819 results match your criteria: "Haga Hospital[Affiliation]"

Background: Prevention of rheumatoid arthritis has become a definitive target. However, whether prevention of anti-citrullinated protein antibody (ACPA)-negative rheumatoid arthritis is possible is still unknown. We aimed to assess the efficacy of a 1-year course of methotrexate on the development of rheumatoid arthritis in ACPA-negative people with clinically suspect arthralgia and predicted increased risk of rheumatoid arthritis.

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Background: Adjunctive catheter-directed thrombolysis shows variable efficacy in preventing postthrombotic syndrome (PTS), despite restored patency.

Objectives: This Ultrasound-Accelerated Catheter-Directed Thrombolysis Versus Anticoagulation for the Prevention of Post-Thrombotic Syndrome (CAVA) trial subanalysis investigated the effect of ultrasound-accelerated catheter-directed thrombolysis (UACDT) on patency, reflux, and their relevance in PTS development.

Methods: This multicenter, randomized, single-blind trial enrolled patients (aged 18-85 years) with a first iliofemoral deep vein thrombosis and symptom duration ≤14 days.

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Objectives: This study aims to assess pharmacodynamic target attainment in critically ill patients and identify factors influencing target attainment and mortality outcomes.

Methods: We analysed data from the DOLPHIN trial. Beta-lactam and ciprofloxacin peak and trough concentration were measured within the first 36 h (T1) after initiation of treatment.

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Real-World Implementation of a Genotype-Guided P2Y Inhibitor De-Escalation Strategy in Acute Coronary Syndrome Patients.

JACC Cardiovasc Interv

July 2024

Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands; Department of Cardiology, University Medical Center Maastricht, Maastricht, the Netherlands.

Article Synopsis
  • The study investigated whether using CYP2C19 genetic testing to guide medication choices improves outcomes for patients with acute coronary syndrome (ACS) compared to standard treatment.
  • Out of 5,321 ACS patients, those who were genotyped and had their medications tailored showed significantly lower bleeding rates while maintaining a similar risk of ischemic events compared to those on standard therapy.
  • The findings suggest that a personalized approach to antiplatelet therapy based on genetic markers can enhance safety without compromising efficacy in managing ACS.
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Continuation versus Interruption of Oral Anticoagulation during TAVI.

N Engl J Med

August 2024

From the Department of Cardiology, St. Antonius Hospital, Nieuwegein (D.J.G., W.L.B., J.P., B.J.W.M.R., L.T., M.J.S., J.B., V.J.N., D.C.O., J.M.B.), the Department of Cardiology, Amsterdam UMC, Amsterdam (H.M.A., J.G.P.T., R.D.), the Department of Cardiology, University Medical Center Utrecht, Utrecht (H.M.A., M. Voskuil), the Department of Cardiology, Radboud University Medical Center, Nijmegen (M.J.P.R., V.J.N., N.R.), the Department of Cardiology, Maastricht University Medical Center (L.V., A.J.J.I., P.A.V., A.W.J.H.), and Cardiovascular Research Institute Maastricht (L.V., P.A.V., A.W.J.H., J.M.B.), Maastricht, the Department of Cardiology, Leiden University Medical Center, Leiden (F.K., J.M.M.-C.), the Department of Cardiology, University Medical Center Groningen, Groningen (K.H.B., J.J.W.), the Department of Cardiology, Erasmus University Medical Center, Rotterdam (N.M.V.M.), the Department of Cardiology, Haga Hospital, the Hague (C.E.S.), the Department of Cardiology, Amphia Hospital, Breda (A.J.J.I., J.H., B.J.L.V.B.), the Department of Cardiology, Isala Hospital, Zwolle (R.S.H., R.L.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (J.H.) - all in the Netherlands; the Department of Cardiovascular Medicine, University Hospital Leuven, Leuven (C.D., T.A.), the Department of Cardiology, Algemeen Stedelijk Hospital Aalst (L.R.), and Cardiovascular Center Aalst, Onze Lieve Vrouw Hospital (E.B., M. Vanderheyden), Aalst, the Department of Cardiology, Hospital Network Antwerp (ZNA) Middelheim, Antwerp (P.A., H.E.J.), the Department of Cardiology, Sint-Jan Hospital, Bruges (J.A.S.V.D.H.), the Department of Cardiology, AZ Delta, Roeselare (K.D.), and the Department of Cardiology, Hospital Oost-Limburg, Genk (B.F.) - all in Belgium; the Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen (O.D.B., Y.K.); the Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome (E.B.), and the Cardiothoracovascular Department, University of Trieste, Trieste (E.F.) - both in Italy; the Department of Cardiology, University Hospital Galway, Galway, Ireland (D.M.); and the Department of Cardiology, Institut National de Chirurgie Cardiaque et de Cardiologie Interventionnelle, Luxembourg (P.F., M.L.).

