Publicaties van medewerkers Sint Antonius Ziekenhuis 2008
Deze lijst is gepubliceerd op 17 maart 2009
Aantal publicaties : 476
Waarvan dissertaties:
Besselink MGH. Prevention and intervention strategies in acute pancreatitis. s.l.: s.n., 2008.
Proefschrift Universiteit Utrecht
Grootenboers MJJH. Regional chemotherapy of the lung : investigations of isolated lung perfusion and selective pulmonary artery perfusion. s.n.: s.l., 2008.
Proefschrift Universiteit Utrecht
Slieker MG. Prognosis in cystic fibrosis : trends and predictors. s.l.: s.n., 2008.
Proefschrift Universiteit Utrecht
Wasowicz-Kemps DK. Trends in day surgery in the Netherlands. s.l.: s.n., 2008.
Proefschrift Universiteit Utrecht
Westerweel PE. Vascular progenitor cells in renal and cardiovascular disease. s.l.: s.n., 2008.
Proefschrift Universiteit Utrecht
Publicatielijst
Aanen MC, Bredenoord AJ, Numans ME, Samson M, Smout AJ. Reproducibility of Symptom Association Analysis in Ambulatory Reflux Monitoring. American Journal of Gastroenterology 2008; 103(9):2200-2208.
Abstract: INTRODUCTION: The temporal relationship between reflux symptoms and reflux episodes during ambulatory reflux monitoring can be studied with symptom association analysis, and the strength of the relationship can be expressed using indices such as the SAP (symptom association probability), SI (symptom index), and SSI (symptom sensitivity index). The reproducibility of these indices has not been determined yet. METHOD: Twenty-one patients with typical reflux symptoms (9 men, 53 [38-57] yr) underwent two 24-h combined pH-impedance recordings off acid-secretory medication with an interval of 1-4 wk. The SAP, SI, and SSI were calculated for each measurement. Reproducibility of these indices was determined with Kendall's coefficients of concordance. RESULTS: The number of reflux events were highly reproducible (Kendall W = 0.92, P < 0.01). The number of symptoms related to reflux events was reproducible (Kendall W = 0.91, P < 0.01) while the number of reported reflux symptoms was not (Kendall W = 0.75, P= 0.07). The SAP and SSI were highly reproducible (Kendall W = 0.90, P= 0.01, and W = 0.86, P < 0.05, respectively) but the SI was not (W = 0.73, P= 0.09). The percentage of patients with similar outcomes on two separate test days for the SAP, SI, and SSI was 86%, 67%, and 86%, respectively. DISCUSSION: In 24-h pH-impedance recordings of patients with reflux symptoms, the number of reflux events and the number of symptoms related to reflux events were highly reproducible as were the SAP and SSI. This supports the use of these indices to express the relationship between symptoms and reflux episodes in clinical practice
Aanen MC, Bredenoord AJ, Samsom M, Smout AJ. Reliability of oesophageal pH recording for the detection of gastro-oesophageal reflux. Scandinavian Journal of Gastroenterology 2008; 43(12):1442-1447.
Abstract: Objective. Despite the new gold standard oesophageal impedance monitoring, pH monitoring is still used frequently for detection of gastro-oesophageal reflux (GOR). Besides drops in pH from above to below pH4, drops of >/=1 unit are also used as a marker for GOR. In this study the objective was to investigate the accuracy of drops in pH for detection of GOR, using impedance monitoring as the gold standard. Material and methods. Nineteen GORD patients (9 M, 55+/-11 years) underwent combined 24-h pH-impedance recording off acid-suppressive therapy. All drops in pH >/=0.5 pH units, with a duration >/=4 s, reaching the nadir pH within 5 s after onset were included. Reflux events detected with impedance monitoring were taken as the reference. Results. In total, 2221 drops in pH were found; 47% were acid (nadir pH <4), 47% weakly acidic (nadir pH between pH7 and 4) and 5% were superimposed (pH drop starting below pH4). The sensitivities of acid, weakly acidic and superimposed pH drops >/=1 were 91%, 28%, 24%, respectively, and the percentages of false-positive reflux episodes were 20, 56 and 54, respectively. Acid reflux with a cut-off >/=0.5 and </=3.3 had a moderate-to-good sensitivity (94-70%) and low false-positive percentages (23-13%). In contrast, weakly acidic and superimposed reflux showed greater false-positive than true-positive percentages for all cut-off values. Conclusions. Compared to impedance monitoring, detection of reflux with pH monitoring is clearly inferior. When drops in pH >/=1 are used irrespective of nadir pH as an indicator of reflux episodes, the number of reflux episodes is overestimated. Decreases from above to below 4 with cut-offs between >/=0.5 and </=3.3 are the most indicative of true reflux episodes
Aanen MC, Weusten BL, Numans ME, de Wit NJ, Samsom M, Smout AJ. Effect of proton-pump inhibitor treatment on symptoms and quality of life in GERD patients depends on the symptom-reflux association. Journal of Clinical Gastroenterology 2008; 42(5):441-447.
Abstract: BACKGROUND: Gastroesophageal reflux disease patients demonstrate various pathophysiologic backgrounds. Therefore, a heterogeneous response to proton-pump inhibitor (PPI) treatment can be expected. We investigated the effect of short-term PPI treatment on symptoms and quality of life (QOL) in primary care patients with and without pathologic esophageal acid exposure and in presence or absence of a positive association between symptoms and reflux episodes. STUDY: Seventy-four heartburn patients were categorized into 4 groups according to positive or negative symptom-reflux association, as expressed in symptom index, symptom sensitivity index, and symptom association probability (SAP) and presence or absence of pathologic reflux, defined as esophageal pH<4%>6% of the time (pH+/pH-). Overall and specific reflux symptoms were assessed 1 week before and the last week during a 2-week course of 40-mg esomeprazole daily. The QOL was scored by the Quality of Life in Reflux and Dyspepsia questionnaire 2 weeks before treatment and directly after. RESULTS: Using the SAP to assess symptom-reflux associations, the 4 groups [SAP+pH+(n=40); SAP+pH-(n=12); SAP-pH+(n=10); SAP-pH-(n=10)] had similar demographic characteristics. The SAP-pH- subgroup had the least overall symptom reduction (P<0.01) and in the SAP+pH+ subgroup the greatest heartburn symptom reduction was found (P<0.02). The residual symptom scores on treatment were lowest in SAP+pH+ and highest in SAP-pH- subgroups and relatively high in the SAP+pH-. QOL was severely reduced and SAP-pH- patients had the lowest QOL overall. Similar findings were made using symptom index and symptom sensitivity index. CONCLUSIONS: Symptomatic reflux patients without evidence of reflux disease on a 24-hour pH recording responded less favorably to PPI treatment than patients with a positive symptom-reflux association or with pathologic reflux
Agterof MJ, ter Borg EJ. Erythematous pigmentation of the arm for more than ten years. Netherlands Journal of Medicine 2008; 66(4):176, 179.
Abstract: No abstract available
Ahlers SJ, van Gulik L, van der Veen AM, van Dongen HP, Bruins P, Belitser SV, de Boer A, Tibboel D, Knibbe CA. Comparison of different pain scoring systems in critically ill patients in a general ICU. Critical Care (London) 2008; 12(1):R15.
Abstract: BACKGROUND: Pain in critically ill patients in the intensive care unit (ICU) is common. However, pain assessment in critically ill patients often is complicated because these patients are unable to communicate effectively. Therefore, we designed a study (a) to determine the inter-rater reliability of the Numerical Rating Scale (NRS) and the Behavioral Pain Scale (BPS), (b) to compare pain scores of different observers and the patient, and (c) to compare NRS, BPS, and the Visual Analog Scale (VAS) for measuring pain in patients in the ICU. METHODS: We performed a prospective observational study in 113 non-paralyzed critically ill patients. The attending nurses, two researchers, and the patient (when possible) obtained 371 independent observation series of NRS, BPS, and VAS. Data analyses were performed on the sample size of patients (n = 113). RESULTS: Inter-rater reliability of the NRS and BPS proved to be adequate (kappa = 0.71 and 0.67, respectively). The level of agreement within one scale point between NRS rated by the patient and NRS scored by attending nurses was 73%. However, high patient scores (NRS > or = 4) were underestimated by nurses (patients 33% versus nurses 18%). In responsive patients, a high correlation between NRS and VAS was found (rs = 0.84, P < 0.001). In ventilated patients, a moderate positive correlation was found between the NRS and the BPS (rs = 0.55, P < 0.001). However, whereas 6% of the observations were NRS of greater than or equal to 4, BPS scores were all very low (median 3.0, range 3.0 to 5.0). CONCLUSION: The different scales show a high reliability, but observer-based evaluation often underestimates the pain, particularly in the case of high NRS values (> or = 4) rated by the patient. Therefore, whenever this is possible, ICU patients should rate their pain. In unresponsive patients, primarily the attending nurse involved in daily care should score the patient's pain. In ventilated patients, the BPS should be used only in conjunction with the NRS nurse to measure pain levels in the absence of painful stimuli
Akdim F, Kastelein JJ, Gaudet D. The ENHANCE study and marketing ezetimibe. JAMA 2008; 299(23):2747-2748.
Alipour A, van Oostrom AJHH, van Wijk JPH, Verseyden C, Plokker HWM, Jukema JW, Rabelink AJ, Cabezas MC. Dissociation of postprandial clearance of chylomicrons and VLDL1 in MBL deficiency: Role of the innate immune system in postprandial lipemia? Atherosclerosis Supplements 2008; 9(2):88-89.
Alipour A, van Oostrom AJ, Izraeljan A, Verseyden C, Collins JM, Frayn KN, Plokker TW, Elte JW, Castro Cabezas M. Leukocyte activation by triglyceride-rich lipoproteins. Arteriosclerosis, Thrombosis & Vascular Biology 2008; 28(4):792-797.
Abstract: OBJECTIVE: Postprandial lipemia has been linked to atherosclerosis and inflammation. Because leukocyte activation is obligatory for atherogenesis, leukocyte activation by triglyceride-rich lipoproteins (TRLs) was investigated. METHODS AND RESULTS: The expression of CD11b and CD66b after incubation with glucose and native and artificial TRLs (NTRL and ATRL) in vivo and in vitro was evaluated by flowcytometry. Oral fat loading tests showed an increased expression of CD11b on monocytes and neutrophils and CD66b on neutrophils. In 11 volunteers, postprandial leukocytes became enriched with meal-derived fatty acids ([1-(13)C]16:0) suggesting uptake of exogenous fat. ApoB binding on leukocytes measured by flowcytometry in 65 subjects was highest on neutrophils and monocytes suggesting adherence of apoB-containing lipoproteins. Physiological concentrations of TRLs showed 62% increased neutrophil CD11b and a dose-dependent increased monocyte CD11b up to 84% in vitro. Incubations with lipid emulsions in the hypertriglyceridemic range showed a 5-fold increased monocyte CD11b expression, which was higher than the positive control (fMLP), and a dose-dependent 2- to 3-fold increased neutrophil CD11b and CD66b. The oxidative scavenger DMTU decreased the neutrophil CD66b expression by 36%. CONCLUSIONS: Acute hypertriglyceridemia is a leukocyte activator most likely by direct interaction between TRLs and leukocytes and uptake of fatty acids. TG-mediated leukocyte activation is an alternative proinflammatory and proatherogenic mechanism of hypertriglyceridemia in part associated to the generation of oxidative stress
Amini M, Harmsze AM, Tupker RA. Patient's Estimation of Efficacy of Various Hyperhidrosis Treatments in a Dermatological Clinic. Acta Dermato-Venereologica 2008; 88(4):356-362.
Abstract: Hyperhidrosis is a common ailment, which is accompanied by a low quality of life. There are many current treatment options. The aims of this study were to investigate: (i) the characteristics of sweating in patients referred for hyperhidrosis; (ii) their quality of life, using the Dermatology Life Quality Index and the Hyperhidrosis Disease Severity Scale; and (iii) their estimation of efficacy of the treatments given, using a patient's global assessment score and the quality of life scores. In 47 of 94 patients (50%) responding to the questionnaires, hyperhidrosis was confined exclusively to the axillae. In 21 (22%) of the patients, sweating in the axillae was combined with sweating of the hands and/or feet, face or other, more widespread, regions. Fifteen patients (16%) had generalized hyperhidrosis. In half of all cases, sweating occurred in attacks. Attacks were mostly triggered by warmth, exercise, emotions, or had no apparent cause. Quality of life was low in all cases. All treatments improved quality of life
Ascoop CAPL, Boersma LVA. Wat is het verschil tussen pulseless electric activity (PEA) en elektromechanische dissociatie (EMD)? Vademecum permanente nascholing huisartsen 2008;(Oktober).
Baan A. Vertrouwen, vooruitgang en professionalisering. Critical care : multidisciplinair vakblad 2008; 5(1):2.
Backus B, Konijnenberg M, Verburg E, Verzijlbergen F. Reproducibility of Myocardial SPECT with 201Tl. European Journal of Nuclear Medicine & Molecular Imaging 2008; 35(suppl 2):S254.
Backus BE. Coronarialijden. In: Six AJ, Budde RPJ, Cramer MJM, Backus BE, editors. De cardiologie vereenvoudigd : een didactische wegwijzer voor hartfunctielaboranten, gespecialiseerde verpleegkundigen, paramedici, artsen, researchmedewerkers. Den Haag: Lemma, 2008: 33-53.
Backus BE, Verburg FA, Konijnenberg MW, Verzijlbergen JF. Myocardial perfusion SPECT: Rest and stress in one acquisition. Journal of Nuclear Cardiology 2008; 15(4):S19.
Barlo N, van Moorsel C, Grutters J, van den Bosch J. Clinical description of a population of Dutch IPF patients. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract P3475.
Bartelink IH, Bredius RGM, Egberts TCG, Suttorp MM, Bierings M, Knibbe C, Zwaveling J, Boelens JJ. 194: Intravenous Busulfan in Children Prior to Haematological Stem Cell Transplantation, How Narrow is the Therapeutic Window? Biology of Blood and Marrow Transplantation 2008; 14(2, Supplement 1):71-72.
Beckers MM, Verzijlbergen JF, van Buul MM, Prins MH, Biesma DH. The potential role of positron emission tomography in the detection of occult cancer in 25 patients with venous thromboembolism. Annals of Oncology 2008; 19(6):1203-1204.
Besselink MG, van Santvoort HC, Bollen TL, Boermeester MA, Dejong CH, Gooszen HC. Management of patients with severe acute pancreatitis in the new millenium: prophylaxis, nutrition, imaging and intervention. Netherlands Journal of Critical Care 2008; 12(1):14-19.
Besselink MG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM, Nieuwenhuijs VB, Bollen TL, van Ramshorst B, Witteman BJ, Rosman C, Ploeg RJ, Brink MA, Schaapherder AF, Dejong CH, Wahab PJ, van Laarhoven CJ, van der Harst E, van Eijck CH, Cuesta MA, Akkermans LM, Gooszen HG, Acute Pancreatitis Werkgroep Nederland. Probioticaprofylaxe bij voorspeld ernstige acute pancreatitis: een gerandomiseerde, dubbelblinde, placebogecontroleerde trial. Nederlands Tijdschrift voor Geneeskunde 2008; 152(12):685-696.
Abstract: OBJECTIVE: To evaluate whether enteral prophylaxis with probiotics in patients with predicted severe acute pancreatitis prevents infectious complications. DESIGN: Multicentre, randomised, double-blind, placebo-controlled trial. METHOD: A total of 296 patients with predicted severe acute pancreatitis (APACHE II score > or = 8, Imrie score > or = 3 or C-reactive protein concentration > 150 mg/l) were included and randomised to one of two groups. Within 72 hours after symptom onset, patients received a multispecies preparation of probiotics or placebo given twice daily via a jejunal catheter for 28 days. The primary endpoint was the occurrence of one of the following infections during admission and go-day follow-up: infected pancreatic necrosis, bacteraemia, pneumonia, urosepsis or infected ascites. Secondary endpoints were mortality and adverse reactions. The study registration number is ISRCTN38327949. RESULTS: Treatment groups were similar at baseline with regard to patient characteristics and disease severity. Infections occurred in 30% of patients in the probiotics group (46 of 152 patients) and 28% of those in the placebo group (41 of 144 patients; relative risk (RR): 1.1; 95% CI: 0.8-1.5). The mortality rate was 16% in the probiotics group (24 of 152 patients) and 6% (9 of 144 patients) in the placebo group (RR: 2.5; 95% CI: 1.2-5.3). In the probiotics group, 9 patients developed bowel ischaemia (of whom 8 patients died), compared with none in the placebo group (p = 0.004). CONCLUSION: In patients with predicted severe acute pancreatitis, use of this combination of probiotic strains did not reduce the risk of infections. Probiotic prophylaxis was associated with a more than two-fold increase in mortality and should therefore not be administered in this category of patients
Besselink MG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM, Nieuwenhuijs VB, Bollen TL, van Ramshorst B, Witteman BJ, Rosman C, Ploeg RJ, Brink MA, Schaapherder AF, Dejong CH, Wahab PJ, van Laarhoven CJ, van der Harst E, van Eijck CH, Cuesta MA, Akkermans LM, Gooszen HG. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008; 371(9613):651-659.
