518 research outputs found
Predictors and Dynamics of the Humoral and Cellular Immune Response to SARS-CoV-2 mRNA Vaccines in Hemodialysis Patients: A Multicenter Observational Study
No full textBackground Preliminary evidence suggests patients on hemodialysis have a blunted early serological response to SARS-CoV-2 vaccination. Optimizing the vaccination strategy in this population requires a thorough understanding of predictors and dynamics of humoral and cellular immune responses to differentSARS-CoV-2 vaccines.Methods This prospective multicenter study of 543 patients on hemodialysis and 75 healthy volunteers evaluated the immune responses at 4 or 5 weeks and 8 or 9 weeks after administration of the BNT162b2or mRNA-1273 vaccine, respectively. We assessed antiSARS-CoV-2 spike antibodies and T cell responses by IFN-? secretion of peripheral blood lymphocytes upon SARS-CoV-2 glycoprotein stimulation (QuantiFERON assay) and evaluated potential predictors of the responses.Results Compared with healthy volunteers, patients on hemodialysis had an incomplete, delayed humoral immune response and a blunted cellular immune response. Geometric mean antibody titers at both timepoints were significantly greater in patients vaccinated with mRNA-1273 versus BNT162b2, and a larger proportion of them achieved the threshold of 4160 AU/ml, corresponding with high neutralizing antibody titers in vitro(53.6% versus 31.8% at 8 or 9 weeks, P Conclusions The mRNA-1273 vaccine's greater immunogenicity may be related to its higher mRNA dose. This suggests a high-dose vaccine might improve the impaired immune response to SARS-CoV-2 vaccination in patients on hemodialysis.This research was supported by Amgen (DONATION-331036).
A. De Vriese and J. Van Praet designed the study; R. Caluw e, A. De Bel, A. De Vriese, P. Doubel, L. Heylen, M. Schoutteten, J. Van Praet, B. Van Vlem, and L. Viaene provided study materials or patients; D. De Bacquer, A. De Vriese, M. Reynders, and J. Van Praet analyzed the data; D. De Bacquer and J. Van Praet made the figures; A. De Vriese drafted the paper; D. De Bacquer, M. Reynders, and J. Van Praet revised it critically for important intellectual content; all authors approved the final version
of the manuscript. The authors are indebted to Tessa Acke, Manuela Caster, Evelyne Deglorie, Mirjam Demesmaecker, Suzanne Driessens, Inne Hoebrekx, Annelien Leunen, Carine Lowis, Isabel Moyaert, Danny Pauwels, Joris Penders, Melissa Renders, Carmen Reynders, Sofie Tombeur, Katrien Uyttersprot, Femke Van Den Berg, Kristel Van Varenbergh, Tine Verheyen, Manon Verhulst, and Sophie Vleeschouwers for their invaluable help in the collection of the patient data and analysis of the samples
Effectiveness of a preventive cardiology programme for high CVD risk persistent smokers: the EUROACTION PLUS varenicline trial
No full textAim The EUROACTION PLUS trial measured the effectiveness of a nurse-led preventive cardiology programme (EUROACTION) offering intensive smoking cessation PLUS optional varenicline for persistent high CVD risk smokers to reduce overall cardiovascular risk compared with usual care (UC) in general practice (GP). Methods and results A parallel group randomized controlled trial in 20 GP in Italy, Netherlands, Spain, and UK. Six hundred and ninety-six current smokers, (137 vascular disease and 559 high total CVD risk), were randomized 350 to EUROACTION PLUS (EA+) and 346 to UC. Specially, trained nurses offered the EUROACTION preventive cardiology programme addressing smoking cessation, diet, physical activity, and risk factor management to reduce overall cardiovascular risk. The primary endpoint was 7 day point prevalence of self-reported abstinence (validated breath carbon monoxide <10 p.p.m.) at 16 weeks. Secondary outcomes included dietary habits, physical activity, weight, blood pressure (BP), lipid, and glucose management. One hundred and seventy-seven (51%) EA+ patients (91% opted to use varenicline) were abstinent vs. 63 (19%) in UC; OR 4.52 (95% CI: 3.20-6.39). The Mediterranean diet score of ≥9 in 149 (52%) EA+ patients vs. 97 (37%) in UC; OR 1.84 (95% CI: 1.31-2.59). Physical activity target achieved in 46 (16%) EA+ patients vs. 19 (7%) in UC; OR 2.48 (95% CI: 1.41-4.36). Target BP (<140/90 mm Hg) achieved in 150 (52%) EA+ patients vs. 112 (43%) in UC, OR 1.47 (95% CI: 1.05-2.06) with no difference in antihypertensive drugs. There were no differences in management of cholesterol or glucose. Conclusions The EUROACTION preventive cardiology programme in high CVD risk smokers using optional varenicline substantially increased smoking abstinence over 16 weeks and also reduced overall cardiovascular risk compared with UC
Pressure ulcers and incontinence-associated dermatitis: effectiveness of the Pressure Ulcer Classification education tool on classification by nurses
No full textContext: previous studies report that pressure ulcer classification and differentiation from incontinence associated dermatitis are difficult. Incorrect classification and differentiation result in incorrect prevention and treatment. Education is important to spread evidence-based insights about this topic and to improve classification skills.Aim: to assess the effectiveness of the Pressure Ulcer Classification (PUCLAS) education tool. PUCLAS was developed by the PUCLAS Workgroup of the European Pressure Ulcer Advisory Panel.Design: randomised controlled trial.Setting and participants: a convenience sample of 1217 Belgian, Dutch, British and Portuguese nurses.Outcome measure: correct classification of pressure ulcer photographs and differentiation from photographs of incontinence-associated dermatitis.Results: baseline, 44.5% of the photographs were classified correctly. In the post-test, the results in the intervention group were significantly higher (63.2%) compared with the control group (53.1%; p<0.001). The percentage of correct assessments of incontinence associated dermatitis (IAD) was 70.7% in the intervention group and 35.6% in the control group (p<0.001). The skill to differentiate IAD from pressure ulcers was significantly associated with the experimental intervention (OR 4.07, 95% CI 3.21 to 5.15, p<0.001).Conclusion: the PUCLAS tool improved pressure ulcer classification and IAD differentiation significantl
