6,703 results match your criteria: "Julius Center for Health Sciences and Primary Care.[Affiliation]"

Background: In line with the WHO Global Action Plan's objective to achieve a 30% relative reduction in the mean population intake of sodium by 2025, the Nigeria Sodium Study (NaSS) team, which aimed to evaluate the implementation and scale-up of national sodium reduction programme, hosted a policy meeting May 22, 2023, in Abuja, the Federal Capital Territory of Nigeria. The aim was to deliberate on strategies for translating data on salt levels in food and dietary patterns, intending to strengthen sodium policies in Nigeria, with the ultimate goal of producing evidence-based information that can effectively guide strategies and policies for sodium reduction.

Methods: Policymakers from federal, state, and local government levels attended, as well as representatives from national and international universities and non-governmental organizations.

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Tumor infiltrating lymphocytes and change in tumor load on MRI to assess response and prognosis after neoadjuvant chemotherapy in breast cancer.

Breast Cancer Res Treat

September 2024

Image Sciences Institute, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.

Purpose: In this study, we aimed to explore if the combination of tumor infiltrating lymphocytes (TILs) and change in tumor load on dynamic contrast-enhanced magnetic resonance imaging leads to better assessment of response to neoadjuvant chemotherapy (NAC) in patients with breast cancer, compared to either alone.

Methods: In 190 NAC treated patients, MRI scans were performed before and at the end of treatment. The percentage of stromal TILs (%TILs) was assessed in pre-NAC biopsies according to established criteria.

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Regulatory readiness to facilitate the appropriate use of innovation in clinical trials: The case of decentralized clinical trial approaches.

Drug Discov Today

November 2024

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands; Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland. Electronic address:

Article Synopsis
  • Clinical trials face challenges like limited generalizability and slow recruitment, necessitating innovative methods to improve their efficiency and effectiveness.
  • The article advocates for implementing decentralized clinical trial (DCT) approaches that bring trial activities closer to participants, highlighting the importance of regulatory readiness and timely responses to new situations.
  • It emphasizes the need for explorative research, including regulatory sandboxes, to gather data on DCT usefulness and suggests that DCTs should be evaluated on par with traditional clinical trials.
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Optimal use of guideline-directed medical therapy (GDMT) can prevent hospitalization and mortality among patients with heart failure (HF). We aimed to assess the prevalence of GDMT use for HF across geographic regions and country-income levels. We systematically reviewed observational studies (published between January 2010 and October 2020) involving patients with HF with reduced ejection fraction.

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Introduction: The FLAME trial demonstrated that the dose to the gross tumor volume (GTV) is associated with tumour control in prostate cancer patients. This raises the question if dose de-escalation to the remaining prostate gland can be considered. Therefore, we investigated if intraprostatic recurrences occur at the location of the GTV and which dose was delivered at that location.

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Background: Tetralogy of Fallot (TOF) is typically treated in infancy but often done late in many resource-limited countries, jeopardizing surgical outcomes. This study examined the early results of children undergoing primary complete TOF repair at the Jakaya Kikwete Cardiac Institute (JKCI) in Tanzania, an emerging cardiac center in Eastern Africa.

Methods: A retrospective cohort study of children ≤ 18 years undergoing primary TOF complete repair between 2019 and 2021 was conducted.

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Article Synopsis
  • Many heart failure (HF) patients do not receive optimal doses of RAAS inhibitors due to worries about hyperkalemia (HK).
  • The CARE-HK registry enrolled 2558 adults with chronic HF, primarily those with reduced ejection fraction, to evaluate RAASi treatment patterns and HK management across clinical practices in Europe and the USA.
  • The study aims to better understand how RAAS inhibitors are used in patients at high risk for HK and to analyze their treatment outcomes in routine medical settings.
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  • - The study examines the relationship between kidney function and echocardiography findings related to left ventricular diastolic dysfunction (LVDD) in patients from a university hospital, categorizing them by levels of kidney function based on estimated glomerular filtration rate (eGFR).
  • - Among 4,022 patients, those with increasingly decreased kidney function showed higher odds of having abnormal echocardiographic parameters, including the E/e' ratio and left ventricular mass index (LVMI), indicating a clear connection between deteriorating kidney health and worsening cardiac function.
  • - The findings reveal that even mildly decreased kidney function is associated with signs of LVDD, suggesting that as kidney function declines, the risk of echocardiographic abnormalities in
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Advancements in Assays for Micro- and Nanoplastic Detection: Paving the Way for Biomonitoring and Exposomics Studies.

