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4. Identifying effect modifiers of systemic hydrocortisone treatment initiated 7-14 days after birth in ventilated very preterm infants on long-term outcome: secondary analysis of a randomised controlled trial

Author

Halbmeijer, N.M., Sonnaert, M., Swarte, R.M., Koopman-Esseboom, C., Stuijvenberg, M. van, Mulder-de Tollenaer, S., Tan, R., Mohns, T., Bruneel, E., Steiner, K., Kramer, B.W., Debeer, A., Weissenbruch, M.M. van, Marechal, Y., Blom, H., Plaskie, K., Offringa, M., Merkus, M.P., Onland, W., Leemhuis, A.G., Kaam, A.H. van, Halbmeijer, N.M., Sonnaert, M., Swarte, R.M., Koopman-Esseboom, C., Stuijvenberg, M. van, Mulder-de Tollenaer, S., Tan, R., Mohns, T., Bruneel, E., Steiner, K., Kramer, B.W., Debeer, A., Weissenbruch, M.M. van, Marechal, Y., Blom, H., Plaskie, K., Offringa, M., Merkus, M.P., Onland, W., Leemhuis, A.G., and Kaam, A.H. van

Abstract

Contains fulltext : 305092.pdf (Publisher’s version ) (Closed access), OBJECTIVE: To explore clinical effect modifiers of systemic hydrocortisone in ventilated very preterm infants for survival and neurodevelopmental outcome at 2 years' corrected age (CA). DESIGN: Secondary analysis of a randomised placebo-controlled trial. SETTING: Dutch and Belgian neonatal intensive care units. PATIENTS: Infants born <30 weeks' gestational age (GA), ventilator-dependent in the second week of postnatal life. INTERVENTION: Infants were randomly assigned to systemic hydrocortisone (cumulative dose 72.5 mg/kg; n=182) or placebo (n=190). MAIN OUTCOME MEASURES: The composite of death or neurodevelopmental impairment (NDI) at 2 years' CA and its components. Candidate effect modifiers (GA, small for GA, respiratory index, sex, multiple births, risk of moderate/severe bronchopulmonary dysplasia or death) were analysed using regression models with interaction terms and subpopulation treatment effect pattern plots. RESULTS: The composite outcome was available in 356 (96.0%) of 371 patients (one consent withdrawn). For this outcome, treatment effect heterogeneity was seen across GA subgroups (<27 weeks: hydrocortisone (n=141) vs placebo (n=156), 54.6% vs 66.2%; OR 0.61 (95% CI 0.38 to 0.98); ≥27 weeks: hydrocortisone (n=30) vs placebo (n=31), 66.7% vs 45.2%; OR 2.43 (95% CI 0.86 to 6.85); p=0.02 for interaction). This effect was also found for the component death (<27 weeks: 20.1% vs 32.1%; OR 0.53 (95% CI 0.32 to 0.90); ≥27 weeks: 28.1% vs 16.1%; OR 2.04 (95% CI 0.60 to 6.95); p=0.049 for interaction) but not for the component NDI. No differential treatment effects were observed across other subgroups. CONCLUSION: This secondary analysis suggests that in infants <27 weeks' GA, systemic hydrocortisone may improve the outcome death or NDI, mainly driven by its component death. There was insufficient evidence for other selected candidate effect modifiers.

Published
2024

11. Repetitive transcranial magnetic stimulation in patients with late life depression influences phenylalanine metabolism

Author

Leblhuber F, Steiner K, Gostner Jm, and Fuchs D

Subjects
late life depression, neopterin, phenylalanine hydroxylase, phenylalanine to tyrosineratio, transcranial magnetic stimulation, tryptophan metabolism, Crystallography, QD901-999
Abstract

