondary outcomes of procedural efficiency, technical effectiveness, patient outcomes, and cost-effectiveness. Patients with a clinical diagnosis of AAA or TAAA suitable for endovascular repair and able to provide written informed consent will be invited to participate. DISCUSSION This trial is the first randomised controlled trial evaluating advanced image fusion technology in endovascular aortic surgery and is well placed to evaluate the effect of this technology on patient outcomes and cost to the NHS. TRIAL REGISTRATION ISRCTN13832085. Dec. 3, 2021.
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Affiliation(s)
- James Budge
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- St George's Vascular Institute, St George's University, London, UK
| | | | - Medeah Yaqub
- King's Clinical Trials Unit, King's College London, London, UK
| | - Hatem Wafa
- Department of Population Health Sciences, King's College London, London, UK
| | | | - Izabela Pilecka
- King's Clinical Trials Unit, King's College London, London, UK
| | - Joanna Kelly
- King's Clinical Trials Unit, King's College London, London, UK
| | - Caroline Murphy
- King's Clinical Trials Unit, King's College London, London, UK
| | - Stephen Palmer
- Centre for Health Economics, University of York, York, UK
| | - Yanzhong Wang
- Department of Population Health Sciences, King's College London, London, UK
| | - Rachel E Clough
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
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McIlroy G, Lax S, Gaskell C, Jackson A, Rhodes M, Seale T, Fox S, Hopkins L, Okosun J, Barrington SF, Ringshausen I, Ramsay AG, Calaminici M, Linton K, Bishton M. Investigator choice of standard therapy versus sequential novel therapy arms in the treatment of relapsed follicular lymphoma (REFRACT): study protocol for a multi-centre, open-label, randomised, phase II platform trial. BMC Cancer 2024; 24:370. [PMID: 38528445 DOI: 10.1186/s12885-024-12112-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Relapsed or refractory follicular lymphoma (rrFL) is an incurable disease associated with shorter remissions and survival after each line of standard therapy. Many promising novel, chemotherapy-free therapies are in development, but few are licensed as their role in current treatment pathways is poorly defined. METHODS The REFRACT trial is an investigator-initiated, UK National Cancer Research Institute, open-label, multi-centre, randomised phase II platform trial aimed at accelerating clinical development of novel therapies by addressing evidence gaps. The first of the three sequential novel therapy arms is epcoritamab plus lenalidomide, to be compared with investigator choice standard therapy (ICT). Patients aged 18 years or older with biopsy proven relapsed or refractory CD20 positive, grade 1-3a follicular lymphoma and assessable disease by PET-CT are eligible. The primary outcome is complete metabolic response by PET-CT at 24 weeks using the Deauville 5-point scale and Lugano 2014 criteria. Secondary outcomes include overall metabolic response, progression-free survival, overall survival, duration of response, and quality of life assessed by EQ-5D-5 L and FACT-Lym. The trial employs an innovative Bayesian design with a target sample size of 284 patients: 95 in the ICT arm and 189 in the novel therapy arms. DISCUSSION Whilst there are many promising novel drugs in early clinical development for rrFL, understanding the relative efficacy and safety of these agents, and their place in modern treatment pathways, is limited by a lack of randomised trials and dearth of published outcomes for standard regimens to act as historic controls. Therefore, the aim of REFRACT is to provide an efficient platform to evaluate novel agents against standard therapies for rrFL. The adaptive Bayesian power prior methodology design will minimise patient numbers and accelerate trial delivery. TRIAL REGISTRATION ClinicalTrials.gov: NCT05848765; 08-May-2023. EUDRACT 2022-000677-75; 10-Feb-2022.
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Affiliation(s)
- Graham McIlroy
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK.
| | - Siân Lax
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK
| | - Charlotte Gaskell
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK
| | - Aimee Jackson
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK
| | | | - Tania Seale
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Sonia Fox
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK
| | - Lousie Hopkins
- Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Birmingham, UK
| | - Jessica Okosun
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Sally F Barrington
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, UK
| | | | - Alan G Ramsay
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Maria Calaminici
- Department of Cellular Pathology Barts Health and Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Kim Linton
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Mark Bishton
- Translational Medical Sciences, University of Nottingham, Nottingham, UK
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
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36
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Burggraaf-van Delft JLI, van Rein N, Bemelmans RHH, van den Berg JWK, Bruggeman CY, Cloos-van Balen M, Coppens M, Eefting M, Ende-Verhaar Y, van Es N, van Guldener C, de Jong WK, Kleijwegt F, Koster T, Kroon C, Kuipers S, Leentjens J, Luijten D, Mairuhu ATA, Meijer K, van de Ree MA, Roos R, Schrover I, Swart-Heikens J, van der Velden AWG, van den Akker-van Marle EM, le Cessie S, Geersing GJ, Middeldorp S, Huisman MV, Klok FA, Cannegieter SC. Tailored anticoagulant treatment after a first venous thromboembolism: protocol of the Leiden Thrombosis Recurrence Risk Prevention (L-TRRiP) study - cohort-based randomised controlled trial. BMJ Open 2024; 14:e078676. [PMID: 38521524 PMCID: PMC10961563 DOI: 10.1136/bmjopen-2023-078676] [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: 08/08/2023] [Accepted: 02/06/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION Patients with a first venous thromboembolism (VTE) are at risk of recurrence. Recurrent VTE (rVTE) can be prevented by extended anticoagulant therapy, but this comes at the cost of an increased risk of bleeding. It is still uncertain whether patients with an intermediate recurrence risk or with a high recurrence and high bleeding risk will benefit from extended anticoagulant treatment, and whether a strategy where anticoagulant duration is tailored on the predicted risks of rVTE and bleeding can improve outcomes. The aim of the Leiden Thrombosis Recurrence Risk Prevention (L-TRRiP) study is to evaluate the outcomes of tailored duration of long-term anticoagulant treatment based on individualised assessment of rVTE and major bleeding risks. METHODS AND ANALYSIS The L-TRRiP study is a multicentre, open-label, cohort-based, randomised controlled trial, including patients with a first VTE. We classify the risk of rVTE and major bleeding using the L-TRRiP and VTE-BLEED scores, respectively. After 3 months of anticoagulant therapy, patients with a low rVTE risk will discontinue anticoagulant treatment, patients with a high rVTE and low bleeding risk will continue anticoagulant treatment, whereas all other patients will be randomised to continue or discontinue anticoagulant treatment. All patients will be followed up for at least 2 years. Inclusion will continue until the randomised group consists of 608 patients; we estimate to include 1600 patients in total. The primary outcome is the combined incidence of rVTE and major bleeding in the randomised group after 2 years of follow-up. Secondary outcomes include the incidence of rVTE and major bleeding, functional outcomes, quality of life and cost-effectiveness in all patients. ETHICS AND DISSEMINATION The protocol was approved by the Medical Research Ethics Committee Leiden-Den Haag-Delft. Results are expected in 2028 and will be disseminated through peer-reviewed journals and during (inter)national conferences. TRIAL REGISTRATION NUMBER NCT06087952.
