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T Thomsen, M Aadahl, N Beyer, M L Hetland, K Løppenthin, J Midtgaard, R Christensen, B A Esbensen
BACKGROUND: Patients with rheumatoid arthritis (RA) spend a high proportion of their waking time in sedentary behaviour (SB) and have an increased risk of cardiovascular disease. Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems. Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary populations. To evaluate descriptively the feasibility of recruitment, randomisation, outcome assessments, retention and the acceptability of an individually tailored, theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA...
October 18, 2016: BMC Musculoskeletal Disorders
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
David M Dror, Arpita Chakraborty, Atanu Majumdar, Pradeep Panda, Ruth Koren
BACKGROUND & OBJECTIVES: The evidence-base of the impact of community-based health insurance (CBHI) on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households' self-medication and financial position. METHODS: Data originated from (i) household surveys, and (ii) the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013...
June 2016: Indian Journal of Medical Research
Helen S Marshall, Peter C Richmond, Johannes Beeslaar, Qin Jiang, Kathrin U Jansen, Maria Garcés-Sánchez, Federico Martinón-Torres, Leszek Szenborn, Jacek Wysocki, Joseph Eiden, Shannon L Harris, Thomas R Jones, Su-San Lee, John L Perez
BACKGROUND: Bivalent rLP2086 is a recombinant factor H binding protein-based vaccine approved in the USA for prevention of meningococcal serogroup B disease in 10-25-year-olds. We aimed to assess the persistence of bactericidal antibodies up to 4 years after a three-dose schedule of bivalent rLP2086. METHODS: We did this randomised, single-blind, placebo-controlled, phase 2 trial at 25 sites in Australia, Poland, and Spain. In stage 1 of the study (February, 2009-May, 2010), healthy adolescents (aged 11-18 years) were randomly assigned, via an interactive voice and web-response system with computer-generated sequential random numbers, to receive either ascending doses of vaccine (60 μg, 120 μg, and 200 μg) or placebo at months 0, 2, and 6...
October 10, 2016: Lancet Infectious Diseases
Koichi Goto, Masahiro Endo, Masahiko Kusumoto, Nobuyuki Yamamoto, Yuichiro Ohe, Ayaka Shimizu, Masahiro Fukuoka
Potentially life-threatening, serious hemoptysis is an adverse event associated with bevacizumab in non-squamous non-small-cell lung cancer (NSCLC) trials. Suggested risk factors include central tumor location and cavitation; however, the profile of hemoptysis occurrence in clinical practice is still unclear. A nested case-control study was conducted to assess the onset profile and risk factors for hemoptysis in bevacizumab-treated patients in a real-world setting in Japan. After bevacizumab was approved for NSCLC, Physicians registered all NSCLC patients scheduled for bevacizumab therapy, from November 2009 to August 2011...
October 6, 2016: Cancer Science
Gretchen L Gierach, Rochelle E Curtis, Ruth M Pfeiffer, Maeve Mullooly, Estelle A Ntowe, Robert N Hoover, Sarah J Nyante, Heather Spencer Feigelson, Andrew G Glass, Amy Berrington de Gonzalez
Importance: Within 10 years after breast cancer diagnosis, roughly 5% of patients develop contralateral breast cancer (CBC). Randomized trials have found that therapy including tamoxifen citrate and aromatase inhibitors (AIs) reduces CBC risk. But little is known about the magnitude and duration of protective associations within the context of real-world clinical management settings, where varying durations of and gaps in treatment are common. Objective: To determine the association between adjuvant tamoxifen and AI therapy and CBC risk within a general community setting...
October 6, 2016: JAMA Oncology
Sebastian Pratschke, Hannah Arnold, Alfred Zollner, Michael Heise, Andreas Pascher, Peter Schemmer, Marcus N Scherer, Andreas Bauer, Karl-Walter Jauch, Jens Werner, Markus Guba, Martin K Angele
BACKGROUND: Organ shortage results in the transplantation of extended donor criteria (EDC) livers which is associated with increased ischemia-reperfusion injury (IRI). Experimental studies indicate that an organ rinse with the calcineurin inhibitor tacrolimus before implantation protects against IRI. The tacrolimus organ perfusion study was initiated to examine the effects of ex vivo tacrolimus perfusion on IRI in transplantation of EDC livers. METHODS: A prospective randomized multicenter trial comparing ex vivo perfusion of marginal liver grafts (≥2 EDC according to Eurotransplant manual) with tacrolimus (20 ng/mL) or histidine-tryptophane-ketoglutarate solution (control) was carried out at 5 German liver transplant centers (Munich Ludwig-Maximilians University, Berlin, Heidelberg, Mainz, Regensburg) between October 2011 and July 2013...