Article Synopsis
  • * In a trial with 858 patients, results showed no significant difference in major complications between those who continued anticoagulation (16.5% experienced primary outcomes) and those who interrupted it (14.8%).
  • * Continuation of anticoagulation led to higher incidences of major bleeding (31.1% vs. 21.3%), suggesting that interrupting anticoagulation is safer in this patient population undergoing TAVI.
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Article Synopsis
  • The HOVON 104 study involved 50 patients receiving bortezomib-dexamethasone therapy followed by autologous stem cell transplantation (ASCT), with 35 patients undergoing the transplantation.
  • The study reported a 5-year overall survival rate of 73% and progression-free survival of 52% for all patients, while those who received ASCT had even better outcomes, with 5-year overall survival at 91% and progression-free survival at 68%.
  • Notably, the study indicated a 60% complete response in organ function after ASCT, with cardiac responses stabilizing after 2 years and renal responses gradually improving, achieving completeness in 61% of affected patients by 5 years.
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Indocyanine green near-infrared fluorescence bowel perfusion assessment to prevent anastomotic leakage in minimally invasive colorectal surgery (AVOID): a multicentre, randomised, controlled, phase 3 trial.

Lancet Gastroenterol Hepatol

October 2024

Department of Surgery, Leiden University Medical Center, Leiden, Netherlands; Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands. Electronic address:

Background: Anastomotic leakage is a severe postoperative complication in colorectal surgery and compromised bowel perfusion is considered a major contributing factor. Conventional methods to assess bowel perfusion have a low predictive value for anastomotic leakage. We therefore aimed to evaluate the efficacy of real-time assessment with near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) in the prevention of anastomotic leakage.

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Introduction: Treating older adults with chemotherapy remains a challenge, given their under-representation in clinical trials and the lack of robust treatment guidelines for this population. Moreover, older patients, especially those with frailty, have an increased risk of developing chemotherapy-related toxicity, resulting in a decreased quality of life (QoL), increased hospitalisations and high healthcare costs. Phase II trials have suggested that upfront dose reduction of chemotherapy can reduce toxicity rates while maintaining efficacy, leading to fewer treatment discontinuations and an improved QoL.

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Article Synopsis
  • In out-of-hospital cardiac arrest (OHCA) cases without ST-elevation, researchers investigated the usefulness of troponin-T (cTnT) levels in predicting the risk of acute coronary syndrome and patient survival.
  • The study analyzed data from 352 patients, revealing that higher cTnT values were independent predictors for 90-day mortality and the presence of acute unstable lesions and thrombotic occlusions.
  • However, cTnT levels did not show a significant correlation with left ventricular function, highlighting its role primarily in assessing mortality risk and acute coronary issues in these patients.
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Background: Several prehospital scales have been designed to aid paramedics in identifying stroke patients in the ambulance setting. However, external validation and comparison of these scales are largely lacking.

Aims: To compare all published prehospital stroke detection scales in a large cohort of unselected stroke code patients.

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Article Synopsis
  • Haematology patients experiencing high-risk neutropenia are susceptible to bloodstream infections linked to mucosal barrier injuries, particularly during episodes of fever.
  • A study involving 416 neutropenic haematology patients identified risk factors for these infections, noting that certain conditions like low MASCC scores and specific fungal colonizations significantly increased risk.
  • Findings revealed that while low citrulline levels at fever onset correlated with candidaemia, they did not indicate the likelihood of bacterial infections; moreover, quinolone antibiotics appeared beneficial.
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Long-Term Effectiveness and Reasons for Discontinuation of Dupilumab in Patients With Atopic Dermatitis.

JAMA Dermatol

October 2024

National Expertise Center for Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, the Netherlands.

