The Experts below are selected from a list of 87831 Experts worldwide ranked by ideXlab platform
Michelle Harvie - One of the best experts on this subject based on the ideXlab platform.
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Risk Determination and prevention of breast cancer
Breast Cancer Research, 2014Co-Authors: Anthony Howell, Annie S Anderson, Robert Clarke, Stephen W Duffy, Gareth D Evans, Montserat Garciaclosas, Andy J Gescher, John Saxton, Michelle HarvieAbstract:Breast cancer is an increasing public health problem. Substantial advances have been made in the treatment of breast cancer, but the introduction of methods to predict women at elevated Risk and prevent the disease has been less successful. Here, we summarize recent data on newer approaches to Risk prediction, available approaches to prevention, how new approaches may be made, and the difficult problem of using what we already know to prevent breast cancer in populations. During 2012, the Breast Cancer Campaign facilitated a series of workshops, each covering a specialty area of breast cancer to identify gaps in our knowledge. The Risk-and-prevention panel involved in this exercise was asked to expand and update its report and review recent relevant peer-reviewed literature. The enlarged position paper presented here highlights the key gaps in Risk-and-prevention research that were identified, together with recommendations for action. The panel estimated from the relevant literature that potentially 50% of breast cancer could be prevented in the subgroup of women at high and moderate Risk of breast cancer by using current chemoprevention (tamoxifen, raloxifene, exemestane, and anastrozole) and that, in all women, lifestyle measures, including weight control, exercise, and moderating alcohol intake, could reduce breast cancer Risk by about 30%. Risk may be estimated by standard models potentially with the addition of, for example, mammographic density and appropriate single-nucleotide polymorphisms. This review expands on four areas: (a) the prediction of breast cancer Risk, (b) the evidence for the effectiveness of preventive therapy and lifestyle approaches to prevention, (c) how understanding the biology of the breast may lead to new targets for prevention, and (d) a summary of published guidelines for preventive approaches and measures required for their implementation. We hope that efforts to fill these and other gaps will lead to considerable advances in our efforts to predict Risk and prevent breast cancer over the next 10 years.
Wouter Hoefsloot - One of the best experts on this subject based on the ideXlab platform.
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assessing covid 19 pneumonia clinical extension and Risk with point of care ultrasound a multicenter prospective observational study
Journal of the American College of Emergency Physicians open, 2021Co-Authors: Arthur W. E. Lieveld, Bram Kok, Kaoutar Azijli, Frederik H. Schuit, Robin Nijveldt, Bernd P. Teunissen, C.l. De ,korte, Peter M Van De Ven, Frederik M A Van Den Heuvel, Wouter HoefslootAbstract:Background: Assessing the extent of lung involvement is important for the triage and care of COVID-19 pneumonia. We sought to determine the utility of point-of-care ultrasound (POCUS) for characterizing lung involvement and, thereby, clinical Risk Determination in COVID-19 pneumonia. Methods: This multicenter, prospective, observational study included patients with COVID-19 who received 12-zone lung ultrasound and chest computed tomography (CT) scanning in the emergency department (ED). We defined lung disease severity using the lung ultrasound score (LUS) and chest CT severity score (CTSS). We assessed the association between the LUS and poor outcome (ICU admission or 30-day all-cause mortality). We also assessed the association between the LUS and hospital length of stay. We examined the ability of the LUS to differentiate between disease severity groups. Lastly, we estimated the correlation between the LUS and CTSS and the interrater agreement for the LUS. We handled missing data by multiple imputation with chained equations and predictive mean matching. Results: We included 114 patients treated between March 19, 2020, and May 4, 2020. An LUS >=12 was associated with a poor outcome within 30 days (hazard ratio [HR], 5.59;95% confidence interval [CI], 1.26-24.80;P = 0.02). Admission duration was shorter in patients with an LUS <12 (adjusted HR, 2.24;95% CI, 1.47-3.40;P < 0.001). Mean LUS differed between disease severity groups: no admission, 6.3 (standard deviation [SD], 4.4);hospital/ward, 13.1 (SD, 6.4);and ICU, 18.0 (SD, 5.0). The LUS was able to discriminate between ED discharge and hospital admission excellently, with an area under the curve of 0.83 (95% CI, 0.75-0.91). Interrater agreement for the LUS was strong: kappa = 0.88 (95% CI, 0.77-0.95). Correlation between the LUS and CTSS was strong: kappa = 0.60 (95% CI, 0.48-0.71). Conclusions: We showed that baseline lung ultrasound - is associated with poor outcomes, admission duration, and disease severity. The LUS also correlates well with CTSS. Point-of-care lung ultrasound may aid the Risk stratification and triage of patients with COVID-19 at the ED.
