948 results match your criteria: "Isala hospital[Affiliation]"

The co-treatment of androgen deprivation therapy (ADT) for advanced prostate cancer (PCa) with the fetal estrogen estetrol (E4) may further inhibit endocrine PCa tumor stimulators. We previously reported the suppression of follicle-stimulating hormone (FSH), total and free testosterone, and prostate-specific antigen by ADT+E4. Here, we provide more detailed data on FSH suppression by E4 and present new findings on the effect of ADT+E4 on insulin-like growth factor-1 (IGF-1).

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The treatment of older patients with acute myeloid leukemia (AML) considered unfit for receiving intensive chemotherapy is challenging. Based on the hypothesis that addition of the broad tyrosine kinase inhibitor (TKI) midostaurin could improve the response to hypomethylating agents, irrespective of FLT3 gene mutational status, we conducted a randomized phase II multicenter study to assess the tolerability and efficacy of the addition of midostaurin to a 10-day schedule of decitabine in unfit (i.e.

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Magnetic Resonance-Guided Focused Ultrasound Surgery for Gynecologic Indications.

Magn Reson Imaging Clin N Am

November 2024

Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands; Imaging & Oncology Division, Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.

Article Synopsis
  • MRgFUS is a promising and safe treatment for uterine fibroids and adenomyosis, especially for women looking to preserve their fertility.
  • It has shown potential in relieving pain for conditions like endometriosis and recurrent gynecologic cancers, but further research is required.
  • Widespread reimbursement for MRgFUS is limited due to insufficient large-scale studies comparing it to standard treatment options.
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Background: The multicenter ATTEST study recently assessed 1084 patients with ischemic stroke or transient ischemic attack (TIA) of undetermined cause and found that routine transthoracic echocardiography (TTE) detects abnormalities with treatment implications (i.e., major cardiac sources of embolism) in only 1 % of patients, of whom most (91 %) also had major electrocardiographic (ECG)-abnormalities.

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Article Synopsis
  • Percutaneous treatment for structural heart disease is advancing quickly, with the EAPCI's Core Curriculum defining crucial competencies for new interventional cardiologists specializing in this area.
  • These specialists, trained in interventional cardiology, manage adult patients and perform various procedures, requiring skills in advanced imaging and planning software, with a focus on the aortic, mitral, and tricuspid valves.
  • Comprehensive training in all three areas typically takes at least 18 months, supporting consistent education across Europe, which will eventually influence certifications and patient safety measures.
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Background: Metallic artefacts caused by metal implants, are a common problem in computed tomography (CT) imaging, degrading image quality and diagnostic accuracy. With advancements in artificial intelligence, novel deep learning (DL)-based metal artefact reduction (MAR) algorithms are entering clinical practice.

Objective: This systematic review provides an overview of the performance of the current supervised DL-based MAR algorithms for CT, focusing on three different domains: sinogram, image, and dual domain.

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Article Synopsis
  • Recurrent events after myocardial infarction (MI) often arise from non-flow limiting lesions, which may differ between sexes, prompting this study to investigate these potential differences among MI patients.
  • The study examined 420 patients, finding that female patients had longer NC lesions and smaller lumen areas and diameters, as well as thinner fibrous caps compared to male patients.
  • Despite females exhibiting more high-risk plaque characteristics, both genders experienced similar rates of major cardiovascular events at two years, suggesting the need for further research on long-term outcomes related to these differences.
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Risk Stratification in Older Intensively Treated Patients With AML.

J Clin Oncol

December 2024

MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.

Article Synopsis
  • - The study focuses on older patients (over 60 years) with acute myeloid leukemia (AML) and aims to create a prognostic model to identify those who would benefit from intensive chemotherapy and stem cell transplantation.
  • - Researchers analyzed data from 1,910 patients, using a random survival forest to evaluate clinical and genetic factors associated with overall survival, resulting in the identification of four distinct survival groups based on nine variables.
  • - The newly developed AML60+ classification shows improved prognostic accuracy and indicates that intermediate- and very poor-risk patients may benefit from allogeneic hematopoietic cell transplantation, potentially guiding treatment decisions for older adults with AML.
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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 percutaneous treatment of structural heart disease (SHD) is advancing quickly, with the EAPCI's Core Curriculum (CC) defining the necessary competencies for newly trained interventional cardiologists (IC).
  • SHD interventional cardiologists manage adult patients throughout the entire treatment process, requiring skills in advanced imaging and planning software, as well as proficiency in procedures related to the aortic, mitral, and tricuspid heart valves.
  • Completing specialized SHD training typically takes at least 18 months, though it can be shortened to 1 year for focused training on specific areas, with the goal of promoting standardized, high-quality training across Europe for better patient care and future certifications.
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B cells critical for outcome in high grade serous ovarian carcinoma.

