47 results match your criteria: "The Leiden University Medical Center[Affiliation]"

General practitioners' and community pharmacists' beliefs and practices on opioids for non-malignant pain.

Eur J Pain

November 2024

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.

Article Synopsis
  • Opioid use for chronic non-malignant pain has increased in Europe, prompting a need to explore the beliefs and practices of general practitioners (GPs) and community pharmacists (CPs) regarding this issue.
  • Both GPs and CPs largely agree on the overuse of opioids and express concerns about their addictive potential; however, GPs feel more self-efficacious and see fewer benefits from opioids than CPs.
  • Despite recognizing the need to reduce opioid prescriptions, less than half of GPs and CPs actively implement recommended strategies, highlighting the need for better education and collaboration to enhance opioid-related care.
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Unraveling the Myth of Radiation Resistance in Soft Tissue Sarcomas.

Semin Radiat Oncol

April 2024

Department of Radiotherapy, The Leiden University Medical Center, Leiden, The Netherlands; Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands. Electronic address:

There is a misconception that sarcomas are resistant to radiotherapy. This manuscript summarizes available (pre-) clinical data on the radiosensitivity of soft tissue sarcomas. Currently, clinical practice guidelines suggest irradiating sarcomas in 1.

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Mycosis fungoides and Sézary syndrome are rare and largely incurable types of cutaneous T-cell lymphoma with limited therapeutic options. In 1984 Bunn et al. reported that interferon alpha is an efficient monotherapy in cutaneous T-cell lymphoma and 14 years later it was shown in a prospective, randomized trial that a combination of interferon alpha and psoralen plus ultraviolet A therapy (PUVA) is most efficient in the treatment of cutaneous T-cell lymphoma.

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Effectiveness of Antiseizure Medication Triple Therapy in Patients With Glioma With Refractory Epilepsy: An Observational Cohort Study.

Neurology

April 2023

From the Leiden University Medical Center (P.B.v.d.M., L.D., M.F., M.J.V., M.J.B.T., J.A.F.K.); Haaglanden Medical Center (P.B.v.d.M., L.D., M.J.V., J.A.F.K.), The Hague; Amsterdam University Medical Centers (M.C.M.K.); and Erasmus Medical Center (M.J.v.d.B.), Rotterdam, the Netherlands.

Article Synopsis
  • A study evaluated the effectiveness of a triple therapy of levetiracetam, valproic acid, and clobazam (LEV + VPA + CLB) for patients with glioma and refractory epilepsy to see how it compares to other ASM triple therapies.
  • The research involved analyzing data from 90 patients who had persistent seizures after trying other treatments, finding no significant difference in treatment failure rates between LEV + VPA + CLB and other combinations after 12 months.
  • The results suggest that the LEV + VPA + CLB combination is as effective as other triple therapy options for managing seizures in glioma patients, although further studies are needed for confirmation.
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Background: Owing to the rarity and heterogeneity in biology and presentation, there are multiple areas in the diagnosis, treatment and follow-up of soft tissue sarcoma (STS), with no, low-level or conflicting evidence.

Methods: During the first Consensus Conference on the State of Science in Sarcoma (CSSS), we used a modified Delphi process to identify areas of controversy in the field of sarcoma, to name topics with limited evidence-based data in which a scientific and knowledge gap may remain and a consensus statement will help to guide patient management. We determined scientific questions which need to be addressed in the future in order to generate evidence and to inform physicians and caregivers in daily clinical practice in order to improve the outcomes of patients with sarcoma.

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Background: In ultra-rare sarcomas (URS) the conduction of prospective, randomized trials is challenging. Data from retrospective observational studies (ROS) may represent the best evidence available. ROS implicit limitations led to poor acceptance by the scientific community and regulatory authorities.

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Article Synopsis
  • Researchers created a new risk model called G-score to better predict if patients with solitary fibrous tumors will have recurrences, or if their disease will come back.
  • They studied a large group of 318 patients worldwide and found that 33% had their disease come back over time.
  • The G-score did a really good job at predicting who was at low risk for recurrence compared to other models, which means patients with a low score might not need to visit the doctor as often.
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Utilization and Effectiveness of eHealth Technology in the Follow-up of Celiac Disease: A Systematic Review.

J Pediatr Gastroenterol Nutr

June 2022

the Department of Pediatrics, institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg.

Objectives: To systematically review the literature on the utilization and effectiveness of electronic-health technologies (eHealth), such as smartphone applications, in managing patients with celiac disease (CD).

Methods: PubMed, Scopus, and the Cochrane Library were all searched (until February 2021). Inclusion criteria were full-text English articles reporting original data on the use of eHealth technologies in the follow-up of CD patients, with no age restriction.

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Management of Synovial Sarcoma and Myxoid Liposarcoma.

Surg Oncol Clin N Am

July 2022

Department of Radiotherapy at the Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Radiotherapy at the Leiden University Medical Center, Leiden, the Netherlands.

Synovial sarcoma and myxoid liposarcoma are translocation-related sarcomas, with a high risk of developing distant metastasis, which often affect young patients and which are sensitive to chemo and radiotherapy. Surgery is the mainstay of therapy in localized disease. In these entities, perioperative radiotherapy is frequently administered, and chemotherapy is evaluated in patients with high-risk limb/trunk wall tumors in which an advantage in overall survival has been shown in the latest clinical trials.

