Welcome to CBHRI.com

Mon – Fri: 9AM – 6PM

Address

Pater Eeuwensweg 36 Willemstad Curaçao

Email

info@cbhri.com
www.cbhri.com

Phone

+5999 788 9903
(Mon – Fri)

contact:

Dr. John-John Schnog
Head of the Department of Oncology

email: j.schnog@cbhri.com

Our aim is delivering the best possible care and guidance of each individual patient and their loved ones based on a sound multidisciplinary approach

 

Biography

Dr. J. Schnog is head of the Department of Oncology of Curaçao Biomedical & Health Research Institute.

John-John Schnog started his medical studies at the University of Leiden, The Netherlands. He obtained his medical degree at the University of Groningen in 1999. He specialized in Internal Medicine at the Academic Medical Center and Slotervaart Hospital, Amsterdam The Netherlands, completed his training as a medical oncologist at the Departments of Medical Oncology in the Academic Medical Center and the Netherlands Cancer Institute. He specialized in Hematology at the Depatment of Hematology in the Erasmus Medical Center, Rotterdam, The Netherlands. Prior to starting his internships he started participating in fundamental and clinical research mainly on sickle cell disease. He defended his thesis titled ‘Studies on the pathophysiology, disease severity assessment and management of sickle cell disease’ cum laude at the University of Groningen in 2004. He is practicing medicine since 2009 at the Department of Hematology/Medical Oncology of the Sint Elisabeth Hospital in Curaçao and is currently head of the department.

Curruculum Vitea:

Name:                           John-John Bryan Schnog

Date of birth:                February 5th 1974

Place of Birth:               Curaçao, Netherlands Antilles

Marital status:               Married

Profession:                   Internist (registered April 1st 2006) Hematologist (registered August 6th 2008)

Medical oncologist (registered January 29th 2009)

BIG:                                       89051528101

High-school:                 Peter Stuyvesant College Curaçao, Netherlands Antilles (1986-1992) Medical studies:                                    University Hospital Leiden, the Netherlands (1992-1997)

Rotations the Sint Elisabeth Hospital, Curaçao, Netherlands Antilles (1998- 1999)

Medical degree obtained at the University of Groningen, the Netherlands (October 1999)

April 1st 2000-March 31st 2006: Residency Internal Medicine in the Slotervaart Hospital Amsterdam (Dr. D.P.M. Brandjes, internist), the Academic Medical Center Amsterdam (Prof. Dr. P. Speelman, internist and Prof. Dr. M. Levi, internist) and at the Antoni van Leeuwenhoek Cancer Center in Amsterdam (Prof. Dr. S. Rodenhuis).

May 1st 2006 – April 30th 2008: Fellowship hematology in the Erasmus Medical Center, Rotterdam, The Netherlands (Prof. Dr. B. Löwenberg)

May 1st 2008 – October 31st 2008: Completion fellowship oncology in the Academic Medical Center, Amsterdam, The Netherlands (Prof. Dr. D. Richel)

Research experience:  From 1996 active in researcher on sickle cell disease. Co-founder of CURAMA in 2004 (Curaçao-Rotterdam-Amsterdam-Maastricht en Anderen), which is a collaborative effort studying sickle cell disease in the Netherlands and Netherlands Antilles.

 

Thesis: Defended thesis ‘Cum laude’ at the University Hospital Groningen. Title: ‘Studies on the pathophysiology, disease severity assessment and management of sickle cell disease’ (June 30th 2004).

 

Awards:            Hematology thesis of the year award 2005 (received from the Netherlands Society of Hematology)

 

Research abstract oral presentation award 2008 (received from the Netherlands Society of Internal Medicine)

Lectures:           Various educational lectures at NASKHO (Netherlands Antilles for Higher Clinical Education) meetings.

 

Educational session at 2010 European Hematology Association meeting in Barcelona entitled ‘Hypercoagability in sickle cell disease’.

Co-promotor:

 

Thesis E. van Beers (2008): Sickle cell disease; pathophysiology and clinical complications. Thesis P. Landburg (2013): ADMA, Angiogenesis and clinical complications in sickle cell disease.

 

List of publications:

 

Books

Contributing author of: Lang, Florian (Ed.). Encyclopedia of Molecular Mechanisms of Human Disease. 2009, ISBN: 978-3-540-67136-7.

Contributing author of: More Attention for Care. M.A.C. Foundation, ISBN: 978-99904-1-205-5.

Editor and main contributing author of: Schnog JB, Brandjes DPM, Duits AJ, Rojer RA, Muskiet FD eds. Sikkelcelziekte; een praktische handleiding. Van Zuiden Publishers 2006, ISBN: 90-8523-110-8

 

Scientific papers

 

Schnog JB, Duits AJ, Samson MJ. Design Issues with Lutetium-177 PSMA-617 Registration Studies that Bias the Outcome of the Experimental Arm Reflect an Increasing Misalignment of Contemporary Oncology Trials with True Patient Benefit. BJC Reports, in press.