Abstract: BACKGROUND: Infectious complications and associated mortality are a major concern in acute pancreatitis. Enteral administration of probiotics could prevent infectious complications, but convincing evidence is scarce. Our aim was to assess the effects of probiotic prophylaxis in patients with predicted severe acute pancreatitis. METHODS: In this multicentre randomised, double-blind, placebo-controlled trial, 298 patients with predicted severe acute pancreatitis (Acute Physiology and Chronic Health Evaluation [APACHE II] score >/=8, Imrie score >/=3, or C-reactive protein >150 mg/L) were randomly assigned within 72 h of onset of symptoms to receive a multispecies probiotic preparation (n=153) or placebo (n=145), administered enterally twice daily for 28 days. The primary endpoint was the composite of infectious complications-ie, infected pancreatic necrosis, bacteraemia, pneumonia, urosepsis, or infected ascites-during admission and 90-day follow-up. Analyses were by intention to treat. This study is registered, number ISRCTN38327949. FINDINGS: One person in each group was excluded from analyses because of incorrect diagnoses of pancreatitis; thus, 152 individuals in the probiotics group and 144 in the placebo group were analysed. Groups were much the same at baseline in terms of patients' characteristics and disease severity. Infectious complications occurred in 46 (30%) patients in the probiotics group and 41 (28%) of those in the placebo group (relative risk 1.06, 95% CI 0.75-1.51). 24 (16%) patients in the probiotics group died, compared with nine (6%) in the placebo group (relative risk 2.53, 95% CI 1.22-5.25). Nine patients in the probiotics group developed bowel ischaemia (eight with fatal outcome), compared with none in the placebo group (p=0.004). INTERPRETATION: In patients with predicted severe acute pancreatitis, probiotic prophylaxis with this combination of probiotic strains did not reduce the risk of infectious complications and was associated with an increased risk of mortality. Probiotic prophylaxis should therefore not be administered in this category of patients
Besselink MGH, Santvoort HC, Buskens E, Boermeester MA, van Goor H, Timmerman HM, Nieuwenhuijs VB, Bollen TL, van Ramshorst B, Witteman BJ, Rosman C, Ploeg RJ, Brink MA, Schaapherder AF, de Jong Ch, Wahab PJ, van Laarhoven CJ, van der Harst E, van Eijck CH, Cuesta MA, Akkermans LMA, Gooszen HG, for the Dutch Pancreatitis Study Group. Probioticaprofylaxe bij voorspeld ernstige acute pancreatitis: een multicentrische gerandomiseerde placebogecontroleerde trial. Nederlands Tijdschrift voor Heelkunde 2008; 17(4).
Besselink MGH. Prevention and intervention strategies in acute pancreatitis. s.l.: s.n., 2008.
Ref ID: 9218
Biemond-Moeniralam H. Alle tradities overboord. Medisch Contact 2008; 63(51-52):2120-2121.
Blusse van Oud-Alblas B, Fioole B, Jansen MC, van Duijnhoven FH, van Hillegersberg R, Rijken AM, van Coevorden F, Borel Rinkes IH. Radiofrequente ablatie van colorectale levermetastasen: resultaten vanaf de eerste toepassing in Nederland. Nederlands Tijdschrift voor Geneeskunde 2008; 152(15):880-886.
Abstract: OBJECTIVE:To provide an overview of the morbidity, mortality and survival following the introduction of radiofrequency ablation (RFA) of colorectal liver metastases in the Netherlands. DESIGN: Prospective, descriptive study. METHOD: Between June 1999 and December 2003 in eight hospitals in the Netherlands, 87 patients treated by RFA for colorectal liver metastases were included in the study. The outcome measures were morbidity, 30-day mortality and the percentage local recurrence. RESULTS: In 104 RFA procedures, 199 metastases were ablated; 31 procedures were performed percutaneously and 73 by laparotomy. In 29 procedures, RFA was combined with partial liver resection. The overall postoperative morbidity rate was 19% and the RFA-related morbidity was 14%. 1 patient died following right hemihepatectomy and RFA in the remaining parenchyma (mortality: 1%). Median survival following RFA was 25 months, with a median progression-free survival of 13 months. The overall local recurrence rate was 46%. Since January 2004, this percentage has decreased to approximately 6. Diameter and central location of the metastases were independent risk factors for the development of a local recurrence. CONCLUSION: RFA is an alternative treatment for patients who are not eligible for partial liver resection. The high local recurrence rate in this series reflects the limited experience with this technique during its introduction in the Netherlands. In specialised centres the percentage local recurrence is now 5. Treatment by RFA should always be weighed against the option of partial liver resection and possible (neoadjuvant) chemotherapy. RFA should therefore preferably be carried out in a centre with expertise in the field of liver surgery
Boellaard R, Oyen WJ, Hoekstra CJ, Hoekstra OS, Visser EP, Willemsen AT, Arends B, Verzijlbergen FJ, Zijlstra J, Paans AM, Comans EF, Pruim J. The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials. European journal of nuclear medicine and molecular imaging 2008; 35(12):2320-2333.
Abstract: INTRODUCTION: Several studies have shown the usefulness of positron emission tomography (PET) quantification using standardised uptake values (SUV) for diagnosis and staging, prognosis and response monitoring. Many factors affect SUV, such as patient preparation procedures, scan acquisition, image reconstruction and data analysis settings, and the variability in methodology across centres prohibits exchange of SUV data. Therefore, standardisation of 2-[(18)F] fluoro-2-deoxy-D-glucose (FDG) PET whole body procedures is required in multi-centre trials. METHODS: A protocol for standardisation of quantitative FDG whole body PET studies in the Netherlands (NL) was defined. This protocol is based on standardisation of: (1) patient preparation; (2) matching of scan statistics by prescribing dosage as function of patient weight, scan time per bed position, percentage of bed overlap and image acquisition mode (2D or 3D); (3) matching of image resolution by prescribing reconstruction settings for each type of scanner; (4) matching of data analysis procedure by defining volume of interest methods and SUV calculations and; (5) finally, a multi-centre QC procedure is defined using a 20-cm diameter phantom for verification of scanner calibration and the NEMA NU 2 2001 Image Quality phantom for verification of activity concentration recoveries (i.e., verification of image resolution and reconstruction convergence). DISCUSSION: This paper describes a protocol for standardization of quantitative FDG whole body multi-centre PET studies. CONCLUSION: The protocol was successfully implemented in the Netherlands and has been approved by the Netherlands Society of Nuclear Medicine
Boersma L, Wijffels M, Wever E, Morady F, Oral H. PV antrum isolation by phased bipolar-unipolar RF ablation with a circular multi-electrode catheter. Heart Rhythm 2008;(Suppl).
Boersma L, Wijffels M, Morady F, Oral H. PV antrum isolation by phased bipolar-unipolar RF ablation with a circular multi-electrode catheter. Boston AF symposium 2008.
Boersma L, Wijffels M, Wever E, Oral H. PV antrum isolation by phased bipolar-unipolar RF ablation with a circular multi-electrode catheter. Netherlands Heart Journal 2008.
Boersma L, Scharf C, Kanagaratnam P, Davies W, Peters N, Fyn S, Rowland E, Grace A, Morady F, Oral H. Netherlands Heart Journal 2008.
Boersma LV, Wijffels MC, Oral H, Wever EF, Morady F. Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. Heart Rhythm 2008; 5(12):1635-1642.
Abstract: BACKGROUND: Pulmonary vein (PV) isolation for ablation of atrial fibrillation (AF) remains a complex and lengthy procedure. OBJECTIVE: The purpose of this study was to evaluate the feasibility and safety of a novel multielectrode catheter that delivers duty-cycled bipolar and unipolar radiofrequency (RF) energy. METHODS: Patients eligible for catheter ablation of paroxysmal AF after screening with magnetic resonance imaging and transesophageal echocardiography were included in the study. A decapolar (3-mm electrode, 3-mm spacing, 25-mm diameter), circular, over-the-wire mapping and ablation catheter was deployed in the antrum of each PV. Ablation was performed with 60-second, 60 degrees C applications of duty-cycled bipolar/unipolar RF in a 4:1 ratio simultaneously at all selected electrode pairs until local activity was no longer observed. At 6 months, 7-day Holter monitoring was performed to determine freedom from AF without use of antiarrhythmic drugs. RESULTS: In 98 patients (mean age 59 +/- 9 years), the PV ablation catheter was used for ablation of 369 veins (20 common left antra). All targeted veins (100%) were isolated as confirmed by the absence of potentials in the ostium either by PV ablation catheter or Lasso mapping. Mean number of RF applications was 27 +/- 7, total procedural time 84 +/- 29 minutes, and fluoroscopy time 18 +/- 8 minutes. Follow-up after 6 months without antiarrhythmic drugs showed freedom from AF in 83% of patients. No procedure-related complications were observed. CONCLUSION: PV isolation by duty-cycled bipolar/unipolar low-power RF energy through a circular, decapolar catheter can be achieved safely and efficiently, with good efficacy at 6 months
Boersma LVA. The editorial by Dr. Kistler on the use of the Multi-Electrode Ablation. Heart Rhythm 2008; 5(12):e2-e3.
Boersma LVA, Wijffels MCE, Wever EFD, Oral H, Morady F. PV antrum ablation for PAF by duty-cycled bipolar/unipolar RF energy through a novel circular decapolar catheter. European Heart Journal 2008; 29(Suppl 1):409.
Boersma LVA, Wijffels MC, Wever EFD, Oral H, Morady F. Clinical efficacy of PV antrum ablation for AF by duty-cycled RF energy thorough a novel circumlinear decapolar catheter. Heart Rhythm 2008; 5(Suppl):S19.
Boersma LVA. Cardiale resynchronisatie. In: van der Wall EE, van de Werf F, Zijlstra F, editors. Cardiologie. Houten: Bohn Stafleu van Loghum, 2008: 229-235.
Boersma LVA, Scharf C, Davies W, Kanagaratnam P, Paul V, Rowland E, Grace A, Fyn S, Oral H, Morady F. Multi-electrode ablation with duty-cycled low power bipolar/uniplolar RF energy for chronic AF. European Heart Journal 2008; 29(Suppl 1):410.
Boezeman E. 33. Inhibition of cortical laser evoked potentials by transcutaneous electrical nerve stimulation. Clinical Neurophysiology 2008; 119(3):e37.
Bogte A, Bredenoord AJ, Smout AJ. Diagnostic yield of oesophageal pH monitoring in patients with chronic unexplained cough. Scandinavian Journal of Gastroenterology 2008; 43(1):13-19.
Bollen TL, van Santvoort HC, Besselink MG, van Leeuwen MS, Horvath KD, Freeny PC, Gooszen HG, Dutch Acute Pancreatitis Study Group. The Atlanta Classification of acute pancreatitis revisited. British Journal of Surgery 2008; 95(1):6-21.
Abstract: BACKGROUND: In a complex disease such as acute pancreatitis, correct terminology and clear definitions are important. The clinically based Atlanta Classification was formulated in 1992, but in recent years it has been increasingly criticized. No formal evaluation of the use of the Atlanta definitions in the literature has ever been performed. METHODS: A Medline literature search sought studies published after 1993. Guidelines, review articles and their cross-references were reviewed to assess whether the Atlanta or alternative definitions were used. RESULTS: A total of 447 articles was assessed, including 12 guidelines and 82 reviews. Alternative definitions of predicted severity of acute pancreatitis, actual severity and organ failure were used in more than half of the studies. There was a large variation in the interpretation of the Atlanta definitions of local complications, especially relating to the content of peripancreatic collections. CONCLUSION: The Atlanta definitions for acute pancreatitis are often used inappropriately, and alternative definitions are frequently applied. Such lack of consensus illustrates the need for a revision of the Atlanta Classification. Copyright (c) 2007 British Journal of Surgery Society Ltd
Boomsma MF, van der Linden ASA, van Heesewijk JPM. Diagnose in beeld (337). Een zuigeling met een bomberende fontanel. Nederlands Tijdschrift voor Geneeskunde 2008; 152(1):58.
Bos WJW, van der Waal RIF. Kippenvel in de nek, oksels en liezen. Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(3):100.
Botta L, Sonker U, Heijmen RH. Diffuse atherosclerosis of thoracic aorta involving supraaortic and coronary arteries: single-stage surgical revascularization. Thoracic & Cardiovascular Surgeon 2008; 56(8):490-492.
Botta L, Yilmaz A, Schepens M. Streptococcidal infection of the aortic arch: aggressive evolution managed by homograft replacement. Acta Cardiologica 2008; 63(1):85-86.
Botta L, van Putte B, Sonker U, van Boven WJ. Successful surgical management of late coronary sequelae in a young woman with Kawasaki disease. Thoracic & Cardiovascular Surgeon 2008; 56(3):182-184.
Botta L, Bruins P, van Muiswinkel KW, D'Andrea A, Di Bartolomeo R, Yilmaz A. Intraoperative endobronchial tube displacement requiring unplanned extracorporeal circulation support. Journal of extra-corporeal technology 2008; 40(2):135-137.
Abstract: We describe the adoption of extracorporeal circulation (ECC) as temporary pulmonary support in a patient operated on for a broncho-pleural fistula. Complex thoracic surgical procedures can require one-lung ventilation with double-lumen or selective bronchial tubes. Intraoperative tube displacement can cause severe desaturation and hypoxia, finally resulting in severe cerebral or multiorgan damages. Cardiopulmonary bypass, being able to temporarily take over the gas exchange function of the lung, is the only chance to support pulmonary function in cases such as this one. We suggest performing complex thoracic surgical procedures in centers with the availability and experience of ECC techniques
Bouman HJ, van Werkum JW, Postma S, Elsenburg EHAM, ten Berg JM, Hackeng CM. Cangrelor enhances P2Y12 inhibition and decreases interindividual variability in the magnitude of residual platelet reactivity. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):80.
Bouman HJ, van Werkum JW, Hackeng CM, Verheugt FW, ten Berg JM. The importance of anticoagulant agents in measuring platelet aggregation in clopidogrel and aspirin treated patients. Journal of Thrombosis & Haemostasis 2008; 6(6):1040-1042.
Bowles EC, Hillenius JM, Biesma DH, Kortbeek LM, de Jongh BM. Postnataal verworven oculaire toxoplasmose bij een volwassen vrouw. Nederlands Tijdschrift voor Geneeskunde 2008; 152:B57.
Braak SJ, van Strijen MJ, van Leersum M, van Es HW, van Heesewijk JPM. Effective Dose during Needle interventions: Real-Time 3D Fluoroscopy Guidance versus CT-Fluoroscopy. Radiological Society of North America 94th Scientific Assembly and Annual Meeting 30 November- 5 December 2008 Chicago USA 2008.
Braak SJ, van Strijen MJ, van Leersum M, van Es HW, van Heesewijk JPM. Considerable reduction of the effective dose during needle interventions: real-time 3D-fluoroscopy guidance versus CT-fluoroscopy. Radiologendagen 2008 October 9 & 10 2008 Rotterdam The Netherlands 2008.
Braak SJ, van Strijen MJ, van Leersum M, van Es HW, van Heesewijk JPM. Dose during Needle interventions: Real-Time 3D Fluoroscopy Guidance versus CT (-fluoroscopy). 20th International Conference of Society for Medical Innovation and Technology August 28-30 2008 Vienna Austria 2008.
Braak SJ, van Strijen MJ, van Leersum M, van Es HW, van Heesewijk JPM. Real-Time 3D-fluoroscopy Guidance during Needle Interventions: Results of the first 85 patients. Radiologendagen 2008 October 9 & 10 2008 Rotterdam The Netherlands 2008.
Braak SJ, van Strijen MJ, van Leersum M, van Es HW, van Heesewijk JPM. Real-Time 3D-fluoroscopy Guidance during Needle Interventions: Results of the first 61 patients. 20th International Conference of Society for Medical Innovation and Technology August 28-30 2008 Vienna Austria 2008.
Braam RL, Walhout RJ, Jaarsma W, van Es HW, Rensing BJ. An unexpected finding in a patient with haematuria. Netherlands Heart Journal 2008; 16(4):137, 146.
Braam RL, van Uum SH, Lenders JW, Thien T. Bromide as marker for drug adherence in hypertensive patients. British Journal of Clinical Pharmacology 2008; 65(5):733-736.
