126 results on '"Emmelot-Vonk M"'
Search Results
2. Dietary habits and compliance with dietary guidelines in patients with established cardiovascular disease.
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Bonekamp, Nadia E., Geleijnse, Johanna M., van der Schouw, Yvonne T., Dorresteijn, Jannick A. N., van der Meer, Manon G., Ruigrok, Ynte M., Teraa, Martin, Visseren, Frank L. J., Koopal, Charlotte, Cramer, M. J., Nathoe, H. M., van de Meer, M. G., de Borst, G. J., Teraa, M., Bots, M. L., van Smeden, M., Emmelot-Vonk, M. H., de Jong, P. A., Lely, A. T., and van der Kaaij, N. P.
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CARDIOVASCULAR disease prevention ,PATIENT compliance ,NUTRITION policy ,MYOCARDIAL infarction ,RESEARCH funding ,FOOD consumption ,QUESTIONNAIRES ,DAIRY products ,CARDIOVASCULAR diseases risk factors ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,FISHES ,MEAT ,LONGITUDINAL method ,FOOD habits ,MEDICAL records ,ACQUISITION of data ,DISEASE relapse ,CONFIDENCE intervals ,DIET ,PROPORTIONAL hazards models ,LEGUMES - Abstract
Background: Unhealthy dietary habits are an important risk factor for cardiovascular disease (CVD) and adopting a healthy diet is a central recommendation in CVD prevention. This study assessed the dietary habits of patients with established CVD, their compliance to dietary guidelines, and the relationship between guideline-compliance and recurrent cardiovascular event risk. Methods: 2656 patients with established CVD from the Utrecht Cardiovascular Cohort-Secondary Manifestations of ARTerial disease (UCC-SMART) prospective cohort study, were included between 1996 and 2022. Data on dietary intake was retrospectively collected for all participants in December 2022 using a 160-item food frequency questionnaire. Compliance with dietary guidelines was quantified using an amended version of the Dutch Healthy Diet 2015 (DHD-15) index (range: 0–135). Cox proportional hazard models were used to quantify the relationship with cardiovascular events (stroke and myocardial infarction). Results: Among 2656 CVD patients (77% male, mean age 59 ± 9 years), median energy intake was 1922 [IQR: 1536–2351] kcal/day. The median DHD-15 index was 81.7 [IQR 71.2–92.0], with high compliance scores for recommendations on legumes and fish, and low scores for recommendations on whole grains, red meat, processed meat, and dairy. A higher DHD-15 score was associated with lower stroke risk (HR 0.78, 95% CI 0.66–0.92 per 10-point increase) but not with myocardial infarction. Conclusion: Compliance with dietary guidelines was suboptimal in patients with established CVD. High compliance was associated with a clinically significant reduction in stroke risk in patients with established CVD, emphasizing the importance of dietary counseling. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Correction: Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer
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Scheepers, E. R. M., Vink, G. R., Schiphorst, A. H. W., Emmelot-Vonk, M. H., van Huis-Tanja, L. H., and Hamaker, M. E.
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- 2023
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4. Osteoporose
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Emmelot-Vonk, M. H., Visser, M., editor, Kok, A.A.L., editor, Spies, P.E., editor, and Buurman, B.M., editor
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- 2020
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5. Study objectives in clinical trials in older patients with solid malignancies: do we measure what matters?
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Scheepers, E. R. M., van Huis-Tanja, L. H., Emmelot-Vonk, M. H., and Hamaker, M. E.
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- 2021
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6. Prognostic value of screening instrument based on the Dutch national VMS guidelines for older patients in the emergency department
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Snijders, B. M. G., Emmelot-Vonk, M. H., Souwer, E. T. D., Kaasjager, H. A. H., and van den Bos, F.
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- 2021
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7. Sex differences in modifiable risk factors for stroke incidence and recurrence: the UCC-SMART study.
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Rissanen, Ina, Basten, Maartje, Exalto, Lieza G., Peters, Sanne A. E., Visseren, Frank L. J., Geerlings, Mirjam I., For the UCC-SMART-Study Group, Cramer, M. J., van der Meer, M. G., Nathoe, H. M., de Borst, G. J., Bots, M. L., Geerlings, M. I., Emmelot-Vonk, M. H., de Jong, P. A., Lely, A. T., van der Kaaij, N. P., Kappelle, L. J., Ruigrok, Y. M., and Verhaar, M. C.
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SEX factors in disease ,DISEASE risk factors ,DYSLIPIDEMIA ,HEMORRHAGIC stroke ,PROPORTIONAL hazards models ,STROKE - Abstract
Background and purpose: Risk factors for stroke differ between women and men in general populations. However, little is known about sex differences in secondary prevention. We investigated if sex interacted with modifiable risk factors for stroke in a large arterial disease cohort. Methods: Within the prospective UCC-SMART study, 13,898 patients (35% women) with atherosclerotic disease or high-risk factor profile were followed up to 23 years for stroke incidence or recurrence. Hypertension, smoking, diabetes, overweight, dyslipidemia, high alcohol use, and physical inactivity were studied as risk factors. Association between these factors and ischemic and hemorrhagic stroke incidence or recurrence was studied in women and men using Cox proportional hazard models and Poisson regression models. Women-to-men relative hazard ratios (RHR) and rate differences (RD) were estimated for each risk factor. Left-truncated age was used as timescale. Results: The age-adjusted stroke incidence rate was lower in women than men (3.9 vs 4.4 per 1000 person-years), as was the age-adjusted stroke recurrence rate (10.0 vs 11.7). Hypertension and smoking were associated with stroke risk in both sexes. HDL cholesterol was associated with lower stroke incidence in women but not in men (RHR 0.49; CI 0.27–0.88; and RD 1.39; CI − 1.31 to 4.10). Overweight was associated with a lower stroke recurrence in women but not in men (RHR 0.42; CI 0.23–0.80; and RD 9.05; CI 2.78–15.32). Conclusions: In high-risk population, sex modifies the association of HDL cholesterol on stroke incidence, and the association of overweight on stroke recurrence. Our findings highlight the importance of sex-specific secondary prevention. [ABSTRACT FROM AUTHOR]
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- 2024
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8. The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis
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Goto, N. A., Weststrate, A. C. G., Oosterlaan, F. M., Verhaar, M. C., Willems, H. C., Emmelot-Vonk, M. H., and Hamaker, M. E.
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- 2020
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9. Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer
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Chargi, N., Bril, S. I., Emmelot-Vonk, M. H., and de Bree, R.