 

Schnog JB, Samson MJ, Gersenbluth I, Duits AJ. Pharmaceutical Industry Payments to Medical Oncologists in the Netherlands: Trends and Patterns Provided by an Open-Access Transparency Data Set. JCO Oncol Pract. 2024 Feb 14:OP2300533. doi: 10.1200/OP.23.00533.

 

de Vocht DECM, Schnog JB, Merkies IS, Samson MJ. Untoward global effects of current guideline formulation of stereotactic radiotherapy for symptomatic brain metastases by international medical societies. Lancet Reg Health Am. 2023 Sep 1;25:100584.

 

Schnog JB, Samson MJ, Duits AJ. An analytical view of the BJH publication of ‘a clinician’s view of voxelotor’. Br J Haematol. 2023 Mar;200(6):e56-e57.

 

Schnog JB, Samson MJ, Duits AJ. Financiële belangen en oncologische geneesmiddelen [Financial conflict of interest and anti-cancer drugs: Why the NTVG’s stance to exclude pharma-advertisement is of importance.]. Ned Tijdschr Geneeskd. 2022;166:D6738.

 

Schnog JB, Samson MJ, Duits AJ. Trastuzumab Deruxtecan in HER2-Low Breast Cancer. N Engl J Med 2022;387:1143-1144.

 

Schnog JB, Samson MJ, Duits AJ. Contemporary oncology trials, drug approvals and the physician- patient relationship. The Lancet Regional Health-Americas 2022;11:100247.

 

Schnog JB, Samson MJ, Gans ROB, Duits AJ. An urgent call to raise the bar in oncology. Br J Cancer. 2021;125:1477-1485.

 

Boerrigter E, Havenith T, van Erp NP, Schnog JB. Deep and ongoing response of castrate-resistant prostate cancer on very low-dose enzalutamide in an elderly chemotherapy-naïve patient: a case report. Cancer Chemother Pharmacol. 2021;88:165-168.

 

Archuleta J, van der Graaf M, Kaptein FHJ, Althaus L, Kooij N, Schnog JB. Sudden death due to massive bone marrow sequestration crisis in a patient with sickle cell disease. Am J Hematol 2021;96:E100- E102.

 

Gerrits EG, Schnog JB. An unusual craving! Neth J Med. 2015;73(2):96.

Schimmel M, van Beers EJ, van Tuijn CF, Nur E, Rijneveld AW, Mac Gillavry MR, Brandjes DP, Schnog JB, Biemond BJ; on behalf of the CURAMA study group. N-terminal pro-B-type natriuretic peptide, tricuspid jet flow velocity, and death in adults with sickle cell disease. Am J Hematol. 2015;90(4):E75-6.

 

Schimmel M, Nur E, Biemond BJ, van Mierlo GJ, Solati S, Brandjes DP, Otten HM, Schnog JB, Zeerleder

  1. Nucleosomes and neutrophil activation in sickle cell disease painful crisis. Haematologica 2013;98:1797-803.

 

E Nur, DP Brandjes, T Teerlink, HM Otten, RPJ Oude Elferink, F Muskiet, LM Evers, H ten Cate, BJ Biemond, AJ Duits, JB Schnog on behalf of the CURAMA study group. N-acetylcysteine Reduces Oxidative Stress in Sickle Cell Patients. Ann Hematol 2012;91(7):1097-105.

 

E Nur, BJ Biemond, HM Otten, DP Brandjes, JB Schnog on behalf of the CURAMA Study Group. Oxidative stress in sickle cell disease; pathophysiology and potential implications for disease management. Am J Hematol. 2011;86:484-9.

 

E Nur, M Verwijs, DR de Waart, JB Schnog, HM Otten, DP Brandjes, BJ Biemond, RP Elferink on behalf of the CURAMA Study Group. Increased efflux of oxidized glutathione (GSSG) causes glutathione depletion and potentially diminishes antioxidant defense in sickle erythrocytes. Biochim Biophys Acta 2011;1812:1412-7.

E Nur, EJ van Beers, S Martina, I Cuccovillo, HM Otten, JB Schnog, JCM Meijers, A Mantovani, DP Brandjes, B Bottazzi, BJ Biemond on behalf of the CURAMA Study Group. Levels of Pentraxin-3, an Acute Phase Protein, Are Increased During Sickle Cell Painful Crisis. Blood Cells Mol Dis 2011;46:189-94.

E Nur, W Mairuhu, BJ Biemond, AP van Zanten, JB Schnog, DP Brandjes, HM Otten HM; CURAMA study group. Urinary markers of bone resorption, pyridinoline and deoxypyridinoline, are increased in sickle cell patients with further increments during painful crisis. Am J Hematol 2010;85:902-4.

E Nur, DP Brandjes, JB Schnog, HM Otten, K Fijnvandraat, CG Schalkwijk, BJ Biemond BJ; CURAMA Study Group. Plasma levels of advanced glycation end products are associated with haemolysis-related organ complications in sickle cell patients. Br J Haematol 2010;151:62-9.

CF van Tuijn, EJ van Beers, JB Schnog, Biemond BJ. Pain rate and social circumstances rather than cumulative organ damage determine the quality of life in adults with sickle cell disease. Am J Hematol 2010;85:532-5.

