Publications by authors named "Vaart T"

Article Synopsis
  • Staphylococcus aureus is a leading cause of severe healthcare-related infections, and existing antibiotic treatments often have high mortality rates, necessitating new treatment approaches.
  • Researchers studied blood samples from 17 S. aureus bacteremia patients to analyze immune responses by isolating plasmablasts and sequencing their antibody genes, resulting in the identification of over 300 unique antibody sequences.
  • Four novel monoclonal antibodies (mAbs) were developed, with one specifically targeting wall teichoic acid in S. aureus, while three showed cross-reactivity with Staphylococcus epidermidis and were able to trigger immune cell phagocytosis of staphylococci.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess whether short-term treatment with lamotrigine can enhance cognitive functioning in adolescents with neurofibromatosis type 1 (NF1).
  • A double-blind, randomized clinical trial involved 31 participants aged 12 to 17 taking 200 mg of lamotrigine for 26 weeks, measuring outcomes like performance IQ and various cognitive skills.
  • Results indicated that lamotrigine did not significantly affect overall cognitive performance or most secondary outcomes, with only a slight trend towards improved visual sustained attention noted in the treatment group.
View Article and Find Full Text PDF

Staphylococcus aureus is a major human pathogen, yet the immune factors that protect against infection remain elusive. High titers of opsonic IgG antibodies, achieved in preclinical animal immunization studies, have consistently failed to provide protection in humans. Here, we investigate antibody responses to the conserved S.

View Article and Find Full Text PDF

Purpose: IDH-mutant glioma is classified as oligodendroglioma or astrocytoma based on 1p19q-codeletion. Whether prognostic factors are similar between these tumor types is not well understood.

Experimental Design: Retrospective cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to identify risk factors for acute kidney injury (AKI) and assess its impact on mortality in patients with Staphylococcus aureus bacteraemia (SAB), considering variables like recurrent AKI episodes and competing risks.
  • A total of 453 patients were analyzed, revealing that 43% experienced AKI episodes, with age, comorbidity, septic shock, persistent bacteraemia, and vancomycin therapy linked to an increased AKI risk.
  • The findings highlighted that AKI significantly raises the risk of 90-day mortality in SAB patients, indicating a worse clinical outcome than previously understood, especially in those treated with vancomycin.
View Article and Find Full Text PDF

Although collaboration between healthcare professionals is essential for the delivery of effective, efficient, and high-quality care, it remains an ongoing and critical challenge across health systems. As a result, many countries are experimenting with innovative payment and employment models. The literature tends to focus on improving collaboration across organizational and sectoral boundaries, and largely ignores potential barriers to collaborative work between members of the same profession within a single organization.

View Article and Find Full Text PDF
Article Synopsis
  • - The 2023 Duke-ISCVID criteria were developed to enhance the classification of infective endocarditis (IE) for better research and clinical outcomes, requiring further external validation.
  • - A study at Amsterdam University Medical Center reviewed 595 patients with suspected IE, finding that the new criteria were more sensitive and specific compared to earlier criteria, highlighting their effectiveness in diagnosis.
  • - Overall, the new criteria showed significant improvements in diagnostic accuracy, particularly due to changes in major microbiological and imaging requirements, marking a notable advancement in how suspected IE cases are classified.
View Article and Find Full Text PDF

Introduction: Recommended duration of antibiotic treatment of Staphylococcus aureus bacteremia (SAB) is frequently based on distinguishing uncomplicated and complicated SAB, and several risk factors at the onset of infection have been proposed to define complicated SAB. Predictive values of risk factors for complicated SAB have not been validated, and consequences of their use on antibiotic prescriptions are unknown.

Methods: In a prospective cohort, patients with SAB were categorized as complicated or uncomplicated through adjudication (reference definition).

View Article and Find Full Text PDF
Article Synopsis
  • This study evaluates the feasibility of out-of-hospital coaching for severe COPD patients by specialized nurses, focusing on aspects such as cost-effectiveness, implementation, and recipient acceptability.
  • It involved 170 patients over six months, collecting data on health management and hospitalization rates, finding a 24% reduction in hospitalizations and improvements in health status and anxiety.
  • The coaching service was well-received by patients and coaches, indicating its effectiveness and support for both primary and hospital care systems.
View Article and Find Full Text PDF
Article Synopsis
  • The 2023 Duke-ISCVID IE Criteria update new diagnostic methods and imaging techniques for infective endocarditis, reflecting advancements in microbiology and epidemiology since the original guidelines were published in 1994 and modified in 2000.* -
  • Key changes include new tests for detecting specific bacteria, the introduction of intraoperative inspection as a major criterion, and an expanded list of microorganisms considered typical for IE, especially with certain heart implants.* -
  • Additionally, the updated criteria simplify blood culture requirements and emphasize the need for ongoing updates to these guidelines, proposing that they be maintained as a "Living Document" for continued relevance.*
View Article and Find Full Text PDF

Introduction: A major knowledge gap in the treatment of complicated bacteraemia (SAB) is the optimal duration of antibiotic therapy. Safe shortening of antibiotic therapy has the potential to reduce adverse drug events, length of hospital stay and costs. The objective of the SAFE trial is to evaluate whether 4 weeks of antibiotic therapy is non-inferior to 6 weeks in patients with complicated SAB.

