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- Van Der Vaart, Thomas W., et al.
(författare)
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External Validation of the 2023 Duke-International Society for Cardiovascular Infectious Diseases Diagnostic Criteria for Infective Endocarditis
- 2024
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Ingår i: Clinical Infectious Diseases. - 1058-4838. ; 78:4, s. 922-929
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Tidskriftsartikel (refereegranskat)abstract
- Background. The 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) criteria for infective endocarditis (IE) were introduced to improve classification of IE for research and clinical purposes. External validation studies are required. Methods. We studied consecutive patients with suspected IE referred to the IE team of Amsterdam University Medical Center (from October 2016 to March 2021). An international expert panel independently reviewed case summaries and assigned a final diagnosis of "IE"or "not IE,"which served as the reference standard, to which the "definite"Duke-ISCVID classifications were compared. We also evaluated accuracy when excluding cardiac surgical and pathologic data ("clinical"criteria). Finally, we compared the 2023 Duke- ISCVID with the 2000 modified Duke criteria and the 2015 and 2023 European Society of Cardiology (ESC) criteria. Results. A total of 595 consecutive patients with suspected IE were included: 399 (67%) were adjudicated as having IE; 111 (19%) had prosthetic valve IE, and 48 (8%) had a cardiac implantable electronic device IE. The 2023 Duke-ISCVID criteria were more sensitive than either the modified Duke or 2015 ESC criteria (84.2% vs 74.9% and 80%, respectively; P < .001) without significant loss of specificity. The 2023 Duke-ISCVID criteria were similarly sensitive but more specific than the 2023 ESC criteria (94% vs 82%; P < .001). The same pattern was seen for the clinical criteria (excluding surgical/pathologic results). New modifications in the 2023 Duke-ISCVID criteria related to "major microbiological"and "imaging"criteria had the most impact. Conclusions. The 2023 Duke-ISCVID criteria represent a significant advance in the diagnostic classification of patients with suspected IE.
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| 2. |
- Gurvits,, et al.
(författare)
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The science case and challenges of space-borne sub-millimeter interferometry
- 2022
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Ingår i: Acta Astronautica. - : Elsevier BV. - 0094-5765. ; 196, s. 314-333
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Tidskriftsartikel (refereegranskat)abstract
- Ultra-high angular resolution in astronomy has always been an important vehicle for making fundamental discoveries. Recent results in direct imaging of the vicinity of the supermassive black hole in the nucleus of the radio galaxy M87 by the millimeter VLBI system Event Horizon Telescope and various pioneering results of the Space VLBI mission RadioAstron provided new momentum in high angular resolution astrophysics. In both mentioned cases, the angular resolution reached the values of about 10???20 microarcseconds (0.05???0.1 nanoradian). Further developments towards at least an order of magnitude ???sharper???values, at the level of 1 microarcsecond are dictated by the needs of advanced astrophysical studies. The paper emphasis that these higher values can only be achieved by placing millimeter and submillimeter wavelength interferometric systems in space. A concept of such the system, called Terahertz Exploration and Zooming-in for Astrophysics, has been proposed in the framework of the ESA Call for White Papers for the Voyage 2050 long term plan in 2019. In the current paper we present new science objectives for such the concept based on recent results in studies of active galactic nuclei and supermassive black holes. We also discuss several approaches for addressing technological challenges of creating a millimeter/sub-millimeter wavelength interferometric system in space. In particular, we consider a novel configuration of a space-borne millimeter/sub-millimeter antenna which might resolve several bottlenecks in creating large precise mechanical structures. The paper also presents an overview of prospective space-qualified technologies of low-noise analogue front-end instrumentation for millimeter/sub-millimeter telescopes. Data handling and processing instrumentation is another key technological component of a sub-millimeter Space VLBI system. Requirements and possible implementation options for this instrumentation are described as an extrapolation of the current state-of-the-art Earth-based VLBI data transport and processing instrumentation. The paper also briefly discusses approaches to the interferometric baseline state vector determination and synchronisation and heterodyning system. The technology-oriented sections of the paper do not aim at presenting a complete set of technological solutions for sub-millimeter (terahertz) space-borne interferometers. Rather, in combination with the original ESA Voyage 2050 White Paper, it sharpens the case for the next generation microarcsecond-level imaging instruments and provides starting points for further in-depth technology trade-off studies.
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| 3. |
- Caby, F, et al.
