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Article ; Online: Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals.

Genet, Sylvia A A M / Visser, Esther / Youssef-El Soud, Maggy / Belderbos, Huub N A / Stege, Gerben / de Saegher, Marleen E A / Westeinde, Susan C van 't / Brunsveld, Luc / Broeren, Maarten A C / van de Kerkhof, Daan / Eduati, Federica / van den Borne, Ben E E M / Scharnhorst, Volkher

Lung cancer (Amsterdam, Netherlands)

2024 Volume 189, Page(s) 107477

Abstract: Objectives: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, ... ...

Abstract	Objectives: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed. Materials and methods: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis. Results: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures. Conclusion: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.
MeSH term(s)	Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/therapy ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Non-Small-Cell Lung/therapy ; Artificial Intelligence ; Prospective Studies ; Hospitals ; Carcinoma, Neuroendocrine ; Lung
Language	English
Publishing date	2024-01-22
Publishing country	Ireland
Document type	Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632771-0
ISSN	1872-8332 ; 0169-5002
ISSN (online)	1872-8332
ISSN	0169-5002
DOI	10.1016/j.lungcan.2024.107477
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Zs.A 2135: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Up-front mutation detection in circulating tumor DNA by droplet digital PCR has added diagnostic value in lung cancer.

Visser, Esther / de Kock, Remco / Genet, Sylvia / Borne, Ben van den / Soud, Maggy Youssef-El / Belderbos, Huub / Stege, Gerben / de Saegher, Marleen / 't Westeinde, Susan van / Broeren, Maarten / Eduati, Federica / Deiman, Birgit / Scharnhorst, Volkher

Translational oncology

2022 Volume 27, Page(s) 101589

Abstract: Identification of actionable mutations in advanced stage non-squamous non-small-cell lung cancer (NSCLC) patients is recommended by guidelines as it enables treatment with targeted therapies. In current practice, mutations are identified by next- ... ...

Abstract	Identification of actionable mutations in advanced stage non-squamous non-small-cell lung cancer (NSCLC) patients is recommended by guidelines as it enables treatment with targeted therapies. In current practice, mutations are identified by next-generation sequencing of tumor DNA (tDNA-NGS), which requires tissue biopsies of sufficient quality. Alternatively, circulating tumor DNA (ctDNA) could be used for mutation analysis. This prospective, multicenter study establishes the diagnostic value of ctDNA analysis by droplet digital PCR (ctDNA-ddPCR) in patients with primary lung cancer. CtDNA from 458 primary lung cancer patients was analyzed using a panel of multiplex ddPCRs for EGFR (Ex19Del, G719S, L858R, L861Q and S768I), KRAS G12/G13 and BRAF V600 mutations. For 142 of 175 advanced stage non-squamous NSCLC patients tDNA-NGS results were available to compare to ctDNA-ddPCR. tDNA-NGS identified 98 mutations, of which ctDNA-ddPCR found 53 mutations (54%), including 32 of 45 (71%) targetable driver mutations. In 2 of these 142 patients, a mutation was found by ctDNA-ddPCR only. In 33 advanced stage patients lacking tDNA-NGS results, ctDNA-ddPCR detected 15 additional mutations, of which 7 targetable. Overall, ctDNA-ddPCR detected 70 mutations and tDNA-NGS 98 mutations in 175 advanced NSCLC patients. Using an up-front ctDNA-ddPCR strategy, followed by tDNA-NGS only if ctDNA-ddPCR analysis is negative, increases the number of mutations found from 98 to 115 (17%). At the same time, up-front ctDNA-ddPCR reduces tDNA-NGS analyses by 40%, decreasing the need to perform (additional) biopsies.
Language	English
Publishing date	2022-11-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2443840-6
ISSN	1936-5233
ISSN	1936-5233
DOI	10.1016/j.tranon.2022.101589
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Article ; Online: Liquid biopsy-based decision support algorithms for diagnosis and subtyping of lung cancer.

