7 research outputs found
L’émergence d’une écologie locale des nouvelles médiatée par @CLACMontreal, les audiences de Twitter et les médias d’information en contexte de (sur)veillance
No full textInternational audienceIn this article, the author studies how the anti-capitalist militants at the 2010 meeting of the G20 in Toronto and the thousands of demonstrators during the 2012 Quebec student protest movement used Twitter to develop alternative forms of online news production and journalism practices in an era of technological surveillance. Through a contextual analysis of how activists conjugate their knowledge production practices and identity construction expertise in influential social media, the author sheds new light on recent structures, patterns and routines of news production on Twitter.Dans cet article, l'auteure étudie comment les usages et les appropriations de Twitter par des militants anticapitalistes lors de la réunion du G20 à Toronto en 2010 et de la grève étudiante québécoise de 2012 ont fait émerger de nouvelles formes de production d’information et de nouvelles pratiques journalistiques à l'ère des « relations de surveillance ». Elle s'intéresse notamment aux tactiques de sousveillance visant à provoquer des prises de conscience collective. Son analyse a pour objectif de mieux comprendre les modalités émergentes de construction des identités, des informations et des savoirs et les processus de production de l'information sur Twitter. En conclusion, elle introduit une réflexion sur le contrôle social et la classification générés par les politiques de surveillance sur Twitter
An evidence-based recommendation on bed head elevation for mechanically ventilated patients
No full textA semi-upright position in ventilated patients is recommended to prevent ventilator-associated pneumonia (VAP) and is one of the components in the Ventilator Bundle of the Institute for Health Care Improvement. This recommendation, however, is not an evidence-based one.status: Publishe
Abnormal uterine bleeding in VTE patients treated with rivaroxaban compared to vitamin K antagonists
No full textIntroduction: Rivaroxaban is a convenient oral anticoagulant for patients with venous thromboembolism (VTE). The impact of rivaroxaban and vitamin K antagonists (VKAs) on abnormal uterine bleeding (AUB) in real life has not been previously explored. Materials and methods: We performed a single-center retrospective study on AUB in female VTE patients of reproductive age who were treated with either rivaroxaban or VKAs. Results: Questionnaire results were available for 52 patients in each treatment group. Approximately two thirds of all women reported AUB after initiation of anticoagulant therapy. Patients using rivaroxaban were more likely to experience prolonged (>8 days) menstrual bleeding (27 % vs. 8.3%, P = 0.017). Rivaroxaban treatment increased the duration of menstrual bleeding from median 5 (IQR 3.5-6.0) days before start of treatment to 6 (IQR 4.1-8.9) days (P <0.001). VKA treatment did not lead to significant prolongation of the menstrual period. Patients on rivaroxaban more frequently reported an unscheduled contact with a physician for AUB than women using VKAs (41% vs. 25%, P = 0.096). They also reported increased need for menorrhagia-related medical or surgical intervention (25% vs. 7.7%, P = 0.032) and had more adaptations of anticoagulant therapy (15% vs. 1.9%, P = 0.031). Conclusion: AUB is frequent after initiation of anticoagulant therapy for acute symptomatic VTE. Compared to VKAs, rivaroxaban was associated with prolonged menstrual bleeding and more medical interventions and adaptation of anticoagulant treatment for AUB. These data can guide proactive discussion with patients starting anticoagulant therapy. (C) 2015 Elsevier Ltd. All rights reserve
Itraconazole for COVID-19: preclinical studies and a proof-of-concept randomized clinical trial
No full textBACKGROUND: The antifungal drug itraconazole exerts in vitro activity against SARS-CoV-2 in Vero and human Caco-2 cells. Preclinical and clinical studies are required to investigate if itraconazole is effective for the treatment and/or prevention of COVID-19. METHODS: Due to the initial absence of preclinical models, the effect of itraconazole was explored in a clinical, proof-of-concept, open-label, single-center study, in which hospitalized COVID-19 patients were randomly assigned to standard of care with or without itraconazole. Primary outcome was the cumulative score of the clinical status until day 15 based on the 7-point ordinal scale of the World Health Organization. In parallel, itraconazole was evaluated in a newly established hamster model of acute SARS-CoV-2 infection and transmission, as soon as the model was validated. FINDINGS: In the hamster acute infection model, itraconazole did not reduce viral load in lungs, stools or ileum, despite adequate plasma and lung drug concentrations. In the transmission model, itraconazole failed to prevent viral transmission. The clinical trial was prematurely discontinued after evaluation of the preclinical studies and because an interim analysis showed no signal for a more favorable outcome with itraconazole: mean cumulative score of the clinical status 49 vs 47, ratio of geometric means 1.01 (95% CI 0.85 to 1.19) for itraconazole vs standard of care. INTERPRETATION: Despite