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Article: Ethische Ad-hoc-Entscheidungsfindung in der klinischen Akut- und Notfallmedizin. Positionspapier der Sektion Ethik der Deutschen Interdisziplinaeren Vereinigung fuer Intensiv- und Notfallmedizin (DIVI) unter Mitarbeit der Sektion Ethik der Deutschen Gesellschaft fuer Internistische Intensivmedizin und Notfallmedizin (DGIIN)

Michels, Guido / Dutzmann, Jochen / Duttge, Gunnar / Rogge, Annette / Joebges, Susanne / Grautoff, Steffen / Meier, Stefan / Janssens, Uwe / Michalsen, Andrej

Medizinische Klinik - Intensivmedizin und Notfallmedizin

2022 Volume 117, Issue 2, Page(s) 85–90

Title translation	Ad hoc ethical decision-making in clinical acute and emergency medicine. Position paper of the Ethics Section of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) in collaboration with the Ethics Section of the German Society of Medical Intensive Care and Emergency Medicine (DGIIN)
Institution	Sektion Ethik der DIVI e.V.; Sektion Ethik der DGIIN e.V
Keywords	emergency care ; time factors ; interdisciplinary communication ; autonomy ; clinical ethics ; ethics consultation ; risks and benefits ; legal aspects ; evaluation ; psychological stress ; withholding treatment ; advance directives ; patient care team ; informed consent
Subject code	AN
Language	German
Document type	Article
ZDB-ID	2636018-4
ISSN	1435-1420 ; 2193-6226 ; 0723-5003 ; 2193-6218 ; 0175-3851
ISSN (online)	1435-1420 ; 2193-6226
ISSN	0723-5003 ; 2193-6218 ; 0175-3851
Database	Ethics in Medicine (ETHMED)

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Article: Empfehlungen zur intensivmedizinischen Therapie von Patienten mit COVID-19

Kluge, Stefan / Janssens, Uwe / Welte, Tobias / Weber-Carstens, Steffen / Marx, Gernot / Karagiannidis, Christian

Medizinische Klinik - Intensivmedizin und Notfallmedizin

2020 , Page(s) 175–177

Title translation	Recommendations for critically ill patients with COVID-19
Keywords	intensive care units ; communicable diseases ; diagnosis ; drugs ; ventilators
Subject code	AN
Language	German
Document type	Article
ZDB-ID	2636018-4
ISSN	1435-1420 ; 2193-6226 ; 0723-5003 ; 2193-6218 ; 0175-3851
ISSN (online)	1435-1420 ; 2193-6226
ISSN	0723-5003 ; 2193-6218 ; 0175-3851
Database	Ethics in Medicine (ETHMED)

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Ua VI Zs.120: Show issues

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Article ; Online: Cardiologists’ perceptions on multidisciplinary collaboration in heart failure care - a qualitative study

Willem Raat / Miek Smeets / Isolde Vandewal / Lien Broekx / Sanne Peters / Stefan Janssens / Bert Vaes / Bert Aertgeerts

BMC Health Services Research, Vol 21, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Background Cardiologists play a key role in multidisciplinary care by guiding heart failure (HF) management in the hospital and in the community. Regional implementation of multidisciplinary health care interventions depends on how they perceive ...

Abstract	Abstract Background Cardiologists play a key role in multidisciplinary care by guiding heart failure (HF) management in the hospital and in the community. Regional implementation of multidisciplinary health care interventions depends on how they perceive collaboration with other health care disciplines, yet research on this topic is limited. This study aimed to explore the views and opinions of cardiologists on multidisciplinary collaboration in HF care. Methods We conducted a qualitative study based on face-to-face semi-structured interviews with 11 Belgian cardiologists between September 2019 and February 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached. Results Cardiologists consider the general practitioner (GP) and HF nurse as the most important partners in HF management. Cardiologists identified four problems in current multidisciplinary collaboration: the communication of a HF diagnosis to the patient, advanced care planning, titration of HF medication by the GP and electronic data exchange and communication. Three themes emerged as ideas for improvement of HF care: 1) expansion of the role of the HF nurse, 2) implementation of a structured, patient-centered, and flexible model of disease management program and 3) integrated data approaches. Conclusion Cardiologists value close cooperation with GPs in HF management. They advocate an expanded future role for the HF nurse, increased eHealth, and structured disease management to optimize current HF care.
Keywords	Heart failure ; Cardiology ; Multidisciplinary ; Collaboration ; Perception ; Public aspects of medicine ; RA1-1270
Subject code	360 ; 650
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Urinary Proteomic Profile of Arterial Stiffness Is Associated With Mortality and Cardiovascular Outcomes

Dongmei Wei / Jesus D. Melgarejo / Lutgarde Thijs / Xander Temmerman / Thomas Vanassche / Lucas Van Aelst / Stefan Janssens / Jan A. Staessen / Peter Verhamme / Zhen‐Yu Zhang

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 11, Iss

2022 Volume 8

Abstract: Background The underlying mechanisms of arterial stiffness remain not fully understood. This study aimed to identify a urinary proteomic profile to illuminate its pathogenesis and to determine the prognostic value of the profile for adverse outcomes. ... ...

