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9. Importance of baseline prognostic factors with increasing time since initiation of highly active antiretroviral therapy: collaborative analysis of cohorts of HIV-1-infected patients

Author

Sterne, Jonathan A. C., May, Margaret, Sabin, Caroline, Phillips, Andrew, Costagliola, Dominique, Chêne, Geneviève, Justice, Amy C., De Wolf, Frank, Hogg, Robert, Battegay, Manuel, Monforte, Antonella D'Arminio, Gerdtkenheuer, Fa, Staszewski, Schlomo, Gill, John, Egger, Matthias, Casabona, Jordi, Dabis, Francxois, Kitahata, Mari, Leport, Catherine, Lundgren, Jens, Reiss, Peter, Saag, Michael, Weller, Ian, Beckthold, Brenda, Yip, Benita, Dauer, Brenda, Fusco, Jenifer, Lanoy, Emilie, Rickenbach, Martin, Lavignolle, Valerie, Van Sighem, Ard, Pereira, Edwige, Pezzotti, Patrizio, Schmeisser, Norbert, Billaud, E., Boué, F., Costagliola, D., Duval, X., Duvivier, C., Enel, P., Fournier, S., Gasnault, J., Gaud, C., Gilquin, J., Grabar, S., Khuong, M. A., Lang, J. M., Mary Krause, M., Matheron, S., Meyohas, M. C., Pialoux, G., Poizot Martin, I., Pradier, C., Rouveix, E., Salmon Ceron, D., Sobel, A., Tattevin, P., Tissot Dupont, H., Yasdanpanah, Y., Aronica, E, Tirard Fleury, V., Tortay, I., Abgrall, S., Guiguet, M., Lanoy, E., Leneman, H., Lièvre, L., Potard, V., Saidi, S., Vildé, J. L., Leport, C., Yeni, P., Bouvet, E., Gaudebout, C., Crickx, B., Picard Dahan, C., Weiss, L., Tisne Dessus, D., Sicard, D., Salmon, D., Auperin, I., Viard, J. P., Roudière, L., Fior, R., Delfraissy, J. F., Goujard, C., Lesprit, P. h., Jung, C., Meynard, J. L., Picard, O., Desplanque, N., Cadranel, J., Mayaud, C., Rozenbaum, W., Bricaire, F., Katlama, C., Herson, S., Simon, A., Decazes, J. M., Molina, J. M., Clauvel, J. P., Gerard, L., Sellier, P., Diemer, M., Dupont, C., Berthé, H., Saïag, P., Mortier, E., Chandemerle, C., De Truchis, P., Bentata, M., Honoré, P., Tassi, S., Jeantils, V., Mechali, D., Taverne, B., Laurichesse, H., Gourdon, F., Lucht, F., Fresard, A., Faller, J. P., Eglinger, P., Bazin, C., Verdon, R., Peyramond, D., Boibieux, A., Touraine, J. L., Livrozet, J. M., Trepo, C., Cotte, L., Ravaux, I., Delmont, J. P., Moreau, J., Gastaut, J. A., Soubeyrand, J., Retornaz, F., Blanc, P. A., Allegre, T., Galinier, A., Ruiz, J. M., Lepeu, G., Granet Brunello, P., Pelissier, L., Esterni, J. P., Nezri, M., Cohen Valensi, R., Laffeuillade, A., Chadapaud, S., Reynes, J., May, T., Rabaud, C., Raffi, F., Pugliese, P., Michelet, C., Arvieux, C., Caron, F., Borsa Lebas, F., Rey, D., Fraisse, P., Massip, P., Cuzin, L., Arlet Suau, E., Thiercelin Legrand, M. F., Sobesky, M., Pradinaud, R., Contant, M., Montroni, M., Scalise, G., Braschi, M. C., Riva, A., Tirelli, U., Cinelli, R., Pastore, G., Ladisa, N., Minafra, G., Suter, F., Arici, C., Pristera, R., Chiodo, F., Colangeli, V., Fiorini, C., Coronado, O., Carosi, G., Cadeo, G. P., Torti, C., Minardi, C., Bertelli, D., Rizzardini, G., Melzi, S., Manconi, P. E., Piano, P., Cosco, L., Scerbo, A., Vecchiet, J., D'Alessandro, M., Santoro, D., Pusterla, L., Carnevale, G., Citterio, P., Viganò, P., Mena, M., Ghinelli, F., Sighinolfi, L., Leoncini, F., Mazzotta, F., Pozzi, M., Lo