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Halim J, den Heijer P, van den Branden B, Meuwissen M, Vos J, Schölzel B, IJsselmuiden A. Short-term outcome after transcatheter aortic valve replacement with a novel balloon-expandable valve. Neth Heart J 2023; 31:500-505. [PMID: 36480146 PMCID: PMC10667167 DOI: 10.1007/s12471-022-01738-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Transcatheter aortic valve replacement (TAVR) has been expanding rapidly with numerous transcatheter heart valve (THV) systems currently available. The Myval balloon-expandable (BE) valve (Meril Life Sciences Pvt. Ltd., India) is a novel THV system indicated for the treatment of patients with severe aortic stenosis. The primary objective of this study is to assess the safety and performance of the Myval BE valve. METHODS In this prospective single-centre study, 120 consecutive patients who underwent TAVR with the Myval BE valve were included. Clinical outcomes were evaluated at 30 days and 6 months using Valve Academic Research Consortium‑2 criteria. All-cause mortality, stroke, acute kidney injury, major vascular complications, moderate or severe paravalvular leakage (PVL) and need for a permanent pacemaker implantation (PPI) were investigated. RESULTS At 6‑month follow-up, all-cause death and cardiac death were seen in 5.8% and 0.8% of the patients respectively. Periprocedural stroke and need for PPI were both seen in 3.3% of the patients. Access-site-related vascular and bleeding complications were absent. Improved valve haemodynamics and no moderate to severe PVL could be seen at 30 days. An intermediate valve size was selected in 51% of the patients. CONCLUSIONS The Myval BE valve demonstrates improved valve haemodynamics, absence of moderate to severe PVL and good safety outcomes at 6‑month follow-up with low cardiac death rate and acceptable rates of permanent pacemaker implantation and periprocedural stroke. Future randomised controlled trials will further establish the clinical utility of the Myval BE valve.
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Affiliation(s)
- J Halim
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands.
| | - P den Heijer
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands
| | - B van den Branden
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands
| | - M Meuwissen
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands
| | - J Vos
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands
| | - B Schölzel
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands
| | - A IJsselmuiden
- Department of Cardiology, Amphia Hospital Breda, Breda, The Netherlands
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Vos J, Tejeda-Mora H, Merino A, Wu L, Woud WW, Demmers JAA, van IJcken WFJ, Reinders MEJ, Hoogduijn MJ. Bio-distribution and longevity of mesenchymal stromal cell derived membrane particles. J Control Release 2022; 350:642-651. [PMID: 36063958 DOI: 10.1016/j.jconrel.2022.08.060] [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: 07/12/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022]
Abstract
Vesicle-based medicines hold great promise for therapy development but essential knowledge on the bio-distribution and longevity of vesicles after administration is lacking. We generated vesicles from the membranes of human mesenchymal stromal cells (MSC) and we demonstrated earlier that these so-called membrane particles (MP) mediate immunomodulatory and regenerative responses in target cells. In the present study we examined the bio-distribution and longevity of MP after intravenous administration in mice. While most vesicle tracking methods are based on imaging techniques, which require labeling of vesicles and can only detect dense accumulations of vesicles, we used proteomics analysis to detect the presence of MP-derived proteins in multiple organs and tissues. MP proteins were mainly present in plasma and leukocytes at 1 h after injection, indicating that MP - in contrast to whole MSC - do not accumulate in the lungs upon first passage but remain in circulation. After 24 h, MP proteins were still present in plasma but were most abundant in the liver. RNA sequencing of livers demonstrated that MP impact liver function and in particular induce metabolic pathways. These data provide a clear view of the bio-distribution and longevity of MP, which is likely extrapolatable to other types of vesicles, and demonstrate that MP circulate for up to 24 h and may be a tool for targeting the liver.
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Affiliation(s)
- J Vos
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - H Tejeda-Mora
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - A Merino
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - L Wu
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - W W Woud
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - J A A Demmers
- Proteomics Center, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - W F J van IJcken
- Center for Biomics, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - M E J Reinders
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - M J Hoogduijn
- Erasmus MC Transplant Institute, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Cantwell S, Rae JP, Hayes J, Vos J, Cooper M. Therapists’ questions to clients about what might be helpful can be supportive without being directive: a conversation analysis. Counselling Psychology Quarterly 2022. [DOI: 10.1080/09515070.2021.1997917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - John P. Rae
- School of Psychology, University of Roehampton, London, UK
| | | | | | - Mick Cooper
- School of Psychology, University of Roehampton, London, UK
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Vos J, Traets J, Qiao X, Seignette I, Wouters M, Hooijberg E, Broeks A, Van Der Wal J, Klop M, Schreuder P, Karakullukcu B, van Poelgeest M, Kapiteijn E, Blank C, Haanen J, Zuur C. 23P A comprehensive analysis of the mucosal melanoma immune microenvironment. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Abstract
Introduction/Objective Sarcoidosis is a syndrome of unknown cause that may manifest with clinical, radiographic and pathological findings similar to those seen with histoplasmosis. We present a case of disseminated histoplasmosis in an immunocompetent patient previously diagnosed with sarcoidosis. Methods/Case Report A 69-year-old obese male with a history of hypertension, diabetes mellitus and long-standing sarcoidosis was admitted to the hospital for several months of intermittent fevers and pancytopenia. His sarcoidosis was diagnosed 21 years prior, initially involving the lungs and eventually showing cardiac involvement, requiring a pacemaker. He had been treated with methotrexate and prednisone. His recent medical history was also significant for COVID-19 infection, diagnosed 3 months before admission. His fevers were initially attributed to sarcoidosis and his pancytopenia to methotrexate. However, his symptoms continued despite discontinuation of his medications, and further workup was initiated. Computed tomography showed hepatomegaly, splenomegaly, and lymphadenopathy, concerning for a lymphoproliferative disorder. The patient underwent a bone marrow biopsy that showed noncaseating granulomas and microorganisms consistent with histoplasmosis on fungal stain. Bone marrow cultures were not possible as the marrow was inaspirable. The patient subsequently underwent a lymph node biopsy with both morphology and culture identifying histoplasmosis. Urine and serum histoplasma antigen also returned positive. The patient’s overall clinical picture was consistent with disseminated histoplasmosis and he was administered intravenous Amphotericin B for 3 weeks followed by oral itraconazole for 1 year. One month follow-up after discharge showed significant improvement in the patient’s condition. Results (if a Case Study enter NA) N/A Conclusion Sarcoidosis reduces T-cell activity, and treatment with steroids causes further immunosuppression and vulnerability for development of a disseminated infection. COVID-19 also presumably increases the predisposition to acquire bacterial or fungal co-infections. Clinicians and pathologists should be aware of the overlap in clinical, radiologic and pathological presentations of sarcoidosis and histoplasmosis to make the correct diagnosis and administer the appropriate treatment.
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Affiliation(s)
- I Prisneac
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University, Morgantown, West Virginia, UNITED STATES
| | - J Vos
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University, Morgantown, West Virginia, UNITED STATES
| | - R LaSala
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University, Morgantown, West Virginia, UNITED STATES
| | - C Randall
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University, Morgantown, West Virginia, UNITED STATES
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Hoxhaj A, Drissen M, Vos J, Mann R, Hoogerbrugge N. Breast cancer surveillance in women with PTEN Hamartoma Tumour Syndrome (PHTS). Breast 2021. [DOI: 10.1016/s0960-9776(21)00136-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Al-Farra H, de Mol BAJM, Ravelli ACJ, Ter Burg WJPP, Houterman S, Henriques JPS, Abu-Hanna A, Vis MM, Vos J, Timmers L, Tonino WAL, Schotborgh CE, Roolvink V, Porta F, Stoel MG, Kats S, Amoroso G, van der Werf HW, Stella PR, de Jaegere P. Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR). Int J Cardiol Heart Vasc 2021; 32:100716. [PMID: 33537406 PMCID: PMC7843396 DOI: 10.1016/j.ijcha.2021.100716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023]
Abstract
Background The predictive performance of the models FRANCE-2 and ACC-TAVI for early-mortality after Transcatheter Aortic Valve Implantation (TAVI) can decline over time and can be enhanced by updating them on new populations. We aim to update and internally and temporally validate these models using a recent TAVI-cohort from the Netherlands Heart Registration (NHR). Methods We used data of TAVI-patients treated in 2013-2017. For each original-model, the best update-method (model-intercept, model-recalibration, or model-revision) was selected by a closed-testing procedure. We internally validated both updated models with 1000 bootstrap samples. We also updated the models on the 2013-2016 dataset and temporally validated them on the 2017-dataset. Performance measures were the Area-Under ROC-curve (AU-ROC), Brier-score, and calibration graphs. Results We included 6177 TAVI-patients, with 4.5% observed early-mortality. The selected update-method for FRANCE-2 was model-intercept-update. Internal validation showed an AU-ROC of 0.63 (95%CI 0.62-0.66) and Brier-score of 0.04 (0.04-0.05). Calibration graphs show that it overestimates early-mortality. In temporal-validation, the AU-ROC was 0.61 (0.53-0.67).The selected update-method for ACC-TAVI was model-revision. In internal-validation, the AU-ROC was 0.63 (0.63-0.66) and Brier-score was 0.04 (0.04-0.05). The updated ACC-TAVI calibrates well up to a probability of 20%, and subsequently underestimates early-mortality. In temporal-validation the AU-ROC was 0.65 (0.58-0.72). Conclusion Internal-validation of the updated models FRANCE-2 and ACC-TAVI with data from the NHR demonstrated improved performance, which was better than in external-validation studies and comparable to the original studies. In temporal-validation, ACC-TAVI outperformed FRANCE-2 because it suffered less from changes over time.
