87 results on '"Söderholm, M"'
Search Results
2. A-297 - Unlocking Potential in Clinical Practice: A Comprehensive Assessment of an Artificial Intelligence Based Clinical Decision Support System for Cutaneous Melanoma Detection
- Author
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Papachristou, P., Söderholm, M., Pallon, J., Taloyan, M., Polesie, S., Paoli, J., Anderson, C.D., and Falk, M.
- Published
- 2024
- Full Text
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3. Avoimen tieteen suositus sekä tarkistuslista tutkimusorganisaatioiden ja yritysten yhteistyössä tehtävään tutkimus-, kehitys- ja innovaatiotoimintaan (Recommendation for Open Science and Checklist for Research, Development and Innovation Activities Carried Out in Cooperation Between Research Organisations and Companies)
- Author
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Mikkonen, A., Kärki, A., Lattu, A., Puhakka-Tarvainen, H., Lehtivuori, H., Stormi, I., Lahti, L., Söderholm, M., and Päällysaho, S.
- Abstract
Tämä on suositus avoimen tieteen toimintatavan toteuttamiseen suomalaisten tutkimusorganisaatioiden ja yritysten välisessä tutkimus-, kehitys- ja innovaatiotoiminnassa (TKI-toiminnassa). Suosituksessa kerrotaan, miten yritysyhteistyössä syntyviä tutkimustuloksia ja -aineistoja voidaan hyödyntää ja/tai levittää turvallisesti, tehokkaasti sekä mahdollisimman avoimesti. Suositus on kirjoitettu yhteistyössä avoimen tieteen koordinaation, avoimuus yritysyhteistyössä -työryhmän ja suomalaisen tiedeyhteisön sekä elinkeinoelämän kesken.
- Published
- 2022
4. Sex-specific lesion pattern of functional outcomes after stroke.
- Author
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Bonkhoff, AK, Bretzner, M, Hong, S, Schirmer, MD, Cohen, A, Regenhardt, RW, Donahue, KL, Nardin, MJ, Dalca, AV, Giese, A-K, Etherton, MR, Hancock, BL, Mocking, SJT, McIntosh, EC, Attia, J, Benavente, OR, Bevan, S, Cole, JW, Donatti, A, Griessenauer, CJ, Heitsch, L, Holmegaard, L, Jood, K, Jimenez-Conde, J, Kittner, SJ, Lemmens, R, Levi, CR, McDonough, CW, Meschia, JF, Phuah, C-L, Rolfs, A, Ropele, S, Rosand, J, Roquer, J, Rundek, T, Sacco, RL, Schmidt, R, Sharma, P, Slowik, A, Söderholm, M, Sousa, A, Stanne, TM, Strbian, D, Tatlisumak, T, Thijs, V, Vagal, A, Wasselius, J, Woo, D, Zand, R, McArdle, PF, Worrall, BB, Jern, C, Lindgren, AG, Maguire, J, Fox, MD, Bzdok, D, Wu, O, Rost, NS, MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium, Bonkhoff, AK, Bretzner, M, Hong, S, Schirmer, MD, Cohen, A, Regenhardt, RW, Donahue, KL, Nardin, MJ, Dalca, AV, Giese, A-K, Etherton, MR, Hancock, BL, Mocking, SJT, McIntosh, EC, Attia, J, Benavente, OR, Bevan, S, Cole, JW, Donatti, A, Griessenauer, CJ, Heitsch, L, Holmegaard, L, Jood, K, Jimenez-Conde, J, Kittner, SJ, Lemmens, R, Levi, CR, McDonough, CW, Meschia, JF, Phuah, C-L, Rolfs, A, Ropele, S, Rosand, J, Roquer, J, Rundek, T, Sacco, RL, Schmidt, R, Sharma, P, Slowik, A, Söderholm, M, Sousa, A, Stanne, TM, Strbian, D, Tatlisumak, T, Thijs, V, Vagal, A, Wasselius, J, Woo, D, Zand, R, McArdle, PF, Worrall, BB, Jern, C, Lindgren, AG, Maguire, J, Fox, MD, Bzdok, D, Wu, O, Rost, NS, and MRI-GENIE and GISCOME Investigators and the International Stroke Genetics Consortium
- Abstract
Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level.
- Published
- 2022
5. The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
- Author
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Glasbey, Jc, Nepogodiev, D, Battersby, N, Bhangu, A, El-Hussuna, A, Frasson, M, Singh, B, Vennix, S, Zmora, O, Pinkney, T, Chaudhri, S, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Morton, D, Rubbini, M, Vaizey, C, Mehta, S, Ives, N, Magill, L, Perry, R, Sheward, N, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Nachtergaele, M, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, de Buck van Overstraeten, A, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M Jr, Rocha de Moraes, C, Tercioti, V Jr, Arabadjieva, E, Bulanov, D, Dardanov, D, Stoyanov, V, Yonkov, A, Angelov, K, Maslyankov, S, Sokolov, M, Todorov, G, Toshev, S, Georgiev, Y, Karashmalakov, A, Zafirov, G, Wang, X, Condic, D, Kraljik, D, Mrkovic, H, Pavkovic, V, Raguž, K, Bencurik, V, Holášková, E, Skrovina, M, Farkašová, M, Grolich, T, Kala, Z, Antos, F, Pruchova, V, Sotona, O, Chobola, M, Dusek, T, Ferko, A, Örhalmi, J, Hoch, J, Kocian, P, Martinek, L, Bernstein, I, Gotschalck Sunesen, K, Leunbach, J, Thorlacius-Ussing, O, Uth Oveson, A, Dahl Chirstensen, S, Gamez, V, Oeting, M, Schou Loeve, U, Ugianskis, A, Jessen, M, Krarup, P, Linde, K, Mirza, Q, Overgaard Stovring, J, Erritzøe, L, Loft Jakobsen, H, Lykke, J, Palmgren Colov, E, Husted Madsen, A, Linde Friis, T, Amstrup Funder, J, Dich, R, Kjaer, S, Rasmussen, S, Schlesinger, N, Dilling Kjaer, M, Qvist, N, Khalid, A, Ali, G, Hadi, S, Rosell Walker, L, Kivelä, A, Lehtonen, T, Lepistö, A, Scheinin, T, Siironen, P, Kössi, J, Kuusanmäki, P, Tomminen, T, Turunen, A, Rautio, T, Vierimaa, M, Huhtinen, H, Karvonen, J, Lavonius, M, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, Kepenekian, V, Passot, G, Maggiori, L, Manceau, G, Panis, Y, Gout, M, Rullier, E, van Geluwe, B, Chafai, N, Lefevre, Jh, Parc, Y, Tiret, E, Couette, C, Duchalais, E, Agha, A, Hornberger, M, Hungbauer, A, Iesalnieks, I, Weindl, I, Crescenti, F, Keller, M, Kolodziejski, N, Scherer, R, Sterzing, D, Bock, B, Boehm, G, El-Magd, M, Krones, C, Niewiera, M, Buhr, J, Cordesmeyer, S, Hoffmann, M, Krückemeier, K, Vogel, T, Schön, M, Baral, J, Lukoschek, T, Münch, S, Pullig, F, Horisberger, K, Kienle, P, Magdeburg, J, Post, S, Batzalexis, K, Germanos, S, Agalianos, C, Dervenis, C, Gouvas, N, Kanavidis, P, Kottikias, A, Katsoulis, Ie, Korkolis, D, Plataniotis, G, Sakorafas, G, Akrida, I, Argentou, M, Kollatos, C, Lampropoulos, C, Tsochatzis, S, Besznyák, I, Bursics, A, Egyed, T, Papp, G, Svastics, I, Atladottir, J, Möller, P, Sigurdsson, H, Stefánsson, T, Valsdottir, E, Andrews, E, Foley, N, Hechtl, D, Majeed, M, Mccourt, M, Hanly, A, Hyland, J, Martin, S, O'Connell, Pr, Winter, D, Connelly, T, Joyce, W, Wrafter, P, Berkovitz, R, Avital, S, Haj Yahia, I, Hermann, N, Shpitz, B, White, I, Lishtzinsky, Y, Tsherniak, A, Wasserberg, N, Horesh, N, Keler, U, Pery, R, Shapiro, R, Tulchinsky, H, Badran, B, Dayan, K, Iskhakov, A, Lecaros, J, Nabih, N, Angrima, I, Bardini, R, Pizzolato, E, Tonello, M, Arces, F, Balestri, R, Ceccarelli, C, Prosperi, V, Rossi, E, Giannini, I, Vincenti, L, Di Candido, F, Di Iena, M, Guglielmi, A, Caputi-Iambrenghi, O, Marsanic, P, Mellano, A, Muratore, A, Annecchiarico, M, Bencini, L, Amore Bonapasta, S, Coratti, A, Guerra, F, Asteria, Cr, Boccia, L, Gerard, L, Pascariello, A, Manca, G, Marino, F, Casaril, A, Inama, M, Moretto, G, Bacchelli, C, Carvello, M, Mariani, N, Montorsi, M, Spinelli, A, Romairone, E, Scabini, S, Belli, A, Bianco, F, De Franciscis, S, Maria Romano, G, Delrio, P, Pace, U, Rega, D, Sassaroli, C, Scala, D, De Luca, R, Ruggieri, E, Elbetti, C, Garzi, A, Romoli, L, Scatizzi, M, Vannucchi, A, Curletti, G, Durante, V, Galleano, R, Mariani, F, Reggiani, L, Bellomo, R, Infantino, A, Franceschilli, L, Sileri, P, Clementi, I, Coletta, D, La Torre, F, Mingoli, A, Velluti, F, Di Giacomo, A, Fiorot, A, Massani, M, Padoan, L, Ruffolo, C, Caruso, S, Franceschini, F, Laessig, R, Monaci, I, Rontini, M, Annunziata Azienda SM, De Nardi, P, Elmore, U, Lemma, M, Rosati, R, Tamburini, A, De Luca, M, Sartori, A, Benevento, A, Bottini, C, Ferrari, Cc, Pata, F, Tessera, G, Pellino, G, Selvaggi, F, Lanzani, A, Romano, F, Sgroi, G, Steccanella, F, Turati, L, Yamamoto, T, Ancans, G, Gerkis, S, Leja, M, Pcolkins, A, Sivins, A, Latkauskas, T, Lizdenis, P, Saladžinskas, Ž, Švagždys, S, Tamelis, A, Razbadauskas, A, Sokolovas, M, Dulskas, A, Samalavicius, N, Jotautas, V, Mikalauskas, S, Poskus, E, Poskus, T, Strupas, K, Camenzuli, C, Cini, C, Predrag, A, Psaila, J, Spiteri, N, Buskens, C, de Groof EJ, Gooszen, J, Tanis, P, Belgers, E, Davids, P, Furnee, E, Postma, E, Pronk, A, Smakman, N, Clermonts, S, Zimmerman, D, Omloo, J, van der Zaag, E, van Duijvendijk, P, Wassenaar, E, Bruijninckx, M, de Graff, E, Doornebosch, P, Tetteroo, G, Vermaas, M, Iordens, G, Knops, S, Toorenvliet, B, van Westereenen HL, Boerma, E, Coene, P, van der Harst, E, Van Der Pool, A, Raber, M, Melenhorst, J, de Castro, S, Gerhards, M, Arron, M, Bremers, A, de Wilt, H, Ferenschild, F, Yauw, S, Cense, H, Demirkiran, A, Hunfeld, M, Mulder, I, Nonner, J, Swank, H, van Wagensveld, B, Bolmers, M, Briel, J, van Geloven, A, van Rossem, C, Klemann, V, Konsten, J, Leenders, B, Schok, T, Bleeker, W, Gidwani, A, Lawther, R, Loughlin, P, Skelly, B, Spence, R, Brun, M, Helgeland, M, Ignjatovic, D, Øresland, T, Yousefi, P, Flåten Backe, I, Helmer Sjo, O, Nesbakken, A, Tandberg-Eriksen, M, Cais, A, Hallvard Traeland, J, Herikstad, R, Kørner, H, Lauvland, N, Jajtner, D, Kabiesz, W, Rak, M, Gmerek, L, Horbacka, K, Horst, N, Krokowicz, P, Kwiatkowski, A, Pasnik, K, Karcz, P, Romaniszyn, M, Rusek, T, Walega, P, Czarencki, R, Obuszko, Z, Sitarska, M, Wojciech, W, Zawadzki, M, Amado, S, Clara, P, Couceiro, A, Malaquias, R, Rama, N, Almeida, A, Barbosa, E, Cernadas, E, Duarte, A, Silva, P, Costa, S, Martinez Insua, C, Marques, R, Pereira, J, Pereira, C, Sacchetti, M, Carvalho Pinto, B, Jorge Vieira Sousa, P, Oliveira, A, Cardoso, R, Carlos, S, Corte-Real, J, Moniz Pereira, P, Souto, R, Carneiro, C, Marinho, R, Nunes, V, Rocha, R, Sousa, M, Leite, J, Melo, F, Pimentel, J, Ventura, L, Vila Nova, C, Copăescu, C, Bintintan, V, Ciuce, C, Dindelegan, G, Scurtu, R, Seicean, R, Domansky, N, Karachun, A, Moiseenko, A, Pelipas, Y, Petrov, A, Pravosudov, I, Aiupov, R, Akmalov, Y, Parfenov, A, Suleymanov, N, Tarasov, N, Jumabaev, H, Mamedli, Z, Rasulov, A, Aliev, I, Chernikovskiy, I, Kochnev, V, Komyak, K, Smirnov, A, Achkasov, S, Bolikhov, K, Shelygin, Y, Sushkov, O, Zapolskiy, A, Gvozdenovic, M, Jovanovic, D, Lausevic, Z, Cvetković, D, Maravić, M, Milovanovic, B, Stojakovic, N, Tripković, I, Mihajlovic, D, Nestorovic, M, Pecic, V, Petrovic, D, Stanojevic, G, Barisic, G, Dimitrijevic, I, Krivokapic, Z, Markovic, V, Popovic, M, Aleksic, A, Dabic, D, Kostic, I, Milojkovic, A, Perunicic, V, Lukic, D, Petrovic, T, Radovanovic, D, Radovanovic, Z, Cuk, Vm, Cuk, Vv, Kenic, M, Kovacevic, B, Krdzic, I, Korcek, J, Rems, M, Toplak, J, Escarrâ, J, Gil Barrionuevo, M, Golda, T, Kreisler Moreno, E, Zerpa Martin, C, Álvarez Laso, C, Cumplido, P, Padin, H, Baixauli Fons, J, Hernández-Lizoain, J, Martinez-Ortega, P, Molina-Fernández, M, Sánchez-Justicia, C, Antonio Gracia Solanas, J, Córdoba Díaz de Laspra, E, Echazarreta-Gallego, E, Elia-Guedea, M, Ramirez, J, Arredondo Chaves, J, Diez González, P, Elosua, T, Sahagún, J, Turienzo Frade, A, Álvarez Conde, J, Castrillo, E, Diaz Maag, R, Maderuelo, V, Saldarriaga, L, Aldrey Cao, I, Fernández Varela, X, Núñez Fernández, S, Parajó Calvo, A, Villar Álvarez, S, Blesa Sierra, I, Lozano, R, Márquez, M, Porcel, O, Menendez, P, Fernández Hevia, M, Flores Sigüenza, L, Jimenez Toscano, M, Lacy Fortuny, A, Ordoñez Trujillo, J, Espi, A, Garcia-Botello, S, Martín-Arévalo, J, Moro-Valdezate, D, Pla-Martí, V, Blanco-Antona, F, Abrisqueta, J, Ibañez Canovas, N, Lujan Mompean, J, Escolá Ripoll, D, Martinez Gonzalez, S, Parodi, J, Fernández López, A, Ramos Fernández, M, Castellvi Valls, J, Ortiz de Zarate, L, Ribas, R, Sabia, D, Viso, L, Alonso Gonçalves, S, José Gil Egea, M, Pascual Damieta, M, Pera, M, Salvans Ruiz, S, Bernal, J, Landete, F, Ais, G, Etreros, J, Aguiló Lucia, J, Boscá, A, Deusa, S, García Del Caño, J, Viciano, V, García-Armengol, J, Roig, J, Blas, J, Escartin, J, Fatás, J, Fernando, J, Ferrer, R, Arias Pacheco, R, García Flórez, L, Moreno Gijón, M, Otero Díez, J, Solar Garcia, L, Aguilar Teixido, F, Balaguer Ojo, C, Bargallo Berzosa, J, Lamas Moure, S, Enrique Sierra, J, Fermiñán, A, Herrerias, F, Rufas, M, Viñas, J, Codina-Cazador, A, Farrés, R, Gómez, N, Julià, D, Planellas, P, López, J, Luna, A, Maristany, C, Muñoz Duyos, A, Puértolas, N, Alcantara Moral, M, Serra-Aracil, X, Concheiro Coello, P, Gómez, D, Carton, C, Miguel, A, Reoyo Pascual, F, Valero Cerrato, X, Zambrano Muñoz, R, Cervera-Aldama, J, García González, J, Ramos-Prada, J, Santamaría-Olabarrieta, M, Urigüen-Echeverría, A, Coves Alcover, R, Espinosa Soria, J, Fernandez Rodriguez, E, Hernandis Villalba, J, Maturana Ibañez, V, De la Torre Gonzalez, F, Huerga, D, Pérez Viejo, E, Rivera, A, Ruiz Ucar, E, Garcia-Septiem, J, Jiménez, V, Jiménez Miramón, J, Ramons Rodriquez, J, Rodriguez Alvarez, V, Garcea, A, Ponchietti, L, Borda, N, Enriquez-Navascues, J, Saralegui, Y, Febles Molina, G, Nogues, E, Rodríguez Méndez, Á, Roque Castellano, C, Sosa Quesada, Y, Alvarez-Gallego, M, Pascual, I, Rubio-Perez, I, Diaz-San Andrés, B, Tone-Villanueva, F, Alonso, J, Cagigas, C, Castillo, J, Gómez, M, Martín-Parra, J, Mengual Ballester, M, Pellicer Franco, E, Soria Aledo, V, Valero Navarro, G, Caballero Rodríguez, E, Gonzalez De Chaves, P, Hernandez, G, Perez Alvarez, A, Soto Sanchez, A, Cesar Becerra Garcia, F, Guillermo Alonso Roque, J, López Rodríguez Arias, F, Del Valle Ruiz SR, Sánchez De La Villa, G, Compañ, A, García Marín, A, Nofuentes, C, Orts Micó, F, Pérez Auladell, V, Carrasco, M, Duque Perez, C, Gálvez-Pastor, S, Navarro Garcia, I, Sanchez Perez, A, Enjuto, D, Manuel Bujalance, F, Marcelin, N, Pérez, M, Serrano García, R, Cabrera, A, de la Portilla, F, Diaz-Pavon, J, Jimenez-Rodriguez, R, Vazquez-Monchul, J, Daza González, J, Gómez Pérez, R, Rivera Castellano, J, Roldán de la Rua, J, Errasti Alustiza, J, Fernandez, L, Romeo Ramirez, J, Sardon Ramos, J, Cermeño Toral, B, Alias, D, Garcia-Olmo, D, Guadalajara, H, Herreros, M, Pacheco, P, Del Castillo Díez, F, Lima Pinto, F, Martínez Alegre, J, Ortega, I, Picardo Nieto Antonio, A, Caro, A, Escuder, J, Feliu, F, Millan, M, Alos Company, R, Frangi Caregnato, A, Lozoya Trujillo, R, Rodríguez Carrillo, R, Ruiz Carmona, M, Alonso, N, Ambrona Zafra, D, Amilka Ayala Candia, B, Bonnin Pascual, J, Pineño Flores, C, Alcazar Montero, J, Angoso Clavijo, M, Garcia, J, Sanchez Tocino, J, Gómez-Alcazar, C, Costa-Navarro, D, Ferri-Romero, J, Rey-Riveiro, M, Romero-Simó, M, Arencibia, B, Esclapez, P, García-Granero, E, Granero, P, Medina Fernández FJ, Gallardo Herrera AB, Diaz López, C, Navarro Rodriguez, E, Torres Tordera, E, Arenal, J, Citores, M, Marcos, J, Sánchez, J, Tinoco, C, Espin, E, Garcia Granero, A, Jimenez Gomez, L, Sanchez Garcia, J, Vallribera, F, Folkesson, J, Sköldberg, F, Bergman, K, Borgström, E, Frey, J, Silfverberg, A, Söderholm, M, Nygren, J, Segelman, J, Gustafsson, D, Lagerqvist, A, Papp, A, Pelczar, M, Abraham-Nordling, M, Ahlberg, M, Sjovall, A, Tengstrom, J, Hagman, K, Chabok, A, Ezra, E, Nikberg, M, Smedh, K, Tiselius, C, Al-Naimi, N, Dao Duc, M, Meyer, J, Mormont, M, Ris, F, Prevost, G, Villiger, P, Hoffmann, H, Kettelhack, C, Kirchhoff, P, Oertli, D, Weixler, B, Aytac, B, Leventoglu, S, Mentes, B, Yuksel, O, Demirbas, S, Busra Ozkan, B, Selçuk Özbalci, G, Sungurtekin, U, Gülcü, B, Ozturk, E, Yilmazlar, T, Challand, C, Fearnhead, N, Hubbard, R, Kumar, S, Arthur, J, Barben, C, Skaife, P, Slawik, S, Williams, M, Zammit, M, Barker, J, French, J, Sarantitis, I, Slawinski, C, Clifford, R, Eardley, N, Johnson, M, Mcfaul, C, Vimalachandran, D, Allan, S, Bell, A, Oates, E, Shanmugam, V, Brigic, A, Halls, M, Pucher, P, Stubbs, B, Agarwal, T, Chopada, A, Mallappa, S, Pathmarajah, M, Sugden, C, Brown, C, Macdonald, E, Mckay, A, Richards, J, Robertson, A, Kaushal, M, Patel, P, Tezas, S, Touqan, N, Ayaani, S, Marimuthu, K, Piramanayagam, B, Vourvachis, M, Iqbal, N, Korsgen, S, Seretis, C, Shariff, U, Arnold, S, Chan, H, Clark, E, Fernandes, R, Moran, B, Bajwa, A, Mcarthur, D, Cao, K, Cunha, P, Pardoe, H, Quddus, A, Theodoropoulou, K, Bolln, C, Denys, G, Gillespie, M, Manimaran, N, Reidy, J, Malik, Ai, Malik, A, Pitt, J, Aryal, K, El-Hadi, A, Lal, R, Pal, A, Velchuru, V, Oliveira Cunha, M, Thomas, M, Bains, S, Boyle, K, Miller, A, Norwood, M, Yeung, J, Goian, L, Gurjar, S, Saghir, W, Sengupta, N, Stewart-Parker, E, Bailey, S, Khalil, T, Lawes, D, Nikolaou, S, Omar, G, Church, R, Muthiah, B, Garrett, W, Marsh, P, Obeid, N, Chandler, S, Coyne, P, Evans, M, Hunt, L, Lim, J, Oliphant, Z, Papworth, E, Weaver, H, Cuiñas Leon, K, Williams, G, Hernon, J, Kapur, S, Moosvi, R, Shaikh, I, Swafe, L, Aslam, M, Evans, J, Ihedioha, U, Kang, P, Merchant, J, Hompes, R, Middleton, R, Broomfield, A, Crutten-Wood, D, Foster, J, Nash, G, Akhtar, M, Boshnaq, M, Eldesouky, S, Mangam, S, Rabie, M, Ahmed, J, Khan, J, Ming Goh, N, Shamali, A, Stefan, S, Thompson, C, Amin, A, Docherty, J, Lim, M, Walker, K, Watson, A, Hossack, M, Mackenzie, N, Paraoan, M, Alam, N, Daniels, I, Narang, S, Pathak, S, Smart, N, Al-Qaddo, A, Codd, R, Rutka, O, Bronder, C, Crighton, I, Davies, E, Raymond, T, Bookless, L, Griffiths, B, Plusa, S, Carlson, G, Harrison, R, Lees, N, Mason, C, Quayle, J, Branagan, G, Broadhurst, J, Chave, H, Sleight, S, Awad, F, Cruickshank, N, Joy, H, Boereboom, C, Daliya, P, Dhillon, A, Watson, N, Watson, R, Artioukh, D, Gokul, K, Javed, M, Kong, R, Sutton, J, Faiz, O, Jenkins, I, Leo, Ca, Samaranayake, Sf, Warusavitarne, J, Arya, S, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Duff, S, Fatayer, T, Mbuvi, J, Sharma, A, Cornish, J, Davies, L, Harries, R, Morris, C, Torkington, J, Knight, J, Lai, C, Shihab, O, Tzivanakis, A, Hussain, A, Luke, D, Padwick, R, Torrance, A, Tsiamis, A, Dawson, P, Balfour, A, Brady, R, Mander, J, Paterson, H, Chandratreya, N, Chu, H, Cutting, J, Vernon, S, Wai Ho, C, Andreani, S, Patel, H, Warner, M, Yan Qi Tan, J, Iqbal, A, Khan, A, Perrin, K, Raza, A, Tan, S., Glasbey, J. C., Nepogodiev, D., Battersby, N., Bhangu, A., El-Hussuna, A., Frasson, M., Singh, B., Vennix, S., Zmora, O., Pinkney, T., Chaudhri, S., Bemelman, W., Christensen, P., D'Hoore, A., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Mehta, S., Ives, N., Magill, L., Perry, R., Sheward, N., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Salomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Bouckaert, W., Houben, B., Knol, J., Sergeant, G., Vangertruyden, G., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., de