Repetitive transcranial magnetic stimulation (rTMS) is used to treat different neuropsychiatric conditions like Parkinson’s disease, essential tremor, stroke, cognitive decline, dementia and depression. rTMS may exert its therapeutic effects by influencing the biochemistry of neurotransmitters. In this exploratory study, safety symptom improvement and changes in the availability of neurotransmitter precursor amino acids were studied following prefrontal cortex (PFC) stimulation using repetitive transcranial stimulation with TheraCell apparatus R (Guth Meditec, Salach, Germany) as an additional treatment in ten patients with late life depression. Treatment was well tolerated with no serious adverse effects being observed. rTMS induced a significant improvement in the symptoms of depression and a significant decrease in the HAMD-7 (p

Published
2018
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26. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study

Author

Raña, S., Serrano, M., Claros, S., Arias, M., Petracci, L., Arana, M., De Rosa, P., Gutierrez, A., Simon, M., Vergara, V., Tosi, M., Cernadas, M., Vilamajó, I., Gravac, D., Paulón, M., Penayo, L., Carrizo, G., Ghiani, M., Perez, G., Da Cruz, O., Galarce, D., Gravielle, M., Vescovo, E., Paparone, R., Mato Mira, C., Mojico, E., Hermida, O., Florio, D., Yucoswky, M., Labonia, W., Rubio, D., Di Napoli, G., Fernandez, A., Altman, H., Rodriguez, J., Serrano, S., Valle, G., Lobos, M., Acosta, V., Corpacci, G., Jofre, M., Gianoni, L., Chiesura, G., Capdevila, M., Montenegro, J., Bequi, J., Dayer, J., Gómez, A., Calderón, C., Abrego, E., Cechín, C., García, J., Corral, J., Natiello, M., Coronel, A., Muñiz, M., Muñiz, V., Bonelli, A., Sanchez, F., Maestre, S., Olivera, S., Camargo, M., Avalos, V., Geandet, E., Canteli, M., Escobar, A., Sena, E., Tirado, S., Peñalba, A., Neme, G., Cisneros, M., Oliszewski, R., Nascar, V., Daud, M., Mansilla, S., Paredes Álvarez, A., Gamín, L., Arijón, M., Coombes, M., Zapata, M., Boriceanu, C., Frantzen-Trendel, S., Albert, K., Csaszar, I., Kiss, E., Kosa, D., Orosz, A., Redl, J., Kovacs, L., Varga, E., Szabo, M., Magyar, K., Kriza, G., Zajko, E., Bereczki, A., Csikos, J., Kuti, A., Mike, A., Steiner, K., Nemeth, E., Tolnai, K., Toth, A., Vinczene, J., Szummer, Sz., Tanyi, E., Toth, R., Szilvia, M., Dambrosio, N., Paparella, G., Sambati, M., Donatelli, C., Pedone, F., Cagnazzo, V.A., Antinoro, R., Torsello, F., Saturno, C., Giannoccaro, G., Maldera, S., Boccia, E., Mantuano, M., Di Toro Mammarella, R., Meconizzi, M., Steri, P.F., Riccardi, C., Flammini, A., Moscardelli, L., Murgo, M., San Filippo, N., Pagano, S., Marino, G., Montalto, G., Cantarella, S., Salamone, B., Randazzo, G., Rallo, D., Maniscalco, A., Fici, M., Lupo, A., Pellegrino, P., Fichera, R., D’Angelo, A., Falsitta, N., Bochenska-Nowacka, E., Jaroszynski, A., Drabik, J., Birecka, M., Daniewska, D., Drobisz, M., Doskocz, K., Wyrwicz, G., Inchaustegui, L., Outerelo, C., Sousa Mendes, D., Mendes, A., Lopes, J., Barbas, J., Madeira, C., Fortes, A., Vizinho, R., Cortesão, A., Almeida, E., Bernat, A., De la Torre, B., Lopez, A., Martín, J., Cuesta, G., Rodriguez, R.M., Ros, F., Garcia, M., Orero, E., Ros, E., Caetano, A., MacGregor, K., Santos, M., Silva Pinheiro, S., Martins, L., Leitão, D., Izidoro, C., Bava, G., Bora, A., Gorena, H., Calderón, T., Dupuy, R., Alonso, N., Siciliano, V., Nagy, K., Bajusz, Ö., Pinke, I., Decsi, G., Gyergyoi, L., Jobba, Zs., Zalai, Zs., Zsedenyi, Á., Kiss, G., Pinter, M., Kereszturi, M., Petruzzi, M., De Benedittis, M., Szkutnik, J., Sieczkarek, J., Capelo, A., Garcia Gallart, M., Mendieta, C., Palmer, Suetonia C., Ruospo, Marinella, Wong, Germaine, Craig, Jonathan C., Petruzzi, Massimo, De Benedittis, Michele, Ford, Pauline, Johnson, David W., Tonelli, Marcello, Natale, Patrizia, Saglimbene, Valeria, Pellegrini, Fabio, Celia, Eduardo, Gelfman, Ruben, Leal, Miguel R., Torok, Marietta, Stroumza, Paul, Bednarek-Skublewska, Anna, Dulawa, Jan, Frantzen, Luc, Ferrari, Juan Nin, del Castillo, Domingo, Bernat, Amparo G., Hegbrant, Jorgen, Wollheim, Charlotta, Gargano, Letizia, Bots, Casper P., and Strippoli, Giovanni F.M.