PP Landburg, T Teerlink, BJ Biemond, DP Brandjes, FA Muskiet, AJ Duits, JB Schnog on behalf of the CURAMA study group. Plasma asymmetric dimethylarginine concentrations in sickle cell disease are related to the hemolytic phenotype. Blood Cells Mol Dis 2010;44:229-32.

EJ Van Beers, BJ Biemond, JB Schnog on behalf of the CURAMA Study Group. Letter in response to “Pulmonary thrombi are not detected by 3D magnetic resonance angiography in adults with sickle cell anemia and an elevated triscuspid regurgitant jet velocity”. Am J Hematol. 2010;85:217.

PP Landburg, E Nur, N Maria, DP Brandjes, BJ Biemond, JB Schnog, AJ Duits on behalf of the CURAMA Study Group. Elevated circulating stromal-derived factor-1 levels in sickle cell disease. Acta Haematol. 2009;122:64-9.

LJ van Tits, WL van Heerde, PP Landburg, MJ Boderie, FA Muskiet, N Jacobs, AJ Duits, JB Schnog. Plasma annexin A5 and microparticle phosphatidylserine levels are elevated in sickle cell disease and increase further during painful crisis. Biochem Biophys Res Commun. 2009;390:161-4.

RT van Beem, E Nur, JJ Zwaginga, PP Landburg, EJ van Beers, AJ Duits, DP Brandjes, I Lommerse, HC de Boer, CE van der Schoot, JB Schnog and BJ Biemond on behalf of the CURAMA study group. Elevated endothelial progenitor cells during painful sickle cell crisis. Exp Haematol,2009;37:1054-9.

MH Strijbos, PP Landburg, E Nur, T Teerlink, FW Leebeek, AW Rijneveld, BJ Biemond, S Sleijfer, JW Gratama, AJ Duits, JB Schnog on behalf of the CURAMA study group. Circulating endothelial cells: a potential parameter of organ damage in sickle cell anemia? Blood Cells Mol Dis. 2009;43:63-7.

PP Landburg, H Elsenga, JB Schnog, AJ Duits on behalf of the CURAMA Study Group*. Increased serum levels of anti-angiogenic factors soluble FMS-like tyrosine kinase and soluble endoglin in sickle cell disease. Acta Haematol 2008;120:130-3.

 

K Berend, VGM Abreu de Martinez, JB Schnog. An unusual way of diagnosing sickle cell disease. Am J Hematol 2009;84:371.

EJ van Beers, E Nur, CM Schaefer-Prokop, MR Mac Gillavry, JWJ van Esser, DPM Brandjes, MC Kappers- Klunne, AJ Duits, FAJ Muskiet, JB Schnog, BJ Biemond on behalf of the CURAMA study group. Cardiopulmonary imaging, functional and laboratory studies in sickle cell disease associated pulmonary hypertension. Am J Hematol 2008;83:850-4.

PP Landburg, T Teerlink, FAJ Muskiet, JWJ van Esser, MR Mac Gillavry, BJ Biemond, DPM Brandjes, AJ Duits, JB Schnog on behalf of the CURAMA study group. Association of asymetric dimethylarginine concentrations with pulmonay hypertension in sickle cell disease. Haematologica 2008;93:1410-2.

                        

RM Van Hest, JB Schnog, MB Van ’t Veer, JJ Cornelissen. Extremely slow methotrexate elimination in a patient with t(9;22) positive acute lymphoblastic leukemia treated with imatinib. Am J Hematol 2008;83:757-8.

PP Landburg, T Teerlink, FAJ Muskiet, AJ Duits, JB Schnog on behalf of the CURAMA study group. Plasma concentrations of asymmetric dimethylarginine, an endogenous nitric oxide inhibitor, are elevated in sickle cell disease but do not increase further during painful crises. Am J Hematol 2008;83:577-9.

 

E.J. van Beers, van Oerle R, Brandjes DPM, Duits AJ, van Esser JWJ, ten Cate H, Biemond BJ, Schnog JB on behalf of the CURAMA study Group. No Association of the Hypercoagulable State With Sickle Cell Disease Related Pulmonary Hypertension. Haematologica 2008;93:e42-e44.

EJ van Beers, CFJ van Tuijn, A van der Giessen, JB Schnog, BJ Biemond on behalf of the CURAMA study group. High prevalence of sickle cell disease related organ damage occurs irrespective of pain rate; implications for clinical practice. Haematologica 2008;93:757-60.

 

EJ van Beers, M Nieuwdorp, AJ Duits, LM Evers, JB Schnog, BJ Biemond on behalf of the CURAMA study group. Sickle cell patients are characterized by a reduced glycocalyx volume. Haematologica. 2008;93:307-8.

 

EJ van Beers, BLF van Eck-Smit, MR Mac Gillavry, CFJ van Tuijn, JWJ van Esser, DPM Brandjes, MC Kappers-Klunne, AJ Duits, BJ Biemond, JB Schnog on behalf of the CURAMA study group. Large and medium sized pulmonary artery obstruction does not play a role of primary importance in the etiology of sickle cell disease related pulmonary hypertension. Chest. 2008;133:646-52.