Visser, Esther / Genet, Sylvia A A M / de Kock, Remco P P A / van den Borne, Ben E E M / Youssef-El Soud, Maggy / Belderbos, Huub N A / Stege, Gerben / de Saegher, Marleen E A / van 't Westeinde, Susan C / Brunsveld, Luc / Broeren, Maarten A C / van de Kerkhof, Daan / Deiman, Birgit A L M / Eduati, Federica / Scharnhorst, Volkher

Lung cancer (Amsterdam, Netherlands)

2023 Volume 178, Page(s) 28–36

Abstract: Objectives: Pathologic subtyping of tissue biopsies is the gold standard for the diagnosis of lung cancer (LC), which could be complicated in cases of e.g. inconclusive tissue biopsies or unreachable tumors. The diagnosis of LC could be supported in a ... ...

Abstract	Objectives: Pathologic subtyping of tissue biopsies is the gold standard for the diagnosis of lung cancer (LC), which could be complicated in cases of e.g. inconclusive tissue biopsies or unreachable tumors. The diagnosis of LC could be supported in a minimally invasive manner using protein tumor markers (TMs) and circulating tumor DNA (ctDNA) measured in liquid biopsies (LBx). This study evaluates the performance of LBx-based decision-support algorithms for the diagnosis of LC and subtyping into small- and non-small-cell lung cancer (SCLC and NSCLC) aiming to directly impact clinical practice. Materials and methods: In this multicenter prospective study (NL9146), eight protein TMs (CA125, CA15.3, CEA, CYFRA 21-1, HE4, NSE, proGRP and SCCA) and ctDNA mutations in EGFR, KRAS and BRAF were analyzed in blood of 1096 patients suspected of LC. The performance of individual and combined TMs to identify LC, NSCLC or SCLC was established by evaluating logistic regression models at pre-specified positive predictive values (PPV) of ≥95% or ≥98%. The most informative protein TMs included in the multi-parametric models were selected by recursive feature elimination. Results: Single TMs could identify LC, NSCLC and SCLC patients with 46%, 25% and 40% sensitivity, respectively, at pre-specified PPVs. Multi-parametric models combining TMs and ctDNA significantly improved sensitivities to 65%, 67% and 50%, respectively. Conclusion: In patients suspected of LC, the LBx-based decision-support algorithms allowed identification of about two-thirds of all LC and NSCLC patients and half of SCLC patients. These models therefore show clinical value and may support LC diagnostics, especially in patients for whom pathologic subtyping is impossible or incomplete.
MeSH term(s)	Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/genetics ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Non-Small-Cell Lung/genetics ; Carcinoma, Non-Small-Cell Lung/pathology ; Prospective Studies ; Biomarkers, Tumor ; Phosphopyruvate Hydratase ; Liquid Biopsy
Chemical Substances	antigen CYFRA21.1 ; Biomarkers, Tumor ; Phosphopyruvate Hydratase (EC 4.2.1.11)
Language	English
Publishing date	2023-02-01
Publishing country	Ireland
Document type	Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632771-0
ISSN	1872-8332 ; 0169-5002
ISSN (online)	1872-8332
ISSN	0169-5002
DOI	10.1016/j.lungcan.2023.01.014
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Zs.A 2135: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Circulating biomarkers for monitoring therapy response and detection of disease progression in lung cancer patients.

de Kock, Remco / Borne, Ben van den / Soud, Maggy Youssef-El / Belderbos, Huub / Stege, Gerben / de Saegher, Marleen / van Dongen-Schrover, Claartje / Genet, Sylvia / Brunsveld, Luc / Scharnhorst, Volkher / Deiman, Birgit

Cancer treatment and research communications

2021 Volume 28, Page(s) 100410

Abstract: Liquid biopsies have become of interest as minimally invasive ways to monitor treatment response in lung cancer patients. Circulating tumor DNA (ctDNA) and protein biomarkers are evaluated for their added value in monitoring therapy response and early ... ...

