Advance care planning in COPD

COPD (Chronic Obstructive Pulmonary Disease) affects an estimated 600,000 Dutch citizens. This chronic disease often has an unpredictable and sometimes a very invalidating course, despite various treatment options. It is important to timely initiate advance care planning in this patient population, to address any disease-related worries, needs and wishes the patient has. In this way patients (and their caregivers) can stay in the lead regarding their chronic condition, by making decisions for (future) medical, psychological, spiritual, and social needs based upon good information, their values, beliefs and experiences.</p

Advance care planning in COPD

COPD (Chronic Obstructive Pulmonary Disease) affects an estimated 600,000 Dutch citizens. This chronic disease often has an unpredictable and sometimes a very invalidating course, despite various treatment options. It is important to timely initiate advance care planning in this patient population, to address any disease-related worries, needs and wishes the patient has. In this way patients (and their caregivers) can stay in the lead regarding their chronic condition, by making decisions for (future) medical, psychological, spiritual, and social needs based upon good information, their values, beliefs and experiences.</p

Advance care planning in COPD

COPD (Chronic Obstructive Pulmonary Disease) affects an estimated 600,000 Dutch citizens. This chronic disease often has an unpredictable and sometimes a very invalidating course, despite various treatment options. It is important to timely initiate advance care planning in this patient population, to address any disease-related worries, needs and wishes the patient has. In this way patients (and their caregivers) can stay in the lead regarding their chronic condition, by making decisions for (future) medical, psychological, spiritual, and social needs based upon good information, their values, beliefs and experiences.</p

Advance care planning in COPD

COPD (Chronic Obstructive Pulmonary Disease) affects an estimated 600,000 Dutch citizens. This chronic disease often has an unpredictable and sometimes a very invalidating course, despite various treatment options. It is important to timely initiate advance care planning in this patient population, to address any disease-related worries, needs and wishes the patient has. In this way patients (and their caregivers) can stay in the lead regarding their chronic condition, by making decisions for (future) medical, psychological, spiritual, and social needs based upon good information, their values, beliefs and experiences.</p

Increased resistance to activated protein C after short-term oral hormone replacement therapy in healthy post-menopausal women

As hormone replacement therapy is associated with an early excess risk of venous thrombosis, we investigated the effect of different oral hormone replacement therapies on resistance to activated protein C, and on levels of factor VIII antigen (FVIII:Ag) and factor XI antigen (FXI:Ag). In a prospective, randomized, placebo-controlled 12-week study, 60 healthy post-menopausal women daily received either placebo (n = 16) or 2 mg of micronized 17beta-oestradiol, either alone (E2, n = 16) or sequentially combined with dydrogesterone 10 mg (E2 + D, n = 14) or trimegestone 0.5 mg (E2 + T, n = 14). Medication was given orally. Normalized activated protein C sensitivity ratios (nAPCsr) were determined by quantifying the effect of activated protein C on the endogenous thrombin potential. FVIII:Ag and FXI:Ag were determined by enzyme-linked immunosorbent assay. Compared with baseline and placebo, the nAPCsr increased (92% to 142%; all P <0.001) in all active treatment groups after both 4 and 12 weeks. Compared with placebo, hormone replacement therapy was not associated with significant changes in FVIII:Ag. After 4 and 12 weeks, FXI:Ag levels were significantly decreased in the E2 group (mean percentage changes from baseline versus placebo: -15.0%, P = 0.001 at 4 weeks and -16.6%, P = 0.003 at 12 weeks) and in the E2 + D group (-10.4%, P = 0.02 and -10.4%, P = 0.02). In conclusion, all hormone replacement regimens were associated with a large increase in resistance to activated protein C. In contrast, hormone replacement therapy had no effect on FVIII:Ag. Oral E2 and E2 + D had a small, favourable effect on FXI:Ag

Similar occurrence of febrile episodes reported in non-atopic children at three to five years of age after prebiotics supplemented infant formula

This is a follow up study of a multicenter randomised placebo-controlled trial in seven centres in five West European countries. The RCT assessed the effect of infant formula supplemented with a mixture of prebiotics (with neutral short-chain and long-chain oligosaccharides and pectin-derived acidic oligosaccharides) during infancy in term-born children (n=1130). In the follow-up study 672 children (60% of the study population) participated: 232 (56%) from the prebiotics group (PG), 243 (58%) from the control group (CG), and 197 (66%) from the non-randomised breast-fed group (BG). The primary outcome was the occurrence of febrile episodes at three to five years of age prospectively documented by the parents: in the PG 1.17 (interquartile range 0.50-2.08) episodes per year versus 1.20 (0.52-2.57) in the CG; and 1.48 (0.65-2.60) in the BG. This specific prebiotics mixture given during infancy in healthy non-atopic subjects does not decrease febrile episodes and therefore seems not to prevent infection between their third and fifth birthday

Similar occurrence of febrile episodes reported in non-atopic children at three to five years of age after prebiotics supplemented infant formula

This is a follow up study of a multicenter randomised placebo-controlled trial in seven centres in five West European countries. The RCT assessed the effect of infant formula supplemented with a mixture of prebiotics (with neutral short-chain and long-chain oligosaccharides and pectin-derived acidic oligosaccharides) during infancy in term-born children (n=1130). In the follow-up study 672 children (60% of the study population) participated: 232 (56%) from the prebiotics group (PG), 243 (58%) from the control group (CG), and 197 (66%) from the non-randomised breast-fed group (BG). The primary outcome was the occurrence of febrile episodes at three to five years of age prospectively documented by the parents: in the PG 1.17 (interquartile range 0.50-2.08) episodes per year versus 1.20 (0.52-2.57) in the CG; and 1.48 (0.65-2.60) in the BG. This specific prebiotics mixture given during infancy in healthy non-atopic subjects does not decrease febrile episodes and therefore seems not to prevent infection between their third and fifth birthday