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Key Words
- ACC-TAVI (ACC TVT), American College of Cardiology Transcatheter Valve Therapy
- AU-PRC, Area Under the Precision-Recall Curve
- AU-ROC, Area Under the Receiver Operating-Characteristic Curve
- Amsterdam UMC, Amsterdam University Medical Center - location AMC (Academic Medical Center)
- BSS, Brier-skill score
- Closed-testing procedure
- EuroSCORE, European System for Cardiac Operative Risk Evaluation
- External Validation
- FRANCE-2, French Aortic National CoreValve and Edwards [15]
- LVEF, Left Ventricular Ejection Fraction
- MPM, Mortality Prediction Models
- Model recalibration
- Model updating
- NHR, Netherlands Heart Registration (“Nederlandse Hart Registratie in Dutch”)
- NYHA, New York Heart Association
- Prediction models
- SAVR, Surgical Aortic Valve Replacement
- TAVI (TAVR), Transcatheter Aortic Valve Implantation (Replacement)
- Transcatheter Aortic Valve Implantation (TAVI)
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Affiliation(s)
- Hatem Al-Farra
- Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bas A J M de Mol
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anita C J Ravelli
- Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - W J P P Ter Burg
- Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - José P S Henriques
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ameen Abu-Hanna
- Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M M Vis
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J Vos
- Amphia Hospital, the Netherlands
| | - L Timmers
- St. Antonius Hospital, the Netherlands
| | | | | | | | - F Porta
- Leeuwarden Medical Center, the Netherlands
| | - M G Stoel
- Medisch Spectrum Twente, the Netherlands
| | - S Kats
- Maastricht University Medical Center, the Netherlands
| | - G Amoroso
- Onze Lieve Vrouwe Gasthuis, the Netherlands
| | | | - P R Stella
- University Medical Center Utrecht, the Netherlands
| | - P de Jaegere
- Erasmus University Medical Center, the Netherlands
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Vos J, Leiner T, Van Dijk A, Meijboom F, Sieswerda G, Snijder R, Post M, Nijveldt R, Driessen M. CMR markers for early right ventricular dysfunction in precapillary pulmonary hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Precapillary pulmonary hypertension (pPH) causes right ventricular (RV) pressure overload inducing RV remodeling, often resulting in dysfunction and dilatation, heart failure, and ultimately death. The ability of the right ventricle to adequately adapt to increased pressure loading is key for patients' prognosis. RV ejection fraction (RVEF) by cardiac magnetic resonance (CMR) is related to outcome in pPH patients, but this global measurement is not ideal for detecting early changes in RV function. Strain analysis on CMR using feature tracking (FT) software provides a more detailed assessment, and might therefore detect early changes in RV function.
Aim
1) To compare RV strain parameters in pPH patients and healthy controls, and 2) to compare strain parameters in a subgroup of pPH patients with preserved RVEF (pRVEF) and healthy controls.
Methods
In this prospective study, a CMR was performed in pPH patients and healthy controls. Using FT-software on standard cine images, the following RV strain parameters were analyzed: global, septal, and free wall longitudinal strain (GLS, sept-LS, free wall-LS), time to peak strain (TTP, as a % of the whole cardiac cycle), the fractional area change (FAC), global circumferential strain (GCS), global longitudinal and global circumferential strain rate (GLSR and GCSR, respectively). A pRVEF is defined as a RVEF >50%. To compare RV strain parameters in pPH patients to healthy controls, the Mann-Whitney U test was used.
Results
33 pPH-patients (55 [45–63] yrs; 10 (30%) male) and 22 healthy controls (40 [36–48] yrs; 15 (68%) male) were included. All RV strain parameters were significantly reduced in pPH patients compared to healthy controls (see table), except for GCS and GCSR. Most importantly, in pPH patients with pRVEF (n=8) GLS (−26.6% [−22.6 to −27.3] vs. −28.1% [−26.2 to −30.6], p=0.04), sept-LS (−21.2% [−19.8 to −23.2] vs. −26.0% [−24.0 to −27.9], p=0.005), and FAC (39% [35–44] vs. 44% [42–47], p=0.02) were still significantly impaired compared to healthy controls. The RV TTP was significantly increased in pPH patients compared to healthy controls (47% [44–57] vs. 40% [33–43], p≤0.001).
Conclusions
Several CMR-FT strain parameters of the right ventricle are impaired in pPH patients when compared to healthy controls. Moreover, even in pPH patients with a preserved RVEF multiple RV strain parameters (GLS, sept-LS, and FAC) remained significantly impaired, and TTP significantly prolonged, in comparison to healthy controls. This suggests that RV strain parameters may be used as an early marker of RV dysfunction in pPH patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Vos
- Radboud University Medical Centre, Department of Cardiology, Nijmegen, Netherlands (The)
| | - T Leiner
- University Medical Center Utrecht, Department of Radiology, Utrecht, Netherlands (The)
| | - A.P.J Van Dijk
- Radboud University Medical Centre, Department of Cardiology, Nijmegen, Netherlands (The)
| | - F.J Meijboom
- University Medical Center Utrecht, Cardiology, Utrecht, Netherlands (The)
| | - G.T Sieswerda
- University Medical Center Utrecht, Cardiology, Utrecht, Netherlands (The)
| | - R.J Snijder
- St Antonius Hospital, Department of Pulmonology, Nieuwegein, Netherlands (The)
| | - M.C Post
- St Antonius Hospital, Cardiology, Nieuwegein, Netherlands (The)
| | - R Nijveldt
- Radboud University Medical Centre, Department of Cardiology, Nijmegen, Netherlands (The)
| | - M.M.P Driessen
- University Medical Center Utrecht, Department of Radiology, Utrecht, Netherlands (The)
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Al-Farra H, Abu-Hanna A, de Mol BA, ter Burg W, Houterman S, Henriques JP, Ravelli AC, Vis M, Vos J, Ten Berg J, Tonino W, Schotborgh C, Roolvink V, Porta F, Stoel M, Kats S, Amoroso G, van der Werf H, Stella P, de Jaegere P. External validation of existing prediction models of 30-day mortality after Transcatheter Aortic Valve Implantation (TAVI) in the Netherlands Heart Registration. Int J Cardiol 2020; 317:25-32. [DOI: 10.1016/j.ijcard.2020.05.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/19/2020] [Accepted: 05/13/2020] [Indexed: 12/12/2022]
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Simsek C, Schölzel BE, den Heijer P, Vos J, Meuwissen M, van den Branden B, IJsselmuiden AJJ. The rationale of using cerebral embolic protection devices during transcatheter aortic valve implantation. Neth Heart J 2020; 28:249-252. [PMID: 32152782 PMCID: PMC7190763 DOI: 10.1007/s12471-020-01380-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aortic valve stenosis is one of the most common valvular abnormalities, which can manifest as angina, syncope, dyspnoea and sudden cardiac death. Transcatheter aortic valve implantation (TAVI) has been introduced as an alternative to surgical valve replacement in patients with severe aortic valve stenosis, resulting in less morbidity, shorter time to recovery and similar mortality rates. Progress in this field has reduced complication rates. However, the incidence of peri-procedural stroke remains relatively high (around 4%). To fully utilise the potential of TAVI, cerebral embolic protection devices (CEPD) have been developed and introduced. In this position paper, we aim to summarise the available data on several CEPD.
