Radboud University Nijmegen

About: Radboud University Nijmegen is a education organization based out in Nijmegen, Gelderland, Netherlands. It is known for research contribution in the topics: Population & Context (language use). The organization has 35417 authors who have published 83035 publications receiving 3285064 citations. The organization is also known as: Catholic University of Nijmegen & Radboud University.

Imaging findings in acute invasive pulmonary aspergillosis: Clinical significance of the halo sign

Abstract: Background. Computed tomography (CT) of the chest may be used to identify the halo sign, a macronodule surrounded by a perimeter of ground-glass opacity, which is an early sign of invasive pulmonary aspergillosis (IPA). This study analyzed chest CT findings at presentation from a large series of patients with IPA, to assess the prevalence of these imaging findings and to evaluate the clinical utility of the halo sign for early identification of this potentially life-threatening infection. Methods. Baseline chest CT imaging findings from 235 patients with IPA who participated in a previously published study were systematically analyzed. To evaluate the clinical utility of the halo sign for the early identification and treatment of IPA, we compared response to treatment and survival after 12 weeks of treatment in 143 patients who presented with a halo sign and in 79 patients with other imaging findings. Results. At presentation, most patients (94%) had 1 macronodules, and many (61%) also had halo signs. Other imaging findings at presentation, including consolidations (30%), infarct-shaped nodules (27%), cavitary lesions (20%), and air-crescent signs (10%), were less common. Patients presenting with a halo sign had significantly better responses to treatment (52% vs. 29%; ) and greater survival to 84 days (71% vs. 53%; ) than P ! .001 P ! .01 did patients who presented with other imaging findings. Conclusions. Most patients presented with a halo sign and/or a macronodule in this large imaging study of IPA. Initiation of antifungal treatment on the basis of the identification of a halo sign by chest CT is associated with a significantly better response to treatment and improved survival.

The Parkinson Pandemic-A Call to Action

Abstract: Pandemics are usually equated with infectious diseases such as Zika, influenza, and HIV. However, an imminent noninfectious pandemic, Parkinson disease (PD), requires immediate action. Neurological disorders are now the leading cause of disability in the world.1 Among these neurological disorders, the fastest growing is PD, whose growth is surpassing that of Alzheimer disease.1 From 1990 to 2015, the prevalence of, and thus disability and deaths owing to, PD more than doubled.1 The Global Burden of Disease Study estimates that 6.2 million individuals currently have PD. Because the incidence of PD increases sharply with age and because the world’s population is aging, the number of individuals affected is poised for exponential growth (Figure). Conservatively applying worldwide prevalence data from a 2014 meta-analysis2 to projections of the world’s future population,3 the number of people with PD will double from 6.9 million in 2015 to 14.2 million in 2040. Applying this same growth rate to the lower estimate by the Global Burden of Disease study (6.2 million in 2015) projects to a staggering 12.9 million affected by 2040. All these estimates likely understate the true prevalence of PD. The future burden will probably be higher owing to underreporting (record-based studies miss many who have not been diagnosed), declining smoking rates (smoking is associated with a 50% decreased risk of PD), and increasing longevity. Regardless of the exact numbers, if PD were an infectious condition, it would rightly be called a pandemic.4 To address this pandemic, the PD community should follow the efforts of the HIV community as detailed in David France’s book How to Survive a Plague.5 In just 15 years, the affected community took what was initially an unknown and rapidly fatal illness and transformed it into one that was highly treatable, allowing millions of individuals around the world to live long, healthy lives. France outlines at least 4 efforts that should be applied to PD.