Buck van Overstraeten, A., Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., Rocha de Moraes, C., Tercioti, V., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguž, K., Bencurik, V., Holášková, E., Skrovina, M., Farkašová, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Örhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Gotschalck Sunesen, K., Leunbach, J., Thorlacius-Ussing, O., Uth Oveson, A., Dahl Chirstensen, S., Gamez, V., Oeting, M., Schou Loeve, U., Ugianskis, A., Jessen, M., Krarup, P., Linde, K., Mirza, Q., Overgaard Stovring, J., Erritzøe, L., Loft Jakobsen, H., Lykke, J., Palmgren Colov, E., Husted Madsen, A., Linde Friis, T., Kjær, S., Rasmussen, S., Schlesinger, N., Dilling Kjaer, M., Qvist, N., Khalid, A., Ali, G., Hadi, S., Rosell Walker, L., Kivelä, A., Lehtonen, T., Lepistö, A., Scheinin, T., Siironen, P., Kössi, J., Kuusanmäki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., van Geluwe, B., Chafai, N., Lefevre, J. H., Parc, Y., Tiret, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krückemeier, K., Vogel, T., Schön, M., Baral, J., Lukoschek, T., Münch, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., Katsoulis, I. E., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyák, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Möller, P., Sigurdsson, H., Stefánsson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., Mccourt, M., Hanly, A., Hyland, J., Martin, S., O'Connell, P. R., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., Haj Yahia, I., Hermann, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angrima, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., Di Candido, F., Di Iena, M., Guglielmi, A., Caputi-Iambrenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., Amore Bonapasta, S., Coratti, A., Guerra, F., Asteria, C. R., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., De Franciscis, S., Maria Romano, G., Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., De Luca, R., Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., La Torre, F., Mingoli, A., Velluti, F., Di Giacomo, A., Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., De Nardi, P., Elmore, U., Lemma, M., Rosati, R., Tamburini, A., De Luca, M., Sartori, A., Benevento, A., Bottini, C., Ferrari, C. C., Pata, F., Tessera, G., Pellino, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladžinskas, Ž., Švagždys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Buskens, C., de Groof, E. J., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., van der Zaag, E., van Duijvendijk, P., Wassenaar, E., Bruijninckx, M., de Graff, E., Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., van Westereenen, H. L., Boerma, E., Coene, P., van der Harst, E., Van Der Pool, A., Raber, M., Melenhorst, J., de Castro, S., Gerhards, M., Arron, M., Bremers, A., de Wilt, H., Ferenschild, F., Yauw, S., Cense, H., Demirkiran, A., Hunfeld, M., Mulder, I., Nonner, J., Swank, H., van Wagensveld, B., Bolmers, M., Briel, J., van Geloven, A., van Rossem, C., Klemann, V., Konsten, J., Leenders, B., Schok, T., Bleeker, W., Gidwani, A., Lawther, R., Loughlin, P., Skelly, B., Spence, R., Brun, M., Helgeland, M., Ignjatovic, D., Øresland, T., Yousefi, P., Flåten Backe, I., Helmer Sjo, O., Nesbakken, A., Tandberg-Eriksen, M., Cais, A., Hallvard Træland, J., Herikstad, R., Kørner, H., Lauvland, N., Jajtner, D., Kabiesz, W., Rak, M., Gmerek, L., Horbacka, K., Horst, N., Krokowicz, P., Kwiatkowski, A., Pasnik, K., Karcz, P., Romaniszyn, M., Rusek, T., Walega, P., Czarencki, R., Obuszko, Z., Sitarska, M., Wojciech, W., Zawadzki, M., Amado, S., Clara, P., Couceiro, A., Malaquias, R., Rama, N., Almeida, A., Barbosa, E., Cernadas, E., Duarte, A., Silva, P., Costa, S., Martinez Insua, C., Marques, R., Pereira, J., Pereira, C., Sacchetti, M., Carvalho Pinto, B., Jorge Vieira Sousa, P., Oliveira, A., Cardoso, R., Carlos, S., Corte-Real, J., Moniz Pereira, P., Souto, R., Carneiro, C., Marinho, R., Nunes, V., Rocha, R., Sousa, M., Leite, J., Melo, F., Pimentel, J., Ventura, L., Vila Nova, C., Copăescu, C., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Domansky, N., Karachun, A., Moiseenko, A., Pelipas, Y., Petrov, A., Pravosudov, I., Aiupov, R., Akmalov, Y., Parfenov, A., Suleymanov, N., Tarasov, N., Jumabaev, H., Mamedli, Z., Rasulov, A., Aliev, I., Chernikovskiy, I., Kochnev, V., Komyak, K., Smirnov, A., Achkasov, S., Bolikhov, K., Shelygin, Y., Sushkov, O., Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., Cvetković, D., Maravić, M., Milovanovic, B., Stojakovic, N., Tripković, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukic, D., Petrovic, T., Radovanovic, D., Radovanovic, Z., Cuk, V. M., Cuk, V. V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarrâ, J., Gil Barrionuevo, M., Golda, T., Kreisler Moreno, E., Zerpa Martin, C., Álvarez Laso, C., Cumplido, P., Padin, H., Baixauli Fons, J., Hernández-Lizoain, J., Martinez-Ortega, P., Molina-Fernández, M., Sánchez-Justicia, C., Antonio Gracia Solanas, J., Córdoba Díaz de Laspra, E., Echazarreta-Gallego, E., Elia-Guedea, M., Ramirez, J., Arredondo Chaves, J., Diez González, P., Elosua, T., Sahagún, J., Turienzo Frade, A., Álvarez Conde, J., Castrillo, E., Diaz Maag, R., Maderuelo, V., Saldarriaga, L., Aldrey Cao, I., Fernández Varela, X., Núñez Fernández, S., Parajó Calvo, A., Villar Álvarez, S., Blesa Sierra, I., Lozano, R., Márquez, M., Porcel, O., Menendez, P., Fernández Hevia, M., Flores Sigüenza, L., Jimenez Toscano, M., Lacy Fortuny, A., Ordoñez Trujillo, J., Espi, A., Garcia-Botello, S., Martín-Arévalo, J., Moro-Valdezate, D., Pla-Martí, V., Blanco-Antona, F., Abrisqueta, J., Ibañez Canovas, N., Lujan Mompean, J., Escolá Ripoll, D., Martinez Gonzalez, S., Parodi, J., Fernández López, A., Ramos Fernández, M., Castellvi Valls, J., Ortiz de Zarate, L., Ribas, R., Sabia, D., Viso, L., Alonso Gonçalves, S., José Gil Egea, M., Pascual Damieta, M., Pera, M., Salvans Ruiz, S., Bernal, J., Landete, F., Ais, G., Etreros, J., Aguiló Lucia, J., Boscá, A., Deusa, S., García del Caño, J., Viciano, V., García-Armengol, J., Roig, J., Blas, J., Escartin, J., Fatás, J., Fernando, J., Ferrer, R., Arias Pacheco, R., García Flórez, L., Moreno Gijón, M., Otero Díez, J., Solar Garcia, L., Aguilar Teixido, F., Balaguer Ojo, C., Bargallo Berzosa, J., Lamas Moure, S., Enrique Sierra, J., Fermiñán, A., Herrerias, F., Rufas, M., Viñas, J., Codina-Cazador, A., Farrés, R., Gómez, N., Julià, D., Planellas, P., López, J., Luna, A., Maristany, C., Muñoz Duyos, A., Puértolas, N., Alcantara Moral, M., Serra-Aracil, X., Concheiro Coello, P., Gómez, D., Carton, C., Miguel, A., Reoyo Pascual, F., Valero Cerrato, X., Zambrano Muñoz, R., Cervera-Aldama, J., García González, J., Ramos-Prada, J., Santamaría-Olabarrieta, M., Urigüen-Echeverría, A., Coves Alcover, R., Espinosa Soria, J., Fernandez Rodriguez, E., Hernandis Villalba, J., Maturana Ibañez, V., De la Torre Gonzalez, F., Huerga, D., Pérez Viejo, E., Rivera, A., Ruiz Ucar, E., Garcia-Septiem, J., Jiménez, V., Jiménez Miramón, J., Ramons Rodriquez, J., Rodriguez Alvarez, V., Garcea, A., Ponchietti, L., Borda, N., Enriquez-Navascues, J., Saralegui, Y., Febles Molina, G., Nogues, E., Rodríguez Méndez, à ., Roque Castellano, C., Sosa Quesada, Y., Alvarez-Gallego, M., Pascual, I., Rubio-Perez, I., Diaz-San Andrés, B., Tone-Villanueva, F., Alonso, J., Cagigas, C., Castillo, J., Gómez, M., Martín-Parra, J., Mengual Ballester, M., Pellicer Franco, E., Soria Aledo, V., Valero Navarro, G., Caballero Rodríguez, E., Gonzalez De Chaves, P., Hernandez, G., Perez Alvarez, A., Soto Sanchez, A., Cesar Becerra Garcia, F., Guillermo Alonso Roque, J., López Rodríguez Arias, F., Del Valle Ruiz, S. R., Sánchez De La Villa, G., Compañ, A., García Marín, A., Nofuentes, C., Orts Micó, F., Pérez Auladell, V., Carrasco, M., Duque Perez, C., Gálvez-Pastor, S., Navarro Garcia, I., Sanchez Perez, A., Enjuto, D., Manuel Bujalance, F., Marcelin, N., Pérez, M., Serrano García, R., Cabrera, A., de la Portilla, F., Diaz-Pavon, J., Jimenez-Rodriguez, R., Vazquez-Monchul, J., Daza González, J., Gómez Pérez, R., Rivera Castellano, J., Roldán de la Rua, J., Errasti Alustiza, J., Fernandez, L., Romeo Ramirez, J., Sardon Ramos, J., Cermeño Toral, B., Alias, D., Garcia-Olmo, D., Guadalajara, H., Herreros, M., Pacheco, P., del Castillo Díez, F., Lima Pinto, F., Martínez Alegre, J., Ortega, I., Picardo Nieto Antonio, A., Caro, A., Escuder, J., Feliu, F., Millan, M., Alos Company, R., Frangi Caregnato, A., Lozoya Trujillo, R., Rodríguez Carrillo, R., Ruiz Carmona, M., Alonso, N., Ambrona Zafra, D., Amilka Ayala Candia, B., Bonnin Pascual, J., Pineño Flores, C., Alcazar Montero, J., Angoso Clavijo, M., Garcia, J., Sanchez Tocino, J., Gómez-Alcazar, C., Costa-Navarro, D., Ferri-Romero, J., Rey-Riveiro, M., Romero-Simó, M., Arencibia, B., Esclapez, P., García-Granero, E., Granero, P., Medina Fernández, F. J., Gallardo Herrera, A. B., Diaz López, C., Navarro Rodriguez, E., Torres Tordera, E., Arenal, J., Citores, M., Marcos, J., Sánchez, J., Tinoco, C., Espin, E., Garcia Granero, A., Jimenez Gomez, L., Sanchez Garcia, J., Vallribera, F., Folkesson, J., Sköldberg, F., Bergman, K., Borgström, E., Frey, J., Silfverberg, A., Söderholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., Abraham-Nordling, M., Ahlberg, M., Sjovall, A., Tengstrom, J., Hagman, K., Chabok, A., Ezra, E., Nikberg, M., Smedh, K., Tiselius, C., Al-Naimi, N., Dao Duc, M., Meyer, J., Mormont, M., Ris, F., Prevost, G., Villiger, P., Hoffmann, H., Kettelhack, C., Kirchhoff, P., Oertli, D., Weixler, B., Aytac, B., Leventoglu, S., Mentes, B., Yuksel, O., Demirbas, S., Busra Ozkan, B., Selçuk Özbalci, G., Sungurtekin, U., Gülcü, B., Ozturk, E., Yilmazlar, T., Challand, C., Fearnhead, N., Hubbard, R., Kumar, S., Arthur, J., Barben, C., Skaife, P., Slawik, S., Williams, M., Zammit, M., Barker, J., French, J., Sarantitis, I., Slawinski, C., Clifford, R., Eardley, N., Johnson, M., Mcfaul, C., Vimalachandran, D., Allan, S., Bell, A., Oates, E., Shanmugam, V., Brigic, A., Halls, M., Pucher, P., Stubbs, B., Agarwal, T., Chopada, A., Mallappa, S., Pathmarajah, M., Sugden, C., Brown, C., Macdonald, E., Mckay, A., Richards, J., Robertson, A., Kaushal, M., Patel, P., Tezas, S., Touqan, N., Ayaani, S., Marimuthu, K., Piramanayagam, B., Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Chan, H., Clark, E., Fernandes, R., Moran, B., Bajwa, A., Mcarthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., Malik, A. I., Malik, A., Pitt, J., Aryal, K., El-Hadi, A., Lal, R., Pal, A., Velchuru, V., Oliveira Cunha, M., Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., Stewart-Parker, E., Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., Cuiñas Leon, K., Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., Crutten-Wood, D., Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., Ming Goh, N., Shamali, A., Stefan, S., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., Al-Qaddo, A., Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., Leo, C. A., Samaranayake, S. F., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., Wai Ho, C., Andreani, S., Patel, H., Warner, M., Yan Qi Tan, J., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., Meyer, Jérémy, Graduate School, TOBB ETÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, TOBB ETU, Faculty of Medicine, Department of Surgical Sciences, and Demirbaş, Sezai
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Crohn’s disease ,Male ,Leak ,Surgi-cal technique ,anastomotic leak ,Bowel anastomosis ,colorectal cancer ,Crohn's disease ,epidemiology ,international ,oversewn ,stapler ,surgery ,surgical technique ,Colorectal cancer ,medicine.medical_treatment ,030230 surgery ,Colon/surgery ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,0302 clinical medicine ,Epidemiology ,Prospective Studies ,Treatment Failure ,Young adult ,Prospective cohort study ,Colectomy ,Aged, 80 and over ,General Surgery/statistics & numerical data ,Medical Audit ,ddc:617 ,Anastomosis, Surgical ,Gastroenterology ,Middle Aged ,Colorectal Neoplasms/surgery ,Colorectal surgery ,030220 oncology & carcinogenesis ,Female ,Colectomy/adverse effects ,Colorectal Neoplasms ,Anastomotic Leak/etiology ,Adult ,medicine.medical_specialty ,Adolescent ,Colon ,bowel anastomosis ,Colorectal Surgery/statistics & numerical data ,Anastomosis ,NO ,Young Adult ,03 medical and health sciences ,Surgical Stapling ,medicine ,Humans ,Aged ,ta3126 ,business.industry ,Anastomosis, Surgical/adverse effects ,Surgical Stapling/adverse effects ,Bowel anastomosi ,medicine.disease ,Surgery ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,General Surgery ,business ,Colorectal Surgery - Abstract
AIM: There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure.METHOD: Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak.RESULTS: One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04).CONCLUSION: This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.
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- 2018
6. Genetic Predisposition to Mosaic Chromosomal Loss Is Associated With Functional Outcome After Ischemic Stroke.
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Johansson, M, Pedersen, A, Cole, JW, Lagging, C, Lindgren, A, Maguire, JM, Rost, NS, Söderholm, M, Worrall, BB, Stanne, TM, Jern, C, Johansson, M, Pedersen, A, Cole, JW, Lagging, C, Lindgren, A, Maguire, JM, Rost, NS, Söderholm, M, Worrall, BB, Stanne, TM, and Jern, C
- Abstract
Background and Objectives: To test the hypothesis that a predisposition to acquired genetic alterations is associated with ischemic stroke outcome by investigating the association between a polygenic risk score (PRS) for mosaic loss of chromosome Y (mLOY) and outcome in a large international data set. Methods: We used data from the genome-wide association study performed within the Genetics of Ischemic Stroke Functional Outcome network, which included 6,165 patients (3,497 men and 2,668 women) with acute ischemic stroke of mainly European ancestry. We assessed a weighted PRS for mLOY and examined possible associations with the modified Rankin Scale (mRS) score 3 months poststroke in logistic regression models. We investigated the whole study sample as well as men and women separately. Results: Increasing PRS for mLOY was associated with poor functional outcome (mRS score >2) with an odds ratio (OR) of 1.11 (95% confidence interval [CI] 1.03-1.19) per 1 SD increase in the PRS after adjustment for age, sex, ancestry, stroke severity (NIH Stroke Scale), smoking, and diabetes mellitus. In sex-stratified analyses, we found a statistically significant association in women (adjusted OR 1.20, 95% CI 1.08-1.33). In men, the association was in the same direction (adjusted OR 1.04, 95% CI 0.95-1.14), and we observed no significant genotype-sex interaction. Discussion: In this exploratory study, we found associations between genetic variants predisposing to mLOY and stroke outcome. The significant association in women suggests underlying mechanisms related to genomic instability that operate in both sexes. These findings need replication and mechanistic exploration.
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- 2021
7. Outcome after acute ischemic stroke is linked to sex-specific lesion patterns
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Bonkhoff, AK, Schirmer, MD, Bretzner, M, Hong, S, Regenhardt, RW, Brudfors, M, Donahue, KL, Nardin, MJ, Dalca, AV, Giese, A-K, Etherton, MR, Hancock, BL, Mocking, SJT, McIntosh, EC, Attia, J, Benavente, OR, Bevan, S, Cole, JW, Donatti, A, Griessenauer, CJ, Heitsch, L, Holmegaard, L, Jood, K, Jimenez-Conde, J, Kittner, SJ, Lemmens, R, Levi, CR, McDonough, CW, Meschia, JF, Phuah, C-L, Rolfs, A, Ropele, S, Rosand, J, Roquer, J, Rundek, T, Sacco, RL, Schmidt, R, Sharma, P, Slowik, A, Söderholm, M, Sousa, A, Stanne, TM, Strbian, D, Tatlisumak, T, Thijs, V, Vagal, A, Wasselius, J, Woo, D, Zand, R, McArdle, PF, Worrall, BB, Jern, C, Lindgren, AG, Maguire, J, Bzdok, D, Wu, O, Rost, NS, Bonkhoff, AK, Schirmer, MD, Bretzner, M, Hong, S, Regenhardt, RW, Brudfors, M, Donahue, KL, Nardin, MJ, Dalca, AV, Giese, A-K, Etherton, MR, Hancock, BL, Mocking, SJT, McIntosh, EC, Attia, J, Benavente, OR, Bevan, S, Cole, JW, Donatti, A, Griessenauer, CJ, Heitsch, L, Holmegaard, L, Jood, K, Jimenez-Conde, J, Kittner, SJ, Lemmens, R, Levi, CR, McDonough, CW, Meschia, JF, Phuah, C-L, Rolfs, A, Ropele, S, Rosand, J, Roquer, J, Rundek, T, Sacco, RL, Schmidt, R, Sharma, P, Slowik, A, Söderholm, M, Sousa, A, Stanne, TM, Strbian, D, Tatlisumak, T, Thijs, V, Vagal, A, Wasselius, J, Woo, D, Zand, R, McArdle, PF, Worrall, BB, Jern, C, Lindgren, AG, Maguire, J, Bzdok, D, Wu, O, and Rost, NS
- Abstract
Acute ischemic stroke affects men and women differently. In particular, women are often reported to experience higher acute stroke severity than men. We derived a low-dimensional representation of anatomical stroke lesions and designed a Bayesian hierarchical modeling framework tailored to estimate possible sex differences in lesion patterns linked to acute stroke severity (National Institute of Health Stroke Scale). This framework was developed in 555 patients (38% female). Findings were validated in an independent cohort (n = 503, 41% female). Here, we show brain lesions in regions subserving motor and language functions help explain stroke severity in both men and women, however more widespread lesion patterns are relevant in female patients. Higher stroke severity in women, but not men, is associated with left hemisphere lesions in the vicinity of the posterior circulation. Our results suggest there are sex-specific functional cerebral asymmetries that may be important for future investigations of sex-stratified approaches to management of acute ischemic stroke.
