Arno Hessels: Treatment outcomes in ANCA-associated vasculitis: determinants of efficacy and toxicity ANCA-geassocieerde vasculitis is de naam voor …
Arno Hessels: Treatment outcomes in ANCA-associated vasculitis: determinants of efficacy and toxicity. ANCA-geassocieerde vasculitis is de …
Frederike Bensch: Molecular imaging on the move: from feasibility to contribution in clinical questions. In de laatste decennia is de prognose van …
Peer support and skills training through an eating club for people with psychotic disorders: A feasibility study.
J Behav Ther Exp Psychiatry. 2019 Feb 28;64:80-86
Authors: Vogel JS, Swart M, Slade M, Bruins J, van der Gaag M, Castelein S
OBJECTIVE: The HospitalitY (HY) intervention is a novel recovery oriented intervention for people with psychotic disorders in which peer support and home-based skill training are combined in an eating club. A feasibility study was conducted to inform a subsequent randomised trial.
METHODS: This study evaluated three eating clubs consisting of nine participants and three nurses. Semi-structured interviews and pre- and post-intervention measures (18 weeks) of personal recovery, quality of life and functioning were used to evaluate the intervention. Participants received individual skills training, guided by self-identified goals, while organising a dinner at their home. During each dinner, participants engaged in peer support, led by a nurse.
RESULTS: In personal interviews participants reported positive effects on social support, loneliness, and self-esteem. Nurses reported that participants became more independent during the intervention. Participants were satisfied with the HY-intervention (attendance rate = 93%). All were able to organise a dinner for their peers with practical support from a nurse. Pre- and post -intervention measures did not show important improvements.
LIMITATIONS: Outcome measures were not sensitive to change, likely due to a short intervention period (5 months) and a limited number of participants (N = 9). Using Goal Attainment Scaling to evaluate personal goals turned out to be unfeasible.
CONCLUSIONS: The HY-intervention is feasible for participants with psychotic disorders. This study refined intervention and research design for the upcoming multicentre randomised controlled trial. We expect that the Experience Sampling Method will be more sensitive to changes in recovery outcomes than regular pre-post intervention measures.
PMID: 30875541 [PubMed – as supplied by publisher]
Recent Patents in Allergy/Immunology: Use of arginase inhibitors in the treatment of asthma and allergic rhinitis.
Allergy. 2019 Mar 13;:
Authors: Meurs H, Zaagsma J, Maarsingh H, van Duin M
Asthma is a chronic inflammatory disease characterized by recurrent airways obstruction, airway hyperresponsiveness (AHR), airway inflammation and airway remodeling, which is often associated with allergy and allergic rhinitis. Many patients with asthma are poorly controlled by current drug treatment, particularly a subgroup of patients with difficult-to-treat severe asthma, characterized by chronic symptoms, severe exacerbations, progressive loss of lung function and resistance to corticosteroids. New therapeutic options are therefore highly warranted. This article is protected by copyright. All rights reserved.
PMID: 30865303 [PubMed – as supplied by publisher]
Posted in Allergy
Psychosocial factors associated with poor outcomes after amputation for complex regional pain syndrome type-I.
PLoS One. 2019;14(3):e0213589
Authors: Schrier E, Geertzen JHB, Scheper J, Dijkstra PU
BACKGROUND: Amputation for longstanding therapy resistant complex regional pain syndrome type-I (CRPS-I) is controversial. Reported results are inconsistent. It is assumed that psychological factors play a role in CRPS-I.
OBJECTIVE: To explore which psychological factors prior to amputation are associated with poor outcomes after amputation in the case of longstanding therapy resistant CRPS-I.
METHODS: Between May 2008 and August 2015, 31 patients with longstanding therapy resistant CRPS-I were amputated. Before the amputation 11 psychological factors were assessed. In 2016, participants had a structured interview by telephone and filled out questionnaires to assess their outcome. In case of a perceived recurrence of CRPS-I a physician visited the patient to examine the symptoms. Associations between psychological factors and poor outcomes were analysed.
