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  1. Article ; Online: Effect of interprofessional and intraprofessional clinical collaboration on patient related outcomes in multimorbid older patients - a retrospective cohort study on the Intensive Collaboration Ward.

    de Gans, Simon T / Maessen, Gerdinique C / van de Pol, Marjolein H J / van Apeldoorn, Marjan J / van Ingen-Stokbroekx, Margot A L / van der Sloot, Niels / Keijsers, Carolina J P W / van der Zwaard, Babette C

    BMC geriatrics

    2023  Volume 23, Issue 1, Page(s) 519

    Abstract: Background: The management and care of older patients with multiple health problems is demanding and complex. Interprofessional and intraprofessional collaboration has the potential to improve both the efficiency and the quality of care for these ... ...

    Abstract Background: The management and care of older patients with multiple health problems is demanding and complex. Interprofessional and intraprofessional collaboration has the potential to improve both the efficiency and the quality of care for these patients. However, it has proven difficult to demonstrate the efficacy of this approach in terms of objective patient-related outcomes. Recently, a care model with interprofessional and intraprofessional care was started, the Intensive Collaboration Ward (ICW). This ward combines interprofessional care and intraprofessional care for older patients with multiple health problems. The aim of this study was to evaluate the effects of ICW care in older patients with multiple health problems.
    Methods: This retrospective cohort study evaluated the effects on patients outcomes. This was done by comparing patients of the new model, the ICW (ICW group), to a historical cohort of comparable patients who would have been eligible for the ICW (control group). Outcomes were medical consultations, allied health professional consultations, radiological procedures, waiting time for radiological procedures, change in primary treating specialty, length of hospital stay, readmission rate, and mortality rate. Linear and logistic regression analyses were performed, adjusted for baseline differences.
    Results: The ICW group required significantly fewer medical consultations than the control group. Calls to specialists from the emergency room decreased significantly, but there was no change in in-person consultations on the ER. 51% of control patients had ≥ 1 in-hospital consultation compared to 21% of ICW patients (p < 0.05). Patients in the ICW group received significantly more consultations with allied health professionals and more often had a change in primary treating specialty.
    Conclusions: Interprofessional and intraprofessional clinical collaboration on the ICW reduced in-hospital consultations and increased allied health professionals' consultations. This approach may decrease fragmentation of care and provide more integrated, efficient and patient centered care. This may improve the overall care of older patients with multiple health problems.
    MeSH term(s) Humans ; Aged ; Retrospective Studies ; Critical Care ; Emergency Service, Hospital ; Hospitals ; Length of Stay
    Language English
    Publishing date 2023-08-26
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-023-04232-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: First case of human Brucella canis infection in the Netherlands.

    Kolwijck, Eva / Lutgens, Suzanne Pm / Visser, Vanessa Xn / van Apeldoorn, Marjan J / Graham, Heather / Koets, Ad P / Schrauwen, Michelle Mwp / Reubsaet, Frans Ag / Broens, Els M / Kortbeek, Laetitia M

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2022  

    Abstract: A patient was diagnosed with B. canis following exposure to infected dogs in her breeding facility. Transboundary spread of B. canis trough (illegal) import of infected dogs to non-endemic countries in Europe suggest that B. canis infection should be ... ...

    Abstract A patient was diagnosed with B. canis following exposure to infected dogs in her breeding facility. Transboundary spread of B. canis trough (illegal) import of infected dogs to non-endemic countries in Europe suggest that B. canis infection should be considered in European patients with occupational exposure to dogs.
    Language English
    Publishing date 2022-06-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciac425
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Home-based initiatives for acute management of COVID-19 patients needing oxygen: differences across The Netherlands.

    Boeijen, Josi A / van de Pol, Alma C / van Uum, Rick T / Smit, Karin / Ahmad, Abeer / van Rijswijk, Eric / van Apeldoorn, Marjan J / van Thiel, Eric / de Graaf, Netty / Menkveld, R Michiel / Mantingh, Martijn R / Geertman, Silke / Couzijn, Nicolette / van Groenendael, Leon / Schers, Henk / Bont, Jettie / Bonten, Tobias N / Rutten, Frans H / Zwart, Dorien L M

    BMC health services research

    2023  Volume 23, Issue 1, Page(s) 1257

    Abstract: Objective: During the COVID-19 pandemic new collaborative-care initiatives were developed for treating and monitoring COVID-19 patients with oxygen at home. Aim was to provide a structured overview focused on differences and similarities of initiatives ... ...

