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1دورية أكاديمية
المؤلفون: Arnlov, J, Sang, YY, Ballew, SH, Vaidya, D, Michos, ED, Jacobs, DR, Lima, J, Shlipak, MG, Bertoni, AG, Coresh, J, Blaha, M, Post, WS, Matsushita, K
المصدر: ESC heart failure. 7(6):4231-4240
مصطلحات موضوعية: Medicin och hälsovetenskap
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2
المؤلفون: Mörtzell Henriksson, M., Weiner, Maria, Sperker, W., Berlin, G., Segelmark, M., Javier Martinez, A., Audzijoniene, J., Griskevicius, A., Newman, E., Blaha, M., Vrielink, H., Witt, V., Stegmayr, B.
المصدر: Transfusion and Apheresis Science. 60(6)
مصطلحات موضوعية: Anti-GBM, Antibodies, MPO, PR-3, Renal impairment, Therapeutic apheresis, Vasculitis, Medicin och hälsovetenskap, Klinisk medicin, Urologi och njurmedicin, Medical and Health Sciences, Clinical Medicine, Urology and Nephrology
الوصف: Therapeutic apheresis (TA) as a treatment for antibody-associated vasculitis (AAV) was questioned by the PEXIVAS although the MEPEX study favored TA. The aim of this study was to evaluate the efficacy of TA to improve renal function in patients consecutively included in the WAA-apheresis registry versus patients not treated with TA. Materials and methods: Included were 192 patients that suffered from anti-glomerular basement membrane disease (anti-GBM, n = 28) and antineutrophil cytoplasmic antibody-associated vasculitis of MPO or PR3 origin. Of these 119 had performed TA and the other 73 had not performed TA for theses diagnoses (CTRL). Results: Elderly had an increased risk to die within 12 months (p = 0.002). All 28 anti-GBM had renal involvement, 21 dialysis dependent. At 3 month nine (36 %) did not need dialysis. Baseline data regarding renal function of AAV patients, subtype MPO and PR3, were worse in the TA groups than in CTRL. Recovery out of dialysis was better for the PR3-TA group compared with 1) the controls of MEPEX (RR 0.59, CI 0.43−0.80) and 2) the MPO-TA patients (RR 0.28, CI 0.12−0.68). The MPO-TA recovered similarly as the MEPEX-CTRL. Renal function improved most for TA-patients from baseline during the first 3 months (MPO-TA and PR3-TA) and stabilized thereafter and less for MPO-CTRL and PR3-CTRL. Conclusion: PR3-TA patients seem to have best chances to get out of dialysis. PR3-TA and MPO-TA improved residual renal function better than CTRL. The present study recommends reconsiderations to use TA for AAV especially those with PR3-vasculitis with severe renal vasculitis.
الوصول الحر: https://lup.lub.lu.se/record/4879fe36-1900-4104-bf1f-9b035f54e6d1Test
http://dx.doi.org/10.1016/j.transci.2021.103227Test -
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المؤلفون: Blaha, M., Gasova, Z., Berlin, G., Audzijoniene, J., Griskevicius, A., Dykes, J., Bhuiyanova, Z., Lanska, M., Eich, T., Vrielink, H., Witt, V., Seval, G.C., Ilhan, O., Stegmayr, Bernd, 1949
المصدر: Transfusion and apheresis science. 60(5)
مصطلحات موضوعية: Adverse events, Apheresis, Extracorporeal photopheresis, Graft versus host disease, Health criteria, Quality of life
الوصف: The aim of the study was to investigate safety and if extracorporeal photopheresis (ECP) may change health criteria (HC) and quality of life (QoL).Material and method: 560 patients (33 % women) were treated with ECP for a total of 13,871 procedures during a 17-years period. Mean age was 48 years (±18, range 3−81 years). Self-estimation of QoL was graded: 0 (suicidal) up to 10 (best ever) and HC: 0 (Bed ridden, ICU condition) up to 10 (athletic). Adverse events were analyzed. ANOVA and paired comparisons were performed.Results: Patients were treated due to graft versus host disease (GVHD, n = 317), skin lymphoma (n = 70), solid organ transplants (n = 47), skin diseases (n = 20) and other diseases (n = 106). Adverse events (AEs) were registered in 5.4 % of the first treatments and in 1.2 % of the subsequent procedures. Severe AEs were present in 0.04 % of all procedures. No patient died due to the procedure. Tingling and stitching were the most common AE. For those with GVHD an improvement was noticed within approximately 10 procedures of ECP in the severity stage, QoL (from a mean of 6.1 to 6.8, p < 0.002) and the HC (6.1 -> 6.4, p < 0.014) and improved further with added procedures.Conclusion: Photopheresis is an established therapy with few side effects. The present study of soft variables indicate that GVHD shows benefits upon ECP within approximately 10 procedures in regard to the severity of mainly skin GVHD, and lower baseline levels of HC and QoL.