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- 2021
8. Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate
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Dich Grandt, S, El-Hussuna, A, Frasson, M, Singh, B, Gallo, G, Pata, F, Negoi, I, Pinkney, T, Zmora, O, Bhangu, A, Battersby, N, Chaudhri, S, Nepogodiev, D, Vennix, S, Glasbey, J, Minaya, A, Basso, L, Pukuotukai, M, Kelly, Me, Sánchez Guillén, L, Pellino, G, Buchs, N, Morton, D, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Rubbini, M, Vaizey, C, Magill, L, Perry, R, Sheward, N, Mortensen, Rn, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, de Buck van Overstraeten, A, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M Jr, Rocha de Moraes, C, Tercioti, V Jr, Arabadjieva, E, Bulanov, D, Dardanov, D, Stoyanov, V, Yonkov, A, Angelov, K, Maslyankov, S, Sokolov, M, Todorov, G, Toshev, S, Georgiev, Y, Karashmalakov, A, Zafirov, G, Wang, X, Condic, D, Kraljik, D, Mrkovic, H, Pavkovic, V, Raguž, K, Bencurik, V, Holášková, E, Skrovina, M, Farkašová, M, Grolich, T, Kala, Z, Antos, F, Pruchova, V, Sotona, O, Chobola, M, Dusek, T, Ferko, A, Örhalmi, J, Hoch, J, Kocian, P, Martinek, L, Bernstein, I, Gotschalck Sunesen, K, Leunbach, J, Thorlacius-Ussing, O, Uth Oveson, A, Dahl Chirstensen, S, Gamez, V, Oeting, M, Schou Loeve, U, Ugianskis, A, Jessen, M, Krarup, Pm, Linde, K, Mirza, Q, Overgaard Stovring, J, Erritzøe, L, Loft Jakobsen, H, Lykke, J, Palmgren Colov, E, Husted Madsen, A, Linde Friis, T, Amstrup Funder, J, Dich, R, Kjær, S, Rasmussen, S, Schlesinger, N, Dilling Kjaer, M, Qvist, N, Khalid, A, Ali, G, Hadi, S, Rosell Walker, L, Kivelä, A, Lehtonen, T, Lepistö, A, Scheinin, T, Siironen, P, Kössi, J, Kuusanmäki, P, Tomminen, T, Turunen, A, Rautio, T, Vierimaa, M, Huhtinen, H, Karvonen, J, Lavonius, M, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, Kepenekian, V, Passot, G, Maggiori, L, Manceau, G, Panis, Y, Gout, M, Rullier, E, van Geluwe, B, Chafai, N, Lefevre, Jh, Parc, Y, Tiret, E, Couette, C, Duchalais, E, Agha, A, Hornberger, M, Hungbauer, A, Iesalnieks, I, Weindl, I, Crescenti, F, Keller, M, Kolodziejski, N, Scherer, R, Sterzing, D, Bock, B, Boehm, G, El-Magd, M, Krones, C, Niewiera, M, Buhr, J, Cordesmeyer, S, Hoffmann, M, Krückemeier, K, Vogel, T, Schön, M, Baral, J, Lukoschek, T, Münch, S, Pullig, F, Horisberger, K, Kienle, P, Magdeburg, J, Post, S, Batzalexis, K, Germanos, S, Agalianos, C, Dervenis, C, Gouvas, N, Kanavidis, P, Kottikias, A, Katsoulis, Ie, Korkolis, D, Plataniotis, G, Sakorafas, G, Akrida, I, Argentou, M, Kollatos, C, Lampropoulos, C, Tsochatzis, S, Besznyák, I, Bursics, A, Egyed, T, Papp, G, Svastics, I, Atladottir, J, Möller, P, Sigurdsson, H, Stefánsson, T, Valsdottir, E, Andrews, E, Foley, N, Hechtl, D, Majeed, M, Mccourt, M, Hanly, A, Hyland, J, Martin, S, O'Connell, Pr, Winter, D, Connelly, T, Joyce, W, Wrafter, P, Berkovitz, R, Avital, S, Haj Yahia, I, Hermann, N, Shpitz, B, White, I, Lishtzinsky, Y, Tsherniak, A, Wasserberg, N, Horesh, N, Keler, U, Pery, R, Shapiro, R, Tulchinsky, H, Badran, B, Dayan, K, Iskhakov, A, Lecaros, J, Nabih, N, Angrima, I, Bardini, R, Pizzolato, E, Tonello, M, Arces, F, Balestri, R, Ceccarelli, C, Prosperi, V, Rossi, E, Giannini, I, Vincenti, L, Di Candido, F, Di Iena, M, Guglielmi, A, Caputi-Iambrenghi, O, Marsanic, P, Mellano, A, Muratore, A, Annecchiarico, M, Bencini, L, Amore Bonapasta, S, Coratti, A, Guerra, F, Asteria, Cr, Boccia, L, Gerard, L, Pascariello, A, Manca, G, Marino, F, Casaril, A, Inama, M, Moretto, G, Bacchelli, C, Carvello, M, Mariani, N, Montorsi, M, Spinelli, A, Romairone, E, Scabini, S, Belli, A, Bianco, F, De Franciscis, S, Maria Romano, G, Delrio, P, Pace, U, Rega, D, Sassaroli, C, Scala, D, De Luca, R, Ruggieri, E, Elbetti, C, Garzi, A, Romoli, L, Scatizzi, M, Vannucchi, A, Curletti, G, Durante, V, Galleano, R, Mariani, F, Reggiani, L, Bellomo, R, Infantino, A, Franceschilli, L, Sileri, P, Clementi, I, Coletta, D, La Torre, F, Mingoli, A, Velluti, F, Di Giacomo, A, Fiorot, A, Massani, M, Padoan, L, Ruffolo, C, Caruso, S, Franceschini, F, Laessig, R, Monaci, I, Rontini, M, De Nardi, P, Elmore, U, Lemma, M, Rosati, R, Tamburini, A, De Luca, M, Sartori, A, Benevento, A, Bottini, C, Ferrari, Cc, Tessera, G, Selvaggi, F, Lanzani, A, Romano, F, Sgroi, G, Steccanella, F, Turati, L, Yamamoto, T, Ancans, G, Gerkis, S, Leja, M, Pcolkins, A, Sivins, A, Latkauskas, T, Lizdenis, P, Saladžinskas, Ž, Švagždys, S, Tamelis, A, Razbadauskas, A, Sokolovas, M, Dulskas, A, Samalavicius, N, Jotautas, V, Mikalauskas, S, Poskus, E, Poskus, T, Strupas, K, Camenzuli, C, Cini, C, Predrag, A, Psaila, J, Spiteri, N, Buskens, C, de Groof EJ, Gooszen, J, Tanis, P, Belgers, E, Davids, P, Furnee, E, Postma, E, Pronk, A, Smakman, N, Clermonts, S, Zimmerman, D, Omloo, J, van der Zaag, E, van Duijvendijk, P, Wassenaar, E, Bruijninckx, M, de Graff, E, Doornebosch, P, Tetteroo, G, Vermaas, M, Iordens, G, Knops, S, Toorenvliet, B, van Westereenen HL, Boerma, E, Coene, P, van der Harst, E, Van Der Pool, A, Raber, M, Melenhorst, J, de Castro, S, Gerhards, M, Arron, M, Bremers, A, de Wilt, H, Ferenschild, F, Yauw, S, Cense, H, Demirkiran, A, Hunfeld, M, Mulder, I, Nonner, J, Swank, H, van Wagensveld, B, Bolmers, M, Briel, J, van Geloven, A, Echazarreta-Gallego, E, Elia-Guedea, M, Ramirez, J, van Rossem, C, Klemann, V, Konsten, J, Leenders, B, Schok, T, Bleeker, W, Gidwani, A, Lawther, R, Loughlin, P, Skelly, B, Spence, R, Brun, M, Helgeland, M, Ignjatovic, D, Øresland, T, Yousefi, P, Flåten Backe, I, Helmer Sjo, O, Nesbakken, A, Tandberg Eriksen, M, Cais, A, Hallvard Træland, J, Herikstad, R, Kørner, H, Lauvland, N, Jajtner, D, Kabiesz, W, Rak, M, Gmerek, L, Horbacka, K, Horst, N, Krokowicz, P, Kwiatkowski, A, Pasnik, K, Karcz, P, Romaniszyn, M, Rusek, T, Walega, P, Czarencki, R, Obuszko, Z, Sitarska, M, Wojciech, W, Zawadzki, M, Amado, S, Clara, P, Couceiro, A, Malaquias, R, Rama, N, Almeida, A, Barbosa, E, Cernadas, E, Duarte, A, Silva, P, Costa, S, Martinez Insua, C, Pereira, J, Pereira, C, Sacchetti, M, Carvalho Pinto, B, Jorge Vieira Sousa, P, Marques, R, Oliveira, A, Cardoso, R, Carlos, S, Corte-Real, J, Moniz Pereira, P, Souto, R, Carneiro, C, Marinho, R, Nunes, V, Rocha, R, Sousa, M, Leite, J, Melo, F, Pimentel, J, Ventura, L, Vila Nova, C, Copăescu, C, Bintintan, V, Ciuce, C, Dindelegan, G, Scurtu, R, Seicean, R, Domansky, N, Karachun, A, Moiseenko, A, Pelipas, Y, Petrov, A, Pravosudov, I, Aiupov, R, Akmalov, Y, Parfenov, A, Suleymanov, N, Tarasov, N, Jumabaev, H, Mamedli, Z, Rasulov, A, Aliev, I, Chernikovskiy, I, Kochnev, V, Komyak, K, Smirnov, A, Achkasov, S, Bolikhov, K, Shelygin, Y, Sushkov, O, Zapolskiy, A, Gvozdenovic, M, Jovanovic, D, Lausevic, Z, Cvetković, D, Maravić, M, Milovanovic, B, Stojakovic, N, Tripković, I, Mihajlovic, D, Nestorovic, M, Pecic, V, Petrovic, D, Stanojevic, G, Barisic, G, Dimitrijevic, I, Krivokapic, Z, Markovic, V, Popovic, M, Aleksic, A, Dabic, D, Kostic, I, Milojkovic, A, Perunicic, V, Lukic, D, Petrovic, T, Radovanovic, D, Radovanovic, Z, Cuk, Vm, Cuk, Vv, Kenic, M, Kovacevic, B, Krdzic, I, Korcek, J, Rems, M, Toplak, J, Escarrâ, J, Gil Barrionuevo, M, Golda, T, Kreisler Moreno, E, Zerpa Martin, C, Álvarez Laso, C, Cumplido, P, Padin, H, Baixauli Fons, J, Hernández Lizoain, J, Martinez Ortega, P, Molina Fernández, M, Sánchez Justicia, C, Antonio Gracia Solanas, J, Córdoba Díaz de Laspra, E, Arredondo Chaves, J, Diez González, P, Elosua, T, Sahagún, J, Turienzo Frade, A, Álvarez Conde, J, Castrillo, E, Diaz Maag, R, Maderuelo, V, Saldarriaga, L, Aldrey Cao, I, Fernández Varela, X, Núñez Fernández, S, Parajó Calvo, A, Villar Álvarez, S, Blesa Sierra, I, Lozano, R, Márquez, M, Porcel, O, Menendez, P, Fernández Hevia, M, Flores Sigüenza, L, Jimenez Toscano, M, Lacy Fortuny, A, Ordoñez, J, Espi, A, Garcia Botello, S, Martín Arévalo, J, Moro Valdezate, D, Pla, M, Blanco Antona, F, Abrisqueta, J, Ibañez Canovas, N, Lujan Mompean, J, Escolá Ripoll, D, Martinez Gonzalez, S, Parodi, J, Fernández López, A, Ramos Fernández, M, Castellvi Valls, J, Ortiz de Zarate, L, Ribas, R, Sabia, D, Viso, L, Alonso Gonçalves, S, José Gil, M, Pascual Damieta, M, Pera, M, Salvans Ruiz, S, Bernal, J, Landete, F, Ais, G, Etreros, J, Aguiló Lucia, J, Boscá, A, Deusa, S, García Del Caño, J, Viciano, V, García Armengol, J, Roig, J, Blas, J, Escartin, J, Fatás, J, Fernando, J, Ferrer, R, Arias Pacheco, R, García Flórez, L, Moreno Gijón, M, Otero Díez, J, Solar Garcia, L, Aguilar Teixido, F, Balaguer Ojo, C, Bargallo Berzosa, J, Lamas Moure, S, Enrique Sierra, J, Fermiñán, A, Herrerias, F, Rufas, M, Viñas, J, Codina Cazador, A, Farrés, R, Gómez, N, Julià, D, Planellas, P, López, J, Luna, A, Maristany, C, Muñoz Duyos, A, Puértolas, N, Alcantara Moral, M, Serra Aracil, X, Concheiro Coello, P, Gómez, D, Carton, C, Miguel, A, Reoyo Pascual, F, Valero Cerrato, X, Zambrano Muñoz, R, Cervera Aldama, J, García González, J, Ramos Prada, J, Santamaría Olabarrieta, M, Urigüen Echeverría, A, Coves Alcover, R, Espinosa Soria, J, Fernandez Rodriguez, E, Hernandis Villalba, J, Maturana Ibañez, V, De la Torre Gonzalez, F, Huerga, D, Pérez Viejo, E, Rivera, A, Ruiz Ucar, E, Garcia Septiem, J, Jiménez, V, Jiménez Miramón, J, Ramons Rodriquez, J, Rodriguez Alvarez, V, Garcea, A, Ponchietti, L, Borda, N, Enriquez Navascues, J, Saralegui, Y, Febles Molina, G, Nogues, E, Rodríguez, M, Roque Castellano, C, Sosa Quesada, Y, Alvarez Gallego, M, Pascual, I, Rubio Perez, I, Diaz San Andrés, B, Tone Villanueva, F, Alonso, J, Cagigas, C, Castillo, J, Gómez, M, Martín Parra, J, Mengual Ballester, M, Pellicer Franco, E, Soria Aledo, V, Valero Navarro, G, Caballero Rodríguez, E, Gonzalez De Chaves, P, Hernandez, G, Perez Alvarez, A, Soto Sanchez, A, Cesar Becerra Garcia, F, Guillermo Alonso Roque, J, López, R, Arias, F, Del Valle Ruiz SR, Sánchez De La Villa, G, Compañ, A, García Marín, A, Nofuentes, C, Orts, M, Pérez Auladell, V, Carrasco, M, Duque Perez, C, Gálvez Pastor, S, Navarro Garcia, I, Sanchez Perez, A, Enjuto, D, Manuel Bujalance, F, Marcelin, N, Pérez, M, Serrano García, R, Cabrera, A, de la Portilla, F, Diaz Pavon, J, Jimenez Rodriguez, R, Vazquez Monchul, J, Martínez Alegre, J, Ortega, I, Picardo Nieto Antonio, A, Caro, A, Escuder, J, Feliu, F, Millan, M, Alos Company, R, Frangi Caregnato, A, Lozoya Trujillo, R, Rodríguez Carrillo, R, Ruiz Carmona, M, Alonso, N, Ambrona Zafra, D, Amilka Ayala, B, Bonnin Pascual CJ, Pineño Flores, C, Alcazar Montero, J, Angoso Clavijo, M, Garcia, J, Sanchez Tocino, J, Gómez Alcazar, C, Costa Navarro, D, Ferri Romero, J, Rey Riveiro, M, Romero Simó, M, Arencibia, B, Esclapez, P, García Granero, E, Granero, P, Medina Fernández FJ, Gallardo Herrera AB, Diaz López, C, Navarro Rodriguez, E, Torres Tordera, E, Arenal, J, Citores, M, Marcos, J, Sánchez, J, Tinoco, C, Espin, E, Garcia Granero, A, Jimenez Gomez, L, Sanchez Garcia, J, Vallribera, F, Folkesson, J, Sköldberg, F, Bergman, K, Borgström, E, Frey, J, Silfverberg, A, Söderholm, M, Nygren, J, Segelman, J, Gustafsson, D, Lagerqvist, A, Papp, A, Pelczar, M, Abraham Nordling, M, Ahlberg, M, Sjovall, A, Tengstrom, J, Hagman, K, Chabok, A, Ezra, E, Nikberg, M, Smedh, K, Tiselius, C, Al Naimi, N, Dao Duc, M, Meyer, J, Mormont, M, Ris, F, Prevost, G, Villiger, P, Hoffmann, H, Kettelhack, C, Kirchhoff, P, Oertli, D, Weixler, B, Aytac, B, Leventoglu, S, Mentes, B, Yuksel, O, Demirbas, S, Busra Ozkan, B, Selçuk Özbalci, G, Sungurtekin, U, Gülcü, B, Ozturk, E, Yilmazlar, T, Challand, C, Fearnhead, N, Hubbard, R, Kumar, S, Arthur, J, Barben, C, Skaife, P, Slawik, S, Williams, M, Zammit, M, Barker, J, French, J, Sarantitis, I, Slawinski, C, Clifford, R, Eardley, N, Johnson, M, Mcfaul, C, Vimalachandran, D, Allan, S, Bell, A, Oates, E, 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P, Oertli, D, Weixler, B, Aytac, B, Leventoglu, S, Mentes, B, Yuksel, O, Demirbas, S, Busra Ozkan, B, Selçuk Özbalci, G, Sungurtekin, U, Gülcü, B, Ozturk, E, Yilmazlar, T, Challand, C, Fearnhead, N, Hubbard, R, Kumar, S, Arthur, J, Barben, C, Skaife, P, Slawik, S, Williams, M, Zammit, M, Barker, J, French, J, Sarantitis, I, Slawinski, C, Clifford, R, Eardley, N, Johnson, M, Mcfaul, C, Vimalachandran, D, Allan, S, Bell, A, Oates, E, Shanmugam, V, Brigic, A, Halls, M, Pucher, P, Stubbs, B, Agarwal, T, Chopada, A, Mallappa, S, Pathmarajah, M, Sugden, C, Brown, C, Macdonald, E, Mckay, A, Richards, J, Robertson, A, Kaushal, M, Patel, P, Tezas, S, Touqan, N, Ayaani, S, Marimuthu, K, Piramanayagam, B, Vourvachis, M, Iqbal, N, Korsgen, S, Seretis, C, Shariff, U, Arnold, S, Chan, H, Clark, E, Fernandes, R, Moran, B, Bajwa, A, Mcarthur, D, Cao, K, Cunha, P, Pardoe, H, Quddus, A, Theodoropoulou, K, Bolln, C, Denys, G, Gillespie, M, Manimaran, N, Reidy, J, Malik, Ai, Malik, A, Pitt, J, Aryal, K, El Hadi, A, Lal, R, Pal, A, Velchuru, V, Oliveira Cunha, M, Thomas, M, Bains, S, Boyle, K, Miller, A, Norwood, M, Yeung, J, Goian, L, Gurjar, S, Saghir, W, Sengupta, N, Stewart Parker, E, Bailey, S, Khalil, T, Lawes, D, Nikolaou, S, Omar, G, Church, R, Muthiah, B, Garrett, W, Marsh, P, Obeid, N, Chandler, S, Coyne, P, Evans, M, Hunt, L, Lim, J, Oliphant, Z, Papworth, E, Weaver, H, Cuiñas Leon, K, Williams, G, Hernon, J, Kapur, S, Moosvi, R, Shaikh, I, Swafe, L, Aslam, M, Evans, J, Ihedioha, U, Kang, P, Merchant, J, Hompes, R, Middleton, R, Broomfield, A, Crutten Wood, D, Foster, J, Nash, G, Akhtar, M, Boshnaq, M, Eldesouky, S, Mangam, S, Rabie, M, Ahmed, J, Khan, J, Ming Goh, N, Shamali, A, Stefan, S, Thompson, C, Amin, A, Docherty, J, Lim, M, Walker, K, Watson, A, Hossack, M, Mackenzie, N, Paraoan, M, Alam, N, Daniels, I, Narang, S, Pathak, S, Smart, N, Al Qaddo, A, Codd, R, Rutka, O, Bronder, C, Crighton, I, Davies, E, Raymond, T, Bookless, L, Griffiths, B, Plusa, S, Carlson, G, Harrison, R, Lees, N, Mason, C, Quayle, J, Branagan, G, Broadhurst, J, Chave, H, Sleight, S, Awad, F, Cruickshank, N, Joy, H, Boereboom, C, Daliya, P, Dhillon, A, Watson, N, Watson, R, Artioukh, D, Gokul, K, Javed, M, Kong, R, Sutton, J, Faiz, O, Jenkins, I, Leo, Ca, Samaranayake, Sf, Warusavitarne, J, Arya, S, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Duff, S, Fatayer, T, Mbuvi, J, Sharma, A, Cornish, J, Davies, L, Harries, R, Morris, C, Torkington, J, Knight, J, Lai, C, Shihab, O, Tzivanakis, A, Hussain, A, Luke, D, Padwick, R, Torrance, A, Tsiamis, A, Dawson, P, Balfour, A, Brady, R, Mander, J, Paterson, H, Chandratreya, N, Chu, H, Cutting, J, Vernon, S, Wai Ho, C, Andreani, S, Patel, H, Warner, M, Tan, Yq, Iqbal, A, Khan, A, Perrin, K, Raza, A, and S Tan, And
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Crohn’s disease ,medicine.medical_specialty ,Complications ,Colorectal cancer ,SURGERY ,medicine.medical_treatment ,Bowel resection ,Disease ,Inflammatory bowel disease ,NO ,COLORECTAL-CANCER ,03 medical and health sciences ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,MORBIDITY ,0302 clinical medicine ,Medicine ,Crohn’s disease, Colon cancer, Complications, Length of stay, Bowel resection, Right hemicolectomy ,DIVERTICULAR-DISEASE ,Colon cancer ,Length of stay ,Right hemicolectomy ,colon cancer ,complications ,length of stay ,bowel resection ,right hemicolectomy ,PREOPERATIVE OPTIMIZATION ,RISK ,Crohn's disease ,ddc:617 ,business.industry ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,digestive system diseases ,Surgery ,030220 oncology & carcinogenesis ,3121 General medicine, internal medicine and other clinical medicine ,Diverticular disease ,Prospective Study ,030211 gastroenterology & hepatology ,SMOKING ,business ,Complication ,Hospital stay ,INFLAMMATORY-BOWEL-DISEASE - Abstract
BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.
