Muscle ultrasound quantifies segmental neuromuscular outcome in pediatric myelomeningocele.

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Muscle ultrasound quantifies segmental neuromuscular outcome in pediatric myelomeningocele.

Ultrasound Med Biol. 2014 Jan;40(1):71-7

Authors: …

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Associations between lifetime traumatic events and subsequent chronic physical conditions: a cross-national, cross-sectional study.

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Associations between lifetime traumatic events and subsequent chronic physical conditions: a cross-national, cross-sectional study.

PLoS One. 2013;8(11):e80573

Authors: Scott KM, Koenen KC, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Benjet C, Bruffaerts R, Caldas-de-Almeida JM, de Girolamo G, Florescu S, Iwata N, Levinson D, Lim CC, Murphy S, Ormel J, Posada-Villa J, Kessler RC

Abstract

BACKGROUND: Associations between lifetime traumatic event (LTE) exposures and subsequent physical ill-health are well established but it has remained unclear whether these are explained by PTSD or other mental disorders. This study examined this question and investigated whether associations varied by type and number of LTEs, across physical condition outcomes, or across countries.

METHODS: Cross-sectional, face-to-face household surveys of adults (18+) were conducted in 14 countries (n = 38, 051). The Composite International Diagnostic Interview assessed lifetime LTEs and DSM-IV mental disorders. Chronic physical conditions were ascertained by self-report of physician’s diagnosis and year of diagnosis or onset. Survival analyses estimated associations between the number and type of LTEs with the subsequent onset of 11 physical conditions, with and without adjustment for mental disorders.

FINDINGS: A dose-response association was found between increasing number of LTEs and odds of any physical condition onset (OR 1.5 [95% CI: 1.4-1.5] for 1 LTE; 2.1 [2.0-2.3] for 5+ LTEs), independent of all mental disorders. Associations did not vary greatly by type of LTE (except for combat and other war experience), nor across countries. A history of 1 LTE was associated with 7/11 of the physical conditions (ORs 1.3 [1.2-1.5] to 1.7 [1.4-2.0]) and a history of 5+ LTEs was associated with 9/11 physical conditions (ORs 1.8 [1.3-2.4] to 3.6 [2.0-6.5]), the exceptions being cancer and stroke.

CONCLUSIONS: Traumatic events are associated with adverse downstream effects on physical health, independent of PTSD and other mental disorders. Although the associations are modest they have public health implications due to the high prevalence of traumatic events and the range of common physical conditions affected. The effects of traumatic stress are a concern for all medical professionals and researchers, not just mental health specialists.

PMID: 24348911 [PubMed - indexed for MEDLINE]

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Dual role of miR-21 in CD4+ T-cells: activation-induced miR-21 supports survival of memory T-cells and regulates CCR7 expression in naive T-cells.

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Dual role of miR-21 in CD4+ T-cells: activation-induced miR-21 supports survival of memory T-cells and regulates CCR7 expression in naive T-cells.

PLoS One. 2013;8(10):e76217

Authors: Smigielska-Czepiel K, van den Berg A, Jellema P, Slezak-Prochazka I, Maat H, van den Bos H, van der Lei RJ, Kluiver J, Brouwer E, Boots AM, Kroesen BJ

Abstract

Immune cell-type specific miRNA expression patterns have been described but the detailed role of single miRNAs in the function of T-cells remains largely unknown. We investigated the role of miR-21 in the function of primary human CD4+ T-cells. MiR-21 is substantially expressed in T-cells with a memory phenotype, and is robustly upregulated upon αCD3/CD28 activation of both naive and memory T-cells. By inhibiting the endogenous miR-21 function in activated naive and memory T-cells, we showed that miR-21 regulates fundamentally different aspects of T-cell biology, depending on the differentiation status of the T-cell. Stable inhibition of miR-21 function in activated memory T-cells led to growth disadvantage and apoptosis, indicating that the survival of memory T-cells depends on miR-21 function. In contrast, stable inhibition of miR-21 function in activated naive T-cells did not result in growth disadvantage, but led to a significant induction of CCR7 protein expression. Direct interaction between CCR7 and miR-21 was confirmed in a dual luciferase reporter assay. Our data provide evidence for a dual role of miR-21 in CD4+ T cells; Regulation of T-cell survival is confined to activated memory T-cells, while modulation of potential homing properties, through downregulation of CCR7 protein expression, is observed in activated naive T-cells.