وصف الملف: electronic
الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-184056Test
https://doi.org/10.1016/j.transci.2021.103172Test
https://umu.diva-portal.org/smash/get/diva2:1563863/FULLTEXT02.pdfTest -
4
المؤلفون: Henriksson, M. Mörtzell, Weiner, Maria, Sperker, W., Berlin, Gösta, Segelmark, M., Martinez, A. Javier, Audzijoniene, J., Griskevicius, A., Newman, E., Blaha, M., Vrielink, H., Witt, V, Stegmayr, B.
المصدر: Transfusion and apheresis science. 60(6)
مصطلحات موضوعية: Therapeutic apheresis, Antibodies, Vasculitis, Renal impairment, PR-3, MPO, Anti-GBM
الوصف: Therapeutic apheresis (TA) as a treatment for antibody-associated vasculitis (AAV) was questioned by the PEXIVAS although the MEPEX study favored TA. The aim of this study was to evaluate the efficacy of TA to improve renal function in patients consecutively included in the WAA-apheresis registry versus patients not treated with TA. Materials and methods: Included were 192 patients that suffered from anti-glomerular basement membrane disease (anti-GBM, n = 28) and antineutrophil cytoplasmic antibody-associated vasculitis of MPO or PR3 origin. Of these 119 had performed TA and the other 73 had not performed TA for theses diagnoses (CTRL). Results: Elderly had an increased risk to die within 12 months (p = 0.002). All 28 anti-GBM had renal involvement, 21 dialysis dependent. At 3 month nine (36 %) did not need dialysis. Baseline data regarding renal function of AAV patients, subtype MPO and PR3, were worse in the TA groups than in CTRL. Recovery out of dialysis was better for the PR3-TA group compared with 1) the controls of MEPEX (RR 0.59, CI 0.43-0.80) and 2) the MPO-TA patients (RR 0.28, CI 0.12-0.68). The MPO-TA recovered similarly as the MEPEX-CTRL. Renal function improved most for TA-patients from baseline during the first 3 months (MPO-TA and PR3-TA) and stabilized thereafter and less for MPO-CTRL and PR3-CTRL. Conclusion: PR3-TA patients seem to have best chances to get out of dialysis. PR3-TA and MPO-TA improved residual renal function better than CTRL. The present study recommends reconsiderations to use TA for AAV especially those with PR3-vasculitis with severe renal vasculitis.
وصف الملف: electronic
الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-182082Test
https://liu.diva-portal.org/smash/get/diva2:1624358/FULLTEXT01.pdfTest -
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المؤلفون: Blaha, M., Hruška, A., Švestka, Z., Vanýsek, V.
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المؤلفون: Blaha, M., Švestka, Z.
