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Serbanescu-Kele Apor de Zalán C, Bouwman M, van Osch F, Damoiseaux J, Funnekotter-van der Snoek MA, Verduyn Lunel F, Van Hunsel F, de Vries J. Changes in Local and Systemic Adverse Effects following Primary and Booster Immunisation against COVID-19 in an Observational Cohort of Dutch Healthcare Workers Vaccinated with BNT162b2 (Comirnaty ®). Vaccines (Basel) 2023; 12:39. [PMID: 38250852 PMCID: PMC10821042 DOI: 10.3390/vaccines12010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
In healthcare workers (HCWs) and in the general population, fear of adverse effects is among the main reasons behind COVID-19 vaccine hesitancy. We present data on self-reported adverse effects from a large cohort of HCWs who underwent primary (N = 470) and booster (N = 990) mRNA vaccination against SARS-CoV-2. We described general patterns in, and predictors of self-reported adverse effect profiles. Adverse effects following immunisation (AEFI) were reported more often after the second dose of primary immunisation than after the first dose, but there was no further increase in adverse effects following the booster round. Self-reported severity of systemic adverse effects was less following booster immunisation. Prior infection with SARS-CoV-2 was found to be a significant predictor of AEFI following primary immunisation, but was no longer a predictor after booster vaccination. Compared to other studies reporting specifically on adverse effects of SARS-CoV-2 vaccination in healthcare workers, we have a relatively large cohort size, and are the first to compare adverse effects between different rounds of vaccination. Compared to studies in the general population, we have a considerably homogenous population. Insights in AEFI following primary and booster vaccinations may help in addressing vaccine hesitancy, both in HCWs and in the general population.
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Affiliation(s)
- Christiaan Serbanescu-Kele Apor de Zalán
- Department of Intensive Care, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
- Department of Internal Medicine, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
| | - Maud Bouwman
- Department of Medical Microbiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (M.B.); (J.D.); (J.d.V.)
| | - Frits van Osch
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands;
- Department of Epidemiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Jan Damoiseaux
- Department of Medical Microbiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (M.B.); (J.D.); (J.d.V.)
- Central Diagnostic Laboratory, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands
| | | | - Frans Verduyn Lunel
- Department of Medical Microbiology, Utrecht University Medical Centre, 3584 CX Utrecht, The Netherlands;
| | - Florence Van Hunsel
- Department of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands;
- Netherlands Pharmacovigilance Centre (Lareb), 5237 MH Hertogenbosch, The Netherlands
| | - Janneke de Vries
- Department of Medical Microbiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (M.B.); (J.D.); (J.d.V.)
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Badia-Soteras A, de Vries J, Dykstra W, Broersen LM, Verkuyl JM, Smit AB, Verheijen MHG. High-Throughput Analysis of Astrocyte Cultures Shows Prevention of Reactive Astrogliosis by the Multi-Nutrient Combination Fortasyn Connect. Cells 2022; 11:cells11091428. [PMID: 35563732 PMCID: PMC9099974 DOI: 10.3390/cells11091428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 12/23/2022] Open
Abstract
Astrocytes are specialized glial cells that tile the central nervous system (CNS) and perform numerous essential functions. Astrocytes react to various forms of CNS insults by altering their morphology and molecular profile, through a process known as reactive astrogliosis. Accordingly, astrocyte reactivity is apparent in many neurodegenerative diseases, among which one is Alzheimer’s disease (AD). Recent clinical trials on early-stage AD have demonstrated that Fortasyn Connect (FC), a multi-nutrient combination providing specific precursors and cofactors for phospholipid synthesis, helps to maintain neuronal functional connectivity and cognitive performance of patients. Several studies have shown that FC may act through its effects on neuronal survival and synaptogenesis, leading to reduced astrocyte reactivity, but whether FC can directly counteract astrocyte reactivity remains to be elucidated. Hence, we developed an in vitro model of reactive astrogliosis using the pro-inflammatory cytokines TNF-α and IFN-γ together with an automated high-throughput assay (AstroScan) to quantify molecular and morphological changes that accompany reactive astrogliosis. Next, we showed that FC is potent in preventing cytokine-induced reactive astrogliosis, a finding that might be of high relevance to understand the beneficial effects of FC-based interventions in the context of neurodegenerative diseases.
