| 1. |
- Valassi, E., et al.
(författare)
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High mortality within 90 days of diagnosis in patients with Cushing's syndrome: results from the ERCUSYN registry
- 2019
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Ingår i: European Journal of Endocrinology. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 181:5, s. 461-472
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Patients with Cushing's syndrome (CS) have increased mortality. The aim of this study was to evaluate the causes and time of death in a large cohort of patients with CS and to establish factors associated with increased mortality. Methods: In this cohort study, we analyzed 1564 patients included in the European Registry on CS (ERCUSYN); 1045 (67%) had pituitary-dependent CS, 385 (25%) adrenal-dependent CS, 89 (5%) had an ectopic source and 45 (3%) other causes. The median (IQR) overall follow-up time in ERCUSYN was 2.7 (1.2-5.5) years. Results: Forty-nine patients had died at the time of the analysis; 23 (47%) with pituitary-dependent CS, 6 (12%) with adrenal-dependent CS, 18 (37%) with ectopic CS and two (4%) with CS due to other causes. Of 42 patients whose cause of death was known, 15 (36%) died due to progression of the underlying disease, 13 (31%) due to infections, 7 (17%) due to cardiovascular or cerebrovascular disease and 2 due to pulmonary embolism. The commonest cause of death in patients with pituitary-dependent CS and adrenal-dependent CS were infectious diseases (n = 8) and progression of the underlying tumor (n = 10) in patients with ectopic CS. Patients who had died were older and more often males, and had more frequently muscle weakness, diabetes mellitus and ectopic CS, compared to survivors. Of 49 deceased patients, 22 (45%) died within 90 days from start of treatment and 5 (10%) before any treatment was given. The commonest cause of deaths in these 27 patients were infections (n = 10; 37%). In a regression analysis, age, ectopic CS and active disease were independently associated with overall death before and within 90 days from the start of treatment. Conclusion: Mortality rate was highest in patients with ectopic CS. Infectious diseases the commonest cause of death soon after diagnosis, emphasizing the need for careful vigilance at that time, especially in patients presenting with concomitant diabetes mellitus.
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| 2. |
- Burisch, J., et al.
(författare)
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Environmental factors in a population-based inception cohort of inflammatory bowel disease patients in Europe : An ECCO-EpiCom study
- 2014
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Ingår i: Journal of Crohn's & Colitis. - : Oxford University Press. - 1873-9946 .- 1876-4479. ; 8:7, s. 607-616
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of Living. The aim of this study was to investigate differences in exposure to environmental factors prior to diagnosis in Eastern and Western European IBD patients.Methods: The EpiCom cohort is a population-based, prospective inception cohort of 1560 unselected IBD patients from 31 European countries covering a background population of 10.1 million. At the time of diagnosis patients were asked to complete an 87-item questionnaire concerning environmental factors.Results: A total of 1182 patients (76%) answered the questionnaire, 444 (38%) had Crohn's disease (CD), 627 (53%) ulcerative colitis (UC), and 111 (9%) IBD unclassified. No geographic differences regarding smoking status, caffeine intake, use of oral contraceptives, or number of first-degree relatives with IBD were found. Sugar intake was higher in CD and UC patients from Eastern Europe than in Western Europe while fibre intake was lower (p < 0.01). Daily consumption of fast food as well as appendectomy before the age of 20 was more frequent in Eastern European than in Western European UC patients (p < 0.01). Eastern European CD and UC patients had received more vaccinations and experienced fewer childhood infections than Western European patients (p < 0.01).Conclusions: In this European population-based inception cohort of unselected IBD patients, Eastern and Western European patients differed in environmental factors prior to diagnosis. Eastern European patients exhibited higher occurrences of suspected risk factors for IBD included in the Western lifestyle. (C) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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| 3. |
- Burisch, J., et al.