Annu Rev Pharmacol Toxicol

January 2025

Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA; email:

Although plastic pollution and exposure to plastic-related compounds have received worldwide attention, health risks associated with micro- and nanoplastics (MNPs) are largely unknown. Emerging evidence suggests MNPs are present in human biofluids and tissue, including blood, breast milk, stool, lung tissue, and placenta; however, exposure assessment is limited and the extent of human exposure to MNPs is not well known. While there is a critical need to establish robust and scalable biomonitoring strategies to assess human exposure to MNPs and plastic-related chemicals, over 10,000 chemicals have been linked to plastic manufacturing with no existing standardized approaches to account for even a fraction of these exposures.

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Identification of a "Blue Zone" in the Netherlands: A Genetic, Personal, Sociocultural, and Environmental Profile.

Gerontologist

November 2024

Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, North-Holland, The Netherlands.

Background And Objectives: "Blue Zones" (BZs) are regions with exceptionally high numbers of longevous inhabitants. Several factors have been suggested to promote longevity in BZs, but the evidence generally does not meet scientific quality criteria. We aimed to characterize a municipality as a "relative BZ," satisfying 3 criteria: compared to other municipalities, more exceptionally longevous inhabitants, a higher life expectancy, and a more stable population.

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Background: Patients with rectal cancer are often treated with neoadjuvant chemoradiotherapy, followed by a waiting period and surgical resection. Good or complete response to neoadjuvant chemoradiotherapy might enable organ preservation, which highlights the need to increase response rates. Pre-clinical studies suggest that physical activity during neoadjuvant chemoradiotherapy may improve tumor downstaging.

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Importance: The aging and multimorbid population and health personnel shortages pose a substantial burden on primary health care. While predictive machine learning (ML) algorithms have the potential to address these challenges, concerns include transparency and insufficient reporting of model validation and effectiveness of the implementation in the clinical workflow.

Objectives: To systematically identify predictive ML algorithms implemented in primary care from peer-reviewed literature and US Food and Drug Administration (FDA) and Conformité Européene (CE) registration databases and to ascertain the public availability of evidence, including peer-reviewed literature, gray literature, and technical reports across the artificial intelligence (AI) life cycle.

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Background: Peritoneal dialysis (PD) is a home-based kidney replacement therapy (KRT) performed in people with kidney failure. PD can be performed by manual filling and draining of the abdominal cavity, i.e.

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Collective knowledge exchange through regional hubs: Local expertise, global platform.

Trop Med Int Health

October 2024

Julius Global Health, Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.

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Global inequities in adverse pregnancy outcomes: what can we do?

AJOG Glob Rep

August 2024

Departments of Obstetrics and Gynecology and Global Health, University of Washington, Seattle, WA (Gravett).

The Health Equity Leadership & Exchange Network states that "health equity exists when all people, regardless of race, sex, sexual orientation, disability, socioeconomic status, geographic location, or other societal constructs, have fair and just access, opportunity, and resources to achieve their highest potential for health." It is clear from the wide discrepancies in maternal and infant mortalities, by race, ethnicity, location, and social and economic status, that health equity has not been achieved in pregnancy care. Although the most obvious evidence of inequities is in low-resource settings, inequities also exist in high-resource settings.

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Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses: Insights from prospectively collected data in the BRACE trial.