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Affiliation(s)
- C Simsek
- Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands
| | - B E Schölzel
- Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands
| | - P den Heijer
- Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands
| | - J Vos
- Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands
| | - M Meuwissen
- Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands
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Smit W, Schouten N, van den Berg N, Langedijk MJ, Struijk DG, Krediet RT, Birnie R, de Charro F, Fieren M, Kolsters G, Koolen M, Leurs P, Rens A, ter Wee P, van der Wall Bake A, van Essen G, van Geelen J, van Leusen R, Vos J. Analysis of the Prevalence and Causes of Ultrafiltration Failure during Long-Term Peritoneal Dialysis: A Cross-Sectional Study. Perit Dial Int 2020. [DOI: 10.1177/089686080402400616] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BackgroundUltrafiltration failure (UFF) is a major complication of peritoneal dialysis (PD). It can occur at any stage of PD, but develops in time and is, therefore, especially important in long-term treatment. To investigate its prevalence and to identify possible causes, we performed a multicenter study in The Netherlands, where patients treated with PD for more than 4 years were studied using a peritoneal function test (standard peritoneal permeability analysis) with 3.86% glucose. UFF was defined as net UF < 400 mL after a 4-hour dwell.Results55 patients unselected for the presence or absence of UFF were analyzed. Mean age was 48 years (range 18 – 74 years); duration of PD ranged from 48 to 144 months (median 61 months); UFF was present in 20 patients (36%). Patients with and without UFF did not differ in age or duration of PD. Median values for patients with normal UF compared to patients with UFF were, for net UF 659 mL versus 120 mL ( p < 0.01), transcapillary UF rate 3.8 versus 2.1 mL/minute ( p < 0.01), effective lymphatic absorption 1.0 versus 1.6 mL/min ( p < 0.05), mass transfer area coefficient (MTAC) for creatinine 9.0 versus 12.9 mL/min ( p < 0.01), dialysate-to-plasma ratio (D/P) for creatinine 0.71 versus 0.86 ( p < 0.01), glucose absorption 60% versus 73% ( p < 0.01), maximum dip in D/P sodium (as a measure of free water transport) 0.109 versus 0.032 ( p < 0.01), and osmotic conductance to glucose 3.0 versus 2.1 μL/min/mmHg ( p < 0.05). As causes for UFF, high MTAC creatinine, defined as > 12.5 mL/min, or a glucose absorption > 72%, both reflecting a large vascular surface, a lymphatic absorption rate (LAR) of > 2.14 mL/min, and a decreased dip in D/P sodium of < 0.046 were identified. Most patients had a combination of causes (12 patients), whereas there was only a decreased dip in D/P sodium in 3 patients, only high MTAC creatinine in 1 patient, and only high LAR in 2 patients. We could not identify a cause in 2 patients. Both groups had similar clearances of serum proteins and peritoneal restriction coefficients. However, dialysate cancer antigen 125 concentrations, reflecting mesothelial cell mass, were lower in the UFF patients (2.79 vs 5.38 U/L).ConclusionThe prevalence of UFF is high in long-term PD. It is caused mainly by a large vascular surface area and by impaired channel-mediated water transport. In addition, these patients also had signs of a reduced mesothelial cell mass, indicating damage of the peritoneum on both vascular and mesothelial sites.
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Affiliation(s)
- Watske Smit
- Department of Nephrology, Academic Medical Center, University of Amsterdam
| | - Natalie Schouten
- Department of Nephrology, Academic Medical Center, University of Amsterdam
| | | | | | | | - Raymond T. Krediet
- Department of Nephrology, Academic Medical Center, University of Amsterdam
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Vos J, Franklin BD, Chumbley G, Galal-Edeen GH, Furniss D, Blandford A. Nurses as a source of system-level resilience: Secondary analysis of qualitative data from a study of intravenous infusion safety in English hospitals. Int J Nurs Stud 2019; 102:103468. [PMID: 31805449 PMCID: PMC7026708 DOI: 10.1016/j.ijnurstu.2019.103468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 11/21/2022]
Abstract
Background Deviations from local policy and national recommended best practice are common in the administration of intravenous infusions, but not all result in negative consequences. Some are the result of nurses’ clinical judgement. However, little is known about such practices and their effects on the safety of intravenous infusions. Our objective was to explore ways in which nurses contribute to system-level resilience when administering intravenous infusions. Methods We conducted a secondary analysis of qualitative data from debriefs and focus groups from a mixed methods study of errors and policy deviations in intravenous infusion administration across 16 English hospitals. Analysis focused on nurses’ contributions to system-level resilience, drawing on Larcos’s et al. framework of types of resilience. Results Five types of system-level resilience were identified in nurses’ behaviour: anticipatory resilience, responsive resilience, resilience based on past experience, workarounds and nurses performing informal ‘risk assessments’ in relation to how best to treat individual patients. Examples of practices contributing to infusion safety were found for each of these types of resilience. Conclusion Our findings suggest nurses are a key source of system-level resilience. Some behaviours that may be considered deviations from policy or best practice are the result of reasoned clinical judgement to improve infusion safety in response to the specific situation at hand. Adaptive behaviour is necessary to cope with the complexity of practice. There is a tension between standardisation and supporting flexibility in safety management.
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Affiliation(s)
- J Vos
- UCL Interaction Centre, London, UK.
| | - B D Franklin
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK; Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - G Chumbley
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - G H Galal-Edeen
- UCL Interaction Centre, London, UK; Faculty of Computers and Information, Cairo University, Cairo, Egypt
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Durot E, Kanagaratnam L, D'sa S, Tomowiak C, Hivert B, Toussaint E, Guerrero-Garcia T, Itchaki G, Vos J, Michallet A, Godet S, Bomsztyk J, Morel P, Leblond V, Treon S, Delmer A, Castillo J. A PROGNOSTIC SCORE FOR TRANSFORMED WALDENSTRÖM MACROGLOBULINEMIA. Hematol Oncol 2019. [DOI: 10.1002/hon.71_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- E. Durot
- Department of Hematology; University Hospital of Reims; Reims France
| | - L. Kanagaratnam
- Department of Research and Innovation; University Hospital of Reims; Reims France
| | - S. D'sa
- Department of Hematology; University College London Hospitals (UCLH) NHS Foundation Trust; London United Kingdom
| | - C. Tomowiak
- Department of Hematology; University Hospital of Poitiers; Poitiers France
| | - B. Hivert
- Department of Hematology; Hospital of Lens; Lens France
| | - E. Toussaint
- Department of Hematology; University Hospital of Strasbourg; Strasbourg France
| | - T. Guerrero-Garcia
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
| | - G. Itchaki
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
| | - J. Vos
- Department of Hematology; Academical Medical Center; Amsterdam Netherlands
| | - A. Michallet
- Department of Hematology; Centre Léon Bérard; Lyon France
| | - S. Godet
- Department of Hematology; University Hospital of Reims; Reims France
| | - J. Bomsztyk
- Department of Hematology; University College London Hospitals (UCLH) NHS Foundation Trust; London United Kingdom
| | - P. Morel
- Department of Hematology; University Hospital of Amiens; Amiens France
| | - V. Leblond
- Department of Hematology; Pitié-Salpêtrière Hospital; Paris France
| | - S.P. Treon
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
| | - A. Delmer
- Department of Hematology; University Hospital of Reims; Reims France
| | - J.J. Castillo
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
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Abstract
Summary50 patients from a group of 130 patients with transient ischaemic attacks or cerebral infarction were found to demonstrate in vitro spontaneous platelet aggregation (SPA) while 80 normal subjects tested never showed this phenomenon.The following additional findings point towards a possible platelet abnormality:1. Platelets from 10 patients with SPA when isolated and resuspended in normal plasma still demonstrated SPA while isolated normal platelets resuspended in patient’s plasma did not.2. Platelets demonstrating SPA showed an increased aggregation tendency upon incubation with ADP while normal platelets developed the expected refractory state.SPA was found to be dependant upon the presence of divalent cations and could further be inhibited by phentolamine and adenosine. Aspirin effectively abolished SPA in 50 patients and relieved the clinical symptoms of patients with recurrent complaints of transient blindness and paraesthesia.
