Laparoscopic Versus Robot-assisted Left-sided Pancreatectomy for Benign and Pre-malignant Lesions (DIPLOMA-3): an International Multicenter Patient-blinded Randomized Controlled Trial

The DIPLOMA-3 trial is an international, multicenter, patient-blinded randomized controlled trial comparing laparoscopic and robot-assisted left-sided pancreatectomy. Patients with an indication for elective left-sided pancreatecomy for benign or premalignant lesions in the body or tail of the pancreas and considered eligible will be randomized between laparoscopic and robot-assisted resection.

开始日期2025-06-01

申办/合作机构

Catharina Ziekenhuis

[+3]

NL-OMON56624

/ SuspendedN/A

Accuracy of synthetic CT-images based on MRI-images compared to conventional CT-images for shoulder osteoarthritis evaluation and surgical planning - Accuracy of sCT in osteoarthritis shoulders compared to CT

开始日期2025-04-01

申办/合作机构

Onze Lieve Vrouwe Gasthuis

100 项与 Onze Lieve Vrouwe Gasthuis 相关的临床结果

登录后查看更多信息

0 项与 Onze Lieve Vrouwe Gasthuis 相关的专利（医药）

登录后查看更多信息

1,497

项与 Onze Lieve Vrouwe Gasthuis 相关的文献（医药）

2025-07-22·Blood Advances

Atezolizumab consolidation in patients with high-risk diffuse large B-cell lymphoma in complete remission after R-CHOP

Article

作者: van der Poel, Marjolein W. ; Velders, Gerjo A. ; Nijziel, Marten R. ; Diepstra, Arjan ; Fijnheer, Rob ; Zijlstra, Josée M. ; Visser, Otto ; Vergote, Vibeke ; Issa, Djamila E. ; Sandberg, Yorick ; Gadisseur, Alain ; Zwezerijnen, Gerben J. C. ; Silbermann, Matthijs H. ; Mous, Rogier ; Snijders, Tjeerd J. F. ; van Kampen, Roel J. W. ; Terpstra, Wim E. ; Brouwer, Rolf E. ; Strobbe, Leonie ; Beeker, Aart ; Visser-Wisselaar, Heleen ; Nijland, Marcel ; Vermaat, Joost S. P. ; de Jong, Daphne ; Chitu, Dana A. ; Boersma, Rinske S. ; Nieuwenhuizen, Laurens ; Jansen van de Bergh, Sonja ; Deeren, Dries ; Oosterveld, Margriet ; van Rijn, Roos S. ; Bult, Johanna A. A. ; de Jongh, Eva ; Koene, Harry R. ; Doorduijn, Jeanette K. ; Chamuleau, Martine ; Durian, Marc F. ; Snauwaert, Sylvia ; Wu, Kalung ; Bremer, Edwin ; Brink, Mirian ; Jalving, Hilde

Abstract:

The risk of relapse among high-risk patients with diffuse large B-cell lymphoma (DLBCL) in complete metabolic remission (CMR) after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy is 20% to 25%. Here, we evaluated whether consolidation with the programmed cell death ligand 1 checkpoint inhibitor atezolizumab could reduce the relapse risk. In this phase 2, open-label trial, patients with DLBCL with an International Prognostic Index (IPI) score of ≥3 and CMR after R-CHOP received 1200 mg atezolizumab every 3 weeks for 18 cycles. The primary end point was disease-free survival (DFS) at 2 years, with the aim of improving it to 89% compared to historical 79%. Secondary end points included overall survival (OS) and safety (Common Terminology Criteria for Adverse Events version 4.0). Analyses were on an intention-to-treat principle. Of 109 patients, 65% completed treatment. The cohort was 59% males, with 63% having high-intermediate risk IPI scores. At a median follow-up of 36.4 months, 15 relapses occurred (median, 8.2 months). The 2-year DFS was 87.9% (90% confidence interval [CI], 81.5-92.1), and the 2-year OS was 96.3% (90% CI, 91.7-98.3), meeting the primary objective. Treatment with salvage chemotherapy resulted in 10 of 13 patients achieving a second CMR. OS was significantly better among atezolizumab-treated patients than in a population-based matched control cohort from the Netherlands Cancer Registry. Adverse events (AEs) affected 79% of patients, with 18% developing immune-related AEs, including 4.5% grade 3 to 4. Atezolizumab consolidation significantly improved DFS in high-risk patients with DLBCL compared to historical cohorts. OS was significantly better than a population-based control cohort. These findings warrant further validation and assessment of immune checkpoint inhibitors as consolidation strategy in DLBCL. This trial was registered at www.clinicaltrials.gov as #NCT03463057.

