Publications by authors named "Minder A"

Article Synopsis
  • The erythropoietic protoporphyrias are three rare genetic disorders that disrupt heme production, causing a buildup of protoporphyrin IX (PPIX) in red blood cells and leading to severe skin pain from light exposure, starting in early childhood.
  • Diagnosis involves measuring PPIX levels in the blood, and complications can include liver issues, gallstones, anemia, and vitamin D deficiency.
  • Management focuses on avoiding light triggers, addressing complications, and using treatments like afamelanotide to improve quality of life, with careful consideration of iron supplementation depending on the specific disorder.
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Objectives: In our study, we aimed to characterise adult childhood cancer survivors (ACCS), assess their health issues, gauge health-related quality of life (HRQOL) and evaluate visit satisfaction.

Design: Prospective cohort study using data from clinical visits and questionnaires.

Setting: Interdisciplinary follow-up programme for ACCS based on the long-term follow-up (LTFU) guidelines of the Children's Oncology Group and overseen by internists in two Swiss hospitals.

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Article Synopsis
  • Acute porphyrias are inherited disorders that disrupt heme production, leading to severe neurovisceral symptoms under certain triggers.
  • A Swiss patient diagnosed with acute intermittent porphyria exhibited typical metabolic patterns, but routine genetic tests did not reveal any mutations in the expected gene.
  • Advanced sequencing techniques uncovered a de novo mosaic mutation in the patient, suggesting that such mutations may play a role in acute porphyrias when standard tests fail to identify a cause.
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Background & Aims: Acute hepatic porphyria (AHP) is caused by defects in hepatic heme biosynthesis, leading to disabling acute neurovisceral attacks and chronic symptoms. In ENVISION (NCT03338816), givosiran treatment for 6 months reduced attacks and other disease manifestations compared with placebo. Herein, we report data from the 36-month final analysis of ENVISION.

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Unlabelled: In animal models, melanocyte-stimulating hormones (MSHs) protect the liver from various injuries. Erythropoietic protoporphyria (EPP), a metabolic disorder, leads to the accumulation of protoporphyrin (PPIX). In addition to the most prominent symptom of incapacitating phototoxic skin reactions, 20% of EPP patients exhibit disturbed liver functioning and 4% experience terminal liver failure caused by the hepatobiliary elimination of excess PPIX.

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Article Synopsis
  • Erythropoietic protoporphyria (EPP) is a rare metabolic disorder that causes severe pain from light exposure, making it hard to gauge patients' quality of life (QoL).
  • A feasibility study involved five EPP patients on long-term treatment with afamelanotide, assessing QoL using the EQ-5D tool, especially after they experienced treatment interruptions.
  • Findings showed that patients' QoL while treated was similar to the general population, and their experiences during treatment interruptions compared to patients with chronic pain and burn injuries, supporting afamelanotide's cost-effectiveness evaluation in England.
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Since the introduction of the reimbursement system based on diagnosis-related groups (DRG) in Swiss hospitals in 2012, most readmissions occurring within 18 days and appertaining to the same major diagnostic category (MDC) are merged and thus often reimbursed to a lesser extent. While readmissions reflect increased distress for patients and their relatives, the causes are mainly patient-related and difficult to influence. However, it may be possible to identify cases at higher risk for readmission.

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Article Synopsis
  • Porphyrias are rare genetic disorders caused by mutations that lead to a deficiency in enzymes responsible for heme biosynthesis, resulting in toxic compound accumulation and various symptoms.
  • Variegate porphyria, a type of acute hepatic porphyria, is linked to a mutation in the PPOX gene and can be triggered by factors like stress, drugs, or fasting, causing severe neurological issues.
  • A case study of a 46-year-old woman who developed severe symptoms after gastric bypass surgery highlights the importance of recognizing porphyria symptoms before surgical interventions to prevent serious complications.
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One-year data from EXPLORE Part A showed high disease burden and impaired quality of life (QOL) in patients with acute hepatic porphyria (AHP) with recurrent attacks. We report baseline data of patients who enrolled in EXPLORE Part B for up to an additional 3 years of follow-up. EXPLORE B is a long-term, prospective study evaluating disease activity, pain intensity, and QOL in patients with AHP with ≥1 attack in the 12 months before enrollment or receiving hemin or gonadotropin-releasing hormone prophylaxis.

