Institution
Katholieke Universiteit Leuven
Education•Leuven, Belgium•
About: Katholieke Universiteit Leuven is a education organization based out in Leuven, Belgium. It is known for research contribution in the topics: Population & Transplantation. The organization has 61109 authors who have published 176584 publications receiving 6210872 citations.
Topics: Population, Transplantation, CMOS, European union, Stars
Papers published on a yearly basis
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TL;DR: It is concluded that nighttime blood pressure is in general a better predictor of outcome than daytime pressure in hypertensive patients, and the night–day blood pressure ratio predicts mortality, even after adjustment for 24-hour blood pressure.
Abstract: Our aim was to assess the prognostic significance of nighttime and daytime ambulatory blood pressure and their ratio for mortality and cause-specific cardiovascular events in hypertensive patients without major cardiovascular disease at baseline. We performed a meta-analysis on individual data of 3468 patients from 4 prospective studies performed in Europe. Age of the subjects averaged 61+/-13 years, 45% were men, 13.7% smoked, 8.4% had diabetes, and 61% were under antihypertensive treatment at the time of ambulatory blood pressure monitoring. Office, daytime, and nighttime blood pressure averaged 159+/-20/91+/-12, 143+/-17/87+/-12, and 130+/-18/75+/-12 mm Hg. Total follow-up amounted to 23 164 patient-years. We used multivariable Cox regression analysis to assess the hazard ratios associated with 1 standard deviation higher blood pressure. Daytime and nighttime systolic blood pressure predicted all-cause and cardiovascular mortality, coronary heart disease, and stroke, independently from office blood pressure and confounding variables. When these blood pressures were entered simultaneously into the models, nighttime blood pressure predicted all outcomes, whereas daytime blood pressure did not add prognostic precision to nighttime pressure. Appropriate interaction terms indicated that the results were similar in men and women, in younger and older patients, and in treated and untreated patients The systolic night-day blood pressure ratio predicted all outcomes, which only persisted for all-cause mortality after adjustment for 24-hour blood pressure. In conclusion, nighttime blood pressure is in general a better predictor of outcome than daytime pressure in hypertensive patients, and the night-day blood pressure ratio predicts mortality, even after adjustment for 24-hour blood pressure.
624 citations
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Utrecht University1, Stanford University2, University Hospital of Lausanne3, University of Duisburg-Essen4, University of Bern5, University Hospital of Basel6, Sheba Medical Center7, University of Glasgow8, Katholieke Universiteit Leuven9, Charité10, Ludwig Maximilian University of Munich11, Heidelberg University12, Helsinki University Central Hospital13, Federal University of Rio de Janeiro14
TL;DR: The results do not support unequivocal superiority of IAT over IVT, and the efficacy of I AT versus IVT in patients with an acute BAO needs to be assessed in a randomised controlled trial.
Abstract: Summary Background Treatment strategies for acute basilar artery occlusion (BAO) are based on case series and data that have been extrapolated from stroke intervention trials in other cerebrovascular territories, and information on the efficacy of different treatments in unselected patients with BAO is scarce. We therefore assessed outcomes and differences in treatment response after BAO. Methods The Basilar Artery International Cooperation Study (BASICS) is a prospective, observational registry of consecutive patients who presented with an acute symptomatic and radiologically confirmed BAO between November 1, 2002, and October 1, 2007. Stroke severity at time of treatment was dichotomised as severe (coma, locked-in state, or tetraplegia) or mild to moderate (any deficit that was less than severe). Outcome was assessed at 1 month. Poor outcome was defined as a modified Rankin scale score of 4 or 5, or death. Patients were divided into three groups according to the treatment they received: antithrombotic treatment only (AT), which comprised antiplatelet drugs or systemic anticoagulation; primary intravenous thrombolysis (IVT), including subsequent intra-arterial thrombolysis; or intra-arterial therapy (IAT), which comprised thrombolysis, mechanical thrombectomy, stenting, or a combination of these approaches. Risk ratios (RR) for treatment effects were adjusted for age, the severity of neurological deficits at the time of treatment, time to treatment, prodromal minor stroke, location of the occlusion, and diabetes. Findings 619 patients were entered in the registry. 