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1. Redispensing of expensive oral anticancer medicines: A practical application

Author

Apotheek Klinische Farmacie, Apotheek O&O&O, Cancer, Akgöl, Kübra, van Merendonk, Lisanne N, Barkman, Hannerieke J, van Balen, Dorieke Em, van den Hoek, Hester L, Klous, Marjolein G, Hendrikx, Jeroen Jma, Huitema, Alwin Dr, Beijnen, Jos H, Nuijen, Bastiaan, Apotheek Klinische Farmacie, Apotheek O&O&O, Cancer, Akgöl, Kübra, van Merendonk, Lisanne N, Barkman, Hannerieke J, van Balen, Dorieke Em, van den Hoek, Hester L, Klous, Marjolein G, Hendrikx, Jeroen Jma, Huitema, Alwin Dr, Beijnen, Jos H, and Nuijen, Bastiaan

Published
2024

3. Redispensing of expensive oral anticancer medicines: A practical application.

Author

Akgöl, Kübra, van Merendonk, Lisanne N, Barkman, Hannerieke J, van Balen, Dorieke EM, van den Hoek, Hester L, Klous, Marjolein G, Hendrikx, Jeroen JMA, Huitema, Alwin DR, Beijnen, Jos H, and Nuijen, Bastiaan

Subjects
THERAPEUTIC use of antineoplastic agents, COST control, ANTINEOPLASTIC agents, MEDICAL wastes, MEDICAL waste disposal, DRUG packaging, ENVIRONMENTAL exposure, TUMORS, DRUGS, MEDICAL care costs
Abstract

Introduction: Increasing use of expensive oral anticancer medicines comes with the downside of a financial and environmental burden, partially caused by unused medication. Returned oral anticancer medicine to the pharmacy could be considered for redispensing providing guaranteed quality. This study aimed to identify and implement quality aspects and criteria for redispensing oral anticancer medicine in daily pharmacy practice. Methods: A systematic analysis was conducted to determine the eligibility of oral anticancer medicine for redispensing. Over a one-year period, the number of returned oral anticancer medicine accepted for redispensing was quantified, and the reduction in financial waste and environmental burden calculated based on this assessment. Results: Four categories of quality aspects were identified for determining the eligibility of oral anticancer medicine for redispensing: Product presentation suitability (stability characteristics, storage requirements), physical condition (unopened or opened secondary or primary packaging, visual appearance), authentication (Falsified Medicines Directive, confirmation of initial dispense, recall), and additional aspects (remaining shelf life, period of storage in uncontrolled conditions). A standardized procedure for redispensing was implemented in daily pharmacy practice. During the study period, 10,415 oral anticancer medicine dose units out of 13,210 returns (79%) were accepted for redispensing. The total value of oral anticancer medicine accepted for redispensing was €483,301, accounting for 0.9% of the total value dispensed during this period. Furthermore, the potential reduction in environmental burden was estimated at 1132.1 g of potent active pharmaceutical ingredient. Conclusions: By implementing strict procedures considering all relevant quality aspects, redispensing of oral anticancer medicine can be successfully implemented into daily pharmacy practice, resulting in a significant reduction in financial waste and environmental burden. [ABSTRACT FROM AUTHOR]

Published
2024
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7. A simplified mesoscale 3D model for characterizing fibrinolysis under flow conditions

Author

Petkantchin, Rémy, Rousseau, Alexandre, Eker, Omer, Zouaoui Boudjeltia, Karim, Raynaud, Franck, Chopard, Bastien, Majoie, Charles, van Bavel, Ed, Marquering, Henk, Arrarte-Terreros, Nerea, Konduri, Praneeta, Georgakopoulou, Sissy, Roos, Yvo, Hoekstra, Alfons, Padmos, Raymond, Azizi, Victor, Miller, Claire, van der Kolk, Max, van der Lugt, Aad, Dippel, Diederik W.J., Lingsma, Hester L., Boodt, Nikki, Samuels, Noor, Payne, Stephen, Jozsa, Tamas, El-Bouri, Wahbi K., Gilvarry, Michael, McCarthy, Ray, Duffy, Sharon, Dwivedi, Anushree, Fereidoonnezhad, Behrooz, Moerman, Kevin, McGarry, Patrick, Staessens, Senna, de Meyer, Simon, Vandelanotte, Sarah, Migliavacca, Francesco, Dubini, Gabriele, Luraghi, Giulia, Rodriguez Matas, Jose Felix, Bridio, Sara, Blanc-Guillemaud, Vanessa, Panteleev, Mikhail, Shibeko, Alexey, Petkantchin, Rémy, Rousseau, Alexandre, Eker, Omer, Zouaoui Boudjeltia, Karim, Raynaud, Franck, Chopard, Bastien, Majoie, Charles, van Bavel, Ed, Marquering, Henk, Arrarte-Terreros, Nerea, Konduri, Praneeta, Georgakopoulou, Sissy, Roos, Yvo, Hoekstra, Alfons, Padmos, Raymond, Azizi, Victor, Miller, Claire, van der Kolk, Max, van der Lugt, Aad, Dippel, Diederik W.J., Lingsma, Hester L., Boodt, Nikki, Samuels, Noor, Payne, Stephen, Jozsa, Tamas, El-Bouri, Wahbi K., Gilvarry, Michael, McCarthy, Ray, Duffy, Sharon, Dwivedi, Anushree, Fereidoonnezhad, Behrooz, Moerman, Kevin, McGarry, Patrick, Staessens, Senna, de Meyer, Simon, Vandelanotte, Sarah, Migliavacca, Francesco, Dubini, Gabriele, Luraghi, Giulia, Rodriguez Matas, Jose Felix, Bridio, Sara, Blanc-Guillemaud, Vanessa, Panteleev, Mikhail, and Shibeko, Alexey

Abstract

One of the routine clinical treatments to eliminate ischemic stroke thrombi is injecting a biochemical product into the patient’s bloodstream, which breaks down the thrombi’s fibrin fibers: intravenous or intravascular thrombolysis. However, this procedure is not without risk for the patient; the worst circumstances can cause a brain hemorrhage or embolism that can be fatal. Improvement in patient management drastically reduced these risks, and patients who benefited from thrombolysis soon after the onset of the stroke have a significantly better 3-month prognosis, but treatment success is highly variable. The causes of this variability remain unclear, and it is likely that some fundamental aspects still require thorough investigations. For that reason, we conducted in vitro flow-driven fibrinolysis experiments to study pure fibrin thrombi breakdown in controlled conditions and observed that the lysis front evolved non-linearly in time. To understand these results, we developed an analytical 1D lysis model in which the thrombus is considered a porous medium. The lytic cascade is reduced to a second-order reaction involving fibrin and a surrogate pro-fibrinolytic agent. The model was able to reproduce the observed lysis evolution under the assumptions of constant fluid velocity and lysis occurring only at the front. For adding complexity, such as clot heterogeneity or complex flow conditions, we propose a 3-dimensional mesoscopic numerical model of blood flow and fibrinolysis, which validates the analytical model’s results. Such a numerical model could help us better understand the spatial evolution of the thrombi breakdown, extract the most relevant physiological parameters to lysis efficiency, and possibly explain the failure of the clinical treatment. These findings suggest that even though real-world fibrinolysis is a complex biological process, a simplified model can recover the main features of lysis evolution.

Published
2023

8. The potential contribution of house crickets to the dietary zinc content and nutrient adequacy in young Kenyan children : A linear programming analysis using Optifood

Author

Coppoolse, Hester L., Borgonjen-Van Den Berg, Karin J., Chopera, Prosper, Hummel, Marijke, Grimble, George, Brouwer, Inge, Melse-Boonstra, Alida, Coppoolse, Hester L., Borgonjen-Van Den Berg, Karin J., Chopera, Prosper, Hummel, Marijke, Grimble, George, Brouwer, Inge, and Melse-Boonstra, Alida

Abstract

Zinc deficiency arising from inadequate dietary intake of bioavailable zinc is common in children in developing countries. Because house crickets are a rich source of zinc, their consumption could be an effective public health measure to combat zinc deficiency. This study used Optifood, a tool based on linear programming analysis, to develop food-based dietary recommendations (FBR) and predict whether dietary house crickets can improve both zinc and overall nutrient adequacy of children's diets. Two quantitative, multi-pass 24-hour recalls from 47 children aged two and three years residing in rural Kenya were collected and used to derive model parameters, including a list of commonly consumed foods, median serving sizes, and frequency of consumption. Two scenarios were modelled: (i) FBR based on local available foods and (ii) FBR based on local available foods with house crickets. Results revealed that zinc would cease to be a problem nutrient when including house crickets to children's diets (PRI coverage for zinc increased from 89% to 121% in the best-case scenario). FBR based on both scenarios could ensure nutrient adequacy for all nutrients except for fat, but energy percentage (E%) for fat was higher when house crickets were included in the diet (23 E% versus 19 E%). This manoeuvre, combined with realistic changes in dietary practices, could therefore improve dietary zinc content and ensure adequacy for twelve nutrients for Kenyan children. Further research is needed to render these theoretical recommendations, practical.

Published
2023

9. sj-docx-1-opp-10.1177_10781552231176199 - Supplemental material for Redispensing of expensive oral anticancer medicines: A practical application

Author

Akgöl, Kübra, van Merendonk, Lisanne N, Barkman, Hannerieke J, van Balen, Dorieke EM, van den Hoek, Hester L, Klous, Marjolein G, Hendrikx, Jeroen JMA, Huitema, Alwin DR, Beijnen, Jos H, and Nuijen, Bastiaan

Subjects
FOS: Clinical medicine, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified
Abstract

Supplemental material, sj-docx-1-opp-10.1177_10781552231176199 for Redispensing of expensive oral anticancer medicines: A practical application by Kübra Akgöl, Lisanne N van Merendonk, Hannerieke J Barkman, Dorieke EM van Balen, Hester L van den Hoek, Marjolein G Klous, Jeroen JMA Hendrikx, Alwin DR Huitema, Jos H Beijnen and Bastiaan Nuijen in Journal of Oncology Pharmacy Practice

Published
2023
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10. sj-docx-2-opp-10.1177_10781552231176199 - Supplemental material for Redispensing of expensive oral anticancer medicines: A practical application

Author

Akgöl, Kübra, van Merendonk, Lisanne N, Barkman, Hannerieke J, van Balen, Dorieke EM, van den Hoek, Hester L, Klous, Marjolein G, Hendrikx, Jeroen JMA, Huitema, Alwin DR, Beijnen, Jos H, and Nuijen, Bastiaan

Subjects
FOS: Clinical medicine, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified
Abstract

Supplemental material, sj-docx-2-opp-10.1177_10781552231176199 for Redispensing of expensive oral anticancer medicines: A practical application by Kübra Akgöl, Lisanne N van Merendonk, Hannerieke J Barkman, Dorieke EM van Balen, Hester L van den Hoek, Marjolein G Klous, Jeroen JMA Hendrikx, Alwin DR Huitema, Jos H Beijnen and Bastiaan Nuijen in Journal of Oncology Pharmacy Practice

Published
2023
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11. Opportunities for Recognition Can Improve Learning and Performance

Author

French, Ron, Henderson, Hester L., and Lavay, Barry

Abstract

Physical educators need to make an effort to catch students being good and recognize them for their positive accomplishments. Unfortunately, it is usually the students who act inappropriately who receive the majority of the teachers' attention. In order to help increase learning and improve performance and behavior, the physical educator must pay attention to all students and provide frequent, positive social reinforcement and constructive feedback. This article describes techniques that can be used to increase the number of opportunities for recognition and student-teacher interactions.