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- 2019
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10. EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research
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Seppala, L. J., van der Velde, N., Masud, T., Blain, H., Petrovic, M., van der Cammen, T. J., Szczerbińska, K., Hartikainen, S., Kenny, R. A., Ryg, J., Eklund, P., Topinková, E., Mair, A., Laflamme, L., Thaler, H., Bahat, G., Gutiérrez-Valencia, M., Caballero-Mora, MA, Landi, F., Emmelot-Vonk, M. H., the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs, Cherubini, A., Baeyens, J. P., Correa-Pérez, A., Gudmundsson, A., Marengoni, A., O’Mahony, D., Parekh, N., Pisa, F. E., Rajkumar, C., Wehling, M., Ziere, G., and the EuGMS Special Interest Group on Pharmacology
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- 2019
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11. Contextual determinants influencing the implementation of fall prevention in the community: a scoping review
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van Scherpenseel, M. C., primary, te Velde, S. J., additional, Veenhof, C., additional, Emmelot-Vonk, M. H., additional, and Barten, J. A., additional
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- 2023
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12. Reply to comment on “Sarcopenia is a prognostic factor for overall survival in elderly patients with head and neck cancer”
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Chargi, N., Bril, S. I., de Jong, P. A., Emmelot-Vonk, M. H., and de Bree, Remco
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- 2019
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13. A comprehensive fracture prevention strategy in older adults: The European union geriatric medicine society (EUGMS) statement
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Alvarez, M.N., Annweiler, C., Bernard, P.-L., Beswetherick, N., Bischoff-Ferrari, H.A., Bloch, F., Boddaert, J., Bonnefoy, M., Bousson, V., Bourdel-Marchasson, I., Capisizu, A., Che, H., Clara, J.G., Combe, B., Delignieres, D., Eklund, P., Emmelot-Vonk, M., Freiberger, E., Gauvain, J.-B., Goswami, N., Guldemond, N., Herrero, Á.C., Joël, M.-E., Jónsdóttir, A.B., Kemoun, G., Kiss, I., Kolk, H., Kowalski, M.L., Krajcík, Š., Kutsal, Y.G., Lauretani, F., Macijauskienė, J., Mellingsæter, M., Morel, J., Mourey, F., Nourashemi, F., Nyakas, C., Puisieux, F., Rambourg, P., Ramírez, A.G., Rapp, K., Rolland, Y., Ryg, J., Sahota, O., Snoeijs, S., Stephan, Y., Thomas, E., Todd, C., Treml, J., Adachi, R., Agnusdei, D., Body, J.-J., Breuil, V., Bruyère, O., Burckardt, P., Cannata-Andia, J.B., Carey, J., Chan, D.-C., Chapuis, L., Chevalley, T., Cohen-Solal, M., Dawson-Hughes, B., Dennison, E.M., Devogelaer, J.-P., Fardellone, P., Féron, J.-M., Perez, A.D., Felsenberg, D., Glueer, C., Harvey, N., Hiligsman, M., Javaid, M.K., Jörgensen, N.R., Kendler, D., Kraenzlin, M., Laroche, M., Legrand, E., Leslie, W.D., Lespessailles, E., Lewiecki, E.M., Nakamura, T., Papaioannou, A., Roux, C., Silverman, S., Henriquez, M.S., Thomas, T., Vasikaran, S., Watts, N.B., Weryha, G., Blain, H., Masud, T., Dargent-Molina, P., Martin, F.C., Rosendahl, E., van der Velde, N., Bousquet, J., Benetos, A., Cooper, C., Kanis, J.A., Reginster, J.Y., Rizzoli, R., Cortet, B., Barbagallo, M., Dreinhöfer, K., Vellas, B., Maggi, S., and Strandberg, T.
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- 2016
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14. Links between Atherosclerosis and Osteoporosis in Middle Aged and Elderly Men
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van den Bos, Frederiek, Emmelot-Vonk, M. H., Verhaar, H. J., and van der Schouw, Y. T.
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- 2018
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15. A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia: a controlled before-and-after study
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Engel, M. F., Bruns, A. H. W., Hulscher, M. E. J. L., Gaillard, C. A. J. M., Sankatsing, S. U. C., Teding van Berkhout, F., Emmelot-Vonk, M. H., Kuck, E. M., Steeghs, M. H. M., den Breeijen, J. H., Stellato, R. K., Hoepelman, A. I. M., and Oosterheert, J. J.
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- 2014
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16. Predictors of clinical outcome following transcatheter aortic valve implantation
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Dautzenberg, L., Pals, J.E.M., Lefeber, G.J., Stella, P.R., Abawi, M., Emmelot-Vonk, M., and Koek, H.L.
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transcatheter aortic valve replacement ,risk factors ,aortic valve stenosis - Abstract
Objective In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in older adults undergoing TAVI.Methods A prospective observational cohort study of patients who were referred to a geriatric outpatient clinic for a geriatric assessment prior to TAVI was conducted. The outcomes were mortality and hospital readmission within 3 months of TAVI and the occurrence of major postoperative complications during hospitalisation according to the Clavien-Dindo classification. These three outcomes were also combined to a composite outcome. Univariate and multivariate logistic regression analyses were performed to identify predictors of the outcomes and composite outcome of adverse events.Results This cohort included 490 patients who underwent TAVI (mean age 80.7 +/- 6.2 years, 47.3% male). Within 3 months of TAVI, 19 (3.9%) patients died and 46 (9.4%) patients experienced a hospital readmission. A total of 177 (36.1%) patients experienced one or more major complications according to the Clavien-Dindo classification during hospitalisation and 193 patients (39.4%) experienced the composite outcome of adverse events. In multivariate analyses, cognitive impairment was identified as an independent predictor of major postoperative complications (OR 2.16; 95% CI 1.14 to 4.19) and the composite outcome of adverse events (OR 2.40; 95% CI 1.21 to 4.79). No association was found between the other variables and the separate outcomes and composite outcome.Conclusion Cognitive impairment is associated with postoperative adverse events in older patients undergoing TAVI. Therefore, it is important to screen for cognitive impairment prior to TAVI and it is recommended to include this in current TAVI guidelines.
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- 2021
17. Frailty: Defining and measuring of a concept
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Pel-Littel, R. E., Schuurmans, M. J., Emmelot-Vonk, M. H., and Verhaar, H. J. J.
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- 2009
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18. Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial
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Emmelot-Vonk, M H, Verhaar, H J J, Nakhai-Pour, H R, Grobbee, D E, and van der Schouw, Y T
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- 2009
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19. Deprescribing tool for STOPPFall (screening tool of older persons prescriptions in older adults with high fall risk) items
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Seppala, L. J., Petrovic, M., Jesper Ryg, Bahat, G., Topinkova, E., Szczerbińska, K., Cammen, T. J., Hartikainen, S., Ilhan, B., Landi, F., Morrissey, Y., Mair, A., Gutiérrez-Valencia, M., Emmelot-Vonk, M. H., Caballero Mora, M. A., Michael Denkinger, Crome, P., Jackson, S. H. D., Correa-Pérez, A., Knol, W., Soulis, G., Adalsteinn Gudmundsson, Ziere, G., Wehling, M., O’mahony, D., Antonio Cherubini, and Nathalie van der Velde
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screening ,fall risk ,Medicine and Health Sciences ,Deprescribing tool ,older persons prescriptions ,STOPPFall - Abstract
Background: Health care professionals are often reluctant to deprescribe fall-risk-increasing drugs (FRIDs). Lack of knowledge and skills form a significant barrier. To support clinicians in the management of FRIDs and to facilitate the deprescribing process, a deprescribing tool was developed by a European expert group for STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) items. Methods: STOPPFall was created using an expert Delphi consensus process in 2019 and in 2020, 24 panellists from EuGMS SIG on Pharmacology and Task and Finish on FRIDs completed deprescribing tool questionnaire. To develop the questionnaire, a Medline literature search was performed. The panellists were asked to indicate for every medication class a possible need for stepwise withdrawal and strategy for withdrawal. They were asked in which situations withdrawal should be performed. Furthermore, panellists were requested to indicate those symptoms patients should be monitored for after deprescribing and a possible need for follow-ups. Results: Practical deprescribing guidance was developed for STOPPFall medication classes. For each medication class, a decision tree algorithm was developed including steps from medication review to symptom monitoring after medication withdrawal. Conclusion: STOPPFall was combined with a practical deprescribing tool designed to optimize medication review. This practical guide can help overcome current reluctance towards deprescribing in clinical practice by providing an up-to-date and straightforward source of expert knowledge.
