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Enthesitis in a European registry-based cohort of patients with psoriatic arthritis treated with tumour necrosis factor inhibitors : clinical burden, patient-reported outcomes, and treatment response
(2024) Mathew, A. J.; Lund, M. L.; Pedersen, M. P.; Rasmussen, S. H.; Glintborg, B.; Loft, A. G.; Nissen, M. J.; Möller, B.; Rodrigues, A. M.; Santos, F. P.; Rotar, Z.; Tomšič, M.; Relas, H.; Peltomaa, R.; Guðbjörnsson, Björn; Löve, Þorvarður Jón; Kocaer, S. B.; Koken Avsar, A.; Midtbøll Ørnbjerg, L.; Østergaard, M.; Faculty of Medicine
Objective: To explore the registration of enthesitis among biologic-naïve patients with psoriatic arthritis (PsA) initiating tumour necrosis factor inhibitor (TNFi) treatment across 12 European registries, compare the disease burden and patient-reported outcomes (PROs) between patients with and without enthesitis, and assess the enthesitis treatment response. Method: Demographics, clinical characteristics, and PROs at first TNFi (TNFi-1) initiation (baseline) were assessed in patients with PsA, diagnosed by a rheumatologist, with versus without assessment of entheses and between those with versus without enthesitis. Enthesitis scores and resolution frequency were identified at follow-up. Results: Of 10 547 patients in the European Spondyloarthritis (EuroSpA) Research Collaboration Network initiating TNFi, 1357 underwent evaluation for enthesitis. Eight registries included a validated scoring system for enthesitis. At baseline, 874 patients underwent entheses assessment [Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 485 patients, Spondyloarthritis Research Consortium of Canada (SPARCC) 389 patients]. Enthesitis was detected by MASES in 170/485 (35%, mean score ± sd 3.1 ± 2.4) and by SPARCC in 236/389 (61%, 4 ± 3.4). Achilles enthesitis was most frequent, by both MASES (unilateral/bilateral 28%/9%) and SPARCC (48%/18%). MASES/SPARCC baseline and follow-up scores for TNFi-1 were available for 100/105 patients. Of these, 63 patients (63%) (MASES) and 46 (43.8%) (SPARCC) achieved resolution of enthesitis. The site-specific enthesitis resolution was overall lower at SPARCC sites (peripheral; 63–80%) than at MASES sites (mainly axial; 82–100%) following TNFi-1. Disease activity and PROs were worse in patients with versus without enthesitis. Conclusion: Entheseal assessments are only registered in a minority of patients with PsA in routine care. When assessed, enthesitis was common, and a substantial proportion demonstrated resolution following treatment with TNFi-1.
Verk
Children with palliative care needs – the landscape of the nordic countries
(2024-05-08) Winger, Anette; Holmen, Heidi; Birgisdóttir, Dröfn; Lykke, Camilla; Lövgren, Malin; Neergaard, Mette Asbjoern; Grönroos, Marika; Kero, Johanna; Kristinsdóttir, Oddný; Pétursdóttir, Ásta Bjarney; Castor, Charlotte; Faculty of Nursing and Midwifery
Background: To strengthen palliative care for children in the Nordic countries, an updated status of current needs, resources, clinical services, education, and research is necessary to align and consolidate future research. A Nordic research collaboration initiative for children with palliative care needs was assembled in 2023. Building on this initiative, this paper presents an overview of pediatric palliative care (PPC) in the Nordic countries’ (a) population characteristics, (b) care models and setting of care, (c) education and training, and (d) research. Methods: The Nordic initiative researchers collaboratively gathered and assessed available data on the characteristics of PPC within Denmark, Finland, Greenland, Iceland, Norway, the Faroe Islands, Sweden, and Åland. Data were compiled in a matrix with population characteristics, models- and setting of care, education and training, and areas of research in a Nordic context. The findings are narratively and descriptively presented, providing an overview of Nordic PPC. Results: In total, the Nordic child population comprises around six million children (0–19 years), of which about 41.200 are estimated to be living with a life-limiting and/or life-threatening condition. Healthcare services are provided through various care models, ranging from specialized care to homecare settings. Overall, there remain few opportunities for education and training with some exceptions. Also, Nordic research within PPC has been shown to be a growing field although much remains to be done. Conclusion: This overview is the first outline of the current PPC in Nordic countries. Although some differences remain important to acknowledge, overall, the strengths and challenges faced within PPC in the Nordic countries are comparable and call for joint action to increase evidence, services, and education to better serve the children, families, and healthcare personnel within PPC. Despite the varying structural premises for PPC, research endeavors aiming to provide evidence in this field seem increasing, timely and relevant for the Nordic countries, as well as the international context.