Published
2013
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13. Differences in Quantitative Sensory Testing Outcomes between Patients With Low Back Pain in Primary Care and Healthy Controls

Author

Hester L. den Bandt, Kelly Ickmans, Lynn Leemans, Jo Nijs, Lennard Voogt, Physiotherapy, Human Physiology and Anatomy, Pain in Motion, Movement and Sport Sciences, Physical Medicine and Rehabilitation, Movement and Nutrition for Health and Performance, and Rehabilitation Research

Subjects
Pain Threshold, Central Nervous System Sensitization, Primary Health Care, Case-Control Studies, Humans, Low Back Pain
Abstract

Objectives: Quantitative Sensory Testing (QST) is used to test somatosensory functioning in patients with low back pain (LBP) and most performed on people with chronic LBP in secondary/tertiary health care facilities. Studies using QST-testing on LBP populations in primary care are scarce. Central Sensitization Inventory (CSI) measures central sensitization (CS)-related symptoms and studies investigating the differences between QST-testing and participants with LBP with a positive and negative score on the CSI questionnaire are also rare. This case-control study investigates differences of an extensive QST-measurement between patients with acute, chronic LBP and healthy controls in primary care. Secondary aim is to investigate differences of an extensive QST-measurement between "CS" and "no-CS" group. Methods: Participants with LBP were recruited from November 2016 to October 2019. Demographic and clinical information was collected and a standardized QST-protocol was taken. Data-analysis involved determining differences between groups. Results: Data of 100 participants with LBP and 50 healthy controls were analyzed. Heat pain thresholds, pressure pain threshold, conditioned pain modulation local and remote were significantly moderately to relatively strongly affected by acute, chronic LBP and healthy controls (P

Published
2022

14. Redispensing of expensive oral anticancer medicines: A practical application

Author

Kübra Akgöl, Lisanne N van Merendonk, Hannerieke J Barkman, Dorieke EM van Balen, Hester L van den Hoek, Marjolein G Klous, Jeroen JMA Hendrikx, Alwin DR Huitema, Jos H Beijnen, and Bastiaan Nuijen

Subjects
Oncology, Pharmacology (medical)
Abstract

Introduction Increasing use of expensive oral anticancer medicines comes with the downside of a financial and environmental burden, partially caused by unused medication. Returned oral anticancer medicine to the pharmacy could be considered for redispensing providing guaranteed quality. This study aimed to identify and implement quality aspects and criteria for redispensing oral anticancer medicine in daily pharmacy practice. Methods A systematic analysis was conducted to determine the eligibility of oral anticancer medicine for redispensing. Over a one-year period, the number of returned oral anticancer medicine accepted for redispensing was quantified, and the reduction in financial waste and environmental burden calculated based on this assessment. Results Four categories of quality aspects were identified for determining the eligibility of oral anticancer medicine for redispensing: Product presentation suitability (stability characteristics, storage requirements), physical condition (unopened or opened secondary or primary packaging, visual appearance), authentication (Falsified Medicines Directive, confirmation of initial dispense, recall), and additional aspects (remaining shelf life, period of storage in uncontrolled conditions). A standardized procedure for redispensing was implemented in daily pharmacy practice. During the study period, 10,415 oral anticancer medicine dose units out of 13,210 returns (79%) were accepted for redispensing. The total value of oral anticancer medicine accepted for redispensing was €483,301, accounting for 0.9% of the total value dispensed during this period. Furthermore, the potential reduction in environmental burden was estimated at 1132.1 g of potent active pharmaceutical ingredient. Conclusions By implementing strict procedures considering all relevant quality aspects, redispensing of oral anticancer medicine can be successfully implemented into daily pharmacy practice, resulting in a significant reduction in financial waste and environmental burden.

Published
2023

18. Reporting Grades for Students with Disabilities in General Physical Education.

Author

Henderson, Hester L., French, Ron, and Kinnison, Lloyd

Abstract

Discusses traditional grading procedures used in education in general, and physical education in particular, suggesting an alternative procedure that may be more appropriate for grading students with disabilities in inclusive settings while still meeting the standards of the Individuals with Disabilities Education Act. Suggestions include IEP contract grading and criteria sheets, which more accurately reflect student learning. (SM)

Published
2001

19. First Teach Their Teachers: Technology Support and Computer Use in Academic Subjects.

Author

Fuller, Hester L.

Abstract

Describes a study that used innovation diffusion theory to investigate the effects of the allocation of computer coordinator work time on student computer use in academic subjects in grade 5 and grade 11. Findings suggest that teacher support is more critical than student support and that effects differ in different grades. (Contains 31 references.)(Author/LRW)

Published
2000

21. Food Security, Gender, and Education

Author

Hester L. Furey

Abstract

“Food security” is a term that came into use in the second half of the 20th century as government leaders and nongovernmental organizations began to apply systemic thought to global issues of availability of food, the safety and nutritional sufficiency of available food, and the stability of individuals’ access to it. Hunger and starvation as global problems began to be studied at the end of World War II. Concerns about global food supply management prompted the establishment of the United Nations’ Food and Agriculture Organization (FAO) and increasing levels of policymaking and intervention, enacted through a series of conferences and culminating in a World Food Summit in 1996. Although world food production increased by 50% in the decades following WWII and the 1990s were believed to be a “golden age” of food security, the United Nations believes that before the 2020 world health crisis some 815 million people experienced chronic hunger. Spikes in unemployment such as those associated with the 2008 world financial crisis and the 2020 coronavirus pandemic cause accompanying increases in food insecurity. Global climate change continually challenges efforts to address food-related crises, and at the same time rising numbers of refugees add to the numbers of people who would be food insecure even if all other conditions were optimal. Awareness of the special role of gender within this field has only begun to develop since the first decade of the 21st century. Although the field of food studies is older, most academic studies of food focus on histories of specific commodities, regional folkways, and/or food and literature. Systemic studies of food policy outcomes have not examined gender as a vector of knowledge until about 2010. Consequently, this more specialized field of knowledge remains in an early stage of development, with activists at the forefront more often than academics. Considerable pushback has emerged against the idea that experts should educate locals about food, and many food activists now argue that education should arise from those in production rather than those who create policy. Women represent 60% of all people living with hunger and food insecurity. They also make up at least 60% of agricultural workers. Most of these women growing food are feeding families and regions rather than aspiring to be participants in global economies. As women they experience food insecurity because of cultural gender biases, and as farmers they are twice disadvantaged because neither agriculture nor women’s production within families tends to garner widespread respect or wealth. Gender-blindness has plagued efforts to resolve these issues even when the UN and others have placed women’s progress at the forefront of millennium goals. Organizations charged with analysis of poverty and hunger still operate using out-of-date analytical tools that themselves perpetuate sexist discrimination. “Global” does not necessarily mean more progressive or inclusive. Despite the discourse of goodwill, in practice the unquestioned dominance of WWII-era paradigms of large-scale agricultural production and food supply chains has limited rather than supported collective ability to effect change. In the final years of the 20th century, a growing number of alternative voices such as the anti-globalist scholar Vandana Shiva and fair trade and sustainability groups like Café Campesino began to introduce dissenting ideas about food security using the terminology of food sovereignty and biodiversity, tying these concepts to the empowerment of women, local communities, and “eaters.”

Published
2021

22. Comparison of hypersensitivity reactions of intravenous iron: iron isomaltoside‐1000 (Monofer ® ) versus ferric carboxy‐maltose (Ferinject ® ). A single center, cohort study

Author

Midas B. Mulder, Elsbeth M. Westerman, Hester L. van den Hoek, Antonie J.P. van Tilburg, and Erwin Birnie

Subjects
Pharmacology, medicine.medical_specialty, education.field_of_study, business.industry, Anemia, Population, Iron deficiency, medicine.disease, Lower risk, 030226 pharmacology & pharmacy, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Iron-deficiency anemia, Internal medicine, Iron Isomaltoside 1000, medicine, Ferric, Pharmacology (medical), 030212 general & internal medicine, business, education, medicine.drug, Cohort study
Abstract

AIMS Intravenous iron supplementation is widely used to treat iron deficiency and iron deficiency anemia when oral iron administration is ineffective or poorly tolerated. Hypersensitivity reactions (HSRs) during infusions are rare, but can be life-threatening. This study aimed to compare the risk for HSRs with the intravenous administration of iron isomaltoside-1000 and ferric carboxymaltose for the treatment of iron deficiency and iron deficiency anemia. METHODS This was a single-centre cohort study. Nurses and physicians were instructed to fill out an HSR registration form with every administration of intravenous iron. HSRs were distinguished into serious and non-serious HSRs using the Ring and Messmer classification. RESULTS HSRs occurred in 18/836 (2.1%) ferric carboxymaltose and 43/496 (8.7%) iron isomaltoside-1000 administrations. The crude risk for HSRs was 75% lower after ferric carboxymaltose treatment (RR = 0.248, 95% CI: 0.145-0.426, P

Published
2018

23. O-182 Higher risk of preeclampsia and pregnancy-induced hypertension with artificial cycle for Frozen-thawed Embryo Transfer compared to ovulatory cycle or fresh transfer following In Vitro Fertilization

Author

Epelboin, S, primary, Labrosse, J, additional, Fauque, P, additional, Levy, R, additional, Mouzon, J. De, additional, Boyer, M, additional, Vienne, C. De, additional, Bergere, M, additional, Valentin, M, additional, Devaux, A, additional, Hester, L, additional, Sermondade, N, additional, Jonveaux, P, additional, and Pessione1, F, additional

Published
2021
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24. Perceptions of the Frontline Craft: Assessing Value Convergence Between Policy Makers, Managers, and Street-Level Professionals in the Prison Sector

Author

Paanakker, Hester L. and Paanakker, Hester L.

Abstract

01 juli 2020, Contains fulltext : 239155.pdf (Publisher’s version ) (Open Access), From the unique perspective of perceptions of the frontline craft, this study examines value convergence between policy makers, managers, and street-level professionals (N = 55). Toxic stereotyping between staff levels, exacerbated by restrictive organizational conditions, are shown to overshadow positive value convergence from socialization processes. In this Dutch prison study, public officials are consistently biased to believe that the management above them prioritizes targets (values that support the organization) over content (values that serve prison inmates). This explains how perceived role and value differences impact the actualization of shared values in public service delivery much more negatively than the actual differences.