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- 2020
20. Performance of five automated white matter hyperintensity segmentation methods in a multicenter dataset
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Heinen, Rutger, Steenwijk, Martijn D., Barkhof, Frederik, Biesbroek, J. Matthijs, van der Flier, Wiesje M., Kuijf, H. J., Prins, N. D., Vrenken, Hugo, Biessels, Geert Jan, de Bresser, Jeroen, van den Berg, E., Boomsma, J. M. F., Exalto, L. G., Ferro, D. A., Frijns, C. J. M., Groeneveld, O. N., van Kalsbeek, N. M., Verwer, J. H., de Bresser, J., Emmelot-Vonk, M. E., Koek, H. L., Benedictus, M. R., Bremer, J., Leeuwis, A. E., Leijenaar, J., Scheltens, P., Tijms, B. M., Wattjes, M. P., Teunissen, C. E., Koene, T., Weinstein, H. C., Hamaker, M., Faaij, R., Pleizier, M., Prins, M., Vriens, E., Anatomy and neurosciences, Radiology and nuclear medicine, Amsterdam Neuroscience - Neurodegeneration, Neurology, APH - Personalized Medicine, APH - Methodology, Other Research, Clinical chemistry, CCA - Imaging and biomarkers, Immunology, Erasmus MC other, and Public Health
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Male ,Computer science ,lcsh:Medicine ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,medicine ,Journal Article ,Humans ,Multicenter Studies as Topic ,Segmentation ,lcsh:Science ,General ,Aged ,Automation, Laboratory ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Magnetic resonance imaging ,Pattern recognition ,Middle Aged ,Magnetic Resonance Imaging ,White Matter ,Hyperintensity ,Stroke ,White matter hyperintensity ,Female ,lcsh:Q ,Artificial intelligence ,Small vessel ,business ,Algorithms ,030217 neurology & neurosurgery - Abstract
White matter hyperintensities (WMHs) are a common manifestation of cerebral small vessel disease, that is increasingly studied with large, pooled multicenter datasets. This data pooling increases statistical power, but poses challenges for automated WMH segmentation. Although there is extensive literature on the evaluation of automated WMH segmentation methods, such evaluations in a multicenter setting are lacking. We performed WMH segmentations in sixty patients scanned on six different magnetic resonance imaging (MRI) scanners (10 patients per scanner) using five freely available and fully-automated WMH segmentation methods (Cascade, kNN-TTP, Lesion-TOADS, LST-LGA and LST-LPA). Different MRI scanner vendors and field strengths were included. We compared these automated WMH segmentations with manual WMH segmentations as a reference. Performance of each method both within and across scanners was assessed using spatial and volumetric correspondence with the reference segmentations by Dice’s similarity coefficient (DSC) and intra-class correlation coefficient (ICC) respectively. We found the best performance, both within and across scanners, for kNN-TTP, followed by LST-LPA and LST-LGA, with worse performance for Lesion-TOADS and Cascade. Our findings can serve as a guide for choosing a method and also highlight the importance to further improve and evaluate consistency of methods in a multicenter setting.
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- 2019
21. Voorkomen dat ouderen vallen: Een sleutelrol voor valklinieken
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Emmelot-Vonk, M. H.
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- 2005
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22. Low testosterone concentrations and the symptoms of testosterone deficiency according to the Androgen Deficiency in Ageing Males (ADAM) and Ageing Males’ Symptoms rating scale (AMS) questionnaires
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Emmelot-Vonk, M. H., Verhaar, H. J. J., Nakhai-Pour, H. R., Grobbee, D. E., and van der Schouw, Y. T.
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- 2011
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23. Prognostic value of screening instrument based on the Dutch national VMS guidelines for older patients in the emergency department
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Snijders, B. M. G., primary, Emmelot-Vonk, M. H., additional, Souwer, E. T. D., additional, Kaasjager, H. A. H., additional, and van den Bos, F., additional
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- 2020
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24. (Neiging tot) vallen en mobiliteitsstoornissen
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Verhaar, H. J. J., primary, Emmelot-Vonk, M. H., additional, and Neyens, J. C. L., additional
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- 2007
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25. Stoornissen van de calcium- en
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Verhaar, H. J. J., primary and Emmelot-Vonk, M. H., additional
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- 2007
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26. The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis
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Goto, N. A., primary, Weststrate, A. C. G., additional, Oosterlaan, F. M., additional, Verhaar, M. C., additional, Willems, H. C., additional, Emmelot-Vonk, M. H., additional, and Hamaker, M. E., additional
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- 2019
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27. Estimating individual cardiovascular disease risk reduction by blood pressure lowering in elderly patients: results from the HYVET study
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De Vries, T. I., Peters, R., Beckett, N. S., Dorresteijn, J. A. N., Westerink, J., Emmelot-Vonk, M. H., Muller, M., Van Der Graaf, Y., Bulpitt, C. J., Visseren, F. L. J., Pulmonary medicine, and General practice
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- 2018
28. PO-178 Sarcopenia is a predictor for overall survival in elderly patients with head and neck cancer
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Chargi, N., primary, Bril, S., additional, Emmelot-Vonk, M., additional, and Bree, R., additional
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- 2019
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29. A comprehensive fracture prevention strategy in older adults : The European union geriatric medicine society (EUGMS) statement
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Blain, H., Masud, T., Dargent-Molina, P., Martin, F. C., Rosendahl, E., van der Velde, N., Bousquet, J., Benetos, A., Cooper, C., Kanis, J. A., Reginster, J. Y., Rizzoli, R., Cortet, B., Barbagallo, M., Dreinhöfer, K., Vellas, B., Maggi, S., Strandberg, T., Alvarez, M. N., Annweiler, C., Bernard, P. L., Beswetherick, N., Bischoff-Ferrari, H. A., Bloch, F., Boddaert, J., Bonnefoy, M., Bousson, V., Bourdel-Marchasson, I., Capisizu, A., Che, H., Clara, J. G., Combe, B., Delignieres, D., Eklund, P., Emmelot-Vonk, M., Freiberger, E., Gauvain, J. B., Goswami, N., Guldemond, N., Herrero, C., Joël, M. E., Jónsdóttir, A. B., Kemoun, G., Kiss, I., Kolk, H., Kowalski, M. L., Krajcík, Kutsal, Y. G., Lauretani, F., Macijauskienė, J., Mellingsæter, M., Morel, J., Mourey, F., Nourashemi, F., Nyakas, C., Puisieux, F., Rambourg, P., Ramírez, A. G., Rapp, K., Rolland, Y., Ryg, J., Sahota, O., Snoeijs, S., Stephan, Y., Thomas, E., Todd, C., Treml, J., Adachi, R., Agnusdei, D., Body, J. J., Breuil, V., Bruyère, O., Burckardt, P., Cannata-Andia, J. B., Carey, J., Chan, D. C., Chapuis, L., Chevalley, T., Cohen-Solal, M., Dawson-Hughes, B., Dennison, E. M., Devogelaer, J. P., Fardellone, P., Féron, J. M., Perez, A. D., Felsenberg, D., Glueer, C., Harvey, N., Hiligsman, M., Javaid, M. K., Jörgensen, N. R., Kendler, D., Kraenzlin, M., Laroche, M., Legrand, E., Leslie, W. D., Lespessailles, E., Lewiecki, E. M., Nakamura, T., Papaioannou, A., Roux, C., Silverman, S., Henriquez, M. S., Thomas, T., Vasikaran, S., Watts, N. B., and Weryha, G.