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Affiliation(s)
- Aina Badia-Soteras
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Earth and Life Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands; (A.B.-S.); (J.d.V.); (W.D.); (A.B.S.)
| | - Janneke de Vries
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Earth and Life Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands; (A.B.-S.); (J.d.V.); (W.D.); (A.B.S.)
| | - Werner Dykstra
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Earth and Life Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands; (A.B.-S.); (J.d.V.); (W.D.); (A.B.S.)
| | - Laus M. Broersen
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands; (L.M.B.); (J.M.V.)
| | - Jan Martin Verkuyl
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands; (L.M.B.); (J.M.V.)
| | - August B. Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Earth and Life Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands; (A.B.-S.); (J.d.V.); (W.D.); (A.B.S.)
| | - Mark H. G. Verheijen
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Earth and Life Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands; (A.B.-S.); (J.d.V.); (W.D.); (A.B.S.)
- Correspondence:
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Bouwman M, van Osch F, Crijns F, Trienekens T, Mehagnoul-Schipper J, van den Bergh JP, de Vries J. SARS-CoV-2 seroprevalence in healthcare workers of a teaching hospital in a highly endemic region in the Netherlands after the first wave: a cross-sectional study. BMJ Open 2021; 11:e051573. [PMID: 34663664 PMCID: PMC8523962 DOI: 10.1136/bmjopen-2021-051573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To study the SARS-CoV-2 infection rate among hospital healthcare workers after the first wave of the COVID-19 pandemic, and provide more knowledge in the understanding of the relationship between infection, symptomatology and source of infection. DESIGN A cross-sectional study in healthcare workers. SETTING Northern Limburg, the Netherlands. PARTICIPANTS All employees of VieCuri Medical Center (n=3300) were invited to enrol in current study. In total 2507 healthcare workers participated. INTERVENTION Between 22 June 2020 and 3 July 2020, participants provided venous blood samples voluntarily, which were tested for SARS-CoV-2 antibodies with the Wantai SARS-CoV-2 Ig total ELISA test. Work characteristics, exposure risks and prior symptoms consistent with COVID-19 were gathered through a survey. MAIN OUTCOME MEASURE Proportion of healthcare workers with positive SARS-CoV-2 serology. RESULTS The overall seroprevalence was 21.1% (n=530/2507). Healthcare workers between 17 and 30 years were more likely to have SARS-CoV-2 antibodies compared with participants >30 years. The probability of having SARS-CoV-2 antibodies was comparable for healthcare workers with and without direct patient (OR 1.42, 95% CI 0.86 to 2.34) and COVID-19 patient contact (OR 1.62, 95% CI 0.80 to 3.33). On the contrary, exposure to COVID-19 positive coworkers (OR 1.83, 95% CI 1.15 to 2.93) and household members (OR 6.09, 95% CI 2.23 to 16.64) was associated with seropositivity. Of those healthcare workers with SARS-CoV-2 antibodies, 16% (n=85/530) had not experienced any prior COVID-19-related symptoms. Only fever and anosmia were associated with seropositivity (OR 1.90, 95% CI 1.42 to 2.55 and OR 10.51, 95% CI 7.86 to 14.07). CONCLUSIONS Healthcare workers caring for hospitalised COVID-19 patients were not at an increased risk of infection, most likely as a result of taking standard infection control measures into consideration. These data show that compliance with infection control measures is essential to control secondary transmission and constrain the spread of the virus.
