Characteristics and quality of oral anticoagulation treatment in pediatric patients in the Netherlands based on the CAPS cohort

OBJECTIVEHydrocephalus is a chronic medical condition that has a significant impact on children and their caregivers. The objective of this study was to measure the quality of life (QOL) of children with hydrocephalus, as assessed by both caregivers and patients.METHODSPediatric patients with hydrocephalus and their caregivers were enrolled during routine neurosurgery clinic visits. The Hydrocephalus Outcomes Questionnaire (HOQ), a report of hydrocephalus-related QOL, was administered to both children with hydrocephalus (self-report) and their caregivers (proxy report about the child). Patients with hydrocephalus also completed measures of anxiety, depression, fatigue, traumatic stress, and headache. Caregivers completed a proxy report of child traumatic stress and a measure of caregiver burden. Demographic information was collected from administration of the Psychosocial Assessment Tool (version 2.0) and from the medical record. Child and caregiver HOQ scores were analyzed and correlated with clinical, demographic, and psychological variables.RESULTSThe mean overall HOQ score (parent assessment of child QOL) was 0.68. HOQ Physical Health, Social-Emotional Health, and Cognitive Health subscore averages were 0.69, 0.73, and 0.54, respectively. The mean overall child self-assessment (cHOQ) score was 0.77, with cHOQ Physical Health, Social-Emotional Health, and Cognitive Health subscore means of 0.84, 0.79, and 0.66, respectively. Thirty-nine dyads were analyzed, in which both a child with hydrocephalus and his or her caregiver completed the cHOQ and HOQ. There was a positive correlation between parent and child scores (p < 0.004 for all subscores). Child scores were consistently higher than parent scores. Variables that showed association with caregiver-assessed QOL in at least one domain included child age, etiology of hydrocephalus, and history of endoscopic third ventriculostomy. There was a significant negative relationship (rho −0.48 to −0.60) between child-reported cHOQ score and child-reported measures of posttraumatic stress, anxiety, depression, and fatigue. There was a similar significant relationship between caregiver report of child’s QOL (HOQ) and caregiver assessment of the child’s posttraumatic stress symptoms as well as their assessment of burden of care (rho = −0.59 and rho = −0.51, respectively). No relationship between parent-reported HOQ and child-reported psychosocial factors was significant. No clinical or demographic variables were associated with child self-assessed cHOQ.CONCLUSIONSPediatric patients with hydrocephalus consistently rate their own QOL higher than their caregivers do. Psychological factors such as anxiety and posttraumatic stress may be associated with lower QOL. These findings warrant further exploration.

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Quality of life among people living with HIV in England and the Netherlands: a population-based study

The Lancet Regional Health - Europe ◽

10.1016/j.lanepe.2021.100177 ◽

2021 ◽

Vol 8 ◽

pp. 100177

Author(s):

Stephanie Popping ◽

Meaghan Kall ◽

Brooke E. Nichols ◽

Evelien Stempher ◽

Lisbeth Versteegh ◽

...

Keyword(s):

Quality Of Life ◽

The Netherlands ◽

Population Based ◽

People Living With Hiv ◽

Population Based Study ◽

Living With Hiv

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Implementation of Oral Anticoagulation Treatment Guidelines in Patients with Newly Diagnosed Atrial Fibrillation

British Journal of Clinical Pharmacology ◽

10.1111/bcp.14899 ◽

2021 ◽

Author(s):

Anat Arbel ◽

Zomoroda Abu‐Ful ◽

Meir Preis ◽

Shai Cohen ◽

Walid Saliba

Keyword(s):

Atrial Fibrillation ◽

Oral Anticoagulation ◽

Treatment Guidelines ◽

Newly Diagnosed ◽

Anticoagulation Treatment

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Characteristics associated with clinical response to Comano thermal spring water balneotherapy in pediatric patients with atopic dermatitis

Italian Journal of Pediatrics ◽

10.1186/s13052-021-00971-3 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Davide Geat ◽

Mattia Giovannini ◽

Ezio Gabriele Barlocco ◽

Riccardo Pertile ◽

Stefania Farina ◽

...