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- 2019
9. Predictors for Anastomotic Leak, Postoperative Complications, and Mortality After Right Colectomy for Cancer: Results From an International Snapshot Audit
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Gallo, G., Pata, F., Vennix, S., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., Hervas, D., Cillo, M., Estefania, D., Uriburu, J.P., Ruiz, H., Solomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Houben, B., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., D'Hoore, A., De Buck Van Overstraeten, A., Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., Jr., De Moraes, C.R., Tercioti, V., Jr., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguž, K., Bencurik, V., Holášková, E., Skrovina, M., Farkašová, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Örhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Sunesen, K.G., Leunbach, J., Thorlacius-Ussing, O., Oveson, A.U., Christensen, P., Chirstensen, S.D., Gamez, V., Oeting, M., Loeve, U.S., Ugianskis, A., Jessen, M., Krarup, P., Linde, K., Mirza, Q., Stovring, J.O., Erritzøe, L., Jakobsen, H.L., Lykke, J., Colov, E.P., Madsen, A.H., Friis, T.L., Funder, J.A., Dich, R., Kjar, S., Rasmussen, S., Schlesinger, N., Kjaer, M.D., Qvist, N., Khalid, A., Ali, G., El-Hussuna, A., Hadi, S., Walker, L.R., Kivelä, A., Lehtonen, T., Lepistö, A., Scheinin, T., Siironen, P., Kössi, J., Kuusanmäki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., Van Geluwe, B., 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Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., Cvetković, D., Maravić, M., Milovanovic, B., Stojakovic, N., Tripković, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Dragana, R., Lukic, D., Petrovic, T., Radovanovic, Z., Cuk, V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarrâ, J., Barrionuevo, M.G., Golda, T., Moreno, E.K., Martin, C.Z., Laso, C.A., Cumplido, P., Padin, H., Fons, J.B., Hernández-Lizoain, J., Martinez-Ortega, P., Molina-Fernández, M., Sánchez-Justicia, C., Solanas, J.A.G., De Laspra, E.C.D., Elia-Guedea, M., Gallego, E., Ramirez, J., Chaves, J.A., González, P.D., Elosua, T., Sahagún, J., Frade, A.T., Conde, J.A., Castrillo, E., Maag, R.D., Maderuelo, V., Saldarriaga, L., Cao, I.A., Varela, X.F., Fernández, S.N., Calvo, A.P., Álvarez, S.V., Sierra, I.B., 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E.M.T., Fernandez, F.M., Rodriguez, E.N., Arenal, J., Citores, M., Marcos, J., Sánchez, J., Tinoco, C., Espin, E., Granero, A.G., Gomez, L.J., Garcia, J.S., Vallribera, F., Folkesson, J., Sköldberg, F., Bergman, K., Borgström, E., Frey, J., Silfverberg, A., Söderholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., Abraham-Nordling, M., Ahlberg, M., Sjovall, A., Tengstrom, J., Hagman, K., Chabok, A., Ezra, E., Nikberg, M., Smedh, K., Tiselius, C., Al-Naimi, N., Dao Duc, M., Meyer, J., Mormont, M., Ris, F., Prevost, G., Villiger, P., Hoffmann, H., Kettelhack, C., Kirchhoff, P., Oertli, D., Weixler, B., Aytac, B., Leventoglu, S., Mentes, B., Yuksel, O., Demirbas, S., Ozkan, B.B., Özbalci, G.S., Sungurtekin, Uğur, Gülcü, B., Ozturk, E., Yilmazlar, T., Challand, C., Fearnhead, N., Hubbard, R., Kumar, S., Arthur, J., Barben, C., Skaife, P., Slawik, S., Williams, M., Zammit, M., Barker, J., French, J., Sarantitis, I., Slawinski, C., Clifford, R., Eardley, N., Johnson, M., McFaul, C., Vimalachandran, D., Allan, S., Bell, A., Oates, E., Shanmugam, V., Brigic, A., Halls, M., Pucher, P., Stubbs, B., Agarwal, T., Chopada, A., Mallappa, S., Pathmarajah, M., Sugden, C., Brown, C., Macdonald, E., Mckay, A., Richards, J., Robertson, A., Kaushal, M., Patel, P., Tezas, S., Touqan, N., Ayaani, S., Marimuthu, K., Piramanayagam, B., Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Battersby, N.J., Chan, H., Clark, E., Fernandes, R., Moran, S., Bajwa, A., McArthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., Malik, A., Pitt, J., Aryal, K., El-Hadi, A., Lal, R., Pal, A., Velchuru, V., Chaudhri, S., Cunha, M.O., Singh, B., Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., Stewart-Parker, E., Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., Leon, K.C., Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., Crutten-Wood, D., Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., Goh, N.M., Shamali, A., Stefan, S., Nepogodiev, D., Pinkney, T.D., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., Al-Qaddo, A., Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Bhangu, A., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., Leo, C., Samaranayake, F., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., Ho, C.W., Andreani, S., Patel, H., Warner, M., Tan, J.Y.Q., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., European Society of Coloproctology Collaborating Group Collaborators, Group, ESCP Cohort Studies Sub-Committee, ESCP Research Committee, Logistical Support and Data Collection, Analysis, Investigators, Radiology and nuclear medicine, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Surgery, MUMC+: MA Heelkunde (9), Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and Quality of Life, Neurology, and Center for Evidence Based Education
- Subjects
Male ,Leak ,Conference Paper ,adverse event ,ileostomy ,non-smoker ,0302 clinical medicine ,middle aged ,antibiotic therapy ,80 and over ,antibiotic agent ,postoperative complication ,emergency surgery ,Colectomy ,cecum ,Aged, 80 and over ,OUTCOMES ,adult ,COLON-CANCER ,Gastroenterology ,operation duration ,clinical trial ,General Medicine ,cohort analysis ,laparoscopic surgery ,ureter injury ,Survival Rate ,aged ,risk factor ,030220 oncology & carcinogenesis ,Cohort ,kidney injury ,030211 gastroenterology & hepatology ,Colonic Neoplasms/mortality ,anastomosis leakage ,liver injury ,prospective study ,medicine.medical_specialty ,SURGICAL STRESS ,ELECTIVE RIGHT ,surgical infection ,03 medical and health sciences ,Humans ,human ,Aged ,clinical audit ,sex ratio ,major clinical study ,mortality ,hemicolectomy ,multicenter study ,RISK-FACTORS ,observational study ,Complication ,Anastomotic leak ,Colon cancer ,Postoperative outcome ,Right colectomy ,general surgery ,surgical mortality ,SURGERY ,very elderly ,morbidity ,Anastomotic Leak ,mortality rate ,open surgery ,Cohort Studies ,Postoperative Complications ,gallbladder disease ,LAPAROSCOPY ,Risk Factors ,Neoplasms ,cancer mortality ,Laparoscopy ,Prospective cohort study ,colon resection ,Medical Audit ,medicine.diagnostic_test ,Mortality rate ,colon tumor ,Middle Aged ,female ,colon cancer ,Right Colectomy ,Colonic Neoplasms ,ileum ,surgical stapling ,Female ,cancer surgery ,Colectomy/adverse effects ,duodenum injury ,small intestine resection ,RESECTION ,reoperation ,Anastomosis ,NO ,MORBIDITY ,medicine ,operative blood loss ,LS7_4 ,percutaneous drainage ,business.industry ,suture technique ,Surgery ,blood vessel injury ,peroperative complication ,elective surgery ,Anastomotic Leak/epidemiology ,pathology ,business - Abstract
A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking.This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy.This was a snapshot observational prospective study.The study was conducted as a multicenter international study.The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients.Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method.Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041).This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors.Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery. See Video Abstract at http://links.lww.com/DCR/B165. PREDICTORES DE FUGA ANASTOMóTICA, COMPLICACIONES POSTOPERATORIAS Y MORTALIDAD DESPUéS DE LA COLECTOMíA DERECHA POR CáNCER: RESULTADOS DE UNA AUDITORíA INTERNACIONAL DE CORTO PLAZO: La hemicolectomía derecha se encuentra entre las operaciones más frecuentemente realizadas para cáncer de colon, pero faltan datos modernos multinacionales de alta calidad, que aborden las tasas de morbilidad y mortalidad.Reportar la tasa de morbilidad y mortalidad para cáncer de colon del lado derecho, e identificar predictores de resultados desfavorables a corto plazo, después de la hemicolectomía derecha.Estudio prospectivo observacional de corto plazo.Estudio multicéntrico internacional.El estudio de corto plazo de la Sociedad Europea de Coloproctología de 2015, fue una serie prospectiva multicéntrica internacional, que incluyó a todos los pacientes sometidos a hemicolectomía derecha electiva, de emergencia o resección ileocecal, por un período de dos meses y a principios de 2015. Este es un subanálisis, cohorte de pacientes con cáncer de colon.Los predictores de fuga anastomótica, morbilidad y mortalidad postoperatorias a los 30 días, se evaluaron usando modelos de regresión logística de efectos multivariables mixtos, después de la selección de variables con el método Lasso.De los 2,515 pacientes incluidos, se realizó una anastomosis en el 97,2% (n = 2,444); sutura manual en 38.5% (n = 940) y por engrapadora en 61.5% (n = 1504) casos. La tasa global de fuga anastomótica fue del 7,4% (180/2,444), morbilidad a los 30 días fue del 38,0% (n = 956) y la mortalidad fue del 2,6% (n = 66). Los pacientes con fuga anastomótica tuvieron una tasa de mortalidad significativamente mayor (10,6% frente al 1,6% de pacientes sin fuga, p0,001). En el análisis multivariable, las siguientes variables se asociaron con la fuga anastomótica: mayor duración de la cirugía (OR 1.007 por minuto, p = 0.0037), abordaje abierto (OR 1.9, p = 0.0037) y anastomosis por engrapadora (OR 1.5, p = 0.041).Este es un estudio observacional y por lo tanto podría estar presente el sesgo de selección. Por esta razón, se realizó un modelo de regresión logística multivariable, tratando de corregir posibles factores de confusión.La fuga anastomótica después de la hemicolectomía derecha oncológica, es una complicación frecuente y asociada a mayor mortalidad. Los factores quirúrgicos clave que contribuyeron a la fuga anastomótica, fueron la técnica anastomótica, abordaje quirúrgico y duración de la cirugía. Consulte Video Resumen en http://links.lww.com/DCR/B165. (Traducción-Dr. Fidel Ruiz Healy).
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- 2020
10. Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO
- Author
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El-Hussuna, A., Pinkney, T., Zmora, O., Frasson, M., Bhangu, A., Battersby, N., Chaudhri, S., Nepogodiev, D., Singh, B., Vennix, S., Altomare, D., Bemelman, W., Christensen, P., D'Hoore, A., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., Nørmark Mortensen, Rikke, El-Hussuna, Alaa, Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Salomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Bouckaert, W., Houben, B., Knol, J., Sergeant, G., Vangertruyden, G., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., de Buck van Overstraeten, A., Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., Rocha de Moraes, C., Tercioti, V., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguž, K., Bencurik, V., Holášková, E., Skrovina, M., Farkašová, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Örhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Gotschalck Sunesen, K., Leunbach, J., Thorlacius-Ussing, O., Uth Oveson, A., Dahl Chirstensen, S., Gamez, V., Oeting, M., Schou Loeve, U., Ugianskis, A., Jessen, M., Krarup, P. M., Linde, K., Mirza, Q., Overgaard Stovring, J., Erritzøe, L., Loft Jakobsen, H., Lykke, J., Palmgren Colov, E., Husted Madsen, A., Linde Friis, T., Amstrup Funder, J., Dich, R., Kjær, S., Rasmussen, S., Schlesinger, N., Dilling Kjaer, M., Qvist, N., Khalid, A., Ali, G., Hadi, S., Rosell Walker, L., Kivelä, A., Lehtonen, T., Lepistö, A., Scheinin, T., Siironen, P., Kössi, J., Kuusanmäki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., van Geluwe, B., Chafai, N., Lefevre, J. H., Parc, Y., Tiret, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krückemeier, K., Vogel, T., Schön, M., Baral, J., Lukoschek, T., Münch, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., Katsoulis, I. E., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyák, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Möller, P., Sigurdsson, H., Stefánsson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., Mccourt, M., Hanly, A., Hyland, J., Martin, S., O'Connell, P. R., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., Haj Yahia, I., Hermann, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angriman, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., Altomare, D. F., Di Candido, F., Di Iena, M., Guglielmi, A., Caputi-Iambrenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., Amore Bonapasta, S., Coratti, A., Guerra, F., Asteria, C. R., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., De Franciscis, S., Maria Romano, G., Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., De Luca, R., Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., La Torre, F., Mingoli, A., Velluti, F., Di Giacomo, A., Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., De Nardi, P., Elmore, U., Lemma, M., Rosati, R., Tamburini, A., De Luca, M., Sartori, A., Benevento, A., Bottini, C., Ferrari, C. C., Pata, F., Tessera, G., Pellino, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladžinskas, Ž., Švagždys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Buskens, C., de Groof, E. J., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., van der Zaag, E., van Duijvendijk, P., Wassenaar, E., Bruijninckx, M., de Graff, E., Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., van Westereenen, H. 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Mulder, I, Nonner, J, Swank, H, van Wagensveld, B, Bolmers, M, Briel, J, van Geloven, A, van Rossem, C, Klemann, V, Konsten, J, Leenders, B, Schok, T, Bleeker, W, Gidwani, A, Lawther, R, Loughlin, P, Skelly, B, Spence, R, Brun, M, Helgeland, M, Ignjatovic, D, Øresland, T, Yousefi, P, Flåten Backe, I, Helmer Sjo, O, Nesbakken, A, Tandberg-Eriksen, M, Cais, A, Hallvard Traeland, J, Herikstad, R, Kørner, H, Lauvland, N, Jajtner, D, Kabiesz, W, Rak, M, Gmerek, L, Horbacka, K, Horst, N, Krokowicz, P, Kwiatkowski, A, Pasnik, K, Karcz, P, Romaniszyn, M, Rusek, T, Walega, P, Czarencki, R, Obuszko, Z, Sitarska, M, Wojciech, W, Zawadzki, M, Amado, S, Clara, P, Couceiro, A, Malaquias, R, Rama, N, Almeida, A, Barbosa, E, Cernadas, E, Duarte, A, Silva, P, Costa, S, Martinez Insua, C, Pereira, J, Pereira, C, Sacchetti, M, Carvalho Pinto, B, Jorge Vieira Sousa, P, Marques, R, Oliveira, A, Cardoso, R, Carlos, S, Corte-Real, J, Moniz Pereira, P, Souto, R, Carneiro, C, Marinho, R, Nunes, V, Rocha, R, Sousa, M, Leite, J, Melo, F, Pimentel, J, Ventura, L, Vila Nova, C, Copăescu, C, Bintintan, V, Ciuce, C, Dindelegan, G, Scurtu, R, Seicean, R, Domansky, N, Karachun, A, Moiseenko, A, Pelipas, Y, Petrov, A, Pravosudov, I, Aiupov, R, Akmalov, Y, Parfenov, A, Suleymanov, N, Tarasov, N, Jumabaev, H, Mamedli, Z, Rasulov, A, Aliev, I, Chernikovskiy, I, Kochnev, V, Komyak, K, Smirnov, A, Achkasov, S, Bolikhov, K, Shelygin, Y, Sushkov, O, Zapolskiy, A, Gvozdenovic, M, Jovanovic, D, Lausevic, Z, Cvetković, D, Maravić, M, Milovanovic, B, Stojakovic, N, Tripković, I, Mihajlovic, D, Nestorovic, M, Pecic, V, Petrovic, D, Stanojevic, G, Barisic, G, Dimitrijevic, I, Krivokapic, Z, Markovic, V, Popovic, M, Aleksic, A, Dabic, D, Kostic, I, Milojkovic, A, Perunicic, V, Lukic, D, Petrovic, T, Radovanovic, D, Radovanovic, Z, Cuk, Vm, Cuk, Vv, Kenic, M, Kovacevic, B, Krdzic, I, Korcek, J, Rems, M, Toplak, J, Escarrâ, J, Gil Barrionuevo, M, Golda, T, Kreisler Moreno, E, Zerpa Martin, C, Álvarez Laso, C, Cumplido, P, Padin, H, Baixauli Fons, J, Hernández-Lizoain, J, Martinez-Ortega, P, Molina-Fernández, M, Sánchez-Justicia, C, Antonio Gracia Solanas, J, Córdoba Díaz de Laspra, E, Echazarreta-Gallego, E, Elia-Guedea, M, Ramirez, J, Arredondo Chaves, J, Diez González, P, Elosua, T, Sahagún, J, Turienzo Frade, A, Álvarez Conde, J, Castrillo, E, Diaz Maag, R, Maderuelo, V, Saldarriaga, L, Aldrey Cao, I, Fernández Varela, X, Núñez Fernández, S, Parajó Calvo, A, Villar Álvarez, S, Blesa Sierra, I, Lozano, R, Márquez, M, Porcel, O, Menendez, P, Fernández Hevia, M, Flores Sigüenza, L, Jimenez Toscano, M, Lacy Fortuny, A, Ordoñez Trujillo, J, Espi, A, Garcia-Botello, S, Martín-Arévalo, J, Moro-Valdezate, D, Pla-Martí, V, Blanco-Antona, F, Abrisqueta, J, Ibañez Canovas, N, Lujan Mompean, J, Escolá Ripoll, D, Martinez Gonzalez, S, Parodi, J, Fernández López, A, Ramos Fernández, M, Castellvi Valls, J, Ortiz de Zarate, L, Ribas, R, Sabia, D, Viso, L, Alonso Gonçalves, S, José Gil Egea, M, Pascual Damieta, M, Pera, M, Salvans Ruiz, S, Bernal, J, Landete, F, Ais, G, Etreros, J, Aguiló Lucia, J, Boscá, A, Deusa, S, García Del Caño, J, Viciano, V, García-Armengol, J, Roig, J, Blas, J, Escartin, J, Fatás, J, Fernando, J, Ferrer, R, Arias Pacheco, R, García Flórez, L, Moreno Gijón, M, Otero Díez, J, Solar Garcia, L, Aguilar Teixido, F, Balaguer Ojo, C, Bargallo Berzosa, J, Lamas Moure, S, Enrique Sierra, J, Fermiñán, A, Herrerias, F, Rufas, M, Viñas, J, Codina-Cazador, A, Farrés, R, Gómez, N, Julià, D, Planellas, P, López, J, Luna, A, Maristany, C, Muñoz Duyos, A, Puértolas, N, Alcantara Moral, M, Serra-Aracil, X, Concheiro Coello, P, Gómez, D, Carton, C, Miguel, A, Reoyo Pascual, F, Valero Cerrato, X, Zambrano Muñoz, R, Cervera-Aldama, J, García González, J, Ramos-Prada, J, Santamaría-Olabarrieta, M, Urigüen-Echeverría, A, Coves Alcover, R, Espinosa Soria, J, Fernandez Rodriguez, E, Hernandis Villalba, J, Maturana Ibañez, V, De la Torre Gonzalez, F, Huerga, D, Pérez Viejo, E, Rivera, A, Ruiz Ucar, E, Garcia-Septiem, J, Jiménez, V, Jiménez Miramón, J, Ramons Rodriquez, J, Rodriguez Alvarez, V, Garcea, A, Ponchietti, L, Borda, N, Enriquez-Navascues, J, Saralegui, Y, Febles Molina, G, Nogues, E, Rodríguez Méndez, Á, Roque Castellano, C, Sosa Quesada, Y, Alvarez-Gallego, M, Pascual, I, Rubio-Perez, I, Diaz-San Andrés, B, Tone-Villanueva, F, Alonso, J, Cagigas, C, Castillo, J, Gómez, M, Martín-Parra, J, Mengual Ballester, M, Pellicer Franco, E, Soria Aledo, V, Valero Navarro, G, Caballero Rodríguez, E, Gonzalez De Chaves, P, Hernandez, G, Perez Alvarez, A, Soto Sanchez, A, Cesar Becerra Garcia, F, Guillermo Alonso Roque, J, López Rodríguez Arias, F, Del Valle Ruiz, Sr, Sánchez De La Villa, G, Compañ, A, García Marín, A, Nofuentes, C, Orts Micó, F, Pérez Auladell, V, Carrasco, M, Duque Perez, C, Gálvez-Pastor, S, Navarro Garcia, I, Sanchez Perez, A, Enjuto, D, Manuel Bujalance, F, Marcelin, N, Pérez, M, Serrano García, R, Cabrera, A, de la Portilla, F, Diaz-Pavon, J, Jimenez-Rodriguez, R, Vazquez-Monchul, J, Daza González, J, Gómez Pérez, R, Rivera Castellano, J, Roldán de la Rua, J, Errasti Alustiza, J, Fernandez, L, Romeo Ramirez, J, Sardon Ramos, J, Cermeño Toral, B, Alias, D, Garcia-Olmo, D, Guadalajara, H, Herreros, M, Pacheco, P, Del Castillo Díez, F, Lima Pinto, F, Martínez Alegre, J, Ortega, I, Picardo Nieto Antonio, A, Caro, A, Escuder, J, Feliu, F, Millan, M, Alos Company, R, Frangi Caregnato, A, Lozoya Trujillo, R, Rodríguez Carrillo, R, Ruiz Carmona, M, Alonso, N, Ambrona Zafra, D, Amilka Ayala Candia, B, Bonnin Pascual, J, Pineño Flores, C, Alcazar Montero, J, Angoso Clavijo, M, Garcia, J, Sanchez Tocino, J, Gómez-Alcazar, C, Costa-Navarro, D, Ferri-Romero, J, Rey-Riveiro, M, Romero-Simó, M, Arencibia, B, Esclapez, P, García-Granero, E, Granero, P, Medina Fernández, Fj, Gallardo Herrera, Ab, Diaz López, C, Navarro Rodriguez, E, Torres Tordera, E, Arenal, J, Citores, M, Marcos, J, Sánchez, J, Tinoco, C, Espin, E, Garcia Granero, A, Jimenez Gomez, L, Sanchez Garcia, J, Vallribera, F, Folkesson, J, Sköldberg, F, Bergman, K, Borgström, E, Frey, J, Silfverberg, A, Söderholm, M, Nygren, J, Segelman, J, Gustafsson, D, Lagerqvist, A, Papp, A, Pelczar, M, Abraham-Nordling, M, Ahlberg, M, Sjovall, A, Tengstrom, J, Hagman, K, Chabok, A, Ezra, E, Nikberg, M, Smedh, K, Tiselius, C, Al-Naimi, N, Dao Duc, M, Meyer, J, Mormont, M, Ris, F, Prevost, G, Villiger, P, Hoffmann, H, Kettelhack, C, Kirchhoff, P, Oertli, D, Weixler, B, Aytac, B, Leventoglu, S, Mentes, B, Yuksel, O, Demirbas, S, Busra Ozkan, B, Selçuk Özbalci, G, Sungurtekin, U, Gülcü, B, Ozturk, E, Yilmazlar, T, Challand, C, Fearnhead, N, Hubbard, R, Kumar, S, Arthur, J, Barben, C, Skaife, P, Slawik, S, Williams, M, Zammit, M, Barker, J, French, J, Sarantitis, I, Slawinski, C, Clifford, R, Eardley, N, Johnson, M, Mcfaul, C, Vimalachandran, D, Allan, S, Bell, A, Oates, E, Shanmugam, V, Brigic, A, Halls, M, Pucher, P, Stubbs, B, Agarwal, T, Chopada, A, Mallappa, S, Pathmarajah, M, Sugden, C, Brown, C, Macdonald, E, Mckay, A, Richards, J, Robertson, A, Kaushal, M, Patel, P, Tezas, S, Touqan, N, Ayaani, S, Marimuthu, K, Piramanayagam, B, Vourvachis, M, Iqbal, N, Korsgen, S, Seretis, C, Shariff, U, Arnold, S, Chan, H, Clark, E, Fernandes, R, Moran, B, Bajwa, A, Mcarthur, D, Cao, K, Cunha, P, Pardoe, H, Quddus, A, Theodoropoulou, K, Bolln, C, Denys, G, Gillespie, M, Manimaran, N, Reidy, J, Malik, Ai, Malik, A, Pitt, J, Aryal, K, El-Hadi, A, Lal, R, Pal, A, Velchuru, V, Oliveira Cunha, M, Thomas, M, Bains, S, Boyle, K, Miller, A, Norwood, M, Yeung, J, Goian, L, Gurjar, S, Saghir, W, Sengupta, N, Stewart-Parker, E, Bailey, S, Khalil, T, Lawes, D, Nikolaou, S, Omar, G, Church, R, Muthiah, B, Garrett, W, Marsh, P, Obeid, N, Chandler, S, Coyne, P, Evans, M, Hunt, L, Lim, J, Oliphant, Z, Papworth, E, Weaver, H, Cuiñas Leon, K, Williams, G, Hernon, J, Kapur, S, Moosvi, R, Shaikh, I, Swafe, L, Aslam, M, Evans, J, Ihedioha, U, Kang, P, Merchant, J, Hompes, R, Middleton, R, Broomfield, A, Crutten-Wood, D, Foster, J, Nash, G, Akhtar, M, Boshnaq, M, Eldesouky, S, Mangam, S, Rabie, M, Ahmed, J, Khan, J, Ming Goh, N, Shamali, A, Stefan, S, Thompson, C, Amin, A, Docherty, J, Lim, M, Walker, K, Watson, A, Hossack, M, Mackenzie, N, Paraoan, M, Alam, N, Daniels, I, Narang, S, Pathak, S, Smart, N, Al-Qaddo, A, Codd, R, Rutka, O, Bronder, C, Crighton, I, Davies, E, Raymond, T, Bookless, L, Griffiths, B, Plusa, S, Carlson, G, Harrison, R, Lees, N, Mason, C, Quayle, J, Branagan, G, Broadhurst, J, Chave, H, Sleight, S, Awad, F, Cruickshank, N, Joy, H, Boereboom, C, Daliya, P, Dhillon, A, Watson, N, Watson, R, Artioukh, D, Gokul, K, Javed, M, Kong, R, Sutton, J, Faiz, O, Jenkins, I, Leo, Ca, Samaranayake, Sf, Warusavitarne, J, Arya, S, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Duff, S, Fatayer, T, Mbuvi, J, Sharma, A, Cornish, J, Davies, L, Harries, R, Morris, C, Torkington, J, Knight, J, Lai, C, Shihab, O, Tzivanakis, A, Hussain, A, Luke, D, Padwick, R, Torrance, A, Tsiamis, A, Dawson, P, Balfour, A, Brady, R, Mander, J, Paterson, H, Chandratreya, N, Chu, H, Cutting, J, Vernon, S, Wai Ho, C, Andreani, S, Patel, H, Warner, M, Yan Qi Tan, J, Iqbal, A, Khan, A, Perrin, K, Raza, A, Tan, S., and 2015 European Society of Coloproctology collaborating, Group
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creatinine blood level ,adverse event ,Disease ,open surgery ,surgery ,0302 clinical medicine ,hospital readmission ,postoperative complication ,resection ,Crohn's disease ,Resection ,Surgery ,outcome ,parenteral nutrition ,postoperative complications ,C reactive protein ,adult ,Gastroenterology ,creatinine ,Crohn disease ,cohort analysis ,female ,priority journal ,risk factor ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,abdominal abscess ,anastomosis leakage ,prospective study ,medicine.medical_specialty ,side to side anastomosis ,surgical infection ,reoperation ,Anastomosis ,Article ,NO ,03 medical and health sciences ,intestine resection ,length of stay ,male ,medicine ,intraoperative period ,follow up ,ileocecal resection ,controlled study ,human ,Adverse effect ,outcome assessment ,preoperative period ,ta3126 ,business.industry ,Postoperative complication ,Odds ratio ,medicine.disease ,surgical margin ,major clinical study ,Confidence interval ,hemicolectomy ,Parenteral nutrition ,protein blood level ,business ,abscess drainage - Abstract
Aim: Patient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method: This was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien–Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. Results: In all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10–4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13–3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20–4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08–1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07–1.37). Conclusion: Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland
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- 2018
11. Risk factors for subarachnoid haemorrhage: A nationwide cohort of 950 000 adults
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Sundström, J, Söderholm, M, Söderberg, S, Alfredsson, L, Andersson, M, Bellocco, R, Wiberg, B, Johan Sundström, Martin Söderholm, Stefan Söderberg, Lars Alfredsson, Martin Andersson, Rino Bellocco, Bernice Wiberg, Sundström, J, Söderholm, M, Söderberg, S, Alfredsson, L, Andersson, M, Bellocco, R, Wiberg, B, Johan Sundström, Martin Söderholm, Stefan Söderberg, Lars Alfredsson, Martin Andersson, Rino Bellocco, and Bernice Wiberg
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Background: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium. Methods: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries. Results: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH. Conclusions: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.
