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  1. AU=de Jong Jelle S. Y.
  2. AU="Wattacheril, Julia"
  3. AU="Wangen, Patrice"
  4. AU="Mayuri Gupta"
  5. AU=Basta Giuseppina
  6. AU="Karppinen, Maarit"
  7. AU="Rounis, Konstantinos"
  8. AU="Perrier, Prunelle"
  9. AU=Chisari Emanuele AU=Chisari Emanuele
  10. AU="Sibiya, Maureen Nokuthula"
  11. AU="Gokce, Emine"
  12. AU="Muth, Christiane"
  13. AU="Cüneyt Orhan Kara"
  14. AU="Arnberg, Fabian"
  15. AU="Rana, Shubham"
  16. AU="Hugen, Cory M"
  17. AU="Andres M. Rubiano"
  18. AU="Nicole Matejka"
  19. AU="Nunes, Pedro M. Sales"
  20. AU="Sánchez-Montero, María Teresa"
  21. AU="Jiexin Zhang"
  22. AU=Mladinic M
  23. AU="Canfarotta, Michael W"
  24. AU="Merani, Shaheed"
  25. AU="Tarver, James E"
  26. AU=Wirestam Lina
  27. AU="Karen Martz"
  28. AU="Yadav, Kanhaiya L."
  29. AU="Girmay, Tigisty"
  30. AU="Hain, Sofia"
  31. AU="de Kler, R C F"
  32. AU="Veness, R."

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  1. Artikel ; Online: A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.

    van Zanten, Steven / de Jong, Jelle S Y / Scheffer, Mike G / Kaal, Evert C A / de Groot, Joris R / de Lange, Frederik J

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2024  Band 26, Heft 1

    Abstract: Aims: We aimed to identify all syncope units (SUs) in the Netherlands and assess the extent to which these SUs fulfil the essential requirements outlined by the consensus statements of the European Heart Rhythm Association and the European Society of ... ...

    Abstract Aims: We aimed to identify all syncope units (SUs) in the Netherlands and assess the extent to which these SUs fulfil the essential requirements outlined by the consensus statements of the European Heart Rhythm Association and the European Society of Cardiology syncope guidelines. For this, we developed the SU-19 score, a novel guideline based validation tool for best practice.
    Methods and results: All outpatient clinics of cardiology, neurology, and internal medicine in the Netherlands were screened for presence of any form of structured specialized syncope care. If present, these were included as SUs and requested to complete a questionnaire regarding syncope care. We assessed all SUs using the SU-19 score regarding structure (3 points), available tests (12 points), and initial evaluation (4 points). Twenty SUs were identified in the Netherlands, both academic (5/20) and non-academic hospitals (15/20), 17/20 reported multidisciplinary involvement during initial evaluation. In 19/20, neurology, cardiology, or both were responsible for the syncope management. Non-physicians were involved performing the head-up tilt test (44%) and initial evaluation (40%). The mean SU-19 score was 18.0 ± 1.1, 45% achieved the maximum score of 19 points. Variations were observed in protocols for active standing test, carotid sinus massage, and head-up tilt test.
    Conclusion: There is a network of 20 SUs in the Netherlands. Forty-five per cent fully met the SU-19 score (mean 18.0 ± 1.1). Slight variety existed in protocols for autonomic function tests. Neurology and cardiology were mostly involved in syncope management. Non-physicians play an important role in syncope care.
    Mesh-Begriff(e) Humans ; Netherlands/epidemiology ; Cross-Sectional Studies ; Syncope/diagnosis ; Syncope/therapy ; Tilt-Table Test ; Cardiology
    Sprache Englisch
    Erscheinungsdatum 2024-01-07
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euae002
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  2. Artikel: Syncope Diagnosis at Referral to a Tertiary Syncope Unit: An in-Depth Analysis of the FAST II.

    de Jong, Jelle S Y / van Zanten, Steven / Thijs, Roland D / van Rossum, Ineke A / Harms, Mark P M / de Groot, Joris R / Sutton, Richard / de Lange, Frederik J

    Journal of clinical medicine

    2023  Band 12, Heft 7

    Abstract: Objective: A substantial number of patients with a transient loss of consciousness (T-LOC) are referred to a tertiary syncope unit without a diagnosis. This study investigates the final diagnoses reached in patients who, on referral, were undiagnosed or ...