PMID: 24098447 [PubMed - indexed for MEDLINE]

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Stu die naar het effect van de ZeroGerm TM UVtandenborstelreiniger op de inactivatie van cariogene en parodontitis veroorzakende bacterien.

In this study, the effect of the ZeroGerm ™ UV toothbrush cleaner is performed on the survival of the anaerobic bacteria Aggretibacter actinomycetemcomicans (Aa.), Porphyromonas gingivalis (Pg.), Prevotella intennedia(Pi.), Fusobacterium nucleatwn (Fn.) and aerobic bacteria Streptococcus mutans, Lactobacillus species in a toothbrush (in-vitro). For all of the bacteria mentioned above, the experiment was carried out in quadruplicate. In addition, five subjects were randomly selected to brush without toothpaste and then with toothpaste to determine the total number of surviving micro-organisms (both aerobic and anaerobic) on the toothbrush before and after the UV-treatment with the ZeroGerm™ UV cleaner (in-vivo). In both the in-vitro and in-vivo experiment, it was found that the ZeroGermTM sanitiser did have effect, but it was not always significantly different compared to the control results.

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De lokale controle van brachytherapie versus chirurgie bij plaveiselcelcarcinomen van de onderlip

Background and purpose
The term lip carcinoma is used to describe squamous cell carcinoma of the vermillion border of the lips. This type of tumor is mostly localized on the lower lip. The disease is most frequently seen with older white males whom have passed the age of 40.
Both brachytherapy and surgery are recommended as curative treatment.
Brachytherapy is a radiation technique that provides radiation from within the tissue.
Radioactive sources are implanted inside the tumor tissue.
There are several options to obtain a radical removal of the tumor through surgery.
Basically these options consist of three surgical techniques:
lipshave or vermillionectomy,
wedge excision, and
bloc resection.
The purpose of this studies is to compare brachytherapy and surgery as primary, curative
treatment of squamous cell carcinomas (Tl NO, T2NO) of the vermillion border of the lower lip. Local control rates and side effects of both treatments are evaluated into detail.
Materials and methods
From January 2005 to December 2011,49 patients underwent surgery or brachytherapy as a primary, curative treatment ofT1 and T2 squamous cell carcinoma of the vermillion border of the lower lip. Data about tumor staging, tumor size, treatment, side effects and oncologic outcomes were obtained from digital patient files and were recorded carefully in tables.
Results
A local control outcome of 82.6% was obtained in the brachytherapy group after a median follow-up period of 32.0 months (SD: 16.3). In the surgery group, a local control outcome of 100% was obtained after a median follow-up period of 47.7 months (SD:21.3).
All patients suffered from mucositis after brachytherapy. As regards most of the patients,
namely 39.1 %, the mucositis was cured within merely a month. Concerning the surgery groups, 55.2% of the patients reported no complaints at all.
Conclusion
Brachytherapy as a treatment for T1-2 squamous cell carcinomas of the vermillion border of the lower lip, is the treatment of choice if surgery can lead to serious functional or esthetic damage. Local recurrence after brachytherapy can be successfully treated with
salvage surgery.

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Verificatie functioneel afkappunt voor trismus bij hoofdhals oncologie patienten.