(författare)
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CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies
- 2021
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Ingår i: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - : Oxford University Press (OUP). - 1537-6591. ; 73:1, s. 50-59
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA persistently low CD4/CD8 ratio has been reported to inversely correlate with the risk of non-AIDS defining cancer in people living with human immunodeficiency virus (HIV; PLWH) efficiently treated by combination antiretroviral therapy (cART). We evaluated the impact of the CD4/CD8 ratio on the risk of Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL), still among the most frequent cancers in treated PLWH.MethodsPLWH from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) were included if they achieved virological control (viral load ≤ 500 copies/mL) within 9 months following cART and without previous KS/LNH diagnosis. Cox models were used to identify factors associated with KS or NHL risk, in all participants and those with CD4 ≥ 500/mm3 at virological control. We analyzed the CD4/CD8 ratio, CD4 count and CD8 count as time-dependent variables, using spline transformations.ResultsWe included 56 708 PLWH, enrolled between 2000 and 2014. At virological control, the median (interquartile range [IQR]) CD4 count, CD8 count, and CD4/CD8 ratio were 414 (296–552)/mm3, 936 (670–1304)/mm3, and 0.43 (0.28–0.65), respectively. Overall, 221 KS and 187 NHL were diagnosed 9 (2–37) and 18 (7–42) months after virological control. Low CD4/CD8 ratios were associated with KS risk (hazard ratio [HR] = 2.02 [95% confidence interval {CI } = 1.23–3.31]) when comparing CD4/CD8 = 0.3 to CD4/CD8 = 1) but not with NHL risk. High CD8 counts were associated with higher NHL risk (HR = 3.14 [95% CI = 1.58–6.22]) when comparing CD8 = 3000/mm3 to CD8 = 1000/mm3). Similar results with increased associations were found in PLWH with CD4 ≥ 500/mm3 at virological control (HR = 3.27 [95% CI = 1.60–6.56] for KS; HR = 5.28 [95% CI = 2.17–12.83] for NHL).ConclusionsLow CD4/CD8 ratios and high CD8 counts despite effective cART were associated with increased KS/NHL risks respectively, especially when CD4 ≥ 500/mm3.
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| 4. |
- Gurvits, Leonid I., et al.
(författare)
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THEZA: TeraHertz Exploration and Zooming-in for Astrophysics
- 2021
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Ingår i: Experimental Astronomy. - : Springer Science and Business Media LLC. - 0922-6435 .- 1572-9508. ; 51:3, s. 559-594
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents the ESA Voyage 2050 White Paper for a concept of TeraHertz Exploration and Zooming-in for Astrophysics (THEZA). It addresses the science case and some implementation issues of a space-borne radio interferometric system for ultra-sharp imaging of celestial radio sources at the level of angular resolution down to (sub-) microarcseconds. THEZA focuses at millimetre and sub-millimetre wavelengths (frequencies above similar to 300 GHz), but allows for science operations at longer wavelengths too. The THEZA concept science rationale is focused on the physics of spacetime in the vicinity of supermassive black holes as the leading science driver. The main aim of the concept is to facilitate a major leap by providing researchers with orders of magnitude improvements in the resolution and dynamic range in direct imaging studies of the most exotic objects in the Universe, black holes. The concept will open up a sizeable range of hitherto unreachable parameters of observational astrophysics. It unifies two major lines of development of space-borne radio astronomy of the past decades: Space VLBI (Very Long Base-line Interferometry) and mm- and sub-mm astrophysical studies with "single dish" instruments. It also builds upon the recent success of the Earth-based Event Horizon Telescope (EHT) - the first-ever direct image of a shadow of the super-massive black hole in the centre of the galaxy M87. As an amalgam of these three major areas of modern observational astrophysics, THEZA aims at facilitating a breakthrough in high-resolution high image quality studies in the millimetre and sub-millimetre domain of the electromagnetic spectrum.
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| 5. |
- Senneville, Eric, et al.
(författare)
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Expert Opinion on Dose Regimen and Therapeutic Drug Monitoring for Long-Term Use of Dalbavancin : Expert Review Panel
- 2023
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Ingår i: International Journal of Antimicrobial Agents. - : Elsevier. - 0924-8579 .- 1872-7913. ; 62:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dalbavancin is a lipoglycopeptide with a long elimination half-life, currently licensed for the treatment of acute bacterial skin and skin structure infections (ABSSSI) in adults. Dalbavancin's potential in treating off-label complex gram-positive infections is promising and real-world experience in treating such infections is growing. However, clear guidance on extended dosing regimens is lacking.OBJECTIVES: We aim to provide clear expert opinion based on recent pharmacokinetic literature and expert and real-world experience in infection areas that require >2 weeks of treatment.METHODS: A single face-to-face meeting was held in September 2022 to collate expert opinion and present safety data of dalbavancin use in these clinical indications. A survey was completed by all authors on their individual experience with dalbavancin which highlighted the heterogeneity in the regimens used. RESULTS: After review of the survey data and recent literature, we present expert panel proposals which accommodate different healthcare settings and resource availability, and centre around the length of treatment duration including up to, or exceeding, 6 weeks. To achieve adequate dalbavancin concentrations for up to 6 weeks, 3,000mg of dalbavancin should be given over 4 weeks for the agreed complex infections requiring >2 weeks treatment. Therapeutic drug monitoring (TDM) is advised for longer treatment durations and in case of renal failure. Specific dosing recommendations for other special populations require further investigation.CONCLUSIONS: These proposals based on expert opinion have been defined to encourage best practice with dalbavancin to optimise its administration beyond the current approved licenced dose across different healthcare settings.
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