Published
2021

26. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study

Author

van Essen T. A., den Boogert H. F., Cnossen M. C., de Ruiter G. C. W., Haitsma I., Polinder S., Steyerberg E. W., Menon D., Maas A. I. R., Lingsma H. F., Peul W. C., Cecilia A., Hadie A., Vanni A., Judith A., Krisztina A., Norberto A., Nada A., Lasse A., Azasevac A., Audny A., Anna A., Hilko A., Gerard A., Kaspars A., Philippe A., Luisa A. M., Camelia B., Rafael B., Ronald B., Pal B., Ursula B., Romuald B., Ronny B., Javier B. F., Bo-Michael B., Antonio B., Remy B., Habib B., Thierry B., Maurizio B., Luigi B., Christopher B., Federico B., Harald B., Erta B., Morten B., den Hugo B., Pierre B., Peter B., Alexandra B., Vibeke B., Joanne B., Camilla B., Andras B., Monika B., Emiliana C., Rosa C. M., Peter C., Guillermo C. L., Marco C., Elsa C., Carpenter K., Castano-Leon Ana M., Francesco C., Giorgio C., Arturo C., Giuseppe C., Maryse C., Mark C., Jonathan C., Lizzie C. -K., Johnny C., Cooper Jamie D., Marta C., Amra C., Nicola C., Endre C., Marek C., Claire D. -F., Francois D., Pierre D., Helen D., Veronique D. K., Francesco D. C., Bart D., de Ruiter Godard C. W., Dula D., Shenghao D., Diederik D., Abhishek D., Emma D., Jens D., Guy-Loup D., George E., Heiko E., Ari E., Patrick E., Erzsebet E., Martin F., Feigin Valery L., Junfeng F., Kelly F., Francesca F., Gilles F., Ulderico F., Shirin F., Alex F., Pablo G., Damien G., Dashiell G., Guoyi G., Karin G., Pradeep G., Alexandre G., Lelde G., Benoit G., Ben G., Jagos G., Gomez Pedro A., Francesca G., Gruen Russell L., Deepak G., Haagsma Juanita A., Iain H., Hartings Jed A., Raimund H., Eirik H., Daniel H., Astrid H., Stefan H., Lindsay H., Jilske H., Hutchinson Peter J., Kristine H. A., Bram J., Stefan J., Mike J., Bojan J., Ji-yao J., Kelly J., Konstantinos K., Mladen K., Ari K., Maija K., Thomas K., Riku K., Kolias Angelos G., Balint K., Erwin K., Ksenija K., Daniel K., Lars-Owe K., Noemi K., Alfonso L., Linda L., Steven L., Fiona L., Christian L., Rolf L., Valerie L., Jin L., Leon L., Roger L., Hester L., Dirk L., Angels L., Maas Andrew I. R., Stephen M. D., Marc M., Marek M., Sebastian M., Alex M., Geoffrey M., Didier M., Francisco M. L., Costanza M., Armando M., Hugues M., Alessandro M., Julia M., Charles M. F., Catherine M. M., Bela M., David M., Tomas M., Cristina M. -K., Davide M., Visakh M., Lynnette M., Holger M., Nandesh N., Ancuta N., David N., Virginia N., Daan N., Quentin N., Jozsef N., Mauro O., Annemarie O., Matej O., Fabrizio O., Aarno P., Parizel Paul M., Adriana P., Jean-Francois P., Natascha P., Vincent P., Paolo P., Wilco P., Anna P. -K., Sebastien P. F., Matti P., Horia P., Antonia P. M., Suzanne P., Inigo P., Jussi P., Louis P., Andreea R., Arminas R., Rahul R., Malinka R., Ruben R., Veronika R., Jonathan R., Samuli R., Saulius R., Cecilie R., Olav R., Gerwin R., Jeffrey R., Christina R., Guy R., Rolf R., Sandra R., Daniel R., Martin R., Marco S., Barbara S., Juan S., Oliver S., Francesca S., Renan S. -P., Janos S., Edgar S., Luminita S., Davide S., Nadine S., Inger S., Barbara S. ss., Silke S., Herbert S., Guus S., Frederik S. R., Elisabeth S., Michael S., Ozcan S., Toril S., Lidwien S., Dirk S., Peter S., Abayomi S., Emmanuel S., Simon S., Nicole S., Ana S., Robert S., William S., Steyerberg Ewout W., Nino S., Nina S., Anneliese S., Silvio T. F., Riikka T., Viktoria T., Paivi T., Steven T. M., Braden T. A., Olli T., Ralph T., Guido T., Alice T., Matt T., Dick T., Christos T., Luaba T. J. -F., Tony T., Maria T. C., Peter V., Shirley V., Egils V., der Steen Gregory V., van der Mathieu J., van der Joukje N., van Dijck Jeroen T. J. M., van Essen Thomas A., Wim V. H., van Caroline H., Dominique V. P., Thijs V. V., Julia V. W., Audrey V., Alessia V., Emmanuel V., Kimberley V., Jan V., Vespa Paul M., Anne V., Rimantas V., Giacinta V., Carmen V. -L., Victor V., Daphne V., Zoltan V., Derick W., Wang Kevin K. W., Lei W., Lars W., Eno W., Guy W., Lindsay W., Winkler Maren K. L., Stefan W., Peter Y., Alexander Y., Menashe Z., Yang Z., Agate Z., Fabrizio Z., Van Essen, T, den Boogert, H, Cnossen, M, de Ruiter, G, Haitsma, I, Polinder, S, Steyerberg, E, Menon, D, Maas, A, Lingsma, E, Peul, W, Citerio, G, CENTER-TBI Investigators and Participants, Ragauskas, Arminas, Ročka, Saulius, Vilcinis, Rimantas, Commission of the European Communities, Public Health, Neurosurgery, Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, Clinicum, Department of Diagnostics and Therapeutics, Anestesiologian yksikkö, University of Helsinki, Neurokirurgian yksikkö, Doctoral Programme in Clinical Research, Centre of Excellence in Complex Disease Genetics, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Helsinki Institute for Information Technology, Biostatistics Helsinki, Samuli Olli Ripatti / Principal Investigator, University Management, Doctoral Programme in Social Sciences, HUS Perioperative, Intensive Care and Pain Medicine, Complex Disease Genetics, Genomics of Neurological and Neuropsychiatric Disorders, Statistical and population genetics, Psychology 3, Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Rocka, Saulius, „Springer' grupė, van Essen, T. A., den Boogert, H. F., Cnossen, M. C., de Ruiter, G. C. W., Haitsma, I., Polinder, S., Steyerberg, E. W., Menon, D., Maas, A. I. R., Lingsma, H. F., Peul, W. C., Cecilia, A., Hadie, A., Vanni, A., Judith, A., Krisztina, A., Norberto, A., Nada, A., Lasse, A., Azasevac, A., Audny, A., Anna, A., Hilko, A., Gerard, A., Kaspars, A., Philippe, A., Luisa, A. M., Camelia, B., Rafael, B., Ronald, B., Pal, B., Ursula, B., Romuald, B., Ronny, B., Javier, B. F., Bo-Michael, B., Antonio, B., Remy, B., Habib, B., Thierry, B., Maurizio, B., Luigi, B., Christopher, B., Federico, B., Harald, B., Erta, B., Morten, B., den Hugo, B., Pierre, B., Peter, B., Alexandra, B., Vibeke, B., Joanne, B., Camilla, B., Andras, B., Monika, B., Emiliana, C., Rosa, C. M., Peter, C., Guillermo, C. L., Marco, C., Elsa, C., Carpenter, K., Castano-Leon Ana, M., Francesco, C., Giorgio, C., Arturo, C., Giuseppe, C., Maryse, C., Mark, C., Jonathan, C., Lizzie, C. -K., Johnny, C., Cooper Jamie, D., Marta, C., Amra, C., Nicola, C., Endre, C., Marek, C., Claire, D. -F., Francois, D., Pierre, D., Helen, D., Veronique, D. K., Francesco, D. C., Bart, D., de Ruiter Godard, C. W., Dula, D., Shenghao, D., Diederik, D., Abhishek, D., Emma, D., Jens, D., Guy-Loup, D., George, E., Heiko, E., Ari, E., Patrick, E., Erzsebet, E., Martin, F., Feigin Valery, L., Junfeng, F., Kelly, F., Francesca, F., Gilles, F., Ulderico, F., Shirin, F., Alex, F., Pablo, G., Damien, G., Dashiell, G., Guoyi, G., Karin, G., Pradeep, G., Alexandre, G., Lelde, G., Benoit, G., Ben, G., Jagos, G., Gomez Pedro, A., Francesca, G., Gruen Russell, L., Deepak, G., Haagsma Juanita, A., Iain, H., Hartings Jed, A., Raimund, H., Eirik, H., Daniel, H., Astrid, H., Stefan, H., Lindsay, H., Jilske, H., Hutchinson Peter, J., Kristine, H. A., Bram, J., Stefan, J., Mike, J., Bojan, J., Ji-yao, J., Kelly, J., Konstantinos, K., Mladen, K., Ari, K., Maija, K., Thomas, K., Riku, K., Kolias Angelos, G., Balint, K., Erwin, K., Ksenija, K., Daniel, K., Lars-Owe, K., Noemi, K., Alfonso, L., Linda, L., Steven, L., Fiona, L., Christian, L., Rolf, L., Valerie, L., Jin, L., Leon, L., Roger, L., Hester, L., Dirk, L., Angels, L., Maas Andrew, I. R., Stephen, M. D., Marc, M., Marek, M., Sebastian, M., Alex, M., Geoffrey, M., Didier, M., Francisco, M. L., Costanza, M., Armando, M., Hugues, M., Alessandro, M., Julia, M., Charles, M. F., Catherine, M. M., Bela, M., David, M., Tomas, M., Cristina, M. -K., Davide, M., Visakh, M., Lynnette, M., Holger, M., Nandesh, N., Ancuta, N., David, N., Virginia, N., Daan, N., Quentin, N., Jozsef, N., Mauro, O., Annemarie, O., Matej, O., Fabrizio, O., Aarno, P., Parizel Paul, M., Adriana, P., Jean-Francois, P., Natascha, P., Vincent, P., Camici, Paolo, Wilco, P., Anna, P. -K., Sebastien, P. F., Matti, P., Horia, P., Antonia, P. M., Suzanne, P., Inigo, P., Jussi, P., Louis, P., Andreea, R., Arminas, R., Rahul, R., Malinka, R., Ruben, R., Veronika, R., Jonathan, R., Samuli, R., Saulius, R., Cecilie, R., Olav, R., Gerwin, R., Jeffrey, R., Christina, R., Guy, R., Rolf, R., Sandra, R., Daniel, R., Martin, R., Marco, S., Barbara, S., Juan, S., Oliver, S., Francesca, S., Renan, S. -P., Janos, S., Edgar, S., Luminita, S., Davide, S., Nadine, S., Inger, S., Barbara, S. ss., Silke, S., Herbert, S., Guus, S., Frederik, S. R., Elisabeth, S., Michael, S., Ozcan, S., Toril, S., Lidwien, S., Dirk, S., Peter, S., Abayomi, S., Emmanuel, S., Simon, S., Nicole, S., Ana, S., Robert, S., William, S., Steyerberg Ewout, W., Nino, S., Nina, S., Anneliese, S., Silvio, T. F., Riikka, T., Viktoria, T., Paivi, T., Steven, T. M., Braden, T. A., Olli, T., Ralph, T., Guido, T., Alice, T., Matt, T., Dick, T., Christos, T., Luaba, T. J. -F., Tony, T., Maria, T. C., Peter, V., Shirley, V., Egils, V., der Steen Gregory, V., van der Mathieu, J., van der Joukje, N., van Dijck Jeroen, T. J. M., van Essen Thomas, A., Wim, V. H., van Caroline, H., Dominique, V. P., Thijs, V. V., Julia, V. W., Audrey, V., Alessia, V., Emmanuel, V., Kimberley, V., Jan, V., Vespa Paul, M., Anne, V., Rimantas, V., Giacinta, V., Carmen, V. -L., Victor, V., Daphne, V., Zoltan, V., Derick, W., Wang Kevin, K. W., Lei, W., Lars, W., Eno, W., Guy, W., Lindsay, W., Winkler Maren, K. L., Stefan, W., Peter, Y., Alexander, Y., Menashe, Z., Yang, Z., Agate, Z., and Fabrizio, Z.

Subjects
SURGERY, medicine.medical_treatment, CENTER-TBI Investigators and Participants, GUIDELINES, 3124 Neurology and psychiatry, 030218 nuclear medicine & medical imaging, law.invention, 0302 clinical medicine, Traumatic brain injury, Randomized controlled trial, Trauma Centers, law, Neurosurgeons/standards, Surveys and Questionnaires, Brain Injuries, Traumatic, Acute subdural hematoma, Neurosurgery, Practice variation, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurosurgery: 786, Neuroradiology, OUTCOMES, medicine.diagnostic_test, Trauma center, Interventional radiology, 3. Good health, Europe, Monitoring, Physiologic/methods, SURGICAL-MANAGEMENT, Decompressive craniectomy, Life Sciences & Biomedicine, medicine.medical_specialty, Decompressive Craniectomy/methods, Decompressive Craniectomy, RANDOMIZED CONTROLLED-TRIALS, Comparative effectiveness research, Clinical Decision-Making, Clinical Neurology, Brain Injuries, Traumatic/surgery, 03 medical and health sciences, Original Article - Brain trauma, medicine, Humans, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrokirurgi: 786, Trauma Centers/statistics & numerical data, acute subdural hematoma, neurosurgery, practice variation, traumatic brain injury, Monitoring, Physiologic, Neurology & Neurosurgery, Science & Technology, ACUTE SUBDURAL HEMATOMAS, business.industry, 3112 Neurosciences, 1103 Clinical Sciences, medicine.disease, nervous system diseases, Neurosurgeons, Emergency medicine, MODERATE, Neurology (clinical), Human medicine, Neurosciences & Neurology, business, 1109 Neurosciences, 030217 neurology & neurosurgery
Abstract

Background Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care. © The Author(s) 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Published
2019

27. Impact of nutrition education on nutritional knowledge and intentions towards nutritional counselling in Dutch medical students: An intervention study

Author

S. Coosje Dijkstra, Hester L Coppoolse, Jaap Seidell, APH - Health Behaviors & Chronic Diseases, and Youth and Lifestyle

Subjects
Counseling, Male, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, knowledge, Students, Medical, Nutrition Education, Psychological intervention, Intervention group, Health Promotion, Intention, Social support, Intervention (counseling), Nutritional knowledge, medicine, Humans, Netherlands, Self-efficacy, Nutrition and Metabolism, attitudes, business.industry, nutrition education, General Medicine, social support, Intervention studies, self efficacy, Nutrition Assessment, Family medicine, Female, intentions, Curriculum, business, SDG 4 - Quality Education
Abstract

ObjectiveManagement of diet-related chronic diseases may benefit from improved nutrition education of medical students. This study aims to investigate the effects of a nutrition education course on nutritional knowledge and intentions towards nutritional counselling in Dutch medical students.DesignThis is a pre–post intervention study with a comparison group. Participants completed self-reported questionnaires on nutritional knowledge and intentions towards nutritional counselling.ParticipantsIn total, 118 medical students (64.4% undergraduate, 73.2% women) were recruited from two medical schools in the Netherlands (n=66 intervention group, n=52 comparison group).InterventionThe intervention group completed a 25-hour course in nutritional counselling (the Students Experienced in Lifestyle and Food (SELF) course) in addition to the standard medical curriculum. The comparison group followed the standard medical curriculum.Outcome measuresSelf-reported nutritional knowledge and intentions towards nutritional counselling, including attitude, self-efficacy and social support.ResultsNutritional knowledge (B: 2.42, 95% CI 1.81 to 3.02), attitude in men (B: 0.50, 95% CI 0.13 to 0.87) and self-efficacy (B: 0.78, 95% CI 0.62 to 0.95) significantly increased in the intervention group compared with the comparison group. No significant differences were found for social support (B: 0.20, 95% CI −0.02 to 0.43) and attitude in women (B: 0.08, 95% CI −0.24 to 0.31) between the two groups.ConclusionsThe SELF course increased medical students’ nutritional knowledge and stimulated their intentions towards nutritional counselling. Future research is needed to evaluate the long-term impact of nutrition education interventions on physician practice patterns and patient outcomes.