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Prevention ,Falls ,Position statement ,Older people ,Geriatrics and Gerontology ,Fragility fracture ,Gerontology - Abstract
Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) – European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
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- 2016
30. 114Estimating individual cardiovascular disease risk reduction by blood pressure lowering in elderly patients: results from the HYVET study
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De Vries, T I, primary, Peters, R, additional, Beckett, N S, additional, Dorresteijn, J A N, additional, Westerink, J, additional, Emmelot-Vonk, M H, additional, Muller, M, additional, Van Der Graaf, Y, additional, Bulpitt, C J, additional, and Visseren, F L J, additional
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- 2018
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31. VALIDITY OF A SCREENING METHOD FOR DELIRIUM RISK IN OLDER PATIENTS ADMITTED TO A GENERAL HOSPITAL
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Ettema, R., primary, Heim, N., additional, Hamaker, M., additional, Emmelot-Vonk, M., additional, van der Mast, R., additional, and Schuurmans, M., additional
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- 2017
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32. A comprehensive fracture prevention strategy in older adults: The European union geriatric medicine society (EUGMS) statement
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Blain, H., primary, Masud, T., additional, Dargent-Molina, P., additional, Martin, F.C., additional, Rosendahl, E., additional, van der Velde, N., additional, Bousquet, J., additional, Benetos, A., additional, Cooper, C., additional, Kanis, J.A., additional, Reginster, J.Y., additional, Rizzoli, R., additional, Cortet, B., additional, Barbagallo, M., additional, Dreinhöfer, K., additional, Vellas, B., additional, Maggi, S., additional, Strandberg, T., additional, Alvarez, M.N., additional, Annweiler, C., additional, Bernard, P.-L., additional, Beswetherick, N., additional, Bischoff-Ferrari, H.A., additional, Bloch, F., additional, Boddaert, J., additional, Bonnefoy, M., additional, Bousson, V., additional, Bourdel-Marchasson, I., additional, Capisizu, A., additional, Che, H., additional, Clara, J.G., additional, Combe, B., additional, Delignieres, D., additional, Eklund, P., additional, Emmelot-Vonk, M., additional, Freiberger, E., additional, Gauvain, J.-B., additional, Goswami, N., additional, Guldemond, N., additional, Herrero, Á.C., additional, Joël, M.-E., additional, Jónsdóttir, A.B., additional, Kemoun, G., additional, Kiss, I., additional, Kolk, H., additional, Kowalski, M.L., additional, Krajcík, Š., additional, Kutsal, Y.G., additional, Lauretani, F., additional, Macijauskienė, J., additional, Mellingsæter, M., additional, Morel, J., additional, Mourey, F., additional, Nourashemi, F., additional, Nyakas, C., additional, Puisieux, F., additional, Rambourg, P., additional, Ramírez, A.G., additional, Rapp, K., additional, Rolland, Y., additional, Ryg, J., additional, Sahota, O., additional, Snoeijs, S., additional, Stephan, Y., additional, Thomas, E., additional, Todd, C., additional, Treml, J., additional, Adachi, R., additional, Agnusdei, D., additional, Body, J.-J., additional, Breuil, V., additional, Bruyère, O., additional, Burckardt, P., additional, Cannata-Andia, J.B., additional, Carey, J., additional, Chan, D.-C., additional, Chapuis, L., additional, Chevalley, T., additional, Cohen-Solal, M., additional, Dawson-Hughes, B., additional, Dennison, E.M., additional, Devogelaer, J.-P., additional, Fardellone, P., additional, Féron, J.-M., additional, Perez, A.D., additional, Felsenberg, D., additional, Glueer, C., additional, Harvey, N., additional, Hiligsman, M., additional, Javaid, M.K., additional, Jörgensen, N.R., additional, Kendler, D., additional, Kraenzlin, M., additional, Laroche, M., additional, Legrand, E., additional, Leslie, W.D., additional, Lespessailles, E., additional, Lewiecki, E.M., additional, Nakamura, T., additional, Papaioannou, A., additional, Roux, C., additional, Silverman, S., additional, Henriquez, M.S., additional, Thomas, T., additional, Vasikaran, S., additional, Watts, N.B., additional, and Weryha, G., additional
- Published
- 2016
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33. High fall incidence and fracture rate in elderly dialysis patients
- Author
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Polinder-Bos, H. A., Emmelot-Vonk, M. H., Gansevoort, R. T., Diepenbroek, A., Gaillard, C. A.J.M., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), and Internal Medicine
- Subjects
NURSING-HOME ,geriatric ,HEMODIALYSIS-PATIENTS ,INJURIOUS FALLS ,OLDER PERSONS ,COGNITIVE IMPAIRMENT ,elderly ,COMMUNITY ,MORTALITY RISK ,fracture ,REGISTRY ,RISK-FACTORS ,dialysis ,Falls ,PRIMARY HYPERPARATHYROIDISM - Abstract
Background: Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. Methods: A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. Results: 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Conclusions: Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.
- Published
- 2014
34. VALIDITY OF A SCREENING METHOD FOR DELIRIUM RISK IN OLDER PATIENTS ADMITTED TO A GENERAL HOSPITAL
- Author
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Marieke Schuurmans, Hamaker M, van der Mast R, Heim N, Emmelot-Vonk M, and Ettema R
- Subjects
medicine.medical_specialty ,Health (social science) ,business.industry ,medicine.disease ,behavioral disciplines and activities ,Health Professions (miscellaneous) ,nervous system diseases ,Abstracts ,Older patients ,mental disorders ,Emergency medicine ,medicine ,Screening method ,Delirium ,Medical emergency ,medicine.symptom ,General hospital ,Life-span and Life-course Studies ,business - Abstract
Routine care data were used to examin the predictive value of three Dutch health care inspection mandatory questions for screening on delirium. Delirium diagnosis was established on three proxy measures.
