Publications by authors named "A Ma��as"

876 Publications

Hormone therapy and cardiovascular disease: Benefits and harms.

Best Pract Res Clin Endocrinol Metab 2021 Sep 10:101576. Epub 2021 Sep 10.

Chair Women's Cardiovascular Health Program, Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address:

Menopause transition marks an important phase in life when cardiovascular risk in women gradually takes an adverse turn. Although menopausal hormone therapy has gained a negative appreciation over the last decades, its value in the treatment of disabling vasomotor symptoms is still undisputed. Cardiovascular risk assessment has become a matter of precision medicine, which is helpful for safe menopausal hormone therapy prescription. With a multidisciplinary approach the current available hormone regimens can be even given to women at intermediate cardiovascular risk, when risk factors such as hypertension and dyslipidemia are adequately monitored and treated.
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http://dx.doi.org/10.1016/j.beem.2021.101576DOI Listing
September 2021

The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry: A comparative cohort study.

PLoS Med 2021 Sep 14;18(9):e1003761. Epub 2021 Sep 14.

Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.

Background: Traumatic brain injury (TBI) is an important global public health burden, where those injured by high-energy transfer (e.g., road traffic collisions) are assumed to have more severe injury and are prioritised by emergency medical service trauma triage tools. However recent studies suggest an increasing TBI disease burden in older people injured through low-energy falls. We aimed to assess the prevalence of low-energy falls among patients presenting to hospital with TBI, and to compare their characteristics, care pathways, and outcomes to TBI caused by high-energy trauma.

Methods And Findings: We conducted a comparative cohort study utilising the CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) Registry, which recorded patient demographics, injury, care pathway, and acute care outcome data in 56 acute trauma receiving hospitals across 18 countries (17 countries in Europe and Israel). Patients presenting with TBI and indications for computed tomography (CT) brain scan between 2014 to 2018 were purposively sampled. The main study outcomes were (i) the prevalence of low-energy falls causing TBI within the overall cohort and (ii) comparisons of TBI patients injured by low-energy falls to TBI patients injured by high-energy transfer-in terms of demographic and injury characteristics, care pathways, and hospital mortality. In total, 22,782 eligible patients were enrolled, and study outcomes were analysed for 21,681 TBI patients with known injury mechanism; 40% (95% CI 39% to 41%) (8,622/21,681) of patients with TBI were injured by low-energy falls. Compared to 13,059 patients injured by high-energy transfer (HE cohort), the those injured through low-energy falls (LE cohort) were older (LE cohort, median 74 [IQR 56 to 84] years, versus HE cohort, median 42 [IQR 25 to 60] years; p < 0.001), more often female (LE cohort, 50% [95% CI 48% to 51%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001), more frequently taking pre-injury anticoagulants or/and platelet aggregation inhibitors (LE cohort, 44% [95% CI 42% to 45%], versus HE cohort, 13% [95% CI 11% to 14%]; p < 0.001), and less often presenting with moderately or severely impaired conscious level (LE cohort, 7.8% [95% CI 5.6% to 9.8%], versus HE cohort, 10% [95% CI 8.7% to 12%]; p < 0.001), but had similar in-hospital mortality (LE cohort, 6.3% [95% CI 4.2% to 8.3%], versus HE cohort, 7.0% [95% CI 5.3% to 8.6%]; p = 0.83). The CT brain scan traumatic abnormality rate was 3% lower in the LE cohort (LE cohort, 29% [95% CI 27% to 31%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001); individuals in the LE cohort were 50% less likely to receive critical care (LE cohort, 12% [95% CI 9.5% to 13%], versus HE cohort, 24% [95% CI 23% to 26%]; p < 0.001) or emergency interventions (LE cohort, 7.5% [95% CI 5.4% to 9.5%], versus HE cohort, 13% [95% CI 12% to 15%]; p < 0.001) than patients injured by high-energy transfer. The purposive sampling strategy and censorship of patient outcomes beyond hospital discharge are the main study limitations.

Conclusions: We observed that patients sustaining TBI from low-energy falls are an important component of the TBI disease burden and a distinct demographic cohort; further, our findings suggest that energy transfer may not predict intracranial injury or acute care mortality in patients with TBI presenting to hospital. This suggests that factors beyond energy transfer level may be more relevant to prehospital and emergency department TBI triage in older people. A specific focus to improve prevention and care for patients sustaining TBI from low-energy falls is required.
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http://dx.doi.org/10.1371/journal.pmed.1003761DOI Listing
September 2021

Advanced Cardiac Interventions During Pregnancy: A Personal Perspective.

Authors:
Angela Hem Maas

Interv Cardiol 2021 Apr 12;16:e25. Epub 2021 Aug 12.

Department of Cardiology, Radboud University Medical Center Nijmegen, the Netherlands.

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http://dx.doi.org/10.15420/icr.2020.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383141PMC
April 2021

Mammograms to catch many birds with one stone.

Eur Heart J 2021 Sep;42(34):3371-3373

Department of Radiology, University Medical Center Utrecht and Utrecht University, The Netherlands.

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http://dx.doi.org/10.1093/eurheartj/ehab522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423472PMC
September 2021

Follow up: palmitic acid ester of tetrahydrocannabinol (THC) and palmitic acid diester of 11-hydroxy-THC - unsuccessful search for additional THC metabolites.

Drug Metab Pers Ther 2021 Mar 22;36(3):199-203. Epub 2021 Mar 22.

Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Bonn, Germany.

Objectives: In a previous investigation we searched for the occurrence of palmitic acid ester compounds of delta9-tetrahydrocannabinol (THC) and its primary metabolite 11-hydroxy-delta9-THC (11-OH-THC) in human body fluids and tissues (THC palmitic acid monoester [THC-Pal] and 11-OH-THC palmitic acid diester [11-OH-THC-DiPal]). As those esters could not be detected in various human body fluids (e.g. blood) or tissues (e.g. adipose tissue) we extended the investigation analyzing adipose tissue samples of mice previously given synthetic THC or a cannabis extract.

Methods: In total, 48 adipose tissue samples previously tested positive for THC by means of a liquid chromatographic triple quadrupole mass spectrometric (LC-QQQ-MS) method were analyzed for the presence of THC-Pal and 11-OH-THC-DiPal by means of LC-QQQ-MS.

Results: THC-Pal and 11-OH-THC-DiPal were not detected among the adipose tissue samples analyzed despite the presence of high THC concentrations within the adipose tissue. THC concentrations in adipose tissue were in a range of approximately 7-2,595 ng/g (median: 468 ng/g, average: 704 ng/g).

Conclusions: A (site-specific) synthesis of 11-OH-THC palmitic acid monoesters (11-hydroxy-delta9-THC-1-palmitate and 11-palmitoyloxy-delta9-THC) still remains to be done. After synthesis of these monoesters, their presence in the body fluids and tissues after THC administration should be investigated.
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http://dx.doi.org/10.1515/dmpt-2020-0151DOI Listing
March 2021
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