Opioid prescribing in out-of-hours primary care in Flanders and the Netherlands:A retrospective cross-sectional study

BACKGROUND: Increased opioid prescribing has raised concern, as the benefits of pain relief not always outweigh the risks. Acute and chronic pain is often treated in a primary care out-of-hours (OOH) setting. This setting may be a driver of opioid use but the extent to which opioids are prescribed OOH is unknown. We aimed to investigate weak and strong opioid prescribing at OOH primary care services (PCS) in Flanders (Northern, Dutch-speaking part of Belgium) and the Netherlands between 2015 and 2019. METHODS: We performed a retrospective cross sectional study using data from routine electronic health records of OOH-PCSs in Flanders and the Netherlands (2015–2019). Our primary outcome was the opioid prescribing rate per 1000 OOH-contacts per year, in total and for strong (morphine, hydromorphone, oxycodone, oxycodone and naloxone, fentanyl, tapentadol, and buprenorphine and weak opioids (codeine combinations and tramadol and combinations) and type of opioids separately. RESULTS: Opioids were prescriped in approximately 2.5% of OOH-contacts in both Flanders and the Netherlands. In Flanders, OOH opioid prescribing went from 2.4% in 2015 to 2.1% in 2017 and then increased to 2.3% in 2019. In the Netherlands, opioid prescribing increased from 1.9% of OOH-contacts in 2015 to 2.4% in 2017 and slightly decreased thereafter to 2.1% of OOH-contacts. In 2019, in Flanders, strong opioids were prescribed in 8% of the OOH-contacts with an opioid prescription. In the Netherlands a strong opioid was prescribed in 57% of these OOH-contacts. Two thirds of strong opioids prescriptions in Flanders OOH were issued for patients over 75, in the Netherlands one third was prescribed to this age group. CONCLUSION: We observed large differences in strong opioid prescribing at OOH-PCSs between Flanders and the Netherlands that are likely to be caused by differences in accessibility of secondary care, and possibly existing opioid prescribing habits. Measures to ensure judicious and evidence-based opioid prescribing need to be tailored to the organisation of the healthcare system

P16-49. Broad types of cytokines secreted by Gag-specific T cells from HIV infected patients on HAART

International audiencen.

P17-23. Enhanced expression of HIV antigens and improved antigen presentation after infection with replication competent attenuated vaccinia virus in vitro

1 página.-- Presentación de póster presentation.-- Este artículo es parte del suplemento: AIDS Vaccine 2009.Peer reviewe

S04-04 OA. HIV-specific responses induced by anti-CD40 targeting antibodies

International audiencen.

Overwegingen bij een boerka verbod. Zienswijze van de deskundigen inzaken een verbod op gezichtsbedekende kleding

Modernity (Religion and Modernity

Contenido de minerales en algunas especies forrajeras presentes en el pastizal natural de un sistema silvopastoril en el bajo delta del Río Paraná

We analyzed the content of phosphorus (P), calcium (Ca), magnesium (Mg), total ash (Cen) and insoluble ash (Insol), iron (Fe), copper (Cu) and zinc (Zn) in forage species growing wild in silvopastoral system of the Lower Delta of the Parana River after planting forest. 10 plants were harvested from the following species: Glyceria multiflora (Cebadilla de agua), Deyeuxia viridiflavescens (Pasto plateado), Melilotus officinalis (Trébol de olor amarillo), Phalaris angusta (Alpistillo), Lolium multiflorum (Ray gras), Lathyrus pubescens (Arvejilla), Vicia gramínea (Vicia) y Leersia hexandra (Arrocillo). They were dried, incinerated and ashes dissolved in acid. Mineral determinations were performed by atomic absorption spectrophotometry (AAS) and colorimetry. Mineral contents in the species studied here were lower than values informed previously of forage species of temperate weather and, in some cases, mineral requirements for cattle.Se realizó el análisis del contenido de fósforo (P), calcio (Ca), magnesio (Mg), hierro (Fe), cobre (Cu), zinc (Zn) y cenizas totales (Cen) e insolubles (Insol), en especies forrajeras que crecen naturalmente en el sistema silvopastoril del Bajo Delta del Río Paraná,  luego de la plantación forestal. Se cosecharon 10 plantas de cada una de las siguientesespecies: Glyceria multiflora (Cebadilla de agua), Deyeuxia viridiflavescens (Pasto plateado), Melilotus officinalis (Trébol de olor amarillo), Phalaris angusta (Alpistillo), Lolium multiflorum (Ray gras), Lathyrus pubescens (Arvejilla), Vicia gramínea (Vicia) y Leersia hexandra (Arrocillo). Se secaron y calcinaron, resuspendiendo las cenizas en ácido. Las determinaciones de minerales se realizaron por espectrofotometría de absorción atómica (EAA) y colorimetría. Las concentraciones determinadas fueron inferiores a las informadas para forrajeras de clima templado y, en algunos casos, a los requerimientos establecidos para ganado bovino