- Published
- 2017
35. Peritoneal dialysis II
- Author
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Yayar, O., primary, Buyukbakkal, M., additional, Eser, B., additional, Yildirim, T., additional, Ercan, Z., additional, Erdogan, B., additional, Kali, A., additional, Merhametsiz, O., additional, Haspulat, A., additional, Akdag, I., additional, Ayli, M. D., additional, Quach, T., additional, Tregaskis, P., additional, Menahem, S., additional, Koukounaras, J., additional, Mott, N., additional, Walker, R., additional, Zeiler, M., additional, Santarelli, S., additional, Degano, G., additional, Monteburini, T., additional, Agostinelli, R. M., additional, Marinelli, R., additional, Ceraudo, E., additional, Grzelak, T., additional, Kramkowska, M., additional, Walczak, M., additional, Czyzewska, K., additional, Guney, I., additional, Turkmen, K., additional, Yazici, R., additional, Arslan, S., additional, Altintepe, L., additional, Yeksan, M., additional, Vaduva, C., additional, Popa, S., additional, Mota, M., additional, Mota, E., additional, Wan Md Adnan, W. A. H., additional, Zaharan, N. L., additional, Moreiras-Plaza, M., additional, Blanco-Garcia, R., additional, Beato-Coo, L., additional, Cossio-Aranibar, C., additional, Martin-Baez, I., additional, Santos, M. T., additional, Fonseca, I., additional, Santos, O., additional, Aguiar, P., additional, Rocha, M. J., additional, Carvalho, M. J., additional, Cabrita, A., additional, Rodrigues, A., additional, Guo, Z., additional, Lai, X., additional, Theodoridis, M., additional, Panagoutsos, S., additional, Thodis, E., additional, Karanikas, M., additional, Mitrakas, A., additional, Kriki, P., additional, Kantartzi, K., additional, Passadakis, P., additional, Vargemezis, V., additional, Vakilzadeh, N., additional, Pruijm, M., additional, Burnier, M., additional, Halabi, G., additional, Azevedo, P., additional, Carvalho, M., additional, Laplante, S., additional, Rutherford, P., additional, Shutov, E., additional, Isachkina, A., additional, Gorelova, E., additional, Troya, M.-I., additional, Teixido, J., additional, Pedreira, G., additional, Del Rio, M., additional, Romero, R., additional, Bonet, J., additional, Zhang, X., additional, Ma, J., additional, Kim, Y., additional, Kim, J.-K., additional, Song, Y. R., additional, Kim, S. G., additional, Kim, H. J., additional, Eloot, S., additional, Vanholder, R., additional, Van Biesen, W., additional, Heaf, J., additional, Pedersen, C., additional, Elgborn, A., additional, Arabaci, T., additional, Emrem, G., additional, Keles, M., additional, Kizildag, A., additional, Martino, F., additional, Amici, G., additional, Rodighiero, M. P., additional, Crepaldi, C., additional, Ronco, C., additional, Tanaka, H., additional, Tsuneyoshi, S., additional, Yamasaki, K., additional, Daijo, Y., additional, Tatsumoto, N., additional, Al-Hilali, N., additional, Hussain, N., additional, Fathy, V., additional, Negm, H., additional, Alhilali, M., additional, Grzegorzewska, A., additional, Cieszynski, K., additional, Kaczmarek, A., additional, Sowinska, A., additional, Soleymanian, T., additional, Najafi, I., additional, Ganji, M. R., additional, Ahmadi, F., additional, Saddadi, F., additional, Hakemi, M., additional, Amini, M., additional, Tong, L. N. M. N., additional, Yongcheng, H. N. M. N., additional, Qijun, W. N. M. N., additional, Shaodong, L. N. M. N., additional, Velioglu, A., additional, Albaz, M., additional, Arikan, H., additional, Tuglular, S., additional, Ozener, C., additional, Bakirdogen, S., additional, Eren, N., additional, Mehtap, O., additional, Bek, S. G., additional, Cekmen, M. B., additional, Yilmaz, A., additional, Cabana Carcasi, M. L. L., additional, Fernandez Ferreiro, A., additional, Fidalgo Diaz, M., additional, Becerra Mosquera, V., additional, Alonso Valente, R., additional, Buttigieg, J., additional, Borg Cauchi, A., additional, Rogers, M., additional, Buhagiar, L., additional, Farrugia Agius, J., additional, Vella, M. P., additional, Farrugia, E., additional, Han, J. H., additional, Kim, H. R., additional, Ko, K. I., additional, Kim, C. H., additional, Koo, H. M., additional, Doh, F. M., additional, Lee, M. J., additional, Oh, H. J., additional, Han, S. H., additional, Yoo, T.-H., additional, Kang, S.-W., additional, Choi, K. H., additional, Sikorska, D., additional, Frankiewicz, D., additional, Klysz, P., additional, Schwermer, K., additional, Hoppe, K., additional, Nealis, J., additional, Kaczmarek, J., additional, Baum, E., additional, Wanic-Kossowska, M., additional, Pawlaczyk, K., additional, Oko, A., additional, Hiss, M., additional, Gerstein, F., additional, Haller, H., additional, Gueler, F., additional, Fukasawa, M., additional, Manabe, T., additional, Wan, Q., additional, He, Y., additional, Zhu, D., additional, Li, J., additional, Xu, H., additional, Yayar, O., additional, Oztemel, A., additional, Pilcevic, D., additional, Kovacevic, Z., additional, Maksic, D., additional, Paunic, Z., additional, Tadic-Pilcevic, J., additional, Mijuskovic, M., additional, Petrovic, M., additional, Obrencevic, K., additional, Rabrenovic, V., additional, Ignjatovic, L., additional, Terzic, B., additional, Jovanovic, D., additional, Chang, C.-H., additional, Chang, Y.-S., additional, Busuioc, M., additional, Guerraoui, A., additional, Caillette-Beaudoin, A., additional, Bahte, S. K., additional, Kielstein, J. T., additional, Polinder-Bos, H., additional, Emmelot-Vonk, M., additional, and Gaillard, C., additional
- Published
- 2013
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36. Barriers to an early switch from intravenous to oral antibiotic therapy in hospitalised patients with CAP
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Engel, M. F., primary, Postma, D. F., additional, Hulscher, M. E. J. L., additional, Teding van Berkhout, F., additional, Emmelot-Vonk, M. H., additional, Sankatsing, S., additional, Gaillard, C. A. J. M., additional, Bruns, A. H. W., additional, Hoepelman, A. I. M., additional, and Oosterheert, J. J., additional
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- 2012
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37. Testosterone, sex hormone-binding globulin and the metabolic syndrome: a systematic review and meta-analysis of observational studies
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Brand, J. S., primary, van der Tweel, I., additional, Grobbee, D. E., additional, Emmelot-Vonk, M. H., additional, and van der Schouw, Y. T., additional
- Published
- 2010
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38. The admission of very old patients to our intensive care units: A review
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Haas, L. E. M., Kerckhoffs, M. C., Bakhshi-Raiez, F., Emmelot-Vonk, M. H., and Dylan De Lange
39. Double blind randomized placebo-controlled trial on the effects of testosterone supplementation in elderly men with moderate to low testosterone levels: design and baseline characteristics [ISRCTN23688581]
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Verhaar Harald JJ, Sukel-Helleman Marja, Emmelot-Vonk Marielle H, Nakhai Pour Hamid Reza, Grobbee Diederick E, and van der Schouw Yvonne T
- Subjects
Medicine (General) ,R5-920 - Abstract
Abstract In ageing men testosterone levels decline, while cognitive function, muscle and bone mass, sexual hair growth, libido and sexual activity decline and the risk of cardiovascular diseases increase. We set up a double-blind, randomized placebo-controlled trial to investigate the effects of testosterone supplementation on functional mobility, quality of life, body composition, cognitive function, vascular function and risk factors, and bone mineral density in older hypogonadal men. We recruited 237 men with serum testosterone levels below 13.7 nmol/L and ages 60–80 years. They were randomized to either four capsules of 40 mg testosterone undecanoate (TU) or placebo daily for 26 weeks. Primary endpoints are functional mobility and quality of life. Secondary endpoints are body composition, cognitive function, aortic stiffness and cardiovascular risk factors and bone mineral density. Effects on prostate, liver and hematological parameters will be studied with respect to safety. Measure of effect will be the difference in change from baseline visit to final visit between TU and placebo. We will study whether the effect of TU differs across subgroups of baseline waist girth (< 100 cm vs. ≥ 100 cm; testosterone level ( At baseline, mean age, BMI and testosterone levels were 67 years, 27 kg/m2 and 10.72 nmol/L, respectively.
