Search

In a double-blind prospective study, 180 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated for seven days with twice daily 1 g intramuscular injections of either cefodizime or cefotaxime. Sputum cultures performed before, during and immediately after treatment showed complete eradication of the infection in 89/90 given cefodizime and 86/90 receiving cefotaxime. Some symptomatic Pseudomonas aeruginosa superinfections occurred with each agent. During the follow-up week, recurrences or reinfections after apparent clearance occurred in 15 patients given cefodizime and in 21 receiving cefotaxime. Pharmacokinetic studies in blood showed mean Cmax values of 50.8 mg/l for cefodizime and 36.5 mg/l for cefotaxime, corresponding values in the sputum being 1.61 and 0.62 mg/l. Mean AUC values in both blood and sputum were 2 1/2- to 3-fold higher for cefodizime. Some features suggested better performance by cefodizime than by cefotaxime, but the clinical results were not statistically significantly different. [ABSTRACT FROM AUTHOR]

A group of 41 patients, all admitted to hospital because of acute purulent exacerbations of chronic respiratory disease, were treated with either doxycycline or minocycline in a double-blind randomized study. Drug dosage was one 100 mg capsule twice daily for seven days. Bacteriological and clinical assessment before and immediately after treatment showed no significant differences between the doxycycline and the minocycline groups, nor did further evaluation after seven days follow-up. Pharmacokinetic studies showed that the Cmax and 0-11 h AUC values in blood were higher for doxycycline, whereas the sputum Cmax was, on average, higher for minocycline because of the greater penetration of the latter. The MIC values for the two antibiotics differed slightly, usually, but not always, in favour of minocycline. Problems were experienced with both agents in the eradication of Haemophilus influenzae. The net clinical results with the two drugs were identical. [ABSTRACT FROM AUTHOR]

Many studies have estimated the social cost of carbon (SCC). We critically evaluate SCC estimates, focusing on omitted cost categories, discounting, uncertainties about damage costs and risk aversion. This allows for the calculation of a lower bound to the SCC. Dominant SCC values turn out to be gross underestimates, notably, but not only, for a low discount rate. The validity of this lower bound is supported by a precautionary approach to reflect risk aversion against extreme climate change. The results justify a more stringent climate policy than is suggested by most influential past studies. [ABSTRACT FROM AUTHOR]

Copyright of Climate Policy (Earthscan) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To assess effects on patient outcomes when care for patients with stable chronic obstructive pulmonary disease (COPD) is transferred from respiratory care physician to respiratory nurse. Methods: A randomized controlled trial was used with a follow-up period of 9 months. Of 720 patients from the respiratory outpatient clinic of the general and teaching hospital in Alkmaar (The Netherlands), 187 were eligible for randomization and gave informed consent. Ninety-three patients received care from the nurse, and 87 received usual care. Outcomes measured were: clinical parameters, health status, self-care behaviour (including knowledge), patient satisfaction, and consultations with key care providers. Results: The respiratory nurse reported more consultations than the respiratory care physician [mean (standard deviation)]: number of consultations 3.1(0.7) by nurse and 2.0 (0.9) by physician (p = 0.007). Patients cared for by the nurse showed worsening in mean forced vital capacity [-5.5% (13.3%) v. +2.9% (18.2%) with physician; p = 0.004], and no difference in self-assessed condition, while improvements were found for subjective knowledge (p = 0.017), self-assessed rate for coping with COPD (p = 0.045), overall satisfaction (p = 0.003), and the majority of individual indicators of satisfaction. Groups showed no differences for forced expiratory volume in 1 s, body mass index, smoking status, health status, objective knowledge, other items of self-care behaviour, and consultations with key care providers. Discussion: Assignment of care for outpatients with stable COPD to the respiratory nurse, working under a protocol, seems to be justified in terms of patient outcomes. [ABSTRACT FROM AUTHOR]

Studies the irritation caused by 226 Belgian commercials, broadcast in 1995. Reasons for studying irritation in advertising; Causes of irritation in advertising; Significant interaction effects between product category and ad characteristics.

