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7 results on '"Bresser P"'

1. Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department: a multicentre randomised clinical trial

Author

van den Berk, Inge A H, Kanglie, Maadrika M N P, van Engelen, Tjitske S R, Altenburg, Josje, Annema, Jouke T, Beenen, Ludo F M, Boerrigter, Bart, Bomers, Marije K, Bresser, Paul, Eryigit, Elvin, Groenink, Maarten, Hochheimer, Suzanne M R, Holleman, Frits, Kooter, Jos A J, van Loon, Ramon B, Keijzers, Mitran, van der Lee, Ivo, Luijendijk, Paul, Meijboom, Lilian J, Middeldorp, Saskia, Schijf, Laura J, Soetekouw, Robin, Sprengers, Ralf W, Montauban van Swijndregt, Alexander D, de Monyé, Wouter, Ridderikhof, Milan L, Winter, Michiel M, Bipat, Shandra, Dijkgraaf, Marcel G W, Bossuyt, Patrick M M, Prins, Jan M, and Stoker, Jaap

Abstract

BackgroundChest CT displays chest pathology better than chest X-ray (CXR). We evaluated the effects on health outcomes of replacing CXR by ultra-low-dose chest-CT (ULDCT) in the diagnostic work-up of patients suspected of non-traumatic pulmonary disease at the emergency department.MethodsPragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings.Results2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1–8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1–8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%).ConclusionsShort-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department.Trial registration numberNTR6163.

Published
2023
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2. Hot of the breath: Mortality as a primary end-point in IPF treatment trials: the best is the enemy of the good

Author

Wells, Athol U, Behr, Juergen, Costabel, Ulrich, Cottin, Vincent, Poletti, Venerino, Richeldi, Luca, Albera, C, Ancochea, J, Antoniou, KM, Bonella, F, Bonniaud, P, Bouros, D, Bresser, P, Cordier, JF, Crestani, B, Domagala-Kulawik, J, Drent, M, Egan, JJ, Geiser, T, Grunewald, J, Grutters, J, Gudmundsson, G, Guenther, A, Harari, S, Harrison, NK, Hirani, N, Hodgson, U, Kahler, CM, Keane, MP, Kiter, G, Kneussl, M, Maher, TM, Mogulkoc, N, Muller-Quernheim, J, Neurohr, C, Nunes, H, Parfrey, H, Peros-Golubicic, T, Polychronopoulos, V, Prevot, G, Renzoni, ER, Robalo Cordeiro, C, Saltini, C, Skold, M, Spagnolo, P, Thomeer, M, Tomasseti, S, Valeyre, D, Vancheri, C, Wallaert, B, Wuyts, W, and Xaubet, A

Published
2012
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6. Systemic tryptophan and kynurenine catabolite levels relate to severity of rhinovirus-induced asthma exacerbation: a prospective study with a parallel-group design

Author

van der Sluijs, K. F., van de Pol, M. A., Kulik, W., Dijkhuis, A., Smids, B. S., van Eijk, H. W., Karlas, J. A., Molenkamp, R., Wolthers, K. C., Johnston, S. L., van der Zee, J. S., Sterk, P. J., Lutter, R., Berger, M., Fens, N., Yick, D., Wagener, A. H., Amelink, M., Reesink, H. J., Bresser, P., Kunst, P. W. A., Venekamp, L. N., Majoor, C. J., van Steenwijk, R. P., Jonkers, R. E., AII - Amsterdam institute for Infection and Immunity, Intensive Care Medicine, Pulmonology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Laboratory Genetic Metabolic Diseases, Experimental Immunology, Other departments, Medical Microbiology and Infection Prevention, and Graduate School

Subjects
Male, Rhinovirus, medicine.disease_cause, chemistry.chemical_compound, 0302 clinical medicine, ortho-Aminobenzoates, Exhaled breath condensate, Prospective Studies, Kynurenine, 0303 health sciences, Eosinophil cationic protein, medicine.diagnostic_test, Tryptophan, Interleukin, respiratory system, 3. Good health, Breath Tests, Disease Progression, Cytokines, Female, Bronchoalveolar Lavage Fluid, Adult, Pulmonary and Respiratory Medicine, Nitric Oxide, Young Adult, 03 medical and health sciences, medicine, Humans, Indoleamine-Pyrrole 2,3,-Dioxygenase, Peroxidase, 030304 developmental biology, Asthma, Picornaviridae Infections, business.industry, Eosinophil Cationic Protein, Quinolinic Acid, medicine.disease, respiratory tract diseases, Eosinophils, Bronchoalveolar lavage, chemistry, Case-Control Studies, Immunology, business, Biomarkers, 030215 immunology, Quinolinic acid
Abstract

Background Patients with allergic asthma have exacerbations which are frequently caused by rhinovirus infection. The antiviral tryptophan-catabolising enzyme indoleamine 2,3-dioxygenase (IDO) is induced by interferon-γ and suppressed by Th2 mediators interleukin (IL)-4 and IL-13. We hypothesised that local IDO activity after viral airway infection is lower in patients with allergic asthma than in healthy controls. Objective To determine whether IDO activity differs between patients with allergic asthma and healthy individuals before and after rhinovirus infection. Methods Healthy individuals and patients with allergic asthma were experimentally infected with low-dose (10 TCID50) rhinovirus 16. Blood, bronchoalveolar lavage fluid and exhaled breath condensate (for mass spectrometry by UPLC-MS/MS) were obtained before and after rhinovirus challenge. Results IDO activity was not induced by rhinovirus infection in either group, despite increases in cold scores. However, baseline pulmonary IDO activity was lower in patients with allergic asthma than in healthy individuals. In contrast, systemic tryptophan and its catabolites were markedly higher in patients with allergic asthma. Moreover, systemic quinolinic acid and tryptophan were associated with eosinophil cationic protein (r=0.43 and r=0.78, respectively) and eosinophils (r=0.38 and r=0.58, respectively) in bronchoalveolar lavage fluid and peak asthma symptom scores after rhinovirus challenge (r=0.53 and r=0.64, respectively). Conclusions Rhinovirus infection by itself induces no IDO activity, but the reduced pulmonary IDO activity in patients with allergic asthma at baseline may underlie a reduced control of viral infections. Notably, the enhanced systemic catabolism of tryptophan in patients with allergic asthma was strongly related to the outcome of rhinovirus challenge in asthma and may serve as a prognostic factor.

Published
2013

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