Verk
International circumpolar surveillance : update on the interlaboratory quality control program for Streptococcus pneumoniae, 2009 to 2020
(2024-06-04) Golden, Alyssa R; Griffith, Averil; Simons, Brenna C; Reasonover, Alisa; Slotved, Hans-Christian; Lefebvre, Brigitte; Kristinsson, Karl Gústaf; Hurteau, Donna; Tyrrell, Gregory J; Bruce, Michael G; Martin, Irene; Faculty of Medicine
UNLABELLED: The International Circumpolar Surveillance (ICS) program is a population-based surveillance network for invasive bacterial diseases throughout Arctic countries and territories. The ICS quality control program for Streptococcus pneumoniae serotyping and antimicrobial susceptibility testing has been ongoing since 1999. Current participating laboratories include the Provincial Laboratory for Public Health in Edmonton, Alberta; Laboratoire de santé publique du Québec in Sainte-Anne-de-Bellevue, Québec; the Centers for Disease Control's Arctic Investigations Program in Anchorage, Alaska; the Neisseria and Streptococcus Reference Laboratory at Statens Serum Institut in Copenhagen, Denmark; the Department of Clinical Microbiology, Landspitali in Reykjavik, Iceland; and Public Health Agency of Canada's National Microbiology Laboratory in Winnipeg, Manitoba. From 2009 to 2020, 140 isolates of S. pneumoniae were distributed among the six laboratories as part of the quality control program. Overall serotype concordance was 96.9%, with 99.3% concordance to pool level. All participating laboratories had individual concordance rates >92% for serotype and >97% for pool. Overall concordance by modal minimum inhibitory concentration (MIC) for testing done by broth microdilution or Etest was 99.1%, and >98% for all antimicrobials tested. Categorical concordance was >98% by both CLSI and EUCAST criteria. For two laboratories performing disc diffusion, rates of concordance by modal MIC were >97% for most antimicrobials, except chloramphenicol (>93%) and trimethoprim/sulfamethoxazole (>88%). Data collected from 12 years of the ICS quality control program for S. pneumoniae demonstrate excellent (≥95%) overall concordance for serotype and antimicrobial susceptibility testing results across six laboratories. IMPORTANCE: Arctic populations experience several social and physical challenges that lead to the increased spread and incidence of invasive diseases. The International Circumpolar Surveillance (ICS) program was developed to monitor five invasive bacterial diseases in Arctic countries and territories. Each ICS organism has a corresponding interlaboratory quality control (QC) program for laboratory-based typing, to ensure the technical precision and accuracy of reference testing services for these regions, and identify and correct potential problems. Here, we describe the results of the ICS Streptococcus pneumoniae QC program, from 2009 to 2020. Excellent overall concordance was achieved for serotype and antimicrobial susceptibility testing results across six laboratories. Ongoing participation in these QC programs ensures the continuation of quality surveillance systems within Arctic populations that experience health disparities.
Verk
Integrative common and rare variant analyses provide insights into the genetic architecture of liver cirrhosis
(2024-05) DBDS Genomic Consortium; Faculty of Medicine; Faculty of Electrical and Computer Engineering
We report a multi-ancestry genome-wide association study on liver cirrhosis and its associated endophenotypes, alanine aminotransferase (ALT) and γ-glutamyl transferase. Using data from 12 cohorts, including 18,265 cases with cirrhosis, 1,782,047 controls, up to 1 million individuals with liver function tests and a validation cohort of 21,689 cases and 617,729 controls, we identify and validate 14 risk associations for cirrhosis. Many variants are located near genes involved in hepatic lipid metabolism. One of these, PNPLA3 p.Ile148Met, interacts with alcohol intake, obesity and diabetes on the risk of cirrhosis and hepatocellular carcinoma (HCC). We develop a polygenic risk score that associates with the progression from cirrhosis to HCC. By focusing on prioritized genes from common variant analyses, we find that rare coding variants in GPAM associate with lower ALT, supporting GPAM as a potential target for therapeutic inhibition. In conclusion, this study provides insights into the genetic underpinnings of cirrhosis.