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المؤلفون: Mörtzell Henriksson, Monica, Newman, E, Witt, V, Derfler, K, Leitner, G, Eloot, S, Dhondt, A, Deeren, D, Rock, G, Ptak, J, Blaha, M, Lanska, M, Gasova, Z, Hrdlickova, R, Ramlow, W, Prophet, H, Liumbruno, G, Mori, E, Griskevicius, A, Audzijoniene, J, Vrielink, H, Rombout, S, Aandahl, A, Sikole, A, Tomaz, J, Lalic, K, Mazic, S, Strineholm, V, Brink, B, Berlin, G, Dykes, J, Toss, F, Axelsson, C G, Stegmayr, Bernd, Nilsson, T, Norda, R, Knutson, F, Ramsauer, Bernd, Wahlström, A
المصدر: Transfusion and apheresis science. 54(1):2-15
مصطلحات موضوعية: Apheresis, Adverse events, Plasma, Albumin, Donor
الوصف: Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). More AEs occurred during the first procedures versus subsequent (8.4 and 5.5%, respectively). AEs were mild in 2.4% (due to access 54%, device 7%, hypotension 15%, tingling 8%), moderate in 3% (tingling 58%, urticaria 15%, hypotension 10%, nausea 3%), and severe in 0.4% of procedures (syncope/hypotension 32%, urticaria 17%, chills/fever 8%, arrhythmia/asystole 4.5%, nausea/vomiting 4%). Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64% of procedures with bronchospasm, plasma was part of the replacement fluid used. Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.
وصف الملف: electronic
الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120207Test
https://doi.org/10.1016/j.transci.2016.01.003Test
https://umu.diva-portal.org/smash/get/diva2:927154/FULLTEXT01.pdfTest -
8دورية أكاديمية
المؤلفون: Víšek, J., Bláha, M., Bláha, V., Lášticová, M., Lánska, M., Andrýs, C., Tebbens, J. Duintjer, Igreja e Sá, Ivone Cristina, Tripská, K., Vicen, M., Najmanová, I., Nachtigal, P.
المساهمون: Ministerstvo Zdravotnictví Ceské Republiky, Univerzita Karlova v Praze
المصدر: Orphanet Journal of Rare Diseases ; volume 16, issue 1 ; ISSN 1750-1172
مصطلحات موضوعية: Pharmacology (medical), Genetics (clinical), General Medicine
الوصف: Background Lipoprotein apheresis (LA) is considered as an add-on therapy for patients with familial hypercholesterolemia (FH). We aimed to analyze the data collected in the last 15 years from FH patients treated with LA, to elucidate the benefit of this procedure with respect to plasma lipids, biomarkers of inflammation, and endothelial dysfunction and soluble endoglin. Results 14 patients (10 heterozygous FH patients (HeFH), 4 homozygous FH patients (HoFH)) were treated by long-term lipoprotein apheresis. Lipid levels were examined, and ELISA detected biomarkers of inflammation and soluble endoglin. Paired tests were used for intergroup comparisons, and a linear regression model served to estimate the influence of the number of days patients were treated with LA on the studied parameters. LA treatment was associated with a significant decrease of total cholesterol (TC), LDL-C, HDL-C, and apoB, in both HeFH and HoFH patients, after single apheresis and in a long-term period during the monitored interval of 15 years. Biomarkers of inflammation and endothelial dysfunction were reduced for soluble endoglin, hsCRP, and MCP-1, and sP-selectin after each procedure in some HeFH and HoFH patients. Conclusions LA treatment up to 15 years, reduced cholesterol levels, levels of biomarkers related to endothelial dysfunction, and inflammation not only after each procedure but also in the long-term evaluation in FH patients. We propose that long-term LA treatment improves lipid profile and endothelial dysfunction in familial hypercholesterolemia patients, suggesting a promising improvement in cardiovascular prognosis in most FH patients.