Abstract	Background The underlying mechanisms of arterial stiffness remain not fully understood. This study aimed to identify a urinary proteomic profile to illuminate its pathogenesis and to determine the prognostic value of the profile for adverse outcomes. Methods and Results We measured aortic stiffness using pulse wave velocity (PWV) and analyzed urinary proteome using capillary electrophoresis coupled with mass spectrometry in 669 randomly recruited Flemish patients (mean age, 50.2 years; 51.1% women). We developed a PWV‐derived urinary proteomic score (PWV‐UP) by modeling PWV with proteomics data at baseline through orthogonal projections to latent structures. PWV‐UP that consisted of 2336 peptides explained the 65% variance of PWV, higher than 36% explained by clinical risk factors. PWV‐UP was significantly associated with PWV (adjusted β=0.73 [95% CI, 0.67–0.79]; P<0.0001). Over 9.2 years (median), 36 participants died, and 75 experienced cardiovascular events. The adjusted hazard ratios (+1 SD) were 1.46 (95% CI, 1.08–1.97) for all‐cause mortality, 2.04 (95% CI, 1.07–3.87) for cardiovascular mortality, and 1.39 (95% CI, 1.11–1.74) for cardiovascular events (P≤0.031). For PWV, the corresponding estimates were 1.25 (95% CI, 0.97–1.60), 1.35 (95% CI, 0.85–2.15), and 1.22 (95% CI, 1.02–1.47), respectively (P≥0.033). Pathway analysis revealed that the peptides in PWV‐UP mostly involved multiple pathways, including collagen turnover, cell adhesion, inflammation, and lipid metabolism. Conclusions PWV‐UP was highly associated with PWV and could be used as a biomarker of arterial stiffness. PWV‐UP, but not PWV, was associated with all‐cause mortality and cardiovascular mortality, implying that PWV‐UP–associated peptides may be multifaceted and involved in diverse pathological processes beyond arterial stiffness.
Keywords	arterial stiffness ; biomarkers ; population science ; proteomics ; pulse wave velocity ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
Subject code	310
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: TI: Empfehlungen zur intensivmedizinischen Therapie von Patienten mit COVID-19

AU: Kluge, Stefan / Janssens, Uwe / Welte, Tobias / Weber-Carstens, Steffen / Marx, Gernot / Karagiannidis, Christian / EDR:

JT: Medizinische Klinik - Intensivmedizin und Notfallmedizin

(SE:)

PY: 2020 , Page(s) PAGINATION: 175–177

Abstract: AB: ...

Title translation	TITLE TRANSLATION: (Recommendations for critically ill patients with COVID-19)
Institution	CS:
Series title	SE:
Abstract	AB:
Keywords	it: intensive care units ; communicable diseases ; diagnosis ; drugs ; ventilators ; keyword identifiers:
Subject code	SC: AN
Language	Latin ; German
Publisher	PU:
Document type	Article
Note	NOTE:
ISSN	ISSN: 2193-6226
Database	Ethics in Medicine (ETHMED)

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Article ; Online: General practitioners’ perceptions about their role in current and future heart failure care

Miek Smeets / Sofia Zervas / Hanne Leben / Mieke Vermandere / Stefan Janssens / Wilfried Mullens / Bert Aertgeerts / Bert Vaes

BMC Health Services Research, Vol 19, Iss 1, Pp 1-

an exploratory qualitative study

2019 Volume 10

Abstract: Abstract Background A comprehensive disease management programme (DMP) with a central role for general practitioners (GPs) is needed to improve heart failure (HF) care. However, previous research has shown that GPs have mixed experiences with ... ...