Published
2015
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28. We are much more than books

Author

Harriss, E, Smith, C, Phillips, D, White, G, Steiner, K, Henry, M, Thurley, N, and Roberts, N

Abstract

We are much more than books. We are experts in systematic reviews, literature searches, training, research question formulation, databases, Boolean logic, and reference management. We are trainers, searchers, authors, and problem solvers. We help students and staff in the university and in the OUH NHS trust.

Published
2022

31. Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study

Author

Beek, P.E. van, Rijken, M., Broeders, L., Horst, H.J. van der, Koopman-Esseboom, C., Kort, E. De, Laarman, C., Mulder-de Tollenaer, S.M., Steiner, K., Swarte, R.M., Westering-Kroon, E. van, Oei, S.G., Leemhuis, A.G., Andriessen, P., Beek, P.E. van, Rijken, M., Broeders, L., Horst, H.J. van der, Koopman-Esseboom, C., Kort, E. De, Laarman, C., Mulder-de Tollenaer, S.M., Steiner, K., Swarte, R.M., Westering-Kroon, E. van, Oei, S.G., Leemhuis, A.G., and Andriessen, P.

Abstract

Contains fulltext : 283154.pdf (Publisher’s version ) (Open Access), OBJECTIVE: In 2010, the Dutch practice regarding initiation of active treatment in extremely preterm infants was lowered from 25 completed weeks' to 24 completed weeks' gestation. The nationwide Extremely Preterm Infants - Dutch Analysis on Follow-up Study was set up to provide up-to-date data on neurodevelopmental outcome at 2 years' corrected age (CA) after this guideline change. Design: National cohort study. PATIENTS: All live born infants between 24(0/7) weeks' and 26(6/7) weeks' gestational age who were 2 years' CA in 2018-2020. MAIN OUTCOME MEASURE: Impairment at 2 years' CA, based on cognitive score (Bayley-III-NL), neurological examination and neurosensory function. RESULTS: 651 of 991 live born infants (66%) survived to 2 years' CA, with data available for 554 (85%). Overall, 62% had no impairment, 29% mild impairment and 9% moderate-to-severe impairment (further defined as neurodevelopmental impairment, NDI). The percentage of survivors with NDI was comparable for infants born at 24 weeks', 25 weeks' and 26 weeks' gestation. After multivariable analysis, severe brain injury and low maternal education were associated with higher odds on NDI. NDI-free survival was 48%, 67% and 75% in neonatal intensive care unit (NICU)-admitted infants at 24, 25 and 26 weeks' gestation, respectively. CONCLUSIONS: Lowering the threshold has not been accompanied by a large increase in moderate-to-severely impaired infants. Among live-born and NICU-admitted infants, an increase in NDI-free survival was observed from 24 weeks' to 26 weeks' gestation. This description of a national cohort with high follow-up rates gives an accurate description of the range of outcomes that may occur after extremely preterm birth.