AJ Duits, T Rodriguez, JB Schnog on behalf of the CURAMA study group. Serum levels of angiogenic factors indicate a pro-angiogenic state in adults with sickle cell disease. Br J Haematol, 2006;134:116- 119.

 

JB Schnog, JA Kremer Hovinga, S Krieg, S Akin, B Lämmle, DPM Brandjes, MR Mac Gillavry, FD Muskiet, AJ Duits on behalf of the CURAMA study group. ADAMTS13 activity in sickle cell disease. Am J Hematol. 2006;81:492-498.

JB Schnog, T Teerlink, FPL van der Dijs, AJ Duits, FAJ Muskiet on behalf of the CURAMA study group. Plasma levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, are elevated in sickle cell disease. Ann Hematol. 2005;84:282-286.

JB Schnog, T Teerlink, FPL van der Dijs, AJ Duits, FAJ Muskiet on behalf of the CURAMA study group. Plasma levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, are elevated in sickle cell disease. Ann Hematol. 2005;84:282-286.

 

JB Schnog, AJ Duits, FAJ Muskiet, H ten Cate, RA Rojer, DPM Brandjes. Sickle cell disease: a general overview. Neth J Med. 2004;62:364-374.

 

JB Schnog, EH Jager, FPL van der Dijs, AJ Duits, H Moshage, FD Muskiet, FAJ Muskiet. Evidence for a metabolic shift of arginine metabolism in sickle cell disease. Ann Hematol. 2004;83:371-375.

JB Schnog, MR Mac Gillavry, AP van Zanten, JCM Meijers, RA Rojer, AJ Duits, H ten Cate, DPM Brandjes. Protein C and S and inflammation in sickle cell disease. Am J Hematol. 2004;76:26-32.

JB Schnog. Studies gericht op ziekte-inzicht, het bepalen van de ziekte-ernst en de behandeling van sikkelcelziekte. Ned Tijdschr Hematol 2004;1:198-200.

AJ Duits, RA Rojer, T van Endt, MR MacGillavry, H ten Cate, DP Brandjes, JB Schnog. Erythropoiesis and serum sVCAM-1 levels in adults with sickle cell disease. Ann Hematol. 2003;82:171-174.

 

JB Schnog, RA Rojer, MR Mac Gillavry, H Ten Cate, DP Brandjes, AJ Duits. Steady-state sVCAM-1 serum levels in adults with sickle cell disease. Ann Hematol. 2003;82:109-113.

 

JB Schnog, MR Mac Gillavry, RA Rojer, JC Meijers, R Fijnheer, H ten Cate, DP Brandjes, AJ Duits. No effect of acenocoumarol therapy on levels of endothelial activation markers in sickle cell disease. Am J Hematol. 2002;71:53-55.

 

FP van der Dijs, MR Fokkema, DA Dijck-Brouwer, B Niessink, TI van der Wal, JB Schnog, AJ Duits, FD Muskiet, FA Muskiet. Optimization of folic acid, vitamin B(12), and vitamin B(6) supplements in pediatric patients with sickle cell disease. Am J Hematol. 2002;69:239-246.

 

JB Schnog, FP van der Dijs, MR Fokkema, FD Muskiet, FA Muskiet. Folate status assessment and folic acid supplements in sickle cell disease. J Pediatr Hematol Oncol. 2001;23:548.

 

Schnog JB, Kater AP, Mac Gillavry MR, Duits AJ, Lard LR, van Der Dijs FP, Brandjes DP, ten Cate H, van Eps LW, Rojer RA. Low adjusted-dose acenocoumarol therapy in sickle cell disease: a pilot study. Am J Hematol. 2001;68:179-183.

Schnog JB, Duits AJ. (Referaat) Ulcera cruris door behandeling van sikkelcelpatiënten met hydroxycarbamide? Ned Tijdschr Geneesk 2001;43:2099.

Schnog JB, Keli SO, Pieters RA, Rojer RA, Duits AJ. Duffy phenotype does not influence the clinical severity of sickle cell disease. Clin Immunol. 2000;96:264-268.

AP Kater, JB Schnog. (Referaat) Sulfasalazine mogelijk effectief bij sikkelcelziekte. Ned Tijdschr Geneesk 2001;34:145.

JB Schnog, FP van der Dijs, DA Brouwer, AJ Duits, FD Muskiet, FA Muskiet. Plasma homocysteine levels in sickle cell disease and the need for folate supplementation. J Pediatr Hematol Oncol. 2000;22:184- 185.

 

AJ Duits, JB Schnog, LR Lard, AW Saleh, RA Rojer. Elevated IL-8 levels during sickle cell crisis. Eur J Haematol. 1998;61:302-305.

FP van der Dijs, JB Schnog, DA Brouwer, HJ Velvis, GA van den Berg, AJ Bakker, AJ Duits, FD Muskiet, FA Muskiet. Elevated homocysteine levels indicate suboptimal folate status in pediatric sickle cell patients. Am J Hematol. 1998;59:192-198.