Abstract	Abstract Background A comprehensive disease management programme (DMP) with a central role for general practitioners (GPs) is needed to improve heart failure (HF) care. However, previous research has shown that GPs have mixed experiences with multidisciplinary HF care. Therefore, in this study, we explore the perceptions that GPs have regarding their role in current and future HF care, prior to the design of an HF disease management programme. Methods This was a qualitative semi-structured interview study with Belgian GPs until data saturation was reached. The QUAGOL method was used for data analysis. Results In general, GPs wanted to assume a central role in HF care. Current interdisciplinary collaboration with cardiologists was perceived as smooth, partly because of the ease of access. In contrast, due to less well-established communication and the variable knowledge of nurses regarding HF care, collaboration with home care nurses was perceived as suboptimal. With regard to the future organization of HF care, all GPs confirmed the need for a structured chronic care approach and envisioned this as a multidisciplinary care pathway: flexible, patient-centred, without additional administration and with appropriate delegation of some critical tasks, including education and monitoring. GPs considered all-round general practice nurses as the preferred partner to delegate tasks to in HF care and reported limited experience in collaborating with specialist HF nurses. Conclusion GPs expressed the need for a protocol-driven care pathway in chronic HF care. However, in contrast to the existing care trajectories, this pathway should be flexible, without additional administrative burdens and with a central role for GPs.
Keywords	Heart failure ; General practice ; Disease management ; Qualitative research ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Low Cytochrome Oxidase 1 Links Mitochondrial Dysfunction to Atherosclerosis in Mice and Pigs.

Paul Holvoet / Maarten Vanhaverbeke / Benjamine Geeraert / Dieuwke De Keyzer / Maarten Hulsmans / Stefan Janssens

PLoS ONE, Vol 12, Iss 1, p e

2017 Volume 0170307

Abstract: Cytochrome oxidase IV complex regulates energy production in mitochondria. Therefore, we determined the relation of COX genes with atherosclerosis in mice and pigs.First, we compared atherosclerosis in the aortic arch of age-matched (24 weeks) C57BL/6J ... ...

Abstract	Cytochrome oxidase IV complex regulates energy production in mitochondria. Therefore, we determined the relation of COX genes with atherosclerosis in mice and pigs.First, we compared atherosclerosis in the aortic arch of age-matched (24 weeks) C57BL/6J control (n = 10), LDL-receptor deficient (n = 8), leptin-deficient ob/ob (n = 10), and double knock-out (lacking LDL-receptor and leptin) mice (n = 12). Low aortic mitochondria-encoded cytochrome oxidase 1 in obese diabetic double knock-out mice was associated with a larger plaque area and higher propensity of M1 macrophages and oxidized LDL. Caloric restriction increased mitochondria-encoded cytochrome oxidase 1 and reduced plaque area and oxidized LDL. This was associated with a reduction of titer of anti-oxidized LDL antibodies, a proxy of systemic oxidative stress. Low of mitochondria-encoded cytochrome oxidase 1 was related to low expression of peroxisome proliferative activated receptors α, δ, and γ and of peroxisome proliferative activated receptor, gamma, co-activator 1 alpha reflecting mitochondrial dysfunction. Caloric restriction increased them. To investigate if there was a diabetic/obesity requirement for mitochondria-encoded cytochrome oxidase 1 to be down-regulated, we then studied atherosclerosis in LAD of hypercholesterolemic pigs (n = 37). Pigs at the end of the study were divided in three groups based on increasing LAD plaque complexity according to Stary (Stary I: n = 12; Stary II: n = 13; Stary III: n = 12). Low mitochondria-encoded cytochrome oxidase 1 in isolated plaque macrophages was associated with more complex coronary plaques and oxidized LDL. Nucleus-encoded cytochrome oxidase 4I1 and cytochrome oxidase 10 did not correlate with plaque complexity and oxidative stress. In mice and pigs, MT-COI was inversely related to insulin resistance.Low MT-COI is related to mitochondrial dysfunction, oxidative stress and atherosclerosis and plaque complexity.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: RNA-sequencing reveals that STRN, ZNF484 and WNK1 add to the value of mitochondrial MT-COI and COX10 as markers of unstable coronary artery disease.

Paul Holvoet / Bernward Klocke / Maarten Vanhaverbeke / Roxane Menten / Peter Sinnaeve / Emma Raitoharju / Terho Lehtimäki / Niku Oksala / Christian Zinser / Stefan Janssens / Karin Sipido / Leo-Pekka Lyytikainen / Stefano Cagnin

PLoS ONE, Vol 14, Iss 12, p e

2019 Volume 0225621

Abstract: Markers in monocytes, precursors of macrophages, which are related to CAD, are largely unknown. Therefore, we aimed to identify genes in monocytes predictive of a new ischemic event in patients with CAD and/or discriminate between stable CAD and acute ... ...