- Published
- 2006
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40. Determinants of vitamin D status in healthy men and women aged 40-80 years.
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Janssen HC, Emmelot-Vonk MH, Verhaar HJ, van der Schouw YT, Janssen, H C J P, Emmelot-Vonk, M H, Verhaar, H J J, and van der Schouw, Y T
- Abstract
Objectives: To determine the contribution of life style and health related factors on vitamin D status in middle-aged and older men and women.Study Design: A cross-sectional single-center study in 400 male subjects (40-80 years) and 402 postmenopausal female subjects (56-73 years), conducted in a University Medical Center in the central part of the Netherlands (52 degrees northern latitude).Main Outcome Measures: Medical history, vitamin D, calcium and alcohol intake, physical activity, Body Mass Index, Blood pressure, smoking, total fat body mass and total lean body mass were measured using DEXA. Laboratory analysis included 25-hydroxyvitamin D (25OHD) and sex hormones.Results: Thirty-six percent of men and 51% of women had 25OHD less than 50 nmol/L. In summertime men had significant higher 25OHD as compared to women (81.5 vs 53.3 nmol/L, P=.000) but this difference disappeared come winter. In a saturated model, male gender (B=.16, P=.008), and season (summer vs winter B=.30, P=.000) remained statistically significant. In men, physical activity and season explained 21% of the variance. In women, household physical activity (B=.13, P=.03), sport physical activity (B=.02, P=.02) and estradiol (B=-.003, P=.048) remained in the model,.Conclusion: In healthy middle-aged and older men and postmenopausal women, male gender and season were important predictors of vitamin D status. In men, physically activity and season, explained 21% of the variance in vitamin D status. In women, physical activity and estradiol explained 9.3% of the variance in vitamin D. [ABSTRACT FROM AUTHOR]- Published
- 2013
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41. Association between perioperative statin treatment and short-term clinical outcomes following transcatheter aortic valve implantation: a retrospective cohort study.
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Lefeber G, Dautzenberg L, Knol W, Huijbers C, Voskuil M, Kraaijeveld AO, Bouvy M, de Boer A, Emmelot-Vonk M, and Koek HL
- Subjects
- Aged, Humans, Retrospective Studies, Risk Factors, Treatment Outcome, Postoperative Complications, Transcatheter Aortic Valve Replacement adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Aortic Valve Stenosis complications
- Abstract
Background: Studies have found statin treatment to be associated with improved 1-year survival after transcatheter aortic valve implantation (TAVI), suggesting pleiotropic effects of statins on preventing perioperative complications. Statin treatment is not associated with postoperative cardiovascular complications or mortality; however, other postoperative complications have not been investigated., Aim: To explore whether preoperative statin treatment is associated with a lower short-term risk of mortality, readmission and major postoperative complications in older patients undergoing TAVI., Methods: A retrospective cohort study including patients aged 65 years and older who had undergone a comprehensive geriatric assessment prior to TAVI between January 2014 and January 2021. The primary outcomes were 90-day mortality, 90-day readmissions and major postoperative complications according to the Clavien-Dindo classification. Multivariable logistic regression was performed with adjustment for potential confounders, namely age, gender, comorbidity, body mass index, smoking, diminished renal function, alcohol use and falls ., Results: This study included 584 patients, of whom 324 (55.5%) were treated with a statin. In the statin treated group, 15 (4.6%) patients died within 90 days of TAVI compared with 10 (3.8%) patients in the non statin group (adjusted OR 1.17; 95% CI 0.51 to 2.70). The number of 90-day readmissions was 39 (12.0%) and 34 (13.1%) (adjusted OR 0.91; 95% CI 0.54 to 1.52), respectively. In the statin treated group, 115 (35.5%) patients experienced a major complication compared with 98 (37.7%) in the non-statin group (adjusted OR 0.95; 95% CI 0.67 to 1.37)., Conclusion: Preoperative statin treatment is not associated with improved short-term outcomes after TAVI. A randomised controlled trial with different statin doses may be warranted to investigate whether initiating statin treatment before TAVI improves both postoperative outcomes and long-term survival., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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42. [Electroencephalography and connectivity in delirium].
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van der A J, Ottens TH, Lodema DY, de Haan W, Tendolkar I, Emmelot-Vonk MH, Schutter DJLG, van Dellen E, and Slooter AJC
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- Humans, Brain, Electroencephalography methods, Delirium diagnosis
- Abstract
Background: Delirium is associated with neurophysiological changes that can be identified with quantitative EEG analysis techniques (qEEG)., Aim: To provide an overview of studies on neurophysiological changes in delirium using various qEEG analysis techniques., Method: Literature review., Results: In delirium, there is an increase in delta and theta activity but a decrease in activity in the alpha frequency band. Additionally, there is a decrease in functional connectivity and efficiency of the brain network in the alpha frequency band., Conclusion: Delirium is characterized by diffuse slowing of the EEG, reduced functional connectivity, and decreased efficiency of the brain network. Improved functional connectivity could be a new approach to treat delirium.
- Published
- 2023
43. The impact of frailty on adverse outcomes after transcatheter aortic valve replacement in older adults: A retrospective cohort study.
- Author
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Dautzenberg L, van Aarle TTM, Stella PR, Emmelot-Vonk M, Weterman MA, and Koek HL
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve surgery, Female, Humans, Male, Postoperative Complications etiology, Postoperative Complications surgery, Prospective Studies, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Frailty complications, Frailty diagnosis, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an effective alternative to surgical aortic valve replacement for patients who are at increased surgical risk. Consequently, frailty is common in patients undergoing TAVR., Objectives: This study aims to investigate the impact of frailty on outcomes following TAVR., Methods: A retrospective cohort study was conducted, including all TAVR candidates who visited the geriatric outpatient clinic for preoperative screening. Frailty status was assessed according to the Groningen Frailty Indicator. The primary outcome of the study was defined as the occurrence of postoperative complications, and this was evaluated according to the Clavien-Dindo classification. An additional analysis was performed to assess the impact of frailty on 1-year all-cause mortality and complications within 30 days of TAVR according to the Valve Academic Research Consortium (VARC-2) criteria. The VARC-2 criteria provide harmonized endpoint definitions for TAVR studies., Results: In total, 431 patients with a mean age of 80.8 ± 6.2 years were included, of whom 56% were female. Frailty was present in 36% of the participants. Frailty was associated with a higher risk of the composite outcome of complications [adjusted odds ratio (OR): 1.55 (95% confidence interval, CI: 1.03-2.34)], 30-day mortality [adjusted OR: 4.84 (95% CI: 1.62-14.49)], 3-month mortality [adjusted OR: 2.52 (95% CI: 1.00-6.28)] and 1-year mortality [adjusted OR: 2.96 (95% CI: 1.46-6.00)]., Conclusions: Frailty is common in TAVR patients and is associated with an increased overall risk of postoperative complications, particularly mortality. Increased optimization of screening and treatment of frailty in the guidelines for valvular heart diseases is recommended., (© 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
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- 2022
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44. [Fall prevention in older adults: what if the physician's and the patient's risk evaluation vary?]