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Affiliation(s)
- Maud Bouwman
- Department of Medical Microbiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Frits van Osch
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Francy Crijns
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Thera Trienekens
- Department of Medical Microbiology, VieCuri Medical Centre, Venlo, The Netherlands
| | | | - Joop P van den Bergh
- Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
- Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands
| | - Janneke de Vries
- Department of Medical Microbiology, VieCuri Medical Centre, Venlo, The Netherlands
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de Vries J, Verbunt J, Stubbe J, Visser B, Ramaekers S, Calders P, Engelbert R. Generalized Joint Hypermobility and Anxiety in Adolescents and Young Adults, the Impact on Physical and Psychosocial Functioning. Healthcare (Basel) 2021; 9:525. [PMID: 33946940 PMCID: PMC8146775 DOI: 10.3390/healthcare9050525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to study the association between the presence of generalized joint hypermobility (GJH) and anxiety within a non-clinical high performing group of adolescents and young adults. Second, to study the impact of GJH and/or anxiety on physical and psychosocial functioning, 168 adolescents and young adults (mean (SD) age 20 (2.9)) were screened. Joint (hyper)mobility, anxiety, and physical and psychosocial functioning were measured. In 48.8% of all high performing adolescents and young adults, GJH was present, whereas 60% had symptoms of anxiety. Linear models controlled for confounders showed that adolescents and young adults with GJH and anxiety had decreased workload (ß (95%CI) -0.43 (-0.8 to -0.08), p-value 0.02), increased fatigue (ß (95%CI) 12.97 (6.3-19.5), p-value < 0.01), and a higher level of pain catastrophizing (ß (95%CI) 4.5 (0.5-8.6), p-value 0.03). Adolescents and young adults with only anxiety had increased fatigue (ß (95%CI) 11 (4.9-19.5). In adolescents and young adults with GJH alone, no impact on physical and psychosocial functioning was found. Adolescents and young adults with the combination of GJH and anxiety were significantly more impaired, showing decreased physical and psychosocial functioning with decreased workload, increased fatigue, and pain catastrophizing. Presence of GJH alone had no negative impact on physical and psychosocial functioning. This study confirms the association between GJH and anxiety, but especially emphasizes the disabling role of anxiety. Screening for anxiety is relevant in adolescents and young adults with GJH and might influence tailored interventions.
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Affiliation(s)
- Janneke de Vries
- School of Physiotherapie, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Movement Sciences, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
| | - Jeanine Verbunt
- Department of Rehabilitation Medicine, CAPHRI, Functioning and Rehabilitation, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
- Adelante Center of Expertise in Rehabilitationand Audiology, 6432 CC Hoensbroek, The Netherlands
| | - Janine Stubbe
- Codarts, University of the Arts, 3012 CC Rotterdam, The Netherlands;
- PErforming Artist and Athlete Research Lab (PEARL), 3012 CC Rotterdam, The Netherlands
- Department of General Practice, Erasmus MC University Medical Center, 3015 GD Rotterdam, The Netherlands
- Rotterdam Arts and Science Lab (RASL), 3012 CC Rotterdam, The Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
| | - Stephan Ramaekers
- School of Physiotherapie, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
| | - Patrick Calders
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Raoul Engelbert
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Movement Sciences, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands;
- Amsterdam UMC, Department of Pediatrics, Emma Children’s Hospital, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Opperhuizen AL, Wang D, Foppen E, Jansen R, Boudzovitch-Surovtseva O, de Vries J, Fliers E, Kalsbeek A. Feeding during the resting phase causes profound changes in physiology and desynchronization between liver and muscle rhythms of rats. Eur J Neurosci 2016; 44:2795-2806. [PMID: 27562056 DOI: 10.1111/ejn.13377] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/18/2016] [Accepted: 08/22/2016] [Indexed: 12/19/2022]
Abstract
Shiftworkers run an increased risk of developing metabolic disorders, presumably as a result of disturbed circadian physiology. Eating at a time-of-day that is normally dedicated to resting and fasting, may contribute to this association. The hypothalamus is the key brain area that integrates different inputs, including environmental time information from the central biological clock in the suprachiasmatic nuclei, with peripheral information on energy status to maintain energy homeostasis. The orexin system within the lateral hypothalamus is an important output of the suprachiasmatic nuclei involved in the control of sleep/wake behavior and glucose homeostasis, among other functions. In this study, we tested the hypothesis that feeding during the rest period disturbs the orexin system as a possible underlying contributor to metabolic health problems. Male Wistar rats were exposed to an 8-week protocol in which food was available ad libitum for 24-h, for 12-h during the light phase (i.e., unnatural feeding time) or for 12-h during the dark phase (i.e., restricted feeding, but at the natural time-of-day). Animals forced to eat at an unnatural time, i.e., during the light period, showed no changes in orexin and orexin-receptor gene expression in the hypothalamus, but the rhythmic expression of clock genes in the lateral hypothalamus was absent in these animals. Light fed animals did show adverse changes in whole-body physiology and internal desynchronization of muscle and liver clock and metabolic gene expression. Eating at the 'wrong' time-of-day thus causes internal desynchronization at different levels, which in the long run may disrupt body physiology.