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- 2019
12. Genome-wide association meta-analysis of functional outcome after ischemic stroke
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Söderholm, M, Pedersen, A, Lorentzen, E, Stanne, TM, Bevan, S, Olsson, M, Cole, JW, Fernandez-Cadenas, I, Hankey, GJ, Jimenez-Conde, J, Jood, K, Lee, JM, Lemmens, R, Levi, C, Mitchell, BD, Norrving, B, Rannikmäe, K, Rost, NS, Rosand, J, Rothwell, PM, Scott, R, Strbian, D, Sturm, JW, Sudlow, C, Traylor, M, Thijs, V, Tatlisumak, T, Woo, D, Worrall, BB, Maguire, JM, Lindgren, A, Jern, C, Söderholm, M, Pedersen, A, Lorentzen, E, Stanne, TM, Bevan, S, Olsson, M, Cole, JW, Fernandez-Cadenas, I, Hankey, GJ, Jimenez-Conde, J, Jood, K, Lee, JM, Lemmens, R, Levi, C, Mitchell, BD, Norrving, B, Rannikmäe, K, Rost, NS, Rosand, J, Rothwell, PM, Scott, R, Strbian, D, Sturm, JW, Sudlow, C, Traylor, M, Thijs, V, Tatlisumak, T, Woo, D, Worrall, BB, Maguire, JM, Lindgren, A, and Jern, C
- Abstract
© American Academy of Neurology. ObjectiveTo discover common genetic variants associated with poststroke outcomes using a genome-wide association (GWA) study.MethodsThe study comprised 6,165 patients with ischemic stroke from 12 studies in Europe, the United States, and Australia included in the GISCOME (Genetics of Ischaemic Stroke Functional Outcome) network. The primary outcome was modified Rankin Scale score after 60 to 190 days, evaluated as 2 dichotomous variables (0-2 vs 3-6 and 0-1 vs 2-6) and subsequently as an ordinal variable. GWA analyses were performed in each study independently and results were meta-analyzed. Analyses were adjusted for age, sex, stroke severity (baseline NIH Stroke Scale score), and ancestry. The significance level was p < 5 × 10-8.ResultsWe identified one genetic variant associated with functional outcome with genome-wide significance (modified Rankin Scale scores 0-2 vs 3-6, p = 5.3 × 10-9). This intronic variant (rs1842681) in the LOC105372028 gene is a previously reported trans-Expression quantitative trait locus for PPP1R21, which encodes a regulatory subunit of protein phosphatase 1. This ubiquitous phosphatase is implicated in brain functions such as brain plasticity. Several variants detected in this study demonstrated suggestive association with outcome (p < 10-5), some of which are within or near genes with experimental evidence of influence on ischemic stroke volume and/or brain recovery (e.g., NTN4, TEK, and PTCH1).ConclusionsIn this large GWA study on functional outcome after ischemic stroke, we report one significant variant and several variants with suggestive association to outcome 3 months after stroke onset with plausible mechanistic links to poststroke recovery. Future replication studies and exploration of potential functional mechanisms for identified genetic variants are warranted.
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- 2019
13. COL4A2 is associated with lacunar ischemic stroke and deep ICH: Meta-analyses among 21,500 cases and 40,600 controls
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Rannikmäe, K, Sivakumaran, V, Millar, H, Malik, R, Anderson, CD, Chong, M, Dave, T, Falcone, GJ, Fernandez-Cadenas, I, Jimenez-Conde, J, Lindgren, A, Montaner, J, O'Donnell, M, Paré, G, Radmanesh, F, Rost, NS, Slowik, A, Söderholm, M, Traylor, M, Pulit, SL, Seshadri, S, Worrall, BB, Woo, D, Markus, HS, Mitchell, BD, Dichgans, M, Rosand, J, Sudlow, CLM, Stroke Genetics Network (SiGN), METASTROKE Collaboration, and International Stroke Genetics Consortium (ISGC), and Maguire, J
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Collagen Type IV ,Europe ,Neurology & Neurosurgery ,Stroke, Lacunar ,Humans ,Polymorphism, Single Nucleotide ,1103 Clinical Sciences, 1109 Neurosciences, 1702 Cognitive Sciences ,Genetic Association Studies ,Cerebral Hemorrhage - Abstract
OBJECTIVE: To determine whether common variants in familial cerebral small vessel disease (SVD) genes confer risk of sporadic cerebral SVD. METHODS: We meta-analyzed genotype data from individuals of European ancestry to determine associations of common single nucleotide polymorphisms (SNPs) in 6 familial cerebral SVD genes (COL4A1, COL4A2, NOTCH3, HTRA1, TREX1, and CECR1) with intracerebral hemorrhage (ICH) (deep, lobar, all; 1,878 cases, 2,830 controls) and ischemic stroke (IS) (lacunar, cardioembolic, large vessel disease, all; 19,569 cases, 37,853 controls). We applied data quality filters and set statistical significance thresholds accounting for linkage disequilibrium and multiple testing. RESULTS: A locus in COL4A2 was associated (significance threshold p < 3.5 × 10-4) with both lacunar IS (lead SNP rs9515201: odds ratio [OR] 1.17, 95% confidence interval [CI] 1.11-1.24, p = 6.62 × 10-8) and deep ICH (lead SNP rs4771674: OR 1.28, 95% CI 1.13-1.44, p = 5.76 × 10-5). A SNP in HTRA1 was associated (significance threshold p < 5.5 × 10-4) with lacunar IS (rs79043147: OR 1.23, 95% CI 1.10-1.37, p = 1.90 × 10-4) and less robustly with deep ICH. There was no clear evidence for association of common variants in either COL4A2 or HTRA1 with non-SVD strokes or in any of the other genes with any stroke phenotype. CONCLUSIONS: These results provide evidence of shared genetic determinants and suggest common pathophysiologic mechanisms of distinct ischemic and hemorrhagic cerebral SVD stroke phenotypes, offering new insights into the causal mechanisms of cerebral SVD.
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- 2017
14. European regulation on orphan medicinal products: 10 years of experience and future perspectives
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Westermark, K, Holm, Bb, Söderholm, M, Llinares Garcia, J, Rivière, F, Aarum, S, Butlen Ducuing, F, Tsigkos, S, Wilk Kachlicka, A, N'Diamoi, C, Borvendég, J, Lyons, D, Sepodes, B, Bloechl Daum, B, Lhoir, A, Todorova, M, Kkolos, I, Kubáčková, K, Bosch Traberg, H, Tillmann, V, Saano, V, Héron, E, Elbers, R, Siouti, M, Eggenhofer, J, Salmon, P, Clementi, Maurizio, Krieviņš, D, Matulevičiene, A, Metz, H, Vincenti, Ac, Voordouw, A, Dembowska Bagińska, B, Nunes, Ac, Saleh, Fm, Foltánová, T, Možina, M, Farnell J, Torrent i., Beerman, B, Mariz, S, Evers, Mp, Greene, L, Thorsteinsson, S, Gramstad, L, Mavris, M, Bignami, F, Lorence, A, Belorgey, C, Committee for Orphan Medicinal Products, and the European Medicines
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Pharmacology ,Economic growth ,medicine.medical_specialty ,Traditional medicine ,business.industry ,Alternative medicine ,Legislation ,General Medicine ,Marketing authorization ,Orphan drug ,Drug development ,Drug Discovery ,Drug approval ,Medicine ,media_common.cataloged_instance ,European commission ,European union ,business ,media_common - Abstract
In 2000, regulation on orphan medicinal products was adopted in the European Union with the aim of benefiting patients who suffer from serious, rare conditions for which there is currently no satisfactory treatment. Since then, more than 850 orphan drug designations have been granted by the European Commission based on a positive opinion from the Committee for Orphan Medicinal Products (COMP), and more than 60 orphan drugs have received marketing authorization in Europe. Here, stimulated by the tenth anniversary of the COMP, we reflect on the outcomes and experience gained in the past decade, and contemplate issues for the future, such as catalysing drug development for the large number of rare diseases that still lack effective treatments.
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- 2011
15. Exome array analysis of ischaemic stroke: results from a southern Swedish study
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Söderholm, M., primary, Almgren, P., additional, Jood, K., additional, Stanne, T. M., additional, Olsson, M., additional, Ilinca, A., additional, Lorentzen, E., additional, Norrving, B., additional, Engström, G., additional, Melander, O., additional, Jern, C., additional, and Lindgren, A., additional
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- 2016
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16. Work hubs : Location considerations and opportunities for reduced travel
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Kramers, Anna, Nyberg, Marcus, Höjer, Mattias, Söderholm, M., Kramers, Anna, Nyberg, Marcus, Höjer, Mattias, and Söderholm, M.
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Cities worldwide are suffering from congestion among public transport users and motorists. Mayors have set ambitious targets to reduce traffic and improve public transportation, while at the same time reducing energy use. This paper investigates the option of using flexible workplaces in local nodes within urban regions in order to transform transportation needs. The business characteristics of this type of flexible workplace and the driving forces and potential barriers in its establishment are examined in an interview study with existing hub owners. The results provide novel information on emerging technologies related to urban transportation solutions and highlight how ICT solutions can affect the accessibility and relevance of flexible workplaces and thereby support their energy reduction potential., QC 20151218
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- 2015
17. Inter-relationships between adaptation and mitigation: a systematic literature review
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Landauer, M., Juhola, S., Söderholm, M., Landauer, M., Juhola, S., and Söderholm, M.
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Based on a systematic literature review method that consists of a bibliometric and a content analysis we examine the current state of research on climate change adaptation and mitigation inter-relationships. Although systematic literature reviews have been applied in other research fields such as health sciences, there are only a few examples in social and environmental sciences. First, we investigate in which research fields the inter-relationships between adaptation and mitigation have been studied and how they have been conceptualised. Second, we analyse what kinds of synergies, trade-offs or conflicts between adaptation and mitigation policies and practices can be identified particularly in urban studies. Third, based on selected urban studies, we examine how inter-relationships between the two policy objectives or practical measures have been studied, in which context, and what is the main outcome of these studies. We also present what suggestions there are for solving conflicts, and how synergies can be enhanced in urban areas. The results indicate that there is value in examining the two together since urban areas are balancing between adaptation and mitigation and have to negotiate trade-offs at diffeent scales.
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- 2015
18. Digital test assembly of truck parts with the IMMA-tool - an illustrative case
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Hanson, Lars, Högberg, Dan, Söderholm, M., Hanson, Lars, Högberg, Dan, and Söderholm, M.
- Abstract
Several digital human modelling (DHM) tools have been developed for simulation and visualisation of human postures and motions. In 2010 the DHM tool IMMA (Intelligently Moving Manikins) was introduced as a DHM tool that uses advanced path planning techniques to generate collision free and biomechanically acceptable motions for digital human models (as well as parts) in complex assembly situations. The aim of the paper is to illustrate how the IPS/IMMA tool is used at Scania CV AB in a digital test assembly process, and to compare the tool with other DHM tools on the market. The illustrated case of using the IMMA tool, here combined with the path planner tool IPS, indicates that the tool is promising. The major strengths of the tool are its user friendly interface, the motion generation algorithms, the batch simulation of manikins and the ergonomics assessment methods that consider time.
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- 2012
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19. Open cholecystectomy for all patients in the era of laparoscopic surgery - a prospective cohort study
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Leo, J, Filipovic, Goran, Krementsova, J, Norblad, R, Söderholm, M, Nilsson, Erik, Leo, J, Filipovic, Goran, Krementsova, J, Norblad, R, Söderholm, M, and Nilsson, Erik
- Published
- 2006
20. Digital test assembly of truck parts with the IMMA-tool - an illustrative case
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Hanson, L., primary, Högberg, D., additional, and Söderholm, M., additional
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- 2012
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21. Fibrinogen concentration in aluminium smelter workers : Results from the WOLF study
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Sjögren, B, Knutsson, Anders, Bergström, H, Fellenius, E, Fernström, B, Isling, D, Söderholm, M, Sjögren, B, Knutsson, Anders, Bergström, H, Fellenius, E, Fernström, B, Isling, D, and Söderholm, M
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- 2002
22. Complete Genomic Sequence of the Lytic Bacteriophage φYeO3-12 of Yersinia enterocolitica Serotype O:3
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Pajunen, Maria I., primary, Kiljunen, Saija J., additional, Söderholm, M. E.-Lotta, additional, and Skurnik, Mikael, additional
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- 2001
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23. Lung function as a risk factor for subarachnoid hemorrhage: a prospective cohort study.
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Söderholm M, Zia E, Hedblad B, Engström G, Söderholm, Martin, Zia, Elisabet, Hedblad, Bo, and Engström, Gunnar
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- 2012
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24. Mortality and cancer incidence among laboratory technicians in medical research and routine laboratories (Sweden).
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Gustavsson, Per, Reuterwall, Christina, Sadigh, Jonas, Söderholm, Monica, Gustavsson, P, Reuterwall, C, Sadigh, J, and Söderholm, M
- Abstract
Objectives: To investigate cancer incidence and mortality among laboratory employees.Methods: Mortality and cancer incidence were investigated among 2553 female and male laboratory workers employed at the Karolinska Institute and Karolinska Hospital in Stockholm between 1950 and 1989. Mortality was followed from 1952-1993 and cancer incidence from 1958-1992. Expected numbers were based on the general population in Stockholm, standardizing for age, gender, and calendar period.Results: The overall mortality and cancer incidence in the cohort was lower than expected. There were in all 10 cases of hemato-lymphatic malignancies (three acute myeloid leukemias, four non-Hodgkin lymphomas, two Hodgkin's lymphomas, and one multiple myeloma) in the cohort. The standardized incidence ratio (SIR) for hematolymphatic tumors was increased among workers who had ever been employed in laboratories with a high probability for chemical exposure, SIR 224 (95% CI 108-412). The risk of breast cancer among women was increased after more than 10 years of work in high-exposure laboratories, SIR 225 (128-365). The number of malignant melanomas exceeded those expected.Conclusions: The findings support earlier observations of an increased risk of hematolymphatic cancer among laboratory workers. The routine for handling chemicals and functionality of ventilatory equipment must be under continuous supervision. [ABSTRACT FROM AUTHOR]- Published
- 1999
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25. Assembly of two-dimensional membrane crystals of Na,K-ATPase
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Hans Hebert, Elisabeth Skriver, Söderholm M, and Arvid B. Maunsbach
- Subjects
Kidney Medulla ,Materials science ,Swine ,Sodium-Potassium-Exchanging ATPase ,Membrane Proteins ,Mineralogy ,Crystal structure ,Negative stain ,law.invention ,Microscopy, Electron ,Crystallography ,Membrane ,law ,Transmission electron microscopy ,Microscopy ,Animals ,Rabbits ,Anatomy ,Crystallization ,Electron microscope ,Molecular Biology - Abstract
The assembly of vanadate-induced two-dimensional membrane crystals of Na,K-ATPase was analyzed by electron microscopy and image processing. Electron micrographs of negatively stained linear arrays of protein molecules were recorded and processed by correlation averaging methods. The arrays were compared with fully developed p21 crystals of the enzyme. On the basis of similarity in protein form, symmetry, and packing arrangement it was concluded that the fully developed crystals are built of tightly packed ribbons. Assembly pathways for two-dimensional membrane crystals of Na,K-ATPase are proposed.