Caputo, S., Vullo, Vincenzo, Lichtner, Miriam, Angarano, G., Grisorio, B., Saracino, A., Ferrara, S., Grima, P., Tundo, P., Pagano, G., Cassola, G., Alessandrini, A., Piscopo, R., Toti, M., Chigiotti, S., Soscia, F., Tacconi, L., Orani, A., Perini, P., Scasso, A., Vincenti, A., Chiodera, F., Castelli, P., Scalzini, A., Palvarini, L., Moroni, M., Lazzarin, A., Cargnel, A., Vigevani, G. M., Caggese, L., d'Arminio Monforte, A., Repetto, D., Galli, A., Merli, S., Pastecchia, C., Moioli, M. C., Esposito, R., Mussini, C., Abrescia, N., Chirianni, A., Izzo, C. M., Piazza, M., De Marco, M., Viglietti, R., Manzillo, E., Nappa, S., Antonucci, G., Iacomi, F., Narciso, P., Zaccarelli, M., Colomba, A., Abbadessa, V., Prestileo, T., Mancuso, S., Ferrari, C., Pizzaferri, P., Filice, G., Minoli, L., Bruno, R., Novati, S., Baldelli, F., Tinca, M., Petrelli, E., Cioppi, A., Alberici, F., Ruggieri, A., Menichetti, F., Martinelli, C., De Stefano, C., La Gala, A., Ballardini, G., Rizzo, E., Magnani, G., Ursitti, M. A., Arlotti, M., Ortolani, P., Cauda, R., Dianzani, F., Ippolito, G., Antinori, A., D'Elia, S., Petrosillo, N., De Luca, A., Bacarelli, A., Acinapura, R., De Longis, P., Brandi, A., Trotta, M. P., Noto, P., Capobianchi, M. R., Carletti, F., Girardi, E., Pezzotti, P., Rezza, G., Mura, M. S., Mannazzu, M., Caramello, P., Di Perri, G., Soranzo, M. L., Orofino, G. C., Arnaudo, I., Bonasso, M., Grossi, P. A., Basilico, C., Poggio, A., Bottari, G., Raise, E., Ebo, F., De Lalla, F., Tositti, G., Resta, F., Loso, K., Cozzi Lepri, A., Johnson, A. M., Mercey, D., Phillips, A., Johnson, M. A., Mocroft, A., Murphy, M., Weber, J., Scullard, G., Fisher, M., Battegay, M., Bernasconi, E., Böni, J., Bucher, H., Bürgisser, P. h., Cattacin, S., Cavassini, M., Dubs, R., Egger, M., Elzi, L., Erb, P., Fantelli, K., Fischer, M., Flepp, M., Fontana, A., Francioli, P., Hirschel, B., Soravia Dunand, V., Furrer, H., Gorgievski, M., Günthard, H., Kaiser, L., Kind, C., Klimkait, T. h., Lauper, U., Ledergerber, B., Opravil, M., Paccaud, F., Pantaleo, G., Perrin, L., Piffaretti, J. C., Rickenbach, M., Rudin, C., Schmid, P., Schüpbach, J., Speck, R., Telenti, A., Trkola, A., Vernazza, P., Buy, E., Bronsveld, W., Hillebrand Haverkort, M. E., Reiss, P., Back, N. K. T., Bakker, M. E. G., Berkhout, B., Jurriaans, S., Cuijpers, T. h., Rietra, P. J. G. M., Roozendaal, K. J., Pauw, W., Van Zanten, A. P., Smits, P. H. M., Von Blomberg, B. M. E., Savelkoul, P., Danner, S. A., Van Agtmael, M. A., Claessen, F. A. P., Perenboom, R. M., Rijkeboer, A., Van Vonderen, M., Kuijpers, T. W., Pajkrt, D., Scherpbier, H. J., Prins, J. M., Bos, J. C., Eeftinck Schattenkerk, J. K. M., Geerlings, S. E., Godfried, M. H., Lange, J. M. A., Van Leth, F. C., Lowe, S. H., Van Der Meer, J. T. M., Nellen, F. J. B., Pogány, K., Van Der Poll, T., Ruys, T. h. A., Sankatsing, S., Steingrover, R., Van Twillert, G., Van Der Valk, M., Van Vonderen, M. G. A., Vrouenraets, S. M. E., Van Vugt, M., Wit, F. W. M. N., Veenstra, J., Van Eeden, A., Veen, J. H., Van