Publications by authors named "J. Bouma"

Rationale: Early detection, standardized therapy, adequate infrastructure and strategies for quality improvement should constitute essential components of every hospital's sepsis plan.

Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute hospitals.

Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals.

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Sprint interval training (SIT) leads to similar improvements in maximal oxygen uptake (V̇O) and maximal cardiac output as previously reported for traditional endurance training, but the exercise-induced effects on cardiac remodeling are still largely unknown. The aim of the current study was therefore to explore the effects of SIT on cardiac structure and function assessed by echocardiography in relation to, and controlling for, changes in both blood volume (BV) and heart rate (HR). Healthy men and women (n = 28) performed 6 weeks of SIT.

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Background: Cardiac computed tomography (CT) is increasingly used to search for cardioembolic sources of acute ischemic stroke (AIS). We assessed the association between high-risk cardioembolic sources on cardiac CT and AIS.

Methods: We performed a case-control study using data from a prospective cohort including consecutive adult patients with suspected stroke who underwent cardiac CT acquired during the initial stroke imaging protocol between 2018 and 2020.

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Objective: Early recognition of sepsis is essential for timely initiation of adequate care. However, this is challenging as signs and symptoms may be absent or nonspecific. The cascade of events leading to organ failure in sepsis is characterized by immune-metabolic alterations.

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Aims: This study aimed to validate the machine learning-based Global Registry of Acute Coronary Events (GRACE) 3.0 score and PRAISE (Prediction of Adverse Events following an Acute Coronary Syndrome) in patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI) for predicting mortality.

Methods And Results: Data of consecutive patients with ACS treated with PCI in a tertiary centre in the Netherlands between 2014 and 2021 were used for external validation.

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Study Objective: Essure is a hysteroscopic sterilization device that has been used in the Netherlands since 2003. Essure has received a lot of publicity due to many reported symptoms associated with the device. Because of this, increasing numbers of patients requested surgical removal of Essure devices.

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Background: Every hospital admission is associated with healthcare costs and a risk of adverse events. The need to identify patients who do not require hospitalization has emerged with the profound increase in hospitalization rates due to infectious diseases during the last decades, especially during the COVID-19 pandemic. This study aimed to identify predictors of safe early discharge (SED) in patients presenting to the emergency department (ED) with a suspected infection meeting the Systemic Inflammatory Response Syndrome (SIRS) criteria.

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Article Synopsis
  • * Data from 1,661 patients at the University Medical Centre Groningen revealed variations in predictive accuracy depending on the infection site, with the NEWS and NEWS-2 performing best for abdominal infections.
  • * The findings suggest that incorporating the source of infection into EWS development could improve prognostic tools for sepsis, advocating for more tailored approaches to enhance prediction accuracy.
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  • The study evaluated a goal-oriented treatment approach for pulmonary arterial hypertension (PAH) in adults with congenital heart disease (CHD), focusing on revised risk assessment tools and their effectiveness in predicting outcomes.
  • A total of 223 participants were analyzed, revealing that the standard risk grouping did not show significant survival differences, prompting the researchers to propose new thresholds for better risk classification.
  • The newly refined instrument successfully reclassified 29% of patients and demonstrated that those with improved low-risk profiles had better survival rates, suggesting that the original PAH risk instrument may have limited applicability for the PAH-CHD population.
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  • The study aims to automate the selection process for echocardiographic exams by classifying routine views, recognizing unknown views, and assessing image quality.
  • A neural network is trained for view classification, and a linear regression model predicts view quality using feature embeddings.
  • Results show that the method performs nearly at expert level, significantly improving efficiency in selecting appropriate echocardiography views for analysis.
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  • About 25% of the population has a patent foramen ovale (PFO), which is usually asymptomatic, but it can sometimes cause right-to-left shunt (RLS)-mediated hypoxaemia, a rare condition.
  • In a case involving a 73-year-old woman, her oxygen levels significantly improved from 87% to 98% after undergoing percutaneous PFO closure due to her progressive difficulty breathing.
  • While most PFOs don't cause problems, RLS-mediated hypoxaemia can occur even in older adults, and percutaneous closure is a safe and effective treatment that provides quick relief.
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  • This study investigates the impact of left atrial appendage (LAA) slow-flow on ischemic stroke outcomes, finding that 16% of patients had slow-flow and shared characteristics with those having LAA thrombus.
  • While both slow-flow and thrombus were linked to a higher prevalence of atrial fibrillation, patients with thrombus experienced more severe strokes and worse functional outcomes than those with slow-flow.
  • Ultimately, slow-flow did not significantly affect functional outcomes or major cardiovascular events, but it was associated with an increased risk of stroke recurrence in patients with unknown causes of their strokes.
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  • Young patients with cryptogenic stroke and a patent foramen ovale (PFO) sometimes receive device closure to prevent future strokes, but about 25% may still have a residual right-to-left shunt after 6 months.
  • In a study of 227 patients, it was found that at 6 months post-closure, 72.7% had no shunt, while the rest had varying degrees of residual shunt.
  • By 12 months, many of these residual shunts had either diminished or closed completely, indicating that while residual shunts are common at 6 months, most are small and tend to close over time.
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Background: Although the prescription of physical activity in clinical care has been advocated worldwide, in the Netherlands, "Exercise is Medicine" (E = M) is not yet routinely implemented in clinical care.