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Assessing COVID‐19 pneumonia—Clinical extension and Risk with point‐of‐care ultrasound: A multicenter, prospective, observational study
'Wiley', 2021Co-Authors: Arthur W. E. Lieveld, Bram Kok, Kaoutar Azijli, Frederik H. Schuit, Peter M. Van Deven, Chris L. Dekorte, Robin Nijveldt, Frederik M. A. Vanden Heuvel, Bernd P. Teunissen, Wouter HoefslootAbstract:Background Assessing the extent of lung involvement is important for the triage and care of COVID‐19 pneumonia. We sought to determine the utility of point‐of‐care ultrasound (POCUS) for characterizing lung involvement and, thereby, clinical Risk Determination in COVID‐19 pneumonia. Methods This multicenter, prospective, observational study included patients with COVID‐19 who received 12‐zone lung ultrasound and chest computed tomography (CT) scanning in the emergency department (ED). We defined lung disease severity using the lung ultrasound score (LUS) and chest CT severity score (CTSS). We assessed the association between the LUS and poor outcome (ICU admission or 30‐day all‐cause mortality). We also assessed the association between the LUS and hospital length of stay. We examined the ability of the LUS to differentiate between disease severity groups. Lastly, we estimated the correlation between the LUS and CTSS and the interrater agreement for the LUS. We handled missing data by multiple imputation with chained equations and predictive mean matching. Results We included 114 patients treated between March 19, 2020, and May 4, 2020. An LUS ≥12 was associated with a poor outcome within 30 days (hazard ratio [HR], 5.59; 95% confidence interval [CI], 1.26–24.80; P = 0.02). Admission duration was shorter in patients with an LUS
Abul Hasnat - One of the best experts on this subject based on the ideXlab platform.
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breast cancer Risk in relation to tp53 codon 72 and cdh1 gene polymorphisms in the bangladeshi women
Tumor Biology, 2016Co-Authors: Samia Shabnaz, Maizbha Uddin Ahmed, Md Siddiqul Islam, Md Reazul Islam, Mir Md Abdullah Almamun, Mohammad Safiqul Islam, Abul HasnatAbstract:Pharmacogenomic studies play a significant role in understanding the Risk of breast cancer where genetic abnormalities are implicated as the etiology of cancer. Various polymorphisms of tumor suppressor gene TP53 and E-cadherin (CDH1) have been found to be associated with increased breast cancer Risk worldwide. This study aimed to analyze the contribution of TP53 and CDH1 gene anomalies in breast cancer Risk in the Bangladeshi breast cancer patients. For Risk Determination, 310 patients with breast cancer and 250 controls from Bangladeshi women were recruited who are matched up with age and use of contraceptives with patients. Genetic polymorphisms were detected by using polymerase chain reaction restriction fragment length polymorphism. A significant association was found between TP53Arg72Pro (rs1042522) and CDH1 -160 C/A (rs16260) polymorphisms and breast cancer Risk. In case of P53rs1042522 polymorphism, Arg/Pro (P = 0.0053, odds ratio (OR) = 1.69) and Pro/Pro (P = 0.018, OR = 1.83) genotypes were associated with increased Risk of breast cancer in comparison to the Arg/Arg genotype. Arg/Pro + Pro/Pro genotype and Pro allele also increased the Risk of breast cancer (P = 0.002, OR = 1.73; P = 0.004, OR = 1.43, respectively). In case of CDH1rs16260 polymorphism, C/A heterozygote and combined C/A + A/A genotypes were found to be strongly associated (P = 0.005, OR = 1.67; P = 0.0037, OR = 1.68) with increased Risk of breast cancer. The variant A allele also increased the breast cancer Risk (P = 0.0058, OR = 1.52). The present study demonstrates that P53Arg72Pro and CDH1rs16260 polymorphisms are associated with elevated breast cancer Risk in the Bangladeshi population.
Anthony Howell - One of the best experts on this subject based on the ideXlab platform.
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Risk Determination and prevention of breast cancer
Breast Cancer Research, 2014Co-Authors: Anthony Howell, Annie S Anderson, Robert Clarke, Stephen W Duffy, Gareth D Evans, Montserat Garciaclosas, Andy J Gescher, John Saxton, Michelle HarvieAbstract:Breast cancer is an increasing public health problem. Substantial advances have been made in the treatment of breast cancer, but the introduction of methods to predict women at elevated Risk and prevent the disease has been less successful. Here, we summarize recent data on newer approaches to Risk prediction, available approaches to prevention, how new approaches may be made, and the difficult problem of using what we already know to prevent breast cancer in populations. During 2012, the Breast Cancer Campaign facilitated a series of workshops, each covering a specialty area of breast cancer to identify gaps in our knowledge. The Risk-and-prevention panel involved in this exercise was asked to expand and update its report and review recent relevant peer-reviewed literature. The enlarged position paper presented here highlights the key gaps in Risk-and-prevention research that were identified, together with recommendations for action. The panel estimated from the relevant literature that potentially 50% of breast cancer could be prevented in the subgroup of women at high and moderate Risk of breast cancer by using current chemoprevention (tamoxifen, raloxifene, exemestane, and anastrozole) and that, in all women, lifestyle measures, including weight control, exercise, and moderating alcohol intake, could reduce breast cancer Risk by about 30%. Risk may be estimated by standard models potentially with the addition of, for example, mammographic density and appropriate single-nucleotide polymorphisms. This review expands on four areas: (a) the prediction of breast cancer Risk, (b) the evidence for the effectiveness of preventive therapy and lifestyle approaches to prevention, (c) how understanding the biology of the breast may lead to new targets for prevention, and (d) a summary of published guidelines for preventive approaches and measures required for their implementation. We hope that efforts to fill these and other gaps will lead to considerable advances in our efforts to predict Risk and prevent breast cancer over the next 10 years.