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Affiliation(s)
| | - Nienke van Rein
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Remy H H Bemelmans
- Department of Internal Medicine, Ziekenhuis Gelderse Vallei, Ede, Gelderland, The Netherlands
| | | | - Coty Y Bruggeman
- Department of Internal Medicine, Martini Ziekenhuis, Groningen, Groningen, The Netherlands
| | - Marissa Cloos-van Balen
- Department of Internal Medicine, Groene Hart Ziekenhuis, Gouda, Zuid-Holland, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam UMC Location AMC, Amsterdam, Noord-Holland, The Netherlands
- Pulmonary Hypertension & Thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, The Netherlands
| | - Matthijs Eefting
- Department of Internal Medicine, Ikazia Ziekenhuis, Rotterdam, Zuid-Holland, The Netherlands
| | - Yvonne Ende-Verhaar
- Department of Internal Medicine, Medisch Centrum Haaglanden, Den Haag, Zuid-Holland, The Netherlands
| | - Nick van Es
- Department of Vascular Medicine, Amsterdam UMC Location AMC, Amsterdam, Noord-Holland, The Netherlands
- Pulmonary Hypertension & Thrombosis, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, The Netherlands
| | - Coen van Guldener
- Department of Internal Medicine, Amphia Ziekenhuis, Breda, North Brabant, The Netherlands
| | - Wouter K de Jong
- Department of Pulmonology, Ziekenhuis Gelderse Vallei, Ede, Gelderland, The Netherlands
| | - Fleur Kleijwegt
- Department of Internal Medicine, Rode Kruis Ziekenhuis, Beverwijk, Noord-Holland, The Netherlands
| | - Ted Koster
- Department of Internal Medicine, Groene Hart Ziekenhuis, Gouda, Zuid-Holland, The Netherlands
| | - Cees Kroon
- Department of Internal Medicine, Ziekenhuis Nij Smellinghe, Drachten, Friesland, The Netherlands
| | - Saskia Kuipers
- Department of Internal Medicine, ADRZ, Goes, Zeeland, The Netherlands
| | - Jenneke Leentjens
- Department of Internal Medicine, Radboud university medical center, Nijmegen, Gelderland, The Netherlands
| | - Dieuwke Luijten
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Albert T A Mairuhu
- Department of Internal Medicine, Haga Hospital, Den Haag, Zuid-Holland, The Netherlands
| | - Karina Meijer
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Marcel A van de Ree
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Rick Roos
- Department of Internal Medicine, Haga Hospital, Den Haag, Zuid-Holland, The Netherlands
| | - Ilse Schrover
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Janneke Swart-Heikens
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | | | | | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
- Department of Clinical Epidemiology, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Geert-Jan Geersing
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Saskia Middeldorp
- Department of Internal Medicine, Radboud university medical center, Nijmegen, Gelderland, The Netherlands
| | - Menno V Huisman
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Frederikus A Klok
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Suzanne C Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
- Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
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Lian J, Li J, Liu C, Luan B, Miao Y. Research progress of robot and laparoscope in postoperative complications of rectal cancer. J Robot Surg 2024; 18:135. [PMID: 38520491 DOI: 10.1007/s11701-024-01872-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/16/2024] [Indexed: 03/25/2024]
Abstract
Rectal cancer is one of the most common malignant tumours worldwide, and it is also one of the major diseases that seriously threatens human life and health. At present, the main treatment for rectal cancer is still surgical treatment. The surgical methods have been rapidly developed from the previous open surgery to the current minimally invasive surgery. At present, there are two main minimally invasive surgeries: robotic surgery and laparoscopic surgery. Due to the particularity of rectal cancer surgery, more and more studies have shown that robotic rectal cancer surgery has more advantages than laparoscopic rectal cancer surgery. However, whether the incidence of postoperative complications after robotic rectal cancer surgery is lower than that after laparoscopy is not uniformly conclusive in the current study. Therefore, in this paper, we searched Pubmed, Cochrane Library, Embase and other databases, collected the latest published meta-analysis on postoperative complications of robots and laparoscopy in rectal cancer, and assessed the quality of the included meta-analysis by AMSTAR-2 evaluation tool, so as to explore the current research status and research quality of postoperative complications of robots and laparoscopy in rectal cancer. The results showed that compared with laparoscopic rectal cancer surgery, robotic rectal cancer surgery could improve the postoperative urinary and reproductive function of male patients, but it could not be proved that robotic rectal cancer surgery could reduce the incidence of postoperative complications, anastomotic leakage, urinary retention, intestinal obstruction, anastomotic bleeding, incision infection, pulmonary infection, venous thrombosis and abdominal abscess; however, the overall quality of meta-analysis of the results of each complication was low or very low. Therefore, multicenter, large-sample, high-quality prospective randomised controlled studies and high-quality meta-analysis are still needed to prove the advantages of robotic rectal cancer surgery in postoperative complications in the future.
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Affiliation(s)
- Jiming Lian
- College of Basic Medical Sciences, Guangdong Yunfu Vocational College of Chinese Medicine, Yunfu, 527300, China
| | - Jinbiao Li
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510000, China
| | - Cong Liu
- Department of General Medicine, The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, 523000, China
| | - BaoDong Luan
- Department of Stomatology, Guangdong Provincial People's Hospital, Guangzhou, 510000, China
| | - Yanmin Miao
- College of Basic Medical Sciences, Guangdong Yunfu Vocational College of Chinese Medicine, Yunfu, 527300, China.