 

JB Schnog, LR Lard, RA Rojer, FP Van der Dijs, FA Muskiet, AJ Duits. New concepts in assessing sickle cell disease severity. Am J Hematol. 1998;58:61-66.

Publications

List of publications:

Books

Contributing author of: Lang, Florian (Ed.). Encyclopedia of Molecular Mechanisms of Human Disease. 2009, ISBN: 978-3-540-67136-7.

Contributing author of: More Attention for Care.  M.A.C. Foundation, ISBN: 978-99904-1-205-5.

Editor and main contributing author of: Schnog JB, Brandjes DPM, Duits AJ, Rojer RA, Muskiet FD eds. Sikkelcelziekte; een praktische handleiding. Van Zuiden Publishers 2006, ISBN: 90-8523-110-8

 

Scientific papers

 Schnog JB, Duits AJ, Samson MJ. Design Issues with Lutetium-177 PSMA-617 Registration Studies that Bias the Outcome of the Experimental Arm Reflect an Increasing Misalignment of Contemporary Oncology Trials with True Patient Benefit. BJC Reports, in press.

Schnog JB, Samson MJ, Gersenbluth I, Duits AJ. Pharmaceutical Industry Payments to Medical Oncologists in the Netherlands: Trends and Patterns Provided by an Open-Access Transparency Data Set. JCO Oncol Pract. 2024 Feb 14:OP2300533. doi: 10.1200/OP.23.00533. 

de Vocht DECM, Schnog JB, Merkies IS, Samson MJ. Untoward global effects of current guideline formulation of stereotactic radiotherapy for symptomatic brain metastases by international medical societies. Lancet Reg Health Am. 2023 Sep 1;25:100584. 

Schnog JB, Samson MJ, Duits AJ. An analytical view of the BJH publication of ‘a clinician’s view of voxelotor’. Br J Haematol. 2023 Mar;200(6):e56-e57. 

Schnog JB, Samson MJ, Duits AJ. Financiële belangen en oncologische geneesmiddelen [Financial conflict of interest and anti-cancer drugs: Why the NTVG’s stance to exclude pharma-advertisement is of importance.]. Ned Tijdschr Geneeskd. 2022;166:D6738. 

Schnog JB, Samson MJ, Duits AJ. Trastuzumab Deruxtecan in HER2-Low Breast Cancer. N Engl J Med 2022;387:1143-1144.

Schnog JB, Samson MJ, Duits AJ. Contemporary oncology trials, drug approvals and the physician-patient relationship. The Lancet Regional Health-Americas 2022;11:100247.

Schnog JB, Samson MJ, Gans ROB, Duits AJ. An urgent call to raise the bar in oncology. Br J Cancer. 2021;125:1477-1485. 

Boerrigter E, Havenith T, van Erp NP, Schnog JB. Deep and ongoing response of castrate-resistant prostate cancer on very low-dose enzalutamide in an elderly chemotherapy-naïve patient: a case report. Cancer Chemother Pharmacol. 2021;88:165-168. 

Archuleta J, van der Graaf M, Kaptein FHJ, Althaus L, Kooij N, Schnog JB. Sudden death due to massive bone marrow sequestration crisis in a patient with sickle cell disease. Am J Hematol 2021;96:E100-E102. 

Gerrits EG, Schnog JB. An unusual craving! Neth J Med. 2015;73(2):96.

Schimmel M, van Beers EJ, van Tuijn CF, Nur E, Rijneveld AW, Mac Gillavry MR, Brandjes DP, Schnog JB, Biemond BJ; on behalf of the CURAMA study group. N-terminal pro-B-type natriuretic peptide, tricuspid jet flow velocity, and death in adults with sickle cell disease. Am J Hematol. 2015;90(4):E75-6. 

Schimmel M, Nur E, Biemond BJ, van Mierlo GJ, Solati S, Brandjes DP, Otten HM, Schnog JB, Zeerleder S. Nucleosomes and neutrophil activation in sickle cell disease painful crisis. Haematologica 2013;98:1797-803.

E Nur, DP Brandjes, T Teerlink, HM Otten, RPJ Oude Elferink, F Muskiet, LM Evers, H ten Cate, BJ Biemond, AJ Duits, JB Schnog on behalf of the CURAMA study group. N-acetylcysteine Reduces Oxidative Stress in Sickle Cell Patients. Ann Hematol 2012;91(7):1097-105.

 

E Nur, BJ Biemond, HM Otten, DP Brandjes, JB Schnog on behalf of the CURAMA Study Group.

Oxidative stress in sickle cell disease; pathophysiology and potential implications for disease management. Am J Hematol. 2011;86:484-9.

 

E Nur, M Verwijs, DR de Waart, JB Schnog, HM Otten, DP Brandjes, BJ Biemond, RP Elferink on behalf of the CURAMA Study Group. Increased efflux of oxidized glutathione (GSSG) causes glutathione depletion and potentially diminishes antioxidant defense in sickle erythrocytes. Biochim Biophys Acta 2011;1812:1412-7.