Purpose: Verify the functional cut-off point for trimsus of S35mm in a group of head
and neck oncology patients, which had not been used earlier for this purpose, and analyse if there is a difference in cut-off point for trismus among: dentate, partially dentate and edentate patients.
Patients and methods: In 122 patients mouth opening was measured and they were asked if they experienced problems with their mouth opening according to question
10 of the EORTC QLQ-H&N35. Based on the answers three criteria were created:
Criterion 1: “not at all” versus “a little” to “very much”,
Criterion 2: “not at al” and “a little” versus “a lot” and “very much” and
criterion 3: “not at all” to “a lot” versus “very much”.
The specificity, sensitivity and the percentage of correctly predicted patients were calculated for the cut-off points 1 Omm to 40mm, according the three criteria, for the total group and subgroups by the use of receiver operating characteristic (ROC)
curves.
Results: The mean mouth opening for the total group (n=1 09) was 40.2 mm (95% Cl:
37.6 tot 42.5) of which 43% experienced a little to very much difficulty with opening
their mouth. The AUC for criterion 1 was 0.702 (95o/o Cl: 0.598;0.805), criterion 2 was
0.805 (95% Cl: 0.683;0.926) and criterion 3 was 0.830 (95% Cl: 0.639;1 ). Criterion 2
was selected as criterion for trismus based on the analysis and clinical judgement.
The percentage correctly predicted was highest for the cut-off point’s S29 up to and
including S32mm (86-87%). The subgroups turned out to be too small for a statistical
analysis.
Conclusion: In this study a range of cut-off points for trismus of S29 up to and including S32mm was found, there is only a minor difference compared to the earlier
proposed cut-off point of S35mm. Influence by dentition couldn’t be determined.

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Lange Termijn Relapse na een Kaakosteotomie gefixeerd met Biodegradeerbare of Titanium Platen en Schroeven : Een Prospectief Cohortonderzoek op basis van een Multicenter Randomized Controlled Trail

Biodegradable fixation systems could reduce or even delete problems and costs associated
with titanium plate removal.
The aim of this study was to compare the long-term relapse of jaw orthognatic procedures
between patients, treated with a biodegradable system and patients, treated with a titanium
system.
Materials and Methods:
A multi-centre RCT was performed in the Netherlands from December 2006 to July 2009.
Originally 230patients were included who underwent osteotomies or were treated because of a
fracture. The patients were randomly assigned to either a titanium-group (KLS Martin) or to a
biodegradable-group (Inion CPS). In the current study only patients of at least 18 years old
who underwent an osteotomy were included. Simultaneous genioplasty was excluded.
Analysis was performed by digitally tracing lateral cephalograms.
Results:
Because there were not enough patients who underwent aLe Fort-I osteotomy or a himaxillary
osteotomy only patients who underwent a bilateral sagittal split osteotomy (BSSO)
were included for analysis. Long-term outcome for relapse in BSSO advancements was not
statistically different at point Bin the analyses. Neither in horizontal (p=0.71) nor vertical
(p=0.41) dimension between patients treated with the biodegradable fixation material and the
titanium fiXation material. There is a relationship between the magnitude of the advancement
and relapse, i.e., the larger the surgical advancement, the larger the relapse ( -0.4 (95%CI -0.8
to -0.1); p=0.008)).
Discussion:
Result from our study were similar with the results found in other studies, although there were
some differences in cephalometric measurements, follow-up time, the biodegradable fixation
system used, and surgical methods. In contrast to most other studies, our study was set-up as a
RCT. Therefore, our study defmitely adds stronger scientific evidence to the available
literature.
Conclusion:
When comparing Inion CPS with KLS Martin titanium osteosynthesis system long-term
outcome for relapse in BSSO advancements was not statistically different in horizontal and
vertical dimension. There is a relationship between the magnitude of the advancement and
relapse in both groups, i.e. the larger the surgical advancement, the larger the relapse.

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Stress responses of the industrial workhorse Bacillus licheniformis to osmotic challenges.

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Stress responses of the industrial workhorse Bacillus licheniformis to osmotic challenges.