View Article and Find Full Text PDF

Bacillus Calmette-Guerin (BCG) vaccination has been hypothesized to reduce severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, severity, and/or duration via trained immunity induction. Health care workers (HCWs) in nine Dutch hospitals were randomized to BCG or placebo vaccination (1:1) in March and April 2020 and followed for 1 year. They reported daily symptoms, SARS-CoV-2 test results, and health care-seeking behavior via a smartphone application, and they donated blood for SARS-CoV-2 serology at two time points.

View Article and Find Full Text PDF

Objectives: Standard once-daily dosing of ceftriaxone may not lead to adequate antibiotic exposure in all cases of Staphylococcus aureus bacteraemia (SAB). Therefore, we compared clinical effectiveness of empirical antibiotic treatment with flucloxacillin, cefuroxime and ceftriaxone in adult patients with MSSA bacteraemia.

Methods: We analysed data from the Improved Diagnostic Strategies in Staphylococcus aureus bacteraemia (IDISA) study, a multicentre prospective cohort study of adult patients with MSSA bacteraemia.

View Article and Find Full Text PDF

Background: Several studies have suggested that in patients with Staphylococcus aureus bacteremia (SAB) [18F] fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) improves outcome. However, these studies often ignored possible immortal time bias.

Methods: Prospective multicenter cohort study in 2 university and 5 non-university hospitals, including all patients with SAB.

View Article and Find Full Text PDF

Background: bacteremia (SAB) is a heterogeneous disease with changing epidemiology due to changing demographics and evolving clinical management. SAB is associated with high mortality, but the current fraction of infection-related mortality is less well quantified.

Methods: In a multicenter prospective cohort study of consecutive patients with SAB, we determined clinical features of SAB and determined 90-day mortality and risk factors of all-cause and infection-related mortality.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the relevance of immunological phenomena like positive IgM rheumatoid factor, haematuria, and Roth's spots in diagnosing endocarditis based on recent epidemiological changes.
  • Out of 285 patients, about 48% were confirmed to have endocarditis, with immunological tests performed in 78% of cases, highlighting the importance of these tests in diagnosis.
  • Haematuria showed the highest sensitivity for detecting endocarditis, while Roth's spots demonstrated the highest specificity, suggesting that these immunological tests can effectively aid in confirming the diagnosis.
View Article and Find Full Text PDF

Background: Current guidelines on the management of infective endocarditis (IE) recommend follow-up blood cultures (FUBCs) to identify persistent bacteraemia, as this has prognostic value and guides treatment decisions. While persistent bacteraemia frequently occurs in Staphylococcus aureus bacteraemia and IE, its prevalence and impact in non-staphylococcal IE is largely unknown. We determined prevalence and prognostic value of persistent bacteraemia in non-staphylococcal IE.

View Article and Find Full Text PDF

Objectives: The COVID-19 pandemic increases healthcare worker (HCW) absenteeism. The bacillus Calmette-Guérin (BCG) vaccine may provide non-specific protection against respiratory infections through enhancement of trained immunity. We investigated the impact of BCG vaccination on HCW absenteeism during the COVID-19 pandemic.

View Article and Find Full Text PDF

Background: Older age is associated with increased severity and death from respiratory infections, including coronavirus disease 2019 (COVID-19). The tuberculosis BCG vaccine may provide heterologous protection against nontuberculous infections and has been proposed as a potential preventive strategy against COVID-19.

Methods: In this multicenter, placebo-controlled trial, we randomly assigned older adults (aged ≥60 years; n = 2014) to intracutaneous vaccination with BCG vaccine (n = 1008) or placebo (n = 1006).

View Article and Find Full Text PDF

The management of infective endocarditis is complex and inherently requires multidisciplinary cooperation. About half of all patients diagnosed with infective endocarditis will meet the criteria to undergo cardiac surgery, which regularly takes place in urgent or emergency settings. The pathophysiology and clinical presentation of infective endocarditis make it a unique disorder within cardiac surgery that warrants a thorough understanding of specific characteristics in the perioperative period.

View Article and Find Full Text PDF

There is a growing trend of physicians becoming employees of hospital systems and employment is viewed as a mechanism to help achieve health system goals. Yet, the research is mixed on the effects of moving physicians to employment models. While the literature has traditionally placed such forms of employment relationships in opposition to professional autonomy, it has often overlooked the effects on other professional values and there is little empirical work that actually assesses how such a shift affects and is perceived by clinicians themselves.

View Article and Find Full Text PDF

Background: Healthcare purchasers such as health insurers and governmental bodies are expected to strategically manage chronic care chains. In doing so, purchasers can contribute to the goal of improving task division and collaboration between chronic care providers as has been recommended by numerous studies. However, healthcare purchasing research indicates that, in most countries, purchasers still struggle to fulfil a proactive, strategic approach.

View Article and Find Full Text PDF