 

E Nur, EJ van Beers, S Martina, I Cuccovillo, HM Otten, JB Schnog, JCM Meijers, A Mantovani, DP Brandjes, B Bottazzi, BJ Biemond on behalf of the CURAMA Study Group. Levels of Pentraxin-3, an Acute Phase Protein, Are Increased During Sickle Cell Painful Crisis. Blood Cells Mol Dis 2011;46:189-94.

 

E Nur, W Mairuhu, BJ Biemond, AP van Zanten, JB Schnog, DP Brandjes, HM Otten HM; CURAMA study group. Urinary markers of bone resorption, pyridinoline and deoxypyridinoline, are increased in sickle cell patients with further increments during painful crisis. Am J Hematol 2010;85:902-4.

E Nur, DP Brandjes, JB Schnog, HM Otten, K Fijnvandraat, CG Schalkwijk, BJ Biemond BJ; CURAMA Study Group. Plasma levels of advanced glycation end products are associated with haemolysis-related organ complications in sickle cell patients. Br J Haematol 2010;151:62-9.

 

CF van Tuijn, EJ van Beers, JB Schnog, Biemond BJ. Pain rate and social circumstances rather than cumulative organ damage determine the quality of life in adults with sickle cell disease. Am J Hematol 2010;85:532-5.

PP Landburg, T Teerlink, BJ Biemond, DP Brandjes, FA Muskiet, AJ Duits, JB Schnog on behalf of the CURAMA study group. Plasma asymmetric dimethylarginine concentrations in sickle cell disease are related to the hemolytic phenotype. Blood Cells Mol Dis 2010;44:229-32.

 

EJ Van Beers, BJ Biemond, JB Schnog on behalf of the CURAMA Study Group. Letter in response to “Pulmonary thrombi are not detected by 3D magnetic resonance angiography in adults with sickle cell anemia and an elevated triscuspid regurgitant jet velocity”. Am J Hematol. 2010;85:217.

PP Landburg, E Nur, N Maria, DP Brandjes, BJ Biemond, JB Schnog, AJ Duits on behalf of the CURAMA Study Group. Elevated circulating stromal-derived factor-1 levels in sickle cell disease. Acta Haematol. 2009;122:64-9.

LJ van Tits, WL van Heerde, PP Landburg, MJ Boderie, FA Muskiet, N Jacobs, AJ Duits, JB Schnog. Plasma annexin A5 and microparticle phosphatidylserine levels are elevated in sickle cell disease and increase further during painful crisis. Biochem Biophys Res Commun. 2009;390:161-4.

RT van Beem, E Nur, JJ Zwaginga, PP Landburg, EJ van Beers, AJ Duits, DP Brandjes, I Lommerse, HC de Boer, CE van der Schoot, JB Schnog and BJ Biemond on behalf of the CURAMA study group. Elevated endothelial progenitor cells during painful sickle cell crisis. Exp Haematol,2009;37:1054-9.

 

MH Strijbos, PP Landburg, E Nur, T Teerlink, FW Leebeek, AW Rijneveld, BJ Biemond, S Sleijfer, JW Gratama, AJ Duits, JB Schnog on behalf of the CURAMA study group. Circulating endothelial cells: a potential parameter of organ damage in sickle cell anemia? Blood Cells Mol Dis. 2009;43:63-7.

 

PP Landburg, H Elsenga, JB Schnog, AJ Duits on behalf of the CURAMA Study Group*. Increased serum levels of anti-angiogenic factors soluble FMS-like tyrosine kinase and soluble endoglin in sickle cell disease. Acta Haematol 2008;120:130-3.

 

K Berend, VGM Abreu de Martinez, JB Schnog. An unusual way of diagnosing sickle cell disease. Am J Hematol 2009;84:371.

 

EJ van Beers, E Nur, CM Schaefer-Prokop, MR Mac Gillavry, JWJ van Esser, DPM Brandjes, MC Kappers-Klunne, AJ Duits, FAJ Muskiet, JB Schnog, BJ Biemond on behalf of the CURAMA study group. Cardiopulmonary imaging, functional and laboratory studies in sickle cell disease associated pulmonary hypertension. Am J Hematol 2008;83:850-4.

 

PP Landburg, T Teerlink, FAJ Muskiet, JWJ van Esser, MR Mac Gillavry, BJ Biemond, DPM Brandjes, AJ Duits, JB Schnog on behalf of the CURAMA study group. Association of asymetric dimethylarginine concentrations with pulmonay hypertension in sickle cell disease. Haematologica 2008;93:1410-2.

 

RM Van Hest, JB Schnog, MB Van ’t Veer, JJ Cornelissen. Extremely slow methotrexate elimination in a patient with t(9;22) positive acute lymphoblastic leukemia treated with imatinib. Am J Hematol 2008;83:757-8.

 

PP Landburg, T Teerlink, FAJ Muskiet, AJ Duits, JB Schnog on behalf of the CURAMA study group. Plasma concentrations of asymmetric dimethylarginine, an endogenous nitric oxide inhibitor, are elevated in sickle cell disease but do not increase further during painful crises. Am J Hematol 2008;83:577-9.