Methods: A set of implementation strategies was pilot implemented to test its feasibility for use in routine care by clinicians in 2 departments of a university medical center. An extensive learning process evaluation was performed, using structured mixed methods methodology, in accordance with the Reach, Effect, Adoption, Implementation, and Maintenance framework.

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  • The cannabinoid receptor type 1 (CBR) plays a key role in various bodily functions, including appetite, pain, memory, and body temperature regulation, but our understanding of its cellular signaling and dynamics is limited.
  • Researchers developed new fluorescent probes for CBR by using a modular design approach that centers around a diethyl glycine-based building block, making synthesis easier and more efficient.
  • Validation of these probes through various assays supports their potential use in real-time imaging studies to explore CBR's localization, movement, and effects in different diseases.
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Rationale: Cervical radiculopathy is initially typically managed conservatively. Surgery is indicated when conservative management fails or with severe/progressive neurological signs. Personalised multimodal physiotherapy could be a promising conservative strategy.

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Cancer vaccines can be utilized in combination with checkpoint inhibitors to optimally stimulate the anti-tumor immune response. Uptake of vaccine antigen by antigen presenting cells (APCs) is a prerequisite for T cell priming, but often relies on non-specific mechanisms. Here, we have developed a novel vaccination strategy consisting of cancer antigen-containing liposomes conjugated with CD169- or DC-SIGN-specific nanobodies (single domain antibodies) to achieve specific uptake by APCs.

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Persistent breeding induced endometritis (PBIE) is a significant cause of infertility in mares. The development of a safe, universal, readily available therapeutic to manage PBIE and facilitate an optimal uterine environment for embryo development may improve pregnancy rates in susceptible mares. Mesenchymal stromal cells (MSCs) are being used increasingly as a therapeutic mediator for inflammatory conditions such as endometritis, and early gestational tissue provides a unique source of multipotent stem cells for creating MSCs.

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Background: A risk model has been proposed to provide a patient individualized estimation of risk for major clinical events (heart failure events, ventricular arrhythmia, all-cause mortality) in patients with transposition of the great arteries and atrial switch surgery. We aimed to externally validate the model.

Methods And Results: A retrospective, multicentric, longitudinal cohort of 417 patients with transposition of the great arteries (median age, 24 years at baseline [interquartile range, 18-30]; 63% men) independent of the model development and internal validation cohort was studied.

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Background: Cardiac computed tomography (CT) acquired during the initial acute stroke imaging protocol (acute cardiac CT) is increasingly used to screen for cardioembolism, but information on the long-term clinical implications of its findings is lacking.

Methods And Results: We performed a prospective, single-center cohort study in which consecutive patients with ischemic stroke underwent ECG-gated acute cardiac CT and were followed up for 2 years. The primary outcome was functional outcome assessed using the modified Rankin Scale.

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Background: Clinical judgment, also known as gestalt or gut feeling, can predict deterioration and can be easily and rapidly obtained. To date, it is unknown what clinical judgement precisely entails. The aim of this study was to elucidate which features define the clinical impression of health care professionals in the ED.

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Article Synopsis
  • Patients with transposition of the great arteries who underwent an arterial switch operation often face complications like right ventricular outflow tract (RVOT) obstruction, which may require additional interventions.
  • This study analyzed the cardiopulmonary exercise capacity and right ventricular function in TGA patients based on their type of RVOT intervention, focusing on various outcome measures such as peak oxygen uptake and RV-arterial coupling.
  • Results showed that patients without RVOT interventions had higher exercise capacity and better RV function compared to those who underwent catheter or surgical RVOT interventions, indicating a notable decline in performance post-intervention.
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