Continuous vital sign monitoring in patients after elective abdominal surgery:a retrospective study on clinical outcomes and costs

Aim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials &amp; methods: Retrospective analysis of clinical outcomes and in-hospital costs compared with a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p &lt; 0.001) and lower costs (p &lt; 0.001). The intervention was associated with a lower odds of ICU admission (odds ratio: 0.422; p = 0.007) and ICU related costs (odds ratio: -662.4; p = 0.083). Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients.</p

imaging and biomarkers in gastroenteropancreatic neuroendocrine tumor disease management

The complexity of the clinical management of neuroendocrine neoplasia (NEN) is exacerbated by limitations in imaging modalities and a paucity of clinically useful biomarkers. Limitations in currently available imaging modalities reflect difficulties in measuring an intrinsically indolent disease, resolution inadequacies and inter-/intra-facility device variability and that RECIST (Response Evaluation Criteria in Solid Tumors) criteria are not optimal for NEN. Limitations of currently used biomarkers are that they are secretory biomarkers (chromogranin A, serotonin, neuron-specific enolase and pancreastatin); monoanalyte measurements; and lack sensitivity, specificity and predictive capacity. None of them meet the NIH metrics for clinical usage. A multinational, multidisciplinary Delphi consensus meeting of NEN experts (n = 33) assessed current imaging strategies and biomarkers in NEN management. Consensus (>75%) was achieved for 78% of the 142 questions. The panel concluded that morphological imaging has a diagnostic value. However, both imaging and current single-analyte biomarkers exhibit substantial limitations in measuring the disease status and predicting the therapeutic efficacy. RECIST remains suboptimal as a metric. A critical unmet need is the development of a clinico-biological tool to provide enhanced information regarding precise disease status and treatment response. The group considered that circulating RNA was better than current general NEN biomarkers and preliminary clinical data were considered promising. It was resolved that circulating multianalyte mRNA (NETest) had clinical utility in both diagnosis and monitoring disease status and therapeutic efficacy. Overall, it was concluded that a combination of tumor spatial and functional imaging with circulating transcripts (mRNA) would represent the future strategy for real- time monitoring of disease progress and therapeutic efficacy

Future Riverine Flood Impacts for NUTS3 regions in Europe: GLOFRIS input to DIFI

&lt;p&gt;This dataset presents results of&nbsp;current and future riverine flood impact data for NUTS3 regions in Europe. The dataset has been developed following the methodology presented in Tiggeloven et al. (2020) and Mortensen et al. (In Review).&lt;/p&gt;&lt;p&gt;This dataset can be used to as direct input for the DIFI model as described in Tesselaar et al. (2023).&lt;/p&gt;&lt;p&gt;References:&lt;/p&gt;&lt;p&gt;Mortensen, E., Tiggeloven, T., Haer, T., van Bemmel, B., Bouwman, A., Ligtvoet, W., &amp; Ward, P.J.: The potential for various riverine flood DRR measures at the global scale. &lt;i&gt;Journal of Coastal and Riverine Flood Risk&lt;/i&gt;, In Review.&lt;/p&gt;&lt;p&gt;Tesselaar, M., Botzen, W.J.W., Aerts, J.C.J.H., Tiggeloven, T. (2023). Flood insurance is a driver of population growth in European floodplains. &lt;i&gt;Nature Communications (provisionally accepted)&lt;/i&gt;&lt;/p&gt;&lt;p&gt;Tiggeloven, T., De Moel, H., Winsemius, H. C., Eilander, D., Erkens, G., Gebremedhin, E., ... &amp; Ward, P. J. (2020). Global-scale benefit–cost analysis of coastal flood adaptation to different flood risk drivers using structural measures. &lt;i&gt;Natural Hazards and Earth System Sciences&lt;/i&gt;, &lt;i&gt;20&lt;/i&gt;(4), 1025-1044.&lt;/p&gt

Effect of Cardiac Resynchronization Therapy on Endothelium-Dependent Vasodilatation in the Cutaneous Microvasculature

Aims: Cardiac resynchronization therapy (CRT) improves hemodynamic parameters, exercise capacity, symptoms, functional status, and prognosis among patients with chronic heart failure (CHF). The role of the vascular endothelium in these improvements is largely unknown. In this study, we aimed to investigate whether the endothelium-dependent reactivity of the peripheral microcirculation improves in CHF patients during the first 2 months of CRT. less thanbrgreater than less thanbrgreater thanMethods: We used local heating and iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) to measure endothelial function and smooth muscle function in the cutaneous microvasculature of 11 CHF patients before and 2 months after CRT. less thanbrgreater than less thanbrgreater thanResults: We found that the perfusion response in the skin to local heating was increased 2 months postCRT compared with baseline, both in terms of maximum perfusion (baseline: 113 [90-137] vs 2-months post-CRT: 137 [98-175], P = 0.037) and area under curve (baseline: 1,601 [935-2,268] vs 2-months CRT: 2,205 [1,654-2,757], P = 0.047). Also, the perfusion response to iontophoresis of ACh was improved (Emax: 23.9 [20.6-26.2] vs at 2-months CRT: 31.2 [29.3-33.4], P = 0.005). No difference was found between the responses to SNP before and after CRT. less thanbrgreater than less thanbrgreater thanConclusion: These results show that CRT improves endothelium-dependent vasodilatory capacity in the peripheral microcirculation within 2 months of therapy. The improvement in functional capacity that is seen in patients treated with CRT may, therefore, be in part mediated by an improvement of endothelium-dependent vasodilatory capacity.Funding Agencies|Medtronic NL B.V., Heerlen, the Netherlands||Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical Psychology, Tilburg University, the Netherlands|

Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs

Aim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials & methods: Retrospective analysis of clinical outcomes and in-hospital costs comparedwith a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p < 0.001) and lower costs (p < 0.001). The intervention was associated with a lower odds of ICU admission (odds ratio: 0.422; p = 0.007) and ICU related costs (coefficient: -622.6; p = 0.083). Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients

CD27-CD70 interactions sensitise naive CD4+ T cells for IL-12-induced Th1 cell development

Stimulation of CD27, a member of the tumour necrosis factor receptor family, by its ligand CD70 induces expansion of IFNgamma secreting CD4+ and CD8+ T cells in vivo. We here analysed the mechanisms through which CD27 mediates this effect. CD27 co-stimulation induced cell division but did not directly instruct naive CD4+ T cells to differentiate into IFNgamma-producing Th1 cells. Rather, in concert with signals delivered through the TCR-CD3 complex, CD27 co-stimulation enhanced the Th1-specific transcription factor T-bet and caused up-regulation of the IL-12Rbeta2 chain. Consequently, CD27-costimulated T cells yielded vast numbers of IFNgamma-secreting cells in response to IL-12. Additionally, CD27 ligation induced a strong up-regulation of Bcl-xL, but not of related anti-apoptotic molecules. Thus, CD27-CD70 interactions may promote Th1 formation by permitting naive T cells to respond to differentiation signals and by promoting survival of activated effector T cell

Supplementary materials: Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs

These are peer-reviewed supplementary materials for the article 'Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs' published in the Journal of Comparative Effectiveness Research.Table S1: Clinical outcomes in different disease categoriesTable S2: Linear regression results for length of stayTable S3: Logistic regression summary results for ICU admissionTable S4: EWS measurementsTable S5: EWS scores of HR and RR measurementsTable S6: Linear regression summary results for ward costsTable S7: Linear regression summary results for ICU costsTable S8: Linear regression summary results for total costsAim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials & methods: Retrospective analysis of clinical outcomes and in-hospital costs compared with a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients.</p

Supplementary materials: Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs

These are peer-reviewed supplementary materials for the article 'Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs' published in the Journal of Comparative Effectiveness Research.Table S1: Clinical outcomes in different disease categoriesTable S2: Linear regression results for length of stayTable S3: Logistic regression summary results for ICU admissionTable S4: EWS measurementsTable S5: EWS scores of HR and RR measurementsTable S6: Linear regression summary results for ward costsTable S7: Linear regression summary results for ICU costsTable S8: Linear regression summary results for total costsAim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials &amp; methods: Retrospective analysis of clinical outcomes and in-hospital costs compared with a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p &lt; 0.001) and lower costs (p &lt; 0.001). The intervention was associated with a lower odds of ICU admission (odds ratio: 0.422; p = 0.007) and ICU related costs (coefficient: -622.6; p = 0.083). Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients

Supplementary materials: Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs

These are peer-reviewed supplementary materials for the article 'Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs' published in the Journal of Comparative Effectiveness Research.Table S1: Clinical outcomes in different disease categoriesTable S2: Linear regression results for length of stayTable S3: Logistic regression summary results for ICU admissionTable S4: EWS measurementsTable S5: EWS scores of HR and RR measurementsTable S6: Linear regression summary results for ward costsTable S7: Linear regression summary results for ICU costsTable S8: Linear regression summary results for total costsAim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials &amp; methods: Retrospective analysis of clinical outcomes and in-hospital costs compared with a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p &lt; 0.001) and lower costs (p &lt; 0.001). The intervention was associated with a lower odds of ICU admission (odds ratio: 0.422; p = 0.007) and ICU related costs (coefficient: -622.6; p = 0.083). Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients

Supplementary materials: Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs

These are peer-reviewed supplementary materials for the article 'Continuous vital sign monitoring in patients after elective abdominal surgery: a retrospective study on clinical outcomes and costs' published in the Journal of Comparative Effectiveness Research.Table S1: Clinical outcomes in different disease categoriesTable S2: Linear regression results for length of stayTable S3: Logistic regression summary results for ICU admissionTable S4: EWS measurementsTable S5: EWS scores of HR and RR measurementsTable S6: Linear regression summary results for ward costsTable S7: Linear regression summary results for ICU costsTable S8: Linear regression summary results for total costsAim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials &amp; methods: Retrospective analysis of clinical outcomes and in-hospital costs compared with a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p &lt; 0.001) and lower costs (p &lt; 0.001). The intervention was associated with a lower odds of ICU admission (odds ratio: 0.422; p = 0.007) and ICU related costs (coefficient: -622.6; p = 0.083). Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients