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Article ; Online: Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure.

Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

The British journal of surgery

2020 Volume 107, Issue 10, Page(s) e384–e385

MeSH term(s)	Anesthesia ; Asymptomatic Infections ; COVID-19/diagnosis ; COVID-19/transmission ; COVID-19 Nucleic Acid Testing ; COVID-19 Testing ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Medical History Taking ; Preoperative Care/methods ; Radiography, Thoracic/methods ; Tomography, X-Ray Computed/methods
Keywords	covid19
Language	English
Publishing date	2020-07-23
Publishing country	England
Document type	Letter
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11822
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Article ; Online: What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure?

Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

World journal of surgery

2020 Volume 44, Issue 10, Page(s) 3199–3206

Abstract: Introduction: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without ... ...

Abstract	Introduction: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without overuse of limited supply of these equipments, screening of patients before surgical or diagnostic procedure was implemented. This study evaluates the results of this screening. Method: All patients screened for COVID-19 before procedure warranting either general, locoregional anaesthesia or sedation were included. Screening included a symptom questionnaire by phone, PCR and HRCT chest testing. Surgical or procedural details were registered together with actions taken based on screening results. Results: Three hundred ninety-eight screenings were performed on 386 patients. The symptom questionnaire was completed in 72% of screenings. In 371 screenings, PCR testing was performed and negative. HRCT chest found 18 cases where COVID-19 could not be excluded, with negative PCR testing. Three patients had their surgery postponed due to inconclusive screening, and additional measures were taken in three other patients. There were incidental findings in 14% of HRCT chest scans. Discussion: Pre-operative screening will differentiate if PPE is needed for procedures and which patients can safely have elective surgery during this COVID-19 pandemic and in the times to come. HRCT chest has no additional value in the pre-operative screening of asymptomatic patients. Screening can be performed with a symptom questionnaire, and additional screening with PCR testing in high-risk patient groups should be considered.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asymptomatic Infections ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Child ; Child, Preschool ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Diagnostic Tests, Routine ; Elective Surgical Procedures ; Female ; Humans ; Infection Control/instrumentation ; Infection Control/methods ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Male ; Mass Screening/methods ; Middle Aged ; Pandemics/prevention & control ; Personal Protective Equipment ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2 ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-08-13
Publishing country	United States
Document type	Evaluation Study ; Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05722-9
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Article ; Online: An outbreak of severe respiratory tract infection caused by human metapneumovirus in a residential care facility for elderly in Utrecht, the Netherlands, January to March 2010.

Te Wierik, M J / Nguyen, D T / Beersma, M F / Thijsen, S F / Heemstra, K A

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

2012 Volume 17, Issue 13

Abstract: Recognition of infections with human metapneumovirus (HMPV) among institutionalised elderly is rising. When HMPV was found to be the causative agent of an outbreak of pneumonia in a residential care facility for elderly in the Netherlands, an elaborate ... ...

Abstract	Recognition of infections with human metapneumovirus (HMPV) among institutionalised elderly is rising. When HMPV was found to be the causative agent of an outbreak of pneumonia in a residential care facility for elderly in the Netherlands, an elaborate outbreak investigation was set up, including active surveillance for new cases. From clinical cases, defined by fever (> 38°C) and symptoms of respiratory tract infections, respiratory samples for analyses of viral pathogens by real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) and blood samples for determination of HMPV-specific IgM and IgG antibody titres were taken. Five staff members and 18 residents fulfilled the clinical case definition. Of those, five residents tested positive for HMPV by rRT-PCR. The combination of rRTPCR and serology identified nine confirmed cases, six probable cases, six possible cases and ruled out two persons as cases. Among residents, the outbreak of HMPV had an attack rate, ranging from 5% for laboratory- confirmed cases, to 13% for clinical cases. This outbreak investigation shows that HMPV is a potential serious pathogen for institutionalised elderly.
MeSH term(s)	Aged, 80 and over ; Comorbidity ; Disease Outbreaks ; Female ; Humans ; Incidence ; Male ; Metapneumovirus/genetics ; Metapneumovirus/isolation & purification ; Netherlands/epidemiology ; Paramyxoviridae Infections/diagnosis ; Paramyxoviridae Infections/epidemiology ; Paramyxoviridae Infections/virology ; Pneumonia/diagnosis ; Pneumonia/epidemiology ; Pneumonia/virology ; Polymerase Chain Reaction ; Residential Facilities ; Severity of Illness Index
Language	English
Publishing date	2012-03-29
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	1338803-4
ISSN	1560-7917 ; 1025-496X
ISSN (online)	1560-7917
ISSN	1025-496X
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Article: Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure

Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

Br. j. surg

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #670614
Database	COVID19

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Article: What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure?

Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

World J Surg

Abstract: INTRODUCTION: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without ... ...

Abstract	INTRODUCTION: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without overuse of limited supply of these equipments, screening of patients before surgical or diagnostic procedure was implemented. This study evaluates the results of this screening. METHOD: All patients screened for COVID-19 before procedure warranting either general, locoregional anaesthesia or sedation were included. Screening included a symptom questionnaire by phone, PCR and HRCT chest testing. Surgical or procedural details were registered together with actions taken based on screening results. RESULTS: Three hundred ninety-eight screenings were performed on 386 patients. The symptom questionnaire was completed in 72% of screenings. In 371 screenings, PCR testing was performed and negative. HRCT chest found 18 cases where COVID-19 could not be excluded, with negative PCR testing. Three patients had their surgery postponed due to inconclusive screening, and additional measures were taken in three other patients. There were incidental findings in 14% of HRCT chest scans. DISCUSSION: Pre-operative screening will differentiate if PPE is needed for procedures and which patients can safely have elective surgery during this COVID-19 pandemic and in the times to come. HRCT chest has no additional value in the pre-operative screening of asymptomatic patients. Screening can be performed with a symptom questionnaire, and additional screening with PCR testing in high-risk patient groups should be considered.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #713528
Database	COVID19

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Article ; Online: Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure ; COVID-19 Screening

Huybens, E. M. / Bus, M. P. A. / Massaad, R. A. / Wijers, L. / van der Voet, J. A. / Delfos, N. M. / van der Feltz, M. / Heemstra, K. A. / Koch, S. M. P.

British Journal of Surgery ; ISSN 0007-1323

2020

Keywords	Surgery ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
DOI	10.1002/bjs.11822
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure?

Huybens, E. M. / Bus, M. P. A. / Massaad, R. A. / Wijers, L. / van der Voet, J. A. / Delfos, N. M. / van der Feltz, M. / Heemstra, K. A. / Koch, S. M. P.

World Journal of Surgery

2020 Volume 44, Issue 10, Page(s) 3199–3206

Keywords	Surgery ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05722-9
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Selection of an optimal antiseptic solution for intraoperative irrigation: an in vitro study.

van Meurs, S J / Gawlitta, D / Heemstra, K A / Poolman, R W / Vogely, H C / Kruyt, M C

The Journal of bone and joint surgery. American volume

2014 Volume 96, Issue 4, Page(s) 285–291

Abstract: Background: With increasing bacterial antibiotic resistance and an increased infection risk due to more complicated surgical procedures and patient populations, prevention of surgical infection is of paramount importance. Intraoperative irrigation with ... ...