(författare)
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Health care and patients' education in a European inflammatory bowel disease inception cohort : an ECCO-EpiCom study
- 2014
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Ingår i: Journal of Crohn's & Colitis. - : Oxford University Press (OUP). - 1873-9946 .- 1876-4479. ; 8:8, s. 811-818
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: The EpiCom study and inception cohort was initiated in 2010 in 31 centers from 14 Western and 8 Eastern European countries, covering a 10.1 million person background population. Our aim was to investigate whether there is a difference between Eastern and Western Europe in health care and education of patients with inflammatory bowel disease (IBD).Methods: A quality of care (QoC) questionnaire was developed in the EpiCom group consisting of 16 questions covering 5 items: time interval between the onset of symptoms and diagnosis, information, education, empathy and access to health care providers.Results: Of 1,515 patients, 947 (217 east/730 west) answered the QoC questionnaire. Only 23% of all patients had knowledge about IBD before diagnosis. In Eastern Europe, significantly more patients searched out information about IBD themselves (77% vs. 68%, p < 0.05), the main source was the Internet (92% vs. 88% p = 0.23). In Western Europe, significantly more patients were educated by nurses (19% vs. 1%, p < 0.05), while in Eastern Europe, gastroenterologists were easier to contact (80% vs. 68%, p < 0.05).Conclusion: Health care differed significantly between Eastern and Western Europe in all items, but satisfaction rates were high in both geographic regions. Because of the low awareness and the rising incidence of IBD, general information should be the focus of patient organizations and medical societies. In Western Europe IBD nurses play a very important role in reducing the burden of patient management. (c) 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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| 4. |
- Burisch, J., et al.
(författare)
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Health-related quality of life improves during one year of medical and surgical treatment in a European population-based inception cohort of patients with Inflammatory Bowel Disease : An ECCO-EpiCom study
- 2014
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Ingår i: Journal of Crohn's & Colitis. - Oxford, United Kingdom : Oxford University Press. - 1873-9946 .- 1876-4479. ; 8:9, s. 1030-1042
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Health-related quality of life (HRQoL) is impaired in patients with Inflammatory Bowel Disease (IBD). The aim was prospectively to assess and validate the pattern of HRQoL in an unselected, population-based inception cohort of IBD patients from Eastern and Western Europe.Methods: The EpiCom inception cohort consists of 1560 IBD patients from 31 European centres covering a background population of approximately 10.1 million. Patients answered the disease specific Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and generic Short Form 12 (SF-12) questionnaire at diagnosis and after one year of follow-up.Results: In total, 1079 patients were included in this study. Crohn's disease (CD) patients mean SIBDQ scores improved from 45.3 to 55.3 in Eastern Europe and from 44.9 to 53.6 in Western Europe. SIBDQ scores for ulcerative colitis (UC) patients improved from 44.9 to 57.4 and from 48.8 to 55.7, respectively. UC patients needing surgery or biologicals had lower SIBDQ scores before and after compared to the rest, while biological therapy improved SIBDQ scores in CD. CD and UC patients in both regions improved all SF-12 scores. Only Eastern European UC patients achieved SF-12 summary scores equal to or above the normal population.Conclusion: Medical and surgical treatment improved HRQoL during the first year of disease. The majority of IBD patients in both Eastern and Western Europe reported a positive perception of disease-specific but not generic HRQoL. Biological therapy improved HRQoL in CD patients, while UC patients in need of surgery or biological therapy experienced lower perceptions of HRQoL than the rest.
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| 5. |
- Saha, S., et al.
(författare)
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Observation of rotation about the longest principal axis in Zr 89
- 2019
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Ingår i: Physical Review C. - 2469-9985. ; 99:5
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Tidskriftsartikel (refereegranskat)abstract
- High-spin states in Zr89 were populated in the Se80(C13,4n) reaction, and γ-ray coincidences were measured using the Indian National Gamma Array. The level scheme of Zr89 has been extended up to spin I=49/2 with the observation of a new dipole band. Directional correlation and polarization asymmetries of the γ rays have been measured to determine spin and parity of the levels. Line shapes of several transitions have been analyzed to determine lifetimes of the levels. Possible configurations of the band have been discussed using the cranked Nilsson-Strutinsky model. The calculations suggest a triaxial shape of the nucleus at high spins, and the band may represent rotation of the nucleus about the longest axis.
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| 6. |
- Bhattacharya, S., et al.
(författare)
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Evolution of collectivity and evidence of octupole correlations in Br 73
- 2019
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Ingår i: Physical Review C. - 2469-9985. ; 100:1
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Tidskriftsartikel (refereegranskat)abstract
- High-spin states in the Br73 nucleus have been populated via the Cr50(Si28,αp)Br73 fusion evaporation reaction with a beam energy of 90 MeV. The deexciting gamma rays were detected using the Indian National Gamma Array (INGA). Using the γ-γ coincidence technique, two new bands and eight new interconnecting transitions have been added. The strong interconnecting E1 transitions, between positive and negative parity bands, ensure the existence of octupole correlations at low spin. Line shapes have been observed for 17 transitions, which were analyzed by the Doppler-shift attenuation method to determine the lifetime of excited states of the yrast negative parity band and its signature partner band along with the positive parity band. The deduced transitional quadrupole moments Qt for the ground state band decrease with increasing spin, with their values ranging from 2.88 to 1.00 eb. A similar trend in the quadrupole moment has also been observed for the signature partner as well as for the positive parity band. This decrease in Qt with increasing spin for these bands is interpreted in terms of the cranked Nilsson-Strutinsky model and total Routhian surface calculations, which indicate possible band termination at higher spin.