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Dautzenberg L, Zijlstra GAR, Knol W, Emmelot-Vonk M, and Koek HL
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- Aged, Exercise Therapy, Fear, Humans, Physicians, Quality of Life
- Abstract
Falls may lead to functional impairment, fear of falling, decreased quality of life, high health care costs and mortality. A case of an older adult presented in this article, illustrates the multifactorial nature of risk of falling and fall prevention strategies. Recently, meta-analyses were performed to determine the effectiveness of interventions to prevent falls and to explore the effect of intervention components in reducing fear of falling. The single interventions whole body vibration, exercise and quality improvement strategies are associated with a reduction in number of fallers. Common components of multiple interventions significantly associated with a reduction in number of fallers are exercise, assistive technology, environmental modifications, quality improvement strategies and basic falls risk assessment. Interventions with meditation, holistic exercises or body awareness are more effective in reducing fear of falling than interventions without these components. The patient's risk evaluation and personal preferences should be taken into account when developing a treatment plan.
- Published
- 2022
45. [The use of telemedicine with frail elderly patients in the Netherlands - experience of caregivers in an outpatient setting].
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Flamand E, Emmelot-Vonk MH, van der Linden CMJ, and van Munster BC
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- Humans, Aged, Caregivers, Outpatients, Frail Elderly, Netherlands, Pandemics, Emergency Service, Hospital, COVID-19 epidemiology, Telemedicine methods
- Abstract
The use of telemedicine (telephone and video consultations) has increased over the past decades and has grown substantially during the COVID-19 pandemic. Multimorbidity, visual - and hearing impairment, cognitive impairment and lack of technical skills might complicate the use of telemedicine in frail elderly patients. Limited research on this topic is has been performed. The aim of this article is to investigate which elements of care could be performed by telemedicine and what patient characteristics are useful in selecting patients for telemedicine. To get more information about the use of telemedicine in frail elderly patients, an online survey was conducted amongst caregivers working in geriatric outpatient care departments in the Netherlands. 67 caregivers completed the survey. The results indicate there is limited experience in video consultations in this population. The experience so far is mainly positive. Caregivers indicate the following elements of care could be performed by telemedicine: follow-up consultations, taking an (hetero)anamnesis, medication review, conversations with multiple contacts or caregivers and informing about test results. Our advice is to decide in dialogue with patient and caregiver, which form of consultation is feasible, desirable and appropriate for every individual process and consultation.
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- 2021
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46. Intraoperative hypotension and delirium among older adults undergoing transcatheter aortic valve replacement.
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Wesselink EM, Abawi M, Kooistra NHM, Kappen TH, Agostoni P, Emmelot-Vonk M, Pasma W, van Klei WA, van Jaarsveld RC, van Dongen CS, Doevendans PAFM, Slooter AJC, and Stella PR
- Subjects
- Aged, 80 and over, Female, Humans, Male, Netherlands, Retrospective Studies, Risk Factors, Treatment Outcome, Anesthesia, General adverse effects, Delirium epidemiology, Hypotension etiology, Intraoperative Complications chemically induced, Postoperative Complications chemically induced, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: Postoperative delirium (POD) is a frequently observed complication after transcatheter aortic valve replacement (TAVR). The effects of intraoperative hypotension (IOH) on POD occurrence are currently unclear., Methods: A retrospective observational cohort study of patients who underwent TAVR was conducted. We predefined IOH as area under the threshold (AUT) of five mean arterial blood pressures (MBP), varying from <100 to <60 mmHg. The AUT consisted of the combination of duration and depth under the MBP thresholds, expressed in mmHg*min. All MBP AUTs were computed based on the complete procedure, independent of procedural phase or duration., Results: This cohort included 675 patients who underwent TAVR under general anesthesia (n = 128, 19%) or procedural sedation (n = 547, 81%). Delirium occurred mostly during the first 2 days after TAVR, and was observed in n = 93 (14%) cases. Furthermore, 674, 672, 663, 630, and 518 patients had at least 1 min intraoperative MBP <100, <90, <80, <70, and <60 mmHg, respectively. Patients who developed POD had higher AUT based on all five MBP thresholds during TAVR. The penalized adjusted odds ratio varied between 1.08 (99% confidence interval [CI] 0.74-1.56) for the AUT based on MBP < 100 mmHg and OR 1.06 (99% CI 0.88-1.28) for the AUT based on MBP < 60 mmHg., Conclusions: Intraoperative hypotension is frequently observed during TAVR, but not independently associated with POD after TAVR. Other potential factors than intraoperative hypotension may explain the occurrence of delirium after TAVR., (© 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
- Published
- 2021
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47. Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis.
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Dautzenberg L, Beglinger S, Tsokani S, Zevgiti S, Raijmann RCMA, Rodondi N, Scholten RJPM, Rutjes AWS, Di Nisio M, Emmelot-Vonk M, Tricco AC, Straus SE, Thomas S, Bretagne L, Knol W, Mavridis D, and Koek HL
- Subjects
- Aged, Aged, 80 and over, Environment Design, Exercise Therapy, Female, Humans, Independent Living, Male, Network Meta-Analysis, Randomized Controlled Trials as Topic, Risk Assessment, Self-Help Devices, Accidental Falls prevention & control, Accidents, Home prevention & control, Fractures, Bone prevention & control
- Abstract
Objective: To compare the effectiveness of single, multiple, and multifactorial interventions to prevent falls and fall-related fractures in community-dwelling older persons., Methods: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) evaluating the effectiveness of fall prevention interventions in community-dwelling adults aged ≥65 years, from inception until February 27, 2019. Two large RCTs (published in 2020 after the search closed) were included in post hoc analyses. Pairwise meta-analysis and network meta-analysis (NMA) were conducted., Results: NMA including 192 studies revealed that the following single interventions, compared with usual care, were associated with reductions in number of fallers: exercise (risk ratio [RR] 0.83; 95% confidence interval [CI] 0.77-0.89) and quality improvement strategies (e.g., patient education) (RR 0.90; 95% CI 0.83-0.98). Exercise as a single intervention was associated with a reduction in falls rate (RR 0.79; 95% CI 0.73-0.86). Common components of multiple interventions significantly associated with a reduction in number of fallers and falls rate were exercise, assistive technology, environmental assessment and modifications, quality improvement strategies, and basic falls risk assessment (e.g., medication review). Multifactorial interventions were associated with a reduction in falls rate (RR 0.87; 95% CI 0.80-0.95), but not with a reduction in number of fallers (RR 0.95; 95% CI 0.89-1.01). The following single interventions, compared with usual care, were associated with reductions in number of fall-related fractures: basic falls risk assessment (RR 0.60; 95% CI 0.39-0.94) and exercise (RR 0.62; 95% CI 0.42-0.90)., Conclusions: In keeping with Tricco et al. (2017), several single and multiple fall prevention interventions are associated with fewer falls. In addition to Tricco, we observe a benefit at the NMA-level of some single interventions on preventing fall-related fractures., (© 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
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- 2021
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48. Predictors of clinical outcome following transcatheter aortic valve implantation: a prospective cohort study.