 

E.J. van Beers, van Oerle R, Brandjes DPM, Duits AJ, van Esser JWJ, ten Cate H, Biemond BJ, Schnog JB on behalf of the CURAMA study Group. No Association of the Hypercoagulable State With Sickle Cell Disease Related Pulmonary Hypertension. Haematologica 2008;93:e42-e44.

 

EJ van Beers,  CFJ van Tuijn, A van der Giessen, JB Schnog, BJ Biemond  on behalf of the CURAMA study group. High prevalence of sickle cell disease related organ damage occurs irrespective of pain rate; implications for clinical practice. Haematologica 2008;93:757-60.

 

EJ van Beers, M Nieuwdorp, AJ Duits, LM Evers, JB Schnog, BJ Biemond on behalf of the CURAMA study group. Sickle cell patients are characterized by a reduced glycocalyx volume. Haematologica. 2008;93:307-8.

 

EJ van Beers, BLF van Eck-Smit, MR Mac Gillavry, CFJ van Tuijn, JWJ van Esser, DPM Brandjes, MC Kappers-Klunne, AJ Duits, BJ Biemond, JB Schnog on behalf of the CURAMA study group. Large and medium sized pulmonary artery obstruction does not play a role of primary importance in the etiology of sickle cell disease related pulmonary hypertension. Chest. 2008;133:646-52.

 

AJ Duits, T Rodriguez, JB Schnog on behalf of the CURAMA study group. Serum levels of angiogenic factors indicate a pro-angiogenic state in adults with sickle cell disease. Br J Haematol, 2006;134:116-119.

 

JB Schnog, JA Kremer Hovinga, S Krieg, S Akin, B Lämmle, DPM Brandjes, MR Mac Gillavry, FD Muskiet, AJ Duits on behalf of the CURAMA study group. ADAMTS13 activity in sickle cell disease. Am J Hematol. 2006;81:492-498.

 

JB Schnog, T Teerlink, FPL van der Dijs, AJ Duits, FAJ Muskiet on behalf of the CURAMA study group. Plasma levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, are elevated in sickle cell disease. Ann Hematol. 2005;84:282-286.

 

JB Schnog, T Teerlink, FPL van der Dijs, AJ Duits, FAJ Muskiet on behalf of the CURAMA study group. Plasma levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, are elevated in sickle cell disease. Ann Hematol. 2005;84:282-286.

 

JB Schnog, AJ Duits, FAJ Muskiet, H ten Cate, RA Rojer, DPM Brandjes. Sickle cell disease: a general overview. Neth J Med. 2004;62:364-374.

 

JB Schnog, EH Jager, FPL van der Dijs, AJ Duits, H Moshage, FD Muskiet, FAJ Muskiet. Evidence for a metabolic shift of arginine metabolism in sickle cell disease. Ann Hematol. 2004;83:371-375.

 

JB Schnog, MR Mac Gillavry, AP van Zanten, JCM Meijers, RA Rojer, AJ Duits, H ten Cate, DPM Brandjes. Protein C and S and inflammation in sickle cell disease. Am J Hematol. 2004;76:26-32.

JB Schnog. Studies gericht op ziekte-inzicht, het bepalen van de ziekte-ernst en de behandeling van sikkelcelziekte. Ned Tijdschr Hematol 2004;1:198-200.

AJ Duits, RA Rojer, T van Endt, MR MacGillavry, H ten Cate, DP Brandjes, JB Schnog.  Erythropoiesis and serum sVCAM-1 levels in adults with sickle cell disease. Ann Hematol. 2003;82:171-174.

 

JB Schnog, RA Rojer, MR Mac Gillavry, H Ten Cate, DP Brandjes, AJ Duits. Steady-state sVCAM-1 serum levels in adults with sickle cell disease. Ann Hematol. 2003;82:109-113.

 

JB Schnog, MR Mac Gillavry, RA Rojer, JC Meijers, R Fijnheer, H ten Cate, DP Brandjes, AJ Duits. No effect of acenocoumarol therapy on levels of endothelial activation markers in sickle cell disease. Am J Hematol. 2002;71:53-55.

 

FP van der Dijs, MR Fokkema, DA Dijck-Brouwer, B Niessink, TI van der Wal, JB Schnog, AJ Duits, FD Muskiet, FA Muskiet. Optimization of folic acid, vitamin B(12), and vitamin B(6) supplements in pediatric patients with sickle cell disease. Am J Hematol. 2002;69:239-246.

 

JB Schnog, FP van der Dijs, MR Fokkema, FD Muskiet, FA Muskiet. Folate status assessment and folic acid supplements in sickle cell disease. J Pediatr Hematol Oncol. 2001;23:548.

 

Schnog JB, Kater AP, Mac Gillavry MR, Duits AJ, Lard LR, van Der Dijs FP, Brandjes DP, ten Cate H, van Eps LW, Rojer RA. Low adjusted-dose acenocoumarol therapy in sickle cell disease: a pilot study. Am J Hematol. 2001;68:179-183.