Dam, P. S., Roos, J. C., Brinkman, K., Frissen, P. H. J., Weigel, H. M., Mulder, J. W., Van Gorp, E. C. M., Meenhorst, P. L., Mairuhu, A. T. A., Richter, C., Van Der Berg, J., Van Leusen, R., Swanink, C. M. A., Vriesendorp, R., Jeurissen, F. J. F., Franck, P. F. H., Lampe, A. S., Kauffmann, R. H., Koger, E. L. W., Bravenboer, B., Ten Napel, C. H. H., Kootstra, G. J., Schirm, J., Bennw, C. A., Sprenger, H. G., Miesen, W. M. A. J., Doedens, R., Scholvinck, E. H., Ten Kate, R. W., Van Houte, D. P. F., Polee, M., Kroes, A. C. M., Claas, H. C. J., Kroon, F. P., Van Den, Broek, Van Dissel, J. T., Schippers, E. F., Bruggeman, C. A. M. V. A., Goossens, V. J., Schreij, G., Van De Geest, S., Verbon, A., Galama, J. M. D., Melchers, W. J. G., Poort, Y. A. G., Koopmans, P. P., Keuter, M., Post, F., Van Der Ven, A. J. A. M., Doornum, G. J. J., Niesters, M. G., Osterhaus, A. D. M. E., Schutten, M., Driessen, G., De Groot, R., Hartwig, N., Van Der Ende, M. E., Gyssens, I. C., Van Der Feltz, M., Den Hollander, J. G., De Marie, S., L. Nouwen, J., Rijnders, B. J. A., De Vries, T. E. M. S., Juttmann, J. R., Van De Heul, C., Van Kasteren, M. E. E., Boucher, C. A. B., Schuurman, R., Geelen, S. P. M., Wolfs, T. F. W., Schneider, M. M. E., Bonten, M. J. M., Borleffs, J. C. C., Ellerbroek, P. M., Hoepelman, I. M., Jaspers, C. A. J. J., Schouten, I., Schurink, C. A. M., Blok, W. L., Tanis, A. A., Groeneveld, P. H. P., Jansen, C. L., Hendriks, R., Veenendaal, D., Storm, H., Weel, J., Van Zeijl, J. H., Buiting, A. G. M., Swaans, C. A. M., Boel, E., Jansz, A. F., Losso, M., Duran, A., Vetter, N., Karpov, I., Vassilenko, A., Clumeck, N., Dewit, S., Poll, B., Colebunders, R., Machala, L., Rozsypal, H., Sedlacek, D., Gerstoft, J., Katzenstein, T., Hansen, A. B. E., Skinhøj, P., Nielsen, J., Lundgren, J., Benfield, T., Kirk, O., Pedersen, C., Zilmer, K., Girard, P. M., Saint Marc, T., Vanhems, P., Dabis, F., Dietrich, M., Manegold, C., Van Lunzen, J., Stellbrink, H. J., Staszewski, S., Bickel, M., Goebel, F. D., Fätkenheuer, G., Rockstroh, J., Schmidt, R., Kosmidis, J., Gargalianos, P., Sambatakou, H., Perdios, J., Panos, G., Filandras, A., Karabatsaki, E., Banhegyi, D., Mulcahy, F., Yust, I., Turner, D., Burke, M., Pollack, S., Hassoun, G., Sthoeger, Z., Maayan, S., Borghi, R., Cotugno, A. D., Gabbuti, A., Chiesi, A., Montesarchio, E., Finazzi, R., D'Arminio Monforte, A., Viksna, L., Chaplinskas, S., Hemmer, R., Staub, T., Bruun, J., Maeland, A., Ormaasen, V., Knysz, B., Gasiorowski, J., Horban, A., Prokopowicz, D., Wiercinska Drapalo, A., Boron Kaczmarska, A., Pynka, M., Beniowski, M., Mularska, E., Trocha, H., Antunes, F., Valadas, E., Mansinho, K., Matez, F., Duiculescu, D., Babes, Victor, Streinu Cercel, A., Vinogradova, E., Rakhmanova, A., Jevtovic, D., Mokráš, M., Staneková, D., González Lahoz, J., Sánchez Conde, M., García Benayas, T., Martin Carbonero, L., Soriano, V., Clotet, B., Jou, A., Conejero, J., Tural, C., Gatell, J. M., Miró, J. M., Blaxhult, A., Karlsson, A., Pehrson, P., Weber, R., Kravchenko, E., Chentsova, N., Barton, S., Brettle, R., Loveday, C., Antunes, Francisco, Blaxhult, Anders, Clumeck, Nathan, Gatell, Jose, Horban, Andrzej, Johnson, Anne, Katlama, Christine, Ledergerber, Bruno, Loveday, Clive, Vella, Stefano, Gjørup, I., Friis