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Naing C, Ni H, Aung HH, Pavlov CS. Endoscopic sphincterotomy for adults with biliary sphincter of Oddi dysfunction. Cochrane Database Syst Rev 2024; 3:CD014944. [PMID: 38517086 PMCID: PMC10958761 DOI: 10.1002/14651858.cd014944.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND The sphincter of Oddi comprises a muscular complex encircling the distal part of the common bile duct and the pancreatic duct regulating the outflow from these ducts. Sphincter of Oddi dysfunction refers to the abnormal opening and closing of the muscular valve, which impairs the circulation of bile and pancreatic juices. OBJECTIVES To evaluate the benefits and harms of any type of endoscopic sphincterotomy compared with a placebo drug, sham operation, or any pharmaceutical treatment, administered orally or endoscopically, alone or in combination, or a different type of endoscopic sphincterotomy in adults with biliary sphincter of Oddi dysfunction. SEARCH METHODS We used extensive Cochrane search methods. The latest search date was 16 May 2023. SELECTION CRITERIA We included randomised clinical trials assessing any type of endoscopic sphincterotomy versus placebo drug, sham operation, or any pharmaceutical treatment, alone or in combination, or a different type of endoscopic sphincterotomy in adults diagnosed with sphincter of Oddi dysfunction, irrespective of year, language of publication, format, or outcomes reported. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods and Review Manager to prepare the review. Our primary outcomes were: proportion of participants without successful treatment; proportion of participants with one or more serious adverse events; and health-related quality of life. Our secondary outcomes were: all-cause mortality; proportion of participants with one or more non-serious adverse events; length of hospital stay; and proportion of participants without improvement in liver function tests. We used the outcome data at the longest follow-up and the random-effects model for our primary analyses. We assessed the risk of bias of the included trials using RoB 2 and the certainty of evidence using GRADE. We planned to present the results of time-to-event outcomes as hazard ratios (HR). We presented dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean difference (MD) with their 95% confidence intervals (CI). MAIN RESULTS We included four randomised clinical trials, including 433 participants. Trials were published between 1989 and 2015. The trial participants had sphincter of Oddi dysfunction. Two trials were conducted in the USA, one in Australia, and one in Japan. One was a multicentre trial conducted in seven US centres, and the remaining three were single-centre trials. One trial used a two-stage randomisation, resulting in two comparisons. The number of participants in the four trials ranged from 47 to 214 (median 86), with a median age of 45 years, and the mean proportion of males was 49%. The follow-up duration ranged from one year to four years after the end of treatment. All trials assessed one or more outcomes of interest to our review. The trials provided data for the comparisons and outcomes below, in conformity with our review protocol. The certainty of evidence for all the outcomes was very low. Endoscopic sphincterotomy versus sham Endoscopic sphincterotomy versus sham may have little to no effect on treatment success (RR 1.05, 95% CI 0.66 to 1.66; 3 trials, 340 participants; follow-up range 1 to 4 years); serious adverse events (RR 0.71, 95% CI 0.34 to 1.46; 1 trial, 214 participants; follow-up 1 year), health-related quality of life (Physical scale) (MD -1.00, 95% CI -3.84 to 1.84; 1 trial, 214 participants; follow-up 1 year), health-related quality of life (Mental scale) (MD -1.00, 95% CI -4.16 to 2.16; 1 trial, 214 participants; follow-up 1 year), and no improvement in liver function test (RR 0.89, 95% CI 0.35 to 2.26; 1 trial, 47 participants; follow-up 1 year), but the evidence is very uncertain. Endoscopic sphincterotomy versus endoscopic papillary balloon dilation Endoscopic sphincterotomy versus endoscopic papillary balloon dilationmay have little to no effect on serious adverse events (RR 0.34, 95% CI 0.04 to 3.15; 1 trial, 91 participants; follow-up 1 year), but the evidence is very uncertain. Endoscopic sphincterotomy versus dual endoscopic sphincterotomy Endoscopic sphincterotomy versus dual endoscopic sphincterotomy may have little to no effect on treatment success (RR 0.65, 95% CI 0.32 to 1.31; 1 trial, 99 participants; follow-up 1 year), but the evidence is very uncertain. Funding One trial did not provide any information on sponsorship; one trial was funded by a foundation (the National Institutes of Diabetes and Digestive and Kidney Diseases, NIDDK), and two trials seemed to be funded by the local health institutes or universities where the investigators worked. We did not identify any ongoing randomised clinical trials. AUTHORS' CONCLUSIONS Based on very low-certainty evidence from the trials included in this review, we do not know if endoscopic sphincterotomy versus sham or versus dual endoscopic sphincterotomy increases, reduces, or makes no difference to the number of people with treatment success; if endoscopic sphincterotomy versus sham or versus endoscopic papillary balloon dilation increases, reduces, or makes no difference to serious adverse events; or if endoscopic sphincterotomy versus sham improves, worsens, or makes no difference to health-related quality of life and liver function tests in adults with biliary sphincter of Oddi dysfunction. Evidence on the effect of endoscopic sphincterotomy compared with sham, endoscopic papillary balloon dilation,or dual endoscopic sphincterotomyon all-cause mortality, non-serious adverse events, and length of hospital stay is lacking. We found no trials comparing endoscopic sphincterotomy versus a placebo drug or versus any other pharmaceutical treatment, alone or in combination. All four trials were underpowered and lacked trial data on clinically important outcomes. We lack randomised clinical trials assessing clinically and patient-relevant outcomes to demonstrate the effects of endoscopic sphincterotomy in adults with biliary sphincter of Oddi dysfunction.
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Affiliation(s)
- Cho Naing
- Division of Tropical Health and Medicine, James Cook University, Queensland, Australia
| | - Han Ni
- Department of Medicine, Newcastle University Medicine Malaysia, Johor, Malaysia
| | - Htar Htar Aung
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Chavdar S Pavlov
- Department of Gastroenterology, Botkin Hospital, Moscow, Russian Federation
- Department of Therapy, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Streichart L, Felldin M, Ekberg J, Mjörnstedt L, Lindnér P, Lennerling A, Bröcker V, Mölne J, Holgersson J, Daenen K, Wennberg L, Lorant T, Baid-Agrawal S. Tocilizumab in chronic active antibody-mediated rejection: rationale and protocol of an in-progress randomized controlled open-label multi-center trial (INTERCEPT study). Trials 2024; 25:213. [PMID: 38519988 PMCID: PMC10958896 DOI: 10.1186/s13063-024-08020-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/26/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Chronic active antibody-mediated rejection (caAMR) in kidney transplants is associated with irreversible tissue damage and a leading cause of graft loss in the long-term. However, the treatment for caAMR remains a challenge to date. Recently, tocilizumab, a recombinant humanized monoclonal antibody directed against the human interleukin-6 (IL-6) receptor, has shown promise in the treatment of caAMR. However, it has not been systematically investigated so far underscoring the need for randomized controlled studies in this area. METHODS The INTERCEPT study is an investigator-driven randomized controlled open-label multi-center trial in kidney transplant recipients to assess the efficacy of tocilizumab in the treatment of biopsy-proven caAMR. A total of 50 recipients with biopsy-proven caAMR at least 12 months after transplantation will be randomized to receive either tocilizumab (n = 25) added to our standard of care (SOC) maintenance treatment or SOC alone (n = 25) for a period of 24 months. Patients will be followed for an additional 12 months after cessation of study medication. After the inclusion biopsies at baseline, protocol kidney graft biopsies will be performed at 12 and 24 months. The sample size calculation assumed a difference of 5 ml/year in slope of estimated glomerular filtration rate (eGFR) between the two groups for 80% power at an alpha of 0.05. The primary endpoint is the slope of eGFR at 24 months after start of treatment. The secondary endpoints include assessment of the following at 12, 24, and 36 months: composite risk score iBox, safety, evolution and characteristics of donor-specific antibodies (DSA), graft histology, proteinuria, kidney function assessed by measured GFR (mGFR), patient- and death-censored graft survival, and patient-reported outcomes that include transplant-specific well-being, adherence to immunosuppressive medications and perceived threat of the risk of graft rejection. DISCUSSION No effective treatment exists for caAMR at present. Based on the hypothesis that inhibition of IL-6 receptor by tocilizumab will reduce antibody production and reduce antibody-mediated damage, our randomized trial has a potential to provide evidence for a novel treatment strategy for caAMR, therewith slowing the decline in graft function in the long-term. TRIAL REGISTRATION ClinicalTrials.gov NCT04561986. Registered on September 24, 2020.
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Affiliation(s)
- Lillian Streichart
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Marie Felldin
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Jana Ekberg
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Lars Mjörnstedt
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Per Lindnér
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Annette Lennerling
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden
| | - Verena Bröcker
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johan Mölne
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Holgersson
- Department of Laboratory Medicine, Institute of Biomedicine, University of Gothenburg and Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristien Daenen
- Department of Nephrology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Wennberg
- Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Tomas Lorant
- Section of Transplantation Surgery, Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Seema Baid-Agrawal
- Transplant Institute, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 413 45, Gothenburg, Sweden.
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Tripathi D, Patch D, Mehrzad H, Yu D, Aspinall RJ, Armstrong MJ, Stanley A, Ireland H, Travis S, Hayes P, Lomax M, Roslund N, Lam E, Slinn G, Jowett S, Moakes C, Maher A, Brettell E, Sehmi S. Study protocol for a Randomised controlled trial of EArly transjugular intrahepatiC porTosystemic stent-shunt in Acute Variceal Bleeding (REACT-AVB trial). BMJ Open Gastroenterol 2024; 11:e001314. [PMID: 38519049 DOI: 10.1136/bmjgast-2023-001314] [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: 12/02/2023] [Accepted: 02/16/2024] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION In liver cirrhosis, acute variceal bleeding (AVB) is associated with a 1-year mortality rate of up to 40%. Data on early or pre-emptive transjugular intrahepatic portosystemic stent-shunt (TIPSS) in AVB is inconclusive and may not reflect current management strategies. Randomised controlled trial of EArly transjugular intrahepatiC porTosystemic stent-shunt in AVB (REACT-AVB) aims to investigate the clinical and cost-effectiveness of early TIPSS in patients with cirrhosis and AVB after initial bleeding control. METHODS AND ANALYSIS REACT-AVB is a multicentre, randomised controlled, open-label, superiority, two-arm, parallel-group trial with an internal pilot. The two interventions allocated randomly 1:1 are early TIPSS within 4 days of diagnostic endoscopy or secondary prophylaxis with endoscopic therapy in combination with non-selective beta blockers. Patients aged ≥18 years with cirrhosis and Child-Pugh Score 7-13 presenting with AVB with endoscopic haemostasis are eligible for inclusion. The primary outcome is transplant-free survival at 1 year post randomisation. Secondary endpoints include transplant-free survival at 6 weeks, rebleeding, serious adverse events, other complications of cirrhosis, Child-Pugh and Model For End-Stage Liver Disease (MELD) scores at 6 and 12 months, health-related quality of life, use of healthcare resources, cost-effectiveness and use of cross-over therapies. The sample size is 294 patients over a 4-year recruitment period, across 30 hospitals in the UK. ETHICS AND DISSEMINATION Research ethics committee of National Health Service has approved REACT-AVB (reference number: 23/WM/0085). The results will be submitted for publication in a peer-reviewed journal. A lay summary will also be emailed or posted to participants before publication. TRIAL REGISTRATION NUMBER ISRCTN85274829; protocol version 3.0, 1 July 2023.
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Affiliation(s)
- Dhiraj Tripathi
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - David Patch
- Hepatology and Liver Transplantation, Royal Free Hampstead NHS Trust, London, UK
| | - Homoyon Mehrzad
- Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
| | - Dominic Yu
- Department of Radiology, Royal Free London NHS Foundation Trust, London, UK
| | - Richard J Aspinall
- Gastroenterology and Hepatology, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Matthew J Armstrong
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
| | | | - Hamish Ireland
- Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Simon Travis
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Hayes
- Hepatology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | | | | | - Emily Lam
- GI and Liver PPI Group, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
| | - Gemma Slinn
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, West Midlands, UK
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham, Birmingham, West Midlands, UK
| | - Catherine Moakes
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, West Midlands, UK
| | - Alisha Maher
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, West Midlands, UK
| | - Elizabeth Brettell
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, West Midlands, UK
| | - Sukhwant Sehmi
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, West Midlands, UK
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Hu LY, Cai AQ, Li B, Li Z, Liu JP, Cao HJ. Chinese herbal medicine for post-viral fatigue: A systematic review of randomized controlled trials. PLoS One 2024; 19:e0300896. [PMID: 38512808 PMCID: PMC10956782 DOI: 10.1371/journal.pone.0300896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Fatigue is a common symptom after viral infection. Chinese herbal medicine (CHM) is thought to be a potential effective intervention in relieving fatigue. PURPOSE To assess the effectiveness and safety of CHM for the treatment of post-viral fatigue. STUDY DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS The protocol of this systematic review was registered on PROSPERO (CRD42022380356). Trials reported changes of fatigue symptom, which compared CHM to no treatment, placebo or drugs, were included. Six electronic databases and three clinical trial registration platforms were searched from inception to November 2023. Literature screening, data extraction, and risk bias assessment were independently carried out by two reviewers. Quality of the included trials was evaluated using Cochrane risk of bias tool, and the certainty of the evidence was evaluated using GRADE. The meta-analysis was performed using Review Manager 5.4, mean difference (MD) and its 95% confidence interval (CI) was used for estimate effect of continuous data. Heterogeneity among trials was assessed through I2 value. RESULTS Overall, nineteen studies with 1921 patients were included. Results of individual trial or meta-analysis showed that CHM was better than no treatment (MD = -0.80 scores, 95%CI -1.43 to -0.17 scores, P = 0.01, 60 participants, 1 trial), placebo (MD = -1.90 scores, 95%CI -2.38 to -1.42 scores, P<0.00001, 184 participants, 1 trial), placebo on basis of rehabilitation therapy (MD = -14.90 scores, 95%CI -24.53 to -5.27 scores, P = 0.02, 118 participants, 1 trial) or drugs (MD = -0.38 scores, 95%CI -0.48 to -0.27 scores, I2 = 0%, P<0.00001, 498 participants, 4 trials) on relieving fatigue symptoms assessing by Traditional Chinese Medicine fatigue scores. Trials compared CHM plus drugs to drugs alone also showed better effect of combination therapy (average MD = -0.56 scores). In addition, CHM may improve the percentage of CD4 T lymphocytes and reduce the level of serum IL-6 (MD = -14.64 scores, 95%CI 18.36 to -10.91 scores, I2 = 0%, P<0.00001, 146 participants, 2 trials). CONCLUSION Current systematic review found that the participation of CHM can improve the symptoms of post-viral fatigue and some immune indicators. However, the safety of CHM remains unknown and large sample, high quality multicenter RCTs are still needed in the future.