Verk
Impact of the COVID-19 Pandemic on Influenza Circulation During the 2020/21 and 2021/22 Seasons, in Europe
(2024-05) Sinnathamby, Mary A; Meslé, Margaux M  I; Mook, Piers; Pebody, Richard; Bino, Silvia; Hasibra, Iris; Bakunts, Nune; Abovyan, Romella; Khachtryan, Evgenia; Redlberger-Fritz, Monika; Mursalova, Nazifa; Aliyeva, Firuza; Vysotskaya, Veronika; Shmialiova, Natallia; Karaban, Inna; Bossuyt, Nathalie; Barbezange, Cyril; Musa, Sanja; Vukmir, Nina Rodić; Ljubović, Amela Dedeić; Baštinac, Dijana; Vladimirov, Nadezhda; Korsun, Neli; Trifonova, Ivelina; Tabain, Irena; Petrović, Goranka; Karagiannis, Christos; Haralambous, Christos; Jirincova, Helena; Kyncl, Jan; Trebbien, Ramona; Vestergaard, Lasse Skafte; Sadikova, Olga; Eero, Irina; Metsoja, Eliisa; Ikonen, Niina; Lyytikäinen, Outi; Nohynek, Hanna; Fournier, Lucie; Guerrisi, Caroline; Valette, Martine; Machablishvili, Ani; Buda, Silke; Dürrwald, Ralf; Gioula, Georgia; Mary, Emmanouil; Mellou, Kassiani; Rózsa, Mónika; Molnár, Zsuzsanna; Ármannsdóttir, Brynja; Aspelund, Guðrún; O’Donnell, Joan; Domegan, Lisa; Connell, Jeff; Mandelboim, Michal; Glatman-Freedman, Aharona; Puzelli, Simona; Palamara, Anna Teresa; Maraglino, Francesco; Smagulova, Smagulova Meiramgul Kanapiyanovna; Userbayev, Aidar Sharipkhanuly; Kalaveshi, Ariana; Jakupi, Xhevat; Gunga, Zana Kaçaniku; Otorbaeva, D. S.; Abdyldaeva, S. Zh; Esengeldiev, G. M.; Vasiļevska, Darja; Tomašūna, Kate Karolīna; Savicka, Oksana; Gargasiene, Greta; Muralyte, Svajune; Nguyen, Trung Nguyen; Mossong, Joel; Abdelrahman, Tamir T.; Melillo, Tanya; Zahra, Graziella; Melillo, Jackie; Rakocevic, Bozidarka; Zekovic, Zeljka; Medenica, Sanja; de Lange, Marit; Meijer, Adam; Kochinski, Dragan; Boshevska, Golubinka; Paulsen, Trinehessevik; Bragstad, Karoline; Brydak, Lidia B.; Hallmann, Ewelina; Szymański, Karol; Rodrigues, Ana Paula; Verdasca, Nuno; Guiomar, Raquel; Druc, Alina; Apostol, Mariana; Popescu, Rodica; Popovici, Odette; Lazar, Mihaela; Komissarov, Andrey B.; Fadeev, Artem; Faculty of Medicine
Background: The emergence of SARS-CoV-2 in late 2019 saw the implementation of public health and social measures (PHSM) by countries across Europe to reduce its transmission and impact on populations. Consequently, countries reported changes in influenza circulation and extensive disruptions to routine surveillance systems. Methods: We describe the epidemiology of influenza in Europe between Weeks 40/2020 and 39/2022 compared to the 2016/17 to 2019/20 seasons, to assess the impact of the COVID-19 pandemic and PHSM on surveillance systems and influenza circulation. Results: Low detections of influenza were observed through primary care sentinel sources during seasonal influenza periods (Week 40 to 20); 56 (of 39,457 specimens tested; < 1% positivity) in 2020/21 and 7261 (of 64,153 specimens tested; 11% positivity) detections in 2021/22 were observed, compared to an average of 18,383 (of 50,544 specimens tested; 36% positivity) detections in 2016/17 to 2019/20. Similarly, 11 (of 19,989 specimens tested; < 1% positivity) and 1488 (of 23,636 specimens tested; 6% positivity) detections were reported through SARI surveillance sources in 2020/21 and 2021/22, respectively, compared to an average of 2850 (of 10,389 specimens tested; 27% positivity) detections in 2016/17 to 2019/20. However, the 2021/22 interseasonal period saw unusual increases in influenza detections across surveillance site types when PHSM were easing. Conclusion: In conclusion, findings suggest that the restriction and easing of PHSM measures were associated with variations in influenza detections. Our observations of out-of-season influenza activity highlight the importance of an integrated respiratory surveillance strategy to monitor circulating respiratory viruses throughout the year to inform optimal prevention and control strategies.