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Affiliation(s)
- Anne-Loes Opperhuizen
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
| | - Dawei Wang
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.,Institute of Plant Protection (IPP), Chinese Academy of Agricultural Science (CAAS), Beijing, China
| | - Ewout Foppen
- Department of Endocrinology and Metabolism, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Remi Jansen
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
| | - Olga Boudzovitch-Surovtseva
- Department of Endocrinology and Metabolism, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Janneke de Vries
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
| | - Eric Fliers
- Department of Endocrinology and Metabolism, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Andries Kalsbeek
- Hypothalamic Integration Mechanisms, Netherlands Institute for Neuroscience (NIN), Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.,Department of Endocrinology and Metabolism, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
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Scheper M, Rombaut L, de Vries J, De Wandele I, van der Esch M, Visser B, Malfait F, Calders P, Engelbert R. The association between muscle strength and activity limitations in patients with the hypermobility type of Ehlers-Danlos syndrome: the impact of proprioception. Disabil Rehabil 2016; 39:1391-1397. [PMID: 27339264 DOI: 10.1080/09638288.2016.1196396] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are characterized by pain, proprioceptive inacuity, muscle weakness, potentially leading to activity limitations. In EDS-HT, a direct relationship between muscle strength, proprioception and activity limitations has never been studied. The objective of the study was to establish the association between muscle strength and activity limitations and the impact of proprioception on this association in EDS-HT patients. METHODS Twenty-four EDS-HT patients were compared with 24 controls. Activity limitations were quantified by Health Assessment Questionnaire (HAQ), Six-Minute Walk test (6MWT) and 30-s chair-rise test (30CRT). Muscle strength was quantified by handheld dynamometry. Proprioception was quantified by movement detection paradigm. In analyses, the association between muscle strength and activity limitations was controlled for proprioception and confounders. RESULTS Muscle strength was associated with 30CRT (r = 0.67, p = <0.001), 6MWT (r = 0.58, p = <0.001) and HAQ (r = 0.63, p= <0.001). Proprioception was associated with 30CRT (r = 0.55, p < 0.001), 6MWT (r = 0.40, p = <0.05) and HAQ (r = 0.46, p < 0.05). Muscle strength was found to be associated with activity limitations, however, proprioceptive inacuity confounded this association. CONCLUSIONS Muscle strength is associated with activity limitations in EDS-HT patients. Joint proprioception is of influence on this association and should be considered in the development of new treatment strategies for patients with EDS-HT. Implications for rehabilitation Reducing activity limitations by enhancing muscle strength is frequently applied in the treatment of EDS-HT patients. Although evidence regarding treatment efficacy is scarce, the current paper confirms the rationality that muscle strength is an important factor in the occurrence of activity limitations in EDS-HT patients. Although muscle strength is the most dominant factor that is associated with activity limitations, this association is confounded by proprioception. In contrast to common belief proprioception was not directly associated with activity limitations but confounded this association. Controlling muscle strength on the bases of proprioceptive input may be more important for reducing activity limitations than just enhancing sheer muscle strength.
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Affiliation(s)
- Mark Scheper
- a Faculty of Health, ACHIEVE , Center for Applied Research, University of Applied Sciences Amsterdam , Amsterdam , The Netherlands.,b Department of Rehabilitation , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
| | - Lies Rombaut
- c Department of Rehabilitation Sciences and Physiotherapy , Ghent University , Ghent , Belgium
| | - Janneke de Vries
- a Faculty of Health, ACHIEVE , Center for Applied Research, University of Applied Sciences Amsterdam , Amsterdam , The Netherlands.,b Department of Rehabilitation , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
| | - Inge De Wandele
- c Department of Rehabilitation Sciences and Physiotherapy , Ghent University , Ghent , Belgium
| | - Martin van der Esch
- a Faculty of Health, ACHIEVE , Center for Applied Research, University of Applied Sciences Amsterdam , Amsterdam , The Netherlands.,d Reade, Amsterdam Rehabilitation Research Centre , Amsterdam , The Netherlands
| | - Bart Visser
- a Faculty of Health, ACHIEVE , Center for Applied Research, University of Applied Sciences Amsterdam , Amsterdam , The Netherlands
| | | | - Patrick Calders
- c Department of Rehabilitation Sciences and Physiotherapy , Ghent University , Ghent , Belgium
| | - Raoul Engelbert
- a Faculty of Health, ACHIEVE , Center for Applied Research, University of Applied Sciences Amsterdam , Amsterdam , The Netherlands.,b Department of Rehabilitation , Academic Medical Centre, University of Amsterdam , Amsterdam , The Netherlands
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van Stigt SFL, de Vries J, Bijker JB, Mollen RMHG, Hekma EJ, Lemson SM, Tan ECTH. Review of 58 patients with necrotizing fasciitis in the Netherlands. World J Emerg Surg 2016; 11:21. [PMID: 27239222 PMCID: PMC4884415 DOI: 10.1186/s13017-016-0080-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/23/2016] [Indexed: 12/05/2022] Open
Abstract
Background Necrotizing fasciitis is a rare, life threatening soft tissue infection, primarily involving the fascia and subcutaneous tissue. In a large cohort of patients presenting with Necrotizing fasciitis in the Netherlands we analysed all available data to determine the causative pathogens and describe clinical management and outcome. Methods We conducted a retrospective, multicentre cohort study of patients with a necrotizing fasciitis between January 2003 and December 2013 in an university medical hospital and three teaching hospitals in the Netherlands. We only included patients who stayed at the Intensive Care Unit for at least one day. Results Fifty-eight patients were included. The mortality rate among those patients was 29.3 %. The central part of the body was affected in 28 patients (48.3 %) and in 21 patients (36.2 %) one of the extremities. Most common comorbidity was cardio vascular diseases in 39.7 %. Thirty-nine patients (67.2 %) were operated within 24 h after presentation. We found a type 1 necrotizing fasciitis in 35 patients (60.3 %) and a type 2 in 23 patients (39.7 %). Conclusions Our study, which is the largest study in Europe, reaffirmed that Necrotizing fasciitis is a life threatening disease with a high mortality. Early diagnosis and adequate treatment are necessary to improve the clinical outcome. Clinical awareness off necrotizing fasciitis remains pivotal.