PLoS One. 2013;8(11):e80956

Authors: Schroeter R, Hoffmann T, Voigt B, Meyer H, Bleisteiner M, Muntel J, Jürgen B, Albrecht D, Becher D, Lalk M, Evers S, Bongaerts J, Maurer KH, Putzer H, Hecker M, Schweder T, Bremer E

Abstract

The Gram-positive endospore-forming bacterium Bacillus licheniformis can be found widely in nature and it is exploited in industrial processes for the manufacturing of antibiotics, specialty chemicals, and enzymes. Both in its varied natural habitats and in industrial settings, B. licheniformis cells will be exposed to increases in the external osmolarity, conditions that trigger water efflux, impair turgor, cause the cessation of growth, and negatively affect the productivity of cell factories in biotechnological processes. We have taken here both systems-wide and targeted physiological approaches to unravel the core of the osmostress responses of B. licheniformis. Cells were suddenly subjected to an osmotic upshift of considerable magnitude (with 1 M NaCl), and their transcriptional profile was then recorded in a time-resolved fashion on a genome-wide scale. A bioinformatics cluster analysis was used to group the osmotically up-regulated genes into categories that are functionally associated with the synthesis and import of osmostress-relieving compounds (compatible solutes), the SigB-controlled general stress response, and genes whose functional annotation suggests that salt stress triggers secondary oxidative stress responses in B. licheniformis. The data set focusing on the transcriptional profile of B. licheniformis was enriched by proteomics aimed at identifying those proteins that were accumulated by the cells through increased biosynthesis in response to osmotic stress. Furthermore, these global approaches were augmented by a set of experiments that addressed the synthesis of the compatible solutes proline and glycine betaine and assessed the growth-enhancing effects of various osmoprotectants. Combined, our data provide a blueprint of the cellular adjustment processes of B. licheniformis to both sudden and sustained osmotic stress.

PMID: 24348917 [PubMed - indexed for MEDLINE]

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Do cancer and treatment type affect distress?

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Do cancer and treatment type affect distress?

Psychooncology. 2013 Aug;22(8):1766-73

Authors: Admiraal JM, Reyners AK, Hoekstra-Weebers JE

Abstract

OBJECTIVE: We examined differences in distress levels and Distress Thermometer (DT) cutoff scores between different cancer types. The effect of socio-demographic and illness-related variables on distress was also examined.

METHODS: One thousand three hundred fifty patients (response = 51%) completed questions on socio-demographic and illness-related variables, the Dutch version of the DT and Problem List, and the Hospital Anxiety and Depression Scale. Receiver operating characteristics analyses were performed to determine cancer specific cutoff scores. Univariate and multivariate effects of socio-demographic and illness-related variables (including cancer type) on distress were examined.

RESULTS: Prostate cancer patients reported significantly lower DT scores (M = 2.5 ± 2.5) and the cutoff score was lower (≥ 4) than in patients with most other cancer types (M varied between 3.4 and 5.1; cutoff ≥ 5). Multivariate analyses (F = 10.86, p < .001, R(2) = 0.08) showed an independent significant effect of four variables on distress: intensive treatment (β = .10, any (combination of) treatment but surgery only and ‘wait and see’); a non-prostate cancer type (β = -.17); the interaction between gender and age (β = -.12, highest distress in younger women as compared with older women and younger and older men); and the interaction between cancer type and treatment intensity (β = .08, lowest scores in prostate cancer patients receiving non-intensive treatment as compared with their counterparts).

CONCLUSIONS: Distress and cutoff score in prostate cancer patients were lower than in patients with other cancer types. Additionally, younger women and patients receiving treatment other than surgery only or ‘wait and see’ are at risk for higher distress. These results can help identify patients possibly in need of referral to professional psychosocial and/or allied health care.

PMID: 23109282 [PubMed - indexed for MEDLINE]

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Pontine control of ejaculation and female orgasm.

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Pontine control of ejaculation and female orgasm.

J Sex Med. 2013 Dec;10(12):3038-48

Authors: Huynh HK, Willemsen AT, Lovick TA, Holstege G

Abstract

INTRODUCTION: The physiological component of ejaculation shows parallels with that of micturition, as both are essentially voiding activities. Both depend on supraspinal influences to orchestrate the characteristic pattern of activity in the pelvic organs. Unlike micturition, little is known about the supraspinal pathways involved in ejaculation and female orgasm.