Udo Hoffmann - One of the best experts on this subject based on the ideXlab platform.
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outcomes of anatomical vs functional testing for coronary artery disease lessons from the promise trial
Herz, 2016Co-Authors: Ravi V Shah, Borek Foldyna, Udo HoffmannAbstract:The development of coronary artery disease (CAD) is a major, final common pathway in heart disease worldwide. With a rise in stress testing and increased scrutiny on cost-effectiveness and radiation exposure in medical imaging, a focus on the relative merits of anatomic versus functional characterization of CAD has emerged. In this context, coronary computed tomography angiography (CCTA) is a noninvasive alternative to functional testing as a first-line test for CAD detection but is complimentary in its nature. Here, we discuss the design, results, and implications of the PROMISE trial, a randomized comparative effectiveness study of 10,003 patients across 193 sites in the United States and Canada comparing the prognostic and diagnostic power of CCTA and standard stress testing. Specifically, we discuss the safety (e. g., contrast, radiation exposure) of CCTA versus functional testing in CAD, the need for improved selection for noninvasive testing, the frequency of downstream testing after anatomic or functional imaging, the use of imaging results in clinical management, and novel modalities of CAD Risk Determination using CCTA. PROMISE demonstrated that in a real-world, low-to-intermediate Risk patient population referred to noninvasive testing for CAD, both CCTA and functional testing approaches have similar clinical, economic, and safety-based outcomes. We conclude with open questions in CAD imaging, specifically as they pertain to the utilization of CCTA.
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inflammatory markers and incident heart failure Risk in older adults the health abc health aging and body composition study
Journal of the American College of Cardiology, 2010Co-Authors: Andreas P Kalogeropoulos, Anne B Newman, Udo Hoffmann, Vasiliki V Georgiopoulou, Bruce M Psaty, Nicolas Rodondi, Andrew L Smith, David G Harrison, Douglas C Bauer, Stephen B KritchevskyAbstract:Inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP), are elevated in patients with heart failure (HF) and are associated with outcomes regardless of etiology (1–6). Inflammatory markers are also elevated in individuals with asymptomatic left ventricular systolic and diastolic dysfunction (7–9), and experimental studies have suggested that IL-6 and TNF-α are associated with left ventricular remodeling, fetal gene expression, myocyte hypertrophy, and myocyte apoptosis (10). These observations raise the possibility that inflammation may be related to a heightened Risk for HF, and previous studies have indeed suggested such an association (11–13). However, the number of incident HF events in these studies was small precluding an opportunity to assess for possible differential association across major demographic groups and adequately control for important predictors of HF including incident coronary events. Finally, the incremental value of inflammatory markers for HF Risk Determination was not assessed in these studies. We recently developed and validated a prediction model for incident HF in the elderly, the Health ABC HF model (14), based on nine routinely available variables including age, history of coronary heart disease (CHD), smoking, systolic blood pressure, heart rate, and serum concentrations of fasting glucose, creatinine, and albumin. Most of these Risk factors have been associated with inflammation. For example, the association of inflammation with CHD and subclinical atherosclerosis is well documented (15,16), as is the association between inflammation and diabetes mellitus (17). Systemic low-grade inflammation has been reported in smokers (18). Both inflammation and oxidative stress have been correlated with chronic kidney disease (19). Similar associations have been reported for hypertension and hypoalbuminemia (20,21). Thus, beyond the direct effects on myocardial cells, inflammation may also drive HF Risk through the creation of a biologic milieu that predisposes individuals to HF. In this study, we assessed the association between baseline levels of inflammatory markers and Risk for HF among the elderly participants of the Health, Aging, and Body Composition (Health ABC) Study in the total cohort and in predefined subgroups of interest, as well as the possible incremental value of these markers for incident HF prediction. In addition, we assessed the impact of multiple inflammatory marker elevation and the incremental value of serial biomarker measurements for incident HF prediction.