    Abstract Objective: A substantial number of patients with a transient loss of consciousness (T-LOC) are referred to a tertiary syncope unit without a diagnosis. This study investigates the final diagnoses reached in patients who, on referral, were undiagnosed or inaccurately diagnosed in secondary care.
    Methods: This study is an in-depth analysis of the recently published Fainting Assessment Study II, a prospective cohort study in a tertiary syncope unit. The diagnosis at the tertiary syncope unit was established after history taking (phase 1), following autonomic function tests (phase 2), and confirming after critical follow-up of 1.5-2 years, with the adjudicated diagnosis (phase 3) by a multidisciplinary committee. Diagnoses suggested by the referring physician were considered the phase 0 diagnosis. We determined the accuracy of the phase 0 diagnosis by comparing this with the phase 3 diagnosis.
    Results: 51% (134/264) of patients had no diagnosis upon referral (phase 0), the remaining 49% (130/264) carried a diagnosis, but 80% (104/130) considered their condition unexplained. Of the patients undiagnosed at referral, three major causes of T-LOC were revealed: reflex syncope (69%), initial orthostatic hypotension (20%) and psychogenic pseudosyncope (13%) (sum > 100% due to cases with multiple causes). Referral diagnoses were either inaccurate or incomplete in 65% of the patients and were mainly altered at tertiary care assessment to reflex syncope, initial orthostatic hypotension or psychogenic pseudosyncope. A diagnosis of cardiac syncope at referral proved wrong in 17/18 patients.
    Conclusions: Syncope patients diagnosed or undiagnosed in primary and secondary care and referred to a syncope unit mostly suffer from reflex syncope, initial orthostatic hypotension or psychogenic pseudosyncope. These causes of T-LOC do not necessarily require ancillary tests, but can be diagnosed by careful history-taking. Besides access to a network of specialized syncope units, simple interventions, such as guideline-based structured evaluation, proper risk-stratification and critical follow-up may reduce diagnostic delay and improve diagnostic accuracy for syncope.
    Sprache Englisch
    Erscheinungsdatum 2023-03-29
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12072562
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Syncope Diagnosis at Referral to a Tertiary Syncope Unit

    Jelle S. Y. de Jong / Steven van Zanten / Roland D. Thijs / Ineke A. van Rossum / Mark P. M. Harms / Joris R. de Groot / Richard Sutton / Frederik J. de Lange

    Journal of Clinical Medicine, Vol 12, Iss 2562, p

    An in-Depth Analysis of the FAST II

    2023  Band 2562

    Abstract: Objective: A substantial number of patients with a transient loss of consciousness (T-LOC) are referred to a tertiary syncope unit without a diagnosis. This study investigates the final diagnoses reached in patients who, on referral, were undiagnosed or ... ...