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Affiliation(s)
- Le-Yan Hu
- Beijing University of Chinese Medicine, Beijing, China
| | - An-Qi Cai
- Beijing University of Chinese Medicine, Beijing, China
| | - Bo Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Zheng Li
- Traditional Chinese Medicine Hospital affiliated to Xinjiang Medical University, Ürümqi, Xinjiang, China
| | - Jian-Ping Liu
- Beijing University of Chinese Medicine, Beijing, China
| | - Hui-Juan Cao
- Beijing University of Chinese Medicine, Beijing, China
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Harvey S, Stone M, Zingelman S, Copland DA, Kilkenny MF, Godecke E, Cadilhac DA, Kim J, Olaiya MT, Rose ML, Breitenstein C, Shrubsole K, O'Halloran R, Hill AJ, Hersh D, Mainstone K, Mainstone P, Unsworth CA, Brogan E, Short KJ, Burns CL, Baker C, Wallace SJ. Comprehensive quality assessment for aphasia rehabilitation after stroke: protocol for a multicentre, mixed-methods study. BMJ Open 2024; 14:e080532. [PMID: 38514146 PMCID: PMC10961567 DOI: 10.1136/bmjopen-2023-080532] [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: 10/03/2023] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. METHODS AND ANALYSIS This research aims to deliver a comprehensive quality assessment toolkit for poststroke aphasia services in four studies. A multicentre pilot study (study 1) will test the administration of the MEASuRES minimum dataset within five Australian health services. An embedded mixed-methods process evaluation (study 2) will evaluate the performance of the minimum dataset and explore its clinical applicability. A consensus study (study 3) will establish consumer-informed thresholds of meaningful change on core aphasia outcome constructs, which will then be used to establish minimal important change values for corresponding core outcome measurement instruments (study 4). ETHICS AND DISSEMINATION Studies 1 and 2 have been registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12623001313628). Ethics approval has been obtained from the Royal Brisbane and Women's Hospital (HREC/2023/MNHB/95293) and The University of Queensland (2022/HE001946 and 2023/HE001175). Study findings will be disseminated through peer-reviewed publications, conference presentations and engagement with relevant stakeholders including healthcare providers, policy-makers, stroke and rehabilitation audit and clinical quality registry custodians, consumer support organisations, and individuals with aphasia and their families.
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Affiliation(s)
- Sam Harvey
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
- Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Marissa Stone
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
- St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - Sally Zingelman
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
- Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - David A Copland
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
- Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Monique F Kilkenny
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
| | - Dominique A Cadilhac
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Joosup Kim
- Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Muideen T Olaiya
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Miranda L Rose
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| | - Caterina Breitenstein
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany
| | - Kirstine Shrubsole
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
- Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Robyn O'Halloran
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| | - Annie J Hill
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia
| | - Deborah Hersh
- Curtin School of Allied Health and EnAble Institute, Curtin University, Perth, Western Australia, Australia
- Australian Aphasia Association, Perth, Western Australia, Australia
| | - Kathryn Mainstone
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Penelope Mainstone
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Carolyn A Unsworth
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Institute of Health and Wellbeing, Federation University, Ballarat, Victoria, Australia
| | - Emily Brogan
- Edith Cowan University, Joondalup, Western Australia, Australia
- Fiona Stanley Fremantle Hospitals Group, South Metropolitan Health Service, Palmyra, Western Australia, Australia
| | - Kylie J Short
- Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Clare L Burns
- Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Caroline Baker
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- Speech Pathology Department, Monash Health, Clayton, Victoria, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, The University of Queensland, Saint Lucia, Queensland, Australia
- Surgical, Treatment and Rehabilitation Service Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, Herston, Queensland, Australia
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Lieberman EG. Dialing in Diosmin: Promising Findings of Swelling Reduction Using Diosmin After TKA: Commentary on an article by Qiuru Wang, MD, et al.: "Efficacy of Diosmin in Reducing Lower-Extremity Swelling and Pain After Total Knee Arthroplasty. A Randomized, Controlled Multicenter Trial". J Bone Joint Surg Am 2024; 106:e15. [PMID: 38506722 DOI: 10.2106/jbjs.23.01264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
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Cowan K, Semmens EO, Lee JY, Walker ES, Smith PG, Fu L, Singleton R, Cox SM, Faiella J, Chassereau L, Lawrence L, Ying J, Baldner J, Garza M, Annett R, Chervinskiy SK, Snowden J. Bronchiolitis recovery and the use of High Efficiency Particulate Air (HEPA) Filters (The BREATHE Study): study protocol for a multi-center, parallel, double-blind, randomized controlled clinical trial. Trials 2024; 25:197. [PMID: 38504367 PMCID: PMC10953277 DOI: 10.1186/s13063-024-08012-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Acute viral bronchiolitis is the most common reason for hospitalization of infants in the USA. Infants hospitalized for bronchiolitis are at high risk for recurrent respiratory symptoms and wheeze in the subsequent year, and longer-term adverse respiratory outcomes such as persistent childhood asthma. There are no effective secondary prevention strategies. Multiple factors, including air pollutant exposure, contribute to risk of adverse respiratory outcomes in these infants. Improvement in indoor air quality following hospitalization for bronchiolitis may be a prevention opportunity to reduce symptom burden. Use of stand-alone high efficiency particulate air (HEPA) filtration units is a simple method to reduce particulate matter ≤ 2.5 µm in diameter (PM2.5), a common component of household air pollution that is strongly linked to health effects. METHODS BREATHE is a multi-center, parallel, double-blind, randomized controlled clinical trial. Two hundred twenty-eight children < 12 months of age hospitalized for the first time with bronchiolitis will participate. Children will be randomized 1:1 to receive a 24-week home intervention with filtration units containing HEPA and carbon filters (in the child's sleep space and a common room) or to a control group with units that do not contain HEPA and carbon filters. The primary objective is to determine if use of HEPA filtration units reduces respiratory symptom burden for 24 weeks compared to use of control units. Secondary objectives are to assess the efficacy of the HEPA intervention relative to control on (1) number of unscheduled healthcare visits for respiratory complaints, (2) child quality of life, and (3) average PM2.5 levels in the home. DISCUSSION We propose to test the use of HEPA filtration to improve indoor air quality as a strategy to reduce post-bronchiolitis respiratory symptom burden in at-risk infants with severe bronchiolitis. If the intervention proves successful, this trial will support use of HEPA filtration for children with bronchiolitis to reduce respiratory symptom burden following hospitalization. TRIAL REGISTRATION NCT05615870. Registered on November 14, 2022.