Abstract: WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Insufficient drug adherence is an important reason for inadequate blood pressure control. Currently, methods that measure drug adherence objectively are lacking. Objective methods are needed to help improve blood pressure control and outcome in hypertensive patients. WHAT THIS STUDY ADDS: Potassium bromide added to antihypertensive drugs can be used to monitor drug adherence in individual patients. However, although this method is objective, it is rather time-, cost- and work-consuming. AIMS Adherence to antihypertensive medication is essential for adequate long-term control of blood pressure (BP). This study investigated different methods of measuring adherence in hypertensive patients. METHODS: Patients were included if BP was insufficiently controlled on monotherapy. After a placebo period patients were treated with trandolapril 2 mg/verapamil SR 180 mg (TV). BP was determined using a mercury sphygmomanometer and ambulatory BP monitoring. Adherence was measured by capsule counting, electronic registration of pill-box openings and by measuring serum bromide concentrations. Potassium bromide was added to each TV capsule. RESULTS: Thirty patients participated in the study. Treatment with TV significantly lowered office BP and ambulatory BP. Results for electronic monitoring and adherence based on bromide measurements were comparable. Adherence was slightly higher when assessed by capsule counting. CONCLUSIONS: Measuring serum bromide concentrations may be suitable for assessment of adherence to drug therapy giving comparable results to electronic monitoring. Using capsule counting, electronic monitoring and measurement of bromide concentrations, nonadherent patients were identified
Brantjes HM, Niers LEM, Renardel de Lavalette PAWA, van Loon D, Ruven HJT. Cyanose bij een pasgeborene. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):94.
Bredenoord AJ, Smout AJ. Refractory gastrooesophageal reflux disease. European Journal of Gastroenterology & Hepatology 2008; 20(3):217-223.
Bredenoord AJ, Draaisma WA, Weusten BLAM, Gooszen HG, Smout AJPM. Mechanisms of acid, weakly acidic and gas reflux after anti-reflux surgery. Gut 2008; 57(2):161-166.
Bredenoord AJ, Smout AJ. Esophageal motility testing: impedance-based transit measurement and high-resolution manometry. Gastroenterology Clinics of North America 2008; 37(4):775-791.
Abstract: Esophageal function tests are widely used, not only to obtain insight into esophageal physiology and pathophysiology in a research setting, but also to diagnose esophageal motor disorders in patients with symptoms such as dysphagia and chest pain. While esophageal function testing has long been considered almost synonymous with manometry, recently new techniques such as impedance measurement and high-resolution manometry have emerged. With impedance monitoring the transit of a bolus through the esophagus can be studied without the use of ionizing radiation. High-resolution manometry offers a highly detailed and comprehensive view of esophageal pressure patterns. Multichannel high resolution manometry with color plotting facilitates positioning of the catheter and interpretation of the tracings. In this article the development, clinical usefulness, and indications of these new tests are discussed
Bredenoord AJ, Smout AJPM. Therapieresistentie van gastro-oesofageale refluxklachten: zure reflux, niet-zure reflux of geen reflux. Nederlands Tijdschrift voor Geneeskunde 2008; 152(47):2548-2552.
Bredenoord AJ, Onaca MG, van Ramshorst B, Biesma DH. Sigmoïdcarcinoom als langetermijncomplicatie na ureterosigmoïdostomie. Nederlands Tijdschrift voor Geneeskunde 2008; 152(4):213-215.
Bredenoord AJ. Impedance-pH monitoring: new standard for measuring gastro-oesophageal reflux. Neurogastroenterology & Motility 2008; 20(5):434-439.
Bredenoord AJ, Smout AJ. High-resolution manometry. Digestive & Liver Disease 2008; 40(3):174-181.
Abstract: Recently, high-resolution oesophageal manometry was added to the armamentarium of researchers and gastroenterologists. Current studies suggest that the yield of high-resolution oesophageal manometry is higher than that of conventional pull-through manometry and is at least comparable to that of sleeve sensor manometry. Probably the most important advantage of solid-state high-resolution manometry is that it makes oesophageal manometry faster and easier to perform. Topographic plotting of high-resolution manometry signals facilitates their interpretation. It is concluded that high-resolution manometry is a promising technique for the evaluation of oesophageal motor function. Further studies will have to determine whether high-resolution manometry is superior to conventional manometry in the diagnostic work-up of patients with oesophageal symptoms
Breugem CC, Mink van der Molen AB. What is 'Pierre Robin sequence'? Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS 2008; [Epub ahead of print].
Abstract: Different nosology has hampered our understanding of patients with Robin sequence. Defining this disorder correctly has important consequences for physicians and parents. While reviewing treatment options for Robin sequence we were surprised to see how often different definitions were used to describe this condition. This prompted us to perform a review into the current understanding when diagnosing and defining this disorder. At our Annual Dutch Cleft Palate Meeting a questionnaire was given to all those attending requesting them to summarise characteristics needed for a definition of 'Robin sequence'. Sixty-six questionnaires were returned, demonstrating 29 different descriptions. Our study demonstrates that there is widespread confusion in the Netherlands defining Robin sequence. This lack of uniformity in the definition hampers the comparison of outcome studies. The treatment of patients with Robin sequence often involves multidisciplinary involvement, making it crucial to have one common definition. We suggest using the description originally summarised by Pierre Robin consisting of micrognathia, glossoptosis and airway compromise. Once the diagnosis of Robin sequence is made other adjuncts such as an associated cleft palate, syndrome or feeding problems could be added to the description
Breunis WB, van Mirre E, Bruin M, Geissler J, de Boer M, Peters M, Roos D, de Haas M, Koene HR, Kuijpers TW. Copy number variation of the activating FCGR2C gene predisposes to idiopathic thrombocytopenic purpura. Blood 2008; 111(3):1029-1038.
Abstract: Gene copy number variation (CNV) and single nucleotide polymorphisms (SNPs) count as important sources for interindividual differences, including differential responsiveness to infection or predisposition to autoimmune disease as a result of unbalanced immunity. By developing an FCGR-specific multiplex ligation-dependent probe amplification assay, we were able to study a notoriously complex and highly homologous region in the human genome and demonstrate extensive variation in the FCGR2 and FCGR3 gene clusters, including previously unrecognized CNV. As indicated by the prevalence of an open reading frame of FCGR2C, Fcgamma receptor (FcgammaR) type IIc is expressed in 18% of healthy individuals and is strongly associated with the hematological autoimmune disease idiopathic thrombocytopenic purpura (ITP) (present in 34.4% of ITP patients; OR 2.4 (1.3-4.5), P < .009). FcgammaRIIc acts as an activating IgG receptor that exerts antibody-mediated cellular cytotoxicity by immune cells. Therefore, we propose that the activating FCGR2C-ORF genotype predisposes to ITP by altering the balance of activating and inhibitory FcgammaR on immune cells
Bruggink AH, van Oosterhout MF, de Jonge N, Gmelig-Meyling FH, de Weger RA. TNFalpha in patients with end-stage heart failure on medical therapy or supported by a left ventricular assist device. Transplant Immunology 2008; 19(1):64-68.
Abstract: BACKGROUND: In the heart elevated levels of TNFalpha can cause lethal heart failure, like Dilated Cardiomyopathy (DCM). The level of TNFalpha production is in part determined by promoter gene polymorphisms. We investigated whether the TNFalpha promoter gene polymorphism is in this way involved in the outcome of end-stage heart failure and predicts whether patients require left ventricular assist device (LVAD) support or can be kept on medical therapy (MT)while awaiting heart transplantation (HTx). As most patients in this study received a heart transplant, the role of the TNFalpha polymorphisms in transplant rejection was studied as well. METHODS AND RESULTS: In twenty nine patients with DCM, 35 patients with Ischemic Heart Disease (IHD; both on MT), 26 patients on LVAD support and 61 cardiac transplant donors TNFalpha plasma level was detected by EASIA. In both patients groups high levels of TNFalpha plasma levels was observed however, in patients supported by LVAD this increase was much higher compared to patients on MT. Furthermore, this increase seems to be associated with the TNF 1 allele ('G' at position -308) instead of the TNF2 allele (A at position -308). The promoter polymorphisms at positions -238, -244 and -308 were observed by polymerase chain reaction and sequencing. Polymorphism at positions -238, -244 and -308 did not show any relevant differences between the groups. However, at position -308, a trend of a higher incidence of the TNF2 allele (an "A" at position -308) in DCM patients compared to donors was shown. The distribution of the TNF1 and TNF2 alleles was not different in patients on medical therapy compared to the patients supported by a LVAD. No association was found between patients' TNFalpha promoter gene polymorphism and rejection. However, patients that received a donor heart with the TNF2 allele developed more rejection episodes, compared to patients that received a donor heart with the TNF1 allele. CONCLUSION: TNFalpha levels are high in patients with end-stage heart failure on MT, but even higher in patients on LVAD support. These high TNFalpha plasma levels however, are not correlated with the TNF2 allele but seems to be associated with the TNF1 allele. Furthermore, in HTx the donor TNFalpha gene seem to play a more important role in severity of acute rejection than that of the patient
Brugts MP, Luermans JGLM, Lentjes EGWM, van Trooyen - van Vrouwenerff NJ, van der Horst FAL, Slee PHTJ, Janssen JAMJL. Heterophilic antibodies may be a cause of falsely low total IGF-I levels. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;53-54.
Bruins Slot MH, van der Heijden GJ, Rutten FH, van der Spoel OP, Mast EG, Bredero AC, Doevendans PA, Glatz JF, Hoes AW. Heart-type Fatty acid-binding protein in Acute Myocardial infarction Evaluation (FAME): background and design of a diagnostic study in primary care. BMC Cardiovascular Disorders 2008; 8:8.
Abstract: BACKGROUND: Currently used biomarkers for cardiac ischemia are elevated in blood plasma after a delay of several hours and therefore unable to detect acute coronary syndrome (ACS) in a very early stage. General practitioners (GPs), however, are often confronted with patients suspected of ACS within hours after onset of complaints. This ongoing study aims to evaluate the added diagnostic value beyond clinical assessment for a rapid bedside test for heart-type fatty-acid binding protein (H-FABP), a biomarker that is detectable as soon as one hour after onset of ischemia. METHODS: Participating GPs perform a blinded H-FABP rapid bedside test (Cardiodetect) in patients with symptoms suggestive of ACS such as chest pain or discomfort at rest. All patients, whether referred to hospital or not, undergo electrocardiography (ECG) and venapunction for a plasma troponin test within 12-36 hours after onset of complaints. A final diagnosis will be established by an expert panel consisting of two cardiologists and one general practitioner (blinded to the H-FABP test result), using all available patient information, also including signs and symptoms. The added diagnostic value of the H-FABP test beyond history taking and physical examination will be determined with receiver operating characteristic curves derived from multivariate regression analysis. CONCLUSION: Reasons for presenting the design of our study include the prevention of publication bias and unacknowledged alterations in the study aim, design or data-analysis. To our knowledge this study is the first to assess the diagnostic value of H-FABP outside a hospital-setting. Several previous hospital-based studies showed the potential value of H-FABP in diagnosing ACS. Up to now however it is unclear whether these results are equally promising when the test is used in primary care. The first results are expected in the end of 2008
Cannata-Andia JB, Fernandez-Martin JL, Zoccali C, London GM, Locatelli F, Ketteler M, Ferreira A, Covic A, Floege J, Gorriz JL, Rutkowski B, Ferreira A, Memmos DE, Verbeelen D, Tielemans C, Teplan V, Bos WJ, Nagy J, Kramar R, Goldsmith DJ, Martin PY, Wuethrich RP, Pavlovic D, Benedik M. Current Management of Secondary Hyperparathyroidism: a Multicenter Observational Study (COSMOS). Journal of Nephrology 2008; 21(3):290-298.
Abstract: Protocol synopsis - Title: Current Management of Secondary Hyperparathyroidism: a Multicentre Observational Study (COSMOS). Study aims: To survey bone mineral disturbances in the hemodialysis (HD) population in Europe and current clinical practice in Europe for the prevention, diagnosis and treatment of secondary hyperparathyroidism (SHPT) in HD patients. Primary objectives: First, to estimate the prevalence of Kidney Disease Outcomes Quality Initiative (K/DOQI) guideline achievement in a representative sample of European hemodialysis subjects. As part of this objective, we will investigate the prevalence of achievement by type of dialysis, type of center and time on dialysis (less than or greater than 1 year). Among new dialysis subjects (less than 1 year), we will evaluate prevalence of K/DOQI target achievement until the end of the study. The study will run for 3 years. Second, to estimate the association of bone mineral markers (parathyroid hormone [PTH], calcium [Ca], serum phosphorus [P] and calcium phosphate product [CaxP]) classified by achievement of K/DOQI targets with mortality and overall cardiovascular hospitalization. Third, to characterize the longitudinal changes in bone mineral markers. As part of this objective, we will describe the patterns and predictors of bone mineral markers and achievement, with K/DOQI targets, using repeated measurements on individuals over time. Secondary objectives: First, To estimate the association of bone mineral markers (PTH, Ca, P and CaxP) classified by achievement of K/DOQI targets with specific cardiovascular outcomes, parathyroidectomy, manifest bone disease (including incidence of symptomatic bone fractures), hospitalizations and vascular access. Second, to evaluate the additional value of albumin and hemoglobin levels in conjunction with bone mineral markers in the prediction of mortality and clinical events
Canton RF, Scholten DE, Marsh G, de Jong PC, van den Berg M. Inhibition of human placental aromatase activity by hydroxylated polybrominated diphenyl ethers (OH-PBDEs). Toxicology & Applied Pharmacology 2008; 227(1):68-75.
Abstract: Polybrominated diphenyl ethers (PBDEs) are widely used as flame retardants in many different polymers, resins and substrates. Due to their widespread production and use, their high binding affinity to particles, and their lipophilic properties, several PBDE congeners can bioaccumulate in the environment. As a result, PBDEs and their hydroxylated metabolites (OH-PBDEs) have been detected in humans and various wildlife samples, such as birds, seals, and whales. Furthermore, certain OH-PBDEs and their methoxylated derivatives (MeO-PBDEs) are natural products in the marine environment. Recently, our laboratory focused on the possible effects on steroidogenesis of PBDEs and OH-PBDEs, e.g. in the human adrenocortical carcinoma (H295R) cell line indicating that some OH-PBDEs can significantly influence steroidogenic enzymes like CYP19 (aromatase) and CYP17. In the present study, human placental microsomes have been used to study the possible interaction of twenty two OH-PBDEs and MeO-PBDEs with aromatase, the enzyme that mediates the conversion of androgens into estrogens. All OH-PBDE derivates showed significant inhibition of placental aromatase activity with IC(50) values in the low micromolar range, while the MeO-PBDEs did not have any effect on this enzyme activity. Enzyme kinetics studies indicated that two OH-PBDEs, 5-hydroxy-2,2',4,4'-tetrabromodiphenyl ether (5-OH-BDE47) and 6-hydroxy-2,2',4,4'-tetrabromodiphenyl ether (6-OH-BDE47), had a mixed-type inhibition of aromatase activity with apparent K(i)/K(i)' of 7.68/0,02 muM and 5.01/0.04 muM respectively. For comparison, some structurally related compounds, a dihydroxylated polybrominated biphenyl, which is a natural product (2,2'-dihyroxy-3,3',5,5'-tetrabromobiphenyl (2,2'-diOH-BB80)) and its non-bromo derivative were also included in the study. Again inhibition of aromatase activity could be measured, but their potency was significantly less than those observed for the OH-PBDEs. These results show that a wide range of OH-PBDEs have the potential to disturb steroidogenesis and indicate a potential mechanism of action of these brominated flame retardant derivatives as endocrine disruptors in humans and wildlife
Carbonnelle S, Bernard A, Doyle IR, Grutters JC, Francaux M. Fractional exhaled NO and serum pneumoproteins after swimming in a chlorinated pool. Medicine and science in sports and exercise 2008; 40(8):1472-1476.
Abstract: PURPOSE: The purpose of this study was to examine whether a swimming session performed in a pool sanitized with chlorine-based agents induces lung inflammation, modifies lung epithelium permeability, and alters lung function. METHODS: Eleven volunteers performed two standardized swimming sessions: one in a nonchlorinated indoor swimming pool and the other one in a chlorinated indoor pool. Lung inflammation was assessed by fractional exhaled nitric oxide (FE(NO)). Changes in lung epithelium permeability were estimated by measuring the surfactant-associated proteins Type A and Type B (SP-A and SP-B), the Clara cell protein (CC16), and the Krebs von den Lungen-6 protein (KL-6). Lung function tests were also performed. All measurements were carried out in basal conditions, after training completion and 3 h postexercise. Nitrogen trichloride (NCl3), the most concentrated gas derived from pool water chlorination, was measured in each pool during the swimming sessions. RESULTS: NCl3 ranged from 160 to 280 microg x m(-3) in the air of the chlorinated pool and was undetectable in the nonchlorinated one. Lung function was affected neither by the exercise session nor by the type of sanitation. Serum pneumoproteins were unchanged excepted SP-A which decreased by 8% after exercise in the chlorinated pool (P < 0.05). FE(NO) increased by 34% (P < 0.05) after exercise in the nonchlorinated pool, whereas it was unaffected in the chlorinated one. CONCLUSIONS: At concentrations lower than 300 microg x m(-3), NCl3 in an indoor chlorinated pool, does not produce short-term changes in lung function or in epithelial permeability. The unchanged FE(NO) found in the chlorinated pool after exercise suggests that chlorination might inhibit NO-induced vasodilation observed during exercise
Cobelens PM, van Putte BP, Kavelaars A, Heijnen CJ, Kesecioglu J. Increased lung inflammation caused by low-pressure ventilation and lung ischemia-reperfusion injury. Intensive Care Medicine 2008; 34(suppl 1):S52.
