Biological OviTex versus synthetic graft in robotic prolapse surgery: a multicentre, phase II-III, partially randomized patient preference trial - ProTex

Start Date01 Sep 2023

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Meander Medisch Centrum

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01 Dec 2024·The Journal of Pediatrics

Use and Waste of Reconstituted Whole Blood Exchange Transfusions: An 11-year National Observational Study

Article

Author: de Vooght, Karen M K ; Dubbink-Verheij, Gerdina H ; van Bohemen, Michaela ; Verweij, E J T Joanne ; van Gammeren, A J Adriaan ; Hulzebos, Christian V ; Trompenaars, Amanda M P ; Zant, Janneke C ; Knol, F R Rachel ; de Winter, Derek P ; Vrancken, Sabine L A G ; van Rossem, Maaike C ; Gijzen, Karlijn ; Lukens, Michaël V ; Lopriore, Enrico ; van Hillegersberg, J L A M Jacqueline ; den Besten, Gijs ; Hoffmann-Haringsma, Angelique ; de Haas, Masja ; Péquériaux, N C V Nathalie ; Schiering, I A M Irene ; Klinkspoor, J H Harriët ; Counsilman, Clare E ; Andriessen, Peter ; Weerkamp, Floor

OBJECTIVESTo identify indications for exchange transfusions, assess the use and waste of exchange transfusion products (ie, reconstituted whole blood exchange transfusions), and determine nationwide distribution and prevalence of these transfusions in the Netherlands.STUDY DESIGNAll 9 neonatal intensive care units and 15 non-neonatal intensive care unit hospitals participated in this retrospective, observational, cohort study. We retrieved data on the indications for and use of all exchange transfusion products ordered by participating centers over an 11-year period.RESULTSA total of 574 patients for whom 1265 products were ordered were included for analyses. Severe ABO (32.6%) and non-ABO (25.2%) immune hemolysis and subsequent hyperbilirubinemia were the most frequent indications. Rare indications were severe leukocytosis in Bordetella pertussis (2.1%) and severe anemia (1.5%). Approximately one-half of all ordered products remained unused. In 278 of 574 neonates (48.4%), ≥1 products were not used, of which 229 (82.7%) were due to the resolving of severe hyperbilirubinemia with further intensification of phototherapy. The overall prevalence of neonates who received an exchange transfusion was 14.6:100 000 liveborn neonates.CONCLUSIONSA considerable proportion of products remained unused, and annually a limited number of patients are treated with an exchange transfusion in the Netherlands, highlighting the rarity of the procedure in the Netherlands.

01 Dec 2024·American Heart Journal

Exploration of the regional effects of colchicine in the LoDoCo2 trial

Article

Author: Thompson, Peter ; Eikelboom, John ; Nidorf, Stefan ; O'Halloran, Sean ; Murray, Kevin ; Cornel, Jan H. ; Tijssen, Jan ; Mosterd, Arend ; Budgeon, Charley A ; Cornel, Jan H ; Fiolet, Aernoud ; Schut, Astrid ; Joyce, David

BACKGROUNDThe Low Dose Colchicine 2 (LoDoCo2) trial randomized 5,522 patients with chronic coronary disease to colchicine 0.5mg daily or placebo in a 1:1 ratio and demonstrated the cardiovascular benefits of colchicine. In the trial, which was conducted in Australia and The Netherlands, a prespecified subgroup analysis suggested a difference in magnitude of treatment effect of colchicine by region (Australia: HR 0.51; 95% CI 0.39-0.67 vs The Netherlands: HR 0.92; 95% CI 0.71-1.20). The aim of this study was to explore possible explanations for the apparent difference in magnitude of treatment effect of colchicine by region in the LoDoCo2 trial.METHODSThe analysis explored potential determinants of variations in the magnitude of effectiveness of colchicine treatment across the regions. This included investigating differences in investigational product, clinical characteristics, concurrent medical therapies and the duration of follow-up using a range of statistical techniques, including sub-group, landmark and effect modification analyses.RESULTSNo differences were found in the colchicine product used in each region. Despite minor differences observed in baseline clinical characteristics and concomitant therapies, the effect modifier analyses demonstrated that these factors did not explain the difference in magnitude of treatment effect of colchicine by region. Randomization in Australia began more than two years before The Netherlands, with shorter duration of follow-up in The Netherlands compared to Australia. In a landmark analysis, over the period when more than 90% of patients in each region had been followed, the effects of colchicine were similar (Australia hazard ratio [HR] 0.58 95% CI 0.34-0.97 vs The Netherlands HR 0.67 95% CI 0.47-0.96).CONCLUSIONSAfter examining several plausible explanations for the observed differences in the magnitude of treatment effect of colchicine between regions in the LoDoCo2 trial could be due to the differences in duration of follow-up but a substantial portion of the differences remain unexplained.CLINICAL TRIAL REGISTRATIONhttps://www.anzctr.org.au/ACTRN12614000093684.

01 Dec 2024·European Journal of Radiology

Photon-counting detector CT (PCD-CT) generated iodine maps to characterize parenchymal lung disease: A feasibility study

Article

Author: Schaefer-Prokop, C. ; Bredemeier, S. ; Werncke, T ; Huisinga, C. ; Shin, H ; Wacker, F. ; Scharm, S ; Renz, D ; Hartung, D. ; Shin, H. ; Hartung, D ; Bredemeier, S ; Schaefer-Prokop, C ; Huisinga, C ; Renz, D. ; Wacker, F ; Werncke, T. ; Scharm, S.

BACKGROUNDWith photon-counting CT, spectral imaging is always available, and iodine maps with high spatial and spectral resolution can be generated.OBJECTIVESThe aim of this study was to investigate whether iodine uptake in different parenchymal patterns can be used to characterise parenchymal disease with increased lung attenuation.METHODS325 patients were scanned with a photon-counting CT using four scan protocols, all with lung parenchymal contrast. Lesions were classified into three basic patterns: consolidation, ground-glass opacities (GGO), and reticular pattern. Lesion classification was performed by 2 of 3 radiologists who were blinded to the diagnosis. Classification was performed twice using a 5-point Likert scale (with and without iodine maps). In case of disagreement, a third reader was consulted, and the decision was made by consensus.RESULTS206 lesions were found with a confirmed diagnosis (83 consolidations, 72 GGO, and 51 reticular). Diagnostic confidence improved when iodine maps were included in the evaluation. The mean Likert score increased significantly for all three basic patterns (consolidations: 3.3 vs. 3.9, GGO: 3.4 vs. 4.1, and reticular: 3.6 vs. 4.4, p < 0.001). However, the score for GGO and reticular pattern was downgraded in three and one cases, respectively. The downgrading occurred for morphologically uncertain GGO findings (3) and atelectasis (1) with inhomogeneous iodine uptake. In 29 lesions, the classification was changed when the iodine maps were included in the evaluation.CONCLUSIONIncluding iodine maps adds contrast uptake information and improves the diagnostic confidence of radiologists in the characterization of parenchymal pathologies.CLINICAL IMPACTIodine maps have the potential to provide complementary information for the interpretation of lung opacities with overlapping morphology.

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