Int J Cancer

December 2024

Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Recent work has shown evidence for the prognostic significance of tumor infiltrating B cells (B-TIL) in high grade serous ovarian carcinoma (HGSOC), the predominant histological subtype of ovarian cancer. However, it remains unknown how the favorable prognosis associated with B-TIL relates to the current standard treatments of primary debulking surgery (PDS) followed by chemotherapy or (neo-)adjuvant chemotherapy (NACT) combined with interval debulking surgery. To address this, we analyzed the prognostic impact of B-TIL in relationship to primary treatment and tumor infiltrating T cell status in a highly homogenous cohort of HGSOC patients.

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A man in his 60s presented to our emergency department with severe peripheral pitting oedema, weight gain, dyspnoea and diarrhoea. Blood tests showed a hypoalbuminaemia of 15 g/L. A suspicion of protein-losing enteropathy arose after the exclusion of albuminuria, cardiac failure, protein deficiency and liver cirrhosis.

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Diffusion MRI (dMRI) enables studying the complex architectural organization of the brain's white matter (WM) through virtual reconstruction of WM fiber tracts (tractography). Despite the anticipated clinical importance of applying tractography to study structural connectivity and tract development during the critical period of rapid infant brain maturation, detailed descriptions on how to approach tractography in young infants are limited. Over the past two decades, tractography from infant dMRI has mainly been applied in research settings and focused on diffusion tensor imaging (DTI).

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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: Fractional flow reserve (FFR) is an established method to guide decisions on revascularization; however, in patients with diabetes mellitus (DM), FFR-negative lesions carrying an optical coherence tomography-detected thin-cap fibroatheroma (TCFA) remain at high risk for adverse cardiac events.

Methods: In this prespecified subanalysis of the COMBINE OCT-FFR trial, DM patients with ≥1 FFR-negative, TCFA-positive medically treated target lesions referred to as vulnerable plaque (VP group), were compared to patients with exclusively FFR-positive target lesions who underwent complete revascularization (CR group). The primary endpoint was first and recurrent event analysis for target lesion failure and the secondary endpoint was a composite of cardiac death, target vessel myocardial infarction, target lesion revascularization, or hospitalization due to unstable angina.

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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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Registration of finger implants in the Dutch arthroplasty registry (LROI).

JPRAS Open

September 2024

Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, the Netherlands.

Finger arthroplasty is commonly used to treat pain in the finger joints due to osteoarthritis or rheumatoid arthritis. Despite the procedure having existed for a relatively long time, it is still unknown which characteristics influence implant survival. The Dutch Arthroplasty Registry (LROI) is one of the 4 registries worldwide registering finger arthroplasties.

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Article Synopsis
  • The study aimed to create a comprehensive guideline for managing patellofemoral pain (PFP) and patellar tendinopathy (PT) to aid healthcare professionals in making clinical decisions.
  • An expert panel assessed existing literature using the GRADE method to evaluate the strength of treatment recommendations, focusing on exercise therapy as the main treatment approach.
  • Key recommendations include starting with exercise therapy, using additional treatments only if necessary, limiting pain medications, and reserving surgery for specific cases, while acknowledging the low certainty of evidence for these strategies.
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Background: Decision-making after local resection of T1 colorectal cancer (T1CRC) is often complex and calls for optimal information provision as well as active patient involvement.

Objective: The aim was to evaluate the perceptions of patients with T1CRC on information provision and therapeutic decision-making.

Methods: This multicenter cross-sectional study included patients who underwent endoscopic or local surgical resection as initial treatment.

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Background: Medical consultations with older patients often include triadic conversations and decision-making processes involving physicians, patients, and family members. The presence of family members may change the communication dynamics and therefore increase the complexity of the consultation and decision-making process.

Objective: This study explored associations between physicians' shared decision-making (SDM) behaviour and patients' and family members' participation in the decision-making process.

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Article Synopsis
  • The study evaluated the use of constrained spherical deconvolution (CSD) tractography for mapping crossing fiber bundles in unsedated neonatal diffusion MRI (dMRI) and looked at how different imaging settings impact results.
  • It involved analyzing dMRI data from preterm infants, comparing techniques like diffusion tensor imaging (DTI) and CSD, and assessing the effects of resolution and processing on tractography outcomes.
  • Findings showed that CSD effectively reconstructed crossing fibers, while variations in imaging settings significantly influenced the properties of the reconstructed streamlines, emphasizing the need for meticulous documentation in studies.
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Background: Therapeutic drug monitoring (TDM) - performing dose adjustments based on measured drug levels and established pharmacokinetic (PK) targets - could optimise treatment with drugs that show large interpatient variability in exposure. We evaluated the feasibility of TDM for multiple oral targeted therapies. Here we report on drugs for which routine TDM is not feasible.

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Background: In patients with ST-elevation myocardial infarction (STEMI), either with or without cardiogenic shock, mechanical circulatory support with an intra-aortic balloon pump (IABP) is not associated with lower mortality. However, in STEMI patients undergoing urgent coronary artery bypass grafting (CABG), preoperative insertion of an IABP has been suggested to reduce mortality. In this study, the effect of preoperative IABP use on mortality in STEMI patients undergoing urgent CABG was investigated.

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