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Unlabelled: Erythropoietic protoporphyria (EPP) is an ultra-rare inherited disorder with overproduction of protoporphyrin in maturating erythroblasts. This excess protoporphyrin leads to incapacitating phototoxic burns in sunlight exposed skin. Its biliary elimination causes cholestatic liver injury in 20% and terminal liver failure in 4% of EPP patients.

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The acute porphyrias are a group of four metabolic defects in which the heme synthesis in the liver is disrupted. They are characterized by massively painful acute attacks, which can be life-threatening if not diagnosed. To raise the awareness for these rare disorders, a heme molecule in cartoon style is introduced, which accurately explains the basic biochemical processes in the body and mediates important information on the acute hepatic porphyrias in a simplified and attractive way.

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Erythropoietic protoporphyria (EPP) is a rare disease in which patients experience severe light sensitivity. It is caused by a deficiency of ferrochelatase (FECH), the last enzyme in heme biosynthesis (HBS). The lack of FECH causes accumulation of its photoreactive substrate protoporphyrin IX (PPIX) in patients' erythrocytes.

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Article Synopsis
  • - Erythropoietic protoporphyria (EPP) is a rare genetic disorder causing painful skin reactions to sunlight, with afamelanotide being the first effective therapy to help patients tolerate sunlight better and lessen these reactions.
  • - Data from a Swiss EPP cohort (n=39) showed significant improvements in patients' maximum time spent in sunlight without reactions (from 10 minutes to 180 minutes) and reduced pain severity after starting treatment with afamelanotide.
  • - The treatment demonstrated high effectiveness in real-world settings, with a treatment adherence rate of 97.4%, and it supports the suggestion of using the maximum phototoxic burn tolerance time (PBTT) as a key endpoint in future clinical trials
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Molecular diagnosis of autosomal dominant acute hepatic porphyrias (AHPs) plays an important role in the management of these disorders. To introduce next generation sequencing (NGS) to the porphyria diagnosis, we designed a panel that contained four genes, , and for mutational analysis of acute intermittent porphyria (AIP), hereditary coproporphyria (HCP) and variegate porphyria (VP). To validate the AHP panel, 30 samples with known pathogenic variants as determined by Sanger sequencing, were analyzed using the Ion PGM™.

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Deficiency in ferrochelatase (FECH), the last enzyme in the heme biosynthetic pathway, leads to an accumulation of protoporphyrin IX (PPIX) that causes a severely painful phototoxic reaction of the skin in patients with erythropoietic protoporphyria (EPP). Besides phototoxicity of the skin, EPP patients often present with symptoms of iron deficiency in form of a microcytic and hypochromic anemia with low serum iron and ferritin. In addition, elevated aminolevulinic acid synthase 2 (ALAS2) both at the mRNA and protein levels have been observed among EPP patients.

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Aim: Prevalence of retinopathy (DR) in patients with type 1 diabetes treated with education-based intensified insulin therapy (EBIIT) and its association with parameters of glucose control.

Methods: 151 patients with mean diabetes duration of 14.3 years [SD ± 5.

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Porphyria - when to think about how to clarify and treat? Abstract. Porphyrias are a group of metabolic disorders that are mostly hereditary. They manifest either as abdominal colic or as skin changes at light-exposed areas.

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Rare Complication of a Common Disease: Thyroid and Epileptic Seizures A myxedema crisis is a life-threatening complication of hypothyroidism (mortality 20-25 %). The diagnosis is made on clinical grounds and thyroid function tests. Treatment with levothyroxine (possibly combined with T3) should be instituted immediately, along with glucocorticoids, until co-existing adrenal insufficiency has been ruled out.

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Background: Cushing's syndrome (CS) is a severe condition with excess mortality and significant morbidity necessitating control of hypercortisolemia. There are few data documenting use of the steroidogenesis inhibitor metyrapone for this purpose.

Objective: The objective was to assess the effectiveness of metyrapone in controlling cortisol excess in a contemporary series of patients with CS.

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