Albert Schweitzer Hospital

About: Albert Schweitzer Hospital is a healthcare organization based out in Lambaréné, Gabon. It is known for research contribution in the topics: Population & Plasmodium falciparum. The organization has 1029 authors who have published 1568 publications receiving 43581 citations.

Coping strategies in relation to negative work events and accommodations in employed multiple sclerosis patients

Abstract: BackgroundJob loss is common in multiple sclerosis (MS) and is known to exert a negative effect on quality of life. The process leading up to job loss typically includes negative work events, produ...

Clinical trials: relevance of correlation between treatment responses.

Abstract: Objective: Trials that do not allow rejection of the null hypothesis of no treatment effect may have had an inappropriate design. Trials are virtually never assessed for correlation between responses to different treatment modalities. Methods: Using a hypothetical example and several published studies we examine the influence of correlation levels between treatment modalities on the sensitivity of testing. Results: The level of correlation between responses to different treatment modalities is a major determinant of the sensitivity both of crossover and parallel group clinical trials. Conclusions: It is very relevant to assess a priori correlation levels between responses to the different treatment modalities of a trial. If a negative correlation is anticipated, a crossover design is likely to lack sensitivity. If a positive correlation is anticipated a parallel-group design seems less appropriate, because it would lack the extra sensitivity of accounting for the positive correlation. Both designs would seem suitable for approximately zero correlations (e.g. comparison vs baseline or vs placebo under the assumption that the number of placebo responders is negligible).

The 2012 revised Dutch national guidelines for the treatment of chronic hepatitis B virus infection.

Abstract: In 2008, the Netherlands Association of Gastroenterologists and Hepatologists (Nederlands Vereniging van Maag-Darm-Leverartsen) published the Dutch national guidelines for the treatment of chronic hepatitis B virus infection. New insights into the treatment of chronic hepatitis B with relevance for clinical practice have been adopted in these concise, revised guidelines. The most important changes include the choice of initial antiviral therapy, licensing of tenofovir for the treatment of chronic hepatitis B and the management of antiviral resistance.

Long-Term Efficacy of Nebivolol Monotherapy in Patients with Hypertension

Abstract: Background: The antihypertensive activity of beta-blockers generally increases during the first 6 to 8 weeks of treatment; however, no study has systematically assessed whether blood pressure continues to decrease with prolonged treatment. Nebivolol is a third-generation beta-blocker that combines beta-blocking activity with nitric oxide—mediated vasodilatory properties. It is not known whether this combination of properties provides better long-term control of blood pressure than other monotherapies. Objectives: The purpose of this study was to determine whether the antihypertensive activity of nebivolol continues to increase over a 6-month period and to assess the efficacy and safety of nebivolol monotherapy over 6 months in previously untreated and treated hypertensive patients. Methods: Patients who had not been treated previously for hypertension took nebivolol 5 mg once daily. Those who had been treated previously replaced their monotherapy with nebivolol 5 mg once daily starting the day after the first evaluation. Patients were evaluated at baseline and 12, 212, and 6 months after nebivolol treatment and were defined as responders if their diastolic blood pressure (DBP) was 10 mm Hg. Patients answered a self-administered questionnaire about general feelings of well-being, compliance with treatment, and side effects. Results: A total of 3741 patients were enrolled; 1656 patients had been treated previously for hypertension. A total of 461 (12.3%) patients did not complete the study. In previously untreated patients, nebivolol reduced blood pressure by 19/11 mm Hg after 12 month and by 24/14 mm Hg after 6 months. In previously treated patients, mean blood pressure reductions were 9/7 mm Hg after 12 month and 14/8 mm Hg after 6 months ( P P P P Conclusions: In this study nebivolol was effective and well tolerated in the long term, and its antihypertensive activity continued to increase during the first 6 months of treatment.

The effectiveness of a routine versus an extensive laboratory analysis in the diagnosis of anaemia in general practice.

Abstract: Background: We investigated the percentage of patients diagnosed with the correct underlying cause of anaemia by general practitioners when using an extensive versus a routine laboratory work-up. Methods: An online survey was distributed among 836 general practitioners. The survey consisted of six cases, selected from an existing cohort of anaemia patients (n = 3325). In three cases, general practitioners were asked to select the laboratory tests for further diagnostic examination from a list of 14 parameters (i.e. routine work-up). In the other three cases, general practitioners were presented with all 14 laboratory test results available (i.e. extensive work-up). General practitioners were asked to determine the underlying cause of anaemia in all six cases based on the test results, and these answers were compared with the answers of an expert panel. Results: A total of 139 general practitioners (partly) responded to the survey (17%). The general practitioners were able to determine the underlying cause of anaemia in 53% of cases based on the routine work-up, whereas 62% of cases could be diagnosed using an extensive work-up (P = 0.007). In addition, the probability of a correct diagnosis decreased with the patient’s age and was also affected by the underlying cause itself, with anaemia of chronic disease being hardest to diagnose (P = 0.003). Conclusion: The use of an extensive laboratory work-up in patients with newly diagnosed anaemia is expected to increase the percentage of correct underlying causes established by general practitioners. Since the underlying cause can still not be established in 31.3% of anaemia patients, further research is necessary.