AIM: To identify brainstem regions activated during ejaculation and female orgasm and to compare them with those activated during micturition.

METHODS: Ejaculation in men and orgasm in women were induced by manual stimulation of the penis or clitoris by the participants’ partners. Positron emission tomography (PET) with correction for head movements was used to capture the pattern of brain activation at the time of sexual climax.

MAIN OUTCOME MEASURES: PET scans showing areas of activation during sexual climax.

RESULTS: Ejaculation in men and orgasm in women resulted in activation in a localized region within the dorsolateral pontine tegmentum on the left side and in another region in the ventrolateral pontine tegmentum on the right side. The dorsolateral pontine area was also active in women who attempted but failed to have an orgasm and in women who imitated orgasm. The ventrolateral pontine area was only activated during ejaculation and physical orgasm in women.

CONCLUSION: Activation of a localized region on the left side in the dorsolateral pontine tegmentum, which we termed the pelvic organ-stimulating center, occurs during ejaculation in men and physical orgasm in women. This same region has previously been shown to be activated during micturition, but on the right side. The pelvic organ-stimulating center, via projections to the sacral parasympathetic motoneurons, controls pelvic organs involved in voiding functions. In contrast, the ventrolateral pontine area, which we term the pelvic floor-stimulating center, produces the pelvic floor contractions during ejaculation in men and physical orgasm in women via direct projections to pelvic floor motoneurons.

PMID: 23981195 [PubMed - indexed for MEDLINE]

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Adenosine A(2A) receptor antagonists as Positron Emission Tomography (PET) tracers.

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Adenosine A(2A) receptor antagonists as Positron Emission Tomography (PET) tracers.

Curr Med Chem. 2013;21(3):312-28

Authors: Khanapur S, Waarde Av, Ishiwata K, Leenders KL, Dierckx RA, Elsinga PH

Abstract

The adenosine A(2A) receptor (A(2A)R) is highly concentrated in the striatum, and a therapeutic target for Parkinson’s disorder (PD) and Huntington’s disease. High affinity and selective radiolabeled A(2A)R antagonists can be important research and diagnostic tools for PD. Positron Emission Tomography (PET) can play an important role by measuring radiolabeled A(2A) antagonists non-invasively in the brain. However, till date no complete review on A(2A)R PET ligands is available. The present article has been therefore focused on available PET tracers for A(2A)R and their detailed biological evaluation in rodents, nonhuman primates and humans. Drug design and development by molecular modeling including new lead structures that are potential candidates for radiolabeling and mapping of cerebral A(2A)Rs is discussed in the present article. A brief overview of functions of adenosine in health and disease, including the relevance of A(2A)R for PD has also been presented.

PMID: 24059232 [PubMed - indexed for MEDLINE]

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Occupancy of serotonin transporters in the amygdala by paroxetine in association with attenuation of left amygdala activation by negative faces in major depressive disorder.

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Occupancy of serotonin transporters in the amygdala by paroxetine in association with attenuation of left amygdala activation by negative faces in major depressive disorder.

Psychiatry Res. 2014 Feb 28;221(2):155-61

Authors: Ruhé HG, Koster M, Booij J, van Herk M, Veltman DJ, Schene AH

Abstract

Amygdala hyperactivation in major depressive disorder (MDD) might be attenuated by selective serotonin reuptake inhibitors (SSRIs), but the working mechanism remains unclear. We hypothesized that higher amygdala serotonin transporter (SERT) occupancy by paroxetine results in greater attenuation of amygdala activation by negative facial expressions in MDD patients. We treated fifteen MDD patients (22-55 years) with paroxetine 20-50mg/day. After 6 and 12 weeks, we quantified (1) clinical response (≥50% decrease in Hamilton Depression Rating Scale (HDRS), (2) SERT occupancy in both amygdala measured by repeated [123I]β-CIT single photon emission computed tomography (SPECT), and (3) amygdala activation when viewing fearful and angry (negative) faces with repeated functional MRI scans. Response rates were 4/15 and 9/15 at 6 and 12 weeks, respectively. Attenuation of left amygdala activation was associated with amygdala SERT occupancy (P=0.006) and response (P=0.015). This association may provide a rationale for decreased limbic activity seen during treatment of MDD. It might also explain the rapid decrease in negative attentional bias and amygdala activation caused by SSRIs.