    Abstract Objective: During the COVID-19 pandemic new collaborative-care initiatives were developed for treating and monitoring COVID-19 patients with oxygen at home. Aim was to provide a structured overview focused on differences and similarities of initiatives of acute home-based management in the Netherlands.
    Methods: Initiatives were eligible for evaluation if (i) COVID-19 patients received oxygen treatment at home; (ii) patients received structured remote monitoring; (iii) it was not an 'early hospital discharge' program; (iv) at least one patient was included. Protocols were screened, and additional information was obtained from involved physicians. Design choices were categorised into: eligible patient group, organization medical care, remote monitoring, nursing care, and devices used.
    Results: Nine initiatives were screened for eligibility; five were included. Three initiatives included low-risk patients and two were designed specifically for frail patients. Emergency department (ED) visit for an initial diagnostic work-up and evaluation was mandatory in three initiatives before starting home management. Medical responsibility was either assigned to the general practitioner or hospital specialist, most often pulmonologist or internist. Pulse-oximetry was used in all initiatives, with additional monitoring of heart rate and respiratory rate in three initiatives. Remote monitoring staff's qualification and authority varied, and organization and logistics were covered by persons with various backgrounds. All initiatives offered remote monitoring via an application, two also offered a paper diary option.
    Conclusions: We observed differences in the organization of interprofessional collaboration for acute home management of hypoxemic COVID-19 patients. All initiatives used pulse-oximetry and an app for remote monitoring. Our overview may be of help to healthcare providers and organizations to set up and implement similar acute home management initiatives for critical episodes of COVID-19 (or other acute disorders) that would otherwise require hospital care.
    MeSH term(s) Humans ; COVID-19/epidemiology ; COVID-19/therapy ; Oxygen ; Netherlands/epidemiology ; Pandemics ; Patient Discharge
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-11-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-023-10191-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Mesothelioma of the tunica vaginalis complicated by chyluria.

    van Apeldoorn, Marjan J / Rustemeijer, Cees / Voerman, Bert J / Peterse, Johannes

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2006  Volume 24, Issue 33, Page(s) 5329–5330

    MeSH term(s) Aged, 80 and over ; Chyle ; Diagnosis, Differential ; Humans ; Male ; Mesothelioma/diagnosis ; Mesothelioma/urine ; Testicular Neoplasms/diagnosis ; Testicular Neoplasms/urine
    Language English
    Publishing date 2006-11-20
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.2006.07.6596
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Dysregulated Innate and Adaptive Immune Responses Discriminate Disease Severity in COVID-19.

    Janssen, Nico A F / Grondman, Inge / de Nooijer, Aline H / Boahen, Collins K / Koeken, Valerie A C M / Matzaraki, Vasiliki / Kumar, Vinod / He, Xuehui / Kox, Matthijs / Koenen, Hans J P M / Smeets, Ruben L / Joosten, Irma / Brüggemann, Roger J M / Kouijzer, Ilse J E / van der Hoeven, Hans G / Schouten, Jeroen A / Frenzel, Tim / Reijers, Monique H E / Hoefsloot, Wouter /
    Dofferhoff, Anton S M / van Apeldoorn, Marjan J / Blaauw, Marc J T / Veerman, Karin / Maas, Coen / Schoneveld, Arjan H / Hoefer, Imo E / Derde, Lennie P G / van Deuren, Marcel / van der Meer, Jos W M / van Crevel, Reinout / Giamarellos-Bourboulis, Evangelos J / Joosten, Leo A B / van den Heuvel, Michel M / Hoogerwerf, Jacobien / de Mast, Quirijn / Pickkers, Peter / Netea, Mihai G / van de Veerdonk, Frank L

    The Journal of infectious diseases

    2021  Volume 223, Issue 8, Page(s) 1322–1333

    Abstract: The clinical spectrum of COVID-19 varies and the differences in host response characterizing this variation have not been fully elucidated. COVID-19 disease severity correlates with an excessive proinflammatory immune response and profound lymphopenia. ... ...

    Abstract The clinical spectrum of COVID-19 varies and the differences in host response characterizing this variation have not been fully elucidated. COVID-19 disease severity correlates with an excessive proinflammatory immune response and profound lymphopenia. Inflammatory responses according to disease severity were explored by plasma cytokine measurements and proteomics analysis in 147 COVID-19 patients. Furthermore, peripheral blood mononuclear cell cytokine production assays and whole blood flow cytometry were performed. Results confirm a hyperinflammatory innate immune state, while highlighting hepatocyte growth factor and stem cell factor as potential biomarkers for disease severity. Clustering analysis revealed no specific inflammatory endotypes in COVID-19 patients. Functional assays revealed abrogated adaptive cytokine production (interferon-γ, interleukin-17, and interleukin-22) and prominent T-cell exhaustion in critically ill patients, whereas innate immune responses were intact or hyperresponsive. Collectively, this extensive analysis provides a comprehensive insight into the pathobiology of severe to critical COVID-19 and highlights potential biomarkers of disease severity.
    MeSH term(s) Adaptive Immunity/immunology ; Aged ; Biomarkers/blood ; COVID-19/blood ; COVID-19/immunology ; COVID-19/virology ; Cytokine Release Syndrome/blood ; Cytokine Release Syndrome/immunology ; Cytokine Release Syndrome/virology ; Cytokines/immunology ; Female ; Humans ; Immunity, Innate/immunology ; Inflammation/blood ; Inflammation/immunology ; Inflammation/virology ; Leukocytes, Mononuclear/immunology ; Leukocytes, Mononuclear/virology ; Lymphopenia/blood ; Lymphopenia/immunology ; Lymphopenia/virology ; Male ; Middle Aged ; SARS-CoV-2/immunology ; Severity of Illness Index
    Chemical Substances Biomarkers ; Cytokines
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiab065
    Database MEDical Literature Analysis and Retrieval System OnLINE

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