Published
2020

28. Risk of hydroxychloroquine alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study

Author

Lane, J.C.E., Weaver, J. (JoEllen), Kostka, K., Duarte-Salles, T., Abrahao, M.T.F., Alghoul, H., Alser, O., Alshammari, T.M., Biedermann, P., Banda, J.M., Burn, E., Casajust, P., Conover, M.M., Culhane, A.C., Davydov, A., DuVall, S.L., Dymshyts, D., Fernandez-Bertolin, S., Fister, K., Hardin, J., Hester, L., Hripcsak, G. (G.), Kaas-Hansen, B.S., Kent, S., Khosla, S., Kolovos, S., Lambert, C.G., Lei, J. (Johan) van der, Lynch, K.E., Makadia, R., Margulis, A.V., Matheny, M.E., Mehta, P., Morales, D.R., Morgan-Stewart, H., Mosseveld, M. (Mees), Newby, D., Nyberg, F. (Fredrik), Ostropolets, A., Park, RW, Prats-Uribe, A., Rao, G.A., Reich, C., Reps, J., Rijnbeek, P.R. (Peter), Sathappan, S.M.K., Schuemie, M.J. (Martijn), Seager, S., Sena, A.G., Shoaibi, A., Spotnitz, M., Suchard, M.A. (Marc), Torre, C.O., Vizcaya, D., Wen, H.N., Wilde, M. (Marcel) de, Xie, J.Q., You, S.C., Zhang, L., Zhuk, O., Ryan, P., Prieto-Alhambra, D., Lane, J.C.E., Weaver, J. (JoEllen), Kostka, K., Duarte-Salles, T., Abrahao, M.T.F., Alghoul, H., Alser, O., Alshammari, T.M., Biedermann, P., Banda, J.M., Burn, E., Casajust, P., Conover, M.M., Culhane, A.C., Davydov, A., DuVall, S.L., Dymshyts, D., Fernandez-Bertolin, S., Fister, K., Hardin, J., Hester, L., Hripcsak, G. (G.), Kaas-Hansen, B.S., Kent, S., Khosla, S., Kolovos, S., Lambert, C.G., Lei, J. (Johan) van der, Lynch, K.E., Makadia, R., Margulis, A.V., Matheny, M.E., Mehta, P., Morales, D.R., Morgan-Stewart, H., Mosseveld, M. (Mees), Newby, D., Nyberg, F. (Fredrik), Ostropolets, A., Park, RW, Prats-Uribe, A., Rao, G.A., Reich, C., Reps, J., Rijnbeek, P.R. (Peter), Sathappan, S.M.K., Schuemie, M.J. (Martijn), Seager, S., Sena, A.G., Shoaibi, A., Spotnitz, M., Suchard, M.A. (Marc), Torre, C.O., Vizcaya, D., Wen, H.N., Wilde, M. (Marcel) de, Xie, J.Q., You, S.C., Zhang, L., Zhuk, O., Ryan, P., and Prieto-Alhambra, D.

Abstract

Background Hydroxychloroquine, a drug commonly used in the treatment of rheumatoid arthritis, has received much negative publicity for adverse events associated with its authorisation for emergency use to treat patients with COVID-19 pneumonia. We studied the safety of hydroxychloroquine, alone and in combination with azithromycin, to determine the risk associated with its use in routine care in patients with rheumatoid arthritis. Methods In this multinational, retrospective study, new user cohort studies in patients with rheumatoid arthritis aged 18 years or older and initiating hydroxychloroquine were compared with those initiating sulfasalazine and followed up over 30 days, with 16 severe adverse events studied. Self-controlled case series were done to further establish safety in wider populations, and included all users of hydroxychloroquine regardless of rheumatoid arthritis status or indication. Separately, severe adverse events associated with hydroxychloroquine plus azithromycin (compared with hydroxychloroquine plus amoxicillin) were studied. Data comprised 14 sources of claims data or electronic medical records from Germany, Japan, the Netherlands, Spain, the UK, and the USA. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate calibrated hazard ratios (HRs) according to drug use. Estimates were pooled where the I2 value was less than 0·4. Findings The study included 956 374 users of hydroxychloroquine, 310 350 users of sulfasalazine, 323 122 users of hydroxychloroquine plus azithromycin, and 351 956 users of hydroxychloroquine plus amoxicillin. No excess risk of severe adverse events was identified when 30-day hydroxychloroquine and sulfasalazine use were compared. Self-controlled c

Published
2020
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29. Risk of hydroxychloroquine alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study

Author

Lane, JCE, Weaver, J, Kostka, K, Duarte-Salles, T, Abrahao, MTF, Alghoul, H, Alser, O, Alshammari, TM, Biedermann, P, Banda, JM, Burn, E, Casajust, P, Conover, MM, Culhane, AC, Davydov, A, DuVall, SL, Dymshyts, D, Fernandez-Bertolin, S, Fister, K, Hardin, J, Hester, L, Hripcsak, G, Kaas-Hansen, BS, Kent, S, Khosla, S, Kolovos, S, Lambert, CG, van der Lei, J, Lynch, KE, Makadia, R, Margulis, A, Matheny, ME, Mehta, P, Morales, DR, Morgan-Stewart, H, Mosseveld, M, Newby, D, Nyberg, F, Ostropolets, A, Park, RW, Prats-Uribe, A, Rao, GA, Reich, C, Reps, J, Rijnbeek, P, Sathappan, SMK, Schuemie, M, Seager, S, Sena, AG, Shoaibi, A, Spotnitz, M, Suchard, MA, Torre, CO, Vizcaya, D, Wen, H, de Wilde, M, Xie, J, You, SC, Zhang, L, Zhuk, O, Ryan, P, Prieto-Alhambra, D, Lane, JCE, Weaver, J, Kostka, K, Duarte-Salles, T, Abrahao, MTF, Alghoul, H, Alser, O, Alshammari, TM, Biedermann, P, Banda, JM, Burn, E, Casajust, P, Conover, MM, Culhane, AC, Davydov, A, DuVall, SL, Dymshyts, D, Fernandez-Bertolin, S, Fister, K, Hardin, J, Hester, L, Hripcsak, G, Kaas-Hansen, BS, Kent, S, Khosla, S, Kolovos, S, Lambert, CG, van der Lei, J, Lynch, KE, Makadia, R, Margulis, A, Matheny, ME, Mehta, P, Morales, DR, Morgan-Stewart, H, Mosseveld, M, Newby, D, Nyberg, F, Ostropolets, A, Park, RW, Prats-Uribe, A, Rao, GA, Reich, C, Reps, J, Rijnbeek, P, Sathappan, SMK, Schuemie, M, Seager, S, Sena, AG, Shoaibi, A, Spotnitz, M, Suchard, MA, Torre, CO, Vizcaya, D, Wen, H, de Wilde, M, Xie, J, You, SC, Zhang, L, Zhuk, O, Ryan, P, and Prieto-Alhambra, D

Abstract

BACKGROUND: Hydroxychloroquine, a drug commonly used in the treatment of rheumatoid arthritis, has received much negative publicity for adverse events associated with its authorisation for emergency use to treat patients with COVID-19 pneumonia. We studied the safety of hydroxychloroquine, alone and in combination with azithromycin, to determine the risk associated with its use in routine care in patients with rheumatoid arthritis. METHODS: In this multinational, retrospective study, new user cohort studies in patients with rheumatoid arthritis aged 18 years or older and initiating hydroxychloroquine were compared with those initiating sulfasalazine and followed up over 30 days, with 16 severe adverse events studied. Self-controlled case series were done to further establish safety in wider populations, and included all users of hydroxychloroquine regardless of rheumatoid arthritis status or indication. Separately, severe adverse events associated with hydroxychloroquine plus azithromycin (compared with hydroxychloroquine plus amoxicillin) were studied. Data comprised 14 sources of claims data or electronic medical records from Germany, Japan, the Netherlands, Spain, the UK, and the USA. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate calibrated hazard ratios (HRs) according to drug use. Estimates were pooled where the I 2 value was less than 0·4. FINDINGS: The study included 956 374 users of hydroxychloroquine, 310 350 users of sulfasalazine, 323 122 users of hydroxychloroquine plus azithromycin, and 351 956 users of hydroxychloroquine plus amoxicillin. No excess risk of severe adverse events was identified when 30-day hydroxychloroquine and sulfasalazine use were compared. Self-controlled case series confirmed these findings. However, long-term use of hydroxychloroquine appeared to be associated with increased cardiovascular mortality (calibrated HR 1·65 [95% CI 1·

Published
2020

30. Safety of hydroxychloroquine, alone and in combination with azithromycin, in light of rapid wide-spread use for COVID-19: a multinational, network cohort and self-controlled case series study

Author

C.E.Lane, J, Weaver, J, Kostka, K, Duarte-Salles, T, Abrahao, MT, Alghoul, H, Alser, O, Alshammari, T, Biedermann, P, Burn, E, Casajust, P, Conover, M, Culhane, A, Davydov, A, DuVall, S, Dymshyts, D, Fernandez-Bertolin, S, Fišter, K, Hardin, J, Hester, L, Hripcsak, G, Kent, S, Khosla, S, Kolovos, S, Lambert, C, van der Lei, J, Londhe, A, Lynch, K, Makadia, R, Margulis, A, Matheny, M, Mehta, P, Morales, D, Morgan-Stewart, H, Mosseveld, M, Newby, D, Nyberg, F, Ostropolets, A, Park, RW, Prats-Uribe, A, Rao, G, Reich, C, Reps, J, Rijnbeek, P, Kumaran Sathappan, SM, Schuemie, M, Seager, S, Sena, A, Shoaibi, A, Spotnitz, M, Suchard, M, Swerdel, J, Torre, C, Vizcaya, D, Wen, H, de Wilde, M, You, SC, Zhang, L, Zhuk, O, Ryan, P, Prieto-Alhambra, D, C.E.Lane, J, Weaver, J, Kostka, K, Duarte-Salles, T, Abrahao, MT, Alghoul, H, Alser, O, Alshammari, T, Biedermann, P, Burn, E, Casajust, P, Conover, M, Culhane, A, Davydov, A, DuVall, S, Dymshyts, D, Fernandez-Bertolin, S, Fišter, K, Hardin, J, Hester, L, Hripcsak, G, Kent, S, Khosla, S, Kolovos, S, Lambert, C, van der Lei, J, Londhe, A, Lynch, K, Makadia, R, Margulis, A, Matheny, M, Mehta, P, Morales, D, Morgan-Stewart, H, Mosseveld, M, Newby, D, Nyberg, F, Ostropolets, A, Park, RW, Prats-Uribe, A, Rao, G, Reich, C, Reps, J, Rijnbeek, P, Kumaran Sathappan, SM, Schuemie, M, Seager, S, Sena, A, Shoaibi, A, Spotnitz, M, Suchard, M, Swerdel, J, Torre, C, Vizcaya, D, Wen, H, de Wilde, M, You, SC, Zhang, L, Zhuk, O, Ryan, P, and Prieto-Alhambra, D

Abstract

ABSTRACT

Background

Hydroxychloroquine has recently received Emergency Use Authorization by the FDA and is currently prescribed in combination with azithromycin for COVID-19 pneumonia. We studied the safety of hydroxychloroquine, alone and in combination with azithromycin.

Methods

New user cohort studies were conducted including 16 severe adverse events (SAEs). Rheumatoid arthritis patients aged 18+ and initiating hydroxychloroquine were compared to those initiating sulfasalazine and followed up over 30 days. Self-controlled case series (SCCS) were conducted to further establish safety in wider populations. Separately, SAEs associated with hydroxychloroquine- azithromycin (compared to hydroxychloroquine-amoxicillin) were studied. Data comprised 14 sources of claims data or electronic medical records from Germany, Japan, Netherlands, Spain, UK, and USA. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate calibrated hazard ratios (CalHRs) according to drug use. Estimates were pooled where I2<40%.