27 patients were excluded from the analyses because they did not receive AT, IVT, or IAT, and all had a poor outcome. Of the 592 patients who were analysed, 183 were treated with only AT, 121 with IVT, and 288 with IAT. Overall, 402 (68%) of the analysed patients had a poor outcome. No statistically significant superiority was found for any treatment strategy. Compared with outcome after AT, patients with a mild-to-moderate deficit (n=245) had about the same risk of poor outcome after IVT (adjusted RR 0·94, 95% CI 0·60–1·45) or after IAT (adjusted RR 1·29, 0·97–1·72) but had a worse outcome after IAT compared with IVT (adjusted RR 1·49, 1·00–2·23). Compared with AT, patients with a severe deficit (n=347) had a lower risk of poor outcome after IVT (adjusted RR 0·88, 0·76–1·01) or IAT (adjusted RR 0·94, 0·86–1·02), whereas outcomes were similar after treatment with IAT or IVT (adjusted RR 1·06, 0·91–1·22). Interpretation Most patients in the BASICS registry received IAT. Our results do not support unequivocal superiority of IAT over IVT, and the efficacy of IAT versus IVT in patients with an acute BAO needs to be assessed in a randomised controlled trial. Funding Department of Neurology, University Medical Center Utrecht.
624 citations
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TL;DR: The recommendations presented here are based on the best available evidence and expert agreement and are presented with a summary of evidence supporting each recommendation.
624 citations
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TL;DR: Patients with COPD are markedly inactive during and after hospitalization for an AE, and efforts to enhance physical activity should be among the aims of the disease management during and following the AE periods.
623 citations
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Vrije Universiteit Brussel1, University of Copenhagen2, University of Gothenburg3, New York University4, University of Pennsylvania5, University of Helsinki6, Wageningen University and Research Centre7, King's College London8, Institut national de la recherche agronomique9, University of Maryland, Baltimore10, Waseda University11, Harvard University12, University College Cork13, University of Minnesota14, University of Texas at Austin15, University of Warwick16, Veterans Health Administration17, Stanford University18, ETH Zurich19, Shanghai Jiao Tong University20, Katholieke Universiteit Leuven21, Max Delbrück Center for Molecular Medicine22, Molecular Medicine Partnership Unit23
TL;DR: The concept of enterotypes and their use to characterize the gut microbiome are debated, a classifier and standardized methodology is provided to aid cross-study comparisons, and a balanced application of the concept is encouraged.
Abstract: Population stratification is a useful approach for a better understanding of complex biological problems in human health and wellbeing. The proposal that such stratification applies to the human gut microbiome, in the form of distinct community composition types termed enterotypes, has been met with both excitement and controversy. In view of accumulated data and re-analyses since the original work, we revisit the concept of enterotypes, discuss different methods of dividing up the landscape of possible microbiome configurations, and put these concepts into functional, ecological and medical contexts. As enterotypes are of use in describing the gut microbial community landscape and may become relevant in clinical practice, we aim to reconcile differing views and encourage a balanced application of the concept.
622 citations
Authors
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Name | H-index | Papers | Citations |
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Eugene Braunwald | 230 | 1711 | 264576 |
Joseph L. Goldstein | 207 | 556 | 149527 |
Rakesh K. Jain | 200 | 1467 | 177727 |
Stefan Schreiber | 178 | 1233 | 138528 |
Masayuki Yamamoto | 171 | 1576 | 123028 |
Jun Wang | 166 | 1093 | 141621 |
David R. Jacobs | 165 | 1262 | 113892 |
Klaus Müllen | 164 | 2125 | 140748 |
Peter Carmeliet | 164 | 844 | 122918 |
Hua Zhang | 163 | 1503 | 116769 |
William J. Sandborn | 162 | 1317 | 108564 |
Elliott M. Antman | 161 | 716 | 179462 |
Tobin J. Marks | 159 | 1621 | 111604 |
Ian A. Wilson | 158 | 971 | 98221 |
Johan Auwerx | 158 | 653 | 95779 |