Abstract	Markers in monocytes, precursors of macrophages, which are related to CAD, are largely unknown. Therefore, we aimed to identify genes in monocytes predictive of a new ischemic event in patients with CAD and/or discriminate between stable CAD and acute coronary syndrome. We included 66 patients with stable CAD, of which 24 developed a new ischemic event, and 19 patients with ACS. Circulating CD14+ monocytes were isolated with magnetic beads. RNA sequencing analysis in monocytes of patients with (n = 13) versus without (n = 11) ischemic event at follow-up and in patients with ACS (n = 12) was validated with qPCR (n = 85). MT-COI, STRN and COX10 predicted new ischemic events in CAD patients (power for separation at 1% error rate of 0.97, 0.90 and 0.77 respectively). Low MT-COI and high STRN were also related to shorter time between blood sampling and event. COX10 and ZNF484 together with MT-COI, STRN and WNK1 separated ACS completely from stable CAD patients. RNA expressions in monocytes of MT-COI, COX10, STRN, WNK1 and ZNF484 were independent of cholesterol lowering and antiplatelet treatment. They were independent of troponin T, a marker of myocardial injury. But, COX10 and ZNF484 in human plaques correlated to plaque markers of M1 macrophage polarization, reflecting vascular injury. Expression of MT-COI, COX10, STRN and WNK1, but not that of ZNF484, PBMCs paired with that in monocytes. The prospective study of relation of MT-COI, COX10, STRN, WNK1 and ZNF484 with unstable CAD is warranted.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Molecular signature of progenitor cells isolated from young and adult human hearts

Ann-Sophie Walravens / Maarten Vanhaverbeke / Lara Ottaviani / Hilde Gillijns / Sander Trenson / Nina Vanden Driessche / Aernout Luttun / Bart Meyns / Paul Herijgers / Filip Rega / Ruth Heying / Maurilio Sampaolesi / Stefan Janssens

Scientific Reports, Vol 8, Iss 1, Pp 1-

2018 Volume 14

Abstract: Abstract The loss of endogenous cardiac regenerative capacity within the first week of postnatal life has intensified clinical trials to induce cardiac regeneration in the adult mammalian heart using different progenitor cell types. We hypothesized that ... ...

Abstract	Abstract The loss of endogenous cardiac regenerative capacity within the first week of postnatal life has intensified clinical trials to induce cardiac regeneration in the adult mammalian heart using different progenitor cell types. We hypothesized that donor age-related phenotypic and functional characteristics of cardiac progenitor cells (CPC) account for mixed results of cell-based cardiac repair. We compared expression profiles and cell turnover rates of human heart-derived c-kitpos progenitors (c-kitpos CPC) and cardiosphere-derived cells (CDC) from young and adult donor origin and studied their in vitro angiogenic and cardiac differentiation potential, which can be relevant for cardiac repair. We report that 3-dimensional CDC expansion recapitulates a conducive environment for growth factor and cytokine release from adult donor cells (aCDC) that optimally supports vascular tube formation and vessel sprouting. Transdifferentiation capacity of c-kitpos CPCs and CDCs towards cardiomyocyte-like cells was modest, however, most notable in young c-kitpos cells and adult CDCs. Progenitors isolated with different methods thus show cell- and donor-specific characteristics that may account for variable contributions in functional myocardial recovery.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2018-06-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: MicroRNAs promote skeletal muscle differentiation of mesodermal iPSC-derived progenitors

Giorgia Giacomazzi / Bryan Holvoet / Sander Trenson / Ellen Caluwé / Bojana Kravic / Hanne Grosemans / Álvaro Cortés-Calabuig / Christophe M. Deroose / Danny Huylebroeck / Said Hashemolhosseini / Stefan Janssens / Elizabeth McNally / Mattia Quattrocelli / Maurilio Sampaolesi

Nature Communications, Vol 8, Iss 1, Pp 1-

2017 Volume 14

Abstract: Mesodermal iPSC-derived progenitors (MiPs) can regenerate both skeletal and cardiac muscle. Here, the authors show that a microRNA cocktail stimulates skeletal muscle differentiation and that human MiPs can engraft into striated muscle in mice. ...

Abstract	Mesodermal iPSC-derived progenitors (MiPs) can regenerate both skeletal and cardiac muscle. Here, the authors show that a microRNA cocktail stimulates skeletal muscle differentiation and that human MiPs can engraft into striated muscle in mice.
Keywords	Science ; Q
Language	English
Publishing date	2017-11-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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