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Affiliation(s)
- J W Ten Cate
- The Departments of Haematology and Neurology, University Hospital “Wilhelmina Gasthuis”, Amsterdam, The Netherlands
| | - J Vos
- The Departments of Haematology and Neurology, University Hospital “Wilhelmina Gasthuis”, Amsterdam, The Netherlands
| | - H Oosterhuis
- The Departments of Haematology and Neurology, University Hospital “Wilhelmina Gasthuis”, Amsterdam, The Netherlands
| | - D Prenger
- The Departments of Haematology and Neurology, University Hospital “Wilhelmina Gasthuis”, Amsterdam, The Netherlands
| | - C S P Jenkins
- The Departments of Haematology and Neurology, University Hospital “Wilhelmina Gasthuis”, Amsterdam, The Netherlands
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Abstract
SummaryA group of 186 patients with Transient Ischaemic Attacks (TIA) or cerebral Infarction (Cl) was found to demonstrate in vitro Spontaneous Platelet Aggregation (SPA) in 39% of those studied. Of the 176 normal subjects studied the incidence of in vitro SPA was found to be 5%. Further investigation of the phenomenon of SPA revealed that:1. it is associated with ADP-hyperaggregability, i. e. the threshold concentration to induce second wave aggregation is decreased;2. it is dependant on the increase in pH which occurs in platelet-rich plasma stirring in an aggregometer while concurrent ADP-hyperaggregability is independant of this change in pH;3. it is associated with malondialdehyde production and the release of endogenous 5- hydroxytryptamine; and that4. in addition Km and Vmax values for [14C]-5HT incorporation are normal; and that5. no gross abnormalities of the platelet membrane glycoproteins were apparent although occasionally glycoprotein III was found to be increased.This study demonstrates abnormal platelet behaviour in patients with TIA and Cl where the enzyme system involved in thromboxane production is sufficiently stimulated, by stirring alone, to induce aggregation of platelets and the release reaction.Acetylsalicylic acid abolishes SPA and prolongs the bleeding time with similar characteristics as has been described for normal individuals. Plasma (3-thromboglobulin levels are significantly increased in the patients studied. However, no correlation was established with the incidence of in vitro SPA.
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Affiliation(s)
- E M G Hoogenduk
- The Departments of Haematology and Neurology, University Hospital» Wilhelmina Gasthuis«, Amsterdam, The Netherlands
| | - C S P Jenkins
- The Departments of Haematology and Neurology, University Hospital» Wilhelmina Gasthuis«, Amsterdam, The Netherlands
| | - E M van Wijk
- The Departments of Haematology and Neurology, University Hospital» Wilhelmina Gasthuis«, Amsterdam, The Netherlands
| | - J Vos
- The Departments of Haematology and Neurology, University Hospital» Wilhelmina Gasthuis«, Amsterdam, The Netherlands
| | - J W ten Cate
- The Departments of Haematology and Neurology, University Hospital» Wilhelmina Gasthuis«, Amsterdam, The Netherlands
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16
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van der Spek N, Vos J, van Uden-Kraan CF, Breitbart W, Cuijpers P, Knipscheer-Kuipers K, Willemsen V, Tollenaar RAEM, van Asperen CJ, Leeuw IMVD. Cost-utility analysis of meaning-centered group psychotherapy for cancer survivors. Psychooncology 2018; 27:1772-1779. [PMID: 29624807 PMCID: PMC6043397 DOI: 10.1002/pon.4726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Meaning-centered group psychotherapy for cancer survivors (MCGP-CS) improves meaning, psychological well-being, and mental adjustment to cancer and reduces psychological distress. This randomized controlled trial was conducted to investigate the cost-utility of MCGP-CS compared with supportive group psychotherapy (SGP) and care-as-usual (CAU). METHODS In total, 170 patients were randomized to MCGP-CS, SGP, or CAU. Intervention costs, direct medical and nonmedical costs, productivity losses, and health-related quality of life were measured until 6 months follow-up, using the TIC-P, PRODISQ, data from the hospital information system, and the EQ-5D. The cost-utility was calculated by comparing mean cumulative costs and quality-adjusted life years (QALYs). RESULTS Mean total costs ranged from €4492 (MCGP-CS) to €5304 (CAU). Mean QALYs ranged .507 (CAU) to .540 (MCGP-CS). MCGP-CS had a probability of 74% to be both less costly and more effective than CAU, and 49% compared with SGP. Sensitivity analyses showed these findings are robust. If society is willing to pay €0 for one gained QALY, MCGP-CS has a 78% probability of being cost-effective compared with CAU. This increases to 85% and 92% at willingness-to-pay thresholds of €10 000 and €30 000, which are commonly accepted thresholds. CONCLUSIONS MCGP-CS is highly likely a cost-effective intervention, meaning that there is a positive balance between the costs and gains of MCGP-CS, in comparison with SGP and CAU.
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Affiliation(s)
- Nadia van der Spek
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Joël Vos
- Department of Psychology, University of Roehampton, London, UK
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
- Department of Otolaryngology – Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Kitty Knipscheer-Kuipers
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Vincent Willemsen
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Rob AEM Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
- Department of Otolaryngology – Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
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17
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Vos J, Cattaneo L, Patchkovskii S, Zimmermann T, Cirelli C, Lucchini M, Kheifets A, Landsman AS, Keller U. Orientation-dependent stereo Wigner time delay and electron localization in a small molecule. Science 2018; 360:1326-1330. [PMID: 29930132 DOI: 10.1126/science.aao4731] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 02/21/2018] [Accepted: 04/26/2018] [Indexed: 11/02/2022]
Abstract
Attosecond metrology of atoms has accessed the time scale of the most fundamental processes in quantum mechanics. Transferring the time-resolved photoelectric effect from atoms to molecules considerably increases experimental and theoretical challenges. Here we show that orientation- and energy-resolved measurements characterize the molecular stereo Wigner time delay. This observable provides direct information on the localization of the excited electron wave packet within the molecular potential. Furthermore, we demonstrate that photoelectrons resulting from the dissociative ionization process of the CO molecule are preferentially emitted from the carbon end for dissociative 2Σ states and from the center and oxygen end for the 2Π states of the molecular ion. Supported by comprehensive theoretical calculations, this work constitutes a complete spatially and temporally resolved reconstruction of the molecular photoelectric effect.
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Affiliation(s)
- J Vos
- Department of Physics, ETH Zurich, 8093 Zurich, Switzerland.
| | - L Cattaneo
- Department of Physics, ETH Zurich, 8093 Zurich, Switzerland
| | | | - T Zimmermann
- Max Planck Institute for the Physics of Complex Systems, D-01187 Dresden, Germany.,Max Planck Korea, Department of Physics, Postech, Pohang, Gyeongbuk 37673, Republic of Korea
| | - C Cirelli
- Department of Physics, ETH Zurich, 8093 Zurich, Switzerland.,Empa-Swiss Federal Laboratories for Materials Science & Technology, 8600 Dübendorf, Switzerland
| | - M Lucchini
- Department of Physics, ETH Zurich, 8093 Zurich, Switzerland
| | - A Kheifets
- Research School of Physics and Engineering, The Australian National University, Canberra ACT 0200, Australia
| | - A S Landsman
- Max Planck Institute for the Physics of Complex Systems, D-01187 Dresden, Germany.,Max Planck Korea, Department of Physics, Postech, Pohang, Gyeongbuk 37673, Republic of Korea
| | - U Keller
- Department of Physics, ETH Zurich, 8093 Zurich, Switzerland
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18
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Daeter EJ, Timmermans MJ, Hirsch A, Lipsic E, Houterman S, van Veghel D, van der Nat PB, Amoroso G, Aydin S, Bax M, van Boven W, Brinckman S, Dambrink J, de la Fuente S, van der Ent M, Galema T, Haenen J, Kraaijeveld A, Magro M, Noyez L, van Opstal J, Rensing B, van Straten A, Umans V, Vernooy K, Vos J, Waterbolk T, Rademaker P. Defining and Measuring a Standard Set of Patient-Relevant Outcomes in Coronary Artery Disease. Am J Cardiol 2018; 121:1477-1488. [PMID: 29776654 DOI: 10.1016/j.amjcard.2018.02.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/13/2018] [Accepted: 02/26/2018] [Indexed: 10/17/2022]
Abstract
Systematic outcome measurement enables to continuously improve treatment results and stimulates dissemination of best practices. For patients with coronary artery disease, no examples yet exist of standard sets of patient-relevant outcome measures that have already been fully implemented at a large scale in clinical care. The aim of this paper is twofold: (1) to share the standard set of outcome measures as developed by Meetbaar Beter, and (2) to show how the standard set is presented and published to support improvement of cardiac care. A step-wise approach was followed by an expert panel to construct a standard set of outcome measures. This resulted in a comprehensive set of relevant outcome measures, comprising 4 generic and 11 treatment-specific outcomes. Both short-term and long-term outcomes measures up to 5 years of follow-up were included. Relevant initial conditions were selected to enable case-mix adjustment. The standard set has been implemented in 21 hospitals across the Netherlands. The results and experiences have been used to fine-tune the set in 4 reporting cycles in 2012 to 2016, using an annual maintenance cycle. Currently about 83,000 percutaneous coronary interventions and 30,000 coronary artery bypass graftings are included in the dataset, covering the majority of all percutaneous coronary interventions and coronary artery bypass graftings in the Netherlands. In conclusion, Meetbaar Beter has defined and implemented a comprehensive set of patient-relevant outcome measures for coronary artery disease, and the variation of the results among the centers indicates that there are sufficient opportunities to further improve cardiac care in the Netherlands.