June 2016: Transplantation Direct
Joaniter I Nankabirwa, Melissa D Conrad, Jennifer Legac, Stephen Tukwasibwe, Patrick Tumwebaze, Bonnie Wandera, Simon J Brooker, Sarah G Staedke, Moses R Kamya, Sam L Nsobya, Grant Dorsey, Philip J Rosenthal
Dihydroartemisinin-piperaquine (DP) offers prolonged protection against malaria, but its impact on Plasmodium falciparum drug sensitivity is uncertain. In a trial of intermittent preventive treatment in schoolchildren in Tororo, Uganda, in 2011 to 2012, monthly DP for 1 year decreased the incidence of malaria by 96% compared to placebo; DP once per school term offered protection primarily during the first month after therapy. To assess the impact of DP on selection of drug resistance, we compared the prevalence of key polymorphisms in isolates that emerged at different intervals after treatment with DP...
October 2016: Antimicrobial Agents and Chemotherapy
Marta C Nunes, Clare L Cutland, Stephanie Jones, Andrea Hugo, Richard Madimabe, Eric A F Simões, Adriana Weinberg, Shabir A Madhi
IMPORTANCE: Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear. OBJECTIVE: To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer. DESIGN, SETTING, AND PARTICIPANTS: Infants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)-confirmed influenza illness...
September 1, 2016: JAMA Pediatrics
Ian W Flinn, Panayiotis Panayiotidis, Boris Afanasyev, Ann Janssens, Sebastian Grosicki, Wojciech Homenda, Lukas Smolej, Kazimierz Kuliczkowski, Michael Doubek, Natalia Domnikova, Sarah L West, Chai-Ni Chang, Alison M Barker, Ira V Gupta, Oliver J Wright, Fritz Offner
The purpose of this study is to assess the safety and efficacy of the combination of ofatumumab and bendamustine in patients with previously untreated or relapsed chronic lymphocytic leukemia. Patients received IV ofatumumab (cycle 1: 300 mg day 1 and 1,000 mg day 8; cycles 2-6: 1,000 mg on day 1 every 28 days) and IV bendamustine 90 mg m(-2) (previously untreated) or 70 mg m(-2) (relapsed) on days 1 and 2 of each 28-day cycle, for up to 6 cycles. Forty-four previously untreated and 53 relapsed patients were enrolled...
September 2016: American Journal of Hematology
Jeanette Eckerblad, Kersti Theander, Anne W Ekdahl, Tiny Jaarsma
AIM: To follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment. BACKGROUND: Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health related quality of life. There's a need to move from a single-disease model and address the complexity of older people living with multimorbidity...
May 25, 2016: Journal of Advanced Nursing
Eleonora Mutsaerts, Shabir A Madhi, Clare L Cutland, Stephanie Jones, Andrea Hugo, Siobhan Trenor, Florette K Treurnicht, Kerstin Klipstein-Grobusch, Adriana Weinberg, Marta C Nunes
BACKGROUND: We assessed the persistence of hemagglutinin inhibition (HAI) antibodies and the vaccine efficacy (VE) of trivalent inactivated influenza vaccine (IIV3) following vaccination of a cohort of pregnant South African women during a second influenza season. METHODS: A cohort of women who participated in a randomized placebo-controlled trial on the safety, immunogenicity and efficacy of IIV3 in 2011 had HAI titers measured in 2012 and were monitored for influenza illness until the end of 2012...
August 2016: Expert Review of Vaccines
Nanna Rolving, Claus Vinther Nielsen, Finn Bjarke Christensen, Randi Holm, Cody Eric Bünger, Lisa Gregersen Oestergaard
BACKGROUND: Catastrophic thinking and fear-avoidance belief are negatively influencing severe acute pain following surgery causing delayed ambulation and discharge. We aimed to examine if a preoperative intervention of cognitive-behavioural therapy (CBT) could influence the early postsurgical outcome following lumbar spinal fusion surgery (LSF). METHODS: Ninety patients undergoing LSF due to degenerative spinal disorders were randomly allocated to either the CBT group or the control group...
2016: BMC Musculoskeletal Disorders
I T Wilts, B A Hutten, J C Meijers, C A Spek, H R Büller, P W Kamphuisen
INTRODUCTION: In cancer, tumor progression and metastasis are promoted by prohemostatic activity. Protein C (PC) is involved in hemostasis, inflammation and signal transduction, and has a protective effect on the endothelial barrier. In mice, administration of activated PC reduced experimental metastasis. It is unclear whether PC level is associated with mortality in patients with cancer. AIM: To assess the relation between PC level and survival in patients with advanced cancer...