P16-29. HIV Nef-specific T cells: Th1/CTL, Th2 and Th17 responses

International audiencen.

Study of Muscle Cell Dedifferentiation after Skeletal Muscle Injury of Mice with a Cre-Lox System

Background: Dedifferentiation of muscle cells in the tissue of mammals has yet to be observed. One of the challenges facing the study of skeletal muscle cell dedifferentiation is the availability of a reliable model that can confidentially distinguish differentiated cell populations of myotubes and non-fused mononuclear cells, including stem cells that can coexist within the population of cells being studied. Methodology/Principal Findings: In the current study, we created a Cre/Lox-β-galactosidase system, which can specifically tag differentiated multinuclear myotubes and myotube-generated mononuclear cells based on the activation of the marker gene, β-galactosidase. By using this system in an adult mouse model, we found that β-galactosidase positive mononuclear cells were generated from β-galactosidase positive multinuclear myofibers upon muscle injury. We also demonstrated that these mononuclear cells can develop into a variety of different muscle cell lineages, i.e., myoblasts, satellite cells, and muscle derived stem cells. Conclusions/Significance: These novel findings demonstrated, for the first time, that cellular dedifferentiation of skeletal muscle cells actually occurs in mammalian skeletal muscle following traumatic injury in vivo. © 2011 Mu et al

New physiological activities of myosuppressin, sulfakinin and NVP-like peptide in Zophobas atratus beetle

Three neuropeptides Zopat-MS-2 (pEDVDHVFLRFa), Zopat-SK-1 (pETSDDYGHLRFa) and Zopat-NVPL-4trunc. (GRWGGFA), recently isolated from the neuroendocrine system of the Zophobas atratus beetle, were tested for their myotropic and hyperglycaemic activities in this species. These peptides exerted differentiated dose-dependent and tissue specific physiological effects. Zopat-MS-2 inhibited contractions of the isolated heart, ejaculatory duct, oviduct and hindgut of adult beetles and induced bimodal effects in the heart contractile activity of pupae in vivo. It also increased the haemolymph free sugar level in larvae of this species, apart from myotropic activity. Zopat-SK-1 showed myostimulatory action on the isolated hindgut of the adult beetles, but it decreased contractions of the heart, ejaculatory duct and oviduct. Injections of this peptide at a dose of 2 μg also caused delayed cardioinhibitory effects on the heartbeat of the pupae. Together with the ability to increase free sugar level in the haemolymph of larvae these were new physiological activities of sulfakinins in insects. Zopat-NVPL-4trunc. inhibited the muscle contractions of the two organs: hindgut and ejaculatory duct but it was inactive on the oviduct and the heart of the adult beetles. This peptide also increased free sugar level concentration in the haemolymph of Z. atratus larvae. These physiological actions are the first biological activities discovered for this group of the insect peptides. The present work showed pleiotropic activity of three neuropeptides and indicates that the visceral muscle contractions and the haemolymph sugar homeostasis in Z. atratus are regulated by complex mechanisms