📇 Rhumatologue ·
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Praticien-chercheur
5 articles scientifiques publiés — formation continue solide
✨ Génération du profil synthétique IA en cours…
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Journal of translational medicine · 2012
Lupus · 2008
Mycophenolate mofetil (MMF) with prednisolone has been associated with high remission rates when used as induction treatment for lupus nephritis. This prospective, multicentre, cohort study investigates the efficacy and safety of this regimen over 24 weeks in 213 Chinese patients with active lupus nephritis (Classes III, IV, V or combination). Baseline activity index (AI) was 6.91 ± 3.33 and chronicity index (CI) was 1.9 ± 1.2. The remission rate was 82.6% at 24 weeks (complete remission, 34.3%; partial remission, 48.4%). There were significant ( P < 0.01) improvements in kidney function shown by reductions in proteinuria, serum albumin, serum creatinine and creatinine clearance, as well as in systemic lupus erythematosus disease activity index (SLEDAI) scores. Independent risk factors influencing remission were pathological classification (including Class V and III or Class V and IV nephritis) and elevated serum creatinine at baseline (OR 2.967, 95% CI: 1.479–6.332, P = 0.001 and OR 1.007, 95% CI: 1.002–1.011, P = 0.001, respectively). Patients with concomitant membranous features on biopsy had a lower remission rate than those with Class III and IV nephritis (66.7% vs 87.3%, P = 0.002). Renal biopsy was repeated in 25 patients following treatment. There was a transition to less severe pathological morphologies in majority of subjects. Infections were monitored throughout treatment: eight patients (3.8%) experienced bacterial infections, whereas herpes zoster occurred in seven patients. Nine patients (4.2%) suffered from gastrointestinal upset, which resolved without discontinuation of MMF. One patient became leucopenic, whereas another died from active disease unrelated to kidney symptoms. MMF combined with prednisolone is an effective and well-tolerated induction treatment for patients with active lupus nephritis and for controlling SLE systemic activity.
International journal of mental health nursing · 2025
ABSTRACTOver the past decade, psychiatric wards across the Netherlands have worked in accordance with the High and Intensive Care model to reduce coercion and improve the quality of care. Securing implementation of the model within a challenging mental health care context has proven to be effective but complex in practice. Consequently, this study aimed to both gain insight into the process of implementing the High and Intensive Care model by drawing upon professionals' own reflections and provide recommendations for improving practice and the model. This is a national multicentre study that utilised qualitative methods. Data was collected by a total of 26 institutional and national group interviews on which thematic analysis was conducted. Staff turnover, coercion, collaboration with outpatient care, working methodically and the move from control to contact were found to be the key developments since the model's implementation. Future efforts should focus upon staff retention and acquisition to ensure continuity of care and safety. Ongoing evaluation of coercion is essential to further reduce coercion. Collaborations with outpatient care and other stakeholders should be intensified to promote effective care. Management support, reflexivity and a clear vision are required to strengthen methodical working and collaboration between wards to create uniformity of practice. Working in contact with patients ensures safety but requires time and behavioural change. Applying implementation science can support improvements in acute mental health care by systematically addressing barriers to change, promoting sustainable evidence‐based practices, and guiding the reduction of coercion. Further research into these barriers, including the exploration of non‐coercive strategies and stakeholder involvement, is needed to enhance High and Intensive Care implementation and similar practices.
Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).
The Pan African medical journal · 2020 · Journal Article
Nicole AYA, Charlotte EE, Shanti NC, Edgar MML, et al.
Journal of translational medicine · 2012 · Journal Article
Siebuhr AS, Wang J, Karsdal M, Bay-Jensen AC, et al.
Lupus · 2008 · Clinical Trial
F L, Y T, X P, L W, et al.
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie · 2024 · Journal Article
Charlotte EE, Edgar MML, Yolande PD, Daniele-Christiane KMK, et al.
International journal of mental health nursing · 2025 · Journal Article
Isa ICJ, Laura ALVM, Sylvia SG, Cornelis CLM, et al.