RESULTS: Four of the 11 psychological factors were associated with poor outcomes. Regression analyses showed that change in the worst pain in the past week was associated with poor social support (B = 0.3, 95% confidence interval: 0.1;0.6) and intensity of pain before amputation (B = 2.0, 95% confidence interval 0.9;3.0). Patients who reported important improvements in mobility (n = 23) had significantly higher baseline resilience (median 79) compared to those (n = 8) who did not report it (median 69)(Mann-Whitney U, Z = -2.398, p = 0.015). Being involved in a lawsuit prior to amputation was associated with a recurrence in the residual limb (Bruehl criteria). A psychiatric history was associated with recurrence somewhere else (Bruehl criteria).
CONCLUSION: Poor outcomes of amputation in longstanding therapy resistant CPRS-1 are associated with psychological factors. Outstanding life events are not associated with poor outcome although half of the participants had experienced outstanding life events.
PMID: 30865687 [PubMed – in process]
Posted in PLoS One
Use of infrared thermography in the detection of superficial phlebitis in adult intensive care unit patients: A prospective single-center observational study.
PLoS One. 2019;14(3):e0213754
Authors: Doesburg F, Smit JM, Paans W, Onrust M, Nijsten MW, Dieperink W
Common methods to detect phlebitis may not be sufficient for patients in the intensive care unit (ICU). The goal of this study was to investigate the feasibility of infrared (IR) thermography to objectively detect phlebitis in adult ICU patients. We included a total of 128 adult ICU-patients in a pilot and subsequent validation study. Median [interquartile range] age was 62 [54-71] years and 88 (69%) patients were male. Severity of phlebitis was scored using the visual infusion phlebitis (VIP)-score, ranging from 0 (no phlebitis) to 5 (thrombophlebitis). The temperature difference (ΔT) between the insertion site and a proximal reference point was measured with IR thermography. In 78 (34%) catheters early phlebitis and onset of moderate phlebitis was observed (VIP-score of 1-3). In both the pilot and the validation study groups ΔT was significantly higher when the VIP-score was ≥1 compared to a VIP-score of 0 (p<0.01 and p<0.001, respectively). Multivariate analysis identified ΔT (p<0.001) and peripheral venous catheter (PVC) dwell time (p = 0.001) as significantly associated with phlebitis. IR thermography may be a promising technique to identify phlebitis in the ICU. An increased ΔT as determined with thermography may be a risk factor for phlebitis.
PMID: 30865728 [PubMed – in process]
Posted in PLoS One
Gemma Maters: Lungs under a cloud: psychological aspects of COPD. COPD is een veelvoorkomende progressieve longziekte, met symptomen als dyspneu …
Pre- and Post-analytical Factors in Biomarker Discovery.
Methods Mol Biol. 2019;1959:1-22
Authors: Klont F, Horvatovich P, Govorukhina N, Bischoff R
The translation of promising biomarkers, which were identified in biomarker discovery experiments, to clinical assays is one of the key challenges in present-day proteomics research. Many so-called “biomarker candidates” fail to progress beyond the discovery phase, and much emphasis is placed on pre- and post-analytical variability in an attempt to provide explanations for this bottleneck in the biomarker development pipeline. With respect to such variability, there is a large number of pre- and post-analytical factors which may impact the outcomes of proteomics experiments and thus necessitate tight control. This chapter highlights some of these factors and provides guidance for addressing them on the basis of examples from previously published proteomics studies.
PMID: 30852812 [PubMed – in process]
Dinette van Timmeren: Physical health in adults with severe or profound intellectual and motor disabilities Lichamelijke gezondheidsproblemen komen …
CRISPR/Cas9: a powerful tool for identification of new targets for cancer treatment.