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- 1988
26. Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices
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Vittoria, B., Tsuyoshi, K., Gianluca, P., Yongbo, A., Alfonso, P., Bruno, S., Leandro, S., Krishn, K., Brunella Maria Pirozzi, Marzia, F., Michela, C., Sergey, E., Giuseppe, S.S., El-Hussuna, A., Frasson, M., Singh, B., Gallo, G., Pata, F., Negoi, I., Pinkney, T., Zmora, O., Bhangu, A., Battersby, N., Chaudhri, S., Nepogodiev, D., Vennix, S., Glasbey, J., Minaya, A., Basso, L., Pukuotukai, M., E Kelly, M., L Sánchez Guillén, Pellino, G., Buchs, N., Morton, D., Bemelman, W., Christensen, P., D'Hoore, A., Laurberg, S., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., N Mortensen, R., Cillo, M., Estefania, D., J Patron Uriburu, Ruiz, H., Salomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Bouckaert, W., Houben, B., Knol, J., Sergeant, G., Vangertruyden, G., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., H De Bruyn, Huyghe, M., E De Wolf, Reynders, D., A de Buck van Overstraeten, Wolthuis, A., Delibegovic, S., Christiani, A., M Marchiori Jr, C Rocha de Moraes, V Tercioti Jr, Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguž, K., Bencurik, V., Holášková, E., Skrovina, M., Farkašová, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Örhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., K Gotschalck Sunesen, Leunbach, J., Thorlacius-Ussing, O., A Uth Oveson, S Dahl Chirstensen, Gamez, V., Oeting, M., U Schou Loeve, Ugianskis, A., Jessen, M., M Krarup, P., Linde, K., Mirza, Q., J Overgaard Stovring, Erritzøe, L., H Loft Jakobsen, Lykke, J., E Palmgren Colov, A Husted Madsen, T Linde Friis, J Amstrup Funder, Dich, R., Kjær, S., Rasmussen, S., Schlesinger, N., M Dilling Kjaer, Qvist, N., Khalid, A., Ali, G., Hadi, S., L Rosell Walker, Kivelä, A., Lehtonen, T., Lepistö, A., Scheinin, T., Siironen, P., Kössi, J., Kuusanmäki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., B van Geluwe, Chafai, N., H Lefevre, J., Parc, Y., Tiret, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krückemeier, K., Vogel, T., Schön, M., Baral, J., Lukoschek, T., Münch, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., E Katsoulis, I., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyák, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Möller, P., Sigurdsson, H., Stefánsson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., Mccourt, M., Hanly, A., Hyland, J., Martin, S., R O'Connell, P., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., I Haj Yahia, Hermann, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angrima, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., F Di Candido, M Di Iena, Guglielmi, A., Caputi-Iambrenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., S Amore Bonapasta, Coratti, A., Guerra, F., R Asteria, C., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., S De Franciscis, G Maria Romano, Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., R De Luca, Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., F La Torre, Mingoli, A., Velluti, F., A Di Giacomo, Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., P De Nardi, Elmore, U., Lemma, M., Rosati, R., Tamburini, A., M De Luca, Sartori, A., Benevento, A., Bottini, C., C Ferrari, C., Tessera, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladžinskas, Ž., Švagždys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Buskens, C., J de Groof, E., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., E van der Zaag, P van Duijvendijk, Wassenaar, E., Bruijninckx, M., E de Graff, Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., L van Westereenen, H., Boerma, E., Coene, P., E van der Harst, A Van Der Pool, Raber, M., Melenhorst, J., S de Castro, Gerhards, M., Arron, M., Bremers, A., H de Wilt, Ferenschild, F., Yauw, S., Cense, H., Demirkiran, A., Hunfeld, M., Mulder, I., Nonner, J., Swank, H., B van Wagensveld, Bolmers, M., Briel, J., A van Geloven, Echazarreta-Gallego, E., Elia-Guedea, M., Ramirez, J., C van Rossem, Klemann, V., Konsten, J., Leenders, B., Schok, T., Bleeker, W., Gidwani, A., Lawther, R., Loughlin, P., Skelly, B., Spence, R., Brun, M., Helgeland, M., Ignjatovic, D., Øresland, T., Yousefi, P., I Flåten Backe, O Helmer Sjo, Nesbakken, A., M Tandberg Eriksen, Cais, A., J Hallvard Træland, Herikstad, R., Kørner, H., Lauvland, N., Jajtner, D., Kabiesz, W., Rak, M., Gmerek, L., Horbacka, K., Horst, N., Krokowicz, P., Kwiatkowski, A., Pasnik, K., Karcz, P., Romaniszyn, M., Rusek, T., Walega, P., Czarencki, R., Obuszko, Z., Sitarska, M., Wojciech, W., Zawadzki, M., Amado, S., Clara, P., Couceiro, A., Malaquias, R., Rama, N., Almeida, A., Barbosa, E., Cernadas, E., Duarte, A., Silva, P., Costa, S., C Martinez Insua, Pereira, J., Pereira, C., Sacchetti, M., B Carvalho Pinto, P Jorge Vieira Sousa, Marques, R., Oliveira, A., Cardoso, R., Carlos, S., Corte-Real, J., P Moniz Pereira, Souto, R., Carneiro, C., Marinho, R., Nunes, V., Rocha, R., Sousa, M., Leite, J., Melo, F., Pimentel, J., Ventura, L., C Vila Nova, Copăescu, C., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Domansky, N., Karachun, A., Moiseenko, A., Pelipas, Y., Petrov, A., Pravosudov, I., Aiupov, R., Akmalov, Y., Parfenov, A., Suleymanov, N., Tarasov, N., Jumabaev, H., Mamedli, Z., Rasulov, A., Aliev, I., Chernikovskiy, I., Kochnev, V., Komyak, K., Smirnov, A., Achkasov, S., Bolikhov, K., Shelygin, Y., Sushkov, O., Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., Cvetković, D., Maravić, M., Milovanovic, B., Stojakovic, N., Tripković, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukic, D., Petrovic, T., Radovanovic, D., Radovanovic, Z., M Cuk, V., V Cuk, V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarrâ, J., M Gil Barrionuevo, Golda, T., E Kreisler Moreno, C Zerpa Martin, C Álvarez Laso, Cumplido, P., Padin, H., J Baixauli Fons, J Hernández Lizoain, P Martinez Ortega, M Molina Fernández, C Sánchez Justicia, J Antonio Gracia Solanas, E Córdoba Díaz de Laspra, J Arredondo Chaves, P Diez González, Elosua, T., Sahagún, J., A Turienzo Frade, J Álvarez Conde, Castrillo, E., R Diaz Maag, Maderuelo, V., Saldarriaga, L., I Aldrey Cao, X Fernández Varela, S Núñez Fernández, A Parajó Calvo, S Villar Álvarez, I Blesa Sierra, Lozano, R., Márquez, M., Porcel, O., Menendez, P., M Fernández Hevia, L Flores Sigüenza, M Jimenez Toscano, A Lacy Fortuny, Ordoñez, J., Espi, A., S Garcia Botello, J Martín Arévalo, D Moro Valdezate, Martív, P., F Blanco Antona, Abrisqueta, J., N Ibañez Canovas, J Lujan Mompean, D Escolá Ripoll, S Martinez Gonzalez, Parodi, J., A Fernández López, M Ramos Fernández, J Castellvi Valls, L Ortiz de Zarate, Ribas, R., Sabia, D., Viso, L., S Alonso Gonçalves, M José Gil, M Pascual Damieta, Pera, M., S Salvans Ruiz, Bernal, J., Landete, F., Ais, G., Etreros, J., J Aguiló Lucia, Boscá, A., Deusa, S., J García Del Caño, Viciano, V., J García Armengol, Roig, J., Blas, J., Escartin, J., Fatás, J., Fernando, J., Ferrer, R., R Arias Pacheco, L García Flórez, M Moreno Gijón, J Otero Díez, L Solar Garcia, F Aguilar Teixido, C Balaguer Ojo, J Bargallo Berzosa, S Lamas Moure, J Enrique Sierra, Fermiñán, A., Herrerias, F., Rufas, M., Viñas, J., A Codina Cazador, Farrés, R., Gómez, N., Julià, D., Planellas, P., López, J., Luna, A., Maristany, C., A Muñoz Duyos, Puértolas, N., M Alcantara Moral, X Serra Aracil, P Concheiro Coello, Gómez, D., Carton, C., Miguel, A., F Reoyo Pascual, X Valero Cerrato, R Zambrano Muñoz, J Cervera Aldama, J García González, J Ramos Prada, M Santamaría Olabarrieta, A Urigüen Echeverría, R Coves Alcover, J Espinosa Soria, E Fernandez Rodriguez, J Hernandis Villalba, V Maturana Ibañez, F De la Torre Gonzalez, Huerga, D., E Pérez Viejo, Rivera, A., E Ruiz Ucar, J Garcia Septiem, Jiménez, V., J Jiménez Miramón, J Ramons Rodriquez, V Rodriguez Alvarez, Garcea, A., Ponchietti, L., Borda, N., J Enriquez Navascues, Saralegui, Y., G Febles Molina, Nogues, E., Rodríguez, M., C Roque Castellano, Y Sosa Quesada, M Alvarez Gallego, Pascual, I., I Rubio Perez, B Diaz San Andrés, F Tone Villanueva, Alonso, J., Cagigas, C., Castillo, J., Gómez, M., J Martín Parra, M Mengual Ballester, E Pellicer Franco, V Soria Aledo, G Valero Navarro, E Caballero Rodríguez, P Gonzalez De Chaves, Hernandez, G., A Perez Alvarez, A Soto Sanchez, F Cesar Becerra Garcia, J Guillermo Alonso Roque, Rodríguez, L., Arias, F., R Del Valle Ruiz, S., G Sánchez De La Villa, Compañ, A., A García Marín, Nofuentes, C., Micóf, O., V Pérez Auladell, Carrasco, M., C Duque Perez, S Gálvez Pastor, I Navarro Garcia, A Sanchez Perez, Enjuto, D., F Manuel Bujalance, Marcelin, N., Pérez, M., R Serrano García, Cabrera, A., F de la Portilla, J Diaz Pavon, R Jimenez Rodriguez, J Vazquez Monchul, J Martínez Alegre, Ortega, I., A Picardo Nieto Antonio, Caro, A., Escuder, J., Feliu, F., Millan, M., R Alos Company, A Frangi Caregnato, R Lozoya Trujillo, R Rodríguez Carrillo, M Ruiz Carmona, Alonso, N., D Ambrona Zafra, B Amilka Ayala, J Bonnin Pascual, C., C Pineño Flores, J Alcazar Montero, M Angoso Clavijo, Garcia, J., J Sanchez Tocino, C Gómez Alcazar, D Costa Navarro, J Ferri Romero, M Rey Riveiro, M Romero Simó, Arencibia, B., Esclapez, P., E García Granero, Granero, P., J Medina Fernández, F., B Gallardo Herrera, A., C Diaz López, E Navarro Rodriguez, E Torres Tordera, Arenal, J., Citores, M., Marcos, J., Sánchez, J., Tinoco, C., Espin, E., A Garcia Granero, L Jimenez Gomez, J Sanchez Garcia, Vallribera, F., Folkesson, J., Sköldberg, F., Bergman, K., Borgström, E., Frey, J., Silfverberg, A., Söderholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., M Abraham Nordling, 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Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Chan, H., Clark, E., Fernandes, R., Moran, B., Bajwa, A., Mcarthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., I Malik, A., Malik, A., Pitt, J., Aryal, K., A El Hadi, Lal, R., Pal, A., Velchuru, V., M Oliveira Cunha, Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., E Stewart Parker, Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., K Cuiñas Leon, Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., D Crutten Wood, Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., N Ming Goh, Shamali, A., Stefan, S., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., A Al Qaddo, Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., A Leo, C., F Samaranayake, S., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., C Wai Ho, Andreani, S., Patel, H., Warner, M., Q Tan, Y., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., Bellato, V., Konishi, T., Pellino, G., An, Y., Piciocchi, A., Sensi, B., Siragusa, L., Khanna, K., Pirozzi, B. M., Franceschilli, M., Campanelli, M., Efetov, S., Sica, G. S., Kefleyesus, A., Hoofwijk, A. G. M., Eldaly, A. S., Gonzalez, A., Jawad, A., Jooma, A., Hafez, A. M., Rubio, A. V., Landaluce-Olavarria, A., Wu, A., Nagatsu, A., Inoue, A., Kanamoto, A., Ouchi, A., El-Hussuna, A., Vazquez-Melero, A., Wolthuis, A. M., Peral, A. M., Lozano, A. C., Efremov, A., Ryasantsev, A. V., Di Giorgio, A., Parente, A., Tamburrini, A., Alo, A., Forero-Torres, A., Vahrmeijer, A. L., Varabei, A., Hinojosa, S., Zeynel, A., Balkan, A., Frontali, A., Oleg, A., Soler-Silva, A., Makni, A., Andre, A., Cabrera, A. M. G., Fernandez, A. M. G., Minaya-Bravo, A. M., Rodriguez-Sanchez, A., Musina, A. -M., Pangeni, A., Zolotko, A., Tonoyan, A., Balla, A., Belli, A., Cavallaro, A., Chierici, A., Divizia, A., Bucci, A. F., Salido, A. J., Morini, A., Muratore, A., Vignali, A., Chitul, A., Sebastian, D. A., Pcolkins, A., Shchegolev, A., Hollenbeck, A., Wisneski, A., Iossa, A., D'Amore, A., Hunter, A., Hesketh, A. J., la Brocca, A., Spinelli, A., Caires, A., D'Alessandro, A., Correo, A. F. S. L., Macri, A., Navarro-Sanchez, A., Pronk, A., Akunc, A., Mehri, A., Pelta, A., Papadopoulos, A., Kechagias, A., Rashid, A., Ramazanov, A., Chandio, A., Kohyama, A., Nishimura, A., Ohkawa, A., Dulskas, A., Jamal, A., Mariani, A., Unal, A. G., Karagoz, A., Ozkan, B. B., Salih, B., Gulcu, B., Pessia, B., Martin-Perez, B., Ielpo, B., Tulelli, B., Yang, B., Mhamed, B., Murphy, B., Langenhoff, B., Belevi, B., Guney, B., Ng, C., Rueda, C., Roxburgh, C. S., Feo, C. V., Ferrari, C., Gazia, C., Pratesi, C., Ratto, C., Santacruz, C. C., Arroyave, C. R. M., Macias, C., Fernandez, C. G., Fernandez, C. C., Curtis-Martinez, C., Fortmann, C., Kim, C., Galeano, C. U., Barroso, C., Baldi, C., Foppa, C., Formisano, C., Li, C., Ding, C., Wang, C., Iacusso, C., Yang, C., Pizzera, C., Skias, C., Chouliras, C., Liakos, C., Matsuda, C., Wu, C. -Y., Ozaslan, C., Tanda, C., Tommaso, C. M., Dagorno, C., Ramos, C. P. A., Arcudi, C., Coco, C., Morales, C. M., Ali, M. Z., de Azevedo, C. T. M., Lozano, C. C., Sala, C., Leo, C. A., Scarpa, C. R., Ferro, C. V., Fernandez, C. M., Morales-Garcia, D., Nakano, D., Cristian, D., Hechtl, D., Canovas, D. T., Calabrese, D., Rega, D., Ferraro, D., Morezzi, D., Sommacale, D., Brogden, D., Miskovic, D., Merlini, D., Pertile, D., Coniglio, D., Zhu, D., Wu, D., Coletta, D., Rubio, D. R., Sasia, D., Fillipov, D., Russiello, D., Dardanov, D., Consten, E. C. J., Smolskas, E., Muttillo, E. M., Jones, E., Sunami, E., Etienne, E. -H., Chalkiadaki, E., Giacomelli, E., Karbovnichaya, E., Ruiz-Ucar, E., Guaitoli, E., Samadov, E., Jovine, E., Treppiedi, E., Vaterlini, E. M., Zambaiti, E., Moggia, E., Coetzee, E., Chisari, E., D'Errico, E., Ciofic, E., Pena, E., Kurt, E., Balik, E., Gunay, E., Sivrikoz, E., Andolfi, E., Araimo, E., Lucci, E., Opocher, E., Pinotti, E., Rubino, E., Reyhan, E., Mazzotta, E., Navarro, E. B., El-Helou, E., Licardie-Bolanos, E., Porto, E. I., Contreras, E., Boerma, E. -J., Cianchi, F., Marino, F., Uggeri, F., Han, F., Calculli, F., Falaschi, F., Ghignone, F., Perrone, F., Borghi, F., Garcia, F., Agresta, F., Cananzi, F. C. M., Mendoza-Moreno, F., Cengiz, F., Almeida, F. M., Baracchi, F., Carannante, F., la Torre, F., Fernandes, F., Friedmacher, F., Grama, F., Carissimi, F., Pecchini, F., Bianco, F., Colombo, F., Ferrara, F., Litta, F., Carrano, F. M., Martignoni, F., Tasselli, F. M., Milone, F., Pata, F., Sammartino, F., Zambianchi, F., Barragan, F., Herrero, F., Schlottmann, F., Den Boer, F. C., Pfeffer, F., Fujita, F., Navarra, G., Herrera-Almario, G., Pozzo, G., Capolupo, G. T., van Ramshorst, G. H., Liscia, G., Gallo, G., Asawa, G., Wang, G., Raiyani, G., Beets, G., Naval, G. S., Jin, G., Chang, G. J., Saakian, G., Kahane, G., Borroni, G., Lo Secco, G., Baiocchi, G. L., Baronio, G., Pagano, G., Pattacini, G. C., Lisi, G., Milito, G., Sinibaldi, G., Serrao, G., Bagaglini, G., Sarro, G., Brisinda, G., Candilio, G., Mangiameli, G., Giuliani, G., Martin-Martin, G. P., Bodzin, G., Leon, G., Mackay, G., Vasil, G., Palmisano, G., Giovanna, G. M., Fernandez, G. C., Steingel, G. B., Zhang, G., Choi, G. S., Chen, H., Hirose, H., Kayano, H., Ulgur, H. S., Impellizzeri, H., Ariola, H., Liu, H., Medina, H., Miyauchi, H., Takahashi, H., Hayashi, H., Ishikawa, H., Ishida, H., de Vries, H., Ulman, H., Kon, H., Ota, H., Akamatsu, H., Tamagawa, H., Shoji, H., Egi, H., Matsubara, H., Miki, H., Elfeki, H., Lin, H. -H., Giani, I., Caravaca-Garcia, I., Takemasa, I., Angriman, I., Negoi, I., Volkova, I., Russo, I., Kronberger, I. E., Shageev, I., Aydin, I., Mora-Guzman, I., Novak, I., Giuliano, I., Rachmuth, J., Ngu, J. C. -Y., Glasbey, J., Stoot, J., Zatecky, J., Melenhorst, J., van der Wal, J. B. C., Leijtens, J., Bogach, J., Elliott, J., de Wilt, J. H. W., Han, J., Cui, J., Liu, J., Khan, J., Wirawan, J. P., Zhang, J., Manyari, J. D. O., Doerner, J., Bock, J., Konsten, J., Castro, J. M., Grobas, J. P., Pinto, J. P., Juloski, J., Laina, J. L. B., Solorzano, J. J., Lopez, J. R. G., Li, J., Watanabe, J., Kwak, J. -M., Hasegawa, J., Hiro, J., Sergey, K., Zhang, K., Nagahori, K., Martinez, K., Tokuhara, K., Danno, K., Uehara, K., Yoshimatsu, K., Ehara, K., Ueda, K., Suda, K., Yamamoto, K., Ishimaru, K., Kimura, K., Hirata, K., Deen, K., Imaizumi, K., Yamada, J., Tanakura, K., Rida, K., Sugimoto, K., Kotaro, K., Shi, K., Okabayashi, K., Hida, K., Kataoka, K., Hongo, K., Xia, K., Tseng, L., Reime, L., Lorenzon, L., Ruano, L. M., Zhou, L., de Nes, L., Brandariz, L., Morini, L., Petagna, L., Ripamonti, L., Martinez, L. H., Pio, L., Sacco, L., Carvalho, L., Zorcolo, L., Perez-Sanchez, L. E., Esparza, L. H. R., Aguilar, L. T., Garner, M., Sugimoto, M., Nagashima, M., Shiozawa, M., Simone, M., Ferrer-Marquez, M., Carvalho, M., Alifano, M., Arganini, M., Calussi, M., Catarci, M., Allaix, M. E., Forlin, M., Milone, M., Paci, M., Fodor, M., Antipova, M., Martos, M. B., Giuffrida, M. C., Tabernilla, M. D., Quiros, M. J. A., Lemma, M., Correo, M. L. R. D., Malowiecka, M., Bellomo, M. P., Fernandez, M. R., Socias, M., Rizk, M., Aurora, M., Antolinez, M. A., Ninkovic, M., Giuffrida, M., Leeuwenburgh, M. M. N., de Roos, M. A. J., Lara, M. C., Agustin, M. C., Cuadrado, M., Pascual, M., Lemmerer, M., Carlos, R., Okamoto, M., Miyo, M., Inomata, M., Ikenaga, M., Tsujie, M., Yasuno, M., Kotake, M., Sato, M., Yasui, M., Lavazza, M., Rottoli, M., Zuin, M., Zuluaga, M., Cervellera, M., Cesari, M., Zizzo, M., Garino, M., Ghirardi, M., Montuori, M., Podda, M., Santarelli, M., Koc, M. A., Baini, M., de Cillia, M., de Rosa, M., Manigrasso, M., Zuolo, M., Cunha, M. F., Misca, M., Slavchev, M., Danilov, M., Shigaev, M., Martens, M., Kobayashi, M., Ren, M., Ishizuka, M., Hassan, M. M., Siblini, M., Sahloul, M., Keramati, M. R., Karunakaran, M., Markel, M., Majeed, M., Younis, M. U., Akin, M. I., Laraibe, M., Derebey, M., Kendirci, M., Fukunaga, M., Matsubara, N., Ordaz, N. E. C., Samalavicius, N. E., Keeratibharat, N., de Angelis, N., Gica, N., Mariani, N. M., Ramino, N., Falco, N., Smart, N., de Korte, N., Kok, N. F. M., Jamieson, N. B., Aberyasev, N., Bruklich, N., Ichikawa, N., Miyoshi, N., de Palma, N., Figueiredo, N., Torrecilla, N. O., Dybov, O. G., Yudin, O., Crepin, O., Gomez, O., Sert, O. Z., Lominchar, P. L., Menendez, P., de Nardi, P., Tejedor, P., Jordan, P., Tan, P., Marsanic, P., Natalya, P., Banos, P. P., Rebasa, P., Neary, P. M., Tanis, P., Giustacchini, P., Anoldo, P., Concejo, P., Cao, P., Chandrasinghe, P., Abeyratne, P., Wang, Q., Klicks, R. J., Mukai, R., Riquelme, R. F., de Luca, R., Galli, R., Gianesini, R., Moorjani, R. G., Deshpande, R. K., Gorter, R., Ledesma, R. L., Ruslan, R. -G., Chhabra, R., Talreja-Pelaez, R., Suzuki, R., Balestri, R., Rosati, R., Kiblawi, R., Martins, R., Angelico, R., Tutino, R., Persiani, R., Pollastri, R., Lopez, R. G., Perez, R. O., Hompes, R., Lukanin, R., Roser Termes, S. R., Brunaccino, R., Nakanishi, R., Stefan, S., Hernandez, S. P. S., Di Carlo, S., Ingallinella, S., Domoto, S., Ikeda, S., Mikalauskas, S., Kim, S. H., Mantova, S., Barbuta, S., Li, S., Yamaguchi, S., Yam-Agishi, S., Homma, S., Tsujinaka, S., Yoshioka, S., Mori, S., Tewari, S., Rayman, S., Horiuchi, S., Matoba, S., Morita, S., Yaman, S., Vigna, S., Testa, S., Ng, S., Deidda, S., Cicconi, S., Di Maria, S., Sibio, S., Ersoz, S., Pejkova, S., Altarifi, S., He, S., Malakorn, S., Meindert, S., Sumikawa, S., Parmar, S., Uranitsch, S., D'Ugo, S., Giuliani, S., Breukink, S., Lee, S. -H., Hata, T., Ishikawa, T., Akiyoshi, T., Azuma, T., Kobatake, T., Fukuzaki, T., Aiyama, T., Yamada, T., Garmanova, T., Gomez-Sanchez, T., Yamaguchi, T., de Jesus Flores, T., Usub, T., Tsuruma, T., Shimizu, T., Hristov, T. G., van Loon, T., Funakoshi, T., Manzia, T. M., Kiyomatsu, T., Katayama, T., Akagi, T., Mizushima, T., Kazuhito, U., Elmore, U., Grossi, U., Trucha, V. A., Rodriguez, V. S., Testa, V., Tonini, V., Celentano, V., Nekoval, V. M., Bettencourt, V., Mammadov, V., Leyva, V. A. G., Mariscal, V. G. O., Seid, V. E., Klemann, V., Turrado-Rodriguez, V., Papagni, V., Vento, V., Frering, V., Vigorita, V., Petrove, V. V., Lyadov, V., Fu, W., Mi, W., Jeong, W. K., Leclercq, W. K. G., de Sousa, X., Zhao, X., Li, X., Wang, X., Yang, X., Zhang, X., Zhen, Y., Dong, Y., Erushevich, Y., Takii, Y., Sumi, Y., Loli, Y. T., Yifat, Y. L., Shimada, Y., Nabeya, Y., Ide, Y., Wu, Y., Tsukada, Y., Miyamoto, Y., Toiyama, Y., Fujie, Y., Kaneko, Y., Mokutani, Y., Fujii, Y., Kanemitsu, Y., Medkova, Y., Chen, Y., Ruiz, Y. G., Kinugasa, Y., Sow, Z., Razzaq, Z., Wang, Z., Liu, Z., Han, Z., Tai, Z., Lai, Z., Ng, Z. Q., Dambrauskas, Z., Bellato, V, Konishi, T, Pellino, G, An, Y, Piciocchi, A, Sensi, B, Siragusa, L, Khanna, K, P, Bm, Franceschilli, M, Campanelli, M, Efetov, S, S Sica, G, Uggeri, F, Bellato V., Konishi T., Pellino G., An Y., Piciocchi A., Sensi B., Siragusa L., Khanna K., Pirozzi B.M., Franceschilli M., Rottoli M., Campanelli M., Efetov S., Sica G.S., on behalf of S-COVID Collaborative Group [ .., Tonini V., ], Bellato, Vittoria, Konishi, Tsuyoshi, Pellino, Gianluca, An, Yongbo, Piciocchi, Alfonso, Sensi, Bruno, Siragusa, Leandro, Khanna, Krishn, Pirozzi, Brunella Maria, Franceschilli, Marzia, Campanelli, Michela, Efetov, Sergey, Sica, Giuseppe S, Center of Experimental and Molecular Medicine, Graduate School, ACS - Pulmonary hypertension & thrombosis, AII - Infectious diseases, Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Surgery, Amsterdam Reproduction & Development (AR&D), and Robotics and image-guided minimally-invasive surgery (ROBOTICS)
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Cross Infection/prevention & control ,Cross-sectional study ,Settore MED/18 - CHIRURGIA GENERALE ,Coronavirus Infections/prevention & control ,Practice Patterns ,0302 clinical medicine ,Betacoronavirus ,COVID-19 ,Coronavirus Infections ,Cross Infection ,Cross-Sectional Studies ,Hospitals ,Humans ,Infection Control ,Mass Screening ,Pandemics ,Pneumonia, Viral ,Policy ,Practice Patterns, Physicians ,SARS-CoV-2 ,Surgical Procedures, Operative ,Surveys and Questionnaires ,Pandemic ,Hospitals/standards ,Infection control ,030212 general & internal medicine ,Viral ,Pandemics/prevention & control ,Practice Patterns, Physicians' ,Research Theme 1: COVID-19 Pandemic ,Pneumonia, Viral/prevention & control ,Mass Screening/standards ,Health Policy ,Operative/adverse effects ,Operative ,screening policies ,preventive measures ,Human ,Surgical Procedures, Operative/adverse effects ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,030231 tropical medicine ,MEDLINE ,NO ,Physicians'/standards ,Hospital ,03 medical and health sciences ,Physicians ,medicine ,Practice Patterns, Physicians'/standards ,Mass screening ,Cross-Sectional Studie ,Physicians' ,Surgical Procedures ,Betacoronaviru ,Coronavirus Infection ,business.industry ,Preoperative screening ,Public Health, Environmental and Occupational Health ,Viral/prevention & control ,Perioperative ,Pneumonia ,Settore MED/18 ,COVID-19, Coronavirus Infections, Cross Infection, Cross-Sectional Studies, Hospitals, Humans, Infection Control, Mass Screening, Pandemics, Pneumonia, Viral, Policy, Practice Patterns, Physicians', SARS-CoV-2, Surgical Procedures, Operative, Surveys and Questionnaires ,coronavirus Infections ,cross infection ,cross-sectional studies ,hospitals ,humans ,infection control ,mass screening ,pandemics ,pneumonia, viral ,policy ,practice patterns, physicians' ,surgical procedures ,operative ,surveys and questionnaires ,Family medicine ,Infection Control/standards ,business - Abstract
Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide.Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions.Study registration: Registered in ClinicalTrials.gov: NCT04344197.