Results

Overall, 956,374 and 310,350 users of hydroxychloroquine and sulfasalazine, and 323,122 and 351,956 users of hydroxychloroquine-azithromycin and hydroxychloroquine-amoxicillin were included. No excess risk of SAEs was identified when 30-day hydroxychloroquine and sulfasalazine use were compared. SCCS confirmed these findings. However, when azithromycin was added to hydroxychloroquine, we observed an increased risk of 30-day cardiovascular mortality (CalHR2.19 [1.22- 3.94]), chest pain/angina (CalHR 1.15 [95% CI 1.05-1.26]), and heart failure (CalHR 1.22 [95% CI 1.02- 1.45])

Conclusions

Short-term hydroxychloroquine treatment is safe, but addition of azithromycin may induce heart failure and cardiovascular mortality, potentially due to synergistic effects on QT length. We call for caution if such combination is to be used in the

Published
2020

31. Risk of depression, suicidal ideation, suicide and psychosis with hydroxychloroquine treatment for rheumatoid arthritis: a multi-national network cohort study

Author

Lane, JCE, Weaver, J, Kostka, K, Duarte-Salles, T, Abrahao, MT, Alghoul, H, Alser, O, Alshammari, T, Areia, C, Biedermann, P, Banda, J, Burn, E, Casajust, P, Fišer, K, Hardin, J, Hester, L, Hripcsak, G, Kaas-Hansen, BS, Khosla, S, Kolovos, S, Lynch, K, Makadia, R, Mehta, P, Morales, D, Morgan-Stewart, H, Mosseveld, M, Newby, D, Nyberg, F, Ostropolets, A, Park, RW, Prats-Uribe, A, Rao, G, Reich, C, Rijnbeek, P, Sena, A, Shoaibi, A, Spotnitz, M, Subbian, V, Suchard, M, Vizcaya, D, Wen, H, de Wilde, M, Xie, J, You, SC, Zhang, L, Lovestone, S, Ryan, P, Prieto-Alhambra, D, Lane, JCE, Weaver, J, Kostka, K, Duarte-Salles, T, Abrahao, MT, Alghoul, H, Alser, O, Alshammari, T, Areia, C, Biedermann, P, Banda, J, Burn, E, Casajust, P, Fišer, K, Hardin, J, Hester, L, Hripcsak, G, Kaas-Hansen, BS, Khosla, S, Kolovos, S, Lynch, K, Makadia, R, Mehta, P, Morales, D, Morgan-Stewart, H, Mosseveld, M, Newby, D, Nyberg, F, Ostropolets, A, Park, RW, Prats-Uribe, A, Rao, G, Reich, C, Rijnbeek, P, Sena, A, Shoaibi, A, Spotnitz, M, Subbian, V, Suchard, M, Vizcaya, D, Wen, H, de Wilde, M, Xie, J, You, SC, Zhang, L, Lovestone, S, Ryan, P, and Prieto-Alhambra, D

Abstract

ABSTRACT

Objectives

Concern has been raised in the rheumatological community regarding recent regulatory warnings that hydroxychloroquine used in the COVID-19 pandemic could cause acute psychiatric events. We aimed to study whether there is risk of incident depression, suicidal ideation, or psychosis associated with hydroxychloroquine as used for rheumatoid arthritis (RA).

Methods

New user cohort study using claims and electronic medical records from 10 sources and 3 countries (Germany, UK and US). RA patients aged 18+ and initiating hydroxychloroquine were compared to those initiating sulfasalazine (active comparator) and followed up in the short (30-day) and long term (on treatment). Study outcomes included depression, suicide/suicidal ideation, and hospitalization for psychosis. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate database-specific calibrated hazard ratios (HR), with estimates pooled where I 2 <40%.

Results

918,144 and 290,383 users of hydroxychloroquine and sulfasalazine, respectively, were included. No consistent risk of psychiatric events was observed with short-term hydroxychloroquine (compared to sulfasalazine) use, with meta-analytic HRs of 0.96 [0.79-1.16] for depression, 0.94 [0.49-1.77] for suicide/suicidal ideation, and 1.03 [0.66-1.60] for psychosis. No consistent long-term risk was seen, with meta-analytic HRs 0.94 [0.71-1.26] for depression, 0.77 [0.56-1.07] for suicide/suicidal ideation, and 0.99 [0.72-1.35] for psychosis.

Conclusions

Hydroxychloroquine as used to treat RA does not appear to increase the risk of depression, suicide/suicidal ideation, or psychosis compared to sulfasalazine. No effects were seen in the short or long term. Use at higher dose or for different indications needs further investigation.

TRIAL REGISTRATION

Registered with EU PAS; Reference number EUPAS34497 ( h

Published
2020

32. Effects of salinity on growth and cation accumulation of Sporobolus virginicus (Poaceae)

Author

Bell, Hester L. and O'Leary, James W.

Subjects
Salinity -- Research, Salinity -- Influence, Growth (Plants) -- Research, Grasses -- Research, Grasses -- Physiological aspects, Grasses -- Growth, Botany -- Research, Company growth, Biological sciences
Abstract

Optimal growth of euhalophytes requires moderate concentrations of salt and, in dicotyledons, is associated with succulence and accumulation of [Na.sup.+] in plant tissues. However, reports of salt-stimulated growth in monocotyledons are rare. Relative growth rate (RGR), biomass accumulation, and water content were studied in Sporobolus virginicus (Poaceae), a [C.sub.4] chloridoid grass, grown hydroponically with different concentrations of NaCl. Cation concentrations were determined by atomic absorption spectrophotometry. Optimal growth occurred at 100 150 mmol/L NaCl and was not dependent on nitrogen levels or accompanied by accumulation of [Na.sup.+] in leaves. Biomass accumulation and RGR in plants grown at 450 mmol/L NaCl were greater than in plants grown at 5 mmol/ L. The Na : K ratios were lower in leaves than in roots, indicating discrimination in [Na.sup.+] and [K.sup.+] transport. Secretion of [Na.sup.+] increased from 166.5 to 336.7 mmol * [g.sup.-1] dry biomass * [d.sup.-1] as the NaCl concentration of the nutrient solution increased from 125 mmol/L to 450 mmol/L. Water concentrations of leaves and shoots were significantly greater in plants grown at optimal levels of salinity than in plants grown at lower or higher salinities. These results demonstrate salt-stimulated growth in a monocotyledon. Key words: cation accumulation; chloridoid grasses; halophyte; osmotic adjustment; Na : K ratio; [Na.sup.+] secretion; Poaceae; salt-stimulated growth; Sporobolus virginicus.

Published
2003

33. Contributors

Author

Abercrombie, Diane Dixon, primary, Allison, Linda G., additional, Asprey, David P., additional, Auth, Patrick C., additional, Ballweg, Ruth, additional, Barr, Diana P., additional, Blessing, J. Dennis, additional, Boeve, Wallace D., additional, Brenneman, Anthony, additional, Brown, Darwin, additional, Buck, David R., additional, Buck, Geraldine A., additional, Byers, Tom, additional, Cary, James L., additional, Cary, R. Monty, additional, Chavez, R. Scott, additional, Chitwood, John L., additional, Crouse, Dan, additional, Dale, Linda M., additional, Davis, Ann, additional, Eisenhauer, Walter A., additional, Evans, Timothy C., additional, Gara, Nicole, additional, Gianola, F. J. (Gino), additional, Glicken, Anita Duhl, additional, Goldgar, Constance, additional, Grant, J. Kirkland, additional, Hammond, Jim, additional, Harbert, Kenneth R., additional, Hass, Virginia McCoy, additional, Haverkamp, Ky, additional, Herman, Lawrence, additional, Jones-Hester, L. Jill, additional, Hooker, Roderick S., additional, Johnson, Steven, additional, Jones, Bryanne L., additional, Jones, P. Eugene, additional, Kemle, Kathy A., additional, King, Timothy J., additional, Kohlhepp, William C., additional, Kucera, Kristine J., additional, Kuhns, David H., additional, Lee, Barbara Coombs, additional, Lombardo, Paul, additional, Lurie, H. James, additional, MaHaffy, H. William, additional, Meltzer, Steven, additional, Milton, Mindy G., additional, Morton-Rias, Dawn, additional, Munsell, Debra S., additional, Pedersen, Donald M., additional, Periyakoil, Vyjeyanthi S., additional, Peterson, Martha, additional, Powe, Michael L., additional, Powell, Sharon R., additional, Rackover, Michael A., additional, Rahr, Richard R., additional, Ramos, Maryann, additional, Robinson, Paul S., additional, Simon, Albert, additional, Smith, Anna Mae, additional, Southwick, Lisa K., additional, Statler, P. Michel, additional, Stolberg, Sherry, additional, Stoll, Henry W., additional, Straker, Howard O., additional, Stump, Ernst L., additional, Sullivan, Edward M., additional, Vacala, Mary, additional, Vetrosky, Daniel, additional, Watson, Durward A., additional, WhiteHorse, Emily, additional, Wick, Keren H., additional, Wolpert, Chantelle M., additional, and Yeo, Gwen, additional

Published
2008
Full Text
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38. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study