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Epithelioid hemangioendothelioma, an ultra-rare cancer: a consensus paper from the community of experts.

ESMO Open

June 2021

Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typically refractory to the antitumor drugs used in sarcomas.

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Introduction: The accurate measurement of HbA is essential for the detection of β-thalassaemia carriers and as no single calibrant is used by the various manufacturers of analysers, differences are seen in results obtained. The World Health Organization International Reference Reagent for HbA (WHO IRR 89/666) was made available to diagnostic laboratories in the 1980s and remains the only international reference material available. A previous study (2015) demonstrated that the WHO IRR remained suitable for use as an HbA standard as tested by 52 participants in the UK NEQAS Haematology Abnormal Haemoglobins Programme.

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Management of meningeal solitary fibrous tumors/hemangiopericytoma; surgery alone or surgery plus postoperative radiotherapy?

Acta Oncol

January 2021

Adult Mesenchymal and Rare Tumor Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Introduction: A meningeal solitary fibrous tumor (SFT), also called hemangiopericytoma, is a rare mesenchymal malignancy. Due to anatomic constrains, even after macroscopic complete surgery with curative intent, the local relapse risk is still relatively high, thus increasing the risk of dedifferentiation and metastatic spread. This study aims to better define the role of postoperative radiotherapy (RT) in meningeal SFTs.

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Accurate Statistics on COVID-19 Are Essential for Policy Guidance and Decisions.

Am J Public Health

July 2020

Neil Pearce is with the London School of Hygiene and Tropical Medicine (LSHTM), London, UK. Jan P. Vandenbroucke is with the Leiden University Medical Center, Leiden, Netherlands, Aarhus University, Aarhus, Denmark, and the LSHTM. Tyler J. VanderWeele is with the Harvard T. H. Chan School of Public Health, Boston, MA. Sander Greenland is with the Departments of Epidemiology and Statistics, University of California, Los Angeles.

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Background: Solitary fibrous tumor (SFT) is a rare mesenchymal malignancy. Although surgery is potentially curative, the local relapse risk is high after marginal resections. Given the lack of prospective clinical trial data, the objective of the current study was to better define the role of perioperative radiotherapy (RT) in various SFT presentations by location.

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Purpose: To design a 3D printed anthropomorphic lung vessel phantom for CT image quality assessment and to evaluate the phantom image and dose characteristics.

Methods: An in-house algorithm generated a vessel tree model, based on human lungs anatomy, which was 3D printed using a multi jet modeling printer (0.25 mm ≤ vessel diameters ≤ 8.

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Image registration, the process of aligning two or more images, is the core technique of many (semi-)automatic medical image analysis tasks. Recent studies have shown that deep learning methods, notably convolutional neural networks (ConvNets), can be used for image registration. Thus far training of ConvNets for registration was supervised using predefined example registrations.

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Sex-associated Treatment Differences and Their Outcomes in Rheumatoid Arthritis: Results from the METEOR Register.

J Rheumatol

October 2018

From the Leiden University Medical Center (LUMC), Leiden; Amsterdam Rheumatology and Immunology Center, Amsterdam; Zuyderland Medical Center, Heerlen, the Netherlands; Center for Rheumatic Diseases, Pune, India; University of the Witwatersrand, Johannesburg, South Africa; Instituto Português de Reumatologia, Lisbon, Portugal; Wishaw General Hospital, Wishaw, Lanarkshire, UK.

Objective: To assess differences in initial treatment and treatment response in male and female patients with rheumatoid arthritis (RA) in daily clinical practice.

Methods: The proportion of patients with RA starting different antirheumatic treatments (disease-modifying antirheumatic drugs; DMARD) and the response to treatment were compared in the international, observational METEOR register. All visits from start of the first DMARD until the first DMARD switch or the end of followup were selected.

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Preoperative radiotherapy in soft tissue sarcoma: from general guidelines to personalized medicine.

Chin Clin Oncol

August 2018

Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiotherapy, The Leiden University Medical Center, Leiden, The Netherlands.

This critical review aims to generate hypotheses when to adhere to guidelines and when it could be considered to individualize management of extremity soft tissue sarcomas.Based upon peer-reviewed publications using a PubMed search on the MeSH headings "soft tissue sarcoma" AND "preoperative radiotherapy", data were compiled. Titles and abstracts screened for data including "fraction size AND/OR total dose AND/OR overall treatment time", "chemotherapy", "targeted agents AND/OR tyrosine kinase inhibitors", were screened as well as their respective reference.

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Background: The Committee for Medical Ethics (CME) of Leiden University Medical Center (LUMC) was established as the first medical ethics reviewing committee (MREC) in the Netherlands. In the period 2000-2010 the CME received 2,162 protocols for review. Some of these protocols were never approved.

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Trauma systems around the world: A systematic overview.

J Trauma Acute Care Surg

November 2017

From the Leiden University Medical Center (S.D., C.N., P.K., I.B.S.), Leiden, the Netherlands; and Massachusetts General Hospital (G.C.V.), Boston, Massachusetts.

Background: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally.

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