The article presents an experiment which examines the competition phenomena between two grass species, the Lolium perenne and Anthoxanthum odoratum. In a pot experiment, both grass species were placed in a low and high fertility soils with phosphate and potash compounds. Findings reveal that the nutrients competition of the species resulted to low nourishment and disease of one of the plants. In the experiment, the number of tillers in the turf of each plant has been the indicator of health status of the grass.

Summary: This study explored the course of health state utility value over 3 years in patients with a recent fracture attending a Fracture Liaison Service and suggested that the overall change in health-related quality of life was not significant, although significant improvements were observed at 6 and 12 months compared to baseline. Introduction: To estimate the 3-year health-related quality of life (HRQoL) of patients with a recent fracture presenting at a Fracture Liaison Service (FLS) and to explore factors associated with health state utility value (HSUV). Methods: Patients' HSUVs were derived from the EQ-5D-5L and SF-6D and calculated at six time points. Multiple imputation was applied for missing data. Linear mixed-effects regression analysis with random intercept and slope was applied to explore the course of HSUV over 3 years. The impact of subsequent fracture and the length of time between FLS visit and patients' index fracture on HSUV were also investigated. A backward stepwise elimination was applied to identify factors associated with HSUV. Results: A total of 499 patients were included. The change of EQ-5D HSUV was not significant over 3-year follow-up (P = 0.52), although slightly but significantly higher HSUV was captured at 6 months (mean difference (MD): 0.015, P = 0.02) and 12 months (MD: 0.018, P = 0.01). There was no significant difference in the course of EQ-5D HSUV between fracture locations (P = 0.86). A significant increase in HSUV was only captured for patients had shorter time period (< 107 days) between FLS visit and their index fracture. Suffering a subsequent fracture was associated with significant QoL loss (MD: − 0.078, P < 0.001). Subsequent fracture, previous treatment with anti-osteoporosis medication, a prevalent vertebral fracture (grade 2 or 3), use of a walking aid, previous falls, and higher BMI were negatively associated with mean EQ-5D HSUV over 3 years. Comparable results were found using SF-6D HSUV. The lack of HRQoL data immediately after fracture and selection bias were two main limitations. Conclusion: The 3-year change in HSUV was not statistically significant, although significant improvements were observed at 6 and 12 months in comparison with baseline. Six factors were negatively associated with EQ-5D HSUV. [ABSTRACT FROM AUTHOR]

Summary: Impaired physical performance is associated with increased fracture risk. Performance on four physical functioning tests and prevalence of sarcopenia were assessed for 1789 fracture patients and compared to reference data. Performance was low on all tests, especially for patients with a hip, major or ≥ 1 prevalent vertebral fracture. Purpose Introduction: Impaired physical performance and sarcopenia are associated with increased fracture risk. This study aims to assess physical performance and the prevalence of sarcopenia in patients with a recent clinical fracture attending the Fracture Liaison Service (FLS) compared to population means. Methods: In this cross-sectional study, chair stand test (CST), handgrip strength (HGS), timed-up-and-go (TUG), 6-min walking-test (6MWT), and sarcopenia (following EWGSOP2) were assessed. The proportion of patients with impaired/poor performance compared to reference data was calculated (Z-score: ≥ − 2SD to < − 1 (impaired) and < − 2 SD (poor)). Associations of fracture type, sex, age, and time since fracture with Z-scores were assessed using linear regression analyses. Results: A total of 1789 consecutive FLS patients were included (median age (IQR): 66 (59–74), 70.7% females, 3.9 (± 1.6) months after fracture). The prevalence of impaired/poor performance for CST, HGS, TUG, and 6MWT was 39.2%, 30.4%, 21.9%, and 71.5%, respectively (expected proportion of 16%) and 2.8% had sarcopenia. Lower Z-scores (P < 0.001) were found for hip, major, and ≥ 1 prevalent vertebral fracture (VF) in CST (major: regression coefficient (B) (95%CI) = − 0.25 [− 0.34, − 0.16]; hip: B = − 0.32 [− 0.47, − 0.17], VF: B = − 0.22 [− 0.34, − 0.11]), TUG; (major: B = − 0.54 [− 0.75, − 0.33]; hip: B = − 1.72 [− 2.08, -1.35], VF: B = − 0.61 [− 0.88, − 0.57]), 6MWT (major: B = − 0.34 [− 0.47, − 0.21]; hip: B = − 0.99 [− 1,22, − 0.77], VF: B = − 0.36 [− 0.53, − 0.19]). Conclusions: Physical performance is significantly lower in FLS patients compared to healthy peers, especially in patients with hip, major or prevalent VF. These findings underline the need to assess and improve the physical performance of FLS patients, despite a low prevalence of sarcopenia. [ABSTRACT FROM AUTHOR]

