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3 results on '"Bresser, P.J."'

1. High D-dimer levels increase the likelihood of pulmonary embolism

Author

Tick, L.W., Nijkeuter, M., Kramer, M.H.W., Hovens, M.M., Buller, H.R., Leebeek, F.W., Huisman, M.V., Halkes, C.J., Heggelman, B.G., Nix, M., Sohne, M., Bresser, P.J., Kool, D.R., Phoa, S.S., Rekke, B., Kaasjager, K.A., Kwakkel-van Erp, J.M., Grandjean, H.M., Kesselring, F.O.H.W., Mol, J.J., Ullmann, E.F., Guldener, C. van, Mijnsbergen, J.Y., Sturm, M.F., Swart, C. de, Kuijer, P.M., Schrama, J.G., Velde, A. van de, Huisman, P.M., Eerden, M.M. van der, Janssen, P.J., Jansen, R., Lobatto, S., Compier, E.A., Eikenboom, H.C., Roos, A. de, Belle, A. van, Prins, M.H., Snoep, G., Korte, H. de, Kos, C.B., Laterveer, L., Veldhuizen, W.C. van, Kamphuizen, P.W., Bredie, S.J.H., Die, C.E. van, Heijdra, Y.F., Lenders, J.W.M., Kruip, M.J., Jie, K.S., Kars, A.H., Meiracker, A.H. van den, Pattynama, P.M., Borst, J.M. de, Houten, A.A. van, Teng, H.T., ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, and Hematology

Subjects
medicine.medical_specialty, Health aging / healthy living [IGMD 5], Vascular medicine and diabetes [UMCN 2.2], Malignancy, Sensitivity and Specificity, Fibrin Fibrinogen Degradation Products, Internal medicine, D-dimer, Internal Medicine, medicine, Humans, In patient, Cardiovascular diseases [NCEBP 14], business.industry, Vascular disease, Respiratory disease, Middle Aged, medicine.disease, Surgery, Pulmonary embolism, Pathogenesis and modulation of inflammation [N4i 1], Management strategy, Treatment Outcome, Cardiology, Female, business, Pulmonary Embolism, Venous thromboembolism, Tomography, Spiral Computed, Algorithms, Biomarkers
Abstract

Contains fulltext : 70029.pdf (Publisher’s version ) (Closed access) Objective. To determine the utility of high quantitative D-dimer levels in the diagnosis of pulmonary embolism. Methods. D-dimer testing was performed in consecutive patients with suspected pulmonary embolism. We included patients with suspected pulmonary embolism with a high risk for venous thromboembolism, i.e. hospitalized patients, patients older than 80 years, with malignancy or previous surgery. Presence of pulmonary embolism was based on a diagnostic management strategy using a clinical decision rule (CDR), D-dimer testing and computed tomography. Results. A total of 1515 patients were included with an overall pulmonary embolism prevalence of 21%. The pulmonary embolism prevalence was strongly associated with the height of the D-dimer level, and increased fourfold with D-dimer levels greater than 4000 ng mL(-1) compared to levels between 500 and 1000 ng mL(-1). Patients with D-dimer levels higher than 2000 ng mL(-1) and an unlikely CDR had a pulmonary embolism prevalence of 36%. This prevalence is comparable to the pulmonary embolism likely CDR group. When D-dimer levels were above 4000 ng mL(-1), the observed pulmonary embolism prevalence was very high, independent of CDR score. Conclusion. Strongly elevated D-dimer levels substantially increase the likelihood of pulmonary embolism. Whether this should translate into more intensive diagnostic and therapeutic measures in patients with high D-dimer levels irrespective of CDR remains to be studied.

Published
2008
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2. The course of distress in women at increased risk of breast and ovarian cancer due to an (identified) genetic susceptibility who opt for prophylactic mastectomy and/or salpingo-oophorectomy.

Author

Bresser, P.J., Seynaeve, C., Gool, A.R. van, Niermeijer, M.F., Duivenvoorden, H.J., Dooren, S. van, Geel, A.N. van, Menke-Pluijmers, M.B., Klijn, J.G.M., Tibben, A., Bresser, P.J., Seynaeve, C., Gool, A.R. van, Niermeijer, M.F., Duivenvoorden, H.J., Dooren, S. van, Geel, A.N. van, Menke-Pluijmers, M.B., Klijn, J.G.M., and Tibben, A.

Abstract

Contains fulltext : 52416.pdf (publisher's version ) (Closed access), The levels and course of psychological distress before and after prophylactic mastectomy (PM) and/or prophylactic salpingo-oophorectomy (PSO) were studied in a group of 78 women. General distress was measured through the hospital anxiety and depression scale (HADS), cancer-related distress using the impact of events scale (IES). Measurement moments were baseline (2-4 weeks prior to prophylactic surgery), and 6 and 12 months post-surgery. After PM, anxiety and cancer-related distress were significantly reduced, whereas no significant changes in distress scores were observed after PSO. At one year after prophylactic surgery, a substantial amount of women remained at clinically relevant increased levels of cancer-related distress and anxiety. We conclude that most women can undergo PM and/or PSO without developing major emotional distress. More research is needed to further define the characteristics of the women who continue to have clinically relevant increased scores after surgery, in order to offer them additional counselling.

Published
2007

3. Who is prone to high levels of distress after prophylactic mastectomy and/or salpingo-ovariectomy?

Author

Bresser, P.J., Gool, A.R. van, Seynaeve, C., Duivenvoorden, H.J., Niermeijer, M.F., Geel, A.N. van, Menke, M., Klijn, J.G.M., Tibben, A., Bresser, P.J., Gool, A.R. van, Seynaeve, C., Duivenvoorden, H.J., Niermeijer, M.F., Geel, A.N. van, Menke, M., Klijn, J.G.M., and Tibben, A.

Abstract

Contains fulltext : 52057.pdf (publisher's version ) (Closed access), BACKGROUND: The present study aimed to assess predictors of distress after 'prophylactic mastectomy (PM) and salpingo-ovariectomy (PSO), in order to enable the early identification of patients who could benefit from psychological support. PATIENTS AND METHODS: General distress and cancer-related distress were assessed in 82 women at increased risk of hereditary breast and/or ovarian cancer undergoing PM and/or PSO, before and 6 and 12 months after prophylactic surgery. Neurotic lability and coping were assessed before surgery. RESULTS: Cancer-related distress and general distress at both follow-up moments were best explained by the level of cancer-related and general distress at baseline. Being a mutation carrier was predictive of increased cancer-related distress at 6-month follow-up (but not at 12 months), and of lower general distress 12 months after prophylactic surgery. Also, coping by having comforting thoughts was predictive of less cancer-related distress at 6-month follow-up. CONCLUSIONS: Genetically predisposed women who are at risk of post-surgical distress can be identified using one or more of the predictors found in this study. Exploration of and/or attention to cancer-related distress and coping style before prophylactic surgery may help physicians and psychosocial workers to identify women who might benefit from additional post-surgical support.

Published
2007

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