Contemporary Use of Post-Dilatation for Stent Optimization During Percutaneous Coronary Intervention; Results From the Netherlands Heart Registration.

Backgrounds: Post-dilatation after stenting with a non-compliant (NC) balloon can be used to improve overall percutaneous coronary intervention (PCI) result. Due to lack of evidence on the effect of post-dilatation on adverse clinical endpoints there is no consensus whether post-dilatation should be used routinely. The aim of the current study was to determine the contemporary practice of post-dilatation.

Prognostic value of radiologic and pathological response in colorectal cancer liver metastases upon systemic induction treatment: subgroup analysis of the CAIRO5 trial.

Background: RECIST may not be optimal for assessing treatment response with current systemic regimens. We evaluated RECIST, morphologic, and pathologically documented response (pathological response) in patients with initially unresectable colorectal cancer liver-only metastases (CRLM).

Patients And Methods: Four hundred and eighty-nine patients from the phase III CAIRO5 trial were included who were treated with FOLFOX/FOLFIRI/FOLFOXIRI and bevacizumab or panitumumab.

Antibiotic Utilization Among People With Multiple Sclerosis in the Netherlands, 2018-2020.

Purpose: The purpose of this study was to describe the intensity and patterns of antibiotic drug use among people with multiple sclerosis (pwMS) in the Netherlands.

Methods: People with prevalent MS between 1 January 2018 and 31 December 2020 were identified using ambulatory hospital records from the PHARMO Database Network that contains routinely collected healthcare data from the Netherlands. Out-patient pharmacy dispensing data were used to assess type of antibiotic, dosage, and amounts dispensed.

Optical assessment of scars after endoscopic mucosal resection of large colorectal polyps in a multicenter, community hospital setting: is routine biopsy still necessary?

Background And Study Aims: Piecemeal EMR of large (≥20mm) non-pedunculated colorectal polyps (LNPCPs) is succeeded by a 6-month surveillance endoscopy to evaluate the post-EMR scar for recurrence. Data from expert centers suggest that routine tattoo placement and scar biopsies can be omitted, but data from community hospitals are lacking.

Patients And Methods: In a post-hoc analysis of the STAR-LNPCP study (NTR7477), containing prospective data on 6-month post-pEMR scar assessments in 30 Dutch community hospitals (October 2019 to May 2022), the agreement between optical assessment and histological confirmation by routine biopsies was evaluated.

Expert level of detection of interictal discharges with a deep neural network.

Objective: Deep learning methods have shown potential in automating the detection of interictal epileptiform discharges (IEDs) in electroencephalography (EEG). We compared IED detection using our previously trained deep neural network with a group of experts to assess its potential applicability.

Methods: First, we performed clinical validation on an internal data set.

Follow-up on patients with initial negative mpMRI target and systematic biopsy for PI-RADS ≥ 3 lesions - an EAU-YAU study enhancing prostate cancer detection.

Purpose: To investigate the detection and predictors of prostate cancer (PCA) and clinically significant prostate cancer (csPCA) in patients with positive multiparametric MRI (mpMRI) followed by a negative MRI - guided target biopsy (TB) and systematic biopsy (SB).

Materials And Methods: This retrospective multicenter study included 694 patients from 10 tertiary referral centers with an initial positive mpMRI (PI-RADS ≥ 3) and negative results on both MRI-TB and SB. Patients were classified into three groups based on follow-up: Group 1 (prostate re-biopsy without new mpMRI), Group 2 (standardized second prostate mpMRI and subsequent re-biopsy), and Group 3 (follow-up with mpMRIs and biopsy based on clinical and radiological triggers).

Risk Calculator Strategy Before Magnetic Resonance Imaging Stratification for Biopsy-naïve Men with Suspicion for Prostate Cancer: A Cost-effectiveness Analysis.

Background And Objective: Current guidelines on prostate cancer (PCa) diagnosis recommend risk stratification before prostate biopsy, using either a risk calculator (RC) or magnetic resonance imaging (MRI). The aim of our study was to assess the effectiveness and cost effectiveness of an RC strategy and a direct MRI (dMRI) strategy.

Methods: Data for biopsy-naïve men suspected of having PCa on the basis of elevated prostate specific antigen (PSA) and/or abnormal digital rectal examination (DRE) were retrospectively collected from two large teaching hospitals.

PSMA PET-targeted Biopsy for Prostate Cancer Diagnosis: Initial Experience From a Multicenter Cohort.

Objective: To describe the initial experience with PSMA-PET/CT-guided biopsy in European referral centres.

Methods: This multicenter observational cohort study was endorsed by the Young Academic Urologist (YAU) Prostate Cancer Group of the EAU and conducted across 6 tertiary-level European centres. PSMA-guided biopsies were carried out in a cognitive/fusion manner for all the recruited patients with or without MRI-guided biopsies and/or standard biopsy (SB).

Endoscopic ultrasound with tissue acquisition of lymph nodes in patients with potentially resectable intrahepatic cholangiocarcinoma.

Lymph node (LN) involvement is a poor prognostic factor for patients with intrahepatic cholangiocarcinoma (iCCA). The aim of this study was to evaluate the yield and impact on clinical decision making of endoscopic ultrasound with tissue acquisition (EUS-TA) of LNs in patients with potentially resectable iCCA. In this multicenter cohort study, patients with potentially resectable iCCA and preoperative EUS between 2010 and 2020 were retrospectively included.

Tumor immune microenvironmental characteristics in Human Epidermal Growth Factor-2 (HER2) positive esophageal adenocarcinoma: A comparative analysis and biomarker study.