X-linked hypophosphatemia (XLH) is the most common monogenetic cause of chronic hypophosphatemia, characterized by rickets and osteomalacia. Disease manifestations and treatment of XLH patients in the Netherlands are currently unknown. Characteristics of XLH patients participating in the Dutch observational registry for genetic hypophosphatemia and acquired renal phosphate wasting were analyzed. Eighty XLH patients, including 29 children, were included. Genetic testing, performed in 78.8% of patients, showed a PHEX mutation in 96.8%. Median (range) Z-score for height was − 2.5 (− 5.5; 1.0) in adults and − 1.4 (− 3.7; 1.0) in children. Many patients were overweight or obese: 64.3% of adults and 37.0% of children. All children received XLH-related medication e.g., active vitamin D, phosphate supplementation or burosumab, while 8 adults used no medication. Lower age at start of XLH-related treatment was associated with higher height at inclusion. Hearing loss was reported in 6.9% of children and 31.4% of adults. Knee deformities were observed in 75.0% of all patients and osteoarthritis in 51.0% of adult patients. Nephrocalcinosis was observed in 62.1% of children and 33.3% of adults. Earlier start of XLH-related treatment was associated with higher risk of nephrocalcinosis and detection at younger age. Hyperparathyroidism longer than six months was reported in 37.9% of children and 35.3% of adults. This nationwide study confirms the high prevalence of adiposity, hearing loss, bone deformities, osteoarthritis, nephrocalcinosis and hyperparathyroidism in Dutch XLH patients. Early start of XLH-related treatment appears to be beneficial for longitudinal growth but may increase development of nephrocalcinosis. [ABSTRACT FROM AUTHOR]

Background: We developed a semi-automated algorithm that detects cortical interruptions in finger joints using high-resolution peripheral quantitative computed tomography (HR-pQCT), and extended it with trabecular void volume measurement. In this study we tested the reproducibility of the algorithm using scan/re-scan data. Methods: Second and third metacarpophalangeal joints of 21 subjects (mean age 49 (SD 11) years, 17 early rheumatoid arthritis and 4 undifferentiated arthritis, all diagnosed < 1 year ago) were imaged twice by HR-pQCT on the same day with repositioning between scans. The images were analyzed twice by one operator (OP1) and once by an additional operator (OP2), who independently corrected the bone contours when necessary. The number, surface and volume of interruptions per joint were obtained. Intra- and inter-operator reliability and intra-operator reproducibility were determined by intra-class correlation coefficients (ICC). Intra-operator reproducibility errors were determined as the least significant change (LSCSD). Results: Per joint, the mean number of interruptions was 3.1 (SD 3.6), mean interruption surface 4.2 (SD 7.2) mm2, and mean interruption volume 3.5 (SD 10.6) mm3 for OP1. Intra- and inter-operator reliability was excellent for the cortical interruption parameters (ICC ≥0.91), except good for the inter-operator reliability of the interruption surface (ICC = 0.70). The LSCSD per joint was 4.2 for the number of interruptions, 5.8 mm2 for interruption surface, and 3.2 mm3 for interruption volume. Conclusions: The algorithm was highly reproducible in the detection of cortical interruptions and their volume. Based on the LSC findings, the potential value of this algorithm for monitoring structural damage in the joints in early arthritis patients needs to be tested in clinical studies. [ABSTRACT FROM AUTHOR]