Cobelens PM, van Putte BP, van der Kaaij N, Lachmann B, Kavelaars A, Heijnen CJ, Kesecioglu J. Exogenous surfactant treatment alters inflammatory mediators during lung ischemia-reperfusion injury. Intensive Care Medicine 2008; 34(suppl 1):S50.
Colli A, Verhoye JP, Heijmen R, Strauch JT, Hyde JAJ, Pagano D, Antunes M, Koertke H, Ohri SK, Bail DHL, Leprince P, van Straten BHM, Gherli T. Antithrombotic therapy after bioprosthetic aortic valve replacement: ACTION Registry survey results. European Journal of Cardio-Thoracic Surgery 2008; 33(4):531-536.
Abstract: Aims: A variety of antithrombotic regimens have been described for the early postoperative period after bioprosthetic aortic valve replacement (AVR). This study reviews antithrombotic practice for patients undergoing bioprosthetic AVR with or without coronary artery bypass graft (CABG) amongst the centers participating in the ACTION (Anticoagulation Treatment Influence on Postoperative Patients) Registry. Methods and results: An antithrombotic therapy questionnaire was answered by the 49 centers participating in the ACTION Registry located in Europe, Middle East, Canada and Asia. The 43% of centers prescribe vitamin K antagonist (VKA), 20% prescribe VKA and acetyl salicylic acid (ASA), 33% prescribe only ASA and 4% do not prescribe any therapy after bioprosthetic AVR. For patients undergoing bioprosthetic AVR and CABG 39% of the centers prescribe VKA and ASA, 37% prescribe VKA and 24% prescribe ASA. After the first three postoperative months following bioprosthetic AVR, 61% of the centers prescribe only ASA, while 39% do not prescribe any therapy. Patients with bioprosthetic AVR and CABG receive ASA in 90% centers, in 2% centers VKA and ASA, and 8% centers do not prescribe any antithrombotic. Conclusion: This study demonstrates that, despite guidelines published by several professional societies, medical practice for the prevention of thrombotic events early after bioprosthetic AVR varies widely among cardiac surgical centers
Compter A, van der Wouw P, Schonewille W, Vos JA, Algra A, Lo T, Mali W, Moll F, Kappelle L. VAST: Vertebral Artery Stenting Trial. Protocol for a randomised safety and feasibility trial. Trials 2008; 9:65.
Abstract: ABSTRACT: BACKGROUND: Twenty to 30 percent of all transient ischaemic attacks and ischaemic strokes involve tissue supplied by the vertebrobasilar circulation. Atherosclerotic stenosis >/= 50% in the vertebral artery accounts for vertebrobasilar stroke in at least one third of the patients. The risk of recurrent vascular events in patients with vertebral stenosis is uncertain and revascularisation of vertebral stenosis is rarely performed. Observational studies have suggested that the risk of subsequent stroke or death in patients with vertebrobasilar ischaemic events is comparable with that in patients with carotid territory events. Treatment of vertebral stenosis by percutaneous transluminal angioplasty has been introduced as an attractive treatment option. The safety and benefit of stenting of symptomatic vertebral stenosis as compared with best medical therapy alone remains to be elucidated in a randomised clinical trial. STUDY OBJECTIVES: The primary aim of the Vertebral Artery Stenting Trial (VAST) is to assess whether stenting for symptomatic vertebral artery stenosis >/= 50% is feasible and safe. A secondary aim is to assess the rate of new vascular events in the territory of the vertebrobasilar arteries in patients with symptomatic vertebral stenosis >/= 50% on best medical therapy with or without stenting. DESIGN: This is a randomised, open clinical trial, comparing best medical treatment with or without vertebral artery stenting in patients with recently symptomatic vertebral artery stenosis >/= 50%. The trial will include a total of 180 patients with transient ischaemic attack or non-disabling ischaemic stroke attributed to vertebral artery stenosis >/= 50%. The primary outcome is any stroke, vascular death, or non-fatal myocardial infarction within 30 days after start of treatment. Secondary outcome measures include any stroke or vascular death during follow-up and the degree of (re)stenosis after one year. DISCUSSION: Improvements both in imaging of the vertebral artery and in endovascular techniques have created new opportunities for the treatment of symptomatic vertebral artery stenosis. This trial will assess the feasibility and safety of stenting for symptomatic vertebral artery stenosis and will provide sufficient data to inform a conclusive randomised trial testing the benefit of this treatment strategy. The VAST is supported by the Netherlands Heart Foundation (2007B045; ISRCTN29597900)
Covic A, Fernandez-Martin JL, Floege J, Ketteler M, London G, Locatelli F, Gorriz JL, Rutkowski B, Ferreira A, Memmos D, Teplan V, Tielemans C, Verbeelen D, Nagy J, Bos WJ, Kramar R, Goldsmith D, Pavlovic D, Wüthrich RP, Martin PY, Benedik M, Cannata-Andia JB, COSMOS group. Treatment Of Secondary Hyperparathyroidism And K-DOQI Guidelines Achievement. COSMOS, A European Observational Study. ASN 2008.
Cserni G, Bianchi S, Vezzosi V, van Diest P, van Deurzen C, Sejben I, Regitnig P, Asslaber M, Foschini MP, Sapino A, Castellano I, Callagy G, Arkoumani E, Kulka J, Wells CA. Variations in sentinel node isolated tumour cells/micrometastasis and non-sentinel node involvement rates according to different interpretations of the TNM definitions. European Journal of Cancer 2008; 44(15):2185-2191.
Abstract: Breast cancers with nodal isolated tumour cells (ITC) and micrometastases are categorised as node-negative and node-positive, respectively, in the tumour node metastasis (TNM) classification. Two recently published interpretations of the TNM definitions were applied to cases of low-volume sentinel lymph node (SLN) involvement and their corresponding non-SLNs for reclassification as micrometastasis or ITC. Of the 517 cases reviewed, 82 had ITC and 435 had micrometastasis on the basis of one classification, and the number of ITC increased to 207 with 310 micrometastases on the basis of the other. Approximately 24% of the cases were discordantly categorised. The rates of non-SLN metastases associated with SLN ITCs were 8.5% and 13.5%, respectively. Although the second interpretation of low-volume nodal stage categories has better reproducibility, it may underestimate the rate of non-SLN involvement. The TNM definitions of low-volume nodal metastases need to be better formulated and supplemented with visual information in the form of multiple sample images
Custers IM, Flierman P, Maas P, Cox T, van Dessel HJHM, Gerards MH, Mochtar MH, Janssen CAH, van der Veen F, Moll BWJ. A multicenter randomised controlled trial assessing the effectiveness of immobilisation versus immediate mobilisation after intrauterine insemination. Human Reproduction 2008; 23(Suppl 1):i25.
Daemen J, Kuck KH, Macaya C, Legrand V, Vrolix M, Carrie D, Sheiban, I, Suttorp MJ, Vranckx P, Rademaker T, Goedhart D, Schuijer M, Wittebols K, Macours N, Stoll HP, Serruys PW, ARTS-II,Investigators. Multivessel Coronary Revascularization in Patients With and Without Diabetes Mellitus 3-Year Follow-Up of the ARTS-II (Arterial Revascularization Therapies Study-Part II) Trial. Journal of the American College of Cardiology 2008; 52(24):1957-1967.
Abstract: OBJECTIVES: The purpose of this study was to assess the 3-year outcome of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) using sirolimus-eluting stents (SES) in patients who had multivessel coronary artery disease with and without diabetes mellitus. BACKGROUND: The optimal method of revascularization in diabetic patients remains in dispute. METHODS: The ARTS-II (Arterial Revascularization Therapies Study-Part II) trial is a single-arm study (n = 607) that included 159 diabetic patients treated with SES whose 3-year clinical outcome was compared with that of the historical diabetic and nondiabetic arms of the randomized ARTS-I trial (n = 1,205, including 96 diabetic patients in the CABG arm and 112 in the PCI arm). RESULTS: At 3 years, among nondiabetic patients, the incidence of the primary composite of death, CVA, myocardial infarction (MI), and repeat revascularization (major adverse cardiac and cerebrovascular events [MACCE]), was significantly lower in ARTS-II than in ARTS-I PCI (adjusted odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.26 to 0.64) and similar to ARTS-I CABG. The ARTS-II patients were at significantly lower risk for death, CVA, and MI as compared with both the ARTS-I PCI (adjusted OR: 0.55; 95% CI: 0.34 to 0.91) and ARTS-I CABG patients (adjusted OR: 0.56; 95% CI: 0.35 to 0.92). Among diabetic patients, the incidence of MACCE in ARTS-II was similar to that of both PCI and CABG in ARTS-I. Conversely, the incidence of death, CVA, and MI was significantly lower in ARTS-II than in ARTS-I PCI (adjusted OR: 0.67; 95% CI: 0.27 to 1.65) and was similar to that of ARTS-I CABG. CONCLUSIONS: At 3 years, PCI using SES for patients with multivessel coronary artery disease seems to be safer and more efficacious than PCI using bare-metal stents, irrespective of the diabetic status of the patient. Hence, PCI using SES appears to be a valuable alternative to CABG for both diabetic and nondiabetic patients
Dang L, Boersma L, Oral H, Morady F, Candinas R, Scharf C. Multi-electrode catheters using low energy phased radiofrequency for ablation of chronic atrial fibrillation. Europace 2008; 10:i184.
de Boer AH, Wissink J, Hagedoorn P, Heskamp I, de Kruijf W, Bunder R, Zanen P, Munnik P, van Rijn C, Frijlink HW. In vitro performance testing of the novel Medspray wet aerosol inhaler based on the principle of Rayleigh break-up. Pharmaceutical Research 2008; 25(5):1186-1192.
Abstract: PURPOSE: A new inhaler (Medspray) for pulmonary drug delivery based on the principle of Rayleigh break-up has been tested with three different spray nozzles (1.5; 2.0 and 2.5 mum) using aqueous 0.1% (w/w) salbutamol and 0.9% (w/w) sodium chloride solutions. MATERIALS AND METHODS: Particle size distributions in the aerosol were measured with the principles of time of flight (APS) and laser diffraction (LDA). RESULTS: The Medspray inhaler exhibits a highly constant droplet size distribution in the aerosol during dose emission. Droplets on the basis of Rayleigh break-up theory are monodisperse, but due to some coalescence the aerosols from the Medspray inhaler are slightly polydisperse. Mass median aerodynamic diameters at 60 l.min(-1) from APS are 1.42; 1.32 and 1.27 times the theoretical droplet diameters (TD's) and median laser diffraction diameters are 1.29; 1.14 and 1.05 times TD for 1.5; 2.0 and 2.5 mum nozzles (TD: 2.84; 3.78 and 4.73 mum respectively). CONCLUSIONS: The narrow particle size distribution in the aerosol from the Medspray is highly reproducible for the range of flow rates from 30 to 60 l.min(-1). The mass median aerodynamic droplet diameter can be well controlled within the size range from 4 to 6 mum at 60 l.min(-1)
de Borst GJ, Zanen P, de Vries JP, van de Pavoordt ED, Ackerstaff RG, Moll FL. Durability of surgery for restenosis after carotid endarterectomy. Journal of Vascular Surgery 2008; 47(2):363-371.
Abstract: BACKGROUND: The role of carotid surgery for the management of restenosis after carotid endarterectomy (CEA) is challenged by carotid artery stenting (CAS). We reviewed redo CEA in a consecutive series of patients to determine the safety, durability, and long-term benefit associated with repeat surgical treatment for restenosis. METHODS: A consecutive series of 73 redo procedures in 72 patients (57% men) with a mean age 66 years (range, 49-81 years) was analyzed. The mean interval between prior CEA and redo CEA was 53 months (range, 8-192 months). Operative indications included symptomatic restenosis in 28 patients (38%). A patch angioplasty was performed in 62 patients (85%). The main outcome measures included perioperative and late stroke and death, and the development of secondary restenosis. RESULTS: There were no perioperative deaths or strokes. During a mean follow-up of 52 months (range, 12-144 months), the Kaplan-Meier cumulative survival was 85% at 5 years. At 5 years, the cumulative rate of freedom from all strokes was 98%, and the freedom from ipsilateral stroke was 100%. After secondary procedures, re-recurrent stenosis >/=50% occurred in 10 patients (13.7%). The cumulative freedom from re-restenosis (>/=50%) was 85% at 5 years. Five patients (7%) received tertiary carotid reconstructions. CONCLUSION: Repeat CEA for recurrent stenosis can be performed safely with excellent long-term protection from stroke. These data provide a standard against which the results of CAS can be compared
de Borst GJ, Meijer R, Lo RH, Vosmeer HW, Ackerstaff RG, Moll FL. Effect of carotid angioplasty and stenting on duplex velocity measurements in a porcine model. Journal of Endovascular Therapy 2008; 15(6):672-679.
Abstract: Purpose: To evaluate if there are any differences in duplex ultrasound velocity measurements between native and stented carotid arteries using duplex ultrasound in an animal model. Methods: The common carotid artery of 5 pigs was exposed bilaterally (10 arteries). Diameters and velocities were measured by ultrasound in the proximal, mid, and distal native artery at the intended site of stent implantation. Measurements were repeated after bilateral stent placement (Wallstent versus Precise) under angiographic control. Outcomes of native versus stented arteries and Wallstent versus Precise were statistically compared. Results: Angiographic measurements matched well with duplex-measured diameters. The mean proximal stent diameter (3.5+/-0.5 mm) was significantly smaller than the native proximal artery diameter (4.2+/-0.4 mm, p = 0.004), mostly due to narrowing of the Wallstent diameter to 3.2+/-0.5 mm (p = 0.009). Proximal, mid, and distal segments of the Wallstents were narrower than those of the Precise stent, and associated peak systolic velocities (PSV) were higher at the 3 locations versus the Precise stent, although the differences were not statistically significant. Wallstent PSVs were higher than in the native artery at the proximal, mid, and distal segments, respectively; again, the differences were not statistically significant. Conclusion: Stent placement caused anatomical and hemodynamic alterations. Narrowings and associated increased velocities were noted. Such alterations, however, were stent-type dependent and did not justify a general approach to new velocity criteria indiscriminately applied to all stents
de Brauw M, Wittich P, Smits A, Hofman P. De liesbreuk en galblaas express : de zorg vanuit patiëntenperspectief georganiseerd. Best Practices Zorg 2008; 1(2):18-21.
de Brauw M, van Wagensveld B. De marktmeester laat het liggen : patiënten de dupe van onwerkbare DBC's voor bariatrische chirurgie. Medisch Contact 2008; 63(36):14641467.
de Graauw N, Carpay HA, Slooff WB. The paracondylar process: an unusual and treatable cause of posttraumatic headache. Spine 2008; 33(9):E283-E286.
Abstract: STUDY DESIGN: Case report and clinical discussion. OBJECTIVE: To describe a case of persistent posttraumatic headache associated with the presence of a paracondylar process, and the result of surgical resection of this osseous anomaly. SUMMARY OF BACKGROUND DATA: The paracondylar process is one of a group of congenital anomalies of the craniovertebral junction. This heterogenic group is classified in the literature based on embryologic origin. In general, the paracondylar process has little or no clinical significance. There are some cases reporting symptoms related to the paracondylar process, especially after head trauma. Few report improvement after surgery. METHODS: We describe a case of a 21-year-old woman who was seen for severe persistent daily headache and neck pain after minor head- and neck injury. Clinical examination revealed tenderness and an abnormal structure in the right cervico-occipital region by palpation. A conventional radiograph and computed tomography scan of the craniovertebral junction revealed a paracondylar process on the right side of the skull. RESULTS: After resection of the paracondylar process, headache and cervical pain were substantially reduced. CONCLUSION: This case underlines the possible clinical significance of congenital anomalies of the craniovertebral junction. They can become symptomatic after head trauma, causing headache and/or cervical pain. Surgical extirpation can relieve these symptoms
de Groot AC, Tupker RA. De plaats van tacrolimus en pimecrolimus in de behandeling van constitutioneel eczeem. Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(3):82-86.
de Groot E, van Leuven SI, Duivenvoorden R, Meuwese MC, Akdim F, Bots ML, Kastelein JJ. Measurement of carotid intima-media thickness to assess progression and regression of atherosclerosis. Nature clinical practice Cardiovascular medicine 2008; 5(5):280-288.