    Abstract Objective: A substantial number of patients with a transient loss of consciousness (T-LOC) are referred to a tertiary syncope unit without a diagnosis. This study investigates the final diagnoses reached in patients who, on referral, were undiagnosed or inaccurately diagnosed in secondary care. Methods: This study is an in-depth analysis of the recently published Fainting Assessment Study II, a prospective cohort study in a tertiary syncope unit. The diagnosis at the tertiary syncope unit was established after history taking (phase 1), following autonomic function tests (phase 2), and confirming after critical follow-up of 1.5–2 years, with the adjudicated diagnosis (phase 3) by a multidisciplinary committee. Diagnoses suggested by the referring physician were considered the phase 0 diagnosis. We determined the accuracy of the phase 0 diagnosis by comparing this with the phase 3 diagnosis. Results: 51% (134/264) of patients had no diagnosis upon referral (phase 0), the remaining 49% (130/264) carried a diagnosis, but 80% (104/130) considered their condition unexplained. Of the patients undiagnosed at referral, three major causes of T-LOC were revealed: reflex syncope (69%), initial orthostatic hypotension (20%) and psychogenic pseudosyncope (13%) (sum > 100% due to cases with multiple causes). Referral diagnoses were either inaccurate or incomplete in 65% of the patients and were mainly altered at tertiary care assessment to reflex syncope, initial orthostatic hypotension or psychogenic pseudosyncope. A diagnosis of cardiac syncope at referral proved wrong in 17/18 patients. Conclusions: Syncope patients diagnosed or undiagnosed in primary and secondary care and referred to a syncope unit mostly suffer from reflex syncope, initial orthostatic hypotension or psychogenic pseudosyncope. These causes of T-LOC do not necessarily require ancillary tests, but can be diagnosed by careful history-taking. Besides access to a network of specialized syncope units, simple interventions, such as guideline-based structured ...
    Schlagwörter syncope ; guideline implementation ; diagnostic accuracy ; diagnostic yield ; transient loss of consciousness ; Medicine ; R
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2023-03-01T00:00:00Z
    Verlag MDPI AG
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  4. Artikel ; Online: Pacing in vasovagal syncope: Physiology, pacemaker sensors, and recent clinical trials-Precise patient selection and measurable benefit.

    Sutton, Richard / de Jong, Jelle S Y / Stewart, Julian M / Fedorowski, Artur / de Lange, Frederik J

    Heart rhythm

    2020  Band 17, Heft 5 Pt A, Seite(n) 821–828

    Abstract: The role of pacing in vasovagal syncope (VVS) is considered from a physiological basis. Most VVS patients lose consciousness due to hypotension before severe bradycardia/asystole occurs. Patients who benefit from dual-chamber pacing typically are older ... ...

    Abstract The role of pacing in vasovagal syncope (VVS) is considered from a physiological basis. Most VVS patients lose consciousness due to hypotension before severe bradycardia/asystole occurs. Patients who benefit from dual-chamber pacing typically are older with highly symptomatic, late-onset, frequent and severe syncope with short/no prodrome and documented severe cardioinhibition. Tilt testing is of value in patients with recurrent unexplained syncope to identify important hypotensive susceptibility stemming from reduced venous return and stroke volume (SV). A negative tilt test in vasovagal patients with spontaneous asystole documented by an implantable/insertable loop recorder is associated with lower syncope recurrence rates after pacemaker implantation. Pacing may be more effective if triggered by sensor detection of a parameter changing earlier in the reflex than bradycardia when SV may still be relatively preserved. In this regard, detection of right ventricular impedance offers promise. Conservatism is recommended, limiting pacing in VVS to a small subset of symptomatic older patients with clearly documented cardioinhibition and paying particular attention to the timing of loss of consciousness in relation to asystole/bradycardia. Understanding VVS physiology permits application of well-timed, appropriate pacing that yields benefit for highly symptomatic patients.
    Mesh-Begriff(e) Cardiac Pacing, Artificial/methods ; Heart Conduction System/physiopathology ; Heart Rate/physiology ; Humans ; Recurrence ; Syncope, Vasovagal/physiopathology ; Syncope, Vasovagal/therapy ; Tilt-Table Test
    Sprache Englisch
    Erscheinungsdatum 2020-02-06
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2020.01.029
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Pacing in vasovagal syncope: A physiological paradox?

    de Jong, Jelle S Y / Jardine, David L / Lenders, Jacques W M / Wieling, Wouter

    Heart rhythm

    2019  Band 17, Heft 5 Pt A, Seite(n) 813–820

    Abstract: The physiological principles underlying pacemaker treatment in patients with vasovagal syncope have never been reviewed. Current knowledge suggests that pacing the right heart is unlikely to correct blood pressure during a vasovagal reaction. In adults, ... ...