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Van den Broek A, Robson M, Vos J, Bernstein J, Offit K, Rookus M, Chenevix-Trench G, Easton D, Antoniou A, Schmidt M. The association between Polygenic Risk Scores and contralateral breast cancer risk in BRCA1 and BRCA2 mutation carriers: Analyses in the CIMBA consortium. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30269-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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van der Spek N, Vos J, van Uden-Kraan CF, Breitbart W, Cuijpers P, Holtmaat K, Witte BI, Tollenaar RAEM, Verdonck-de Leeuw IM. Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial. Psychol Med 2017; 47:1990-2001. [PMID: 28374663 PMCID: PMC5501751 DOI: 10.1017/s0033291717000447] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). METHOD A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU). RESULTS Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = -0.87) (3 months FU); and distress (d = -0.6) and depression (d = -0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU). CONCLUSIONS MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.
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Affiliation(s)
- Nadia van der Spek
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
- IDC Center for psychological care for cancer patients, OLVG Hospital, Amsterdam, the Netherlands
| | - Joël Vos
- University of Roehampton, Department of Psychology, London, United Kingdom
| | | | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
| | - Karen Holtmaat
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
| | - Birgit I. Witte
- VU University Medical Center, Epidemiology & Biostatistics, Amsterdam, the Netherlands
| | | | - Irma M. Verdonck-de Leeuw
- VU University, Department of Clinical Psychology, Amsterdam, the Netherlands
- VU University Medical Center, Department of Otolaryngology - Head & Neck Surgery, Amsterdam, the Netherlands
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van Bruggen V, Ten Klooster P, Westerhof G, Vos J, de Kleine E, Bohlmeijer E, Glas G. The Existential Concerns Questionnaire (ECQ)-Development and Initial Validation of a New Existential Anxiety Scale in a Nonclinical and Clinical Sample. J Clin Psychol 2017; 73:1692-1703. [PMID: 28369920 DOI: 10.1002/jclp.22474] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/01/2017] [Accepted: 02/23/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Existential anxiety (EA) is a construct that refers to fears that are provoked by core threats of human existence, such as death, meaninglessness, and fundamental loneliness. The objective of this study was to develop an EA measure that can be used in research and clinical practice. METHOD The Existential Concerns Questionnaire (ECQ) was completed by a nonclinical sample of 389 adults, together with questionnaires measuring death anxiety, intolerance of uncertainty, neuroticism, distress, meaning, and life events. Adaptations were made based on item analysis and factor analysis. A total of 99 adults who had an anxiety and/or depressive disorder completed the final version. RESULTS The ECQ was demonstrated to be essentially unidimensional and showed good reliability and stability. Correlations with other measures were within the expected range of strength, except for a weak association with life events. CONCLUSION Initial results regarding the psychometric properties of the ECQ are promising.
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Cattaneo L, Vos J, Lucchini M, Gallmann L, Cirelli C, Keller U. Comparison of attosecond streaking and RABBITT. Opt Express 2016; 24:29060-29076. [PMID: 27958571 DOI: 10.1364/oe.24.029060] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Recent progress in the generation of ultra-short laser pulses has enabled the measurement of photoionization time delays with attosecond precision. For single photoemission time delays the most common techniques are based on attosecond streaking and the reconstruction of attosecond beating by interference of two-photon transitions (RABBITT). These are pump-probe techniques employing an extreme-ultraviolet (XUV) single attosecond pump pulse for streaking or an attosecond pump pulse train for RABBITT, and a phase-locked infrared (IR) probe pulse. These techniques can only extract relative timing information between electrons originating from different initial states within the same atom or different atoms. Here we address the question whether the two techniques give identical timing information. We present a complete study, supported by both experiments and simulations, comparing these two techniques for the measurement of the photoemission time delay difference between valence electrons emitted from the Ne 2p and Ar 3p ground states. We highlight not only the differences and similarities between the two techniques, but also critically investigate the reliability of the methods used to extract the timing information.
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Dekker S, Vos J, Vermeulen N, Commandeur J. Different reactive metabolites of nevirapine require distinct glutathione S-transferase isoforms for bio-inactivation. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.2043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wiersema A, Jongkind V, Bruijninckx C, Reijnen M, Vos J, Van Delden O, Zeebregts C, Moll F. Prophylactic intraoperative antithrombotics in open infrainguinal arterial bypass surgery: a systematic review. J Cardiovasc Surg (Torino) 2015; 56:127-143. [PMID: 24594802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Unfractionated heparin (UFH) is used intraoperatively as antithrombotic by most vascular surgeons worldwide during infrainguinal bypass surgery (IABS) to reduce the risk of peroperative and early graft thrombosis. To reduce the harmful side effects of UFH (bleeding complications, HIT) and to reduce peroperative and early graft failure, other pharmaceuticals have been suggested for IABS. A systematic review was performed using MEDLINE, EMBASE and Cochrane databases. Only 9 studies on IABS and intraoperative antithrombotic use were eligible for review. Between studies heterogeneity was high and investigated study populations were often of small size. No study was retrieved comparing UFH to no-UFH. Dextran, human antithrombin and iloprost showed no beneficial effect compared to UFH alone for patency, mortality and morbidity. Low molecular weight heparin (LMWH) has potential benefits compared to UFH, but a statistically significant effect could not be demonstrated from the current review. The use of UFH during IABS to prevent intraoperative graft thrombosis has not been proven in randomized clinical trials. Dextran, human antithrombin and iloprost showed to be of no added beneficial effect for the patient compared to UFH alone. Data on the use of LMWH instead of UFH are promising, but no statistically significant benefit could be reproduced from literature. Results from a recent Cochrane review were favourable for LMWH, but it appeared that included data were not complete in that review. Randomized controlled trials are required for intra-operative use of antithrombotics and to improve peroperative and early patency after IABS.
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Affiliation(s)
- A Wiersema
- Department of Surgery, Westfriesgasthuis Hoorn, The Netherlands -
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26
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Wiersema A, Bruijninckx C, Reijnen M, Vos J, Van Delden O, Vahl A, Zeebregts C, Moll F. Perioperative prophylactic antithrombotic strategies in vascular surgery: current practice in the Netherlands. J Cardiovasc Surg (Torino) 2015; 56:119-125. [PMID: 23337406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of this study was to evaluate the current practice of the use of perioperative antithrombotic drugs to prevent arterial thrombo-embolic complications during arterial vascular surgery by Dutch vascular surgeons. Aim was also to compare the results with the literature and to evaluate the effect of guidelines. METHODS A comprehensive questionnaire was sent to all Dutch vascular surgeons performing arterial reconstructive surgery. RESULTS The response rate was 84%. Acetylsalicylic acid (ASA) was continued perioperatively by most surgeons (91%). Clopidogrel was discontinued by the majority of respondents (65%). During operation 97% of surgeons administered unfractionated heparin (UFH) before arterial clamping. A minority (11%) measures peroperatively anticoagulant activity in patients' blood. After infrainguinal venous bypass most surgeons (81%) preferred monotherapy with vitamin K antagonists (VKA), in agreement with the Dutch guideline in this respect. Before the introduction of the guideline in 2005, a survey was performed in 2004. Results of our 2011 survey showed more respondents (6% to 11%) prescribed ASA or VKA according to these guidelines. CONCLUSION This survey showed a recognizable pattern of variation for perioperative arterial thrombosis prophylaxis amongst Dutch vascular surgeons, in agreement with reports from other countries over the past 20 years. Although a higher percentage of surgeons complied in 2011 with existing guidelines than in 2004, guidelines were not completely met. Possibly because current guidelines are not fully supported by evidence and do not cover all aspects of perioperative arterial thrombosis prophylaxis. Clearly there is need for (more) convincing data based on RCT's concerning the various aspects of perioperative arterial thrombosis prophylaxis.