Abstract: Imaging modalities have been developed to assess atherosclerosis in vivo in the arterial wall because large clinical end-point studies are time-consuming and costly. Historically, in-hospital angiography and Doppler ultrasonography have been used to assess atherosclerosis development. Investigations of the arterial lumen are, however, increasingly being replaced by modalities that can measure changes in the arterial wall itself-intravascular ultrasonography, MRI and multislice CT. The fact that intravascular ultrasonography is invasive, CT involves substantial radiation exposure and requires contrast agents, and that MRI is time-consuming and technically challenging all limit the widespread use of these techniques. Moreover, all modalities have high associated costs. B-mode ultrasonographic imaging of the carotid arterial walls occupies a unique position in atherosclerosis research. This method enables sensitive, reproducible and noninvasive assessment of intima-media thickness (IMT) as a continuous variable. Epidemiological and clinical trial evidence as well as digitization and standardization have made carotid IMT a validated and accepted marker for generalized atherosclerosis burden and vascular disease risk. Here we describe the application of carotid IMT measurements as a tool in risk evaluation of individuals and in studies of atherosclerosis progression and regression
de Groot H, Kruyt JM, van der Zee JS, Tupker RA, Hoekstra MO. Effectiviteit en veiligheid van sublinguale immunotherapie met graspollentabletten bij seizoensgebonden allergische rinoconjunctivitis. Nederlands Tijdschrift voor Allergie 2008; 8(2):65-68.
de Haan J, Geers T, Berghout A. Gitelman syndrome in pregnancy. International Journal of Gynecology & Obstetrics 2008; 103(1):69-71.
de Jong-Pleij EA, Bilardo CM, Pistorius LR, Tromp E, Ribbert LS. The Frontal-Fetal-Face vertical at 16-34 weeks' gestation: A reference line for fetal profile anomalies with 3D ultrasound. Ultrasound in Obstetrics & Gynecology 2008; 32(3):363.
de Jong-Pleij EA, Ribbert LS, Manten GT, Tromp E, Bilardo CM. The maxilla-nasion-mandibula angle at 16-34 weeks' gestation: An objective 3D ultrasound measurement for the anteroposterior relationship of the jaws. Ultrasound in Obstetrics & Gynecology 2008; 32(3):353-354.
de Jong PA, Nagtegaal M, de Jong H, Grutters JC, van den Bosch JM, Karthaus V, van Es HW, van Heesewijk JP, Braak S, van Ginneken B, Prokop M. A computed tomography (CT) score for sarcoidosis: observer variation and correlation with lung function. ECR 2008 2008.
de Kok JB, van der Meer J, Stroobants AK, Henskens YMC, Ponjee GAE, van Wijk EM, Hackeng CM, Scharnhorst V, Mulder AB. Veneuze trombo-embolie: wanneer zijn laboratoriumtesten voor trombofilie zinvol? Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(4):228-232.
de Korte FI, van Werkum JW, Vijverberg PL, ten Berg JM. Late Coronary Stent Thrombosis Complicating Urologic Surgery. European Urology 2008; 54(1):221-225.
Abstract: The current practice of withdrawing antiplatelet therapy before major surgery has been challenged by the introduction of coronary drug-eluting stents (DESs) since evidence is accumulating that a DES requires dual antiplatelet therapy for at least a year. The authors present a case demonstrating difficulty in decision-making when it comes to appropriate perioperative antiplatelet therapy. The patient experienced a coronary stent thrombosis possibly due to discontinuation of clopidogrel prior to urologic surgery
de Ruiter SC, Draaisma WA, Wiezer MJ, Borel Rinkes IHM. Is partiële hepatectomie nog nodig wanneer colorectale levermetastasen na neoadjuvante chemotherapie verdwenen zijn? Een casus en literatuurstudie. Nederlands Tijdschrift voor Heelkunde 2008; 17:68-71.
de Voer RM, van der Klis FR, Engels CW, Rijkers GT, Sanders EA, Berbers GA. Development of a fluorescent bead-based multiplex immunoassay to determine the IgG subclass responses to meningococcal serogroup A and C polysaccharides. Clinical and vaccine immunology : CVI 2008; 15(8):1188-1193.
Abstract: A fluorescent multiplex particle-based flow cytometric immunoassay (MIA) for the detection of serum IgG and two IgG subclasses, IgG1 and IgG2, specific for Neisseria meningitidis serogroup A (MenA) and C (MenC) polysaccharides (PS) was developed. The assay was performed in three separate duplex assays, one for the detection of IgG to MenA and MenC PS, another for IgG1 to MenA and MenC PS and a third for IgG2 to MenA and MenC PS. Next, the three separate duplex assays were combined and analyzed as a hexaplex assay. No interference between mono-, du- and hexaplex assays was observed and the assay was found to have low intra- and interassay variation (< 9.0% and < 27%, respectively). Comparison of the meningococcal subclass MIA to the in-house enzyme-linked inmmunosorbent assays (ELISA) showed a good correlation (R=>0.85) for each of the subclasses. We conclude that the hexaplex meningococcal subclass MIA is an easy and specific assay for the determination of anti-MenA and anti-MenC PS subclass IgG, requiring minimal amounts for serum, to study IgG subclass responses towards vaccines
de Vos AM, Prokop M, Roos CJ, Meijs MF, van der Schouw YT, Rutten A, Gorter PM, Cramer MJ, Doevendans PA, Rensing BJ, Bartelink ML, Velthuis BK, Mosterd A, Bots ML. Peri-coronary epicardial adipose tissue is related to cardiovascular risk factors and coronary artery calcification in post-menopausal women. European Heart Journal 2008; 29(6):777-783.
Abstract: Aims To determine whether peri-coronary epicardial adipose tissue (EAT) is associated with vascular risk factors and coronary atherosclerosis. Methods and results In this study, 573 healthy post-menopausal women underwent a cardiac CT scan to assess coronary calcification. Peri-coronary EAT thickness was measured in the areas of right coronary artery (RCA), left anterior descending (LAD) artery, and left circumflex (LCX) coronary artery. Average EAT thickness was 16.5 +/- 4.3 mm (range 5.9-34.6) in the RCA area, 6.4 +/- 2.2 mm (range 2.0-14.0) in the LAD area, and 10.8 +/- 3.0 mm (range 2.8-29.1) in the LCX area. Overall average thickness was 11.2 +/- 2.2 mm (range 5.4-19.1). EAT was positively related to age (P = 0.002). In age-adjusted linear regression models, EAT was positively related to weight (P< 0.001), waist circumference (P< 0.001), waist-to-hip ratio (P< 0.001), body mass index (P< 0.001), glucose (P< 0.001), triglycerides (P = 0.001), use of anti-hypertensive drugs (P = 0.007), and systolic blood pressure (P = 0.034), and inversely to HDL cholesterol (P = 0.005). In multivariable models, age, weight, waist circumference, smoking, and glucose were the main determinants of EAT. EAT showed a graded relation with coronary calcification (P = 0.026). Conclusion EAT is strongly related to vascular risk factors and coronary calcification. Our findings support the hypothesis that EAT affects coronary atherosclerosis and possibly coronary risk
de Vos AM, Rutten A, van de Zaag-Loonen HJ, Bots ML, Dikkers R, Buiskool RA, Mali WP, Lubbers DD, Mosterd A, Prokop M, Rensing BJ, Cramer MJ, van Es HW, Moll FL, van de Pavoordt ED, Doevendans PA, Velthuis BK, Mackaay AJ, Zijlstra F, Oudkerk M. Non-invasive cardiac assessment in high risk patients (The GROUND study): rationale, objectives and design of a multi-center randomized controlled clinical trial. Trials 2008; 9:49.
Abstract: ABSTRACT: BACKGROUND: Peripheral arterial disease (PAD) is a common disease associated with a considerably increased risk of future cardiovascular events and most of these patients will die from coronary artery disease (CAD). Screening for silent CAD has become an option with recent non-invasive developments in CT (computed tomography)-angiography and MR (magnetic resonance) stress testing. Screening in combination with more aggressive treatment may improve prognosis. Therefore we propose to study whether a cardiac imaging algorithm, using non-invasive imaging techniques followed by treatment will reduce the risk of cardiovascular disease in PAD patients free from cardiac symptoms. DESIGN: The GROUND study is designed as a prospective, multi-center, randomized clinical trial. Patients with peripheral arterial disease, but without symptomatic cardiac disease will be asked to participate. All patients receive a proper risk factor management before randomization. Half of the recruited patients will enter the 'control group' and only undergo CT calcium scoring. The other half of the recruited patients (index group) will undergo the non invasive cardiac imaging algorithm followed by evidence-based treatment. First, patients are submitted to CT calcium scoring and CT angiography. Patients with a left main (or equivalent) coronary artery stenosis of > 50% on CT will be referred to a cardiologist without further imaging. All other patients in this group will undergo dobutamine stress magnetic resonance (DSMR) testing. Patients with a DSMR positive for ischemia will also be referred to a cardiologist. These patients are candidates for conventional coronary angiography and cardiac interventions (coronary artery bypass grafting (CABG) or percutaneous cardiac interventions (PCI)), if indicated. All participants of the trial will enter a 5 year follow up period for the occurrence of cardiovascular events. Sequential interim analysis will take place. Based on sample size calculations about 1200 patients are needed to detect a 24% reduction in primary outcome. IMPLICATIONS: The GROUND study will provide insight into the question whether non-invasive cardiac imaging reduces the risk of cardiovascular events in patients with peripheral arterial disease, but without symptoms of coronary artery disease. TRIAL REGISTRATION: Clinicaltrials.gov NCT00189111
de Vries JP, Versteeg D, Dol E, Hoefer I, de Kleijn D, van Dongen E. Arterial surgery is associated with toll-like receptor 2 and 4 decrease which is influenced by smoking. Interactive Cardiovascular and Thoracic Surgery 2008; 7(suppl 1):S58.
de Vries JPPM, Pasterkamp G, Moll FL. Histological and biochemical (carotid) plaque analysis in relation to clinical outcome in vascular patients. In: Greenhalgh RM, editor. Vascular and endovascular consensus update. Biba publishing, 2008.
Deer T, Krames ES, Hassenbusch S, Burton A, Caraway D, Dupen S, Eisenach J, Erdeck M, Grigsby E, Kim P, Levy R, McDowell G, Mekhail N, Panchal S, Prager J, Rauck R, Saulino M, Sitzman T, Staats P, Stanton-Hicks M, Stearns L, Willis KD, Witt W, Follett K, Huntoon M, Liem L, Rathmell J, Wallace M, Buchser E, Cousins M, Donck AV. Future Directions for Intrathecal Pain Management: A Review and Update From the Interdisciplinary Polyanalgesic Consensus Conference 2007. Neuromodulation 2008; 11(2):92-97.
Deer T, Krames ES, Hassenbusch S, Burton A, Caraway D, Dupen S, Eisenach J, Erdeck M, Grigsby E, Kim P, Levy R, McDowell G, Mekhail N, Panchal S, Prager J, Rauck R, Saulino M, Sitzman T, Staats P, Stanton-Hicks M, Stearns L, Willis KD, Witt W, Follett K, Huntoon M, Liem L, Rathmell J, Wallace M, Buchser E, Cousins M, Donck AV. Management of Intrathecal Catheter-Tip Inflammatory Masses: An Updated 2007 Consensus Statement From An Expert Panel. Neuromodulation 2008; 11(2):77-91.
Deng R, Lu M, Korteweg C, Gao Z, McNutt MA, Ye J, Zhang T, Gu J. Distinctly different expression of cytokines and chemokines in the lungs of two H5N1 avian influenza patients. Journal of Pathology 2008; 216(3):328-336.
Abstract: The pathogenesis of human H5N1 influenza remains poorly understood and controversial. 'Cytokine storm' has been hypothesized to be the main cause of the severity of this disease. However, the significance of this hypothesis has been called into question by a recent report, which demonstrates that inhibition of the cytokine response did not protect against lethal H5N1 influenza infection in mice. Here we showed discrepant findings in two adult H5N1 autopsies and a fetus obtained at autopsy which also raise doubt about this hypothesis. Antigens of 10 cytokines/chemokines which were found to be significantly elevated in previous H5N1-infected patients and in vitro experiments, and mRNA of eight of these, were absent from the lungs of a pregnant woman and her fetus. In contrast, antigens of seven cytokines/chemokines and mRNA of six of these were found to be increased in the lungs of a male autopsy. The cells expressing these cytokines and chemokines were identified as type II pneumocytes, bronchial epithelial cells, macrophages and vascular endothelial cells. Levels of cytokines and chemokines in the serum of the male case were also significantly higher than those of infectious (infection other than by H5N1) and non-infectious controls. In comparison with results from our previous study, it appeared that the male case had increased cytokine/chemokine expression but reduced viral load, while the pregnant female had diminished cytokine/chemokine expression but a significantly increased viral load in the lungs. These disparate findings in these two cases suggest that 'cytokine storm' alone could not be a sufficient explanation for the severe lung injury of this newly emerging disease
Dentener MA, Creutzberg EC, Pennings HJ, Rijkers GT, Mercken E, Wouters EF. Effect of infliximab on local and systemic inflammation in chronic obstructive pulmonary disease: a pilot study. Respiration 2008; 76(3):275-282.
Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) with cachexia is characterized by inflammation reflected by increased levels of tumor necrosis factor-alpha (TNF-alpha). Objectives: In this study, infliximab, an anti-TNF-alpha antibody, was evaluated for its effects on systemic (plasma) and local (exhaled breath condensate, EBC) inflammation in cachectic patients with COPD. Also, baseline levels of new inflammatory markers were compared to control subjects. METHODS: Sixteen cachectic patients with moderate to severe COPD were examined for inflammatory status at baseline and compared to 25 control subjects. Patients were randomized (1:1) to receive infliximab (5 mg/kg) or placebo at weeks 0, 2 and 6. Patients were evaluated at weeks 8 and 12 and followed through week 26. RESULTS: EBC analysis revealed increased levels of several novel inflammatory markers, including macrophage migration inhibitory factor, IL-12, RANTES and sICAM-1, in patients with COPD compared to controls. EBC levels of inflammatory markers were unchanged in patients receiving infliximab. In addition, systemic levels of acute-phase proteins (C-reactive protein, fibrinogen and lipopolysaccharide-binding protein), IL-6 and soluble TNF receptor (sTNFR) 55 had not changed at weeks 8 or 12. Small increases in circulating levels of sTNFR75, myeloperoxidase and Clara cell protein 16 were seen at week 8, but not at week 12. CONCLUSIONS: In this small study, infliximab did not produce an observable decrease in local inflammation in cachectic patients with COPD and had minor effects on systemic inflammation. The detection of new inflammatory markers in EBC can help to further characterize local inflammatory processes in COPD
Derksen JW, Gisbertz SS, Velema E, Hellings W, de Kleijn DP, Vink A, de Vries JP, Moll FL, Pasterkamp G. Abstract 6061: Femoral Atherosclerotic Plaque Characteristics are Independent Predictors for Major Systemic Cardiovascular Events. Circulation 2008; 118(Suppl):S1054.
Derksen WJ, Gisbertz SS, Pasterkamp G, de Vries JP, Moll FL. Remote superficial femoral artery endarterectomy. Journal of Cardiovascular Surgery 2008; 49(2):193-198.
Abstract: Remote superficial femoral artery endarterectomy (RSFAE) is an effective minimal invasive treatment modality of TransAtlantic Inter-Society Consensus (TASC) C and D atherosclerotic lesions of the superficial femoral artery (SFA) with at least equal patency rates as supragenicular synthetic bypass grafts. This procedure is performed through a single femoral arteriotomy and the intima core in the SFA is dissected using the Vollmar ring and the Mollring cutter devices, respectively. The intimal core distally of the transaction zone is secured by an expandable polytetrafluoroethylene-covered nitinol stent. By its minimal invasive character, RSFAE will lead to lower rate of postoperative complications and shorter hospital stay compared to supragenicular bypass graft surgery. Additional advantage in comparison with percutaneous procedures is the opportunity of open endarterectomy of the common femoral and/or profunda artery. Synthetic material will be avoided and vein will be preserved for possible future cardiovascular surgery. Reobstruction of the SFA tends to have, in contrast to bypass grafts, less severe symptoms due to preservation of collaterals and thereby lower amputation rate. Achilles heel of RSFAE is the relatively high percentage of first year restenosis due to neointimal hyperplasia. Strict follow-up at 3, 6 and 12 months is advised including duplex ultrasound. In case of symptomatic or asymptomatic hemodynamic restenosis (>50%) percutaneous transluminal angioplasty must be performed to improve long-term patency. The majority of reobstructions can be treated by endovascular means. New endovascular techniques, like balloon cryoplasty or drug eluting stents have to be studied in combination with RSFAE to optimize its technique and improve patency rates
Devos SA, Constandt L, Tupker RA, Noz KC, Lucker GP, Bruynzeel DP, Schuttelaar ML, Kruyswijk MR, van Zuuren EJ, Vink J, Coenraads PJ, Kiemeney LA, van der Valk PG. Relevance of positive patch-test reactions to fragrance mix. Dermatitis 2008; 19(1):43-47.