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Affiliation(s)
- Kelly Cowan
- Department of Pediatrics, Larner College of Medicine at the University of Vermont, 111 Colchester Ave, Smith 5, Burlington, VT, 05403, USA.
| | - Erin O Semmens
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Jeannette Y Lee
- University of Arkansas for Medical Sciences, 4301 West Markham, #781, Little Rock, AR, 72205, USA
| | - Ethan S Walker
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Paul G Smith
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Linda Fu
- National Institutes of Health Environmental Influences On Child, Health Outcomes (ECHO) Program, 11601, Landsdown Street, Rockville, MD, 20852, USA
| | - Rosalyn Singleton
- Alaska Native Tribal Health Consortium, AIP-CDC, 4055 Tudor Centre Drive, Anchorage, AK, 99508, USA
| | - Sara McClure Cox
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Jennifer Faiella
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Laurie Chassereau
- University of Vermont, Given C421, 89 Beaumont Ave, Burlington, VT, 05405, USA
| | - Lora Lawrence
- IDeA States Pediatric Network Data Coordination and Operations Center, 13 Children's Way, Slot 512-35, Little Rock, AR, 72202, USA
| | - Jun Ying
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop F496, Academic Office One L15-3407, 12631 E 17th Avenue, Aurora, CO, 80045, USA
| | - Jaime Baldner
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA
| | - Maryam Garza
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA
| | - Robert Annett
- University of New Mexico Health Sciences Center, Albuquerque, NM, 87106, USA
| | - Sheva K Chervinskiy
- Cook Children's Department of Immunology, 1500 Cooper St, Fort Worth, TX, 76104, USA
| | - Jessica Snowden
- IDeA States Pediatric Network Data Coordination and Operations Center, 13 Children's Way, Slot 512-35, Little Rock, AR, 72202, USA
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Matlock DN, Ratcliffe SJ, Courtney SE, Kirpalani H, Firestone K, Stein H, Dysart K, Warren K, Goldstein MR, Lund KC, Natarajan A, Demissie E, Foglia EE. The Diaphragmatic Initiated Ventilatory Assist (DIVA) trial: study protocol for a randomized controlled trial comparing rates of extubation failure in extremely premature infants undergoing extubation to non-invasive neurally adjusted ventilatory assist versus non-synchronized nasal intermittent positive pressure ventilation. Trials 2024; 25:201. [PMID: 38509583 PMCID: PMC10953115 DOI: 10.1186/s13063-024-08038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/06/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Invasive mechanical ventilation contributes to bronchopulmonary dysplasia (BPD), the most common complication of prematurity and the leading respiratory cause of childhood morbidity. Non-invasive ventilation (NIV) may limit invasive ventilation exposure and can be either synchronized or non-synchronized (NS). Pooled data suggest synchronized forms may be superior. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA) delivers NIV synchronized to the neural signal for breathing, which is detected with a specialized catheter. The DIVA (Diaphragmatic Initiated Ventilatory Assist) trial aims to determine in infants born 240/7-276/7 weeks' gestation undergoing extubation whether NIV-NAVA compared to non-synchronized nasal intermittent positive pressure ventilation (NS-NIPPV) reduces the incidence of extubation failure within 5 days of extubation. METHODS This is a prospective, unblinded, pragmatic, multicenter phase III randomized clinical trial. Inclusion criteria are preterm infants 24-276/7 weeks gestational age who were intubated within the first 7 days of life for at least 12 h and are undergoing extubation in the first 28 postnatal days. All sites will enter an initial run-in phase, where all infants are allocated to NIV-NAVA, and an independent technical committee assesses site performance. Subsequently, all enrolled infants are randomized to NIV-NAVA or NS-NIPPV at extubation. The primary outcome is extubation failure within 5 days of extubation, defined as any of the following: (1) rise in FiO2 at least 20% from pre-extubation for > 2 h, (2) pH ≤ 7.20 or pCO2 ≥ 70 mmHg; (3) > 1 apnea requiring positive pressure ventilation (PPV) or ≥ 6 apneas requiring stimulation within 6 h; (4) emergent intubation for cardiovascular instability or surgery. Our sample size of 478 provides 90% power to detect a 15% absolute reduction in the primary outcome. Enrolled infants will be followed for safety and secondary outcomes through 36 weeks' postmenstrual age, discharge, death, or transfer. DISCUSSION The DIVA trial is the first large multicenter trial designed to assess the impact of NIV-NAVA on relevant clinical outcomes for preterm infants. The DIVA trial design incorporates input from clinical NAVA experts and includes innovative features, such as a run-in phase, to ensure consistent technical performance across sites. TRIAL REGISTRATION www. CLINICALTRIALS gov , trial identifier NCT05446272 , registered July 6, 2022.
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Affiliation(s)
- David N Matlock
- University of Arkansas for Medical Sciences, 4301 W. Markham St., Slot 512-5B, Little Rock, AR, 72205, USA.
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | | | | | - Haresh Kirpalani
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- McMaster University, Hamilton, ON, Canada
| | | | | | - Kevin Dysart
- Nemours Children's Health Wilmington, Philadelphia, PA, USA
| | - Karen Warren
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | - Aruna Natarajan
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ejigayehu Demissie
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth E Foglia
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Elias C, Raad M, Rasoanandrasana S, Raherinandrasana AH, Andriananja V, Raberahona M, Moore CE, Randria M, Raskine L, Vanhems P, Babin FX. Implementation of an antibiotic resistance surveillance tool in Madagascar, the TSARA project: a prospective, observational, multicentre, hospital-based study protocol. BMJ Open 2024; 14:e078504. [PMID: 38508637 PMCID: PMC10953040 DOI: 10.1136/bmjopen-2023-078504] [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: 08/03/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Antimicrobial resistance (AMR) has become a significant public health threat. Without any interventions, it has been modelled that AMR will account for an estimated 10 million deaths annually by 2050, this mainly affects low/middle-income countries. AMR has a systemic negative perspective affecting the overall healthcare system down to the patient's personal outcome. In response to this issue, the WHO urged countries to provide antimicrobial stewardship programmes (ASPs). ASPs in hospitals are a vital component of national action plans for AMR, and have been shown to significantly reduce AMR, in particular in low-income countries such as Madagascar.As part of an ASP, AMR surveillance provides essential information needed to guide medical practice. We developed an AMR surveillance tool-Technique de Surveillance Actualisée de la Résistance aux Antimicrobiens (TSARA)-with the support of the Mérieux Foundation. TSARA combines bacteriological and clinical information to provide a better understanding of the scope and the effects of AMR in Madagascar, where no such surveillance tool exists. METHODS AND ANALYSIS A prospective, observational, hospital-based study was carried out for data collection using a standardised data collection tool, called TSARA deployed in 2023 in 10 hospitals in Madagascar participating in the national Malagasy laboratory network (Réseau des Laboratoires à Madagascar (RESAMAD)). Any hospitalised patient where the clinician decided to take a bacterial sample is included. As a prospective study, individual isolate-level data and antimicrobial susceptibility information on pathogens were collected routinely from the bacteriology laboratory and compiled with clinical information retrieved from face-to-face interviews with the patient and completed using medical records where necessary. Analysis of the local ecology, resistance rates and antibiotic prescription patterns were collected. ETHICS AND DISSEMINATION This protocol obtained ethical approval from the Malagasy Ethical Committee n°07-MSANP/SG/AGMED/CNPV/CERBM on 24 January 2023. Findings generated were shared with national health stakeholders, microbiologists, members of the RESAMAD network and the Malagasy academic society of infectious diseases.