Author

van Essen, TA, den Boogert, HF, Cnossen, MC, de Ruiter, GCW, Haitsma, I, Polinder, S, Steyerberg, EW, Menon, D, Maas, AIR, Lingsma, HF, Peul, WC, Cecilia, A, Hadie, A, Vanni, A, Judith, A, Krisztina, A, Norberto, A, Nada, A, Lasse, A, Azasevac, A, Audny, A, Anna, A, Hilko, A, Gerard, A, Kaspars, A, Philippe, A, Luisa, AM, Camelia, B, Rafael, B, Ronald, B, Pal, B, Ursula, B, Romuald, B, Ronny, B, Francisco Javier, B, Bo-Michael, B, Antonio, B, Remy, B, Habib, B, Thierry, B, Maurizio, B, Luigi, B, Christopher, B, Federico, B, Harald, B, Erta, B, Morten, B, Hugo, DB, Pierre, B, Peter, B, Alexandra, B, Vibeke, B, Joanne, B, Camilla, B, Andras, B, Monika, B, Emiliana, C, Rosa, CM, Peter, C, Lozano Guillermo, C, Marco, C, Elsa, C, Carpenter, K, Ana M, C-L, Francesco, C, Giorgio, C, Arturo, C, Giuseppe, C, Maryse, C, Mark, C, Jonathan, C, Lizzie, C-K, Johnny, C, Jamie, CD, Marta, C, Amra, C, Nicola, C, Endre, C, Marek, C, Claire, D-F, Francois, D, Pierre, D, Helen, D, Veronique, DK, Francesco, DC, Bart, D, Godard, DRCW, Dula, D, Ding, S, Diederik, D, Abhishek, D, Emma, D, Jens, D, Guy-Loup, D, George, E, Heiko, E, Ari, E, Patrick, E, Erzsebet, E, Martin, F, Valery, FL, Feng, J, Kelly, F, Francesca, F, Gilles, F, Ulderico, F, Shirin, F, Alex, F, Pablo, G, Damien, G, Dashiell, G, Gao, G, Karin, G, Pradeep, G, Alexandre, G, Lelde, G, Benoit, G, Ben, G, Jagos, G, Pedro, GA, Francesca, G, Russell, GL, Deepak, G, Juanita, HA, Iain, H, Jed, HA, Raimund, H, Eirik, H, Daniel, H, Astrid, H, Stefan, H, Lindsay, H, Jilske, H, Peter, HJ, Kristine, HA, Bram, J, Stefan, J, Mike, J, Bojan, J, Jiang, J-Y, Kelly, J, Konstantinos, K, Mladen, K, Ari, K, Maija, K, Thomas, K, Riku, K, Angelos, KG, Balint, K, Erwin, K, Ksenija, K, Daniel, K, Lars-Owe, K, Noemi, K, Alfonso, L, Linda, L, Steven, L, Fiona, L, Christian, L, Rolf, L, Valerie, L, Jin, L, Leon, L, Roger, L, Hester, L, Dirk, L, Angels, L, Andrew, MIR, Stephen, M, Marc, M, Marek, M, Sebastian, M, Alex, M, Geoffrey, M, Didier, M, Francisco, ML, Costanza, M, Armando, M, Hugues, M, Alessandro, M, Julia, M, Charles, M, Catherine, M, Bela, M, David, M, Tomas, M, Cristina, M-K, Davide, M, Visakh, M, Lynnette, M, Holger, M, Nandesh, N, Ancuta, N, David, N, Virginia, N, Daan, N, Quentin, N, Jozsef, N, Mauro, O, Annemarie, O, Matej, O, Fabrizio, O, Aarno, P, Paul, PM, Adriana, P, Jean-Francois, P, Natascha, P, Vincent, P, Paolo, P, PeulWilco, Anna, P-K, Sebastien, PF, Matti, P, Horia, P, Maria Antonia, P, Suzanne, P, Inigo, P, Jussi, P, Louis, P, Andreea, R, Arminas, R, Rahul, R, Malinka, R, Ruben, R, Veronika, R, Jonathan, R, Samuli, R, Saulius, R, Cecilie, R, Olav, R, Gerwin, R, Jeffrey, R, Christina, R, Guy, R, Rolf, R, Sandra, R, Daniel, R, Martin, R, Marco, S, Barbara, S, Juan, S, Oliver, S, Francesca, S, Renan, S-P, Janos, S, Edgar, S, Luminita, S, Davide, S, Nadine, S, Inger, S, Silke, S, Herbert, S, Guus, S, Frederik, SR, Elisabeth, S, Michael, S, Ozcan, S, Toril, S, Lidwien, S, Dirk, S, Peter, S, Abayomi, S, Emmanuel, S, Simon, S, Nicole, S, Ana, S, Robert, S, William, S, Ewout, SW, Nino, S, Nina, S, Anneliese, S, Fabio Silvio, T, Riikka, T, Viktoria, T, Paivi, T, Steven, TM, Braden, TA, Olli, T, Ralph, T, Guido, T, Alice, T, Matt, T, Dick, T, Christos, T, Luaba, TJ-F, Tony, T, Maria, TC, Peter, V, Shirley, V, Egils, V, Gregory, VDS, Mathieu, VDJ, Joukje, VDN, Jeroen, VDTJM, Thomas, VEA, Wim, VH, Caroline, VH, Dominique, VP, Thijs, VV, Julia, VW, Audrey, V, Alessia, V, Emmanuel, V, Kimberley, V, Jan, V, Paul, VM, Anne, V, Rimantas, V, Giacinta, V, Carmen, V-L, Victor, V, Daphne, V, Zoltan, V, Derick, W, Kevin, WKW, Lei, W, Lars, W, Eno, W, Guy, W, Lindsay, W, Maren, WKL, Stefan, W, Peter, Y, Alexander, Y, Menashe, Z, Yang, Z, Agate, Z, Fabrizio, Z, van Essen, TA, den Boogert, HF, Cnossen, MC, de Ruiter, GCW, Haitsma, I, Polinder, S, Steyerberg, EW, Menon, D, Maas, AIR, Lingsma, HF, Peul, WC, Cecilia, A, Hadie, A, Vanni, A, Judith, A, Krisztina, A, Norberto, A, Nada, A, Lasse, A, Azasevac, A, Audny, A, Anna, A, Hilko, A, Gerard, A, Kaspars, A, Philippe, A, Luisa, AM, Camelia, B, Rafael, B, Ronald, B, Pal, B, Ursula, B, Romuald, B, Ronny, B, Francisco Javier, B, Bo-Michael, B, Antonio, B, Remy, B, Habib, B, Thierry, B, Maurizio, B, Luigi, B, Christopher, B, Federico, B, Harald, B, Erta, B, Morten, B, Hugo, DB, Pierre, B, Peter, B, Alexandra, B, Vibeke, B, Joanne, B, Camilla, B, Andras, B, Monika, B, Emiliana, C, Rosa, CM, Peter, C, Lozano Guillermo, C, Marco, C, Elsa, C, Carpenter, K, Ana M, C-L, Francesco, C, Giorgio, C, Arturo, C, Giuseppe, C, Maryse, C, Mark, C, Jonathan, C, Lizzie, C-K, Johnny, C, Jamie, CD, Marta, C, Amra, C, Nicola, C, Endre, C, Marek, C, Claire, D-F, Francois, D, Pierre, D, Helen, D, Veronique, DK, Francesco, DC, Bart, D, Godard, DRCW, Dula, D, Ding, S, Diederik, D, Abhishek, D, Emma, D, Jens, D, Guy-Loup, D, George, E, Heiko, E, Ari, E, Patrick, E, Erzsebet, E, Martin, F, Valery, FL, Feng, J, Kelly, F, Francesca, F, Gilles, F, Ulderico, F, Shirin, F, Alex, F, Pablo, G, Damien, G, Dashiell, G, Gao, G, Karin, G, Pradeep, G, Alexandre, G, Lelde, G, Benoit, G, Ben, G, Jagos, G, Pedro, GA, Francesca, G, Russell, GL, Deepak, G, Juanita, HA, Iain, H, Jed, HA, Raimund, H, Eirik, H, Daniel, H, Astrid, H, Stefan, H, Lindsay, H, Jilske, H, Peter, HJ, Kristine, HA, Bram, J, Stefan, J, Mike, J, Bojan, J, Jiang, J-Y, Kelly, J, Konstantinos, K, Mladen, K, Ari, K, Maija, K, Thomas, K, Riku, K, Angelos, KG, Balint, K, Erwin, K, Ksenija, K, Daniel, K, Lars-Owe, K, Noemi, K, Alfonso, L, Linda, L, Steven, L, Fiona, L, Christian, L, Rolf, L, Valerie, L, Jin, L, Leon, L, Roger, L, Hester, L, Dirk, L, Angels, L, Andrew, MIR, Stephen, M, Marc, M, Marek, M, Sebastian, M, Alex, M, Geoffrey, M, Didier, M, Francisco, ML, Costanza, M, Armando, M, Hugues, M, Alessandro, M, Julia, M, Charles, M, Catherine, M, Bela, M, David, M, Tomas, M, Cristina, M-K, Davide, M, Visakh, M, Lynnette, M, Holger, M, Nandesh, N, Ancuta, N, David, N, Virginia, N, Daan, N, Quentin, N, Jozsef, N, Mauro, O, Annemarie, O, Matej, O, Fabrizio, O, Aarno, P, Paul, PM, Adriana, P, Jean-Francois, P, Natascha, P, Vincent, P, Paolo, P, PeulWilco, Anna, P-K, Sebastien, PF, Matti, P, Horia, P, Maria Antonia, P, Suzanne, P, Inigo, P, Jussi, P, Louis, P, Andreea, R, Arminas, R, Rahul, R, Malinka, R, Ruben, R, Veronika, R, Jonathan, R, Samuli, R, Saulius, R, Cecilie, R, Olav, R, Gerwin, R, Jeffrey, R, Christina, R, Guy, R, Rolf, R, Sandra, R, Daniel, R, Martin, R, Marco, S, Barbara, S, Juan, S, Oliver, S, Francesca, S, Renan, S-P, Janos, S, Edgar, S, Luminita, S, Davide, S, Nadine, S, Inger, S, Silke, S, Herbert, S, Guus, S, Frederik, SR, Elisabeth, S, Michael, S, Ozcan, S, Toril, S, Lidwien, S, Dirk, S, Peter, S, Abayomi, S, Emmanuel, S, Simon, S, Nicole, S, Ana, S, Robert, S, William, S, Ewout, SW, Nino, S, Nina, S, Anneliese, S, Fabio Silvio, T, Riikka, T, Viktoria, T, Paivi, T, Steven, TM, Braden, TA, Olli, T, Ralph, T, Guido, T, Alice, T, Matt, T, Dick, T, Christos, T, Luaba, TJ-F, Tony, T, Maria, TC, Peter, V, Shirley, V, Egils, V, Gregory, VDS, Mathieu, VDJ, Joukje, VDN, Jeroen, VDTJM, Thomas, VEA, Wim, VH, Caroline, VH, Dominique, VP, Thijs, VV, Julia, VW, Audrey, V, Alessia, V, Emmanuel, V, Kimberley, V, Jan, V, Paul, VM, Anne, V, Rimantas, V, Giacinta, V, Carmen, V-L, Victor, V, Daphne, V, Zoltan, V, Derick, W, Kevin, WKW, Lei, W, Lars, W, Eno, W, Guy, W, Lindsay, W, Maren, WKL, Stefan, W, Peter, Y, Alexander, Y, Menashe, Z, Yang, Z, Agate, Z, and Fabrizio, Z

Abstract

BACKGROUND: Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. METHODS: A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). RESULTS: The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. CONCLUSION: Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care.

Published
2019

41. The effect of a low essential fatty acid diet on hibernation in marmots

Author

Florant, G.L., Hester, L., Ameenuddin, S., and Rintoul, D.A.

Subjects
Hibernation -- Physiological aspects, Essential fatty acids -- Physiological aspects, Marmots -- Physiological aspects, Dormancy (Biology) -- Research, Biological sciences
Abstract

The effect of a diet deficient in essential fatty acid (EFA) on hibernation patterns were studied in yellow-bellied marmots. Significantly shorter hibernation periods were noted among EFA-deficient subjects. Results show that EFAs regulate body temperatures during hibernation. However, the observation that animals hibernate despite diets deficient in EFA suggest that EFAs are not requisites to hibernation.