Article Synopsis
  • The study examines the long-term effectiveness and safety of dupilumab, a treatment for atopic dermatitis (AD), in a diverse group of patients over a period of up to 5 years.
  • Conducted in the Netherlands using the BioDay registry, the research includes 1,286 patients of different age groups receiving dupilumab between 2017 and 2022, with outcomes evaluated using various clinical measures.
  • Results show that a majority of patients maintained controlled AD symptoms, with high levels of treatment effectiveness observed over time, and factors for treatment discontinuation were also assessed.
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Background: Frequent premature ventricular contractions (PVCs) in children are usually considered benign. Symptoms and left ventricular dysfunction are indications for treatment with antiarrhythmic drugs.

Objective: This study aimed to evaluate the efficacy of flecainide vs metoprolol in reducing PVCs in children.

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Article Synopsis
  • - The study examined the real-world effects of stereotactic body radiotherapy (SBRT) in patients with stage I non-small cell lung cancer (NSCLC), focusing on acute toxicity and 90-day mortality rates among 7,279 patients treated between 2017 and 2021.
  • - Acute toxicity occurred in 3.8% of patients, while 90-day mortality was at 1.7%, with certain factors like age, sex, and lung function impacting these outcomes.
  • - The findings suggest that SBRT has a low rate of acute toxicity and acceptable mortality, with developed prediction models aiding in identifying patients at higher risk for adverse effects.
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Visual Electroencephalography Assessment in the Diagnosis and Prognosis of Cognitive Disorders.

J Clin Neurophysiol

July 2024

Department of Neurology and Clinical Neurophysiology, Haga Hospital, The Hague, the Netherlands.

Purpose: Electroencephalography (EEG) is a noninvasive diagnostic tool that can be of diagnostic value in patients with cognitive disorders. In recent years, increasing emphasis has been on quantitative EEG analysis, which is not easily accessible in clinical practice. The aim of this study was to assess the diagnostic and prognostic value of visual EEG assessment to distinguish different causes of cognitive disorders.

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Diagnostic agreement between emergency medical service and emergency department physicians, a prospective multicentre study.

BMC Emerg Med

July 2024

Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, location VU University Medical Centre, Amsterdam, The Netherlands.

Introduction: Early and adequate preliminary diagnosis reduce emergency department (ED) and hospital stay and may reduce mortality. Several studies demonstrated adequate preliminary diagnosis as stated by emergency medical services (EMS) ranging between 61 and 77%. Dutch EMS are highly trained, but performance of stating adequate preliminary diagnosis remains unknown.

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Article Synopsis
  • The optimal management of patients with atrial fibrillation (AF) requiring oral anticoagulation (OAC) during percutaneous coronary intervention (PCI) is debated, with current guidelines suggesting a temporary triple therapy regimen that includes aspirin, which raises bleeding risks.
  • A new study, the WOEST-3 trial, seeks to compare a 30-day dual antiplatelet therapy (DAPT) strategy that temporarily omits OAC against guideline-directed therapy post-PCI for AF patients, aiming to reduce bleeding without sacrificing efficacy.
  • With a sample of 2,000 patients, the trial will evaluate the rates of major bleeding and adverse ischemic events, making it the first randomized controlled trial to explore the omission of OAC
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Cognitive impairment in young adults following cerebellar stroke: Prevalence and longitudinal course.

Cortex

September 2024

Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, 6525 GA, Nijmegen, the Netherlands. Electronic address:

Article Synopsis
  • Cognitive impairment is prevalent in young cerebellar stroke patients, with about 60% experiencing deficits, especially in visuo-spatial skills and executive functioning.
  • The study found mixed outcomes over time, with some patients showing improvement while others experienced cognitive decline, regardless of recurrence of strokes.
  • Subjective cognitive complaints were high and correlated with levels of fatigue, indicating a significant impact on the patients' overall cognitive health and quality of life.
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The performance of metabolomics-based prediction scores for mortality in older patients with solid tumors.

Geroscience

December 2024

Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.

Prognostic information is needed to balance benefits and risks of cancer treatment in older patients. Metabolomics-based scores were previously developed to predict 5- and 10-year mortality (MetaboHealth) and biological age (MetaboAge). This study aims to investigate the association of MetaboHealth and MetaboAge with 1-year mortality in older patients with solid tumors, and to study their predictive value for mortality in addition to established clinical predictors.

