University of Groningen

About: University of Groningen is a education organization based out in Groningen, Groningen, Netherlands. It is known for research contribution in the topics: Population & Context (language use). The organization has 36346 authors who have published 69116 publications receiving 2940370 citations. The organization is also known as: Rijksuniversiteit Groningen & RUG.

Efficacy and safety of sublingual immunotherapy with grass allergen tablets for seasonal allergic rhinoconjunctivitis

Abstract: Background Allergen immunotherapy (desensitization) by injection is effective for seasonal allergic rhinitis and has been shown to induce long-term disease remission. The sublingual route also has potential, although definitive evidence from large randomized controlled trials has been lacking. Objective The aim was to confirm the efficacy of a rapidly dissolving grass allergen tablet (GRAZAX, ALK-Abello, Horsholm, Denmark) compared with placebo in patients with seasonal rhinoconjunctivitis. Methods A longitudinal, double-blind, placebo-controlled, parallel-group study that included 51 centers from 8 countries. Subjects were randomized (1:1) to receive a grass allergen tablet or placebo once daily. A total of 634 subjects with a history of grass pollen–induced rhinoconjunctivitis for at least 2 years and confirmation of IgE sensitivity (positive skin prick test and serum-specific IgE) were included in the study. Subjects commenced treatment at least 16 weeks before the grass pollen season, and treatment was continued throughout the entire season. Results The primary efficacy analysis showed a reduction of 30% in rhinoconjunctivitis symptom score ( P P Conclusion Sublingual immunotherapy with grass allergen tablets was effective in grass pollen–induced rhinoconjunctivitis. The tablet was well tolerated with minor local side effects. Clinical implications The grass allergen tablet represents a safe alternative to injection immunotherapy suitable for home use.

Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research

Abstract: This paper aims to identify problems in estimating and the interpretation of the magnitude of intervention-related change over time or responsiveness assessed with health outcome measures. Responsiveness is a problematic construct and there is no consensus on how to quantify the appropriate index to estimate change over time between baseline and post-test designs. This paper gives an overview of several responsiveness indices. Thresholds for effect size (or responsiveness index) interpretation were introduced some thirty years ago by Cohen who standardised the difference-scores ( d ) with the pooled standard deviation ( d /SDpooled). However, many effect sizes (ES) have been introduced since Cohen's original work and in the formula of one of these ES, the mean change scores are standardised with the SD of those change scores ( d /SDchange). When health outcome questionnaires are used, this effect size is applied on a wide scale and is represented as the Standardized Response Mean (SRM). However, its interpretation is problematic when it is used as an estimate of magnitude of change over time and interpreted with the thresholds, set by Cohen for effect size (ES) which is based on SDpooled. Thus, in the case of using the SRM, application of these well-known cut-off points for pooled standard deviation units namely: ‘trivial’ (ES Consequently, taking Cohen's thresholds for granted for every version of effect size indices as estimates of intervention-related magnitude of change, may lead to over- or underestimation of this magnitude of intervention-related change over time. For those researchers who use Cohen's thresholds for SRM interpretation, this paper demonstrates a simple method to avoid over-or underestimation.

Clinical implications of azole resistance in Aspergillus fumigatus, The Netherlands, 2007-2009

Abstract: The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azole-resistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate for patients with invasive aspergillosis.