2025-07-17·Nature Communications

Global dissemination of npmA mediated pan-aminoglycoside resistance via a mobile genetic element in Gram-positive bacteria.

Article

作者: Jansen, Rogier R ; Coll, Francesc ; Gonzalez-Zorn, Bruno ; Dupuy, Bruno ; Serna, Carlos ; Willems, Rob J L ; Almeida, Alexandre ; Matamoros, Bosco R ; Delgado-Blas, Jose F ; Harrison, Ewan M ; Pulido-Vadillo, Mario

The npmA gene, encoding a 16S rRNA methyltransferase, confers resistance to all clinically available aminoglycosides, posing a significant threat to effective antibiotic therapy. We analyze 1,932,812 bacterial genomes to investigate the distribution and mobilization of npmA variants. npmA is not found in Gram-negative bacteria, where it was originally described, but is identified among Gram-positive bacteria, predominantly as the npmA2 variant in the globally distributed Clostridioides difficile ST11 lineage. We also detect npmA2 in two vancomycin-resistant Enterococcus faecium isolates from a Dutch hospital. Upon sequencing and phenotypic analysis, we determine that E. faecium isolates are pan-resistant to aminoglycosides. Genomic characterization links npmA2 to a composite transposon, Tn7734, which is integrated within a previously uncharacterized Integrative and Conjugative Element (ICE) Tn7740, present in both npmA2-carrying C. difficile and E. faecium clinical isolates. Tn7740-like, but not npmA2, appears across diverse taxa, including human microbiome members. Here, we show that Tn7740 likely facilitates cross-species npmA2 mobilization between these Gram-positive bacteria and emphasize the risk of mobile genetic elements transferring pan-aminoglycoside resistance between clinically important bacterial pathogens.

2025-07-01·BMJ Open Respiratory Research

Liberation from invasive mechanical ventilation: a nationwide survey among intensive care units in the Netherlands

Article

作者: Heunks, Leo ; Endeman, Henrik ; Baggen, Vivan J M ; Groenland, Carline N L ; Wils, Evert-Jan ; van den Bosch, Kim S ; Janssen, Matthijs L

Background:

Liberation from invasive mechanical ventilation is a milestone in critical care, but approaches vary. This survey aimed to describe current ventilator liberation practices, relate them to available evidence, and identify areas for improvement.

Methods:

A survey was performed among Dutch intensive care unit (ICU) sites. The survey evaluated practice in seven domains of ventilator liberation: protocol availability, transition from controlled to assisted ventilation, spontaneous breathing trials (SBT), cuff-leak test, postextubation support, weaning failure and tracheostomised weaning.

Results:

The survey response rate was 93% (132/142), representing 97% (69/71) of Dutch ICUs. Protocols for postextubation support and weaning failure were available in less than half of the ICUs (44% and 49%, respectively). The transition from controlled to assisted ventilation is regularly evaluated daily in 78% of ICUs. Assisted ventilation tolerance is mainly assessed by clinical signs, respiratory parameters and non-invasive manoeuvres that assess respiratory drive (P0.1). SBTs are regularly performed in 58% of ICUs, using one or more of the following methods: T-piece (52%), pressure support+positive end expiratory pressure (32%) and continuous positive airway pressure (28%). Cuff-leak tests are seldom performed (1.4%), predominantly in cases of intubation for upper-airway obstruction (92%). Postextubation respiratory support with high-flow nasal oxygen or non-invasive ventilation is used at least as often with therapeutic (43%/13%) rather than preventive (35%/4%) of facilitative intent (29%/3%). Delirium screening (87%) and reconsidering sedation (84%) are frequently assessed in case of weaning failure. Regular use of closed-loop ventilation is reported in a minority of ICUs throughout the process of ventilator liberation (3–9%).

Conclusions:

Various aspects of ventilator liberation practices show only limited alignment with existing guidelines. The results of this survey pinpoint areas to prioritise in guideline and practice improvement.