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Article Synopsis
  • Mortality rates in patients with cardiogenic shock due to acute myocardial infarction (AMICS) remain high, prompting research into how prehospital symptom duration affects patient outcomes.
  • A study analyzed data from 1,363 AMICS patients, revealing that longer symptom durations significantly increased the 30-day mortality rates, especially for those with symptoms lasting over 24 hours.
  • The findings highlight the importance of early identification and intervention, suggesting that prolonged symptoms are a strong predictor of poor survival rates in AMICS patients, particularly those receiving mechanical circulatory support.
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Aims: It is not clear which type of casting provides the best initial treatment in adults with a distal radial fracture. Given that between 32% and 64% of adequately reduced fractures redisplace during immobilization in a cast, preventing redisplacement and a disabling malunion or secondary surgery is an aim of treatment. In this study, we investigated whether circumferential casting leads to fewer the redisplacement of fewer fractures and better one-year outcomes compared with plaster splinting.

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  • A study examined health-related quality of life (HRQoL) in patients who survived out-of-hospital cardiac arrest (OHCA) treated with either extracorporeal cardiopulmonary resuscitation (ECPR) or conventional CPR (CCPR) during the first year post-incident.
  • Out of 134 enrolled patients, only 20% survived to hospital discharge, with HRQoL assessed for 25 survivors using the EQ-5D-5L questionnaire, revealing 68% had good HRQoL after one year.
  • Although there was no significant statistical difference in HRQoL scores between ECPR and CCPR groups, results suggested that ECPR survivors experienced numerically better outcomes,
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Quality of life gains in frail and intermediate-fit patients with multiple Myeloma: Findings from the prospective HOVON123 clinical trial.

Eur J Cancer

August 2024

Hematology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlandsī. Electronic address:

Background: Frailty in newly-diagnosed multiple myeloma (NDMM) patients is associated with treatment-related toxicity, which negatively affects health-related quality of life (HRQoL). Currently, data on changes in HRQoL of frail and intermediate-fit MM patients during active treatment and post-treatment follow-up are absent.

Methods: The HOVON123 study (NTR4244) was a phase II trial in which NDMM patients ≥ 75 years were treated with nine dose-adjusted cycles of Melphalan-Prednisone-Bortezomib (MPV).

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Neoadjuvant Immunotherapy in Locally Advanced Mismatch Repair-Deficient Colon Cancer.

N Engl J Med

June 2024

From the Departments of Gastrointestinal Oncology (M.C., Y.L.V., P.B.T., C.G., S.D., N.V.B., I.L.H., M.E.V.L.), Medical Oncology (M.C., C.G., N.V.B., E.E.V., J.B.H.), Biometrics (S.B.), Surgery (B.A.G., K.K., G.L.B.), Pathology (P.S., J.G.B.), Molecular Oncology and Immunology (E.E.V., T.N.S.), and Radiology (R.G.B.-T.), and the Division of Molecular Carcinogenesis (L.F.W.), Netherlands Cancer Institute, and the Department of Gastroenterology and Hepatology, OLVG Hospital (A.U.V.L.), Amsterdam, the Department of Surgery, Catharina Hospital Eindhoven, Eindhoven (J.W.B.), the Department of Surgery, Haga Hospital, the Hague (T.S.A.), the Department of Surgery, Tergooi MC, Hilversum (E.R.H.), the Department of Surgery, Spaarne Gasthuis, Haarlem (S.J.O.), Oncode Institute, Utrecht (E.E.V., L.F.W., T.N.S.), the Faculty of EEMCS, Delft University of Technology, Delft (L.F.W.), GROW School for Oncology and Reproduction, Maastricht University, Maastricht (R.G.B.-T., G.L.B.), and the Departments of Gastroenterology and Hepatology (M.E.V.L.), Hematology (T.N.S.), and Medical Oncology (J.B.H.), Leiden University Medical Center, Leiden - all in the Netherlands; the Faculty of Medicine, University of Iceland, Reykjavik (P.S.); and the Melanoma Clinic, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (J.B.H.).

Background: Mismatch repair-deficient (dMMR) tumors can be found in 10 to 15% of patients with nonmetastatic colon cancer. In these patients, the efficacy of chemotherapy is limited. The use of neoadjuvant immunotherapy has shown promising results, but data from studies of this approach are limited.

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