27. Structural studies of polychlorinated hydrocarbons. II. Hexachloroxanthene and hexachloroxanthone
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Söderholm, M., primary, Sonnerstam, U., additional, Norrestam, R., additional, and Palm, T. B., additional
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- 1976
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28. Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults
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Bengt Järvholm, Lars Lind, Anders Wanhainen, Marie Eriksson, Per-Olof Hansson, Johanna Pennlert, Karl Michaëlsson, Martin Ingelsson, Anders Knutsson, Ylva Trolle Lagerros, Susanna C. Larsson, Susanne Heller, Johan Hallqvist, Cecilia Magnusson, Per Broberg, Patrik K. E. Magnusson, Vilmantas Giedraitis, Håkan Olsson, Payam Khalili, Niclas Håkansson, Jerzy Leppert, Andreas Rosenblad, Rino Bellocco, Mauricio Malfert, Martin Andersson, Jenny Theorell-Haglöw, Stefan Söderberg, Eleonor I. Fransson, Annika Rosengren, Eva Lindberg, Martin Söderholm, Johan Sundström, Martin Björck, Anton Carl Jonas Lager, Bodil Svennblad, Maria Eriksson, Nancy L. Pedersen, Bernice Wiberg, Lars Alfredsson, Gunnar Engström, Peter M. Nilsson, Christer Janson, Kjell Torén, Bertil Forsberg, Karin Leander, Alicja Wolk, Sundström, J, Söderholm, M, Söderberg, S, Alfredsson, L, Andersson, M, Bellocco, R, and Wiberg, B
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Subarachnoid hemorrhage ,030204 cardiovascular system & hematology ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Cause of Death ,Epidemiology ,medicine ,cohort study ,Humans ,Registries ,Stroke ,Cause of death ,Sweden ,business.industry ,Mortality rate ,Smoking ,General Medicine ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Blood pressure ,Cohort ,Hypertension ,Educational Status ,Regression Analysis ,epidemiology ,Female ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Background Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium. Methods We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries. Results During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4–10.6)/100 000 person-years] in men and 13.8 [(11.4–16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95–2.57) in women and 1.62 (1.47–1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81–0.92) in women and 1.02 (0.96–1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH. Conclusions The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.
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- 2019
29. The Post-Stroke Checklist: longitudinal use in routine clinical practice during first year after stroke.
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Månsson K, Söderholm M, Berhin I, Pessah-Rasmussen H, and Ullberg T
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- Humans, Female, Male, Aged, Sweden epidemiology, Time Factors, Middle Aged, Aged, 80 and over, Risk Factors, Longitudinal Studies, Predictive Value of Tests, Secondary Prevention, Treatment Outcome, Prevalence, Stroke Rehabilitation, Health Status, Checklist, Stroke diagnosis, Stroke epidemiology, Stroke therapy, Recurrence
- Abstract
Background: Few studies describe the use of the Post-Stroke Checklist (PSC) as a tool for longitudinal stroke follow-up in clinical practice. We mapped the prevalence of stroke-related health problems and targeted interventions at 3 and 12 months post-stroke by using the PSC., Methods: Patients with acute stroke discharged home in 2018-2019 at Skåne University Hospital, Sweden, were invited to participate in a comprehensive nurse-led follow-up based on a 14-item PSC 3 and 12 months post-stroke. We measured time consumption, screened for stroke-related health problems, compared the findings, and recorded targeted healthcare interventions. Problems at 12 months were grouped into new, persistent, or none compared to the 3-month evaluation., Results: Of 200 consecutively included patients, 146 (77%) completed both the 3- and 12-month follow-ups. At 12-month follow-up, 36% of patients reported no stroke-related health problems, 24% reported persistent problems, and 40% reported new problems since the 3-month evaluation. New problems at 12 months were most common within the domains: secondary prevention (23%) and life after stroke (10%). Stroke recurrence rate was 7.5%, 43% had high blood pressure, and few smokers had quit smoking. At 12 months, 53% received at least one new healthcare intervention, compared to 84% at 3 months., Conclusions: Stroke-related health problems decreased beyond 3 months but were still present in two-thirds of patients at 1 year. This emphasizes the relevance of continuous structured follow-up using the PCS. However, the follow-up alone was insufficient to adequately achieve treatment targets for secondary prevention, which require intensified focus., Trial Registration: ClinicalTrials.gov ID NCT04295226, (04/03/2020)., (© 2024. The Author(s).)
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- 2024
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30. Evaluation of an artificial intelligence-based decision support for the detection of cutaneous melanoma in primary care: a prospective real-life clinical trial.
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Papachristou P, Söderholm M, Pallon J, Taloyan M, Polesie S, Paoli J, Anderson CD, and Falk M
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- Humans, Prospective Studies, Female, Male, Middle Aged, Aged, Adult, Decision Support Systems, Clinical, Sweden, Sensitivity and Specificity, Melanoma diagnosis, Melanoma pathology, Skin Neoplasms diagnosis, Skin Neoplasms pathology, Skin Neoplasms diagnostic imaging, Primary Health Care, Dermoscopy, Artificial Intelligence, Smartphone, Mobile Applications
- Abstract
Background: Use of artificial intelligence (AI), or machine learning, to assess dermoscopic images of skin lesions to detect melanoma has, in several retrospective studies, shown high levels of diagnostic accuracy on par with - or even outperforming - experienced dermatologists. However, the enthusiasm around these algorithms has not yet been matched by prospective clinical trials performed in authentic clinical settings. In several European countries, including Sweden, the initial clinical assessment of suspected skin cancer is principally conducted in the primary healthcare setting by primary care physicians, with or without access to teledermoscopic support from dermatology clinics., Objectives: To determine the diagnostic performance of an AI-based clinical decision support tool for cutaneous melanoma detection, operated by a smartphone application (app), when used prospectively by primary care physicians to assess skin lesions of concern due to some degree of melanoma suspicion., Methods: This prospective multicentre clinical trial was conducted at 36 primary care centres in Sweden. Physicians used the smartphone app on skin lesions of concern by photographing them dermoscopically, which resulted in a dichotomous decision support text regarding evidence for melanoma. Regardless of the app outcome, all lesions underwent standard diagnostic procedures (surgical excision or referral to a dermatologist). After investigations were complete, lesion diagnoses were collected from the patients' medical records and compared with the app's outcome and other lesion data., Results: In total, 253 lesions of concern in 228 patients were included, of which 21 proved to be melanomas, with 11 thin invasive melanomas and 10 melanomas in situ. The app's accuracy in identifying melanomas was reflected in an area under the receiver operating characteristic (AUROC) curve of 0.960 [95% confidence interval (CI) 0.928-0.980], corresponding to a maximum sensitivity and specificity of 95.2% and 84.5%, respectively. For invasive melanomas alone, the AUROC was 0.988 (95% CI 0.965-0.997), corresponding to a maximum sensitivity and specificity of 100% and 92.6%, respectively., Conclusions: The clinical decision support tool evaluated in this investigation showed high diagnostic accuracy when used prospectively in primary care patients, which could add significant clinical value for primary care physicians assessing skin lesions for melanoma., Competing Interests: Conflicts of interest P.P. is a co-founder of the clinical decision support (Dermalyser®) studied in the clinical trial. The other authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.)
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- 2024
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31. Computable species descriptions and nanopublications: applying ontology-based technologies to dung beetles (Coleoptera, Scarabaeinae).
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Montanaro G, Balhoff JP, Girón JC, Söderholm M, and Tarasov S
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Background: Taxonomy has long struggled with analysing vast amounts of phenotypic data due to computational and accessibility challenges. Ontology-based technologies provide a framework for modelling semantic phenotypes that are understandable by computers and compliant with FAIR principles. In this paper, we explore the use of Phenoscript, an emerging language designed for creating semantic phenotypes, to produce computable species descriptions. Our case study centers on the application of this approach to dung beetles (Coleoptera, Scarabaeinae)., New Information: We illustrate the effectiveness of Phenoscript for creating semantic phenotypes. We also demonstrate the ability of the Phenospy python package to automatically translate Phenoscript descriptions into natural language (NL), which eliminates the need for writing traditional NL descriptions. We introduce a computational pipeline that streamlines the generation of semantic descriptions and their conversion to NL. To demonstrate the power of the semantic approach, we apply simple semantic queries to the generated phenotypic descriptions. This paper addresses the current challenges in crafting semantic species descriptions and outlines the path towards future improvements. Furthermore, we discuss the promising integration of semantic phenotypes and nanopublications, as emerging methods for sharing scientific information. Overall, our study highlights the pivotal role of ontology-based technologies in modernising taxonomy and aligning it with the evolving landscape of big data analysis and FAIR principles., (Giulio Montanaro, James P. Balhoff, Jennifer C. Girón, Max Söderholm, Sergei Tarasov.)
- Published
- 2024
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32. qRT-PCR analysis of CEACAM5, KLK6, SLC35D3, MUC2 and POSTN in colon cancer lymph nodes-An improved method for assessment of tumor stage and prognosis.
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Lindmark G, Olsson L, Sitohy B, Israelsson A, Blomqvist J, Kero S, Roshdy T, Söderholm M, Turi A, Isaksson J, Sakari T, Dooper M, Dafnis G, Forsberg P, Skovsted S, Walldén M, Kung CH, Rutegård M, Nordmyr J, Muhrbeck M, Hammarström S, and Hammarström ML
- Subjects
- Humans, Lymph Nodes pathology, Prospective Studies, Biomarkers, Tumor genetics, Biomarkers, Tumor analysis, Neoplasm Recurrence, Local genetics, Neoplasm Recurrence, Local pathology, Prognosis, Lymphatic Metastasis pathology, Recurrence, Polymerase Chain Reaction, Neoplasm Staging, Lymph Node Excision, Retrospective Studies, Cell Adhesion Molecules genetics, Colonic Neoplasms genetics, Colonic Neoplasms pathology, Lymphoma pathology
- Abstract
One fourth of colorectal cancer patients having curative surgery will relapse of which the majority will die. Lymph node (LN) metastasis is the single most important prognostic factor and a key factor when deciding on postoperative treatment. Presently, LN metastases are identified by histopathological examination, a subjective method analyzing only a small LN volume and giving no information on tumor aggressiveness. To better identify patients at risk of relapse we constructed a qRT-PCR test, ColoNode, that determines levels of CEACAM5, KLK6, SLC35D3, MUC2 and POSTN mRNAs. Combined these biomarkers estimate the tumor cell load and aggressiveness allocating patients to risk categories with low (0, -1), medium (1), high (2) and very high (3) risk of recurrence. Here we present result of a prospective, national multicenter study including 196 colon cancer patients from 8 hospitals. On average, 21 LNs/patient, totally 4698 LNs, were examined by both histopathology and ColoNode. At 3-year follow-up, 36 patients had died from colon cancer or lived with recurrence. ColoNode identified all patients that were identified by histopathology and in addition 9 patients who were undetected by histopathology. Thus, 25% of the patients who recurred were identified by ColoNode only. Multivariate Cox regression analysis proved ColoNode (1, 2, 3 vs 0, -1) as a highly significant risk factor with HR 4.24 [95% confidence interval, 1.42-12.69, P = .01], while pTN-stage (III vs I/II) lost its univariate significance. In conclusion, ColoNode surpassed histopathology by identifying a significantly larger number of patients with future relapse and will be a valuable tool for decisions on postoperative treatment., (© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
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- 2024
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33. Age at Menopause and the Risk of Stroke: Observational and Mendelian Randomization Analysis in 204 244 Postmenopausal Women.
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Tschiderer L, Peters SAE, van der Schouw YT, van Westing AC, Tong TYN, Willeit P, Seekircher L, Moreno-Iribas C, Huerta JM, Crous-Bou M, Söderholm M, Schulze MB, Johansson C, Själander S, Heath AK, Macciotta A, Dahm CC, Ibsen DB, Pala V, Mellemkjær L, Burgess S, Wood A, Kaaks R, Katzke V, Amiano P, Rodriguez-Barranco M, Engström G, Weiderpass E, Tjønneland A, Halkjær J, Panico S, Danesh J, Butterworth A, and Onland-Moret NC
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- Female, Humans, Middle Aged, Cerebral Hemorrhage, Mendelian Randomization Analysis, Menopause, Postmenopause, Prospective Studies, Observational Studies as Topic, Hemorrhagic Stroke, Ischemic Stroke, Stroke epidemiology, Stroke genetics
- Abstract
Background Observational studies have shown that women with an early menopause are at higher risk of stroke compared with women with a later menopause. However, associations with stroke subtypes are inconsistent, and the causality is unclear. Methods and Results We analyzed data of the UK Biobank and EPIC-CVD (European Prospective Investigation Into Cancer and Nutrition-Cardiovascular Diseases) study. A total of 204 244 postmenopausal women without a history of stroke at baseline were included (7883 from EPIC-CVD [5292 from the subcohort], 196 361 from the UK Biobank). Pooled mean baseline age was 58.9 years (SD, 5.8), and pooled mean age at menopause was 47.8 years (SD, 6.2). Over a median follow-up of 12.6 years (interquartile range, 11.8-13.3), 6770 women experienced a stroke (5155 ischemic strokes, 1615 hemorrhagic strokes, 976 intracerebral hemorrhages, and 639 subarachnoid hemorrhages). In multivariable adjusted observational Cox regression analyses, the pooled hazard ratios per 5 years younger age at menopause were 1.09 (95% CI, 1.07-1.12) for stroke, 1.09 (95% CI, 1.06-1.13) for ischemic stroke, 1.10 (95% CI, 1.04-1.16) for hemorrhagic stroke, 1.14 (95% CI, 1.08-1.20) for intracerebral hemorrhage, and 1.00 (95% CI, 0.84-1.20) for subarachnoid hemorrhage. When using 2-sample Mendelian randomization analysis, we found no statistically significant association between genetically proxied age at menopause and risk of any type of stroke. Conclusions In our study, earlier age at menopause was related to a higher risk of stroke. We found no statistically significant association between genetically proxied age at menopause and risk of stroke, suggesting no causal relationship.
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- 2023
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34. Mosaic Loss of Chromosome Y Is Associated With Functional Outcome After Ischemic Stroke.
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Dorvall M, Pedersen A, Dumanski JP, Söderholm M, Lindgren AG, Stanne TM, and Jern C
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- Humans, Male, Chromosomes, Human, Y, Mosaicism, Ischemic Stroke complications, Stroke genetics, Stroke therapy, Diabetes Mellitus
- Abstract
Background: Mosaic loss of chromosome Y (LOY) is associated with cardiovascular and neurodegenerative diseases in men, and genetic predisposition to LOY is associated with poor poststroke outcome. We, therefore, tested the hypothesis that LOY itself is associated with functional outcome after ischemic stroke., Methods: The study comprised male patients with ischemic stroke from the cohort studies SAHLSIS2 (Sahlgrenska Academy Study on Ischemic Stroke Phase 2; n=588) and LSR (Lund Stroke Register; n=735). We used binary logistic regression to analyze associations between LOY, determined by DNA microarray intensity data, and poor 3-month functional outcome (modified Rankin Scale score, >2) in each cohort separately and combined. Patients who received recanalization therapy were excluded from sensitivity analyses., Results: LOY was associated with about 2.5-fold increased risk of poor outcome in univariable analyses ( P <0.001). This association withstood separate adjustment for stroke severity and diabetes in both cohorts but not age. In sensitivity analyses restricted to the nonrecanalization group (n=987 in the combined cohort), the association was significant also after separate adjustment for age (odds ratio, 1.6 [95% CI, 1.1-2.4]) and when additionally adjusting for stroke severity and diabetes (odds ratio, 1.6 [95% CI, 1.1-2.5])., Conclusions: We observed an association between LOY and poor outcome after ischemic stroke in patients not receiving recanalization therapy. Future studies on LOY and other somatic genetic alterations in larger stroke cohorts are warranted., Competing Interests: Disclosures Dr Dumanski is a cofounder and shareholder in Cray Innovation AB. Dr Lindgren reports personal fees from AstraZeneca, Bayer, Bristol Myers Squibb, Novo Nordisk, Pfizer, and Portola Pharmaceuticals. The other authors report no conflicts.
- Published
- 2023
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35. How threats inform conservation planning-A systematic review protocol.
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Virtanen EA, Söderholm M, and Moilanen A
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- Ecosystem, Fresh Water, Geography, Systematic Reviews as Topic, Biodiversity, Conservation of Natural Resources methods
- Abstract
Conservation planning addresses the development and expansion of protected areas and requires data on for instance species, habitats, and biodiversity. Data on threats is often minimal, although necessary in conservation planning. In principle, threats should guide which conservation actions to take and where, and how to allocate resources. The lack of threat information may also limit the validity of areas to be conserved, if the condition of areas is degraded by threats unknown. The protocol described here outlines the methodology for a systematic review to explore how threats are theoretically and methodologically understood and used in conservation plans across freshwater, marine and terrestrial environments. Our primary research question is: how have threats informed conservation planning? Studies will be categorized according to the types of threats and conservation features used, theoretical and methodological approaches applied, geographical context, and biome. The results are expected to increase our understanding about how threats can and should be addressed in conservation planning., Competing Interests: The authors have declared that no competing interests exist
- Published
- 2022
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36. Sex-specific lesion pattern of functional outcomes after stroke.
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Bonkhoff AK, Bretzner M, Hong S, Schirmer MD, Cohen A, Regenhardt RW, Donahue KL, Nardin MJ, Dalca AV, Giese AK, Etherton MR, Hancock BL, Mocking SJT, McIntosh EC, Attia J, Benavente OR, Bevan S, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Kittner SJ, Lemmens R, Levi CR, McDonough CW, Meschia JF, Phuah CL, Rolfs A, Ropele S, Rosand J, Roquer J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Söderholm M, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Zand R, McArdle PF, Worrall BB, Jern C, Lindgren AG, Maguire J, Fox MD, Bzdok D, Wu O, and Rost NS
- Abstract
Stroke represents a considerable burden of disease for both men and women. However, a growing body of literature suggests clinically relevant sex differences in the underlying causes, presentations and outcomes of acute ischaemic stroke. In a recent study, we reported sex divergences in lesion topographies: specific to women, acute stroke severity was linked to lesions in the left-hemispheric posterior circulation. We here determined whether these sex-specific brain manifestations also affect long-term outcomes. We relied on 822 acute ischaemic patients [age: 64.7 (15.0) years, 39% women] originating from the multi-centre MRI-GENIE study to model unfavourable outcomes (modified Rankin Scale >2) based on acute neuroimaging data in a Bayesian hierarchical framework. Lesions encompassing bilateral subcortical nuclei and left-lateralized regions in proximity to the insula explained outcomes across men and women (area under the curve = 0.81). A pattern of left-hemispheric posterior circulation brain regions, combining left hippocampus, precuneus, fusiform and lingual gyrus, occipital pole and latero-occipital cortex, showed a substantially higher relevance in explaining functional outcomes in women compared to men [mean difference of Bayesian posterior distributions (men - women) = -0.295 (90% highest posterior density interval = -0.556 to -0.068)]. Once validated in prospective studies, our findings may motivate a sex-specific approach to clinical stroke management and hold the promise of enhancing outcomes on a population level., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Guarantors of Brain.)
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- 2022
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37. Delineating the geographic context of physical activities: A systematic search and scoping review of the methodological approaches used in social ecological research over two decades.
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Rinne T, Kajosaari A, Söderholm M, Berg P, Pesola AJ, Smith M, and Kyttä M
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- Environmental Exposure, Humans, Motor Activity, Research Design, Exercise, Social Environment
- Abstract
Background: The social ecological approach suggests that the spatial context among other factors influence physical activity behavior. Ample research documents physical environmental effects on physical activity. Yet, to date inconsistent associations remain, which might be explained by conceptual and methodological challenges in measuring the spatial dimensions of health behavior. We review methods applied to measure the spatial contexts in the social ecological physical activity literature., Methods: Online databases and selected reviews were used to identify papers published between 1990 and 2020. A total of 2167 records were retrieved, from which 412 studies that used physical activity as a primary outcome variable, included measures of the physical environment and applied the main principles of the social ecological approach, were included., Results: Subjective approaches were the dominant method to capture the spatial context of physical activities. These approaches were applied in 67% (n=279) of the studies. From the objective approaches an administrative unit was most prevalent and was applied in 29% (n=118) of the studies. The most comprehensive objective spatial methods that capture the true environmental exposure, were used only in 2% (n=10) of the studies., Conclusions: Current social ecological physical activity research applies simple conceptualizations and methods of the spatial context. While conceptual and methodological concerns have been repeatedly expressed, no substantive progress has been made in the use of spatial approaches. To further our understanding on place effects on health, future studies should carefully consider the choice of spatial approaches, and their effect on study results., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
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38. Fibroblast growth factor 23 is associated with risk of intracerebral hemorrhage.
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Svensson EH and Söderholm M
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- Case-Control Studies, Cerebral Hemorrhage complications, Humans, Risk Factors, Fibroblast Growth Factor-23 metabolism, Stroke complications
- Abstract
Background and Purpose: Fibroblast growth factor 23 (FGF23) is an osteogenic hormone associated with chronic kidney disease and is an emerging risk factor for several cardiovascular diseases. The association of FGF23 with stroke is unclear. The aim of this study was to investigate the association of FGF23 with incident intracerebral hemorrhage (ICH)., Methods: This was a nested case-control study of 220 ICH cases and 244 age- and sex-matched controls from the population-based Malmö Diet and Cancer Study (n = 28,449). Incident ICH cases were ascertained using national registers and classified by bleeding location. Logistic regression was used to study the association of plasma levels of FGF23 with incident ICH, adjusting for potential ICH risk factors. Subgroup analyses were performed for lobar and non-lobar ICH, fatal ICH, ICH with large volume and ICH with poor functional outcome, respectively., Results: Higher FGF23 levels at baseline were significantly associated with incident ICH. After multivariable adjustment, the odds ratio for the association with all ICH was 1.84 (95% confidence interval [CI] 1.25-2.71, p = 0.002) per doubling of FGF23 concentration. For lobar and non-lobar ICH, odds ratios were 1.73 (95% CI 1.04-2.87, p = 0.035) and 2.13 (95% CI 1.32-3.45, p = 0.002), respectively. FGF23 was also significantly associated with fatal ICH, ICH with large volume and ICH with poor functional outcome., Conclusions: Higher FGF23 was associated with incident ICH in this nested case-control study. Further studies are required to explore whether the association is causal., (© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
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- 2022
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39. Genetic Predisposition to Mosaic Chromosomal Loss Is Associated With Functional Outcome After Ischemic Stroke.