Keyword(s):

Atopic Dermatitis ◽

Clinical Response ◽

Disease Severity ◽

Early Onset ◽

Pediatric Patients ◽

Thermal Spring ◽

Spring Water ◽

Food Allergies ◽

Thermal Spring Water

Abstract Background Several studies have investigated the efficacy of balneotherapy in atopic dermatitis (AD), including a pediatric open randomized clinical trial conducted at the Comano thermal spring water center, which showed a significant reduction in AD severity and an improvement of the quality of life. However, so far many studies on balneotherapy in pediatric AD have included relatively small populations without identifying patients’ characteristics associated with their response. The aim of the present study was to identify any features associated with the clinical response to the Comano thermal spring water balneotherapy in a large cohort of pediatric AD patients. Methods An observational study was conducted on 867 children aged ≤16 years (females 50.5%, mean patient’s age 5.9 years, standard deviation ±3.6 years) with mild to severe AD who underwent balneotherapy at the Comano thermal spring water center (Comano, Trentino, Italy) from April to October 2014. Patients were stratified according to their disease severity, which was evaluated using five SCORing Atopic Dermatitis (SCORAD) categories before and immediately after a thermal spring water balneotherapy course. Potential characteristics associated with the patients’ clinical response to Comano thermal spring water balneotherapy were investigated. Results A statistically significant improvement in AD severity was observed after Comano thermal spring water balneotherapy (p < 0.0001). A significantly higher percentage of patients achieving improvement in AD severity was reported among children ≤4 years old (p < 0.0001) with early-onset AD (p < 0.0001), severe AD (p < 0.0001) or coexistent reported food allergies (p < 0.01). The therapy was well tolerated, and no relevant adverse effects were reported during the treatment course. Conclusions Comano thermal spring water balneotherapy is a safe complementary treatment for pediatric patients with AD, as it was able to reduce the disease severity, especially in children ≤4 years old, with early onset AD, severe AD or concomitant food allergies.

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Tolvaptan in Pediatric Autosomal Dominant Polycystic Kidney Disease: From Here to Where?

Kidney Diseases ◽

10.1159/000517186 ◽

2021 ◽

pp. 1-7

Author(s):

Fei Liu ◽

Chunyue Feng ◽

Huijun Shen ◽

Huaidong Fu ◽

Jianhua Mao

Keyword(s):

Kidney Disease ◽

Polycystic Kidney Disease ◽

Pediatric Patients ◽

Autosomal Dominant ◽

Life Assessment ◽

Therapeutic Approaches ◽

Polycystic Kidney ◽

Autosomal Dominant Polycystic Kidney ◽

Ongoing Phase

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder, accounting for approximately 5% of all ESRD cases worldwide. As a vasopressin receptor 2 antagonist, tolvaptan is the FDA-approved therapeutic agent for ADPKD, which is only made available to a limited number of adult patients; however, its efficacy in pediatric patients has not been reported widely. Summary: Tolvaptan was shown to delay ADPKD progression in the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes (TEMPO) 3:4 study, Replicating Evidence of Preserved Renal Function: an Investigation of Tolvaptan Safety and Efficacy in ADPKD (REPRISE) trial, and other clinical studies. In addition to its effects on aquaretic adverse events and alanine aminotransferase elevation, the effect of tolvaptan on ADPKD is clear, sustained, and cumulative. While ADPKD is a progressive disease, the early intervention has been shown to be important and beneficial in hypotheses as well as in trials. The use of tolvaptan in pediatric ADPKD involves the following challenges: patient assessment, quality of life assessment, cost-effectiveness, safety, and tolerability. The ongoing, phase 3b, 2-part study (ClinicalTrials.gov identifier: NCT02964273) on the evaluation of tolvaptan in pediatric ADPKD (patients aged 12–17 years) may help obtain some insights. Key Messages: This review focuses on the rationality of tolvaptan use in pediatric patients with ADPKD, the associated challenges, and the suggested therapeutic approaches.