Moeller, N., Bannister, W., Mollerup, D., Podlevkareva, D., Holkmann Olsen, C., Kjær, J., Raffanti, Stephen, Dieterch, Douglas, Becker, Stephen, Scarsella, Anthony, Fusco, Gregory, Most, Bernard, Balu, Rukmini, Rana, Rashida, Beckerman, Robin, Ising, Theodore, Fusco, Jennifer, Irek, Renae, Johnson, Bernadette, Hirani, Ashwin, Edwinjesus, De, Pierone, Gerald, Lackey, Philip, Irek, Chip, Johnson, Alison, Burdick, John, Leon, Saul, Arch, Joseph, Helm, Eilke B., Carlebach, Amina, Axelller, Mu, Haberl, Annette, Nisius, Gabi, Lennemann, Tessa, Rottmann, Carsten, Wolf, Timo, Stephan, Christoph, Bickel, Markus, Manfredsch, Mo, Gute, Peter, Locher, Leo, Lutz, Thomas, Klauke, Stephan, Knecht, Gabi, Doerr, Hans W., Stu, Martinrmer, Von Hentig, Nils, Jennings, Beverly, Beylot, J., Chêne, G., Dupon, M., Longy Boursier, M., Pellegrin, J. L., Ragnaud, J. M., Salamon, R., Thiébaut, R., Lewden, C., Lawson Ayayi, S., Mercié, P., Moreau, J. F., Morlat, P., Bernard, N., Lacoste, D., Malvy, D., Neau, D., Blaizeau, M. J., Decoin, M., Delveaux, S., Hannapier, C., Labarrère, S., Lavignolle Aurillac, V., Uwamaliya Nziyumvira, B., Palmer, G., Touchard, D., Balestre, E., Alioum, A., Jacqmin Gadda, H., Bonarek, M., Bonnet, F., Coadou, B., Gellie, P., Nouts, C., Bocquentin, F., Dutronc, H., Lafarie, S., Aslan, A., Pistonne, T., Thibaut, P., Vatan, R., Chambon, D., De La Taille, C., Cazorla, C., Ocho, A., Viallard, J. F., Caubet, O., Cipriano, C., Lazaro, E., Couzigou, P., Castera, L., Fleury, H., Lafon, M. E., Masquelier, B., Pellegrin, I., Breilh, D., Blanco, P., Loste, P., Caunègre, L., Bonnal, F., Farbos, S., Ferrand, M., Ceccaldi, J., Tchamgoué, S., De Witte, S., Alexander, Chris, Barrios, Rolando, Braitstein, Paula, Brumme, Zabrina, Chan, Keith, Cote, Helen, Gataric, Nada, Geller, Josie, Guillemi, Silvia, Richard Harrigan, P., Harris, Marrianne, Joy, Ruth, Levy, Adrian, Montaner, Julio, Montessori, Val, Palepu, Anita, Phillips, Elizabeth, Phillips, Peter, Press, Natasha, Tyndall, Mark, Wood, Evan, Bhagani, S., Byrne, P., Carroll, A., Cuthbertson, Z., Dunleavy, A., Geretti, A. M., Heelan, B., Johnson, M., Kinloch de Loes, S., Lipman, M., Madge, S., Marshall, N., Nair, D., Nebbia, G., Prinz, B., Swaden, L., Tyrer, M., Youle, M., Chaloner, C., Grabowska, H., Holloway, J., Puradiredja, J., Ransom, D., Tsintas, R., Bansi, L., Fox, Z., Harris, E., Hill, T., Lampe, F., Lodwick, R., Reekie, J., Sabin, C., Smith, C., Amoah, E., Booth, C., Clewley, G., Garcia Diaz, A., Gregory, B., Labbett, W., Tahami, F., Thomas, M., Read, Ron, Fatkenheuer, G., Schmeisser, N., Voigt, K., Wasmuth, J. C., Wohrmann, A., Infectious diseases, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Medical Microbiology and Infection Prevention, Paediatric Infectious Diseases / Rheumatology / Immunology, Landsteiner Laboratory, ARD - Amsterdam Reproduction and Development, Graduate School, Cardiology, APH - Global Health, APH - Quality of Care, AII - Infectious diseases, AII - Inflammatory diseases, and Global Health