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Johansson M, Pedersen A, Cole JW, Lagging C, Lindgren A, Maguire JM, Rost NS, Söderholm M, Worrall BB, Stanne TM, and Jern C
- Abstract
Background and Objectives: To test the hypothesis that a predisposition to acquired genetic alterations is associated with ischemic stroke outcome by investigating the association between a polygenic risk score (PRS) for mosaic loss of chromosome Y (mLOY) and outcome in a large international data set., Methods: We used data from the genome-wide association study performed within the Genetics of Ischemic Stroke Functional Outcome network, which included 6,165 patients (3,497 men and 2,668 women) with acute ischemic stroke of mainly European ancestry. We assessed a weighted PRS for mLOY and examined possible associations with the modified Rankin Scale (mRS) score 3 months poststroke in logistic regression models. We investigated the whole study sample as well as men and women separately., Results: Increasing PRS for mLOY was associated with poor functional outcome (mRS score >2) with an odds ratio (OR) of 1.11 (95% confidence interval [CI] 1.03-1.19) per 1 SD increase in the PRS after adjustment for age, sex, ancestry, stroke severity (NIH Stroke Scale), smoking, and diabetes mellitus. In sex-stratified analyses, we found a statistically significant association in women (adjusted OR 1.20, 95% CI 1.08-1.33). In men, the association was in the same direction (adjusted OR 1.04, 95% CI 0.95-1.14), and we observed no significant genotype-sex interaction., Discussion: In this exploratory study, we found associations between genetic variants predisposing to mLOY and stroke outcome. The significant association in women suggests underlying mechanisms related to genomic instability that operate in both sexes. These findings need replication and mechanistic exploration., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)
- Published
- 2021
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40. Comparison of risk factors for ischemic stroke and coronary events in a population-based cohort.
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Muhammad IF, Borné Y, Zaigham S, Söderholm M, Johnson L, Persson M, Melander O, and Engström G
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- Biomarkers blood, Cohort Studies, Heart Disease Risk Factors, Inflammation, Proportional Hazards Models, Risk Assessment, Coronary Disease blood, Ischemic Stroke blood, Risk Factors
- Abstract
Background: Although coronary events (CE) and ischemic stroke share many risk factors, there are also some important differences. The aim of this paper was to assess the association of risk factors in relation to incident CE and ischemic stroke and to evaluate the heterogeneity in patterns of risk factors between the two outcomes., Method: Traditional risk factors and inflammatory markers associated with coronary events and ischemic stroke were measured in the Malmö Diet and Cancer Cohort (MDCS, n = 26 519), where a total of 2270 incident ischemic stroke and 3087 incident CE occurred during a mean follow up time 19 ± 6 years, and in relation to inflammatory markers in the cardiovascular sub-cohort (MDC-CV, n = 4795). Cox regression analysis was used to obtain hazard ratios. A modified Lunn-McNeil competing risk analysis was conducted to assess the significance of any differences in risk profiles of these outcomes., Results: Most cardiovascular risk factors were associated both with incident CE and ischemic stroke. However, current smoking, ApoB, low ApoA1, male sex and education level of ≤ 9 years of schooling were preferentially associated with CE compared to ischemic stroke. Conversely, age showed a stronger association with ischemic stroke than with CE., Conclusion: CE and ischemic stroke have broadly similar risk factors profiles. However, there are some important differential associations, as well as substantial differences in the magnitude of the association. These could reflect the distinct biology of atherogenesis in different vascular beds. The difference in the determinants highlights the importance of looking at CE and ischemic stroke, two manifestations of cardiovascular disease, separately., (© 2021. The Author(s).)
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- 2021
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41. Circulating Growth Differentiation Factor 15 Levels Are Associated With Risk of Both Intracerebral and Subarachnoid Hemorrhage.
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Song L, Söderholm M, Svensson EH, Borné Y, and Engström G
- Abstract
Background: Growth differentiation factor 15 (GDF-15) has been associated with the risk of developing major bleedings, including but not restricted to intracranial hemorrhages, in patients on oral anticoagulants or dual antiplatelet therapy. We hypothesized that there may be an association of GDF-15 with incidence of hemorrhagic strokes in the general population, which has not been investigated before. Methods: Two different case-control studies, one for intracerebral hemorrhage (ICH) and one for subarachnoid hemorrhage (SAH), nested within the population-based Malmö Diet and Cancer cohort, were defined using the incidence density sampling method. GDF-15 was analyzed in frozen blood samples taken at the baseline examination in 1991-1996. The associations between GDF-15 and incident ICH (220 cases, 244 controls) and incident SAH (79 cases, 261 controls), respectively, were explored using conditional logistic regression adjusting for risk factors. Results: GDF-15 levels at baseline were higher in both incident ICH and SAH cases, compared with their respective control subjects. After adjustment for risk factors, significant relationships with high GDF-15 concentrations were observed both for incident ICH (odds ratio (OR) per 1 log2 unit: 2.27, 95% confidence interval (CI): 1.52-3.41; P = 7.1 × 10
-5 ) and incident SAH (OR: 2.16, 95% CI: 1.29-3.59; P = 0.0032). Conclusions: High circulating GDF-15 levels were associated with incident ICH and incident SAH, independently of the main risk factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Song, Söderholm, Svensson, Borné and Engström.)- Published
- 2021
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42. Outcome after acute ischemic stroke is linked to sex-specific lesion patterns.
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Bonkhoff AK, Schirmer MD, Bretzner M, Hong S, Regenhardt RW, Brudfors M, Donahue KL, Nardin MJ, Dalca AV, Giese AK, Etherton MR, Hancock BL, Mocking SJT, McIntosh EC, Attia J, Benavente OR, Bevan S, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Kittner SJ, Lemmens R, Levi CR, McDonough CW, Meschia JF, Phuah CL, Rolfs A, Ropele S, Rosand J, Roquer J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Söderholm M, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Zand R, McArdle PF, Worrall BB, Jern C, Lindgren AG, Maguire J, Bzdok D, Wu O, and Rost NS
- Subjects
- Aged, Aged, 80 and over, Bayes Theorem, Brain Mapping, Brain Stem blood supply, Brain Stem diagnostic imaging, Cerebral Revascularization methods, Cohort Studies, Female, Humans, Image Processing, Computer-Assisted, Ischemic Stroke diagnostic imaging, Ischemic Stroke therapy, Magnetic Resonance Imaging, Male, Middle Aged, Risk Factors, Sensorimotor Cortex blood supply, Sensorimotor Cortex diagnostic imaging, Severity of Illness Index, Sex Factors, Thalamus blood supply, Thalamus diagnostic imaging, Treatment Outcome, Brain Stem pathology, Ischemic Stroke pathology, Sensorimotor Cortex pathology, Thalamus pathology
- Abstract
Acute ischemic stroke affects men and women differently. In particular, women are often reported to experience higher acute stroke severity than men. We derived a low-dimensional representation of anatomical stroke lesions and designed a Bayesian hierarchical modeling framework tailored to estimate possible sex differences in lesion patterns linked to acute stroke severity (National Institute of Health Stroke Scale). This framework was developed in 555 patients (38% female). Findings were validated in an independent cohort (n = 503, 41% female). Here, we show brain lesions in regions subserving motor and language functions help explain stroke severity in both men and women, however more widespread lesion patterns are relevant in female patients. Higher stroke severity in women, but not men, is associated with left hemisphere lesions in the vicinity of the posterior circulation. Our results suggest there are sex-specific functional cerebral asymmetries that may be important for future investigations of sex-stratified approaches to management of acute ischemic stroke.
- Published
- 2021
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43. The copy number variation and stroke (CaNVAS) risk and outcome study.
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Cole JW, Adigun T, Akinyemi R, Akpa OM, Bell S, Chen B, Jimenez Conde J, Lazcano Dobao U, Fernandez I, Fornage M, Gallego-Fabrega C, Jern C, Krawczak M, Lindgren A, Markus HS, Melander O, Owolabi M, Schlicht K, Söderholm M, Srinivasasainagendra V, Soriano Tárraga C, Stenman M, Tiwari H, Corasaniti M, Fecteau N, Guizzardi B, Lopez H, Nguyen K, Gaynor B, O'Connor T, Stine OC, Kittner SJ, McArdle P, Mitchell BD, Xu H, and Grond-Ginsbach C
- Subjects
- Case-Control Studies, Databases, Genetic, Ethnicity genetics, Exome genetics, Female, Genetic Predisposition to Disease genetics, Genome-Wide Association Study methods, Genotype, Humans, Male, MicroRNAs genetics, Outcome Assessment, Health Care statistics & numerical data, Phenotype, Pilot Projects, Polymorphism, Single Nucleotide genetics, Proteomics methods, Risk Factors, Stroke physiopathology, DNA Copy Number Variations genetics, Stroke genetics
- Abstract
Background and Purpose: The role of copy number variation (CNV) variation in stroke susceptibility and outcome has yet to be explored. The Copy Number Variation and Stroke (CaNVAS) Risk and Outcome study addresses this knowledge gap., Methods: Over 24,500 well-phenotyped IS cases, including IS subtypes, and over 43,500 controls have been identified, all with readily available genotyping on GWAS and exome arrays, with case measures of stroke outcome. To evaluate CNV-associated stroke risk and stroke outcome it is planned to: 1) perform Risk Discovery using several analytic approaches to identify CNVs that are associated with the risk of IS and its subtypes, across the age-, sex- and ethnicity-spectrums; 2) perform Risk Replication and Extension to determine whether the identified stroke-associated CNVs replicate in other ethnically diverse datasets and use biomarker data (e.g. methylation, proteomic, RNA, miRNA, etc.) to evaluate how the identified CNVs exert their effects on stroke risk, and lastly; 3) perform outcome-based Replication and Extension analyses of recent findings demonstrating an inverse relationship between CNV burden and stroke outcome at 3 months (mRS), and then determine the key CNV drivers responsible for these associations using existing biomarker data., Results: The results of an initial CNV evaluation of 50 samples from each participating dataset are presented demonstrating that the existing GWAS and exome chip data are excellent for the planned CNV analyses. Further, some samples will require additional considerations for analysis, however such samples can readily be identified, as demonstrated by a sample demonstrating clonal mosaicism., Conclusion: The CaNVAS study will cost-effectively leverage the numerous advantages of using existing case-control data sets, exploring the relationships between CNV and IS and its subtypes, and outcome at 3 months, in both men and women, in those of African and European-Caucasian descent, this, across the entire adult-age spectrum., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2021
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44. Risk factors for intracerebral haemorrhage - Results from a prospective population-based study.
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Svensson EH, Abul-Kasim K, Engström G, and Söderholm M
- Abstract
Introduction: While the relationship between hypertension and incident intracerebral haemorrhage is well established, other risk factors are less clear. This study examined risk factors for primary intracerebral haemorrhage, separately for lobar and non-lobar intracerebral haemorrhage., Patients and Methods: Incidence of intracerebral haemorrhage was studied among 28,416 individuals from the population-based Malmö Diet and Cancer cohort. Intracerebral haemorrhage cases were ascertained using the Swedish Hospital Discharge Register and the Stroke Register of Malmö, validated by review of hospital records and images, and classified by location by a neuroradiologist. Multivariable Cox regression was used., Results: Three hundred and thirty-three intracerebral haemorrhages occurred, mean follow-up time was 18.4 years. Systolic blood pressure (hazard ratio per 10 mmHg 1.19 [95% confidence interval 1.13-1.26], diastolic blood pressure (hazard ratio 1.42 [1.27-1.59]), oral anticoagulants (hazard ratio 4.26 [2.17-8.38]), smoking (hazard ratio 1.45 [1.14-1.87]), living alone (hazard ratio 1.32 [1.04-1.69]) and low apolipoprotein B (hazard ratio per 10 mg/dL: 0.94 [0.90-0.99]) were significantly associated with incident intracerebral haemorrhage after multivariable adjustment. Systolic blood pressure, smoking and oral anticoagulants were associated with lobar intracerebral haemorrhage. Systolic blood pressure, diastolic blood pressure, living alone and diabetes were associated with non-lobar intracerebral haemorrhage. Diabetes and diastolic blood pressure showed significantly different relationships with lobar and non-lobar intracerebral haemorrhage. Alcohol, apolipoprotein A1, body mass index, waist circumference, physical activity and education were not independently associated with intracerebral haemorrhage. Discussion and conclusions: Blood pressure, smoking, low apolipoprotein B, oral anticoagulants and living alone were associated with intracerebral haemorrhage. Diabetes was associated with non-lobar intracerebral haemorrhage only. Further research is required on differences between lobar and non-lobar intracerebral haemorrhage., (© European Stroke Organisation 2020.)
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- 2020
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45. Association of TIM-1 (T-Cell Immunoglobulin and Mucin Domain 1) With Incidence of Stroke.
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Song L, Sun J, Söderholm M, Melander O, Orho-Melander M, Nilsson J, Borné Y, and Engström G
- Subjects
- Biomarkers blood, Female, Genetic Predisposition to Disease, Genome-Wide Association Study, Hepatitis A Virus Cellular Receptor 1 blood, Humans, Incidence, Male, Mendelian Randomization Analysis, Middle Aged, Phenotype, Prognosis, Prospective Studies, Quantitative Trait Loci, Risk Assessment, Risk Factors, Stroke blood, Stroke diagnosis, Sweden epidemiology, Time Factors, Hepatitis A Virus Cellular Receptor 1 genetics, Polymorphism, Single Nucleotide, Stroke epidemiology, Stroke genetics
- Abstract
Objective: The aim of this study was to investigate if there is a causal relationship between circulating levels of TIM-1 (T-cell immunoglobulin and mucin domain 1) and incidence of stroke. Approach and Results: Plasma TIM-1 was analyzed in 4591 subjects (40% men; mean age, 57.5 years) attending the Malmö Diet and Cancer Study. Incidence of stroke was studied in relation to TIM-1 levels during a mean of 19.5 years follow-up. Genetic variants associated with TIM-1 (pQTLs [protein quantitative trait loci]) were examined, and a 2-sample Mendelian randomization analysis was performed to explore the role of TIM-1 in stroke using summary statistics from our pQTLs and the MEGASTROKE consortium. A total of 416 stroke events occurred during follow-up, of which 338 were ischemic strokes. After risk factor adjustment, TIM-1 was associated with increased incidence of all-cause stroke (hazards ratio for third versus first tertile, 1.44 [95% CI, 1.10-1.87]; P for trend, 0.004), and ischemic stroke (hazards ratio, 1.42 [95% CI, 1.06-1.90]; P for trend, 0.011). Nineteen independent lead SNPs, located in three genomic risk loci showed significant associations with TIM-1 ( P <5×10
-8 ). A 2-sample Mendelian Randomization analysis suggested a causal effect of TIM-1 on stroke (β=0.083, P =0.0004) and ischemic stroke (β=0.102, P =7.7×10-5 )., Conclusions: Plasma level of TIM-1 is associated with incidence of stroke. The genetic analyses suggest that this could be a causal relationship.- Published
- 2020
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46. Blood cadmium concentration and risk of subarachnoid haemorrhage.
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Söderholm M, Borné Y, Hedblad B, Persson M, Barregard L, and Engström G
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- Case-Control Studies, Cohort Studies, Humans, Risk Factors, Subarachnoid Hemorrhage chemically induced, Cadmium blood, Environmental Exposure statistics & numerical data, Environmental Pollutants blood, Subarachnoid Hemorrhage epidemiology
- Abstract
Background: Cadmium is a toxic metal and exposure is mainly from diet and tobacco smoke. Cadmium is accumulated in blood vessels and may reduce synthesis of procollagen and inhibit proliferation of vascular smooth muscle cells. High blood cadmium has been associated with increased risk of myocardial infarction, stroke and unruptured intracranial aneurysms. We examined whether blood cadmium increase the risk of subarachnoid haemorrhage (SAH)., Methods: The Malmö Diet and Cancer cohort (n = 28,449) was examined in 1991-1996 and blood samples were taken. Incidence of SAH was followed up to 2014. Cadmium was measured in stored blood samples from incident SAH cases and matched controls (n = 93 vs n = 276) and odds ratio (OR) for SAH was assessed in a nested case control design., Results: Subjects with cadmium concentration in the highest quartile had increased risk of SAH compared to those in the first quartile (OR: 3.22, 95%CI: 1.67-6.22). However, after adjusting for smoking, results were weakened and non-significant (OR: 1.57, 95%CI: 0.51-4.80)., Conclusions: Cadmium concentration was associated with increased risk of SAH but this association was largely explained by smoking. Whether cadmium in tobacco may contribute to the vascular pathology and increased risk of SAH in smokers should be further studied., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2020
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47. Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults.
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Sundström J, Söderholm M, Söderberg S, Alfredsson L, Andersson M, Bellocco R, Björck M, Broberg P, Eriksson M, Eriksson M, Forsberg B, Fransson EI, Giedraitis V, Theorell-Haglöw J, Hallqvist J, Hansson PO, Heller S, Håkansson N, Ingelsson M, Janson C, Järvholm B, Khalili P, Knutsson A, Lager A, Lagerros YT, Larsson SC, Leander K, Leppert J, Lind L, Lindberg E, Magnusson C, Magnusson PKE, Malfert M, Michaëlsson K, Nilsson P, Olsson H, Pedersen NL, Pennlert J, Rosenblad A, Rosengren A, Torén K, Wanhainen A, Wolk A, Engström G, Svennblad B, and Wiberg B
- Subjects
- Adult, Body Mass Index, Cause of Death, Educational Status, Female, Humans, Male, Middle Aged, Registries, Regression Analysis, Sex Factors, Smoking epidemiology, Subarachnoid Hemorrhage mortality, Sweden epidemiology, Hypertension epidemiology, Smoking adverse effects, Subarachnoid Hemorrhage epidemiology
- Abstract
Background: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium., Methods: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries., Results: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH., Conclusions: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives., (© The Author(s) 2019; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)
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- 2019
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48. APOE ε4 is associated with younger age at ischemic stroke onset but not with stroke outcome.
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Lagging C, Lorentzen E, Stanne TM, Pedersen A, Söderholm M, Cole JW, Jood K, Lemmens R, Phuah CL, Rost NS, Thijs V, Woo D, Maguire JM, Lindgren A, and Jern C
- Subjects
- Age of Onset, Alleles, Apolipoprotein E2 genetics, Apolipoprotein E3 genetics, Brain Ischemia epidemiology, Brain Ischemia physiopathology, Genome-Wide Association Study, Genotype, Humans, Polymorphism, Single Nucleotide, Prognosis, Severity of Illness Index, Sex Factors, Stroke epidemiology, Stroke physiopathology, Apolipoprotein E4 genetics, Brain Ischemia genetics, Stroke genetics
- Published
- 2019
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49. Circulating Monocyte Chemoattractant Protein-1 and Risk of Stroke: Meta-Analysis of Population-Based Studies Involving 17 180 Individuals.
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Georgakis MK, Malik R, Björkbacka H, Pana TA, Demissie S, Ayers C, Elhadad MA, Fornage M, Beiser AS, Benjamin EJ, Boekholdt SM, Engström G, Herder C, Hoogeveen RC, Koenig W, Melander O, Orho-Melander M, Schiopu A, Söderholm M, Wareham N, Ballantyne CM, Peters A, Seshadri S, Myint PK, Nilsson J, de Lemos JA, and Dichgans M
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- Adult, Aged, Atherosclerosis blood, Biomarkers blood, Female, Humans, Male, Middle Aged, Stroke blood, Atherosclerosis epidemiology, Chemokine CCL2 blood, Stroke epidemiology
- Abstract
Rationale: Proinflammatory cytokines have been identified as potential targets for lowering vascular risk. Experimental evidence and Mendelian randomization suggest a role of MCP-1 (monocyte chemoattractant protein-1) in atherosclerosis and stroke. However, data from large-scale observational studies are lacking. Objective: To determine whether circulating levels of MCP-1 are associated with risk of incident stroke in the general population. Methods and Results: We used previously unpublished data on 17 180 stroke-free individuals (mean age, 56.7±8.1 years; 48.8% men) from 6 population-based prospective cohort studies and explored associations between baseline circulating MCP-1 levels and risk of any stroke, ischemic stroke, and hemorrhagic stroke during a mean follow-up interval of 16.3 years (280 522 person-years at risk; 1435 incident stroke events). We applied Cox proportional-hazards models and pooled hazard ratios (HRs) using random-effects meta-analyses. After adjustments for age, sex, race, and vascular risk factors, higher MCP-1 levels were associated with increased risk of any stroke (HR per 1-SD increment in ln-transformed MCP-1, 1.07; 95% CI, 1.01-1.14). Focusing on stroke subtypes, we found a significant association between baseline MCP-1 levels and higher risk of ischemic stroke (HR, 1.11 [1.02-1.21]) but not hemorrhagic stroke (HR, 1.02 [0.82-1.29]). The results followed a dose-response pattern with a higher risk of ischemic stroke among individuals in the upper quartiles of MCP-1 levels as compared with the first quartile (HRs, second quartile: 1.19 [1.00-1.42]; third quartile: 1.35 [1.14-1.59]; fourth quartile: 1.38 [1.07-1.77]). There was no indication for heterogeneity across studies, and in a subsample of 4 studies (12 516 individuals), the risk estimates were stable after additional adjustments for circulating levels of IL (interleukin)-6 and high-sensitivity CRP (C-reactive protein). Conclusions: Higher circulating levels of MCP-1 are associated with increased long-term risk of stroke. Our findings along with genetic and experimental evidence suggest that MCP-1 signaling might represent a therapeutic target to lower stroke risk.Visual Overview: An online visual overview is available for this article.
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- 2019
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50. Increased vascular endothelial growth factor D is associated with atrial fibrillation and ischaemic stroke.
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Berntsson J, Smith JG, Johnson LSB, Söderholm M, Borné Y, Melander O, Orho-Melander M, Nilsson J, and Engström G
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- Correlation of Data, Female, Follow-Up Studies, Humans, Incidence, Male, Risk Assessment, Risk Factors, Sweden epidemiology, Atrial Fibrillation blood, Atrial Fibrillation complications, Atrial Fibrillation epidemiology, Stroke blood, Stroke epidemiology, Stroke etiology, Vascular Endothelial Growth Factor D blood
- Abstract
Objective: Vascular endothelial growth factor D (VEGF-D) has important functions in lymphangiogenesis and angiogenesis. High plasma levels of VEGF-D have been associated with incidence of heart failure. The association of VEGF-D with atrial fibrillation (AF) and stroke is unclear and we hypothesised that VEGF-D could also be associated with incidence of AF and ischaemic stroke., Methods: VEGF-D was measured in fasting blood samples of 4689 subjects (40% men) without a history of AF from the Malmö Diet and Cancer Study, a prospective, population-based study in Sweden. Median age was 58 years (range 46-68). Cox regression analyses, adjusted for multiple risk factors, was used to assess AF and ischaemic stroke risk in relation to VEGF-D levels., Results: During a median follow-up time of 20.6 years, there were 637 cases of incident AF and 322 cases of first ischaemic stroke. After adjustment, VEGF-D was significantly associated with AF (HR 1.13(95% CI 1.04 to 1.23) per 1 SD increase) and ischaemic stroke (HR 1.14(95% CI 1.02 to 1.28) per 1 SD). The association with ischaemic stroke was explained by an increased incidence of AF-related stroke. HRs per 1 SD were 1.34 (95% CI 1.04 to 1.71) for AF-related ischaemic stroke and 1.04 (95% CI 0.90 to 1.19) for ischaemic stroke without AF., Conclusions: Increased VEGF-D concentrations were associated with AF and ischaemic stroke. The relationship with ischaemic stroke was more pronounced in subjects with a diagnosis of AF., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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