Drug Discov Today. 2019 Mar 05;:
Authors: Liu B, Saber A, Haisma HJ
Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated nuclease 9 (Cas9), as a powerful genome-editing tool, has revolutionized genetic engineering. It is widely used to investigate the molecular basis of different cancer types. In this review, we present an overview of recent studies in which CRISPR/Cas9 has been used for the identification of potential molecular targets. Based on the collected data, we suggest here that CRISPR/Cas9 is an effective system to distinguish between mutant and wild-type alleles in cancer. We show that several new potential therapeutic targets, such as CD38, CXCR2, MASTL, and RBX2, as well as several noncoding (nc)RNAs have been identified using CRISPR/Cas9 technology. We also discuss the obstacles and challenges that we face for using CRISPR/Cas9 as a therapeutic.
PMID: 30849442 [PubMed – as supplied by publisher]
Strategies for the production of long-acting therapeutics and efficient drug delivery for cancer treatment.
Biomed Pharmacother. 2019 Mar 05;113:108750
Authors: AlQahtani AD, O’Connor D, Domling A, Goda SK
Protein therapeutics play a significant role in treating many diseases. They, however, suffer from patient’s proteases degradation and antibody neutralization which lead to short plasma half-lives. One of the ways to overcome these pitfalls is the frequent injection of the drug albeit at the cost of patient compliance which affects the quality of life of patients. There are several techniques available to extend the half-life of therapeutics. Two of the most common protocols are PEGylation and fusion with human serum albumin. These two techniques improve stability, reduce immunogenicity, and increase drug resistance to proteases. These factors lead to the reduction of injection frequency which increases patient compliance and improve quality of life. Both techniques have already been used in many FDA approved drugs. This review describes many technologies to produce long-acting drugs with the attention of PEGylation and the genetic fusion with human serum albumin. The report also discusses the latest modified therapeutics in the field and their application in cancer therapy. We compare the modification methods and discuss the pitfalls of these modified drugs.
PMID: 30849643 [PubMed – as supplied by publisher]
Intact protein bioanalysis by liquid chromatography – High-resolution mass spectrometry.
J Chromatogr B Analyt Technol Biomed Life Sci. 2019 Feb 01;1110-1111:155-167
Authors: Bults P, Spanov B, Olaleye O, van de Merbel NC, Bischoff R
PMID: 30849729 [PubMed – as supplied by publisher]
Endovascular Aneurysm Repair Complicated with Type Ia Endoleak and Presumable Infection Treated with a Fenestrated Endograft.
Aorta (Stamford). 2018 Aug;6(4):102-106
Authors: de Niet A, van Schaik PM, Saleem BR, Zeebregts CJ, Tielliu IFJ
An 81-year-old patient presented to the emergency room 5 years after infrarenal endovascular aneurysm repair, with a Type Ia endoleak and a presumable infection of the graft material with Listeria monocytogenes. He was treated with a custom-made fenestrated endograft to seal the endoleak and lifelong antibiotic therapy to suppress the infection. Full explantation of graft material is not always preferable, and endovascular treatment combined with antibiotic suppressive therapy is in some cases an appropriate alternative.
PMID: 30849778 [PubMed]
Intralesional treatment versus wide resection for central low-grade chondrosarcoma of the long bones.
Cochrane Database Syst Rev. 2019 Mar 07;3:CD010778
Authors: Dierselhuis EF, Goulding KA, Stevens M, Jutte PC
BACKGROUND: Grade I or low-grade chondrosarcoma (LGCS) is a primary bone tumour with low malignant potential. Historically, it was treated by wide resection, since accurate pre-operative exclusion of more aggressive cancers can be challenging and under-treatment of a more aggressive cancer could negatively influence oncological outcomes. Intralesional surgery for LGCS has been advocated more often in the literature over the past few years. The potential advantages of less aggressive treatment are better functional outcome and lower complication rates although these need to be weighed against the potential for compromising survival outcomes.