Subjects
Adult, medicine.medical_specialty, AIDS, CD4 counts, Highly active antiretroviral therapy, HIV, Prognosis, Substance abuse (intravenous), Adolescent, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Europe, HIV Infections, HIV-1, Humans, Middle Aged, North America, Risk Factors, Substance Abuse, Intravenous, Survival Analysis, Pharmacology (medical), Infectious Diseases, Cost effectiveness, Antiretroviral Therapy, Article, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Highly Active, Survival analysis, Immunodeficiency, business.industry, Transmission (medicine), Hazard ratio, Substance Abuse, medicine.disease, Confidence interval, Physical therapy, Intravenous, business, Cohort study
Abstract

Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.

Published
2007

19. Automatic lung lobe segmentation of COPD patients using iterative B-spline fitting

Author

Shamonin, D. P., Staring, M., Bakker, M. E., Xiao, C., Stolk, J., Reiber, J. H. C., and Stoel, B. C.

Abstract

We present an automatic lung lobe segmentation algorithm for COPD patients. The method enhances fissures, removes unlikely fissure candidates, after which a B-spline is fitted iteratively through the remaining candidate objects. The iterative fitting approach circumvents the need to classify each object as being part of the fissure or being noise, and allows the fissure to be detected in multiple disconnected parts. This property is beneficial for good performance in patient data, containing incomplete and disease-affected fissures. The proposed algorithm is tested on 22 COPD patients, resulting in accurate lobe-based densitometry, and a median overlap of the fissure (defined 3 voxels wide) with an expert ground truth of 0.65, 0.54 and 0.44 for the three main fissures. This compares to complete lobe overlaps of 0.99, 0.98, 0.98, 0.97 and 0.87 for the five main lobes, showing promise for lobe segmentation on data of patients with moderate to severe COPD.

Published
2012
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20. Telephone follow-up by nurse practitioners of geriatric patients discharged from the emergency department after traumatic injury.

Author

Schuitenmaker JW, Argillander TE, Bakker ME, Sandel MH, and Zwartsenburg MMS

Subjects
Humans, Male, Aged, Female, Cohort Studies, Follow-Up Studies, Telephone, Emergency Service, Hospital, Hospitals, Urban, Patient Discharge, Quality of Life
Abstract