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Financial losses for Dutch stakeholders during the 2013 aflatoxin incident in Maize in Europe

Mycotoxin Research ◽

10.1007/s12550-021-00429-9 ◽

2021 ◽

Cited By ~ 1

Author(s):

M. Focker ◽

H. J. van der Fels-Klerx ◽

A. G. J. M. Oude Lansink

Keyword(s):

The Netherlands ◽

Uncertain Data ◽

Feed Industry ◽

Sequence Of Events ◽

Bulk Milk ◽

High Concentrations ◽

Aflatoxin B ◽

Financial Losses

AbstractEarly 2013, high concentrations of aflatoxin M1 were found in the bulk milk of a few dairy farms in the Netherlands. These high concentrations were caused by aflatoxin B1 contaminated maize from Eastern Europe that was processed into compound feed, which was fed to dairy cows. Since the contamination was discovered in the downstream stages of the supply chain, multiple countries and parties were involved and recalls of the feed were necessary, resulting into financial losses. The aim of this study was to estimate the direct short-term financial losses related to the 2013 aflatoxin incident for the maize traders, the feed industry, and the dairy sector in the Netherlands. First, the sequence of events of the incident was retrieved. Then, a Monte Carlo simulation model was built to combine the scarce and uncertain data to estimate the direct financial losses for each stakeholder. The estimated total direct financial losses of this incident were estimated to be between 12 and 25 million euros. The largest share, about 60%, of the total losses was endured by the maize traders. About 39% of the total losses were for the feed industry, and less than 1% of the total losses were for the dairy sector. The financial losses estimated in this study should be interpreted cautiously due to limitations associated with the quality of the data used. Furthermore, this incident led to indirect long-term financial effects, identified but not estimated in this study.

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Health literacy of patients on oral anticoagulation treatment- individual and social determinants and effect on health and treatment outcomes

BMC Public Health ◽

10.1186/s12889-021-11259-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ana Cristina Cabellos-García ◽

Antonio Martínez-Sabater ◽

Miguel Ángel Díaz-Herrera ◽

Vicente Gea-Caballero ◽

Enrique Castro-Sánchez

Keyword(s):

Health Literacy ◽

Treatment Outcomes ◽

Oral Anticoagulation ◽

Anticoagulation Therapy ◽

Self Management ◽

Valve Prosthesis ◽

Anticoagulant Treatment ◽

Cardiovascular Pathology ◽

Anticoagulation Treatment ◽

Adequate Control

Abstract Background Assessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy. Aim: To evaluate the relationship between health literacy and health and treatment outcomes (concordance with oral anticoagulants, Normalized Ratio control and occurrence of complications) in patients with cardiovascular pathology. Methods Observational, analytic and cross-sectional study carried out on 252 patients with cardiovascular pathology (atrial fibrillation, flutter or valve prosthesis), aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. Variables referring to anticoagulant treatment with vitamin K antagonists (years of treatment, adequate control, polypharmacy and occurrence of complications, among others) and health literacy (Health Literacy Questionnaire) were analysed. Results All dimensions of health literacy were significantly related to the level of education (p < 0.02), social class (p < 0.02), an adequate control of acenocoumarol (p < 0.001), frequentation of health services (p < 0.001), information by patients to health professionals about anticoagulant treatment (p < 0.03), emergency care visits (p < 0.001) and unscheduled hospital admissions (p < 0.001). Conclusion Health literacy has a relevant influence on the adequate self-management of anticoagulation treatment and the frequency of complications. The different dimensions that comprise health literacy play an important role, but the “social health support” dimension seems to be essential for such optimal self-management. Trial registration ACC-ACE-2016-01. Registration date: December 2015.

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