Abstract	Liquid biopsies have become of interest as minimally invasive ways to monitor treatment response in lung cancer patients. Circulating tumor DNA (ctDNA) and protein biomarkers are evaluated for their added value in monitoring therapy response and early detection of disease progression. Plasma and serum samples of non-small cell or small cell lung cancer patients were analyzed for driver mutations in ctDNA (EGFR, KRAS or BRAF) using droplet digital PCR and protein biomarkers (CA125, CEA, CA15.3, Cyfra 21-1, HE4, NSE, proGRP and SCCA) using electrochemiluminescence immunoassays. Biomarker concentration changes were compared with the outcome of CT-scans during therapy. The median difference of the concentration of ctDNA, CA125 and Cyfra21-1 was significantly lower in patients with partial response (PR) compared to patients with progressive disease (PD) on the first evaluation CT-scan (P<0.001, P=0.042 and P=0.020, respectively). A substantial agreement between ctDNA or CA125 response and radiographic response was observed (k=0.692 and k=0.792, respectively). The median difference of the concentration of ctDNA and Cyfra21-1 was also significantly lower in PR patients compared to PD patients at the last CT-scan during therapy (P<0.001 and P=0.026, respectively). An almost perfect agreement between ctDNA and radiographic response (k=0.827) and a moderate agreement between Cyfra21-1 response and radiographic response was observed (k=0.553). Serial testing of the concentration of ctDNA, Cyfra21-1, and possibly CA125 could be a useful added tool for monitoring therapy response and early detection of disease progression in lung cancer patients.
MeSH term(s)	Aged ; Biomarkers, Tumor/metabolism ; Disease Progression ; Female ; Humans ; Liquid Biopsy/methods ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Prospective Studies
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2021-06-01
Publishing country	England
Document type	Journal Article ; Multicenter Study
ISSN	2468-2942
ISSN (online)	2468-2942
DOI	10.1016/j.ctarc.2021.100410
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Article ; Online: Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice.

van den Bemt, Lisette / van den Nieuwenhof, Lotte / Rutjes, Anne / van der Meer, Victor / Stege, Gerben / Wensing, Michel / Teichert, Martina / Schermer, Tjard

NPJ primary care respiratory medicine

2020 Volume 30, Issue 1, Page(s) 43

Abstract: The therapeutic value of inhaled corticosteroids (ICSs) for COPD is limited. In published RCTs, ICS could be withdrawn in COPD patients without increasing exacerbation risk when bronchodilator treatment is optimized. Here we report on the feasibility and ...

Abstract	The therapeutic value of inhaled corticosteroids (ICSs) for COPD is limited. In published RCTs, ICS could be withdrawn in COPD patients without increasing exacerbation risk when bronchodilator treatment is optimized. Here we report on the feasibility and risks of ICS withdrawal in Dutch general practice for COPD patients without an indication for ICSs. In our pragmatic trial, general practitioners decided autonomously which of their COPD patients on ICS treatment could stop this, how this was done, and whether additional bronchodilator therapy was needed. We recruited 62 COPD patients (58 analysed) who were eligible for ICS withdrawal in 79 practices. In 32 patients (55.2%, 95% CI: 42.5-67.3%) ICS was withdrawn successfully, 19 (32.8%, 95% CI: 22.1-45.6%) restarted ICS treatment within six months, 12 patients (20.7%, 95% CI: 12.3-32.8%) had a moderate exacerbation, and one patient had a severe exacerbation. ICS withdrawal was successful in just over half of the patients with COPD without an indication for ICS.
MeSH term(s)	Administration, Inhalation ; Adrenal Cortex Hormones/administration & dosage ; Adrenal Cortex Hormones/therapeutic use ; Aged ; Bronchodilator Agents/administration & dosage ; Bronchodilator Agents/adverse effects ; Bronchodilator Agents/therapeutic use ; Dyspnea/epidemiology ; Dyspnea/etiology ; Female ; Health Status ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Quality of Life ; Withholding Treatment
Chemical Substances	Adrenal Cortex Hormones ; Bronchodilator Agents
Language	English
Publishing date	2020-10-09
Publishing country	England
Document type	Journal Article ; Pragmatic Clinical Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2780812-9
ISSN	2055-1010 ; 2055-1010
ISSN (online)	2055-1010
ISSN	2055-1010
DOI	10.1038/s41533-020-00198-5
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Article ; Online: Correction of the NSE concentration in hemolyzed serum samples improves its diagnostic accuracy in small-cell lung cancer.