J Infect

November 2024

Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Infectious Diseases, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia. Electronic address:

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Objective: Chemotherapy treatment modifications can impact survival in patients with ovarian cancer, particularly when the relative dose intensity falls below 85%. Exercise and dietary interventions may benefit treatment tolerability. This study aimed to explore the effects of a combined exercise and dietary intervention on secondary outcomes of the Physical Activity and Dietary intervention in OVArian cancer (PADOVA) trial, specifically relative dose intensity and progression-free survival.

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  • Frequent hemodialysis (more than three times a week) may lower mortality and improve quality of life for kidney failure patients, but the evidence is not clear.
  • A systematic review of available studies found only seven eligible trials with a total of 518 participants, indicating limited data on the health effects of frequent hemodialysis.
  • The analysis suggested a possibly lower risk of death with frequent hemodialysis, but results were uncertain, and important outcomes like cardiovascular events and patient-reported well-being were largely missing.
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Importance: Mega-trials can provide large-scale evidence on important questions.

Objective: To explore how the results of mega-trials compare with the meta-analysis results of trials with smaller sample sizes.

Data Sources: ClinicalTrials.

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Understanding which patients with human epidermal growth factor receptor 2 (HER2)-negative or -low metastatic breast cancer (MBC) benefit from HER2-targeted strategies is urgently needed. We assessed the whole-body heterogeneity of HER2 expression on Zr-trastuzumab PET (HER2 PET) and the diagnostic performance of HER2 PET in a large series of patients, including HER2-negative and -low MBC. In the IMPACT-MBC study, patients with newly diagnosed and nonrapidly progressive MBC of all subtypes were included.

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Background: Health care is an indispensable element for economic growth and development of individuals and nations. Healthcare service quality is associated with patient satisfaction, ensuring the safety and security of patients, reducing mortality and morbidity, and improving the quality of life. Patient satisfaction with health service is linked to increased utilization following contendness with healthcare received from health providers.

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Insight into patients' personal values, wishes, and needs (VWN) by clinicians is essential to guide appropriate palliative care. To gain insight into the exploration and monitoring of the VWN of patients with advanced cancer during the illness trajectory by hospital oncology clinicians. A generic qualitative study was conducted from February 2022 to July 2022.

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HIV cure has been reported for five individuals who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) with cells from CCR5Δ32 homozygous donors. By contrast, viral rebound has occurred in other people living with HIV who interrupted antiretroviral treatment after undergoing allo-HSCT, with cells mostly from wild-type CCR5 donors. Here we report the case of a male individual who has achieved durable HIV remission following allo-HSCT with cells from an unrelated HLA-matched (9 of 10 matching for HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1 alleles) wild-type CCR5 donor to treat an extramedullary myeloid tumor.

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Integrating telemedicine in routine heart failure management: Experiences of healthcare professionals - A qualitative study.

Digit Health

August 2024

Julius Center for Health Sciences and Primary Care, Department General Practice and Nursing Science, University Medical Center Utrecht, Utrecht, the Netherlands.

Article Synopsis
  • * Four key themes emerged: unclear responsibilities among stakeholders, concerns about safety and patient security, the importance of involving users in the development and adoption processes, and the idea that telemedicine complements traditional care rather than replaces it.
  • * While telemedicine shows promise for heart failure management, its limited adoption is tied to existing care systems; enhancing collaboration and establishing clear roles could improve confidence and effectiveness in using telemedicine.
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Article Synopsis
  • Individual participant data (IPD) meta-analysis allows for better understanding of interaction and effect modification compared to traditional studies, especially in public health contexts.
  • The text emphasizes the importance of focusing on additive interactions rather than just multiplicative ones, particularly using measures like Relative Excess Risk due to Interaction (RERI).
  • A three-step method is proposed to correctly estimate additive interaction across studies, ensuring valid results when analyzing factors like the link between depression, smoking, and cancer risk using available data.
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