Published
1993

46. Variation in neurosurgical management of traumatic brain injury

Author

van Essen, T.A. (Thomas A.), den Boogert, H.F. (Hugo F.), Cnossen, M.C. (Maryse), De Ruiter, G.C.W. (Godard C.W.), Haitsma, I. (Iain), Polinder, S. (Suzanne), Steyerberg, E.W. (Ewout), Menon, D.K. (David ), Maas, A.I.R. (Andrew), Lingsma, H.F. (Hester), Peul, W.C. (Wilco), Cecilia, A. (Ackerlund), Hadie, A. (Adams), Vanni, A. (Agnoletti), Judith, A. (Allanson), Krisztina, A. (Amrein), Norberto, A. (Andaluz), Nada, A. (Andelic), Lasse, A. (Andreassen), Azasevac, A. (Antun), Audny, A. (Anke), Anna, A. (Antoni), Hilko, A. (Ardon), Gérard, A. (Audibert), Kaspars, A. (Auslands), Philippe, A. (Azouvi), Luisa, A.M. (Azzolini Maria), Camelia, B. (Baciu), Rafael, B. (Badenes), Ronald, B. (Bartels), Pál, B. (Barzó), Ursula, B. (Bauerfeind), Romuald, B. (Beauvais), Ronny, B. (Beer), Javier, B.F. (Belda Francisco), Bo-Michael, B. (Bellander), Antonio, B. (Belli), Rémy, B. (Bellier), Habib, B. (Benali), Thierry, B. (Benard), Maurizio, B. (Berardino), Luigi, B. (Beretta), Christopher, B. (Beynon), Federico, B. (Bilotta), Harald, B. (Binder), Erta, B. (Biqiri), Morten, B. (Blaabjerg), den Hugo, B. (Boogert), Pierre, B. (Bouzat), Peter, B. (Bragge), Alexandra, B. (Brazinova), Vibeke, B. (Brinck), Joanne, B. (Brooker), Camilla, B. (Brorsson), Andras, B. (Buki), Monika, B. (Bullinger), Emiliana, C. (Calappi), Rosa, C.M. (Calvi Maria), Peter, C. (Cameron), Guillermo, C.L. (Carbayo Lozano), Marco, C. (Carbonara), Elsa, C. (Carise), Carpenter, K.L.H. (Keri L.H.), Castaño-León Ana, M. (M.), Francesco, C. (Causin), Giorgio, C. (Chevallard), Arturo, C. (Chieregato), Giuseppe, C. (Citerio), Maryse, C. (Cnossen), Mark, C. (Coburn), Jonathan, C. (Coles), Lizzie, C.-K. (Coles-Kemp), Johnny, C. (Collett), Cooper Jamie, D. (D.), Marta, C. (Correia), Amra, C. (Covic), Nicola, C. (Curry), Endre, C. (Czeiter), Marek, C. (Czosnyka), Claire, D.-F. (Dahyot-Fizelier), François, D. (Damas), Pierre, D. (Damas), Helen, D. (Dawes), Véronique, D.K. (De Keyser), Francesco, D.C. (Della Corte), Bart, D. (Depreitere), de Ruiter Godard, C.W. (C. W.), Dula, D. (Dilvesi), Shenghao, D. (Ding), Diederik, D. (Dippel), Abhishek, D. (Dixit), Emma, D. (Donoghue), Jens, D. (Dreier), Guy-Loup, D. (Dulière), George, E. (Eapen), Heiko, E. (Engemann), Ari, E. (Ercole), Patrick, E. (Esser), Erzsébet, E. (Ezer), Martin, F. (Fabricius), Feigin Valery, L. (L.), Junfeng, F. (Feng), Kelly, F. (Foks), Francesca, F. (Fossi), Gilles, F. (Francony), Ulderico, F. (Freo), Shirin, F. (Frisvold), Alex, F. (Furmanov), Pablo, G. (Gagliardo), Damien, G. (Galanaud), Dashiell, G. (Gantner), Guoyi, G. (Gao), Karin, G. (Geleijns), Pradeep, G. (George), Alexandre, G. (Ghuysen), Lelde, G. (Giga), Benoit, G. (Giraud), Ben, G. (Glocker), Jagos, G. (Golubovic), Gomez Pedro, A. (A.), Francesca, G. (Grossi), Gruen Russell, L. (L.), Deepak, G. (Gupta), Haagsma Juanita, A. (A.), Iain, H. (Haitsma), Hartings Jed, A. (A.), Raimund, H. (Helbok), Eirik, H. (Helseth), Daniel, H. (Hertle), Astrid, H. (Hoedemaekers), Stefan, H. (Hoefer), Lindsay, H. (Horton), Jilske, H. (Huijben), Hutchinson Peter, J. (J.), Kristine, H.A. (Håberg Asta), Bram, J. (Jacobs), Stefan, J. (Jankowski), Mike, J. (Jarrett), Bojan, J. (Jelaca), Ji-yao, J. (Jiang), Kelly, J. (Jones), Konstantinos, K. (Kamnitsas), Mladen, K. (Karan), Ari, K. (Katila), Maija, K. (Kaukonen), Thomas, K. (Kerforne), Riku, K. (Kivisaari), Kolias Angelos, G. (G.), Bálint, K. (Kolumbán), Erwin, K. (Kompanje), Ksenija, K. (Kolundzija), Daniel, K. (Kondziella), Lars-Owe, K. (Koskinen), Noémi, K. (Kovács), Alfonso, L. (Lagares), Linda, L. (Lanyon), Steven, L. (Laureys), Fiona, L. (Lecky), Christian, L. (Ledig), Rolf, L. (Lefering), Valerie, L. (Legrand), Jin, L. (Lei), Leon, L. (Levi), Roger, L. (Lightfoot), Hester, L. (Lingsma), Dirk, L. (Loeckx), Angels, L. (Lozano), Maas Andrew, I.R. (I. R.), Stephen, M.D. (MacDonald), Marc, M. (Maegele), Marek, M. (Majdan), Sebastian, M. (Major), Alex, M. (Manara), Geoffrey, M. (Manley), Didier, M. (Martin), Francisco, M.L. (Martin Leon), Costanza, M. (Martino), Armando, M. (Maruenda), Hugues, M. (Maréchal), Alessandro, M. (Masala), Julia, M. (Mattern), Charles, M.F. (McFadyen), Catherine, M.M. (McMahon), Béla, M. (Melegh), David, M. (Menon), Tomas, M. (Menovsky), Cristina, M.-K. (Morganti-Kossmann), Davide, M. (Mulazzi), Visakh, M. (Muraleedharan), Lynnette, M. (Murray), Holger, M. (Mühlan), Nandesh, N. (Nair), Ancuta, N. (Negru), David, N. (Nelson), Virginia, N. (Newcombe), Daan, N. (Nieboer), Quentin, N. (Noirhomme), József, N. (Nyirádi), Mauro, O. (Oddo), Annemarie, O. (Oldenbeuving), Matej, O. (Oresic), Fabrizio, O. (Ortolano), Aarno, P. (Palotie), Parizel Paul, M. (M.), Adriana, P. (Patruno), Jean-François, P. (Payen), Natascha, P. (Perera), Vincent, P. (Perlbarg), Paolo, P. (Persona), Wilco, P. (Peul), Anna, P.-K. (Piippo-Karjalainen), Sébastien, P.F. (Pili Floury), Matti, P. (Pirinen), Horia, P. (Ples), Antonia, P.M. (Poca Maria), Suzanne, P. (Polinder), Inigo, P. (Pomposo), Jussi, P. (Posti), Louis, P. (Puybasset), Andreea, R. (Radoi), Arminas, R. (Ragauskas), Rahul, R. (Raj), Malinka, R. (Rambadagalla), Ruben, R. (Real), Veronika, R. (Rehorčíková), Jonathan, R. (Rhodes), Samuli, R. (Ripatti), Saulius, R. (Rocka), Cecilie, R. (Roe), Olav, R. (Roise), Gerwin, R. (Roks), Jonathan, R. (Rosand), Jeffrey, R. (Rosenfeld), Christina, R. (Rosenlund), Guy, R. (Rosenthal), Rolf, R. (Rossaint), Sandra, R. (Rossi), Daniel, R. (Rueckert), Martin, R. (Rusnák), Marco, S. (Sacchi), Barbara, S. (Sahakian), Juan, S. (Sahuquillo), Oliver, S. (Sakowitz), Francesca, S. (Sala), Renan, S.-P. (Sanchez-Porras), Janos, S. (Sandor), Edgar, S. (Santos), Luminita, S. (Sasu), Davide, S. (Savo), Nadine, S. (Schäffer), Inger, S. (Schipper), Barbara, S.ß. (Schlößer), Silke, S. (Schmidt), Herbert, S. (Schoechl), Guus, S. (Schoonman), Frederik, S.R. (Schou Rico), Elisabeth, S. (Schwendenwein), Michael, S. (Schöll), Özcan, S. (Sir), Toril, S. (Skandsen), Lidwien, S. (Smakman), Dirk, S. (Smeets), Peter, S. (Smielewski), Abayomi, S. (Sorinola), Emmanuel, S. (Stamatakis), Simon, S. (Stanworth), Nicole, S. (Steinbüchel), Ana, S. (Stevanovic), Robert, S. (Stevens), William, S. (Stewart), Steyerberg Ewout, W. (W.), Nino, S. (Stocchetti), Nina, S. (Sundström), Anneliese, S. (Synnot), Silvio, T.F. (Taccone Fabio), Riikka, T. (Takala), Viktória, T. (Tamás), Päivi, T. (Tanskanen), Steven, T.M. (Taylor Mark), Braden, T.A. (Te Ao), Olli, T. (Tenovuo), Ralph, T. (Telgmann), Guido, T. (Teodorani), Alice, T. (Theadom), Matt, T. (Thomas), Dick, T. (Tibboel), Christos, T. (Tolias), Luaba, T.J.-F. (Tshibanda Jean-Flory), Tony, T. (Trapani), Maria, T.C. (Tudora Cristina), Peter, V. (Vajkoczy), Shirley, V. (Vallance), Egils, V. (Valeinis), der Steen Gregory, V. (Van), van der Mathieu, J. (Jagt), van der Joukje, N. (Naalt), van Dijck Jeroen, T.J.M. (T. J.M.), van Essen Thomas, A. (A.), Wim, V.H. (Van Hecke), van Caroline, H. (Heugten), Dominique, V.P. (Van Praag), Thijs, V.V. (Vande Vyvere), Julia, V.W. (Van Waesberghe), Audrey, V. (Vanhaudenhuyse), Alessia, V. (Vargiolu), Emmanuel, V. (Vega), Kimberley, V. (Velt), Jan, V. (Verheyden), Vespa Paul, M. (M.), Anne, V. (Vik), Rimantas, V. (Vilcinis), Giacinta, V. (Vizzino), Carmen, V.-L. (Vleggeert-Lankamp), Victor, V. (Volovici), Voormolen, D.C. (Daphne), Peter, V. (Vulekovic), Zoltán, V. (Vámos), Derick, W. (Wade), Wang Kevin, K.W. (K. W.), Lei, W. (Wang), Lars, W. (Wessels), Eno, W. (Wildschut), Guy, W. (Williams), Lindsay, W. (Wilson), Winkler Maren, K.L. (K. L.), Stefan, W. (Wolf), Peter, Y. (Ylén), Alexander, Y. (Younsi), Menashe, Z. (Zaaroor), Yang, Z. (Zhihui), Agate, Z. (Ziverte), Fabrizio, Z. (Zumbo), van Essen, T.A. (Thomas A.), den Boogert, H.F. (Hugo F.), Cnossen, M.C. (Maryse), De Ruiter, G.C.W. (Godard C.W.), Haitsma, I. (Iain), Polinder, S. (Suzanne), Steyerberg, E.W. (Ewout), Menon, D.K. (David ), Maas, A.I.R. (Andrew), Lingsma, H.F. (Hester), Peul, W.C. (Wilco), Cecilia, A. (Ackerlund), Hadie, A. (Adams), Vanni, A. (Agnoletti), Judith, A. (Allanson), Krisztina, A. (Amrein), Norberto, A. (Andaluz), Nada, A. (Andelic), Lasse, A. (Andreassen), Azasevac, A. (Antun), Audny, A. (Anke), Anna, A. (Antoni), Hilko, A. (Ardon), Gérard, A. (Audibert), Kaspars, A. (Auslands), Philippe, A. (Azouvi), Luisa, A.M. (Azzolini Maria), Camelia, B. (Baciu), Rafael, B. (Badenes), Ronald, B. (Bartels), Pál, B. (Barzó), Ursula, B. (Bauerfeind), Romuald, B. (Beauvais), Ronny, B. (Beer), Javier, B.F. (Belda Francisco), Bo-Michael, B. (Bellander), Antonio, B. (Belli), Rémy, B. (Bellier), Habib, B. (Benali), Thierry, B. (Benard), Maurizio, B. (Berardino), Luigi, B. (Beretta), Christopher, B. (Beynon), Federico, B. (Bilotta), Harald, B. (Binder), Erta, B. (Biqiri), Morten, B. (Blaabjerg), den Hugo, B. (Boogert), Pierre, B. (Bouzat), Peter, B. (Bragge), Alexandra, B. (Brazinova), Vibeke, B. (Brinck), Joanne, B. (Brooker), Camilla, B. (Brorsson), Andras, B. (Buki), Monika, B. (Bullinger), Emiliana, C. (Calappi), Rosa, C.M. (Calvi Maria), Peter, C. (Cameron), Guillermo, C.L. (Carbayo Lozano), Marco, C. (Carbonara), Elsa, C. (Carise), Carpenter, K.L.H. (Keri L.H.), Castaño-León Ana, M. (M.), Francesco, C. (Causin), Giorgio, C. (Chevallard), Arturo, C. (Chieregato), Giuseppe, C. (Citerio), Maryse, C. (Cnossen), Mark, C. (Coburn), Jonathan, C. (Coles), Lizzie, C.-K. (Coles-Kemp), Johnny, C. (Collett), Cooper Jamie, D. (D.), Marta, C. (Correia), Amra, C. (Covic), Nicola, C. (Curry), Endre, C. (Czeiter), Marek, C. (Czosnyka), Claire, D.-F. (Dahyot-Fizelier), François, D. (Damas), Pierre, D. (Damas), Helen, D. (Dawes), Véronique, D.K. (De Keyser), Francesco, D.C. (Della Corte), Bart, D. (Depreitere), de Ruiter Godard, C.W. (C. W.), Dula, D. (Dilvesi), Shenghao, D. (Ding), Diederik, D. (Dippel), Abhishek, D. (Dixit), Emma, D. (Donoghue), Jens, D. (Dreier), Guy-Loup, D. (Dulière), George, E. (Eapen), Heiko, E. (Engemann), Ari, E. (Ercole), Patrick, E. (Esser), Erzsébet, E. (Ezer), Martin, F. (Fabricius), Feigin Valery, L. (L.), Junfeng, F. (Feng), Kelly, F. (Foks), Francesca, F. (Fossi), Gilles, F. (Francony), Ulderico, F. (Freo), Shirin, F. (Frisvold), Alex, F. (Furmanov), Pablo, G. (Gagliardo), Damien, G. (Galanaud), Dashiell, G. (Gantner), Guoyi, G. (Gao), Karin, G. (Geleijns), Pradeep, G. (George), Alexandre, G. (Ghuysen), Lelde, G. (Giga), Benoit, G. (Giraud), Ben, G. (Glocker), Jagos, G. (Golubovic), Gomez Pedro, A. (A.), Francesca, G. (Grossi), Gruen Russell, L. (L.), Deepak, G. (Gupta), Haagsma Juanita, A. (A.), Iain, H. (Haitsma), Hartings Jed, A. (A.), Raimund, H. (Helbok), Eirik, H. (Helseth), Daniel, H. (Hertle), Astrid, H. (Hoedemaekers), Stefan, H. (Hoefer), Lindsay, H. (Horton), Jilske, H. (Huijben), Hutchinson Peter, J. (J.), Kristine, H.A. (Håberg Asta), Bram, J. (Jacobs), Stefan, J. (Jankowski), Mike, J. (Jarrett), Bojan, J. (Jelaca), Ji-yao, J. (Jiang), Kelly, J. (Jones), Konstantinos, K. (Kamnitsas), Mladen, K. (Karan), Ari, K. (Katila), Maija, K. (Kaukonen), Thomas, K. (Kerforne), Riku, K. (Kivisaari), Kolias Angelos, G. (G.), Bálint, K. (Kolumbán), Erwin, K. (Kompanje), Ksenija, K. (Kolundzija), Daniel, K. (Kondziella), Lars-Owe, K. (Koskinen), Noémi, K. (Kovács), Alfonso, L. (Lagares), Linda, L. (Lanyon), Steven, L. (Laureys), Fiona, L. (Lecky), Christian, L. (Ledig), Rolf, L. (Lefering), Valerie, L. (Legrand), Jin, L. (Lei), Leon, L. (Levi), Roger, L. (Lightfoot), Hester, L. (Lingsma), Dirk, L. (Loeckx), Angels, L. (Lozano), Maas Andrew, I.R. (I. R.), Stephen, M.D. (MacDonald), Marc, M. (Maegele), Marek, M. (Majdan), Sebastian, M. (Major), Alex, M. (Manara), Geoffrey, M. (Manley), Didier, M. (Martin), Francisco, M.L. (Martin Leon), Costanza, M. (Martino), Armando, M. (Maruenda), Hugues, M. (Maréchal), Alessandro, M. (Masala), Julia, M. (Mattern), Charles, M.F. (McFadyen), Catherine, M.M. (McMahon), Béla, M. (Melegh), David, M. (Menon), Tomas, M. (Menovsky), Cristina, M.-K. (Morganti-Kossmann), Davide, M. (Mulazzi), Visakh, M. (Muraleedharan), Lynnette, M. (Murray), Holger, M. (Mühlan), Nandesh, N. (Nair), Ancuta, N. (Negru), David, N. (Nelson), Virginia, N. (Newcombe), Daan, N. (Nieboer), Quentin, N. (Noirhomme), József, N. (Nyirádi), Mauro, O. (Oddo), Annemarie, O. (Oldenbeuving), Matej, O. (Oresic), Fabrizio, O. (Ortolano), Aarno, P. (Palotie), Parizel Paul, M. (M.), Adriana, P. (Patruno), Jean-François, P. (Payen), Natascha, P. (Perera), Vincent, P. (Perlbarg), Paolo, P. (Persona), Wilco, P. (Peul), Anna, P.-K. (Piippo-Karjalainen), Sébastien, P.F. (Pili Floury), Matti, P. (Pirinen), Horia, P. (Ples), Antonia, P.M. (Poca Maria), Suzanne, P. (Polinder), Inigo, P. (Pomposo), Jussi, P. (Posti), Louis, P. (Puybasset), Andreea, R. (Radoi), Arminas, R. (Ragauskas), Rahul, R. (Raj), Malinka, R. (Rambadagalla), Ruben, R. (Real), Veronika, R. (Rehorčíková), Jonathan, R. (Rhodes), Samuli, R. (Ripatti), Saulius, R. (Rocka), Cecilie, R. (Roe), Olav, R. (Roise), Gerwin, R. (Roks), Jonathan, R. (Rosand), Jeffrey, R. (Rosenfeld), Christina, R. (Rosenlund), Guy, R. (Rosenthal), Rolf, R. (Rossaint), Sandra, R. (Rossi), Daniel, R. (Rueckert), Martin, R. (Rusnák), Marco, S. (Sacchi), Barbara, S. (Sahakian), Juan, S. (Sahuquillo), Oliver, S. (Sakowitz), Francesca, S. (Sala), Renan, S.-P. (Sanchez-Porras), Janos, S. (Sandor), Edgar, S. (Santos), Luminita, S. (Sasu), Davide, S. (Savo), Nadine, S. (Schäffer), Inger, S. (Schipper), Barbara, S.ß. (Schlößer), Silke, S. (Schmidt), Herbert, S. (Schoechl), Guus, S. (Schoonman), Frederik, S.R. (Schou Rico), Elisabeth, S. (Schwendenwein), Michael, S. (Schöll), Özcan, S. (Sir), Toril, S. (Skandsen), Lidwien, S. (Smakman), Dirk, S. (Smeets), Peter, S. (Smielewski), Abayomi, S. (Sorinola), Emmanuel, S. (Stamatakis), Simon, S. (Stanworth), Nicole, S. (Steinbüchel), Ana, S. (Stevanovic), Robert, S. (Stevens), William, S. (Stewart), Steyerberg Ewout, W. (W.), Nino, S. (Stocchetti), Nina, S. (Sundström), Anneliese, S. (Synnot), Silvio, T.F. (Taccone Fabio), Riikka, T. (Takala), Viktória, T. (Tamás), Päivi, T. (Tanskanen), Steven, T.M. (Taylor Mark), Braden, T.A. (Te Ao), Olli, T. (Tenovuo), Ralph, T. (Telgmann), Guido, T. (Teodorani), Alice, T. (Theadom), Matt, T. (Thomas), Dick, T. (Tibboel), Christos, T. (Tolias), Luaba, T.J.-F. (Tshibanda Jean-Flory), Tony, T. (Trapani), Maria, T.C. (Tudora Cristina), Peter, V. (Vajkoczy), Shirley, V. (Vallance), Egils, V. (Valeinis), der Steen Gregory, V. (Van), van der Mathieu, J. (Jagt), van der Joukje, N. (Naalt), van Dijck Jeroen, T.J.M. (T. J.M.), van Essen Thomas, A. (A.), Wim, V.H. (Van Hecke), van Caroline, H. (Heugten), Dominique, V.P. (Van Praag), Thijs, V.V. (Vande Vyvere), Julia, V.W. (Van Waesberghe), Audrey, V. (Vanhaudenhuyse), Alessia, V. (Vargiolu), Emmanuel, V. (Vega), Kimberley, V. (Velt), Jan, V. (Verheyden), Vespa Paul, M. (M.), Anne, V. (Vik), Rimantas, V. (Vilcinis), Giacinta, V. (Vizzino), Carmen, V.-L. (Vleggeert-Lankamp), Victor, V. (Volovici), Voormolen, D.C. (Daphne), Peter, V. (Vulekovic), Zoltán, V. (Vámos), Derick, W. (Wade), Wang Kevin, K.W. (K. W.), Lei, W. (Wang), Lars, W. (Wessels), Eno, W. (Wildschut), Guy, W. (Williams), Lindsay, W. (Wilson), Winkler Maren, K.L. (K. L.), Stefan, W. (Wolf), Peter, Y. (Ylén), Alexander, Y. (Younsi), Menashe, Z. (Zaaroor), Yang, Z. (Zhihui), Agate, Z. (Ziverte), and Fabrizio, Z. (Zumbo)