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| 7. |
- Burisch, J., et al.
(författare)
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East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort
- 2014
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Ingår i: Gut. - : BMJ Publishing Group. - 0017-5749 .- 1468-3288. ; 63:4, s. 588-597
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Tidskriftsartikel (refereegranskat)abstract
- Objective The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East–West gradient in the incidence of IBD in Europe exists.Design A prospective, uniformly diagnosed, population based inception cohort of IBD patients in 31 centres from 14 Western and eight Eastern European countries covering a total background population of approximately 10.1 million people was created. One-third of the centres had previous experience with inception cohorts. Patients were entered into a low cost, web based epidemiological database, making participation possible regardless of socioeconomic status and prior experience.Results 1515 patients aged 15 years or older were included, of whom 535 (35%) were diagnosed with Crohn's disease (CD), 813 (54%) with ulcerative colitis (UC) and 167 (11%) with IBD unclassified (IBDU). The overall incidence rate ratios in all Western European centres were 1.9 (95% CI 1.5 to 2.4) for CD and 2.1 (95% CI 1.8 to 2.6) for UC compared with Eastern European centres. The median crude annual incidence rates per 100 000 in 2010 for CD were 6.5 (range 0–10.7) in Western European centres and 3.1 (range 0.4–11.5) in Eastern European centres, for UC 10.8 (range 2.9–31.5) and 4.1 (range 2.4–10.3), respectively, and for IBDU 1.9 (range 0–39.4) and 0 (range 0–1.2), respectively. In Western Europe, 92% of CD, 78% of UC and 74% of IBDU patients had a colonoscopy performed as the diagnostic procedure compared with 90%, 100% and 96%, respectively, in Eastern Europe. 8% of CD and 1% of UC patients in both regions underwent surgery within the first 3 months of the onset of disease. 7% of CD patients and 3% of UC patients from Western Europe received biological treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy.Conclusions An East–West gradient in IBD incidence exists in Europe. Among this inception cohort—including indolent and aggressive cases—international guidelines for diagnosis and initial treatment are not being followed uniformly by physicians.
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| 8. |
- Petrache, C. M., et al.
(författare)
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Six-quasiparticle isomer in Nd-140
- 2006
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 74:3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A search for isomeric states was performed in the nucleus Nd-140(60)80 using in-beam gamma-ray spectroscopy and the Te-126(O-18,4n) reaction. Prompt and delayed gamma-ray coincidences were measured with the AFRODITE spectrometer using the pulsed beam delivered by the Separated Sector Cyclotron of iThemba LABS. One new isomer was identified, with spin-parity I-pi=20(+) and lifetime T-1/2 >= 400 ns, at an excitation energy E-x=7430 keV. The lifetime of the 10(+) isomer at E-x=3619 keV was determined to be 32.9(1.8) ns, confirming the previously reported value. The configuration of the I-pi=20(+) isomer is assigned based on configuration-dependent cranked Nilsson-Strutinsky (CNS) calculations as a state pi(d(5/2)g(7/2))(10)(+-4)circle times nu(h(11/2)(-2))(10)(+), with the spin vectors of the six holes in the Gd-146(64)82 core fully aligned.
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| 9. |
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| 10. |
- Gale, S. J., et al.
(författare)
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Band termination spectroscopy in 157Er
- 1995
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Ingår i: Journal of Physics G: Nuclear and Particle Physics. - 0954-3899. ; 21:2, s. 193-213
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Tidskriftsartikel (refereegranskat)abstract
- The level scheme of 157Er has been extended from a spin region where the nucleus behaves as a prolate rotor to a region where the spin is produced by the alignment of all or most of the available valence nucleons along the symmetry axis of a weakly deformed oblate shape. The level scheme was established at high spin using up to four-fold gamma -ray coincidences detected in the Eurogam spectrometer following the reaction 114Cd( 48Ca,5n)157Er at a bombarding energy of 210 MeV. Particularly favoured states have been established at IK=69/2+, 81/2+, 71/2+, 77/2-, 87-/2 and 89-/2. Specific single-particle configurations are assigned to these special states by comparison with cranked Nilsson-Strutinsky calculations. These states are related to structures observed in the neighbouring nuclei 158Er and 157Ho. These data provide the spectrum of single-particle states for the lowest lying valence orbitals above the 146Gd closed core.
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