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Affiliation(s)
- Christelle Elias
- Service Hygiène et Epidémiologie, Hospices Civils de Lyon, Lyon, France
- Public Health, Epidemiology & Evolutionary Ecology of Infectious Diseases (PHE3ID) team, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Mathieu Raad
- Direction des Opérations Internationales, Fondation Mérieux, Lyon, France
| | | | | | | | - Mihaja Raberahona
- Service des Maladies Infectieuses, Hôpital Befelatanana, Antananarivo, Madagascar
| | - Catrin E Moore
- Centre for Neonatal and Paediatric Infection, St. George's, University of London, London, UK
| | - Mamy Randria
- Service de Biologie, Hôpital Befelatanana, Antananarivo, Madagascar
| | - Laurent Raskine
- Direction des Opérations Internationales, Fondation Mérieux, Lyon, France
| | - Philippe Vanhems
- Service Hygiène et Epidémiologie, Hospices Civils de Lyon, Lyon, France
- Public Health, Epidemiology & Evolutionary Ecology of Infectious Diseases (PHE3ID) team, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
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Sun Y, Guo N, Zhang M, Liu M, Gao Z, Sun T, Gao X, Xu L, Zhang H, Wei C, Liu P, Liu Y, Zhang X, Guo Y, Chen L, Zhou Z, Su Z, Hu Y, Shi X, Huang L, Wang Y. Association between preoperative frailty and myocardial injury after noncardiac surgery in geriatric patients: study protocol for a prospective, multicentre, real-world observational, cohort trial. BMC Geriatr 2024; 24:271. [PMID: 38504166 PMCID: PMC10953137 DOI: 10.1186/s12877-024-04847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/24/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Frailty has become a worldwide health burden that has a large influence on public health and clinical practice. The incidence of frailty is anticipated to increase as the ageing population increases. Myocardial injury after noncardiac surgery (MINS) is associated with short-term and long-term mortality. However, the incidence of MINS in frail geriatric patients is unknown. METHODS AND ANALYSIS This prospective, multicentre, real-world observational cohort study will be conducted at 18 designated centres in China from January 2023 to December 2024, with an anticipated sample size of 856 patients aged 65 years and older who are scheduled to undergo noncardiac surgery. The primary outcome will be the incidence of MINS. MINS is defined as a fourth-generation plasma cardiac troponin T (cTnT) concentration ≥ 0.03 ng/mL exhibited at least once within 30 days after surgery, with or without symptoms of myocardial ischaemia. All data will be collected via electronic data acquisition. DISCUSSION This study will explore the incidence of MINS in frail patients. The characteristics, predictive factors and 30-day outcomes of MINS in frail patients will be further investigated to lay the foundation for identifying clinical interventions. CLINICAL TRIAL REGISTRATION https://beta. CLINICALTRIALS gov/study/NCT05635877 , NCT05635877.
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Affiliation(s)
- Yongtao Sun
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Na Guo
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Min Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Mengjie Liu
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Zhongquan Gao
- Department of Anesthesiology, Shandong Public Health Clinical Center, Shandong University, Shandong, 250013, China
| | - Tao Sun
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Xiaojun Gao
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Lingling Xu
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Haixia Zhang
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Chuansong Wei
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Peng Liu
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yang Liu
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Xiaoning Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Yongle Guo
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Lina Chen
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
| | - Zheng Zhou
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Zhenqiang Su
- Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, 250014, China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yanmei Hu
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Xin Shi
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Linlin Huang
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China.
| | - Yuelan Wang
- Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University (Shandong Provincial Hospital), Jinan, 250021, China.
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China.
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Liu X, Li W, Gong J, Zhang Q, Tian X, Ren JD, Xia L, Li Y, Zhan Y, Zhang JX, Chuan-Peng H, Chen J, Feng Z, Chen Z. Dataset on the effects of psychological care on depression and suicide ideation in underrepresented children. Sci Data 2024; 11:304. [PMID: 38503792 PMCID: PMC10951232 DOI: 10.1038/s41597-024-03130-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
Massive increases in the risks of depressive disorders and the ensuing suicide have become the overarching menace for children/adolescents. Despite global consensus to instigate psychological healthcare policy for these children/adolescents, their effects remain largely unclear neither from a small amount of official data nor from small-scale scientific studies. More importantly, in underprivileged children/adolescents in lower-middle-economic-status countries/areas, the data collection may not be as equally accessible as in developed countries/areas, thus resulting in underrepresented observations. To address these challenges, we released a large-scale and multi-center cohort dataset (n = 249,772) showing the effects of primary psychological healthcare on decreasing depression and suicidal ideation in these children/adolescents who were underrepresented in previous studies or current healthcare systems, including unattended children/adolescents, orphans, children/adolescents in especially difficult circumstances, and "left-behind" and "single-parenting" children/adolescents. We provided all individual data recording the depressive symptoms and suicide ideation that had been collected at baseline (Oct 2022) and half-year follow-up (May 2023) from practicing this psychological healthcare system.
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Affiliation(s)
- Xuerong Liu
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
| | - Wei Li
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
| | - Jie Gong
- Nanchong Psychosomatic Hospital (The Sixth People's Hospital of Nanchong), Nanchong, Sichuan, 637000, China
| | - Qianyu Zhang
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
- Department of Public Management, Chongqing University, Chongqing, 400044, China
| | - Xiaobing Tian
- Nanchong Psychosomatic Hospital (The Sixth People's Hospital of Nanchong), Nanchong, Sichuan, 637000, China.
- Department of Epidemiology and Public Health Statistics, North Sichuan Medical College, Nanchong, Sichuan, 637000, China.
| | - Ji-Dong Ren
- Nanchong Psychosomatic Hospital (The Sixth People's Hospital of Nanchong), Nanchong, Sichuan, 637000, China
| | - Lei Xia
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
| | - Yanyan Li
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
| | - Yu Zhan
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
| | - Jing-Xuan Zhang
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China
| | - Hu Chuan-Peng
- School of Psychology, Nanjing Normal University, Nanjing, 518872, China
| | - Ji Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310013, China
| | - Zhengzhi Feng
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China.
| | - Zhiyi Chen
- Experimental Research Center for Medical and Psychological Science (ERC-MPS), School of Psychology, Third Military Medical University, Chongqing, 400038, China.