Abstract: BACKGROUND: Fragrances are an important cause of allergic contact dermatitis. We presume that the traditional fragrance mix (FM) detects 70 to 80% of fragrance-allergic patients. FM has an irritant potential. Weak positive reactions may have a greater chance of being irrelevant than strong reactions. OBJECTIVE: To improve the appraisal of FM patch-test reactions, we studied the relevance of reactions of different strength. We also studied the predictive value of the following on the relevance of the initial FM patch-test results: patch-test results of a repeated FM test; results of patch tests with balsam of Peru, colophony, and ingredients of the mix; and (history of) atopic dermatitis. METHODS: One hundred thirty-eight patients who had doubtful positive (?+) or positive (+ to +++) reactions were included in the study. We determined relevance by history taking, location and course of the dermatitis, and additional patch testing. Patients were retested with FM and with each ingredient separately. RESULTS: The relevance of reactions to FM increases with the strength of the reactions. Predictors of relevance are the results of retesting with FM, the results of tests with the ingredients, and a history and/or present symptoms of atopic dermatitis. CONCLUSION: Retesting with FM and its ingredients may add to the benefit of patch testing
Dewilde W, ten Berg JM, Scholzel B. An anomalous right coronary artery originating from the mid portion of the left descending artery. International Journal of Cardiology 2008; [Epub ahead of print].
Abstract: We report on a 76-year old patient in which a very rare coronary anomaly was found
Dewilde W, Kurvers M, Jaarsma W. Aorta-atrial fistula, a rare complication of prosthetic valve endocarditis. European Journal of Echocardiography 2008; 9(3):419-421.
Abstract: A 51-year-old male with a history of a mechanical Carbomedics aortic and mitral valve replacement in 2003 and several re-operations because of endocarditis of the mitral valve in 2007 presented with heart failure 68 days after operation. Echocardiography confirmed the presence of a fistulous connection between the aorta and the left atrium. Because of the multiple surgical interventions and high operative risk, an initial conservative medical treatment was initiated and the clinical course was uneventful to this date
Dewilde W, Boersma L, Delanote J, Pollet P, Scholzel B, Wever E, Vandekerckhove Y. Symptomatic arrhythmogenic right ventricular dysplasia/cardiomyopathy. A two-centre retrospective study of 15 symptomatic ARVD/C cases and focus on the diagnostic value of MRI in symptomatic ARVD/C patients. Acta Cardiologica 2008; 63(2):181-189.
Abstract: BACKGROUND: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is associated with sudden death in the young and heart failure in the elderly. The purpose is to review 15 symptomatic ARVD/C cases and also to describe the use of MRI as a diagnostic tool. METHODS AND RESULTS: This retrospective analysis includes 15 patients who presented with symptomatic ARVD/C. Diagnosis was made upon the criteria proposed by the European Society of Cardiology. In all patients there was at least 1 or more abnormal MRI sign. The most frequent abnormalities were focal right ventricular dyskinesia (64%), MRI fatty infiltration (57%) and right ventricular aneurysm or right ventricular outflow tract microaneurysms (57%). Presenting symptoms were palpitations (60%), atypical chest pain (46%), syncope (40%), and aborted sudden death (26%). T-inversion in V2-V3 was seen in 60% of the patients. Thirteen patients (86%) received an ICD implantation. The mean follow-up per patient was 89 months, which resulted in a total follow-up of 111 patient years. Forty-six percent of the patients with an ICD had one or more appropriate shocks during follow-up. To this date no mortality was reported. CONCLUSION: This retrospective study demonstrates that symptomatic ARVD/C patients typically present with symptoms of syncope, palpitations in association with ventricular tachycardia and in a quarter of the cases with aborted sudden cardiac death. The electrocardiogram mostly shows T inversion in the anterior leads. All patients were treated with medication and ICD-implantation or VT-ablation. The malignant nature of the disease in symptomatic ARVD/C patients is stressed by the fact that the presenting symptom is aborted sudden death in a quarter of the cases and the fact that nearly half of the patients with an ICD had at least one appropriate shock during follow-up. There was an abnormal MRI in 100% of the investigated patients. In 20% (3 patients), the MRI criterion (right ventricular dilatation/bulging/aneurysm) was necessary to meet the ESC criteria. Therefore it has become an important tool in our diagnostic work-up when ARVD/C is suspected. We also suggest a change in the diagnostic criteria of ARVD/C. Whereas fatty infiltration seen on RV biopsy is a major criterion, MRI fatty infiltration is not regarded as a diagnostic criterion by the task force to this day
Dewilde W, Jaarsma W, Scholzel B. Pseudo aneurysm due to dehiscence of a Bentall conduit resulting in systolic aortic compression. International Journal of Cardiology 2008; 130(1):e50-e51.
Dirksen MT, Vink MA, Suttorp MJ, Tijssen JG, Patterson MS, Slagboom T, Kiemeneij F, Laarman GJ, Paclitaxel-Eluting Stent versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation (PASSION) investigators. Two year follow-up after primary PCI with a paclitaxel-eluting stent versus a bare-metal stent for acute ST-elevation myocardial infarction (the PASSION trial): a follow-up study. EuroIntervention 2008; 4(1):64-70.
Abstract: AIMS: This follow-up study was performed to assess the long-term effects of paclitaxel-eluting stents (PES) compared with bare-metal stents (BMS) in patients who had undergone a percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: The PASSION trial randomly assigned 619 patients with STEMI to receive either a PES or BMS. The composite endpoint for the follow-up study was the occurrence of the combination of cardiac death, recurrent myocardial infarction, target lesion revascularisation (TLR) or stent thrombosis at two years. A trend towards a lower rate of the composite endpoint was observed in the PES compared to the BMS group (hazard ratio [HR] 0.70; 95% C.I. 0.45-1.09). This was driven by a reduced TLR in favour of PES (HR 0.60; 95% C.I. 0.34-1.09). Angiographically proven stent thrombosis at two years did not differ significantly between groups (2.1% in the PES group versus 1.4%; HR 1.48; 95% C.I. 0.42-5.23). CONCLUSIONS: PES implantation for STEMI did not significantly improve clinical outcome at two years after the index event, although there was a trend towards a lower rate of target-lesion revascularisation. The rate of stent thrombosis did not differ significantly between groups. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=fulltext&NEWS=n&D=prem&AUTOALERT=28043674%7c5
Disselhoff BC, der Kinderen DJ, Kelder JC, Moll FL. Randomized Clinical Trial Comparing Endovenous Laser Ablation of the Great Saphenous Vein with and without Ligation of the Sapheno-femoral Junction: 2-year Results. European Journal of Vascular & Endovascular Surgery 2008; 36(6):713-718.
Abstract: OBJECTIVE: To evaluate whether ligation of the sapheno-femoral junction (SFJ) improves the 2-year results of endovenous laser ablation (EVA). METHODS: Forty-three symptomatic patients with bilateral varicose veins were studied in which one limb was randomly assigned to receive EVA without SFJ ligation, and the other limb received EVA with SFJ ligation. Recurrence of varicose veins and abolition of great saphenous vein (GSV) reflux on duplex ultrasound imaging, and venous clinical severity score (VCSS) were investigated at 6, 12, and 24 months after treatment. RESULTS: Two-year life table analysis showed freedom from groin varicose vein recurrence in 83% of 43 limbs (95% CI; 67-95%) in the EVA without ligation group and in 87% of 43 limbs (95%; CI 73-97) of limbs in the EVA with ligation group (P=0.47). Thirty-eight (88%) treated GSV segments were ablated completely in the EVA without ligation group and 42 (98%) in the EVA with ligation group (N.S.). Groin recurrence was due to an incompetent SFJ/GSV (9%) and to incompetent tributaries (7%) in the EVA without ligation group and due to neovascularisation (12%) in the EVA with ligation group. The VCSS improved significantly and was comparable in both groups. CONCLUSION: The addition of SFJ ligation to EVA makes no difference to the short-term outcome of varicose veins treatment. Establishing whether SFJ ligation results in a poorer long-term outcome because of neovascularisation needs to be studied in larger populations with longer follow-up. Registration number: ISRCTN60300873 (http://www.controlled-trials.com)
Disselhoff BC, der Kinderen DJ, Kelder JC, Moll FL. Randomized clinical trial comparing endovenous laser with cryostripping for great saphenous varicose veins. British Journal of Surgery 2008; 95(10):1232-1238.
Abstract: BACKGROUND:: The aim of this randomized single-centre trial was to compare the 2-year results of endovenous laser ablation (EVLA) and cryostripping for varicose veins. METHODS:: A total of 120 patients with uncomplicated great saphenous varicose veins were randomized equally to one of the two treatments. Principal outcomes measures were: freedom from recurrent varicose veins on duplex imaging, and improvement in Venous Clinical Severity Score (VCSS) and Aberdeen Varicose Vein Severity Score (AVVSS) 6, 12 and 24 months after treatment. RESULTS:: Life-table analysis showed overall freedom from recurrent incompetence at 2 years in 77 (95 per cent confidence interval (c.i.) 72 to 78) per cent of patients after EVLA and in 66 (95 per cent c.i. 60 to 67) per cent after cryostripping (P = 0.253). VCSS and AVVSS values improved significantly after treatment, but the differences between the treatments were not significant. EVLA provided significantly more favourable results than cryostripping with respect to duration of operation, postprocedural pain, induration and resumption of normal activity. CONCLUSION:: EVLA and cryostripping were similarly effective in patients with varicose veins, but patients favoured EVLA because of less pain and postoperative morbidity, and quicker return to normal activity. Registration number: ISRCTN33832691 (http://www.controlled-trials.com). Copyright (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd
Ehrlich MP, Nienaber CA, Rousseau H, Beregi JP, Piquet P, Schepens M, Bartoli JM, Schillinger M, Fattori R. Short-term conversion to open surgery after endovascular stent-grafting of the thoracic aorta: The Talent thoracic registry. Journal of Thoracic and Cardiovascular Surgery 2008; 135(6):1322-1326.
Abstract: ObjectivePredictors of late conversion to conventional surgery after thoracic endovascular stent-graft placement are currently unknown. MethodsWe analyzed data from 422 of 457 consecutive patients who underwent endovascular thoracic repair with the Medtronic Talent thoracic stent-graft (Medtronic/AVE, Santa Rosa, Calif). Of these, 16 patients (3.8%) required late conversion to open surgery during a median follow-up interval of 17 months (range 7-33 months). Six of these patients had undergone previous aortic surgery, 3 patients had previous cardiac surgery, and 5 patients had Marfan syndrome. In patients with late conversion, indications for primary stent-graft placement were dissection in 10 patients, degenerative aneurysm in 5 patients, and penetrating ulcer in 1 patient. ResultsBy multivariable Cox analysis, Marfan syndrome (adjusted hazard ratio 9.97, P = .008), type I endoleak (adjusted hazard ratio 3.99, P = .012), the use of more than 1 stent-graft (adjusted hazard ratio 3.89, P = .018), and procedural complications (adjusted hazard ratio 17.50, P = .003) were independent predictors of late conversion. ConclusionEndovascular treatment for thoracic aortic disease with the Talent stent-graft is associated with a relatively low rate of late conversion to conventional surgery. Better results may be achieved by excluding patients with Marfan syndrome for such a procedure and early aggressive treatment of early type I endoleaks
El Harchaoui K, Akdim F, Stroes ES, Trip MD, Kastelein JJ. Current and future pharmacologic options for the management of patients unable to achieve low-density lipoprotein-cholesterol goals with statins. American journal of cardiovascular drugs : drugs, devices, and other interventions 2008; 8(4):233-242.
Abstract: Low-density lipoprotein-cholesterol (LDL-C) lowering is the mainstay of the current treatment guidelines in the management of cardiovascular risk. HMG-CoA reductase inhibitors (statins) are currently the most effective LDL-C-lowering drugs. However, a substantial number of patients do not reach treatment targets with statins. Therefore, an unmet medical need exists for lipid-lowering drugs with novel mechanisms of action to reach the recommended cholesterol target levels, either by monotherapy or combination therapy. Upregulation of the LDL receptor with squalene synthase inhibitors has shown promising results in animal studies but the clinical development of the lead compound lapaquistat (TAK-475) has recently been discontinued. Ezetimibe combined with statins allowed significantly more patients to reach their LDL-C targets. Other inhibitors of intestinal cholesterol absorption such as disodium ascorbyl phytostanol phosphate (FM-VP4) and bile acid transport inhibitors have shown positive results in early development trials, whereas the prospect of acyl coenzyme A: cholesterol acyltransferase inhibition in cardiovascular prevention is dire. Selective inhibition of messenger RNA (mRNA) by antisense oligonucleotides is a new approach to modify cholesterol levels. The inhibition of apolipoprotein B mRNA is in advanced development and mipomersen sodium (ISIS 301012) has shown striking results in phase II studies both as monotherapy as well as in combination with statins
Elsenburg EHAM, van Werkum JW, Topcu Y, Postma S, Kelder JC, ten Berg JM, Hackeng CM. Effects of Diabetes Mellitus on platelet reactivity after dual antiplatelet therapy with aspirin and clopidogrel. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):79-80.
Endeman H, Schelfhout V, Voorn GP, van Velzen-Blad H, Grutters JC, Biesma DH. Clinical features predicting failure of pathogen identification in patients with community acquired pneumonia. Scandinavian Journal of Infectious Diseases 2008; 40(9):715-720.
Abstract: Community acquired pneumonia (CAP) is caused by a variety of microorganisms. By identifying patients at risk for failure of pathogen identification, it is possible to make an early decision on the extent of diagnostic procedures to be performed. This is especially important in patients with severe CAP. The aim of this study was to identify these patients by using clinical and laboratory features. In 201 patients hospitalized for CAP, clinical and laboratory variables were collected. Pathogen identification was performed by culture of sputum and blood, urine antigen tests, polymerase chain reaction of sputum, serological testing and viral culture of the pharynx. In 128 patients a respiratory microorganism was identified. In both univariate and multivariate analysis, failure of pathogen identification was predicted by pre-hospital antibiotic therapy, a medical history of hypertension and a low C-reactive protein. We conclude that patients with pre-hospital antibiotic therapy, a medical history of hypertension and a relatively low C-reactive protein are at risk for failure of pathogen identification. These predictors should be confirmed in a larger population. Invasive testing in high-risk patients with CAP in the presence of these predictors should be considered at an early phase of hospitalization
Endeman H, Herpers BL, de Jong BA, Voorn GP, Grutters JC, van Velzen-Blad H, Biesma DH. Mannose-binding lectin genotypes in susceptibility to community acquired pneumonia. Chest 2008; 134(6):1135-1140.
Abstract: Background Community acquired pneumonia (CAP) is most frequently caused by Streptococcus pneumoniae, Haemophilus influenzae, atypical pathogens and respiratory viruses. Susceptibility to CAP can be increased by single nucleotide polymorphisms (SNPs) within the mannose-binding lectin (MBL) gene. We questioned whether MBL polymorphisms are associated with the susceptibility to and outcome of CAP and its most common pathogens. Methods All adult patients presenting with CAP in a 23-month period were included in this study. Frequencies of SNPs were determined for the promoter X/Y and the three coding SNPs in exon1 (A/0). Six genotypes were constructed representing patients with sufficient and deficient serum levels of MBL. The results of the patients with CAP were compared with controls. Results In 199 patients and 223 controls MBL genotypes were determined. There were no differences in MBL genotype frequencies between patients with CAP in general, pneumonia caused by S. pneumoniae or H. influenzae, and controls. The frequency of sufficient MBL genotypes was non-significantly higher in patients with pneumonia with L. species and M. pneumoniae. In L. species, the sufficient YA/YA genotype was significantly more frequent than in controls (OR 5.43; CI 1.32-22.41; p = 0.02). The frequency of the MBL deficient genotype was significantly higher in patients with viral (co-)infections (OR 2.36: CI 1.06-5.26; p = 0.03) and non-significantly higher in patients with pneumococcal pneumonia and viral (co-)infections. MBL genotypes had no effect on outcome. Conclusions MBL genotypes play a limited role in pneumococcal pneumonia. Sufficient MBL genotypes were more frequently found in a small group of patients with atypical pneumonia, and MBL deficient genotypes were more frequently found in patients with viral (co-)infections
Ferreira A, Fernandez-Martin JL, Floege J, Ketteler M, London G, Locatelli F, Gorriz JL, Rutkowski B, Teplan V, Covic A, Kramar R, Nagy J, Bos WJ, Tielemans C, Verbeelen D, Pavlovic D, Martin PY, Wüthrich R, Benedik M, Goldsmith D, Memos D, Cannata-Andia JB. Are calcifications underdiagnosed in European hemodialysis patients? Results from cosmos. ERA-EDTA 2008.