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9دورية أكاديمية
المؤلفون: Kockova, R, Linkova, H, Hlubocka, Z, Blaha, M, Tuna, M, Medilek, K, Lupinek, P, Sedmera, D, Penicka, M
المصدر: European Heart Journal - Cardiovascular Imaging ; volume 22, issue Supplement_1 ; ISSN 2047-2404 2047-2412
مصطلحات موضوعية: Cardiology and Cardiovascular Medicine, Radiology, Nuclear Medicine and imaging, General Medicine
الوصف: Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This study was supported by Ministry of Health of the Czech Republic 17-28265A. Background Indication for surgical treatment in asymptomatic patients with severe aortic regurgitation (AR) is curretly based on 2-dimensional echocardiography derived left ventricle (LV) diameter and ejection fraction. Suboptimal sensitivity of this quideline-directed approach may lead to late intervention in a substantial number of patients. Purpose We aimed to develop a new prognostic stratification scheme based on novel imaging and biochemical markers of heart failure. Methods Consecutive patients with chronic severe AR not indicated for surgery per the current guidelines were enrolled into prospective multi-center study. Baseline examination consisted of B-natriuretic peptide (BNP); comprehensive echocardiography (ECHO) including 3-dimensional (3D) vena contracta area (VCA); comprehensive cardiac magnetic resonance (CMR) including regurgitant volume and fraction measurement, and extracellular volume (ECV); all imaging data were analysed in core lab. The perioperative myocardial biopsy from basal septum was performed in all surgically treated patients for histological myocardial fibrosis quantification by Picrosirius Red staining. Patient follow-up was every 6 months. The endpoint was a disease progression (indication for surgery per the current guidelines). Results In total, 132 patients were enrolled between 2015 and 2019, the endpoint occurred in 39 patients during a median follow-up of 1217 days. Baseline clinical data did not differ between patients with endpoint (surgical group) and stable patients (medical group). Baseline BNP levels were higher in the surgical group (57 vs. 20, P < 0.01). Most baseline ECHO parameters did not differ, only 3D VCA, mitral inflow E-wave and flow reversal velocity in the descending aorta were significantly different between two groups (33 vs. 25 mm2, 61 vs 68 cm/s, ...
الإتاحة: https://doi.org/10.1093/ehjci/jeaa356.365Test
http://academic.oup.com/ehjcimaging/article-pdf/22/Supplement_1/jeaa356.365/36215011/jeaa356.365.pdfTest -
10دورية أكاديمية
المؤلفون: Awad, K, Mohammed, M, Zaki, M M, Abushouk, A I, Lip, G Y H, Blaha, M J, Lavie, C J, Toth, P P, Jukema, J W, Sattar, N, Banach, M
المصدر: European Heart Journal ; volume 42, issue Supplement_1 ; ISSN 0195-668X 1522-9645
مصطلحات موضوعية: Cardiology and Cardiovascular Medicine
الوصف: Background Current evidence from randomized controlled trials on statins for primary prevention of cardiovascular disease (CVD) in older people, especially those aged >75 years, is still lacking. Purpose We conducted a systematic review and meta-analysis of observational studies to extend the current evidence about association of statin use in older people primary prevention group with risk of CVD and mortality. Methods PubMed, Scopus, and Embase were searched from inception until March 18, 2021. We included observational studies (cohort or nested case-control) that compared statin use vs non-use for primary prevention of CVD in older people aged ≥65 years; provided that each of them reported the risk estimate on at least one of the following primary outcomes: all cause-mortality, CVD death, myocardial infarction (MI), and stroke. Risk estimates of each relevant outcome were pooled as a hazard ratio (HR) with a 95% confidence interval (CI) using the random-effects meta-analysis model. Results Ten observational studies (9 cohort and one case-control study; n=872,845) fulfilled our criteria. The overall combined estimate suggested that statin therapy was associated with a significantly lower risk of all-cause mortality (HR: 0.86 [95% CI: 0.79 to 0.93]), CVD death (HR: 0.80 [95% CI: 0.78 to 0.81]), and stroke (HR: 0.85 [95% CI: 0.76 to 0.94]) and a non-significant association with risk of MI (HR: 0.74 [95% CI: 0.53 to 1.02]). The beneficial association of statins with the risk of all-cause mortality remained significant even at higher ages (>75 years old; HR: 0.88 [95% CI: 0.81 to 0.96]) and in both men (HR: 0.75 [95% CI: 0.74 to 0.76]) and women (HR: 0.85 [95% CI: 0.72 to 0.99]). However, this association with the risk of all-cause mortality remained significant only in those with DM (HR: 0.82 [95% CI: 0.68 to 0.98]) but not in those without DM. Conclusions Statin therapy in older people (aged ≥65 years) without CVD was associated with a 14%, 20% and 15% lower risk of all-cause mortality, ...
الإتاحة: https://doi.org/10.1093/eurheartj/ehab724.2588Test
https://academic.oup.com/eurheartj/article-pdf/42/Supplement_1/ehab724.2588/41053355/ehab724.2588.pdfTest
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