- Author
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Dautzenberg L, Pals JEM, Lefeber GJ, Stella PR, Abawi M, Emmelot-Vonk M, and Koek HL
- Subjects
- Aged, Aged, 80 and over, Ambulatory Care Facilities statistics & numerical data, Aortic Valve Stenosis mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netherlands epidemiology, Prospective Studies, Risk Factors, Survival Rate trends, Time Factors, Transcatheter Aortic Valve Replacement, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Geriatric Assessment methods, Patient Readmission trends, Postoperative Complications epidemiology, Registries, Risk Assessment methods
- Abstract
Objective: In recent years, transcatheter aortic valve implantation (TAVI) has become the treatment of choice for patients with symptomatic aortic valve stenosis considered to be at increased or high surgical risk. The aim of this study was to identify predictors of postoperative adverse events in older adults undergoing TAVI., Methods: A prospective observational cohort study of patients who were referred to a geriatric outpatient clinic for a geriatric assessment prior to TAVI was conducted. The outcomes were mortality and hospital readmission within 3 months of TAVI and the occurrence of major postoperative complications during hospitalisation according to the Clavien-Dindo classification. These three outcomes were also combined to a composite outcome. Univariate and multivariate logistic regression analyses were performed to identify predictors of the outcomes and composite outcome of adverse events., Results: This cohort included 490 patients who underwent TAVI (mean age 80.7±6.2 years, 47.3% male). Within 3 months of TAVI, 19 (3.9%) patients died and 46 (9.4%) patients experienced a hospital readmission. A total of 177 (36.1%) patients experienced one or more major complications according to the Clavien-Dindo classification during hospitalisation and 193 patients (39.4%) experienced the composite outcome of adverse events. In multivariate analyses, cognitive impairment was identified as an independent predictor of major postoperative complications (OR 2.16; 95% CI 1.14 to 4.19) and the composite outcome of adverse events (OR 2.40; 95% CI 1.21 to 4.79). No association was found between the other variables and the separate outcomes and composite outcome., Conclusion: Cognitive impairment is associated with postoperative adverse events in older patients undergoing TAVI. Therefore, it is important to screen for cognitive impairment prior to TAVI and it is recommended to include this in current TAVI guidelines., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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49. Treatment patterns and primary reasons for adjusted treatment in older and younger patients with stage II or III colorectal cancer.
- Author
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Scheepers ERM, Schiphorst AH, van Huis-Tanja LH, Emmelot-Vonk MH, and Hamaker ME
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Colorectal Neoplasms pathology, Female, Guideline Adherence, Humans, Male, Middle Aged, Neoplasm Staging, Netherlands, Registries, Practice Patterns, Physicians' statistics & numerical data
- Abstract
Objective: This study aims to assess age-related treatment patterns and primary reasons for adjusted treatment in patients with colorectal cancer., Methods: Patients with colorectal cancer stage II or III diagnosed between 2015 and 2018 in the Netherlands were eligible for this study. Data were provided by the Netherlands Cancer Registry and included socio-demographics, clinical characteristics, treatment patterns and primary reasons for adjusted treatment. Treatment patterns and reasons for adjusted treatment were analysed according to age groups., Results: Of all 29,620 patients, 30% were aged <65 years (n = 8994), 34% between 65 and 75 years (n = 10,173), 27% between 75 and 85 years (n = 8102) and 8% were ≥85 years (n = 2349). Irrespective of cancer location or stage, older patients received less frequently a combination of surgery and (neo)adjuvant therapy compared to younger patients (decreasing from 55% to 1% in colon cancer patients, and from 71% to 23% in rectal cancer patients aged <65 years and ≥85 years respectively). Omission of surgical treatment increased with age in both patients with colon cancer (ranging from 1% in patients aged <65 years to 16% in those ≥85 years) and rectal cancer (ranging from 12% in patients aged <65 years to 56% in those ≥85 years). The most common reasons for adjusted treatment were patient preference (27%) and functional status (20%), both reasons increased with advancing age., Conclusions: Guideline non-adherence increased with advancing age and omission of standard treatment was mainly based on patient preference and functional status. These findings provides insight in the treatment decision-making process in patients with colorectal cancer. Future research is necessary to further assess patient's role in the treatment decision-making process., 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 © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
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- 2021
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50. Medication review interventions to reduce hospital readmissions in older people.
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Dautzenberg L, Bretagne L, Koek HL, Tsokani S, Zevgiti S, Rodondi N, Scholten RJPM, Rutjes AW, Di Nisio M, Raijmann RCMA, Emmelot-Vonk M, Jennings ELM, Dalleur O, Mavridis D, and Knol W
- Subjects
- Aged, Humans, Network Meta-Analysis, Hospitalization, Medication Reconciliation, Patient Readmission statistics & numerical data, Transitional Care
- Abstract
Objective: To assess the efficacy of medication review as an isolated intervention and with several co-interventions for preventing hospital readmissions in older adults., Methods: Ovid MEDLINE, Embase, The Cochrane Central Register of Controlled Trials and CINAHL were searched for randomized controlled trials evaluating the effectiveness of medication review interventions with or without co-interventions to prevent hospital readmissions in hospitalized or recently discharged adults aged ≥65, until September 13, 2019. Included outcomes were "at least one all-cause hospital readmission within 30 days and at any time after discharge from the index admission.", Results: Twenty-five studies met the inclusion criteria. Of these, 11 studies (7,318 participants) contributed to the network meta-analysis (NMA) on all-cause hospital readmission within 30 days. Medication review in combination with (a) medication reconciliation and patient education (risk ratio (RR) 0.45; 95% confidence interval (CI) 0.26-0.80) and (b) medication reconciliation, patient education, professional education and transitional care (RR 0.64; 95% CI 0.49-0.84) were associated with a lower risk of all-cause hospital readmission compared to usual care. Medication review in isolation did not significantly influence hospital readmissions (RR 1.06; 95% CI 0.45-2.51). The NMA on all-cause hospital readmission at any time included 24 studies (11,677 participants). Medication review combined with medication reconciliation, patient education, professional education and transitional care resulted in a reduction of hospital readmissions (RR 0.82; 95% CI 0.74-0.91) compared to usual care. The quality of the studies included in this systematic review raised some concerns, mainly regarding allocation concealment, blinding and contamination., Conclusion: Medication review in combination with medication reconciliation, patient education, professional education and transitional care, was associated with a lower risk of hospital readmissions compared to usual care. An effect of medication review without co-interventions was not demonstrated. Trials of higher quality are needed in this field., (© 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
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- 2021
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