    Abstract The physiological principles underlying pacemaker treatment in patients with vasovagal syncope have never been reviewed. Current knowledge suggests that pacing the right heart is unlikely to correct blood pressure during a vasovagal reaction. In adults, the reason for this is that stroke volume is dictated by central blood volume contained in the cardiopulmonary vessels within the chest (ie, left ventricular preload). Preceding posture-triggered vasovagal syncope, there is a significant fall in central blood volume and therefore in stroke volume and cardiac output long before the onset of bradycardia. This explains why high rate cardiac pacing does not improve cardiac output or blood pressure during presyncope. Contradictory results between physiological theory and trial evidence underlying pacemaker treatment at present cannot be explained. Placebo effects during pacing for vasovagal syncope should be considered. More work is needed to solve the dilemma.
    Mesh-Begriff(e) Blood Pressure/physiology ; Cardiac Output/physiology ; Cardiac Pacing, Artificial/methods ; Heart Rate/physiology ; Humans ; Posture ; Recurrence ; Syncope, Vasovagal/physiopathology ; Syncope, Vasovagal/therapy ; Tilt-Table Test
    Sprache Englisch
    Erscheinungsdatum 2019-09-24
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2019.09.022
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Syncopedia: training a new generation of syncope specialists.

    de Jong, Jelle S Y / de Lange, Frederik J / van Dijk, Nynke / Thijs, Roland D / Wieling, Wouter

    Clinical autonomic research : official journal of the Clinical Autonomic Research Society

    2017  Band 28, Heft 2, Seite(n) 173–176

    Mesh-Begriff(e) Humans ; Internet/trends ; Physicians/trends ; Specialization/trends ; Syncope/diagnosis ; Syncope/physiopathology ; Syncope/therapy ; Syncope, Vasovagal/diagnosis ; Syncope, Vasovagal/physiopathology ; Syncope, Vasovagal/therapy ; Tilt-Table Test/methods ; Tilt-Table Test/trends
    Sprache Englisch
    Erscheinungsdatum 2017-11-14
    Erscheinungsland Germany
    Dokumenttyp Editorial
    ZDB-ID 1080007-4
    ISSN 1619-1560 ; 0959-9851
    ISSN (online) 1619-1560
    ISSN 0959-9851
    DOI 10.1007/s10286-017-0481-z
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Diagnostic yield and accuracy in a tertiary referral syncope unit validating the ESC guideline on syncope: a prospective cohort study.

    de Jong, Jelle S Y / Blok, Minou R Snijders / Thijs, Roland D / Harms, Mark P M / Hemels, Martin E W / de Groot, Joris R / van Dijk, Nynke / de Lange, Frederik J

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2020  Band 23, Heft 5, Seite(n) 797–805

    Abstract: Aims: To assess in patients with transient loss of consciousness the diagnostic yield, accuracy, and safety of the structured approach as described in the ESC guidelines in a tertiary referral syncope unit.: Methods and results: Prospective cohort ... ...

    Abstract Aims: To assess in patients with transient loss of consciousness the diagnostic yield, accuracy, and safety of the structured approach as described in the ESC guidelines in a tertiary referral syncope unit.
    Methods and results: Prospective cohort study including 264 consecutive patients (≥18 years) referred with at least one self-reported episode of transient loss of consciousness and presenting to the syncope unit between October 2012 and February 2015. The study consisted of three phases: history taking (Phase 1), autonomic function tests (AFTs) (Phase 2), and after 1.5-year follow-up with assessment by a multidisciplinary committee (Phase 3). Diagnostic yield was assessed after Phases 1 and 2. Empirical diagnostic accuracy was measured for diagnoses according to the ESC guidelines after Phase 3. The diagnostic yield after Phase 1 (history taking) was 94.7% (95% CI: 91.1-97.0%, 250/264 patients) and increased to 97.0% (93.9-98.6%, 256/264 patients) after Phase 2. The overall diagnostic accuracy (as established in Phase 3) of the Phases 1 and 2 diagnoses was 90.6% (95% CI: 86.2-93.8%, 232/256 patients). No life-threatening conditions were missed. Three patients died, two unrelated to the cause of transient loss of consciousness, and one whom remained undiagnosed.
    Conclusion: A clinical work-up at a tertiary syncope unit using the ESC guidelines has a high diagnostic yield, accuracy, and safety. History taking (Phase 1) is the most important diagnostic tool. Autonomic function tests never changed the Phase 1 diagnosis but helped to increase the certainty of the Phase 1 diagnosis in many patients and yield additional diagnoses in patients who remained undiagnosed after Phase 1. Diagnoses were inaccurate in 9.4%, but no serious conditions were missed. This is adequate for clinical practice.
    Mesh-Begriff(e) Emergency Service, Hospital ; Humans ; Prospective Studies ; Referral and Consultation ; Syncope/diagnosis
    Sprache Englisch
    Erscheinungsdatum 2020-11-18
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euaa345
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Serologic Surveillance and Phylogenetic Analysis of SARS-CoV-2 Infection Among Hospital Health Care Workers.