Abstract

Background: Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods: A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results: The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion: Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care.

Published
2018
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47. Comparison of hypersensitivity reactions of intravenous iron: iron isomaltoside-1000 (Monofer

Author

Midas B, Mulder, Hester L, van den Hoek, Erwin, Birnie, Antonie J P, van Tilburg, and Elsbeth M, Westerman

Subjects
Adult, Male, Anemia, Iron-Deficiency, Comorbidity, Original Articles, Middle Aged, Disaccharides, Ferric Compounds, Drug Hypersensitivity, Risk Factors, Hematinics, Humans, Female, Prospective Studies, Infusions, Intravenous, Maltose, Aged, Netherlands
Abstract

AIMS: Intravenous iron supplementation is widely used to treat iron deficiency and iron deficiency anemia when oral iron administration is ineffective or poorly tolerated. Hypersensitivity reactions (HSRs) during infusions are rare, but can be life‐threatening. This study aimed to compare the risk for HSRs with the intravenous administration of iron isomaltoside‐1000 and ferric carboxymaltose for the treatment of iron deficiency and iron deficiency anemia. METHODS: This was a single‐centre cohort study. Nurses and physicians were instructed to fill out an HSR registration form with every administration of intravenous iron. HSRs were distinguished into serious and non‐serious HSRs using the Ring and Messmer classification. RESULTS: HSRs occurred in 18/836 (2.1%) ferric carboxymaltose and 43/496 (8.7%) iron isomaltoside‐1000 administrations. The crude risk for HSRs was 75% lower after ferric carboxymaltose treatment (RR = 0.248, 95% CI: 0.145–0.426, P

Published
2017

48. Kalinia, a New North American Genus for a Species Long Misplaced in Eragrostis (Poaceae, Chloridoideae)

Author

Hester L Bell, Amanda L. Ingram, and J. Travis Columbus

Subjects
biology, Phylogenetic tree, Genus, Botany, Chloridoideae, General Earth and Planetary Sciences, Poaceae, Eragrostis, Internal transcribed spacer, biology.organism_classification, Tribe (biology), Distichlis, General Environmental Science
Abstract

Eragrostis obtusiflora (Poaceae, Chloridoideae), a species distributed from the southwestern United States to central Mexico, has long been recognized for exhibiting morphological and anatomical features atypical of Eragrostis. Phylogenetic analyses of nuclear internal transcribed spacer sequences and plastid sequences demonstrate that E. obtusiflora should be excluded from Eragrostis (Eragrostideae) and instead be placed in Cynodonteae, although its position within this tribe was unresolved. Additional data, including anatomical and micromorphological characters, suggest a close relationship with Distichlis. However, differences in spikelet and rhizome characters prevent its inclusion in Distichlis. Therefore, the species is transferred to a newly described genus, Kalinia, as K. obtusiflora.

Published
2013

49. Evolutionary history of chloridoid grasses estimated from 122 nuclear loci

Author

Amanda E. Fisher, Amanda L. Ingram, Ellen Blaine, Hester L. Bell, J. Travis Columbus, and Kristen M. Hasenstab

Subjects
0106 biological sciences, 0301 basic medicine, Subfamily, Chloroplasts, Lineage (evolution), Biology, Poaceae, 010603 evolutionary biology, 01 natural sciences, DNA sequencing, Coalescent theory, 03 medical and health sciences, Phylogenetics, Phylogenomics, Genetics, Molecular Biology, Ecology, Evolution, Behavior and Systematics, Phylogeny, Cell Nucleus, Phylogenetic tree, Base Sequence, food and beverages, High-Throughput Nucleotide Sequencing, Bayes Theorem, Models, Theoretical, biology.organism_classification, Biological Evolution, 030104 developmental biology, Genetic Loci, Chloridoideae, Databases, Nucleic Acid
Abstract

Chloridoideae (chloridoid grasses) are a subfamily of ca. 1700 species with high diversity in arid habitats. Until now, their evolutionary relationships have primarily been studied with DNA sequences from the chloroplast, a maternally inherited organelle. Next-generation sequencing is able to efficiently recover large numbers of nuclear loci that can then be used to estimate the species phylogeny based upon bi-parentally inherited data. We sought to test our chloroplast-based hypotheses of relationships among chloridoid species with 122 nuclear loci generated through targeted-enrichment next-generation sequencing, sometimes referred to as hyb-seq. We targeted putative single-copy housekeeping genes, as well as genes that have been implicated in traits characteristic of, or particularly labile in, chloridoids: e.g., drought and salt tolerance. We recovered ca. 70% of the targeted loci (122 of 177 loci) in all 47 species sequenced using hyb-seq. We then analyzed the nuclear loci with Bayesian and coalescent methods and the resulting phylogeny resolves relationships between the four chloridoid tribes. Several novel findings with this data were: the sister lineage to Chloridoideae is unresolved; Centropodia + Ellisochloa are excluded from Chloridoideae in phylogenetic estimates using a coalescent model; Sporobolus subtilis is more closely related to Eragrostis than to other species of Sporobolus; and Tragus is more closely related to Chloris and relatives than to a lineage of mainly New World species. Relationships in Cynodonteae in the nuclear phylogeny are quite different from chloroplast estimates, but were not robust to changes in the method of phylogenetic analysis. We tested the data signal with several partition schemes, a concatenation analysis, and tests of alternative hypotheses to assess our confidence in this new, nuclear estimate of evolutionary relationships. Our work provides markers and a framework for additional phylogenetic studies that sample more densely within chloridoid tribes. These results represent progress towards a robust classification of this important subfamily of grasses, as well as proof-of-concept for hyb-seq next-generation sequencing as a method to generate sequences for phylogenetic analyses in grasses and other plant families.

Published
2016

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