项与 Onze Lieve Vrouwe Gasthuis 相关的新闻（医药）

2025-05-20

·医学新视点

“坏胆固醇”达标率提升至6倍，额外降低32%！加用新药促进降脂达标

既往研究显示，强化降脂治疗与更大的临床获益相关。因此，对于心血管高危人群，多数临床指南均将低密度脂蛋白胆固醇水平（LDL-C，俗称“坏胆固醇”）控制在尽可能低的水平，如＜55 mg/dL作为治疗目标。但这些患者通常需要联合治疗才有可能达到这一目标，而观察性研究发现，临床实践中联合治疗普及率仍较低，这意味着患者将面临更高心血管不良结局风险。Obicetrapib是一款口服、选择性胆固醇酯转移蛋白（CETP）抑制剂，其具有亲水性，能够更好地与CETP结合。早期临床试验已表明，obicetrapib可有效降低LDL-C水平，升高高密度脂蛋白胆固醇（HDL-C）水平。那么，在最大耐受剂量的降脂治疗基础上联用obicetrapib，能否为心血管高危患者带来更大的益处呢？近期，《新英格兰医学杂志》（NEJM）发表BROADWAY试验结果表明，在动脉粥样硬化心血管疾病（ASCVD）或杂合子家族性高胆固醇血症患者中，接受最大耐受剂量降脂治疗的基础上增加obicetrapib可将LDL-C水平多降低32.6%。obicetrapib组LDL-C水平＜55 mg/dL的患者比例是安慰剂组6倍之多（51.0% vs. 8.0%）。截图来源：NEJMBROADWAY试验纳入全球188家医学中心患有ASCVD或杂合子家族性高胆固醇血症成人患者2530例，这些患者均正在接受最大耐受剂量的他汀类药物治疗，且91%的患者正在使用高强度他汀类药物、27%的患者使用依折麦布、4%的患者使用PCSK9抑制剂进行降脂治疗。基线时，所有患者LDL-C平均水平为98 mg/dL、HDL-C平均水平为49 mg/dL、甘油三酯平均水平为124 mg/dL、脂蛋白（a）平均水平为39 nmol/L。研究人员将患者以2：1比例随机分配接受obicetrapib（10 mg/d，口服，1686例）及匹配的安慰剂（844例）治疗365天。研究结果显示，治疗第84天时，obicetrapib组和安慰剂组LDL-C水平分别较基线降低29.9%和2.7%，两组差异为-32.6%（P＜0.001）。obicetrapib组LDL-C水平绝对值降低优于安慰剂组，其中obicetrapib组LDL-C水平自基线的98.1 mg/dL降低至第84天的62.8 mg/dL；安慰剂组LDL-C水平自基线的98.4 mg/dL降低至第84天的92.3 mg/dL。▲obicetrapib组（黄色）和安慰剂组（蓝色）LDL-C水平降幅趋势（图片来源：参考文献[1]）治疗第84天时，obicetrapib组和安慰剂组LDL-C水平＜40 mg/dL的患者比例分别为27.9%和1.1%；LDL-C水平＜55 mg/dL的患者比例分别为51.0%和8.0%；LDL-C水平＜70 mg/dL的患者比例分别为68.4%和27.5%。主要次要研究终点方面，obicetrapib组在LDL-C、载脂蛋白B、非高密度脂蛋白胆固醇和高密度脂蛋白胆固醇等指标上，也均优于安慰剂组：▲不同时间点时，两组主要次要研究终点结局指标对比（内容来源：参考文献[1]；图表制作：医学新视点）安全性方面，obicetrapib组和安慰剂组分别有59.7%和60.8%的患者出现了不良事件，无论在不良事件严重程度、不良事件与治疗用药的关联性，还是停止治疗的原因方面，两组之间对比均无统计学差异。总之，本次研究结果显示，在心血管高危人群中，无论是LDL-C水平较基线百分比变化，还是LDL-C水平绝对值变化，基础降脂治疗联合obicetrapib治疗的效果均优于安慰剂。这意味着obicetrapib可能是心血管高危人群的有效辅助治疗药物。点击文末“阅读原文/Read more”，即可访问NEJM官网阅读完整论文。推荐阅读欢迎投稿：学术成果、前沿进展、临床干货等主题均可，点此了解投稿详情。参考资料[1] S.J. Nicholls, A.J. Nelson, M. Ditmarsch, et al. Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk. Published May 7, 2025. NEJM. DOI: 10.1056/NEJMoa2415820免责声明：本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。版权说明：欢迎个人转发至朋友圈，谢绝媒体或机构未经授权以任何形式转载至其他平台。转载授权请在「医学新视点」微信公众号留言联系。如有其他合作需求，请联系wuxi_media@wuxiapptec.com分享，点赞，在看，传递医学新知

临床结果临床研究

100 项与 Onze Lieve Vrouwe Gasthuis 相关的药物交易

登录后查看更多信息

100 项与 Onze Lieve Vrouwe Gasthuis 相关的转化医学

登录后查看更多信息