Lay summary: Copeptin is a fragment of the vasopressin precursor, a hormone that is known to be increased in patients with cirrhosis and that plays a role in the development of complications of the... Show moreLay summary: Copeptin is a fragment of the vasopressin precursor, a hormone that is known to be increased in patients with cirrhosis and that plays a role in the development of complications of the disease. Vasopressin is difficult to measure, but copeptin is a more stable molecule and is easier to measure in blood. Sola and Kerbert and colleagues have shown in a series of 361 patients that copeptin is markedly increased in patients with cirrhosis who develop complications during the following 3 months, compared to those patients who do not develop complications. Moreover, copeptin correlates with prognosis. (C) 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. Show less
Gelder, J. de; Lucke, J.A.; Groot, B. de; Fogteloo, A.J.; Anten, S.; Mesri, K.; ... ; Mooijaart, S.P. 2016
This thesis describes studies that aimed to evaluate and improve the diagnostic work-up and management of pulmonary embolism. Age-adjusted D-dimer testing was found to be an effective and... Show more This thesis describes studies that aimed to evaluate and improve the diagnostic work-up and management of pulmonary embolism. Age-adjusted D-dimer testing was found to be an effective and safe strategy to reduce the need for CT-imaging in elderly patients with clinically suspected pulmonary embolism. Furthermore, this thesis demonstrates that patients with proven pulmonary embolism who fulfil the Hestia criteria can be safely treated at home, without the need for further prognostic assessment. In the vast majority of patients treated for pulmonary embolism, complete thromboembolic resolution had occurred after six months as assessed by CT pulmonary angiography. The last part of this thesis describes that the outcome of cancer patients incidentally diagnosed with pulmonary embolism mimics the outcome of cancer patients with symptomatic pulmonary embolism. Show less
Mookerjee, R.P.; Pavesi, M.; Thomsen, K.L.; Mehta, G.; Macnaughtan, J.; Bendtsen, F.; ... ; CANONIC Study Investigatos 2016
Over the last decade, there has been an exponential development in cardiac imaging technology. Currently, cardiac imaging plays a central role in clinical management and decision making in the... Show moreOver the last decade, there has been an exponential development in cardiac imaging technology. Currently, cardiac imaging plays a central role in clinical management and decision making in the diverse and growing population of patients encountered in daily cardiology practice. Important outcome-related parameters can be derived from these techniques, allowing better risk stratification of patients with ischemic heart disease. Still, the large amount of information provided by the different imaging modalities can be overwhelming and it can be challenging for the cardiologist to make optimal use of all information that is provided by the different modalities. The purpose of this thesis was to optimize the clinical usefulness of specific cardiac imaging modalities for particular patient categories, with the purpose of improving risk estimation in patients with suspected coronary artery disease, patients who suffered from STEMI and heart failure patients. Show less
This thesis consists of a number of studies revolving around the leading research theme, i.e., the derivation of new vectorcardiographic diagnostic & prognostic information from the 12-lead... Show moreThis thesis consists of a number of studies revolving around the leading research theme, i.e., the derivation of new vectorcardiographic diagnostic & prognostic information from the 12-lead electrocardiogram (ECG). Various research questions have been addressed, but most studies use a similar data processing approach, consisting of initial mathematical synthesis of a vectorcardiogram (VCG) from a standard 12-lead ECG, followed by the measurement of general VCG characteristics like maximal QRS- and T vectors, QRS- and T integrals, the spatial QRS-T angle (SA) and the ventricular gradient (VG). Studies focus on methodological as well as on clinical issues, and are discussed in the thesis. Show less