Introduction: Painful Diabetic Neuropathy (PDN) is known to negatively affect psychosocial functioning as expressed by enhanced levels of anxiety and depression. Objective: To specify diabetes and pain related fears, hereby identifying potential targets for intervention. Patients: This questionnaire-based cross-sectional study included 154 patients with PDN (mean age 65.7 ± 6.6 years). Methods: Linear regression analyses corrected for age, gender, pain intensity, pain duration and insulin treatment were performed to assess the associations of various fear questionnaires (Hypoglycaemia Fear Survey (HFS), Tampa Scale of Kinesiophobia (TSK), Pain Anxiety Symptom Scale (PASS-20), Falls Efficacy Scale-I (FES-I), Tampa Scale of Fatigue (TSF), Brief Fear of Negative Evaluation Scale (BFNE)) with quality of life (QoL) (Norfolk Quality of Life Questionnaire, Diabetic Neuropathy Version, QOL-DN) and disability (Pain Disability Index, PDI), respectively. Results: All fears were independently associated with QoL and disability (p < 0.001 for all variables). Stepwise backward regression models including all fear questionnaires showed that pain intensity, fear of fatigue, fear of hypoglycaemia and fear of falling were significantly associated with decreased QoL; β = 0.253; p < 0.001; β = 0.134; p = 0.045; β = 0.216; p = 0.003, and β = 0.385; p < 0.001, respectively; R2 = 0.629. Pain intensity and fear of falling were significantly associated with disability; β = 0.283; p < 0.001 and β = 0.540; p < 0.001 respectively; R2 = 0.544. Conclusion: In patients with PDN, pain intensity, fear of falling, fear of hypoglycemia and fear of fatigue were associated with decreased QoL. Pain intensity and fear of falling were associated with disability. Clinical message: Unravelling specific fears enables us to identify targets for behavioural interventions that aim to improve psychosocial well-being in patients with PDN. [ABSTRACT FROM AUTHOR]

The SCATE project aims at improving translators' efficiency through improvements in translation technology, evaluation of computer-aided translation, terminology extraction from comparable corpora, speech recognition accuracy, and work flows and personalised user interfaces. It is funded by IWT-SBO*, project nr. 130041. http://www.ccl.kuleuven.be/scate/. [ABSTRACT FROM AUTHOR]

Physical capacity (PC) and physical activity (PA) are associated physical performance measures, and combined, PC and PA are used to categorize physical performance in the "can do, do do" framework. We aimed to explore physical performance of patients attending the fracture liaison service (FLS). In this cross-sectional study, PC was measured by 6-min-walking-test (can't do/can do) and PA by accelerometer (don't do/do do). Following quadrants were defined based on predefined cut-off scores for poor performance: (1) "can't do, don't do"; (2) "can do, don't do"; (3) "can't do, do do"; (4) "can do, do do". Odds ratios (OR) were calculated and fall and fracture risk factors were assessed between quadrants. Physical performance of 400 fracture patients was assessed (mean age 64; female 70.8%). Patients performed as follows: 8.3% "can't do, don't do"; 3.0% "can do, don't do"; 19.3% "can't do, do do"; 69.5% "can do, do do". For the "can't do" group the OR for low PA was 9.76 (95% CI: 4.82–19.80). Both the "can't do, don't do" and "can't do, do do" group differed significantly compared to the "can do, do do" group on several fall and fracture risk factors and had lower physical performance. The "can do, do do" framework is able to identify fracture patients with an impaired physical performance. Of all FLS patients 20% "can't do, but "do do" while having a high prevalence of fall risk factors compared to persons that "can do, do do", which may indicate this group is prone to fall. [ABSTRACT FROM AUTHOR]

This article discusses the challenges of selecting appropriate cases for intermuscular local excision (LE) of early rectal cancer (RC) using optical diagnosis and radiological imaging. The study aimed to determine if the preservation of at least 1 mm of muscularis propria on MRI could accurately identify RC suitable for LE in the intermuscular plane. Twelve radiologists underwent training and reassessed a series of MRI scans. The results showed that the preservation of 1 mm of muscularis propria on rectal MRI is an accurate criterion that can support adequate case selection for rectal-preserving intermuscular LE of RC. [Extracted from the article]

Economic aspects of possible land use strategies and protection measures in coastal zones as a response to global environmental change are examined. First, some key elements are mentioned that are of critical importance for water and land management in coastal zones. Next, various socio-economic repercussions are discussed. In this context, research needs will be addressed. Subsequently, these issues are considered for the case of The Netherlands. It is concluded that integrated modelling and analysis is just starting and needs to receive more attention in order to study long run economic costs, benefits and changes in coastal zones. [ABSTRACT FROM AUTHOR]