OBJECTIVES: To assess the benefits and harms of intralesional treatment by curettage compared to wide resection for central low-grade chondrosarcoma (LGCS) of the long bones.
SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 4), MEDLINE and Embase up to April 2018. We extended the search to include trials registries, reference lists of relevant articles and review articles. We also searched ‘related articles’ of included studies suggested by PubMed.
SELECTION CRITERIA: In the absence of prospective randomised controlled trials (RCTs), we included retrospective comparative studies and case series that evaluated outcome of treatment of central LGCS of the long bones. The primary outcome was recurrence-free survival after a minimal follow-up of 24 months. Secondary outcomes were upgrading of tumour; functional outcome, as assessed by the Musculoskeletal Tumor Society (MSTS) score; and occurrence of complications.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures recognised by Cochrane. We conducted a systematic literature search using several databases and contacted corresponding authors, appraised the evidence using the ROBINS-I risk of bias tool and GRADE, and performed a meta-analysis. If data extraction was not possible, we included studies in a narrative summary.
MAIN RESULTS: We included 18 studies, although we were only able to extract participant data from 14 studies that included a total of 511 participants; 419 participants were managed by intralesional treatment and 92 underwent a wide resection. We were not able to extract participant data from four studies, including 270 participants, and so we included them as a narrative summary only. The evidence was at high risk of performance, detection and reporting bias.Meta-analysis of data from 238 participants across seven studies demonstrated little or no difference in recurrence-free survival after intralesional treatment versus wide resection for central LGCS in the long bones (risk ratio (RR) 0.98; 95% confidence interval (CI) 0.92 to 1.04; very low-certainty evidence). MSTS scores were probably better after intralesional surgery (mean score 93%) versus resection (mean score 78%) with a mean difference of 12.69 (95% CI 2.82 to 22.55; P value < 0.001; 3 studies; 72 participants; low-certainty evidence). Major complications across six studies (203 participants) were lower in cases treated by intralesional treatment (5/125 cases) compared to those treated by wide resection (18/78 cases), with RR 0.23 (95% CI 0.10 to 0.55; low-certainty evidence). In four people (0.5% of total participants) a high-grade (grade 2 or dedifferentiated) tumour was found after a local recurrence. Two participants were treated with second surgery with no evidence of disease at their final follow-up and two participants (0.26% of total participants) died due to disease. Kaplan-Meier analysis of data from 115 individual participants across four studies demonstrated 96% recurrence-free survival after a maximum follow-up of 300 months after resection versus 94% recurrence-free survival after a maximum follow-up of 251 months after intralesional treatment (P value = 0.58; very low-certainty evidence). Local recurrence or metastases were not reported after 41 months in either treatment group.
AUTHORS’ CONCLUSIONS: Only evidence of low- and very low-certainty was available for this review according to the GRADE system. Included studies were all retrospective in nature and at high risk of selection and attrition bias. Therefore, we could not determine whether wide resection is superior to intralesional treatment in terms of event-free survival and recurrence rates. However, functional outcome and complication rates are probably better after intralesional surgery compared to wide resection, although this is low-certainty evidence, considering the large effect size. Nevertheless, recurrence-free survival was excellent in both groups and a prospective RCT comparing intralesional treatment versus wide resection may be challenging for both practical and ethical reasons. Future research could instead focus on less invasive treatment strategies for these tumours by identifying predictors that help to stratify participants for surgical intervention or close observation.
PMID: 30845364 [PubMed – as supplied by publisher]
Vincent Quinten: Early detection of patient deterioration in patients with infection or sepsis Sepsis (bloedvergiftiging) is de meest voorkomende …
Kelly Berghuis: Age-related changes in neural plasticity after motor learning Veroudering gaat gepaard met structurele achteruitgangen in het brein. …
Wouter Meijers: Circulating factors in heart failure Hartfalen is een zeer ernstige aandoening, waarbij het hart niet meer in staat is om voldoende …