Genet, Sylvia A A M / Visser, Esther / van den Borne, Ben E E M / Soud, Maggy Youssef-El / Belderbos, Huub N A / Stege, Gerben / de Saegher, Marleen E A / Eduati, Federica / Broeren, Maarten A C / van Dongen, Joost / Brunsveld, Luc / van de Kerkhof, Daan / Scharnhorst, Volkher

Oncotarget

2020 Volume 11, Issue 27, Page(s) 2660–2668

Abstract: Neuron-specific enolase (NSE) is a well-known biomarker for the diagnosis, prognosis and treatment monitoring of small-cell lung cancer (SCLC). Nevertheless, its clinical applicability is limited since serum NSE levels are influenced by hemolysis, ... ...

Abstract	Neuron-specific enolase (NSE) is a well-known biomarker for the diagnosis, prognosis and treatment monitoring of small-cell lung cancer (SCLC). Nevertheless, its clinical applicability is limited since serum NSE levels are influenced by hemolysis, leading to falsely elevated results. Therefore, this study aimed to develop a hemolysis correction equation and evaluate its role in SCLC diagnostics. Two serum pools were spiked with increasing amounts of hemolysate obtained from multiple individuals. A hemolysis correction equation was obtained by analyzing the relationship between the measured NSE concentration and the degree of hemolysis. The equation was validated using intentionally hemolyzed serum samples, which showed that the correction was accurate for samples with an H-index up to 30 μmol/L. Correction of the measured NSE concentration in patients suspected of lung cancer caused an increase in AUC and a significantly lower cut-off value for SCLC detection when compared to uncorrected results. Therefore, a hemolysis correction equation should be used to correct falsely elevated NSE concentrations. Results of samples with an H-index above 30 μmol/L should not be reported to clinicians. Application of the equation illustrates the importance of hemolysis correction in SCLC diagnostics and questions the correctness of the currently used diagnostic cut-off value.
Language	English
Publishing date	2020-07-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2560162-3
ISSN	1949-2553 ; 1949-2553
ISSN (online)	1949-2553
ISSN	1949-2553
DOI	10.18632/oncotarget.27664
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Article ; Online: Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia.

Stege, Gerben / Fenton, Alan / Jaffray, Bruce

Pediatrics

2003 Volume 112, Issue 3 Pt 1, Page(s) 532–535

Abstract: Objective: Reported survival in congenital diaphragmatic hernia (CDH) fails to allow for case selection bias. This study reports the incidence of CDH in a geographically defined population over 11 years and assesses the effect of new therapies (high- ... ...

Abstract	Objective: Reported survival in congenital diaphragmatic hernia (CDH) fails to allow for case selection bias. This study reports the incidence of CDH in a geographically defined population over 11 years and assesses the effect of new therapies (high-frequency oscillatory ventilation, extracorporeal membrane oxygenation, inhaled nitric oxide, and delayed surgery) on survival when case selection is avoided. Methods: A retrospective review of cases from a regional case registry, the Northern Region Congenital Anomaly Survey, was conducted. Results: A total of 185 cases were identified. Mortality was 62% and did not vary significantly during the study period. Mortality was unaffected by the introduction of new therapies. There was a significant inverse correlation between the rate of elective termination and survival of live borns. The presence of an additional anomaly increased mortality to 79%. Conclusions: The mortality of CDH when complete case ascertainment is achieved is unaffected by new therapies. The survival rate is principally determined by the rate of antenatal termination and the incidence of associated anomalies. Reports of improved survival of CDH should be interpreted with caution, as variations in outcome are more likely to be explained by case selection artifact.
MeSH term(s)	Abnormalities, Multiple/diagnosis ; Abnormalities, Multiple/epidemiology ; Abnormalities, Multiple/mortality ; Abnormalities, Multiple/therapy ; Cohort Studies ; Fetal Death/epidemiology ; Hernia, Diaphragmatic/epidemiology ; Hernia, Diaphragmatic/mortality ; Hernia, Diaphragmatic/therapy ; Hernias, Diaphragmatic, Congenital ; Humans ; Incidence ; Infant Mortality/trends ; Infant, Newborn ; Infant, Newborn, Diseases/diagnosis ; Infant, Newborn, Diseases/epidemiology ; Infant, Newborn, Diseases/mortality ; Infant, Newborn, Diseases/therapy ; Neonatal Screening/methods ; Neonatal Screening/trends ; Prenatal Diagnosis/statistics & numerical data ; Prenatal Diagnosis/trends ; Retrospective Studies ; Survival Analysis ; Survival Rate
Language	English
Publishing date	2003-07-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.112.3.532
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Um IV Zs.131: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 357: Show issues