    Sikkens, Jonne J / Buis, David T P / Peters, Edgar J G / Dekker, Mireille / Schinkel, Michiel / Reijnders, Tom D Y / Schuurman, Alex R / de Brabander, Justin / Lavell, A H Ayesha / Maas, Jaap J / Koopsen, Jelle / Han, Alvin X / Russell, Colin A / Schinkel, Janke / Jonges, Marcel / Matamoros, Sébastien / Jurriaans, Suzanne / van Mansfeld, Rosa / Wiersinga, W Joost /
    Smulders, Yvo M / de Jong, Menno D / Bomers, Marije K

    JAMA network open

    2021  Band 4, Heft 7, Seite(n) e2118554

    Abstract: Importance: It is unclear when, where, and by whom health care workers (HCWs) working in hospitals are infected with SARS-CoV-2.: Objective: To determine how often and in what manner nosocomial SARS-CoV-2 infection occurs in HCW groups with varying ... ...

    Abstract Importance: It is unclear when, where, and by whom health care workers (HCWs) working in hospitals are infected with SARS-CoV-2.
    Objective: To determine how often and in what manner nosocomial SARS-CoV-2 infection occurs in HCW groups with varying exposure to patients with COVID-19.
    Design, setting, and participants: This cohort study comprised 4 weekly measurements of SARS-CoV-2-specific antibodies and collection of questionnaires from March 23 to June 25, 2020, combined with phylogenetic and epidemiologic transmission analyses at 2 university hospitals in the Netherlands. Included individuals were HCWs working in patient care for those with COVID-19, HCWs working in patient care for those without COVID-19, and HCWs not working in patient care. Data were analyzed from August through December 2020.
    Exposures: Varying work-related exposure to patients infected with SARS-CoV-2.
    Main outcomes and measures: The cumulative incidence of and time to SARS-CoV-2 infection, defined as the presence of SARS-CoV-2-specific antibodies in blood samples, were measured.
    Results: Among 801 HCWs, there were 439 HCWs working in patient care for those with COVID-19, 164 HCWs working in patient care for those without COVID-19, and 198 HCWs not working in patient care. There were 580 (72.4%) women, and the median (interquartile range) age was 36 (29-50) years. The incidence of SARS-CoV-2 was increased among HCWs working in patient care for those with COVID-19 (54 HCWs [13.2%; 95% CI, 9.9%-16.4%]) compared with HCWs working in patient care for those without COVID-19 (11 HCWs [6.7%; 95% CI, 2.8%-10.5%]; hazard ratio [HR], 2.25; 95% CI, 1.17-4.30) and HCWs not working in patient care (7 HCWs [3.6%; 95% CI, 0.9%-6.1%]; HR, 3.92; 95% CI, 1.79-8.62). Among HCWs caring for patients with COVID-19, SARS-CoV-2 cumulative incidence was increased among HCWs working on COVID-19 wards (32 of 134 HCWs [25.7%; 95% CI, 17.6%-33.1%]) compared with HCWs working on intensive care units (13 of 186 HCWs [7.1%; 95% CI, 3.3%-10.7%]; HR, 3.64; 95% CI, 1.91-6.94), and HCWs working in emergency departments (7 of 102 HCWs [8.0%; 95% CI, 2.5%-13.1%]; HR, 3.29; 95% CI, 1.52-7.14). Epidemiologic data combined with phylogenetic analyses on COVID-19 wards identified 3 potential HCW-to-HCW transmission clusters. No patient-to-HCW transmission clusters could be identified in transmission analyses.
    Conclusions and relevance: This study found that HCWs working on COVID-19 wards were at increased risk for nosocomial SARS-CoV-2 infection with an important role for HCW-to-HCW transmission. These findings suggest that infection among HCWs deserves more consideration in infection prevention practice.
    Mesh-Begriff(e) Adult ; Antibodies, Viral/blood ; COVID-19/blood ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/genetics ; COVID-19 Serological Testing ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Personnel, Hospital ; Phylogeny ; Population Surveillance ; SARS-CoV-2/immunology
    Chemische Substanzen Antibodies, Viral
    Sprache Englisch
    Erscheinungsdatum 2021-07-01
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2021.18554
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: Serologic Surveillance and Phylogenetic Analysis of SARS-CoV-2 Infection in Hospital Health Care Workers