Published
2022

36. Quantitative suspecptibility mapping reveals alterations of denate nuclei in common types of ataxias

Author

Deistung, A., Jäschke, D., Münchau, A., Minnerop, Martina, Göricke, S. L., Reichenbach, J. R., Timmann, D., Draganova, R., Pfaffenrot, V., Hulst, T., Steiner, K. M., Thieme, A., Giordano, I. A., Klockgether, T., and Tunc, S.

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, nervous system, ddc:610
Abstract

The cerebellar nuclei are a brain region with high iron content. Surprisingly, little is known about iron content in the cerebellar nuclei and its possible contribution to pathology in cerebellar ataxias, with the only exception of Friedreich’s ataxia. In the present exploratory cross-sectional study, quantitative susceptibility mapping was used to investigate volume, iron concentration and total iron content of the dentate nuclei in common types of hereditary and non-hereditary degenerative ataxias. Seventy-nine patients with spinocerebellar ataxias of types 1, 2, 3 and 6; 15 patients with Friedreich’s ataxia; 18 patients with multiple system atrophy, cerebellar type and 111 healthy controls were also included. All underwent 3 T MRI and clinical assessments. For each specific ataxia subtype, voxel-based and volumes-of-interest-based group analyses were performed in comparison with a corresponding age- and sex-matched control group, both for volume, magnetic susceptiblity (indicating iron concentration) and susceptibility mass (indicating total iron content) of the dentate nuclei. Spinocerebellar ataxia of type 1 and multiple system atrophy, cerebellar type patients showed higher susceptibilities in large parts of the dentate nucleus but unaltered susceptibility masses compared with controls. Friedreich’s ataxia patients and, only on a trend level, spinocerebellar ataxia of type 2 patients showed higher susceptibilities in more circumscribed parts of the dentate. In contrast, spinocerebellar ataxia of type 6 patients revealed lower susceptibilities and susceptibility masses compared with controls throughout the dentate nucleus. Spinocerebellar ataxia of type 3 patients showed no significant changes in susceptibility and susceptibility mass. Lower volume of the dentate nuclei was found to varying degrees in all ataxia types. It was most pronounced in spinocerebellar ataxia of type 6 patients and least prominent in spinocerebellar ataxia of type 3 patients. The findings show that alterations in susceptibility revealed by quantitative susceptibility mapping are common in the dentate nuclei in different types of cerebellar ataxias. The most striking changes in susceptibility were found in spinocerebellar ataxia of type 1, multiple system atrophy, cerebellar type and spinocerebellar ataxia of type 6. Because iron content is known to be high in glial cells but not in neurons of the cerebellar nuclei, the higher susceptibility in spinocerebellar ataxia of type 1 and multiple system atrophy, cerebellar type may be explained by a reduction of neurons (increase in iron concentration) and/or an increase in iron-rich glial cells, e.g. microgliosis. Hypomyelination also leads to higher susceptibility and could also contribute. The lower susceptibility in SCA6 suggests a loss of iron-rich glial cells. Quantitative susceptibility maps warrant future studies of iron content and iron-rich cells in ataxias to gain a more comprehensive understanding of the pathogenesis of these diseases.

Published
2022

44. Defining priorities in vascular access research

Author

De Siqueira, JR, primary, Fielding, CA, additional, Pettigrew, GJ, additional, Robson, MG, additional, Rogers, SK, additional, Steiner, K, additional, Withers, W, additional, Long, J, additional, Gronlund, T, additional, Chetter, I, additional, and Smith, GE, additional

Published
2022
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49. Next-Generation Sequencing (NGS) in Pediatric Patients with Epilepsy: How Many Previously Unsolved Cases Can Be Solved?

Author

Zobel, J., additional, Plecko, B., additional, Friedrich, M., additional, Gruber-Sedlmayr, U., additional, Rauter, L., additional, Brunner-Krainz, M., additional, Schwerin-Nagel, A., additional, Kortschak, A., additional, Steiner, K., additional, Pilch, H., additional, Raissakis, M., additional, Köstl, G., additional, Spiegl, B., additional, Seebacher, H., additional, Schreiner, E., additional, Blatterer, J., additional, Speicher, M., additional, and Verheyen, S., additional

Published
2021
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