Netherlands Journal of Medicine最新文献_第10页

Septic patients with cancer: Do prehospital antibiotics improve survival? A sub-analysis of the PHANTASi trial. 脓毒性癌症患者:院前抗生素能提高生存率吗?PHANTASi试验的亚分析。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

R S Nannan Panday, S Wang, E H Schermer, T Cooksley, N Alam, P W B Nanayakkara

{"title":"Septic patients with cancer: Do prehospital antibiotics improve survival? A sub-analysis of the PHANTASi trial.","authors":"R S Nannan Panday, S Wang, E H Schermer, T Cooksley, N Alam, P W B Nanayakkara","doi":"","DOIUrl":"","url":null,"abstract":"Background: Sepsis in patients with cancer is increasingly common and associated with high mortality. To date, no studies have examined the effectiveness of prehospital antibiotics in septic patients with cancer. This study aimed without and to evaluate the effect of prehospital antibiotics in septic patients with cancer.Methods: We conducted a post-hoc sub-analysis of the PHANTASi (PreHospital ANTibioitcs Against Sepsis) trial database: a randomised controlled trial which enrolled patients with suspected sepsis who were transported to the emergency department by ambulance. Patients in the intervention group were administered prehospital intravenous antibiotics while those in the control group received usual care. We compared patients who had cancer to those who did not. Primary outcome was 28-day mortality; among the secondary outcomes, we included in-hospital mortality and 90-day mortality.Results: 357(13.4%) of the 2658 included patients had cancer in the past five years, of which, 209 (58.5%) were included in the intervention and 148 (41.5%) usual care groups; 28-day mortality was significantly higher in patients who were diagnosed with cancer in the past five years than those without cancer in the past five years: 15.2% vs. 7.1%, respectively (p < 0.001). Prehospital antibiotics in the group of patients with cancer in the last five years yielded no significant effect on survival. There were however, significantly fewer 30-day readmissions (p = 0.031) in the intervention group of cancer patients (12.2% vs 5.7%).Conclusion: Prehospital antibiotics did not improve overall survival. However, there was a significant reduction in 30-day readmissions.","PeriodicalId":18918,"journal":{"name":"Netherlands Journal of Medicine","volume":"78 1","pages":"3-9"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37630678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Answer to Photo Quiz Hips don't lie? 臀部不会说谎?

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

引用次数: 0

Hips don't lie? 臀部不会说谎?

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

J Siffels, R van Velde, L J Bakker, J Heidt

引用次数: 0

Answer to Photo Quiz Fatal Spanish Souvenoir. 致命的西班牙纪念品。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

引用次数: 0

Vitamin B12. 维生素B12。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

J Lindeman

引用次数: 0

Association of vitamin B12, methylmalonic acid, and functional parameters. 维生素B12，甲基丙二酸和功能参数的关联。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

B H R Wolffenbuttel, H J C M Wouters, W H A de Jong, G Huls, M M van der Klauw

{"title":"Association of vitamin B12, methylmalonic acid, and functional parameters.","authors":"B H R Wolffenbuttel, H J C M Wouters, W H A de Jong, G Huls, M M van der Klauw","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Diagnosis of vitamin B12 deficiency is difficult, as there is no conclusive single test for this disorder. We evaluated the association of serum B12 and methylmalonic acid (MMA) with haematologic parameters and physical and cognitive functioning in an effort to use such clinical parameters to improve the interpretation of serum values.Methods: We used data of participants > 19 years of age from NHANES 2011-2012 and 2013-2014, a cross-sectional survey in the United States. Functional status was assessed with questionnaires on current health condition, disability, hospital utilisation, cognitive functioning, mental health and depression, and physical functioning. Muscle strength assessed with a handgrip dynamometer was used as a performance parameter. Results were evaluated both for the entire population and participants of Western European descent. Because renal function influences MMA concentrations and is a proxy for both frailty and comorbidity, all results were additionally stratified for individuals with normal vs impaired renal function (eGFR < 60 ml/min).Results: In total, data of 9645 participants (mean age 49 (SD 17) years, 49.3% males) were included. Out of all participants with serum B12 < 140, 140-300, and 301-1000 pmol/l, 56.2%, 13.5%, and 4.1%, respectively had elevated MMA. MMA concentrations were more strongly associated with poor functional status and physical performance than serum B12. We identified a significant and independent association of MMA concentrations, as well as haemoglobin and co-morbidity with muscle strength.Conclusions/interpretations: A large proportion of individuals with a decreased serum B12 concentration still has normal MMA concentrations. Elevated MMA concentrations were more strongly associated with poor functional performance than serum B12.","PeriodicalId":18918,"journal":{"name":"Netherlands Journal of Medicine","volume":"78 1","pages":"10-24"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37630680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A diphtheria case in Indonesia: a future foe to Europe? 印度尼西亚的白喉病例:欧洲未来的敌人?

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

W de Jong, T Asmarawati, E C M van Gorp, M Goeijenbier

引用次数: 0

Fatal Spanish Souvenir. 致命的西班牙纪念品。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

I J B van der Zalm, E H C M Römers, A E van Stuijvenberg-Hamelink, J Nigten, J C Dutilh

引用次数: 0

Efficacy of intravenous iron therapy in non-anaemic iron-deficient patients with fatigue. 静脉铁治疗非贫血性缺铁患者伴疲劳的疗效观察。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

R Arcani, P Suchon, G Venton, C Soubrier, L Gaigne, S Doddoli, M Koubi, L Brandejsky, L Swiader, V Veit, E Jean, J-R Harlé, J-M Durand

{"title":"Efficacy of intravenous iron therapy in non-anaemic iron-deficient patients with fatigue.","authors":"R Arcani, P Suchon, G Venton, C Soubrier, L Gaigne, S Doddoli, M Koubi, L Brandejsky, L Swiader, V Veit, E Jean, J-R Harlé, J-M Durand","doi":"","DOIUrl":"","url":null,"abstract":"Iron deficiency, without anaemia, is common in the general population and induces various symptoms. Its management consists of oral and intravenous supplementation for cases of inefficacy of or intolerance to oral iron. We assessed the efficacy of intravenous iron therapy in non-anaemic iron-deficient patients with fatigue. We prospectively evaluated the level of fatigue, using the Fatigue Severity Scale (FSS), in patients suffering from iron deficiency without anaemia, treated by intravenous iron at the moment of the perfusion (W0), after 4 weeks (W4), and 12 weeks (W12). Of 25 patients, at W0, the mean FFS was 49.3+/-13.7. There was a significant improvement in FSS at W4 (44+/-15; p = 0.01) and a sustained response at W12 with an FFS of 35.8+/-17.1 (p < 0,0001). There was no correlation between FSS and serum ferritin level at W12 (p=0.54) or between serum ferritin at W12 and difference between FSS at W0 and W12 (p=0.58). There were six mild adverse events (24%): asthenia (8%), nausea (8%), headache (4%), local pain (4%); and no serious adverse events. Our results suggest the rapid efficacy of intravenous iron in improving fatigue in iron deficiency without anaemia with a good profile of tolerance.","PeriodicalId":18918,"journal":{"name":"Netherlands Journal of Medicine","volume":"78 1","pages":"34-36"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37632070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Viral encephalitis associated with rituximab maintenance therapy: two cases and a review of literature. 病毒性脑炎与利妥昔单抗维持治疗:2例及文献回顾。

4区医学

Netherlands Journal of Medicine Pub Date : 2020-02-01

D P Noij, T den Heijer, H C T van Zaanen

引用次数: 0