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Article ; Online: Manual vs. automated analysis of polysomnographic recordings in patients with chronic obstructive pulmonary disease.

Stege, Gerben / Vos, Petra J E / Dekhuijzen, P N Richard / Hilkens, Pieter H E / van de Ven, Marjo J T / Heijdra, Yvonne F / van den Elshout, Frank J J

Sleep & breathing = Schlaf & Atmung

2012 Volume 17, Issue 2, Page(s) 533–539

Abstract: Purpose: The sleep quality, as assessed by polysomnography (PSG), of patients with chronic obstructive pulmonary disease (COPD) can be severely disturbed. The manual analysis of PSGs is time-consuming, and computer systems have been developed to ... ...

Abstract	Purpose: The sleep quality, as assessed by polysomnography (PSG), of patients with chronic obstructive pulmonary disease (COPD) can be severely disturbed. The manual analysis of PSGs is time-consuming, and computer systems have been developed to automatically analyze PSGs. Studies on the reliability of automated analyses in healthy subjects show varying results, and the purpose of this study was to assess whether automated analysis of PSG by one certain automatic system in patients with COPD provide accurate outcomes when compared to manual analysis. Methods: In a retrospective study, the full-night polysomnographic recordings of patients with and without COPD were analyzed automatically by Matrix Sleep Analysis software and manually. The outcomes of manual and automated analyses in both groups were compared using Bland-Altman plots and Students' paired t tests. Results: Fifty PSGs from patients with COPD and 57 PSGs from patients without COPD were included. In both study groups, agreement between manual and automated analysis was poor in nearly all sleep and respiratory parameters, like total sleep time, sleep efficiency, sleep latency, amount of rapid eye movement sleep and other sleep stages, number of arousals, apnea-hypopnea index, and desaturation index. Conclusion: Automated analysis of PSGs by the studied automated system in patients with COPD has poor agreement with manual analysis when looking at sleep and respiratory parameters and should, therefore, not replace the manual analysis of PSG recordings in patients with COPD.
MeSH term(s)	Aged ; Arousal/physiology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography/methods ; Predictive Value of Tests ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Retrospective Studies ; Signal Processing, Computer-Assisted ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/physiopathology
Language	English
Publishing date	2012-05-10
Publishing country	Germany
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1500381-4
ISSN	1522-1709 ; 1520-9512
ISSN (online)	1522-1709
ISSN	1520-9512
DOI	10.1007/s11325-012-0714-2
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Article ; Online: Temazepam 10mg does not affect breathing and gas exchange in patients with severe normocapnic COPD.

Stege, Gerben / Heijdra, Yvonne F / van den Elshout, Frank J J / van de Ven, Marjo J T / de Bruijn, Peter J / van Sorge, Adriaan A / Dekhuijzen, P N Richard / Vos, Petra J E

Respiratory medicine

2010 Volume 104, Issue 4, Page(s) 518–524

Abstract: Background: Benzodiazepines can improve sleep quality, but are also thought to cause respiratory depression in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to assess the effects of temazepam on indices of ... ...