Fioole B, de Haas RJ, Wicherts DA, Elias SG, Scheffers JM, van Hillegersberg R, van Leeuwen MS, Borel Rinkes IH. Additional value of contrast enhanced intraoperative ultrasound for colorectal liver metastases. European Journal of Radiology 2008; 67(1):169-176.
Abstract: BACKGROUND: Substantial recurrence rates following partial liver resection for colorectal liver metastases (CRM) imply that small metastases remain undetected using intraoperative ultrasound (IOUS). The aim of this study was to evaluate the additional value of contrast enhanced IOUS (CE-IOUS) when compared to preoperative contrast enhanced computed tomography (CE-CT) and IOUS in liver surgery for CRM. METHODS: After obtaining informed consent, 39 consecutive patients with CRM were included prospectively for evaluation. The study population consisted of 26 male and 13 female patients with a median (range) age of 62 (49-83) years. A lesion-per-lesion analysis was performed with histopathological examination as the reference standard after resection and follow-up for unresected lesions. The added value of CE-IOUS in correctly diagnosing malignant lesions was statistically evaluated, using receiver operating characteristic curves. RESULTS: A total of 234 lesions were identified, 137 of which were malignant, according to the reference standard. The addition of CE-IOUS did not improve the diagnostic accuracy when compared to the combination of CE-CT and IOUS (P=0.617). In one of two patients with newly detected lesions on CE-IOUS the extent of resection changed. CONCLUSIONS: The addition of CE-IOUS to preoperative CE-CT and IOUS does not improve the ability to characterize already detected lesions. In a small number of patients it appears to facilitate the detection of new metastatic lesions with implications on surgical strategy
Fox MR, Bredenoord AJ. Oesophageal high-resolution manometry - moving from research into clinical practice. Gut 2008; 57(3):405-423.
Abstract: Manometry measures pressure within the oesophageal lumen and sphincters, and provides an assessment of the neuromuscular activity that dictates function in health and disease. It is performed to investigate the cause of functional dysphagia, unexplained 'non-cardiac' chest pain, and in the pre-operative work-up of patients referred for anti-reflux surgery. Manometric technique has improved in a step-wise fashion from a single pressure channel to the development of high-resolution manometry (HRM) with up to 36 pressure sensors. At the same time, advances in computer processing allow pressure data to be presented in real time as a compact, visually intuitive 'spatiotemporal plot' of oesophageal pressure activity. HRM recordings reveal the complex functional anatomy of the oesophagus and its sphincters. Spatiotemporal plots provide objective measurements of the forces that move food and fluid from the pharynx to the stomach and determine the risk of reflux events. The introduction of commercially available HRM has been followed by rapid uptake of the technique. This review examines whether the current evidence supports the move of HRM from the research setting into clinical practice. It is assessed whether a detailed description of pressure activity identifies clinically relevant oesophageal dysfunction that is missed by conventional investigation increasing diagnostic yield and/or accuracy. The need for a new classification system for oesophageal motor activity based on HRM recordings is discussed. Looking ahead the potential of this technology to guide more effective medical and surgical treatment of oesophageal disease is considered because, ultimately, it is this that will define the success of HRM in clinical practice
Fredrikze A. Gewapend tegen rampen op de IC. Critical care : multidisciplinair vakblad 2008; 5(2):23-24.
Frenken J. Bloedlink: een mondbodembloeding. NVOI bulletin 2008;(oktober):7-8.
Furnee EJ, Draaisma WA, Broeders IA, Smout AJ, Gooszen HG. Surgical reintervention after antireflux surgery for gastroesophageal reflux disease: a prospective cohort study in 130 patients. Archives of Surgery 2008; 143(3):267-274.
Abstract: HYPOTHESIS: Surgical reintervention after antireflux surgery for gastroesophageal reflux disease is required in 3% to 6% of patients. The subjective outcome after reintervention has been reported in several studies, but objective results after these subsequent operations have rarely been published. The purpose of this study was to assess the symptomatic and objective outcomes in patients who underwent subsequent operation because of recurrent reflux symptoms or troublesome dysphagia after primary antireflux surgery. DESIGN: Prospective cohort study. SETTING: University medical center. PATIENTS: Between January 1, 1994, and March 31, 2005, 130 patients (mean [SD] age, 48.4 [14.1] years) undergoing surgical reintervention after antireflux surgery for gastroesophageal reflux disease were prospectively studied. MAIN OUTCOME MEASURES: Symptomatic outcome was determined by questionnaires. Esophageal manometry and 24-hour pH monitoring were performed to assess the objective outcome. RESULTS: A total of 144 reinterventions were performed in 130 patients, for recurrent reflux in 94 patients (65.3%) and for troublesome dysphagia in 50 patients (34.7%). Belsey Mark IV fundoplication through a left-sided thoracotomy was performed in 78 (54.2%) and a subsequent Nissen or partial fundoplication during 66 reinterventions (45.8%), including 16 laparoscopic procedures. After a mean (SD) follow-up of 60.1 (37.2) months, symptoms were absent or significantly improved in 70.3% of patients and esophageal acid exposure was normalized in 70.2% of patients after surgery. Postoperative complications occurred after 14 subsequent operations (9.7%). CONCLUSIONS: Surgical reintervention after antireflux surgery for gastroesophageal reflux disease yielded good symptomatic and objective results in 70% of patients in this prospective cohort study. Since the morbidity of this type of surgery is far from negligible, the expectations should be discussed in detail before additional operation
Gelinck LBS, van der Bijl AE, Visser LG, Huizinga TWJ, van Hogezand RA, Rijkers GT, Kroon FP. Synergistic immunosuppressive effect of anti-TNF combined with methotrexate on antibody responses to the 23 valent pneumococcal polysaccharide vaccine. Vaccine 2008; 26(27-28):3528-3533.
Abstract: Introduction The efficacy of the immune response upon vaccination in patients treated with anti-tumor necrosis factor-alpha (anti-TNF) with or without methotrexate is the subject of debate. We studied the effect of immunosuppressive treatment, including anti-TNF and methotrexate, on the response to pneumococcal polysaccharide (PPS) vaccine.Methods Fifty-two patients treated with immunosuppressives including anti-TNF (anti-TNF group), 41 patients given a similar immunosuppressive regimen without anti-TNF (no anti-TNF group), and 18 healthy controls were vaccinated with a 23 valent PPS vaccine. The percentage of patients treated with methotrexate in the anti-TNF and no anti-TNF group was 65% and 76%, respectively. Antibodies against four of the vaccine antigens (PPS 6B, 9V, 19F and 23F) were measured before and 4 weeks after vaccination. The primary outcome was the response rate, defined as the percentage with a postvaccination titer 0.35á[mu]g/ml in combination with at least a twofold increase in antibody titer. The protection rate was defined as a postvaccination titer >=0.35á[mu]g/ml.Results The use of methotrexate was the strongest predictor of impaired vaccination outcome. Anti-TNF caused an additional immunosuppressive effect in the presence of methotrexate, leading to the lowest response percentages in patients using the combination of these two drugs. The underlying disease, other immunosuppressives such as prednisone or type of anti-TNF agent used did not influence vaccination outcome.Conclusions Patients who were treated with the combination of methotrexate and anti-TNF demonstrated a significantly impaired immune response following pneumococcal polysaccharide vaccination as compared to patients treated with either methotrexate or anti-TNF only or immunosuppressives excluding these two compounds
Gerritse MB, Veersema S, Timmermans A, Brolmann HA. Incorrect position of Essure microinserts 3 months after successful bilateral placement. Fertility & Sterility 2008; 91(3):930.e1-930.e5.
Abstract: OBJECTIVE: To describe incorrect positions of Essure microinserts detected at 3 months' follow-up. DESIGN: Case report. SETTING: Outpatient department of obstetrics and gynecology in a Dutch teaching hospital. PATIENT(S): Initial series of 100 patients who underwent hysteroscopic sterilization using Essure between December 2003 and June 2004. INTERVENTION(S): Hysteroscopic placement of the Essure System, follow-up at 3 months with transvaginal ultrasound (TVU), and hysterosalpingography. MAIN OUTCOME MEASURE(S): Bilateral placement rate, tubal obstruction, and detection of incorrect Essure microinsert localization at follow-up after apparent successful bilateral placement. RESULT(S): Bilateral placement of Essure microinserts in one session was successful in 93 women (93%). In 90 of these women (96.8%), tubal obstruction was proven at follow-up 3 months later. Three incorrect positions of an Essure insert were seen: two expulsions and one perforation into the abdominal cavity. CONCLUSION(S): Incorrect position of Essure microinserts was seen only when the initial placement procedure was difficult. When a placement procedure was difficult or other suboptimal conditions are present during the procedure, we advise performing a TVU or pelvic X-ray in these women 4 weeks after the procedure or after the first vaginal bleeding, instead of waiting for follow-up after 3 months
Gerritsen WBM, van Boven WJP, Driessen AHG, van Dongen HPA, van Loon D, Ruven HJT. Myocardial oxidative stress, and cell injury comparing three different techniques for CABG; a pilot study. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):78-79.
Geuzebroek G, van de Kraats EJ, van Boven WJ, Yilmaz A. Thoracoscopische pulmonaalvenenisolatie voor behandeling van medicamenteus resistent symptomatisch "lone"boezemfibrilleren. Cordiaal 2008; 29(4):112-116.
Geuzebroek GSC, Ballaux PhKEW, van Hemel NM, Kelder JC, Defauw JJAM. Medium-term outcome of different surgical methods to cure atrial fibrillation: is less worse? Interactive Cardiovascular and Thoracic Surgery 2008; 7(2):201-206.
Abstract: Different lesion sets and ablation techniques have been performed. We compared these outcomes in search of the best method. We performed a retrospective analysis of patients who have undergone AF surgery different from the maze III. The surgical lesion sets were pulmonary vein isolation (PVI) alone, left atrial maze (LAM) and bi-atrial maze (BAM) and were made with different ablation techniques. During surgery one patient died due to bleeding of a pulmonary vein. The number of patients in the PVI-, LAM-, BAM-groups was 12, 28 and 26 respectively with freedom from AF at latest follow-up (22.0{+/-}15.6 (3.1-81.2) months) of 33%, 59% and 60% respectively. Atrial flutter occurred less in the BAM-group (4%) than in the left sided procedures (15.4%) (p=0.231). Multivariate analysis demonstrated a higher recurrence of AF for PVI alone (OR 4.42, CL 0.95-20.6, p=0.0583) and a lower recurrence for the 'cut-and-sew' technique (OR 0.13, CL 0.030-0.60, p=0.0084). Left- and bi-atrial maze procedures are equally effective in the suppression of AF, whereas omission of right-sided lesions results in a higher prevalence of atrial flutter. The 'cut-and-sew' technique is superior in terms of freedom from AF compared to bipolar and unipolar radiofrequency. Keywords: Atrial fibrillation; Rhythm surgery; Maze; Arrhythmia
Gisbertz SS, de Vries JPPM, Moll FL. Distal cutting endarterectomy. In: Greenhalgh RM, editor. Vascular and endovascular consensus update. Biba publishing, 2008.
Gisbertz SS, Derksen WJM, Velema E, Hellings WE, de Kleijn DPV, de Vries JPPM, Moll FL, Pasterkamp G. Alcohol use reduces cardiovascular events in patients with peripheral arterial occlusive disease, possibly due to plaque stabilisation. European Heart Journal 2008; 29(Suppl 1):83-84.
Gooszen HC, Besselink MG, van Santvoort HC, Buskens E, Boermeester MA, van Goor H, Nieuwenhuijs VB, Bollen TL, van Ramshorst B, Witteman BJ, Rosman C, Ploeg RJ, Brink MA, Schaapherder AF, Dejong CH, Wahab P, van der Harts E, van Eijck CH, Cuesta MA, Akkermans LM, van der Graaf Y, van Duijn L. PROPATRIA: een zorgvuldig voorbereid en zorgvuldig uitgevoerd onderzoek. Expertise en recht 2008;(4):138-140.
Graven A, Tan E, Morshuis W. Leidt het klinisch pad vanzelfsprekend tot efficiëntere zorg? Cordiaal 2008; 29(5):154-157.
Groenemeijer BE, Bakker A, Slis HW, Waalewijn RA, Heijmen RH. An unexpected finding late after repair of coarctation of the aorta. Netherlands Heart Journal 2008; 16(7-8):260-263.
Abstract: We describe a late complication in a 75-year-old man 50 years after repair of a coarctation of the aorta (CoA). Two years after an aortic valve replacement, mitral valve repair and radiofrequency MAZE the patient presented with dyspnoea and right-sided heart failure, based on a large pseudoaneurysm of the descending aorta, compressing the main bronchus and possibly temporarily the pulmonary arterial system. After sealing the aneurysm with an endovascular stent the patient recovered uneventfully. Recommendations are made for follow-up in patients after repair of CoA. (Neth Heart J 2008;16:260-3.)
Grootenboers MJJH. Regional chemotherapy of the lung : investigations of isolated lung perfusion and selective pulmonary artery perfusion. s.n.: s.l., 2008.
Ref ID: 8942
Grutters JC, Drent M. Sarcoïdose: een update voor de clinicus practicus. Pulmo-Didact 2008; 11(3):1-16.
Grutters JC, van den Bosch JMM. Connective Tissue Disorders. In: Albert RK, Spiro SG, Jett JR, editors. Clinical respiratory medicine. Philadelphia, Pa: Mosby Elsevier, 2008: 713-727.
Guelen I, Mattace-Raso FU, van Popele NM, Westerhof BE, Hofman A, Witteman JC, Bos WJ. Aortic stiffness and the balance between cardiac oxygen supply and demand: the Rotterdam Study. Journal of Hypertension 2008; 26(6):1237-1243.
Abstract: OBJECTIVES: Aortic stiffness is an independent predictor of cardiovascular morbidity and mortality. We investigated whether aortic stiffness, estimated as aortic pulse wave velocity, is associated with decreased perfusion pressure estimated as the cardiac oxygen supply potential. METHODS: Aortic stiffness and aortic pressure waves, reconstructed from finger blood pressure waves, were obtained in 2490 older adults within the framework of the Rotterdam Study, a large population-based study. Cardiac oxygen supply and demand were estimated using pulse wave analysis techniques, and related to aortic stiffness by linear regression analyses after adjustment for age, sex, mean arterial pressure and heart rate. RESULTS: Cardiac oxygen demand, estimated as the Systolic Pressure Time Index and the Rate Pressure Product, increased with increasing aortic stiffness [0.27 mmHg s (95% confidence interval: 0.21; 0.34)] and [42.2 mmHg/min (95% confidence interval: 34.1; 50.3)], respectively. Cardiac oxygen supply potential estimated as the Diastolic Pressure Time Index decreased [-0.70 mmHg s (95% confidence interval: -0.86; -0.54)] with aortic stiffening. Accordingly, the supply/demand ratio Diastolic Pressure Time Index/Systolic Pressure Time Index -1.11 (95% confidence interval: -0.14; -0.009) decreased with increasing aortic stiffness. CONCLUSION: Aortic stiffness is associated with estimates of increased cardiac oxygen demand and a decreased cardiac oxygen supply potential. These results may offer additional explanation for the relation between aortic stiffness and cardiovascular morbidity and mortality.
Guelen I, Westerhof BE, van der Sar GL, van Montfrans GA, Kiemeneij F, Wesseling KH, Bos WJ. Validation of brachial artery pressure reconstruction from finger arterial pressure. Journal of Hypertension 2008; 26(7):1321-1327.
Abstract: OBJECTIVE: Measurement of finger artery pressure with Finapres offers noninvasive continuous blood pressure, which, however, differs from brachial artery pressure. Generalized waveform filtering and level correction may convert the finger artery pressure waveform to a brachial waveform. An upper-arm cuff return-to-flow measurement may be used to calibrate the blood pressure on an individual basis. We tested these corrective methods as implemented in the Finometer device. METHODS: Intrabrachial artery pressure (BAP) and finger artery pressures were recorded simultaneously in 37 cardiac patients, aged 41-83 years, who underwent a cardiac catheterization procedure. Finger artery pressures were compared after waveform filtering and level correction and after an additional return-to-flow calibration. Measurements were performed in supine and sitting positions. Accuracy and precision were considered clinically acceptable if the mean and standard deviation of the return-to-flow intrabrachial artery pressure (reBAP)-BAP differences were smaller than 5 +/- 8 mmHg (Association for the Advancement of Medical Instrumentation requirements). RESULTS: Finger artery systolic, diastolic and mean pressures for the group differed from that of intrabrachial artery pressure by -10 +/- 13, -12 +/- 8 and -16 +/- 8 mmHg, respectively. After waveform filtering and level correction the filtered level corrected arterial pressure differed by -1 +/- 11, -0 +/- 7 and -2 +/- 7 mmHg. After individual calibration, reBAP differed by 3 +/- 8, 4 +/- 6 and 3 +/- 5 mmHg. Comparable results were found in the sitting position but only when the supine return-to-flow calibration was used. CONCLUSION: Reconstruction of intrabrachial artery pressure from finger artery pressure with waveform filtering and level correction reduces the pressure differences substantially, with diastolic and mean within Association for the Advancement of Medical Instrumentation requirements. After one supine return-to-flow calibration, all pressure differences meet the requirements. Return-to-flow calibration should not be repeated in sitting position
Haas FJLM, Schutgens REG, Biesma DH. Improvement of the performance of d-dimer assays in the elderly. Haematologica 2008; 93(Suppl 1):342-343.