Schnog JB, Duits AJ. (Referaat) Ulcera cruris door behandeling van sikkelcelpatiënten met hydroxycarbamide? Ned Tijdschr Geneesk 2001;43:2099.

Schnog JB, Keli SO, Pieters RA, Rojer RA, Duits AJ. Duffy phenotype does not influence the clinical severity of sickle cell disease. Clin Immunol. 2000;96:264-268.

AP Kater, JB Schnog. (Referaat) Sulfasalazine mogelijk effectief bij sikkelcelziekte. Ned Tijdschr Geneesk 2001;34:145.

JB Schnog, FP van der Dijs, DA Brouwer, AJ Duits, FD Muskiet, FA Muskiet. Plasma homocysteine levels in sickle cell disease and the need for folate supplementation. J Pediatr Hematol Oncol. 2000;22:184-185.

 

AJ Duits, JB Schnog, LR Lard, AW Saleh, RA Rojer. Elevated IL-8 levels during sickle cell crisis. Eur J Haematol. 1998;61:302-305.

 

FP van der Dijs, JB Schnog, DA Brouwer, HJ Velvis, GA van den Berg, AJ Bakker, AJ Duits, FD Muskiet, FA Muskiet.  Elevated homocysteine levels indicate suboptimal folate status in pediatric sickle cell patients. Am J Hematol. 1998;59:192-198.

 

JB Schnog, LR Lard, RA Rojer, FP Van der Dijs, FA Muskiet, AJ Duits. New concepts in assessing sickle cell disease severity. Am J Hematol. 1998;58:61-66.

 

Raise Bar for Sensible Care: Research and Education Program

Raise Bar for Sensible Care: Research and Education Program

A.J. Duits, PhD1-4, M.J. Samson, MD5, I. Gersenbluth, MD1, J.B. Schnog, MD, PhD1,2,8

 1Curaçao Biomedical & Health Research Institute, Curaçao

2Department of Medical Education, Curaçao Medical Center, Curaçao

3Institute for Medical Education, University Medical Center Groningen, The Netherlands

4Red Cross Blood Bank Foundation, Curaçao

5Department of Radiation Oncology, Curaçao Medical Center, Curaçao

6Department of Hematology-Medical Oncology, Curaçao Medical Center, Curaçao

 

 

Background

                In order for health care to remain accesible and sustainable reorganisation of both medical care and societal inequities are being addressed in Govermental programs in The Netherlands. Capital is being reserved for programs addressing determinants of health starting at birth irrespective of economic background with aim of preserving good health as long as possible, thereby reducing health care consumption and societal spending on the long run in health care. Even though it remains to be seen to what extent such lifestyle interventions will result in a healthier society with better outcome and less health care expediture, on the long run, critical appraisal of health care as offered in the present can directly lead to a reduction in spending when widespread administration of low value care would be halted. This would not only lead to savings in health care, allowing immediate re-allocation of scarce funding, but will also protect patients from exposure to ineffective and maybe even harmful treatments.  

                Modern Western medicine is increasingly characterized by overdiagnosis and over treatment. In (acutely) ill patients, medical interventions can lead to significant benefit. For almost all interventions, the greatest gain is in those with highest risk of poor outcome (e.g. treatment of severe hypertension benefits many, as opposed to treating mild hypertension, which benefits few, if any, but leads to high medical consumption). Costs of many new interventions are high. Even in affluent countries rising costs of medical interventions strain increasingly scarce resources and adequate analyses of costs in relation to effectiveness (value) should form the basis for optimizing patterns of resource allocation. However, adequate choices can only follow proper determination of effectiveness of an intervention. Adequate interpretation of medical data by physicians and policymakers is therefore crucial. However, medical education is lacking in adequate preparation of physicians to be able to critically appraise medical research. Physicians should be better prepared to view the impact of medical interventions in a broader scope. Also, when interventions turn out to be no better than a previous standard of care or placebo, it takes many years to abandon such therapies. This leads to ongoing exposure to patients to sometimes intensive treatments and society to waste of financial resources. To re-allocate funding to long term programs for improving health outcomes, choices of interventions in health care should be limited to interventions of high value. Choices should lead to sensible care. Sensible care equates judicious use of interventions in health care leading to an improvement in quality of life (QOL) and/or an increased overall survival (OS). Sensible care is affordable in its specific societal context.  Sensible care is refrainment from or termination of low value interventions, and sensible care is implementation of high value interventions.  

For this to be achieved, physicians need to be able to assess the relative merit of costly interventions without concomitant benefit. For example, even though spending on cancer care is very high in The Netherlands, the outcome of cancer patients is among the worst in high income countries. Fundamental understanding the limitations of medical advances in general and a clear understanding of the many factors at play in drug and medical device development is needed and should be taught during medical education. 

Our research and education program aims to both address shortcomings in evidence underlying development and implementation of (new) medical interventions (with special focus on oncology) as well as implementation of an educational program to better prepare medical students to critically interpret medical evidence, recognize underlying pitfalls and emphasize integration into the context of public health.

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