Longitudinal observational studies to study the efficacy-effectiveness gap in drug therapy: application to mild and moderate dementia

If well-designed, longitudinal observational studies (LOSs) can provide insights to the linkages between real-world outcomes and their multilevel determinants. In this article, some of the scientific and methodologic issues related to LOSs in pharmacotherapeutic evaluations are discussed. A case of such a study in the treatment of mild to moderate dementia is provided-a case in which a pharmaceutic sponsor addressing a medical question (long-term effectiveness) realized that caring for patients who have Alzheimer's disease involves the clinical community of caregivers, physicians, families, nurses, psychologists, and pharmacists, among others, and partnered with nurse researchers to design their inquiry. The authors conclude by presenting an argument for nurses to take the lead in effectiveness research.     

Plant and animal protein intake and its association with overweight and obesity among the Belgian population

The objective of the present study was to assess animal and plant protein intakes in the Belgian population and to examine their relationship with overweight and obesity (OB). The subjects participated in the Belgian National Food Consumption Survey conducted in 2004. Food consumption was assessed by using two non-consecutive 24?h dietary recalls. About 3083 participants (?≥?15 years of age; 1546 males, 1537 females) provided completed dietary information. Animal protein intake (47?g/d) contributed more to total protein intakes of 72?g/d than plant protein intake, which accounted for 25?g/d. Meat and meat products were the main contributors to total animal protein intakes (53?%), whereas cereals and cereal products contributed most to plant protein intake (54?%). Males had higher animal and plant protein intakes than females (P?相似文献   

Antihypertensive effectiveness of aliskiren for the 'real-world' management of hypertension: multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study)

Aims: The ‘DRIVER’ study was designed to investigate the ‘real‐world’ effectiveness of aliskiren‐based treatment of hypertension. This article reports the 180‐day blood pressure (BP) outcomes, and the multilevel (physician‐ and patient‐level) determinants thereof. Methods and results: DRIVER was a prospective, observational, open‐label, multi‐centre, pharmaco‐epidemiologic study of hypertensive patients treated with aliskiren in whom prior treatment failed or was not tolerated. 2070 patients (enrolled by 426 physicians) were enrolled; 1695 patients (81.9%) completed the 180‐day aliskiren treatment period. Mean patient age was 64.2 ± 12.1 years; 53.7% were men, 25.3% diabetic and 40.7% had a high or very high cardiovascular (CV) risk. At 180 days, the mean ± SD reductions in systolic and diastolic BP were ?22.9 ± 16.7 mmHg and ?10.5 ± 10.9 mmHg respectively (both p < .001). 2007 and 2009 guideline‐defined BP control was achieved in 36.4% and 56.3% of patients, respectively (both p < .001). 64.2% of eligible patients had a reduction in CV risk (p < .001). A physician‐level class effect was responsible for 22.8% and 28.1% of variability in systolic and diastolic BP, respectively, for 20.1% of variability in BP control, and for 16.1% of variability in the reduction of CV risk. Both patient‐ (e.g. adherence) and physician‐related factors (e.g. age and knowledge) were significant in profiling best response to treatment with aliskiren. Adverse events reported in this article were consistent with the aliskiren scientific leaflet. Conclusion: Aliskiren is safe and effective in reducing BP, improving BP control and reducing global CV risk in a ‘real‐world’ setting and for patients in whom prior treatment failed or was not tolerated. Optimising treatment adherence and strategic medical education may be ways of improving BP outcomes in patients with hypertension.     

Synthesis and Characterization of Holmium-Doped Iron Oxide Nanoparticles

Rare earth atoms exhibit several interesting properties, for example, large magnetic moments and luminescence. Introducing these atoms into a different matrix can lead to a material that shows multiple interesting effects. Holmium atoms were incorporated into an iron oxide nanoparticle and the concentration of the dopant atom was changed in order to determine its influence on the host crystal. Its magnetic and magneto-optical properties were investigated by vibrating sample magnetometry and Faraday rotation measurements. The luminescent characteristics of the material, in solution and incorporated in a polymer thin film, were probed by fluorescence experiments.     

Health-related quality of life in children after laparoscopic gastrostomy placement

Quality of Life Research - A gastrostomy placement (GP) is an established treatment to provide enteral feeding in pediatric patients with feeding difficulties aiming to improve nutritional status...     

Maintaining the silence: reflections on long-term RNAi

Since the demonstration of RNA interference (RNAi) in mammalian cells, considerable research and financial effort has gone towards implementing RNAi as a viable therapeutic platform. RNAi is, without doubt, the most promising strategy for the treatment of human genetic disorders. Because many of the targets proposed for RNAi therapy require chronic treatment, researchers agree that the emphasis must now be placed on the safe and long-term application of RNAi drugs to reap the benefits at last.