Abstract	Background: With increasing bacterial antibiotic resistance and an increased infection risk due to more complicated surgical procedures and patient populations, prevention of surgical infection is of paramount importance. Intraoperative irrigation with an antiseptic solution could provide an effective way to reduce postoperative infection rates. Although numerous studies have been conducted on the bactericidal or cytotoxic characteristics of antiseptics, the combination of these characteristics for intraoperative application has not been addressed. Methods: Bacteria (Staphylococcus aureus and S. epidermidis) and human cells were exposed to polyhexanide, hydrogen peroxide, octenidine dihydrochloride, povidone-iodine, and chlorhexidine digluconate at various dilutions for two minutes. Bactericidal properties were calculated by means of the quantitative suspension method. The cytotoxic effect on human fibroblasts and mesenchymal stromal cells was determined by a WST-1 metabolic activity assay. Results: All of the antiseptics except for polyhexanide were bactericidal and cytotoxic at the commercially available concentrations. When diluted, only povidone-iodine was bactericidal at a concentration at which some cell viability remained. The other antiseptics tested showed no cellular survival at the minimal bactericidal concentration. Conclusions: Povidone-iodine diluted to a concentration of 1.3 g/L could be the optimal antiseptic for intraoperative irrigation. This should be established by future clinical studies.
MeSH term(s)	Anti-Infective Agents, Local/pharmacology ; Anti-Infective Agents, Local/therapeutic use ; Biguanides/pharmacology ; Biguanides/therapeutic use ; Cell Survival/drug effects ; Chlorhexidine/analogs & derivatives ; Chlorhexidine/pharmacology ; Chlorhexidine/therapeutic use ; Fibroblasts/drug effects ; Humans ; Hydrogen Peroxide/pharmacology ; Hydrogen Peroxide/therapeutic use ; Intraoperative Care/methods ; Mesenchymal Stromal Cells/drug effects ; Povidone-Iodine/pharmacology ; Povidone-Iodine/therapeutic use ; Pyridines/pharmacology ; Pyridines/therapeutic use ; Staphylococcal Infections/prevention & control ; Staphylococcus aureus ; Staphylococcus epidermidis ; Therapeutic Irrigation/methods
Chemical Substances	Anti-Infective Agents, Local ; Biguanides ; Pyridines ; polihexanide (322U039GMF) ; Povidone-Iodine (85H0HZU99M) ; Hydrogen Peroxide (BBX060AN9V) ; chlorhexidine gluconate (MOR84MUD8E) ; octenidine (OZE0372S5A) ; Chlorhexidine (R4KO0DY52L)
Language	English
Publishing date	2014-02-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.M.00313
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Article ; Online: The type 2 deiodinase ORFa-Gly3Asp polymorphism (rs12885300) influences the set point of the hypothalamus-pituitary-thyroid axis in patients treated for differentiated thyroid carcinoma.

Hoftijzer, H C / Heemstra, K A / Visser, T J / le Cessie, S / Peeters, R P / Corssmit, E P M / Smit, J W A

The Journal of clinical endocrinology and metabolism

2011 Volume 96, Issue 9, Page(s) E1527–33

Abstract: Context: Iodothyronine deiodinases D1, D2, and D3 play an important role in synthesis and degradation of T(3). The relationship between serum TSH and free T(4) (FT(4)) levels is determined by an individual set point of the hypothalamus-pituitary-thyroid ...

Abstract	Context: Iodothyronine deiodinases D1, D2, and D3 play an important role in synthesis and degradation of T(3). The relationship between serum TSH and free T(4) (FT(4)) levels is determined by an individual set point of the hypothalamus-pituitary-thyroid axis. Objective: Several polymorphisms have been described in D1 and D2 of which some are associated with serum TSH and iodothyronine levels. In this study we investigate whether polymorphisms of D1 and D2 influence the set point of the hypothalamus-pituitary-thyroid axis. Design: We collected 1905 serum FT(4) and TSH measurements during 11.5 ± 8.8 yr of follow-up in patients treated for differentiated thyroid carcinoma (DTC). We determined these polymorphisms: D1-rs11206244, D1-rs12095080, D2-rs225014, and D2-rs12885300. Effects of these polymorphisms on the set points of the hypothalamus-pituitary-thyroid axis were analyzed with a linear mixed model. Setting: The study was conducted at Leiden University Medical Center, a tertiary referral center for DTC. Patients: One hundred fifty-one consecutive patients were treated and cured for DTC. Main outcome measure: Slopes and intercepts of regression equations representing the relationship between InTSH and FT(4) were measured for all polymorphisms. Results: DTC patients homozygous for the D2-rs12885300 T allele have an altered set point of the hypothalamus-pituitary-thyroid axis. The slope of the regression line (corrected for age, body mass index, and gender) for wild-type patients was -0.32 ± 0.028 (ln[TSH(mU/liter)]/[FT(4)(pmol/liter)]), the intercept, 4.95. For heterozygous patients, the slope was -0.30 ± 0.028 (ln[TSH(mU/liter)]/[FT(4)(pmol/liter)]), the intercept, 4.23. The slope of the homozygous patients was -0.35 ± 0.026 (ln[TSH(mU/liter)]/[FT(4)(pmol/liter)]) and the intercept, 6.07 (P = 0.036 compared with wild-type and heterozygous patients). Conclusion: Our data suggest that the negative feedback of FT(4) on TSH is weaker in patients homozygous for the D2-rs12885300 T allele than in wild-type and heterozygous subjects.
MeSH term(s)	Adult ; Alleles ; Carcinoma/genetics ; Carcinoma/metabolism ; Carcinoma/therapy ; Female ; Humans ; Hypothalamo-Hypophyseal System/metabolism ; Iodide Peroxidase/genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Thyroid Gland/metabolism ; Thyroid Neoplasms/genetics ; Thyroid Neoplasms/metabolism ; Thyroid Neoplasms/therapy ; Thyrotropin/blood ; Iodothyronine Deiodinase Type II
Chemical Substances	Thyrotropin (9002-71-5) ; Iodide Peroxidase (EC 1.11.1.8)
Language	English
Publishing date	2011-06-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/jc.2011-0235
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Article: The effects of thyrotropin-suppressive therapy on bone metabolism in patients with well-differentiated thyroid carcinoma.

Heemstra, K A / Hamdy, N A T / Romijn, J A / Smit, J W A

Thyroid : official journal of the American Thyroid Association

2006 Volume 16, Issue 6, Page(s) 583–591

Abstract: Patients with differentiated thyroid carcinoma (DTC) are commonly treated long-term with thyrotropin (TSH)- suppressive thyroxine replacement therapy resolving in a state of subclinical hyperthyroidism. The relationship between subclinical ... ...

Abstract	Patients with differentiated thyroid carcinoma (DTC) are commonly treated long-term with thyrotropin (TSH)- suppressive thyroxine replacement therapy resolving in a state of subclinical hyperthyroidism. The relationship between subclinical hyperthyroidism and osteoporosis is not clear. In this review, we systematically selected and analyzed 21 studies addressing this issue. Although multiple methodological differences between studies prevented a structured meta-analysis, our data suggest that postmenopausal women with subclinical hyperthyroidism are most at risk, whereas no increased risk was observed in men and premenopausal women. Based on these findings we believe that measurement of bone mineral density is recommended in postmenopausal women with DTC starting TSH suppressive therapy. This should be subsequently regularly measured to enable timely intervention with bone protective agents.
MeSH term(s)	Adult ; Aged ; Bone and Bones/metabolism ; Carcinoma/drug therapy ; Carcinoma/metabolism ; Cell Differentiation ; Databases, Bibliographic ; Female ; Humans ; Hyperthyroidism/complications ; Hyperthyroidism/drug therapy ; Male ; Middle Aged ; Postmenopause ; Premenopause ; Risk ; Thyroid Neoplasms/drug therapy ; Thyroid Neoplasms/metabolism ; Thyrotropin/antagonists & inhibitors ; Thyrotropin/physiology ; Thyroxine/pharmacology
Chemical Substances	Thyrotropin (9002-71-5) ; Thyroxine (Q51BO43MG4)
Language	English
Publishing date	2006-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1086044-7
ISSN	1557-9077 ; 1050-7256
ISSN (online)	1557-9077
ISSN	1050-7256
DOI	10.1089/thy.2006.16.583
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