    Sikkens, Jonne J / Buis, David T.P. / Peters, Edgar J.G. / Dekker, Mireille / Schinkel, Michiel / Reijnders, Tom D.Y. / Schuurman, Alex R. / de Brabander, Justin / Lavell, Ayesha / Maas, Jaap J / Koopsen, Jelle / Han, Alvin X / Russell, Colin A. / Schinkel, Janke / Jonges, Marcel / Matamoros, Sebastien P.F. / Jurriaans, Suzanne / van Mansfeld, Rosa / Wiersinga, W. Joost /
    Smulders, Yvo M / de Jong, Menno D. / Bomers, Marije K

    medRxiv

    Abstract: BACKGROUND It is unclear how, when and where health care workers (HCW) working in hospitals are infected with SARS-CoV-2. METHODS Prospective cohort study comprising 4-weekly measurement of SARS-CoV-2 specific antibodies and questionnaires from March to ... ...

    Abstract BACKGROUND It is unclear how, when and where health care workers (HCW) working in hospitals are infected with SARS-CoV-2. METHODS Prospective cohort study comprising 4-weekly measurement of SARS-CoV-2 specific antibodies and questionnaires from March to June 2020. We compared SARS-CoV-2 incidence between HCW working in Covid-19 patient care, HCW working in non-Covid-19 patient care and HCW not in patient care. Phylogenetic analyses of SARS-CoV-2 samples from patients and HCW were performed to identify potential transmission clusters. RESULTS We included 801 HCW: 439 in the Covid-19 patient care group, 164 in the non-Covid-19 patient care group and 198 in the no patient care group. SARS-CoV-2 incidence was highest in HCW working in Covid-19 patient care (13.2%), as compared with HCW in non-Covid-19 patient care (6.7%, hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.2 to 4.3) and in HCW not working in patient care (3.6%, HR 3.9, 95% CI 1.8 to 8.6). Within the group of HCW caring for Covid-19 patients, SARS-CoV-2 cumulative incidence was highest in HCW working on Covid-19 wards (25.7%), as compared with HCW working on intensive care units (7.1%, HR 3.6, 95% CI 1.9 to 6.9), and HCW working in the emergency room (8.0%, HR 3.3, 95% CI 1.5 to 7.1). Phylogenetic analyses on Covid-19 wards identified multiple potential HCW-to-HCW transmission clusters while no patient-to-HCW transmission clusters were identified. CONCLUSIONS HCW working on Covid-19 wards are at increased risk for nosocomial SARS-CoV-2 infection, with an important role for HCW-to-HCW transmission.
    Schlagwörter covid19
    Sprache Englisch
    Erscheinungsdatum 2021-01-12
    Verlag Cold Spring Harbor Laboratory Press
    Dokumenttyp Artikel ; Online
    DOI 10.1101/2021.01.10.21249440
    Datenquelle COVID19