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Affiliation(s)
- A Wiersema
- Department of Surgery, Westfriesgasthuis Hoorn, The Netherlands -
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Abstract
OBJECTIVE To review the evidence on the efficacy of different types of existential therapies: a family of psychological interventions that draw on themes from existential philosophy to help clients address such issues in their lives as meaning and death anxiety. METHOD Relevant electronic databases, journals, and reference lists were searched for eligible studies. Effects on meaning, psychopathology (anxiety and depression), self-efficacy, and physical well-being were extracted from each publication or obtained directly from its authors. All types of existential therapy for adult samples were included. Weighted pooled mean effects were calculated and analyses performed assuming fixed-effects model. RESULTS Twenty-one eligible randomized controlled trials of existential therapy were found, from which 15 studies with unique data were included, comprising a total of 1,792 participants. Meaning therapies (n = 6 studies) showed large effects on positive meaning in life immediately postintervention (d = 0.65) and at follow-up (d = 0.57), and had moderate effects on psychopathology (d = 0.47) and self-efficacy (d = 0.48) at postintervention; they did not have significant effects on self-reported physical well-being (n = 1 study). Supportive-expressive therapy (n = 5) had small effects at posttreatment and follow-up on psychopathology (d = 0.20, 0.18, respectively); effects on self-efficacy and self-reported physical well-being were not significant (n = 1 and n = 4, respectively). Experiential-existential (n = 2) and cognitive-existential therapies (n = 1) had no significant effects. CONCLUSION Despite the small number and low quality of studies, some existential therapies appear beneficial for certain populations. We found particular support for structured interventions incorporating psychoeducation, exercises, and discussing meaning in life directly and positively with physically ill patients. It is important to study more precisely which existential intervention works the best for which individual client.
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Affiliation(s)
- Joël Vos
- Department of Psychology, University of Roehampton
| | | | - Mick Cooper
- Department of Psychology, University of Roehampton
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28
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Abstract
Existential anxiety (EA) is an expression of being occupied with ultimate concerns such as death, meaninglessness, and fundamental loneliness. Philosophers and psychologists have claimed its importance for the study of human thinking, emotion, decision making, and psychopathology. Until now research has mainly focused on death anxiety. Several death anxiety instruments have been developed and evaluated. This article is the first to review instruments measuring EA in a comprehensive way, that is, by covering several existential themes. Such instruments might be useful to gain insight in the interrelatedness of the aspects of EA, and application in clinical practice. Four models of EA were reviewed and compared resulting in a working definition. This definition was used to develop a search strategy that, after an initial screening, yielded 532 potentially relevant articles. A total of 78 instruments were identified, most of them measuring death anxiety. Five instruments were included that had a comprehensive perspective on EA. These were further evaluated using the consensus-based standards for the selection of health measurement instruments (COSMIN) criteria for publications about test development. The Existential Anxiety Questionnaire, turned out to be the most thoroughly examined, with promising results. The article concludes with recommendations about development and use of EA instruments.
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Affiliation(s)
- Vincent van Bruggen
- University of Twente, Enschede, Netherlands
- Mental Health Institution Dimence, Deventer, Netherlands
| | - Joël Vos
- University of Roehampton, London, UK
| | | | | | - Gerrit Glas
- Mental Health Institution Dimence, Deventer, Netherlands
- VU University, Amsterdam, Netherlands
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van der Spek N, van Uden-Kraan CF, Vos J, Breitbart W, Tollenaar RAEM, van Asperen CJ, Cuijpers P, Verdonck-de Leeuw IM. Meaning-centered group psychotherapy in cancer survivors: a feasibility study. Psychooncology 2014; 23:827-31. [DOI: 10.1002/pon.3497] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 01/06/2014] [Accepted: 01/15/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Nadia van der Spek
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
| | - Cornelia F. van Uden-Kraan
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
- Department of Otolaryngology - Head & Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Joël Vos
- Counselling Psychology; Roehampton University; London United Kingdom
- Department of Clinical Genetics; Leiden University Medical Center; Leiden The Netherlands
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences; Memorial Sloan-Kettering Cancer Center; New York USA
| | | | - Christi J. van Asperen
- Department of Clinical Genetics; Leiden University Medical Center; Leiden The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
| | - Irma M. Verdonck-de Leeuw
- Department of Clinical Psychology; VU University; Amsterdam The Netherlands
- Department of Otolaryngology - Head & Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
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van der Spek N, Vos J, van Uden-Kraan CF, Breitbart W, Cuijpers P, Knipscheer-Kuipers K, Willemsen V, Tollenaar RAEM, van Asperen CJ, Verdonck-de Leeuw IM. Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial. BMC Psychiatry 2014; 14:22. [PMID: 24467861 PMCID: PMC3942178 DOI: 10.1186/1471-244x-14-22] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/24/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS. METHODS/DESIGN Survivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ). DISCUSSION Meaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care. TRIAL REGISTRATION Netherlands Trial Register, NTR3571.
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Affiliation(s)
- Nadia van der Spek
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Joël Vos
- Department of Psychology, University of Roehampton, London, UK,Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands,Department of Otolaryngology - Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands
| | - Kitty Knipscheer-Kuipers
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Vincent Willemsen
- Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands
| | - Rob AEM Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands.
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Cline B, Vos J, Carpenter J, Rai A. O-027 Pathological Analysis Of Extracted Clots In Embolectomy Patients With Acute Ischaemic Stroke. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- V G Meuleman
- Department of Cardiology, Erasmus Medical Center, Thoraxcenter Room Ba 316, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands,
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van den Brom R, van Engelen E, Vos J, Luttikholt S, Moll L, Roest H, van der Heijden H, Vellema P. Detection of Coxiella burnetii in the bulk tank milk from a farm with vaccinated goats, by using a specific PCR technique. Small Rumin Res 2013. [DOI: 10.1016/j.smallrumres.2012.11.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vos J, Menko FH, Oosterwijk JC, van Asperen CJ, Stiggelbout AM, Tibben A. Genetic counseling does not fulfill the counselees' need for certainty in hereditary breast/ovarian cancer families: an explorative assessment. Psychooncology 2012; 22:1167-76. [PMID: 22777929 DOI: 10.1002/pon.3125] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 05/30/2012] [Accepted: 05/30/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Many cancer-patients undergo DNA testing in the BRCA1/2 genes to receive information about the likelihood that cancer is heritable. Previous nonsystematic studies suggested that DNA testing often does not fulfill the counselees' needs for certainty. We explored the balance between the counselees' need for certainty and perceived certainty (NfC-PC, i.e., level of fulfillment of NfC) regarding the specific domains of DNA test result, heredity and cancer. We also examined relationships of NfC-PC with coping styles and distress. METHOD Before disclosure of BRCA1/2 test results for hereditary breast/ovarian cancer (T1), questionnaires were filled in by 467 cancer-patients. Another questionnaire (T2) was filled in after disclosure of pathogenic mutation results (n = 30), uninformative results (n = 202) or unclassified-variants (n = 16). RESULTS Before and after DNA test result disclosure, overall 58-94% of all counselees experienced unfulfilled NfC regarding the DNA test result, heredity and cancer. Compared with T1, the communication of pathogenic mutations (T2) caused more fulfillment of the NfC about the DNA test result, but less about cancer and heredity (p < .01). Compared with T1, unclassified variants (T2) did not significantly change the extent of fulfillment of all counselees' needs for certainty (NfC > PC). Compared with T1, uninformative results (T2) caused more fulfillments of all needs than before disclosure (p < 0.01). Counselees differentiated NfC and PC between the domains of DNA-test result, heredity and cancer (p < 0.01). The unfulfilled needs for certainty (NfC-PC) were uncorrelated with cognitive understanding of the DNA test result. CONCLUSION The counselees' NfC needs more attention in research and practice, for example, when the potential uncertainties of testing are discussed. The counselees' NfC may be assessed and used in tailored, mutual communication of DNA test results.
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Affiliation(s)
- Joël Vos
- Department of Clinical Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
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Vos J, van Asperen CJ, Oosterwijk JC, Menko FH, Collee MJ, Gomez Garcia E, Tibben A. The counselees' self-reported request for psychological help in genetic counseling for hereditary breast/ovarian cancer: not only psychopathology matters. Psychooncology 2012; 22:902-10. [PMID: 22740372 DOI: 10.1002/pon.3081] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 02/03/2012] [Accepted: 03/19/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Several studies have shown that counselees do not experience psychopathological levels of distress after DNA test result disclosure. However, it has not systematically been studied whether the absence of psychopathology also means that counselees do not want to receive help. Their self-reported request for help may be related not only with psychopathology/distress but also with other psychological needs (e.g., surgery decisions), genetics-specific needs (e.g., feeling vulnerable/stigmatized), and existential concerns (e.g., meaning in life). METHODS Questionnaires were filled in by Dutch cancer patients, before and after disclosure of BRCA1/2 test results for hereditary breast/ovarian cancer: pathogenic mutation results (n = 30), uninformative results (n = 202), or unclassified variants (n = 16). Newly developed questions measured request for help, psychopathology was estimated with factor analyses on distress/psychopathology instruments, and several validated questionnaires measured other needs/concerns. RESULTS One-third of all counselees who reported a request for psychological help had actually received help. The level of psychopathology correlated between 0.34 and 0.44 with this self-reported need-for-help. Other needs, genetics-specific distress, and existential concerns correlated strongly/moderately with the counselees' self-reported need-for-help. Examples of other needs were intention to undergo surgery, inaccuracy of their interpretation, the impact of cancer, and family communication difficulties. Genetics-specific distress was for instance feeling vulnerable to develop cancer, stigma, and lack of mastery. Existential concerns were, among others, lack of purpose in life, low self-acceptance, and an unfulfilled wish for certainty. CONCLUSIONS The request for help is related to multiple factors. Referral to psychosocial professionals may be improved by not only discussing psychopathology during genetic-counseling sessions but also by other needs and existential concerns. Questions about other needs and existential issues may be added to psychological screening instruments.