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Hentzien M, Bonnet F, Bernasconi E, Biver E, Braun DL, Munting A, Leuzinger K, Leleux O, Musardo S, Prendki V, Schmid P, Staehelin C, Stoeckle M, Walti CS, Wittkop L, Appay V, Didierlaurent AM, Calmy A. Immune response to the recombinant herpes zoster vaccine in people living with HIV over 50 years of age compared to non-HIV age-/gender-matched controls (SHINGR'HIV): a multicenter, international, non-randomized clinical trial study protocol. BMC Infect Dis 2024; 24:329. [PMID: 38504173 PMCID: PMC10949601 DOI: 10.1186/s12879-024-09192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The burden of herpes zoster (shingles) virus and associated complications, such as post-herpetic neuralgia, is higher in older adults and has a significant impact on quality of life. The incidence of herpes zoster and post-herpetic neuralgia is increased in people living with HIV (PLWH) compared to an age-matched general population, including PLWH on long-term antiretroviral therapy (ART) with no detectable viremia and normal CD4 counts. PLWH - even on effective ART may- exhibit sustained immune dysfunction, as well as defects in cells involved in the response to vaccines. In the context of herpes zoster, it is therefore important to assess the immune response to varicella zoster virus vaccination in older PLWH and to determine whether it significantly differs to that of HIV-uninfected healthy adults or younger PLWH. We aim at bridging these knowledge gaps by conducting a multicentric, international, non-randomised clinical study (SHINGR'HIV) with prospective data collection after vaccination with an adjuvant recombinant zoster vaccine (RZV) in two distinct populations: in PLWH on long-term ART (> 10 years) over 50 years of and age/gender matched controls. METHODS We will recruit participants from two large established HIV cohorts in Switzerland and in France in addition to age-/gender-matched HIV-uninfected controls. Participants will receive two doses of RZV two months apart. In depth-evaluation of the humoral, cellular, and innate immune responses and safety profile of the RZV will be performed to address the combined effect of aging and potential immune deficiencies due to chronic HIV infection. The primary study outcome will compare the geometric mean titer (GMT) of gE-specific total IgG measured 1 month after the second dose of RZV between different age groups of PLWH and between PLWH and age-/gender-matched HIV-uninfected controls. DISCUSSION The SHINGR'HIV trial will provide robust data on the immunogenicity and safety profile of RZV in older PLWH to support vaccination guidelines in this population. TRIAL REGISTRATION ClinicalTrials.gov NCT05575830. Registered on 12 October 2022. Eu Clinical Trial Register (EUCT number 2023-504482-23-00).
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Affiliation(s)
- Maxime Hentzien
- HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
- University of Reims Champagne-Ardenne, Reims, France
| | - Fabrice Bonnet
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, Bordeaux, France
- Université de Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux, F-33000, France
| | - Enos Bernasconi
- Department of Infectious Diseases, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Emmanuel Biver
- Division of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Dominique L Braun
- Division Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aline Munting
- Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudoise (CHUV), Lausanne, Switzerland
| | | | - Olivier Leleux
- Université de Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux, F-33000, France
| | - Stefano Musardo
- HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Virginie Prendki
- Division of Infectious Disease, Geneva University Hospital, Geneva, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital, St Gallen, Switzerland
| | - Cornelia Staehelin
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Carla S Walti
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Linda Wittkop
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, Bordeaux, France
- CHU de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, Bordeaux, F-33000, France
- Inria équipe SISTM team, Talence, France
| | - Victor Appay
- Université de Bordeaux, CNRS UMR 5164, INSERM ERL 1303, ImmunoConcEpT, Bordeaux, 33000, France
| | - Arnaud M Didierlaurent
- Department of Pathology and Immunology, Center of Vaccinology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Alexandra Calmy
- HIV/AIDS Unit, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
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Sekimizu M, Fukano R, Koga Y, Mitsui T, Fujita N, Mori T, Hori D, Tanaka M, Ohki K, Iwafuchi H, Nakazawa A, Mori T, Kobayashi R, Hashimoto H, M Saito A, Kamei M. Rituximab-combined anthracycline-free chemotherapy in newly diagnosed paediatric and adolescent patients with non-high-risk aggressive mature B cell lymphoma: protocol for a single-arm, open-label, multicentre, phase II study (the Japan Children's Cancer Group Multicentre Trial, JPLSG B-NHL-20). BMJ Open 2024; 14:e080762. [PMID: 38508620 PMCID: PMC10953030 DOI: 10.1136/bmjopen-2023-080762] [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: 10/10/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Children and adolescents with mature B cell non-Hodgkin lymphoma (B-NHL) are treated with short-intensive chemotherapy. The burden of short-term and long-term toxicity is highly relative to its high cure rate in good-risk patients. Although the addition of rituximab to standard lymphome Malin B (LMB) chemotherapy markedly prolongs event-free survival and overall survival in high-risk patients, the benefit of rituximab in good-risk patients remains to be elucidated. This clinical trial will examine whether the addition of rituximab eliminates anthracyclines in good-risk patients without compromising treatment outcomes. METHODS AND ANALYSIS We will perform a single-arm, open-label, multicentre phase II study. Low-risk (stage I - completely resected, stage II abdominal) and intermediate-risk (stages I and II - incompletely resected; stage II - resected, other than abdominal; stage III with LDH <2× upper limit of normal) patients with newly diagnosed B-NHL are eligible. Low-risk patients receive two courses of R-COM1P (rituximab, cyclophosphamide, vincristine, methotrexate, prednisolone and intrathecal methotrexate with hydrocortisone), and intermediate-risk patients receive COP (cyclophosphamide, vincristine, prednisolone and intrathecal methotrexate with hydrocortisone) followed by two courses each of R-COM3P and R-CYM (rituximab, cytarabine, methotrexate and intrathecal methotrexate with hydrocortisone). The primary endpoint is a 3-year event-free survival rate in paediatric patients (<18 years) with intermediate-risk disease. 100 patients (10 low-risk and 90 intermediate-risk) will enrol within a 4-year enrolment period and the follow-up period will be 3 years. 108 institutions are participating as of 1 January 2024 (64 university hospitals, 29 general hospitals, 12 children's hospitals and three cancer centres). ETHICS AND DISSEMINATION This research was approved by the Certified Review Board at NHO Nagoya Medical Center (Nagoya, Japan) on 21 September 2021. Written informed consent is obtained from all patients and/or their guardians. The results of this study will be disseminated through peer-reviewed publications and conference presentations. STUDY REGISTRATION Japan Registry of Clinical Trials, jRCTs041210104.
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Affiliation(s)
- Masahiro Sekimizu
- Department of Pediatrics, NHO Nagoya Medical Center, Nagoya, Japan
- NHO Nagoya Medical Center, Nagoya, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Yuhki Koga
- Department of Pediatrics, Kyushu University, Fukuoka, Japan
| | - Tetsuo Mitsui
- Department of Pediatrics, Yamagata University Hospital, Yamagata, Japan
| | - Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic bomb Survivors Hospital, Hiroshima, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Daiki Hori
- Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Makito Tanaka
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hideto Iwafuchi
- Department of Pathology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St Marianna University School of Medicine, Kawasaki, Japan
| | - Ryoji Kobayashi
- Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Hiroya Hashimoto
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Akiko M Saito
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Michi Kamei
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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