in vitro activity, itraconazole was not effective in a preclinical COVID-19 hamster model. This prompted the premature termination of the proof-of-concept clinical study. FUNDING: KU Leuven, Research Foundation - Flanders (FWO), Horizon 2020, Bill and Melinda Gates Foundation.sponsorship: This project has received funding from the Covid-19-Fund KU Leuven/University Hospitals Leuven, the COVID-19 call of the Research Foundation - Flanders (FWO) (grant G0G4820N), the European Union's Horizon 2020 research and innovation program (Grant 101003627, Swift COronavirus therapeutics REsponse project) and the Bill and Melinda Gates Foundation (Grant INV-00636). LLi is member of the Institute of Tropical Medicine's Outbreak Research Team which is financially supported by the Department of Economy, Science and Innovation (EWI) of the Flemish government. BV is supported by a research grant of the Frans Van de Werf Fund for Clinical Cardiovascular Research. P. Verhamme, TV, P. Vermeersch are senior clinical investigators of the FWO. We thank Johnson & Johnson for determining drug concentrations in hamster samples and for providing guidance on the dosing. We thank Lindsey Bervoets, Carolien De Keyzer, Elke Maas and Jasper Rymentants for the technical support with the animal experiments. (Covid-19-Fund KU Leuven/University Hospitals Leuven, COVID-19 call of the Research Foundation - Flanders (FWO)|G0G4820N, European Union|101003627, Bill and Melinda Gates Foundation|INV-00636, Department of Economy, Science and Innovation (EWI) of the Flemish government, Frans Van de Werf Fund for Clinical Cardiovascular Research)status: Publishe
Corrigendum to “itraconazole for COVID-19: Preclinical studies and a proof-of-concept randomized clinical trial Laurens”
No full textsponsorship: This project has received funding from the Covid19-Fund KU Leuven/University Hospitals Leuven, the COVID-19 call of the Research Foundation-Flanders (FWO) (grant G0G4820N) , the European Union's Horizon 2020 research and innovation program (Grant 101,003,627, Swift COronavirus therapeutics REsponse project) and the Bill and Melinda Gates Foundation (Grant INV00,636) . LLi is member of the Institute of Tropical Medicine's Out-break Research Team which is financially supported by the Department of Economy, Science and Innovation (EWI) of the Flemish government. BV is supported by a research grant of the Frans Van de Werf Fund for Clinical Cardiovascular Research. P. Verhamme, TV, P. Vermeersch are senior clinical investigators of the FWO. We thank Johnson & Johnson for determining drug concentrations in hamster samples and for providing. guidance on the dosing. We thank Lindsey Bervoets, Carolien De Keyzer, Elke Maas and Jasper Rymentants for the technical support with the animal experiments.TNDD is funded by the Horizon 2020 grant OrganoVIR 812,673 on the project 'Organoids for Virus Research-An innovative training-ITN programme'. XW and XZ received funding of the China Scholarship Council (CSC) (grant number 201,806,170,087 and 201,906,170,033) . Part of this research work was performed using the 'CapsIt' research infrastructure (project ZW13-02) that was financially supported by the Hercules Foundation (FWO) and Rega Foundation, KU Leuven. (Covid19-Fund KU Leuven/University Hospitals Leuven, Research Foundation-Flanders (FWO)|G0G4820N, European Union|101,003,627, Bill and Melinda Gates Foundation|INV00,636, Department of Economy, Science and Innovation (EWI) of the Flemish government, Frans Van de Werf Fund for Clinical Cardiovascular Research, Horizon 2020 grant|OrganoVIR 812,673, China Scholarship Council (CSC)|201,806,170,087, China Scholarship Council (CSC)|201,906,170,033, Hercules Foundation (FWO)|ZW13-02, Rega Foundation, KU Leuven|ZW13-02)status: Publishe
Intermediate-dose versus low-dose low-molecular-weight heparin in pregnant and post-partum women with a history of venous thromboembolism (Highlow study): an open-label, multicentre, randomised, controlled trial
No full textInternational audienceBackground Pregnancy-related venous thromboembolism is a leading cause of maternal morbidity and mortality, and thromboprophylaxis is indicated in pregnant and post-partum women with a history of venous thromboembolism. The optimal dose of low-molecular-weight heparin to prevent recurrent venous thromboembolism in pregnancy and the post-partum period is uncertain. MethodsIn this open-label, randomised, controlled trial (Highlow), pregnant women with a history of venous thromboembolism were recruited from 70 hospitals in nine countries (the Netherlands, France, Ireland, Belgium, Norway, Denmark, Canada, the USA, and Russia). Women were eligible if they were aged 18 years or older with a history of objectively confirmed venous thromboembolism, and with a gestational age of 14 weeks or less. Eligible women were randomly assigned (1:1), before 14 weeks of gestational age, using a web-based system and permuted block randomisation (block size of six), stratified by centre, to either weight-adjusted intermediate-dose or fixed lowdose low-molecular-weight heparin subcutaneously once daily until 6 weeks post partum. The primary efficacy outcome was objectively confirmed venous thromboembolism (ie, deep-vein thrombosis, pulmonary embolism, or unusual site venous thrombosis), as determined by an independent central adjudication