April 2016: Thrombosis Research
J Latré, K Dewitte, V Derycke, B De Roo, G Haesaert
Integrated pest management has been implemented as a general practice by EU legislation. As weed control actually is the most important crop protection measure in maize for Western Europe, the new legislation will have its impact. The question is of course which systems can be successfully implemented in practice with respect to labour efficiency and economical parameters. During 3 successive growing seasons (2007, 2008, 2009) weed control in maize was evaluated, the main focus was put on different techniques of integrated weed control and was compared with chemical weed control...
2015: Communications in Agricultural and Applied Biological Sciences
Shabir A Madhi, Clare L Cutland, Lisa Jose, Anthonet Koen, Niresha Govender, Frederick Wittke, Morounfolu Olugbosi, Ajoke Sobanjo-Ter Meulen, Sherryl Baker, Peter M Dull, Vas Narasimhan, Karen Slobod
BACKGROUND: Maternal group B streptococcus (GBS) serotype-specific capsular antibody concentrations are correlated with susceptibility to neonatal GBS invasive disease. Maternal immunisation against GBS during pregnancy might protect infants across the period of susceptibility to invasive disease, but no licensed vaccine exists. This study assessed the safety and immunogenicity of a CRM197-conjugated trivalent GBS vaccine in non-pregnant and pregnant women, and antibody transfer to their infants...
August 2016: Lancet Infectious Diseases
Xuerong Wen, Michael Jin Casey, Alfonso H Santos, Abraham Hartzema, Karl L Womer
The performance of belatacept in a real clinical setting has not been reported. A retrospective cohort study was conducted using registry data comparing one-year clinical outcomes between belatacept- and tacrolimus-treated adult kidney transplant recipients (KTR) from 6.1.2011 through 12.1.2014. Of 50 244 total patients, 417 received belatacept+tacrolimus, 458 received belatacept alone, and 49 369 received tacrolimus alone at discharge. In the overall study cohort, belatacept alone was associated with a higher risk for one-year acute rejection, with highest rates associated with non-lymphocyte depleting (LD) induction (aHR: 2...
May 3, 2016: American Journal of Transplantation
Joanna E Long, Mark T Drayson, Angela E Taylor, Kai M Toellner, Janet M Lord, Anna C Phillips
OBJECTIVES: Older adults are less able to produce a protective antibody response to vaccinations. One factor that contributes to this is immune ageing. Here we examined whether diurnal variations in immune responses might extend to the antibody response to vaccination. DESIGN: We utilised a cluster-randomised trial design. SETTING: 24 General Practices (GPs) across the West Midlands, UK who were assigned to morning (9-11am; 15 surgeries) or afternoon (3-5pm; 9 surgeries) vaccination times for the annual UK influenza vaccination programme...
May 23, 2016: Vaccine
Janet E Baack Kukreja, Maureen Kiernan, Bethany Schempp, Aisha Siebert, Adriana Hontar, James Dolan, Katia Noyes, Ann Dozier, Ahmed Ghazi, Hani H Rashid, Guan Wu, Edward M Messing
OBJECTIVES: To determine if patients managed with a cystectomy enhanced recovery pathway (CERP) have improved radical cystectomy (RC) quality of care (Quality Improvement in Cystectomy Care with Enhanced Recovery-QUICCER) defined by a decrease in length of stay (LOS) without an increase in complications or readmissions compared to those not managed with CERP. SUBJECTS AND METHODS: QUICCER is a non-randomized quasi-experimental study. Data were collected from June 2011 to April 2015...
April 29, 2016: BJU International
Julia Origüen, Francisco López-Medrano, Mario Fernández-Ruiz, Natalia Polanco, Esther Gutiérrez, Elena González, Eva Mérida, Tamara Ruiz-Merlo, Alejandra Morales-Cartagena, María Asunción Pérez-Jacoiste Asín, Ana García-Reyne, Rafael San Juan, María Ángeles Orellana, Amado Andrés, José María Aguado
The indication of antimicrobial treatment for asymptomatic bacteriuria (AB) after kidney transplantation (KT) remains controversial. Between January 2011 and December 2013 112 KT recipients that developed ≥1 episode of AB beyond the second month post-transplantation were included in this open-label trial. Participants were randomized (1:1 ratio) to the treatment group (systematic antimicrobial therapy for all episodes of AB occurring up to 24 months post-transplantation [53 patients]) or control group (no antimicrobial therapy [59 patients])...
April 18, 2016: American Journal of Transplantation
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