Background: HER2 targeting in esophageal adenocarcinoma (EAC) has shown potential, but often fails to show durable response. Given the contributions of the tumor immune microenvironment (TIME) to therapeutic responses, we aimed to chart the TIME characteristics of HER2 positive tumors.

Methods: 84 biopsies were taken from the TRAP cohort (neoadjuvant chemoradiotherapy (nCRT) according to CROSS with trastuzumab and pertuzumab; n = 40; HER2n = 40) and a control cohort with nCRT only (n = 44; HER2- n = 40, HER2n = 4) before treatment.

Changes in nutritional status and associations with physical and clinical outcomes in acute myeloid leukemia patients during intensive chemotherapy.

Background/objectives: Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) often receive medical nutrition therapy (MNT) during intensive remission-induction treatment. Since little is known about changes in nutritional status, specifically body composition, in this patient population, these changes and their associations with physical and clinical outcomes were assessed.

Subjects/methods: In this multicenter prospective observational study, newly diagnosed AML/MDS patients who received intensive remission-induction chemotherapy, routine dietary counseling by a dietician and MNT immediately upon inadequate nutritional intake, were included.

Diagnostic criteria and long-term outcomes in AIH-PBC variant syndrome under combination therapy.

Background & Aims: Autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) can co-exist in AIH-PBC, requiring combined treatment with immunosuppression and ursodeoxycholic acid (UDCA). The Paris criteria are commonly used to identify these patients; however, the optimal diagnostic criteria are unknown. We aimed to evaluate the use and clinical relevance of both Paris and Zhang criteria.

Systematic Review on the Cost Effectiveness of Prostate Cancer Screening in Europe.

Background And Objective: In Europe, prostate cancer (PCa) is the most common cancer in men. Screening may therefore be crucial to lower health care costs, morbidity, and mortality. This systematic review aimed to provide a contemporary overview of the costs and benefits of PCa screening programmes.

Favorable resuscitation characteristics in patients undergoing extracorporeal cardiopulmonary resuscitation: A secondary analysis of the INCEPTION-trial.

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used as a supportive treatment for refractory out-of-hospital cardiac arrest (OHCA). Still, there is a paucity of data evaluating favorable and unfavorable prognostic characteristics in patients considered for ECPR.

Methods: We performed a previously unplanned post-hoc analysis of the multicenter randomized controlled INCEPTION-trial.

Patient-clinician collaboration in making care fit: A qualitative analysis of clinical consultations in diabetes care.

Objective: To confirm described dimensions of making care fit and explore how patients and clinicians collaborate to make care fit in clinical practice.

Methods: As part of an ongoing study, we audiotaped and transcribed patient-clinician consultations in diabetes care. We purposively selected consultations based on participants' demographical, biomedical and biographical characteristics.

The additional value of Ga-PSMA PET/CT SUVmax in predicting ISUP GG ≥ 2 and ISUP GG ≥ 3 prostate cancer in biopsy.

Background: Prebiopsy magnetic resonance imaging (MRI) increases the detection rate of clinically significant prostate cancer (csPCa). Prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA PET/CT) maximum standardized uptake value (SUVmax) of the prostate may offer additional value in predicting the likelihood of csPCa in biopsy.

Methods: A single-center cohort study involving patients with biopsy-proven PCa who underwent both MRI and PSMA PET/CT between 2020 and 2021.

Benefits and risks of clofarabine in adult acute lymphoblastic leukemia investigated in depth by multi-state modeling.

Background: We recently reported results of the prospective, open-label HOVON-100 trial in 334 adult patients with acute lymphoblastic leukemia (ALL) randomized to first-line treatment with or without clofarabine (CLO). No improvement of event-free survival (EFS) was observed, while a higher proportion of patients receiving CLO obtained minimal residual disease (MRD) negativity.

Aim: In order to investigate the effects of CLO in more depth, two multi-state models were developed to identify why CLO did not show a long-term survival benefit despite more MRD-negativity.

Effect of optical diagnosis training on recognition and treatment of submucosal invasive colorectal cancer in community hospitals: a prospective multicenter intervention study.

Background:  Recognition of submucosal invasive colorectal cancer (T1 CRC) is difficult, with sensitivities of 35 %-60 % in Western countries. We evaluated the real-life effects of training in the OPTICAL model, a recently developed structured and validated prediction model, in Dutch community hospitals.

Methods:  In this prospective multicenter study (OPTICAL II), 383 endoscopists from 40 hospitals were invited to follow an e-learning program on the OPTICAL model, to increase sensitivity in detecting T1 CRC in nonpedunculated polyps.

Computer-aided diagnosis improves characterization of Barrett's neoplasia by general endoscopists (with video).

Background And Aims: Characterization of visible abnormalities in patients with Barrett's esophagus (BE) can be challenging, especially for inexperienced endoscopists. This results in suboptimal diagnostic accuracy and poor interobserver agreement. Computer-aided diagnosis (CADx) systems may assist endoscopists.

Shared decision-making for non-operative management versus operative management of hip fractures in selected frail older adults with a limited life expectancy: a protocol for a nationwide implementation study.

Background And Purpose: Recent research has highlighted non-operative management (NOM) as a viable alternative for frail older adults with hip fractures in the final phase of life. This study aims to guide Dutch physicians and hospitals nationwide in a standardised implementation of shared decision-making regarding surgery or NOM in selected frail older adults with a hip fracture.

Methods And Analysis: The patient population for implementation includes frail older adults aged ≥70 years with an acute proximal femoral fracture, nursing home care or a similar level of care elsewhere and at least one additional criterion (ie, malnutrition, severe mobility impairment or ASA≥4).