Reproducibility and validity of a diet quality index for children assessed using a FFQ
No full textThe diet quality index (DQI) for preschool children is a new index developed to reflect compliance with four main food-based dietary guidelines for preschool children in Flanders. The present study investigates: (1) the validity of this index by comparing DQI scores for preschool children with nutrient intakes, both of which were derived from 3d estimated diet records; (2) the reproducibility of the DQI for preschoolers based on a parentally reported forty-seven-item FFQ DQI, which was repeated after 5 weeks; (3) the relative validity of the FFQ DQI with 3d record DQI scores as reference. The study sample included 510 and 58 preschoolers (2-5-6.5 years) for validity and reproducibility analyses, respectively. Increasing 3d record DQI scores were associated with decreasing consumption of added sugars, and increasing intakes of fibre, water, Ca and many micronutrients. Mean FFQ DQI test-retest scores were not significantly different: 72 (so 11) v. 71 (Si) 10) (P-=0-218) out of a maximum of 100. Mean 3d record DQI score (66 (so 10)) was significantly lower than mean FFQ DQI (71 (so 10);
Is Type 1 Diabetes Mellitus More Prevalent Than Expected in Transgender Persons? A Local Observation
No full textThe International Diabetes Federation estimates that approximately 0.4% of the Belgian population is diagnosed with type 1 diabetes mellitus, which is similar to other industrialized countries. The prevalence of transgenderism is estimated at 0.6% to 0.7% of all adults in Western populations. In this study, we evaluated whether there was an increased prevalence of type 1 diabetes mellitus in transgender people in the local cohort. Medical records of transgender patients were analyzed retrospectively. From January 1, 2007 until October 10, 2016, 1,081 transgender patients presented at a tertiary reference center to start hormonal treatment. Nine of these 1,081 patients were previously diagnosed with type 1 diabetes mellitus and 1 was diagnosed with latent autoimmune diabetes in adults. A 2.3-fold higher prevalence of type 1 diabetes mellitus was observed in transgender patients. We concluded that type 1 diabetes mellitus was more prevalent in transgender patients than one would expect from population prevalences. This could be a spurious result in a local cohort, because a causal relation seems unlikely, but our finding might encourage other centers to investigate this putative association.
Defreyne J, De Bacquer D, Shadid S, et al. Is Type 1 Diabetes Mellitus More Prevalent Than Expected in Transgender Persons? A Local Observation. Sex Med 2017;5:e215–e218
Cross-Language Differential Item Functioning of the Job Content Questionnaire among European Countries: the JACE Study.
No full textLesão renal aguda em pacientes pediátricos em pós-operatório de cirurgia cardíaca: fatores de risco e prognóstico
No full textTrabalho de Conclusão de Curso - Universidade Federal de Santa Catarina. Curso de Medicina. Departamento de Pediatria
Prevalence and types of persistent dyslipidemia in patients treated with statins
No full textAim To determine the prevalence and types of persistent
dyslipidemia in patients treated with different statins to
reduce cardiovascular disease (CVD) risk, as well as to determine
the proportion of high risk patients who did not
reach the lipid target values and assess cardiologists’ further
treatment advice for these patients.
Methods This cross-sectional, observational study recruited
1849 outpatients from all parts of Croatia between January
and September 2011 (44.6% women), 19 to 90 years
old (average age 63.13) treated with statins for at least 6
months. We analyzed how the potency and type of lipidlowering
treatment were correlated with CVD risk level and
achieving treatment goals according to 2007 Joint European
Guidelines on CVD prevention.
Results Most patients (81.3%) were at high risk for CVD.
The most frequently used statin was atorvastatin (42.8%),
followed by simvastatin (27.6%) and rosuvastatin (22.8%).
Only 35.5% patients achieved low density lipoproteincholesterol
treatment target. Patients treated with more
potent statins had better results. A total of 22.3% of patients
had high density lipoprotein-cholesterol below 1.0
mmol/L ( ~ 40 mg/dL) for men and below 1.2 ( ~ 45 mg/dL)
for women and 46.4% had triglycerides above 1.7 mmol/L
( ~ 150 mg/dL) but there were no significant differences between
statins in improving these parameters. Most of the
patients on more potent statins were not advised by their
cardiologists to change the type or dosage of statin, which
was more common in patients on less potent statins.
Conclusion A considerable number of patients treated
with statins did not achieve the treatment goal values. The
results were better in patients treated with more potent statins
and cardiologists advised them much less frequently
to change the type and dosage of statin. There is a need
for more intensive treatment, especially for high-risk patients.
This could be accomplished by optimizing patients’
adherence, using more potent statins, titrating current statin
therapy to higher doses, or using a combined lipid-lowering
treatment
High awareness of diabetes as a key cardiovascular risk factor among healthcare professionals but suboptimal treatment : results from a survey of the European Association of Preventive Cardiology
No full textThe author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The ESC/EAPC Diabetes and CVD Programme is supported by Novo Nordisk and BI Lilly Alliance with an unrestricted educational grant
Comment to: transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis
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