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Affiliation(s)
- Joël Vos
- Department of Clinical Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
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Peperkamp K, Dijkman R, van Maanen C, Vos J, Wouda W, Holzhauer M, van Wuijckhuise L, Junker K, Greijdanus S, Roumen M. Polioencephalo- myelitis in a calf due to infection with Schmallenberg virus. Vet Rec 2012; 170:570. [DOI: 10.1136/vr.e3795] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K. Peperkamp
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - R. Dijkman
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - C. van Maanen
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - J. Vos
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - W. Wouda
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - M. Holzhauer
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | | | - K. Junker
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - S. Greijdanus
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
| | - M. Roumen
- Animal Health Service; PO Box 9, 7400 AJ Deventer The Netherlands
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Vos J, Oosterwijk JC, Gomez-Garcia E, Menko FH, Collee MJ, van Asperen CJ, Jansen AM, Stiggelbout AM, Tibben A. Exploring the short-term impact of DNA-testing in breast cancer patients: the counselees' perception matters, but the actual BRCA1/2 result does not. Patient Educ Couns 2012; 86:239-251. [PMID: 21684708 DOI: 10.1016/j.pec.2011.04.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 03/11/2011] [Accepted: 04/08/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Previous studies suggest that learning a DNA-test-result has no direct impact on the medical-decisions and psychological well-being of counselees. Their perception, especially their recollections and interpretations of their cancer-risks and heredity, predict and/or mediate this impact. These studies were criticized for their small range of predictors, mediators, outcomes and contextual factors. We studied the short-term impact of DNA-testing with an extended model. METHODS Three months after disclosure of BRCA1/2-test-results, we sent counselees a questionnaire about their perception, medical and psychological outcomes, and medical, familial and psychological contexts. 248 affected women participated; 30 had received pathogenic-mutations, 16 unclassified-variants and 202 uninformative-results. RESULTS The actually communicated genetic-information and the contextual variables predicted the counselees' perception, but did not directly predict any outcomes. The counselees' perception predicted and/or completely mediated the counselees' medical intentions and behavior, physical and psychological life-changes, stigma, mastery, negativity and cancer-worries. Short-term distress was related to the perception not only of their own risks, but also of their relatives' risks and heredity-likelihood. Effect sizes were medium to large. CONCLUSIONS AND IMPLICATIONS The outcomes of DNA-testing were better predicted by the counselees' perception than by the actually given genetic-information. We recommend genetic-counselors to have tailored, interactive dialogues about the counselees' perception.
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Affiliation(s)
- Joël Vos
- Department of Clinical Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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Archontoulis SV, Yin X, Vos J, Danalatos NG, Struik PC. Leaf photosynthesis and respiration of three bioenergy crops in relation to temperature and leaf nitrogen: how conserved are biochemical model parameters among crop species? J Exp Bot 2012; 63:895-911. [PMID: 22021569 PMCID: PMC3254689 DOI: 10.1093/jxb/err321] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 08/31/2011] [Accepted: 09/07/2011] [Indexed: 05/07/2023]
Abstract
Given the need for parallel increases in food and energy production from crops in the context of global change, crop simulation models and data sets to feed these models with photosynthesis and respiration parameters are increasingly important. This study provides information on photosynthesis and respiration for three energy crops (sunflower, kenaf, and cynara), reviews relevant information for five other crops (wheat, barley, cotton, tobacco, and grape), and assesses how conserved photosynthesis parameters are among crops. Using large data sets and optimization techniques, the C(3) leaf photosynthesis model of Farquhar, von Caemmerer, and Berry (FvCB) and an empirical night respiration model for tested energy crops accounting for effects of temperature and leaf nitrogen were parameterized. Instead of the common approach of using information on net photosynthesis response to CO(2) at the stomatal cavity (A(n)-C(i)), the model was parameterized by analysing the photosynthesis response to incident light intensity (A(n)-I(inc)). Convincing evidence is provided that the maximum Rubisco carboxylation rate or the maximum electron transport rate was very similar whether derived from A(n)-C(i) or from A(n)-I(inc) data sets. Parameters characterizing Rubisco limitation, electron transport limitation, the degree to which light inhibits leaf respiration, night respiration, and the minimum leaf nitrogen required for photosynthesis were then determined. Model predictions were validated against independent sets. Only a few FvCB parameters were conserved among crop species, thus species-specific FvCB model parameters are needed for crop modelling. Therefore, information from readily available but underexplored A(n)-I(inc) data should be re-analysed, thereby expanding the potential of combining classical photosynthetic data and the biochemical model.
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Affiliation(s)
- S. V. Archontoulis
- Centre for Crop Systems Analysis, Plant Sciences Group, Wageningen University, Wageningen, The Netherlands
- Laboratory of Agronomy and Applied Crop Physiology, Department of Agriculture, University of Thessaly, Volos, Greece
| | - X. Yin
- Centre for Crop Systems Analysis, Plant Sciences Group, Wageningen University, Wageningen, The Netherlands
| | - J. Vos
- Centre for Crop Systems Analysis, Plant Sciences Group, Wageningen University, Wageningen, The Netherlands
| | - N. G. Danalatos
- Laboratory of Agronomy and Applied Crop Physiology, Department of Agriculture, University of Thessaly, Volos, Greece
| | - P. C. Struik
- Centre for Crop Systems Analysis, Plant Sciences Group, Wageningen University, Wageningen, The Netherlands
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Schrijver A, Vos J, Hoksbergen AW, Fioole B, Fritschy W, Hulsebos R, De Jong S, Reijnen MMP, De Vries JPP. Ultrasound-accelerated thrombolysis for lower extremity ischemia: multicenter experience and literature review. J Cardiovasc Surg (Torino) 2011; 52:467-476. [PMID: 21792154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM This study evaluates the short-term outcome of ultrasound-accelerated thrombolysis in patients with lower extremity ischemia caused by thromboembolic occlusions. METHODS A retrospective cohort study was conducted from December 2008 to May 2011 of 57 patients (42 men; median age, 66 ± 11 years) undergoing 62 episodes of ultrasound-accelerated thrombolysis for thromboembolic arterial occlusions of the lower extremities. The EKOS EndoWave System (EKOS Corporation, Bothell, WA, USA) was combined with urokinase (100000 IU/hour). Thirty-day and 6-month follow-up consisted of clinical evaluation, and Duplex scan or magnetic resonance angiography of the treated extremity. RESULTS Initial technical success was 97%, radiologic success was 82%, and overall clinical success was 77%. Median thrombolysis time was 21 hours (IQR, 15-24). In 38 of 51 procedures with successful lysis (75%) complete lysis was achieved within 24 hours. Major hemorrhage occurred in 2 procedures (3%), and distal embolization in 2 procedures (3%). During the initial hospitalization, the major amputation rate was 8% (N.=5) and the mortality rate was 2% (N.=1). The 30-day patency rate was 81%, without additional mortality. During a median 6-month (range, 2-14) follow-up, 9 reinterventions were performed. Two patients underwent major amputation and 3 patients died; because of malignancy (N.=2) and stroke (N.=1). CONCLUSION Initial success rates of ultrasound-accelerated thrombolysis are high and complication rate is low. However, reintervention rate during short-term follow-up for recurrent ischemia is substantial. Results from a randomized controlled trial comparing ultrasound-accelerated thrombolysis with standard thrombolysis for lower extremity ischemia (DUET, Current Controlled Trials, ISRCTN72676102) are eagerly awaited.