Abstract	Background: Benzodiazepines can improve sleep quality, but are also thought to cause respiratory depression in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to assess the effects of temazepam on indices of circadian respiratory function, dyspnea, sleep quality, and sleepiness in patients with severe COPD and insomnia. Methods: In a double-blind, randomized, placebo-controlled, cross-over study in 14 stable patients with COPD (mean FEV(1) 0.99+/-0.3L) with insomnia, polysomnography with continuous transcutaneous capnography and oximetry, arterial gas sampling, hypercapnic ventilatory response, multiple sleep latency test, Epworth Sleepiness Scale, dyspnea and sleep visual analogue scales (VAS) were performed at baseline, after one week of temazepam 10mg at bedtime and after one week of placebo. Results: Temazepam did not cause statistically significant changes in mean transcutaneous carbon dioxide tension during sleep compared to placebo (5.9+/-1.0 kPa vs. 6.3+/-1.4 kPa, p-value 0.27), nor in mean oxygen saturation (92+/-3% vs. 92+/-2%, p-value 0.31), nor in any of the other investigated variables, except for the total sleep time and sleep latency VAS, which improved with temazepam. Conclusions: One week usage of temazepam 10mg does not influence circadian respiratory function, dyspnea, and sleepiness in patients with stable, severe, normocapnic COPD and insomnia and it improves total sleep time and subjective sleep latency. However, this is a preliminary explorative study for assessing the feasibility to perform a larger study on this topic. The clinical implications of this study are very limited.
MeSH term(s)	Cross-Over Studies ; Double-Blind Method ; Dyspnea/drug therapy ; Female ; Humans ; Hypercapnia/drug therapy ; Hypercapnia/physiopathology ; Hypnotics and Sedatives/therapeutic use ; Male ; Middle Aged ; Netherlands ; Oximetry ; Polysomnography ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Gas Exchange/drug effects ; Pulmonary Gas Exchange/physiology ; Sleep Apnea Syndromes/drug therapy ; Sleep Apnea Syndromes/physiopathology ; Temazepam/therapeutic use ; Treatment Outcome
Chemical Substances	Hypnotics and Sedatives ; Temazepam (CHB1QD2QSS)
Language	English
Publishing date	2010-04
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2009.10.022
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Article ; Online: Accuracy of transcutaneous carbon dioxide tension measurements during cardiopulmonary exercise testing.

Stege, Gerben / van den Elshout, Frank J J / Heijdra, Yvonne F / van de Ven, Marjo J T / Dekhuijzen, P N Richard / Vos, Petra J E

Respiration; international review of thoracic diseases

2009 Volume 78, Issue 2, Page(s) 147–153

Abstract: Background: Measurements of transcutaneous carbon dioxide tension (PtcCO(2)) with current devices are proven to provide clinically acceptable agreement with measurements of partial arterial carbon dioxide tension (PaCO(2)) in several settings but not ... ...

Abstract	Background: Measurements of transcutaneous carbon dioxide tension (PtcCO(2)) with current devices are proven to provide clinically acceptable agreement with measurements of partial arterial carbon dioxide tension (PaCO(2)) in several settings but not during cardiopulmonary exercise testing (CPET). Objectives: The primary objective of this study was to investigate the agreement between PaCO(2) and PtcCO(2) measurements (using a Tosca 500 with a Tosca sensor 92) during CPET. A secondary objective was to investigate the agreement between arterial and transcutaneous oxygen saturation (SaO(2), SpO(2)) as measured with this sensor during CPET. Methods: In patients with various pulmonary diseases, PtcCO(2) and SpO(2) were continuously measured and compared with arterial blood gas samples during CPET. A maximum bias of 0.5 kPa and 95% limits of agreement (LOA) of 1 kPa between carbon dioxide pressure (PCO(2)) measurements were determined as clinically acceptable. Results: In total 101 'paired' arterial and transcutaneous measurements were obtained from 21 patients. Bias between PaCO(2) and PtcCO(2) was -0.03 kPa with LOA from -0.78 to 0.71 kPa. Bias between SaO(2) and SpO(2) was -1.0% with LOA from -2.83 to 0.83%. Conclusions: Transcutaneous estimations of PCO(2) and SpO(2) are accurate and can be used in CPET, circumvening the need for arterial cannulation.
MeSH term(s)	Aged ; Blood Gas Monitoring, Transcutaneous ; Electrocardiography ; Exercise Test ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Prospective Studies
Language	English
Publishing date	2009
Publishing country	Switzerland
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	206674-9
ISSN	1423-0356 ; 0025-7931
ISSN (online)	1423-0356
ISSN	0025-7931
DOI	10.1159/000187631
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