PMID: 24406081 [PubMed - indexed for MEDLINE]

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A single-item measure of social identification: reliability, validity, and utility.

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A single-item measure of social identification: reliability, validity, and utility.

Br J Soc Psychol. 2013 Dec;52(4):597-617

Authors: Postmes T, Haslam SA, Jans L

Abstract

This paper introduces a single-item social identification measure (SISI) that involves rating one’s agreement with the statement ‘I identify with my group (or category)’ followed by a 7-point scale. Three studies provide evidence of the validity (convergent, divergent, and test-retest) of SISI with a broad range of social groups. Overall, the estimated reliability of SISI is good. To address the broader issue of single-item measure reliability, a meta-analysis of 16 widely used single-item measures is reported. The reliability of single-item scales ranges from low to reasonably high. Compared with this field, reliability of the SISI is high. In general, short measures struggle to achieve acceptable reliability because the constructs they assess are broad and heterogeneous. In the case of social identification, however, the construct appears to be sufficiently homogeneous to be adequately operationalized with a single item.

PMID: 23121468 [PubMed - indexed for MEDLINE]

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Comprehension of marked pronouns in Spanish and English: object anaphors cross-linguistically.

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Comprehension of marked pronouns in Spanish and English: object anaphors cross-linguistically.

Q J Exp Psychol (Hove). 2013;66(10):2039-59

Authors: Taylor RC, Stowe LA, Redeker G, Hoeks JC

Abstract

Previous research on pronoun resolution has identified several individual factors that are deemed to be important for resolving reference. In this paper, we argue that of these factors, as tested here, plausibility is the most important, but interacts with form markedness and structural parallelism. We investigated how listeners resolved object pronouns that were ambiguous in the sense of having more than one possible antecedent. We manipulated the form of the anaphoric expression in terms of accentuation (English: Experiments 1a and 2a) and morphology (Spanish: Experiments 1b and 2b). We looked at sentences where both antecedents were equally plausible, or where only one of the antecedents was plausible. Listeners generally resolved toward the (parallel) grammatical object of the previous clause. When the pronouns were marked due to accentuation (English) or use of specific morphology (Spanish), preference switched to the alternative antecedent, the grammatical subject of the previous clause. In contrast, when one of the two antecedents was a much more plausible antecedent than the other, antecedent choice was almost wholly dictated by plausibility, although reference form prominence did significantly attenuate the strength of the preference.

PMID: 23510026 [PubMed - indexed for MEDLINE]

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Dispersal of antibiotic-resistant high-risk clones by hospital networks: changing the patient direction can make all the difference.

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Dispersal of antibiotic-resistant high-risk clones by hospital networks: changing the patient direction can make all the difference.

J Hosp Infect. 2014 Jan;86(1):34-41

Authors: Donker T, Wallinga J, Grundmann H

Abstract

BACKGROUND: Patients who seek treatment in hospitals can introduce high-risk clones of hospital-acquired, antibiotic-resistant pathogens from previous admissions. In this manner, different healthcare institutions become linked epidemiologically. All links combined form the national patient referral network, through which high-risk clones can propagate.

AIM: To assess the influence of changes in referral patterns and network structure on the dispersal of these pathogens.

METHODS: Hospital admission data were mapped to reconstruct the English patient referral network, and 12 geographically distinct healthcare collectives were identified. The number of patients admitted and referred to hospitals outside their collective was measured. Simulation models were used to assess the influence of changing network structure on the spread of hospital-acquired pathogens.