Introduction: Geriatric patients discharged from the emergency department (ED) after an injury are at risk for adverse outcomes. Older patients are at a higher risk for sensory impairments and cognitive problems which can make comprehension of discharge instructions more difficult. Moreover, geriatric patients often have limited skills with or access to alternative sources of information, such as hospital web pages or phone applications, which could put them at a higher risk of undertreatment. Implementing telephone follow-up after discharge presents a potential solution to enhance information transfer and address problems related to the injury., Methods: An exploratory cohort study was conducted in the ED of an inner-city hospital in the Netherlands between 2019-2020. Patients ≥70 years were included if they presented with an injury and were discharged home from the ED. Telephone follow-up was performed by an ED nurse practitioner within 48 hours after discharge to address any problems or questions relating to the injury. Feasibility was assessed by determining whether the intervention could be performed within the allotted time period during normal work hours (1 h per day). The frequency and type of additional advice given, as well as patient satisfaction with the intervention, were documented., Results: 635 patients were eligible for inclusion, and 266 completed the intervention (median age 77 years; 32 % male). Nurse practitioners were able to complete the intervention on over 90 % of days. A total of 64 % of patients received additional advice during the telephone call, mostly related to pain medication adjustments and instructions to contact their GP. Patient satisfaction with the intervention was high (median score 8/10)., Conclusion: Telephone follow-up is a feasible intervention that may be able to enhance older patients' comprehension of discharge instructions and help identify new problems after discharge. During the follow-up call, the majority of patients received additional advice, indicating a potential demand for this intervention. The main limitation was that not all eligible patients were approached or did not want to participate in the intervention. Future studies should investigate whether telephone follow-up can effectively reduce adverse events and improve the quality of life for these patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Published
2024
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21. [A girl with a painful red skin].

Author

Bakker ME and Oberndorff KM

Subjects
Child, Preschool, Female, Humans, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Floxacillin therapeutic use, Staphylococcal Scalded Skin Syndrome diagnosis, Staphylococcal Scalded Skin Syndrome drug therapy
Abstract

A 5-year-old girl presented with increasing erythroderma since one day in combination with impetigo vulgaris. As exfoliative lesions and bullae developed within hours, the patient was diagnosed with staphylococcal scalded skin syndrome. She was successfully treated with flucloxacillin.

Published
2013

22. Correlation between annual change in health status and computer tomography derived lung density in subjects with alpha1-antitrypsin deficiency.

Author

Stolk J, Ng WH, Bakker ME, Reiber JH, Rabe KF, Putter H, and Stoel BC

Subjects
Adult, Female, Forced Expiratory Volume physiology, Humans, Lung diagnostic imaging, Male, Prospective Studies, Pulmonary Disease, Chronic Obstructive diagnostic imaging, Pulmonary Disease, Chronic Obstructive pathology, Pulmonary Disease, Chronic Obstructive physiopathology, Pulmonary Emphysema pathology, Pulmonary Emphysema physiopathology, alpha 1-Antitrypsin Deficiency pathology, alpha 1-Antitrypsin Deficiency physiopathology, Health Status, Lung pathology, Pulmonary Emphysema diagnostic imaging, Tomography, X-Ray Computed methods, alpha 1-Antitrypsin Deficiency diagnostic imaging
Abstract

Background: There is increasing recognition that questionnaires of health status and lung density measurements are more sensitive tools for assessing progression of emphysema than forced expiratory volume in 1 second (FEV(1)) and transfer coefficient (KCO). A study was undertaken to investigate prospectively the correlation between annual change in health status and computer tomography (CT) derived lung density in subjects with alpha(1)-antitrypsin deficiency., Methods: Twenty two patients of mean (SD) age 40.7 (9.2) years with ZZ type alpha(1)-antitrypsin deficiency were investigated at baseline and 30 months later by FEV(1) and KCO, St George Respiratory Questionnaire (SGRQ), and by a spiral CT scan of the chest. CT data of chest images were analysed using software designed for automated lung contour detection and lung density measurements. The density data were corrected for changes in inspiration levels., Results: Changes in lung density, expressed as 15th percentile point or relative area below -950 HU, correlated well with changes in health status (SGRQ total score): R = -0.56, p = 0.007 or R = 0.6, p = 0.003. Neither changes in health status nor changes in lung density correlated significantly with changes in FEV(1) or changes in KCO., Conclusions: The SGRQ total score (which is a global measure in COPD) and lung density (a specific measure of emphysema) are sensitive to deterioration in patients with alpha(1)-antitrypsin deficiency. This finding may facilitate future studies with new drugs specific for emphysema, a frequently occurring component of COPD.

Published
2003
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