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Affiliation(s)
- A Schrijver
- Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
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Vos J, Menko F, Jansen AM, van Asperen CJ, Stiggelbout AM, Tibben A. A whisper-game perspective on the family communication of DNA-test results: a retrospective study on the communication process of BRCA1/2-test results between proband and relatives. Fam Cancer 2011; 10:87-96. [PMID: 20852944 PMCID: PMC3036814 DOI: 10.1007/s10689-010-9385-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective of this paper is to study how DNA-test result information was communicated and perceived within families. A retrospective descriptive study in 13 probands with a BRCA1/2 unclassified variant, 7 with a pathogenic mutation, 5 with an uninformative result, and in 44, 14, and 12 of their 1st and 2nd degree relatives respectively. We examined differences and correlations between: (a) information actually communicated (b) probands' perception, (c) relatives' perception. The perception consisted of recollections and interpretations of both their own and their relatives' cancer-risks, and heredity-likelihood (i.e. likelihood that cancer is heritable in the family). Differences and low correlations suggested few similarities between the actually communicated information, the probands' and the relatives' perception. More specifically, probands recalled the communicated information differently compared with the actually communicated information (R = .40), and reinterpreted this information differently (R = .30). The relatives' perception was best correlated with the proband's interpretation (R = .08), but this perception differed significantly from their proband's perception. Finally, relatives reinterpreted the information they received from their proband differently (R = .25), and this interpretation was only slightly related with the original message communicated by the genetic-counsellor (R = .15). Unclassified-variants were most frequently misinterpreted by probands and relatives, and had the largest differences between probands' and relatives' perceptions. Like in a children's whisper-game, many errors occur in the transmission of DNA-test result information in families. More attention is required for how probands disseminate information to relatives. Genetic-counsellors may help by supporting the probands in communicating to relatives, e.g. by providing clear summary letters for relatives.
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Affiliation(s)
- Joël Vos
- Department of Clinical Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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den Heijer M, Vos J, Seynaeve C, Vanheusden K, Duivenvoorden HJ, Tilanus-Linthorst M, Menke-Pluymers MBE, Tibben A. The impact of social and personal resources on psychological distress in women at risk for hereditary breast cancer. Psychooncology 2010; 21:153-60. [DOI: 10.1002/pon.1879] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 10/12/2010] [Accepted: 10/12/2010] [Indexed: 01/07/2023]
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Vos J, Oosterwijk JC, Gómez-García E, Menko FH, Jansen AM, Stoel RD, van Asperen CJ, Tibben A, Stiggelbout AM. Perceiving cancer-risks and heredity-likelihood in genetic-counseling: how counselees recall and interpret BRCA 1/2-test results. Clin Genet 2010; 79:207-18. [DOI: 10.1111/j.1399-0004.2010.01581.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vos J, Gómez-García E, Oosterwijk JC, Menko FH, Stoel RD, van Asperen CJ, Jansen AM, Stiggelbout AM, Tibben A. Opening the psychological black box in genetic counseling. The psychological impact of DNA testing is predicted by the counselees' perception, the medical impact by the pathogenic or uninformative BRCA1/2-result. Psychooncology 2010; 21:29-42. [DOI: 10.1002/pon.1864] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 07/22/2010] [Accepted: 09/04/2010] [Indexed: 11/09/2022]
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Evers JB, Vos J, Yin X, Romero P, van der Putten PEL, Struik PC. Simulation of wheat growth and development based on organ-level photosynthesis and assimilate allocation. J Exp Bot 2010; 61:2203-16. [PMID: 20231326 DOI: 10.1093/jxb/erq025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Intimate relationships exist between form and function of plants, determining many processes governing their growth and development. However, in most crop simulation models that have been created to simulate plant growth and, for example, predict biomass production, plant structure has been neglected. In this study, a detailed simulation model of growth and development of spring wheat (Triticum aestivum) is presented, which integrates degree of tillering and canopy architecture with organ-level light interception, photosynthesis, and dry-matter partitioning. An existing spatially explicit 3D architectural model of wheat development was extended with routines for organ-level microclimate, photosynthesis, assimilate distribution within the plant structure according to organ demands, and organ growth and development. Outgrowth of tiller buds was made dependent on the ratio between assimilate supply and demand of the plants. Organ-level photosynthesis, biomass production, and bud outgrowth were simulated satisfactorily. However, to improve crop simulation results more efforts are needed mechanistically to model other major plant physiological processes such as nitrogen uptake and distribution, tiller death, and leaf senescence. Nevertheless, the work presented here is a significant step forwards towards a mechanistic functional-structural plant model, which integrates plant architecture with key plant processes.
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Affiliation(s)
- J B Evers
- Centre for Crop Systems Analysis, Wageningen University, PO Box 430, 6700 AK Wageningen, the Netherlands.
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Abstract
Lodging, the permanent displacement of crop plants from their vertical because of root or shoot failure, is a major yield constraint of the gluten free, panicle bearing cereal teff. The objective of this paper was to analyse the causes of lodging of teff by using, modifying and validating conventional biomechanical models. The model parameters were obtained from a field trial with two contrasting teff cultivars, using novel in situ and laboratory measurements under wet and dry conditions. Cross-species model validation was done with rice (Oryza sativa). Teff is more susceptible to root lodging than to shoot lodging, although the data indicated that shoot strength is also insufficient. Hence, simultaneously breeding for both improved root anchorage and shoot strength is advocated. The study showed that the lodging model, derived for the spike-bearing cereal wheat, needed modifications in order to be able to deal with panicle-bearing plants such as teff and rice. Water adhering to plants owing to rain or dew increased calculated lodging susceptibility. To prevent underestimation of lodging susceptibility, future lodging research should be done under completely wet conditions (water saturated soil and wetted shoots).
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Affiliation(s)
- S H van Delden
- Centre for Crop Systems Analysis, Wageningen University, PO Box 430, NL-6700 AK Wageningen, The Netherlands.
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Vos J, Evers JB, Buck-Sorlin GH, Andrieu B, Chelle M, de Visser PHB. Functional-structural plant modelling: a new versatile tool in crop science. J Exp Bot 2010; 61:2101-15. [PMID: 19995824 DOI: 10.1093/jxb/erp345] [Citation(s) in RCA: 209] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Plants react to their environment and to management interventions by adjusting physiological functions and structure. Functional-structural plant models (FSPM), combine the representation of three-dimensional (3D) plant structure with selected physiological functions. An FSPM consists of an architectural part (plant structure) and a process part (plant functioning). The first deals with (i) the types of organs that are initiated and the way these are connected (topology), (ii) co-ordination in organ expansion dynamics, and (iii) geometrical variables (e.g. leaf angles, leaf curvature). The process part may include any physiological or physical process that affects plant growth and development (e.g. photosynthesis, carbon allocation). This paper addresses the following questions: (i) how are FSPM constructed, and (ii) for what purposes are they useful? Static, architectural models are distinguished from dynamic models. Static models are useful in order to study the significance of plant structure, such as light distribution in the canopy, gas exchange, remote sensing, pesticide spraying studies, and interactions between plants and biotic agents. Dynamic models serve quantitatively to integrate knowledge on plant functions and morphology as modulated by environment. Applications are in the domain of plant sciences, for example the study of plant plasticity as related to changes in the red:far red ratio of light in the canopy. With increasing availability of genetic information, FSPM will play a role in the assessment of the significance towards plant performance of variation in genetic traits across environments. In many crops, growers actively manipulate plant structure. FSPM is a promising tool to explore divergent management strategies.
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Affiliation(s)
- J Vos
- Centre for Crop Systems Analysis, Wageningen University, PO Box 430, 6700 AK, Wageningen, The Netherlands.
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Affiliation(s)
| | - J. Vos
- Pathology Department; GD Deventer; PO Box 9 9400 Deventer The Netherland
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Vos J, Otten W, van Asperen C, Jansen A, Menko F, Tibben A. The counsellees' view of an unclassified variant in BRCA1/2: recall, interpretation, and impact on life. Psychooncology 2008; 17:822-30. [DOI: 10.1002/pon.1311] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Muskens J, Veldhorst GJ, Snoep JJ, Vos J. [High mortality in a herd with signs of jejunal hemorrhage syndrome]. Tijdschr Diergeneeskd 2007; 132:116-9. [PMID: 17366873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Eleven cows from a herd of 80 dairy cows (14%) died over a 7-month period. Death occurred within 12-24 hours of the onset of the first clinical signs, namely, dullness and a decrease (mean 25%) in milk production. Within 12 hours the cows were unable to rise, felt cold, and were restless. Examined mucous membranes were pale. Two of three cows examined at necropsy had blood in the jejunum and high counts of Clostridium perfringens. Jejunal hemorrhage syndrome was diagnosed in these two cows on the basis of the clinical signs and postmortem findings.
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