FINDINGS: Simulation models showed that decreasing the number of between-collective referrals by redirecting, on average, just 1.5 patients/hospital/day had a strong effect on dispersal. By decreasing the number of between-collective referrals, the spread of high-risk clones through the network can be reduced by 36%. Conversely, by creating supra-regional specialist centres that provide specialist care at national level, the rate of dispersal can increase by 48%.

CONCLUSION: The structure of the patient referral network has a profound effect on the epidemic behaviour of high-risk clones. Any changes that affect the number of referrals between healthcare collectives, inevitably affect the national dispersal of these pathogens. These effects should be taken into account when creating national specialist centres, which may jeopardize control efforts.

PMID: 24075292 [PubMed - indexed for MEDLINE]

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The polarized architecture of hepatocytes

No description abstract

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Current and upcoming approaches to exploit the reversibility of epigenetic mutations in breast cancer

Fahimeh Falahi, Michel van Kruchten, Nadine Martinet, Geke Hospers, Marianne G Rots
Breast Cancer Research 2014, 16:412 (29 July 2014)

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The effects of computed tomography image characteristics and knot spacing on the spatial accuracy of B-pline deformable image registration in the head and neck geometry

Charlotte L Brouwer, Roel GJ Kierkels, Aart A van ¿t Veld, Nanna M Sijtsema, Harm Meertens
Radiation Oncology 2014, 9:169 (29 July 2014)

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Inventariserende studie naar symptomen van patienten in het palliatieve behandeltraject van hoofd-halskanker

Head and neck cancer is world-wide one of the ten most common cancers.1 The 5-year
survival rate (50%) has not significantly improved in the past few decades. Because of the large numbers of deaths there is a great demand for palliative care. The main purpose of palliative care is to provide patients with symptom relief. In the case of head and neck cancer it is really important to take care of the symptoms, because of the structures affected. Previous studies into symptoms during the period of palliative treatment had important shortcomings regarding the design or the report of the study, which made the clinical
relevance of the results limited.
The objective of this study is to make an inventory of the several symptoms that appear to head and neck cancer patients during the palliative treatment in the Universitair Medisch Centrum Groningen
and to analyze which patient-, tumor-, and treatment-characteristic variables have a relationship with the appearance of those symptoms.
Materials and methods
The charts of patients who were treated at the department kaak- en aangezichtschirurgie between
2007 and 2012 were reviewed to identify charts that meet our inclusion criteria. 57 patients were included. The charts were screened on 29 symptoms and 16 patient­ characteristics. The resulting data were tested by Chi-Square test, Fisher’s Exact test, Mann Whitney test, Kruskal Wallis test
and the Log Rank test. Spearmans Rangcorrelation coefficient was used to analyse possible associations.
Results
The average age at the moment of death was 67,5 year (SD =12,5 year). The median survival time was 145 days and the mean number of symptoms was 3,8 per patient.
Patients that were treated with RTX or MTX had significantly more new symptoms (p=0,006) and a longer survival time (p=0,007) compared to patients who were not treated with RTX or MTX. The
age of the patients had a negative association with the number of symptoms (R2=0,0615 after filtering the outliers). The sex, the location of the tumor, the presence of comorbidity, the presence of a second tumor and the initial stage of the tumor did not give a significant difference in the kind and/or number of symptoms and/or survival.
Discussion and conclusions
A huge number of symptoms were during palliative treatment. There were differences in the frequencies of symptoms depending on patient-, tumor-, or treatmentcharacteristics. These differences were all not statistically significant.
As result of the retrospective character, the collection of data in dossiers was not carried out in a controlled way. Patient- or physician-related differences may result in differences in the way the charts were written and therefore result in differences in the database.
A randomized controlled trial is needed to increase the sensitivity of the results, to decrease the inter- and intraobserver bias and to investigate causal associations. Quality of life­ evaluation should be involved in next studies to increase the clinical relevance of the results.

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Organizational commitment and job satisfaction among nurses in Serbia: A factor analysis.

Organizational commitment and job satisfaction among nurses in Serbia: A factor analysis.

Nurs Outlook. 2014 May 23;

Authors: Veličković VM, Višnjić A, Jović S, Radulović…

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