committee, in the intentionto-treat (ITT) population (ie, all women randomly assigned to treatment). The primary safety outcome was major bleeding which included antepartum, early post-partum (within 24 h after delivery), and late post-partum major bleeding (24 h or longer after delivery until 6 weeks post partum), assessed in all women who received at least one dose of assigned treatment and had a known end of treatment date. This study is registered with ClinicalTrials.gov, NCT01828697, and is now complete. FindingsBetween April 24, 2013, and Oct 31, 2020, 1339 pregnant women were screened for eligibility, of whom 1110 were randomly assigned to weight-adjusted intermediate-dose (n=555) or fixed low-dose (n=555) lowmolecular-weight heparin (ITT population). Venous thromboembolism occurred in 11 (2%) of 555 women in the weight-adjusted intermediate-dose group and in 16 (3%) of 555 in the fixed low-dose group (relative risk [RR] 0•69 [95% CI 0•32-1•47]; p=0•33). Venous thromboembolism occurred antepartum in five (1%) women in the intermediatedose group and in five (1%) women in the low-dose group, and post partum in six (1%) women and 11 (2%) women. On-treatment major bleeding in the safety population (N=1045) occurred in 23 (4%) of 520 women in the intermediatedose group and in 20 (4%) of 525 in the low-dose group (RR 1•16 [95% CI 0•65-2•09]). Interpretation In women with a history of venous thromboembolism, weight-adjusted intermediate-dose lowmolecular-weight heparin during the combined antepartum and post-partum periods was not associated with a lower risk of recurrence than fixed low-dose low-molecular-weight heparin. These results indicate that low-dose lowmolecular-weight heparin for thromboprophylaxis during pregnancy is the appropriate dose for the prevention of pregnancy-related recurrent venous thromboembolism.</div
Intermediate-dose versus low-dose low-molecular-weight heparin in pregnant and post-partum women with a history of venous thromboembolism (Highlow study): an open-label, multicentre, randomised, controlled trial
No full textBackground: Pregnancy-related venous thromboembolism is a leading cause of maternal morbidity and mortality, and thromboprophylaxis is indicated in pregnant and post-partum women with a history of venous thromboembolism. The optimal dose of low-molecular-weight heparin to prevent recurrent venous thromboembolism in pregnancy and the post-partum period is uncertain. Methods: In this open-label, randomised, controlled trial (Highlow), pregnant women with a history of venous thromboembolism were recruited from 70 hospitals in nine countries (the Netherlands, France, Ireland, Belgium, Norway, Denmark, Canada, the USA, and Russia). Women were eligible if they were aged 18 years or older with a history of objectively confirmed venous thromboembolism, and with a gestational age of 14 weeks or less. Eligible women were randomly assigned (1:1), before 14 weeks of gestational age, using a web-based system and permuted block randomisation (block size of six), stratified by centre, to either weight-adjusted intermediate-dose or fixed low-dose low-molecular-weight heparin subcutaneously once daily until 6 weeks post partum. The primary efficacy outcome was objectively confirmed venous thromboembolism (ie, deep-vein thrombosis, pulmonary embolism, or unusual site venous thrombosis), as determined by an independent central adjudication committee, in the intention-to-treat (ITT) population (ie, all women randomly assigned to treatment). The primary safety outcome was major bleeding which included antepartum, early post-partum (within 24 h after delivery), and late post-partum major bleeding (24 h or longer after delivery until 6 weeks post partum), assessed in all women who received at least one dose of assigned treatment and had a known end of treatment date. This study is registered with ClinicalTrials.gov, NCT01828697, and is now complete. Findings: Between April 24, 2013, and Oct 31, 2020, 1339 pregnant women were screened for eligibility, of whom 1110 were randomly assigned to weight-adjusted intermediate-dose (n=555) or fixed low-dose (n=555) low-molecular-weight heparin (ITT population). Venous thromboembolism occurred in 11 (2%) of 555 women in the weight-adjusted intermediate-dose group and in 16 (3%) of 555 in the fixed low-dose group (relative risk [RR] 0·69 [95% CI 0·32–1·47]; p=0·33). Venous thromboembolism occurred antepartum in five (1%) women in the intermediate-dose group and in five (1%) women in the low-dose group, and post partum in six (1%) women and 11 (2%) women. On-treatment major bleeding in the safety population (N=1045) occurred in 23 (4%) of 520 women in the intermediate-dose group and in 20 (4%) of 525 in the low-dose group (RR 1·16 [95% CI 0·65–2·09]). Interpretation: In women with a history of venous thromboembolism, weight-adjusted intermediate-dose low-molecular-weight heparin during the combined antepartum and post-partum periods was not associated with a lower risk of recurrence than fixed low-dose low-molecular-weight heparin. These results indicate that low-dose low-molecular-weight heparin for thromboprophylaxis during pregnancy is the appropriate dose for the prevention of pregnancy-related recurrent venous thromboembolism. Funding: French Ministry of Health, Health Research Board Ireland, GSK/Aspen, and Pfizer