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  10. Artikel ; Online: Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Young, Node-Negative, Triple-Negative Breast Cancer Patients Who Did Not Receive (neo)Adjuvant Systemic Therapy.

    de Jong, Vincent M T / Wang, Yuwei / Ter Hoeve, Natalie D / Opdam, Mark / Stathonikos, Nikolas / Jóźwiak, Katarzyna / Hauptmann, Michael / Cornelissen, Sten / Vreuls, Willem / Rosenberg, Efraim H / Koop, Esther A / Varga, Zsuzsanna / van Deurzen, Carolien H M / Mooyaart, Antien L / Córdoba, Alicia / Groen, Emma J / Bart, Joost / Willems, Stefan M / Zolota, Vasiliki /
    Wesseling, Jelle / Sapino, Anna / Chmielik, Ewa / Ryska, Ales / Broeks, Annegien / Voogd, Adri C / Loi, Sherene / Michiels, Stefan / Sonke, Gabe S / van der Wall, Elsken / Siesling, Sabine / van Diest, Paul J / Schmidt, Marjanka K / Kok, Marleen / Dackus, Gwen M H E / Salgado, Roberto / Linn, Sabine C

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2022  Band 40, Heft 21, Seite(n) 2361–2374

    Abstract: ... thus can be used for chemotherapy de-escalation strategies, is unknown.: Methods: We selected all patients ... clinical trials investigating (neo)adjuvant chemotherapy de-escalation strategies. ...

    Abstract Purpose: Triple-negative breast cancer (TNBC) is considered aggressive, and therefore, virtually all young patients with TNBC receive (neo)adjuvant chemotherapy. Increased stromal tumor-infiltrating lymphocytes (sTILs) have been associated with a favorable prognosis in TNBC. However, whether this association holds for patients who are node-negative (N0), young (< 40 years), and chemotherapy-naïve, and thus can be used for chemotherapy de-escalation strategies, is unknown.
    Methods: We selected all patients with N0 TNBC diagnosed between 1989 and 2000 from a Dutch population-based registry. Patients were age < 40 years at diagnosis and had not received (neo)adjuvant systemic therapy, as was standard practice at the time. Formalin-fixed paraffin-embedded blocks were retrieved (PALGA: Dutch Pathology Registry), and a pathology review including sTILs was performed. Patients were categorized according to sTILs (< 30%, 30%-75%, and ≥ 75%). Multivariable Cox regression was performed for overall survival, with or without sTILs as a covariate. Cumulative incidence of distant metastasis or death was analyzed in a competing risk model, with second primary tumors as competing risk.
    Results: sTILs were scored for 441 patients. High sTILs (≥ 75%; 21%) translated into an excellent prognosis with a 15-year cumulative incidence of a distant metastasis or death of only 2.1% (95% CI, 0 to 5.0), whereas low sTILs (< 30%; 52%) had an unfavorable prognosis with a 15-year cumulative incidence of a distant metastasis or death of 38.4% (32.1 to 44.6). In addition, every 10% increment of sTILs decreased the risk of death by 19% (adjusted hazard ratio: 0.81; 95% CI, 0.76 to 0.87), which are an independent predictor adding prognostic information to standard clinicopathologic variables (χ
    Conclusion: Chemotherapy-naïve, young patients with N0 TNBC with high sTILs (≥ 75%) have an excellent long-term prognosis. Therefore, sTILs should be considered for prospective clinical trials investigating (neo)adjuvant chemotherapy de-escalation strategies.
    Mesh-Begriff(e) Adult ; Biomarkers, Tumor ; Chemotherapy, Adjuvant ; Humans ; Lymphocytes, Tumor-Infiltrating ; Neoadjuvant Therapy ; Prognosis ; Prospective Studies ; Triple Negative Breast Neoplasms/drug therapy
    Chemische Substanzen Biomarkers, Tumor
    Sprache Englisch
    Erscheinungsdatum 2022-03-30
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.21.01536
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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