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Affiliation(s)
- Sander F L van Stigt
- Department of Surgery, Traumasurgery Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Janneke de Vries
- Department of Medical Microbiology, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Jilles B Bijker
- Department of Anesthesiology, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands
| | - Roland M H G Mollen
- Department of Surgery, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands
| | - Edo J Hekma
- Department of Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands
| | - Susan M Lemson
- Department of Surgery, Slingeland Hospital, Kruisbergseweg 25, 7009 BL Doetinchem, The Netherlands
| | - Edward C T H Tan
- Department of Surgery, Traumasurgery Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands
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Schuurman MJ, Loza B, de Vries J, Slabber AJ. [A young boy with pulmonary tuberculosis]. Ned Tijdschr Geneeskd 2014; 158:A6618. [PMID: 24495367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Infectious pulmonary tuberculosis in young children is rare in the Netherlands. Young children with a tuberculosis infection are at high risk of developing miliary tuberculosis or tuberculous meningitis. CASE DESCRIPTION A 12-month-old boy of Turkish descent was brought to our hospital because of coughing present for a few weeks and fever for 10 days. Nine weeks previously the patient had visited family in western Turkey, where, as far as is known, he did not come into contact with anyone who had tuberculosis. A chest X-ray showed infiltration of the middle lobe. He did not recover with empirical treatment for community-acquired pneumonia. Because of treatment failure, tuberculin skin testing was performed, the result of which was positive. The boy fully recovered during tuberculostatic treatment. Open tuberculosis was subsequently confirmed in a family member in Turkey after the boy's visit. CONCLUSION In the event of pneumonia with an atypical course, testing for tuberculosis is justified, even if there is no or little likelihood of contact with a tuberculosis patient in the history.
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Swierstra BA, Vervest AMJS, Walenkamp GHIM, Schreurs BW, Spierings PTJ, Heyligers IC, van Susante JLC, Ettema HB, Jansen MJ, Hennis PJ, de Vries J, Muller-Ploeger SB, Pols MA. Dutch guideline on total hip prosthesis. Acta Orthop 2011; 82:567-76. [PMID: 21992086 PMCID: PMC3242953 DOI: 10.3109/17453674.2011.623575] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 04/25/2011] [Indexed: 01/31/2023] Open
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Wulf M, van Nes A, Eikelenboom-Boskamp A, de Vries J, Melchers W, Klaassen C, Voss A. Methicillin-resistant Staphylococcus aureus in veterinary doctors and students, the Netherlands. Emerg Infect Dis 2007; 12:1939-41. [PMID: 17326948 PMCID: PMC3291345 DOI: 10.3201/eid1212.060355] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the Netherlands, at 1.0%, is among the lowest in Europe. In 2004, a relationship between pig farming and a high risk for MRSA carriage was found. To investigate if those in professional contact with livestock are at higher risk for MRSA carriage, we screened 80 veterinary students and 99 veterinarians and questioned them about animal contacts and known MRSA risk factors. Of these, 27 students who did not have livestock contact were excluded from further analysis. We found 7 carriers of MRSA, a prevalence of 4.6%, which is similar to that found in patients who had previously been treated at foreign hospitals. A correlation of MRSA carriage with a specific animal group could not be established. To preserve the low prevalence of MRSA in the Netherlands, persons involved in the care of livestock should be isolated and screened on admission to the hospital.
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Affiliation(s)
- Mireille Wulf
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
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Vries JD, Doppenberg WG, Henrar RE, Bult A, Beijnen JH. Systematic study on the chemical stability of the prodrug antitumor agent carzelesin (U-80,244). J Pharm Sci 1996; 85:1227-33. [PMID: 8923330 DOI: 10.1021/js960005n] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The chemical stability of the novel anticancer agent carzelesin in aqueous buffer/acetonitrile (1:1, v/v) mixtures has been investigated utilizing a stability-indicating reversed-phase high-performance liquid chromatographic assay. The degradation kinetics of carzelesin has been studied as a function of pH, buffer composition, ionic strength, and temperature. Degradation of carzelesin follows (pseudo-) first-order kinetics. A pH-rate profile, using rate constants extrapolated to zero buffer concentration, was constructed demonstrating that carzelesin is most stable in the pH region 1-4. The degradation rate of carzelesin was not significantly affected by buffer components and by the ionic strength. In addition to the formation of the degradation products U-76,073, U-76,074, and aniline in alkaline medium and in acetate buffer solution, another degradation product was formed in acetate buffer solution. In perchloric acid buffer solution (pH* < 3), U-76,073 and U-76,074 could not be detected as degradation products.
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Affiliation(s)
- J D Vries
- Department of Pharmacy, Slotervaart Hospital/Netherlands Cancer Institute, Amsterdam, The Netherlands
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