Haas FJLM, Schutgens REG, Biesma D. Improving the Efficacy of Non-Radiologic Exclusion of Deep Venous Thrombosis in the Elderly Using the Thrombin Generation Assay. Blood 2008; 112(ASH Annual Meeting Abstracts):3815.
Haas FJLM, Meijer P, Schutgens REG, Biesma DH, Kluft C. Elastase degradation products of fibrinogen and venous thromboembolism. Journal of Thrombosis & Haemostasis 2008; 6(Suppl 1):36.
Haas FJLM, van Wijk EM, Ponjee GAE. De diagnostische waarde van de D-dimeerbepaling. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(4):232-238.
Haas FJLM, Meijer P, Schutgens REG, Biesma DH, Cluft K. Elastase degradation products of fibrinogen and venous thromboembolism. Haematologica 2008; 93(Suppl 1):148.
Hackeng CM, van Werkum JW, Heestermans AACM, Taubert D, Seesing TH, van Beckerath N, Schömig E, Verheugt FWA, ten Berg JM. Impaired bioavailability of clopidogrel in patients with a ST-segment elevation myocardial infarction. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):80-81.
Hackeng CM, van Wijk EM. Heparine-geïnduceerde trombocytopenie: een wolf in schaapskleren. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(4):246-250.
Hagemeijer MC, van Oosterhout MF, van Wichen DF, van Kuik J, Siera-de Koning E, Gmelig Meyling FH, Schipper ME, de Jonge N, de Weger RA. T cells in cardiac allograft vasculopathy are skewed to memory Th-1 cells in the presence of a distinct Th-2 population. American Journal of Transplantation 2008; 8(5):1040-1050.
Abstract: Cardiac allograft vasculopathy (CAV) in heart transplantation (HTx) patients remains the major complication for long-term survival, due to concentric neointima hyperplasia induced by infiltrating mononuclear cells (MNC). Previously, we showed that activated memory T-helper-1 (Th-1) cells are the major component of infiltrating MNC in coronary arteries with CAV. In this study, a more detailed characterization of the MNC in human coronary arteries with CAV (n = 5) was performed and compared to coronary arteries without CAV (n = 5), by investigating MNC markers (CD1a, DRC-1, CD3, CD20, CD27, CD28, CD56, CD68, CD69, FOXP3 and HLA-DR), cytokines (IL-1A, 2, 4, 10, 12B, IFN-gamma, and TGF-beta1), and chemokine receptors (CCR3, CCR4, CCR5, CCR7, CCR8, CXCR3 and CX3CR1) by immunohistochemical double-labeling and quantitative PCR on mRNA isolated from laser microdissected layers of coronary arteries. T cells in the neointima and adventitia of CAV were skewed toward an activated memory Th-1 phenotype, but in the presence of a distinct Th-2 population. FOXP3 positive T cells were not detected and production of most cytokines was low or absent, except for IFN-gamma, and TGF-beta. This typical composition of T-helper cells and especially production of IFN-gamma and TGF-beta may play an important role in the proliferative CAV reaction
Hagendoorn J, Koelemij R. Diagnose in beeld (392). Een vrouw met roodheid en zwelling van de mamma. Nederlands Tijdschrift voor Geneeskunde 2008; 152(42):2287.
Hagendoorn J, van Lammeren G, Boerma D, van der Beek E, Wiezer MJ, van Ramshorst B. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal and gastrointestinal origin shows acceptable morbidity and high survival. European Journal of Surgical Oncology 2008; [Epub ahead of print].
Abstract: BACKGROUND: Peritoneal carcinomatosis from colorectal origin carries a poor prognosis. Recent clinical studies show that cytoreductive surgery (CS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival of selected patients with a colorectal carcinoma and isolated peritoneal carcinomatosis in the absence of extra-abdominal metastases. Here, we report the clinical outcomes and survival after cytoreductive surgery and HIPEC of the first cohort of patients treated in our institution. METHODS: Sixty-seven patients underwent a laparotomy. Complete cytoreduction could be performed in 49 patients, who underwent a total of 53 CS-HIPEC procedures. All had peritoneal carcinomatosis originating from primary colorectal, cecal, appendiceal, and gastric tumors. RESULTS: In patients who underwent CS-HIPEC, an R0 resection could be achieved in 4%, R1 in 88%, and R2 in 8%. The 30-day mortality was 0; one patient died in-hospital after 10 weeks. The median hospital stay was 12 days (range 4-56). The overall morbidity was 43%, including extended gastroparesis (11%), anastomotic failure (11%) and intra-abdominal abscess (9%). Mean time to clinical recurrence was 12 months (range 4-22). The actuarial 1-year survival was 88% and 2-year survival was 75%. CONCLUSION: In well-selected patients referred to a specialized institution, CS-HIPEC has an acceptable morbidity and high survival rate
Hammacher ER. Athroscopische geleide behandeling van syndesmoseletsels-brief aan de redactie. Nederlands Tijdschrift voor Traumatologie 2008; 4:133.
Harmsze AM, van Houte M, Deneer VH, Tupker RA. Exercise-induced Sweating in Healthy Subjects as a Model to Predict a Drug's Sweat-reducing Properties in Hyperhydrosis: a Prospective, Placebo-controlled, Double-blind Study. Acta Dermato-Venereologica 2008; 88(2):108-112.
Abstract: The aim of this study was to develop a model to evaluate the efficacy of drugs with expected sweat-reducing properties in healthy subjects in order to select candidate drugs for the systemic treatment of primary generalized hyperhidrosis. A randomized, double-blind, placebo-controlled cross-over study was performed in 8 healthy subjects. Sweating was induced by exercise. The degree of sweating at different exercise levels was determined by measurement of transepidermal water loss. Either the anticholinergic drug oxybutynin or placebo was given before measurements started. No statistically significant differences in transepidermal water loss between active treatment and placebo were found at the different exercise levels. This is noteworthy, as oxybutynin has been proven successful in patients with generalized hyperhidrosis. Thus, the present model does not mimic the situation in patients with primary generalized hyperhidrosis. This may be because this form of hyperhidrosis is not caused only by sympathetic overactivity, as described in the literature, but is based on more complex mechanisms. Further investigations are required fully to understand the pathophysiology of primary generalized hyperhidrosis in order to develop effective human test models
Haveman LM, van Es HW, ten Berge-Kuipers M. Rugpijnklachten op de kinderleeftijd: behandelbare oorzaken opsporen. Nederlands Tijdschrift voor Geneeskunde 2008; 152(7):353-358.
Heestermans AA, van Werkum JW, Taubert D, Seesing TH, von Beckerath N, Hackeng CM, Schomig E, Verheugt FW, ten Berg JM. Impaired bioavailability of clopidogrel in patients with a ST-segment elevation myocardial infarction. Thrombosis Research 2008; 122(6):776-781.
Heestermans T, van Werkum W, ten Berg J, Giannitsis E, Dill T, Dambrink JH, Hamm C, van 't Hof A. Abstract 6022: The Effect of Pre-Hospital Tirofiban on Early Stent Thrombosis in STEMI Patients Undergoing Primary PCI. Circulation 2008; 118(Suppl):S1049.
Hellings WE, Moll FL, de Vries JP, de Bruin P, de Kleijn DP, Pasterkamp G. Histological characterization of restenotic carotid plaques in relation to recurrence interval and clinical presentation: a cohort study. Stroke 2008; 39(3):1029-1032.
Abstract: Backgrounds and Purpose- Restenosis is an important complication after carotid endarterectomy, but little is known about plaque composition in early versus late restenosis and which plaque characteristics are associated with symptomatic clinical presentation of restenotic lesions. METHODS: Endarterectomy specimens of 822 consecutive patients undergoing carotid endarterectomy (33 restenotic; 789 primary) were subjected to histological examination for the presence of macrophages, smooth muscle cells, collagen, calcifications, luminal thrombus, intraplaque bleeding and lipid core size. RESULTS: Early restenotic plaques showed marked accumulation of smooth muscle cells and fibrous tissue, whereas late restenotic plaques demonstrated increased macrophage infiltration, calcification and lipid core (P trend <0.05), resembling primary plaques. Patients with symptomatic restenosis had plaques with higher macrophage infiltration (P=0.01) and a larger lipid core (P=0.02) than asymptomatic patients, independent of recurrence interval. CONCLUSIONS: Restenosis occurring >5 years after primary carotid endarterectomy resembles primary plaques. Symptomatic presentation of restenotic lesions is independently associated with an unstable plaque phenotype
Hellings WE, Pasterkamp G, Verhoeven BA, de Kleijn DP, de Vries JP, Seldenrijk CA, van den Brock T, Moll FL. Verschillen in samenstelling van de atherosclerotische plaque tussen mannen en vrouwen als verklaring voor het geringere succes van carotisendarteriectomie bij vrouwen. Nederlands Tijdschrift voor Geneeskunde 2008; 152(48):2624-2631.
Abstract: OBJECTIVE: To determine whether men and women differ in the histological characteristics of plaque material removed at carotid endarterectomy. DESIGN: Observational and descriptive. METHODS: Carotid endarterectomy plaque specimens obtained from 45 degrees consecutive patients (135 women, 315 men) were assessed for the presence of macrophages, smooth muscle cells, collagen, calcifications, and luminal thrombus by means ofimmunohistochemical staining. The plaques were categorised in 3 phenotypes according to the overall presentation of histological characteristics and the lipid level. Protein was isolated from the plaques to determine the interleukin-6 (IL-6) and IL-8 concentrations and the activity of matrix metalloproteinase-8 (MMP-8) and MMP-9. RESULTS: Atheromatous plaques (> 40% fat) were less frequently observed in women than in men (22 versus 40%; p < 0.001). In addition, more women than men had a low macrophage staining (18 versus 11%; p = 0.05) and strong smooth muscle cell staining (38 versus 24%; p = 0.001). Compared with men, women had a lower plaque concentration of IL-8 and lower MMP-8 activity. The observed differences were most pronounced in the asymptomatic group. An atheromatous plaque occurred in 9% of asymptomatic women compared to 39% ofasymptomatic men (p = 0.02). Moreover, a large proportion of plaques obtained from asymptomatic women showed high smooth muscle cell content (53 versus 30%; p = 0.03) and high collagen content (55 versus 24%; p = 0.003). All relations between gender and plaque characteristics, except for MMP-8, remained the same in a multivariate analysis that was adjusted for clinical presentation and other cardiovascular risk factors. CONCLUSION: Women with a carotid stenosis had more stable plaques than men, independent of clinical presentation and cardiovascular risk profile. Asymptomatic women demonstrated the highest prevalence of stable plaques. These findings may explain why women benefit less from carotid endarterectomy than men
Hellings WE, Moll FL, de Vries JPPM, Ackerstaff RGA, Seldenrijk CA, Met R, Velema E, Derksen WJ, de Kleijn DPV, Pasterkamp G. Atherosclerotic plaque composition and occurrence of restenosis after carotid endarterectomy. JAMA 2008; 299(5):547-554.
Abstract: CONTEXT: Previous studies have assessed the predictive value of clinical and angiographic parameters for development of restenosis after vascular interventions. The composition of the atherosclerotic plaque at the intervention site has not been evaluated as a marker for restenosis. OBJECTIVE: To investigate the relationship between atherosclerotic plaque histology and the occurrence of restenosis after carotid endarterectomy. DESIGN, SETTING, AND PATIENTS: The Athero-Express study is a longitudinal vascular biobank study that includes the collection of atherosclerotic plaques of patients undergoing primary carotid endarterectomy. Five hundred patients were prospectively followed up between April 1, 2002, and March 14, 2006, to assess carotid artery restenosis measured by duplex ultrasound 1 year after the intervention. MAIN OUTCOME MEASURES: Risk of carotid restenosis in relation to predefined histological characteristics (macrophage and smooth muscle cell infiltration, collagen, calcifications, intraplaque bleeding, luminal thrombus, and lipid core size), adjusted for clinical characteristics (multivariate logistic regression analysis). RESULTS: At 1 year, 85 patients (17%) developed 50% or greater restenosis, including 40 patients (8%) who developed 70% or greater restenosis of the target vessel. Patients whose histological examination of the plaque revealed marked macrophage infiltration (n = 286) had a lower risk than those with none or minor macrophage infiltration (n = 214) of developing 50% or greater restenosis (risk difference, 11.5% vs 24.3%; adjusted odds ratio [OR], 0.43; 95% confidence interval [CI], 0.26-0.72) and a lower risk of developing 70% or greater restenosis (risk difference, 4.5% vs 12.6%; adjusted OR, 0.36; 95% CI, 0.17-0.74). Patients (n = 177) with a plaque having a large lipid core size (>40%) had a lower risk than those (n = 94) with a plaque having a lipid core size of less than 10% of developing 50% or greater restenosis (risk difference, 11.3% vs 25.5%; adjusted OR, 0.40; 95% CI, 0.19-0.81) and a lower risk of developing 70% or greater restenosis (risk difference, 5.6% vs 14.9%; adjusted OR, 0.42; 95% CI, 0.17-1.04), independent of clinical characteristics. CONCLUSIONS: Plaque composition is an independent predictor of restenosis after carotid endarterectomy. The dissection of a lipid-rich, inflammatory plaque is associated with reduced risk of restenosis
Hemmer JM, Kelder JC, van Heesewijk HP. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure. European Radiology 2008; 18(2):351-354.
Abstract: The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy
Hemmink GJ, Bredenoord AJ, Weusten BL, Monkelbaan JF, Timmer R, Smout AJ. Esophageal pH-Impedance Monitoring in Patients With Therapy-Resistant Reflux Symptoms: 'On' or 'Off' Proton Pump Inhibitor? American Journal of Gastroenterology 2008; 103(10):2446-2453.
Abstract: BACKGROUND: In patients with proton pump inhibitor (PPI)-resistant symptoms, ambulatory 24-h pH-impedance monitoring can be used to assess whether a relationship exists between symptoms and reflux episodes. Until now, it is unclear whether combined pH-impedance monitoring in these patients should be performed on or off PPI. METHODS: Thirty patients with symptoms of heartburn, chest pain, and/or regurgitation despite PPI twice daily underwent ambulatory 24-h pH-impedance monitoring twice, once on PPI and once after cessation of the PPI for 7 days. The order of the measurements was randomized. Reflux episodes were identified and classified as acid, weakly acidic, or weakly alkaline reflux. In addition, the symptom association probability (SAP) was calculated for each measurement. RESULTS: The total number of reflux episodes and proximal extent were not affected by PPI therapy. On PPI, there were fewer acid reflux episodes (49 +/- 34 off PPI vs 20 +/- 25 on PPI) while more weakly acidic reflux episodes were identified (24 +/- 17 off PPI vs 48 +/- 31 on PPI). Symptom association analysis identified 15 and 11 patients with a positive SAP in the measurement off and on PPI, respectively, the difference in yield of the SAP not being statistically significant. Eight of the 19 patients who had no symptoms or a negative SAP during measurement on PPI had a positive SAP off PPI therapy. In contrast, only 4 patients with a positive SAP on PPI were missed in the measurement off PPI therapy. CONCLUSIONS: In order to demonstrate or exclude GERD in patients with PPI-resistant symptoms, ambulatory 24-h pH-impedance monitoring should preferably be performed after cessation of PPI therapy because this approach seems to offer the best chance to assess a relationship between symptoms and reflux episodes
Hemmink GJM, Bredenoord AJ, Weusten BLA, Timmer R, Smout AJP. Supragastric belching in patients with reflux symptoms: SAT005. Neurogastroenterology & Motility 2008; 20(Supplement 1):84.
Hendriksen J, ten Cate D, van Meeuwen E. Screenen met SLIM. Een screeningsinstrument voor de ondervoeding bij patiënten na openhartchirurgie. Cordiaal 2008; 29(1):8-11.
Herder GJM, Schramel FMNH. De plaats van adjuvante chemotherapie bij het radicaal geopereerde niet-kleincellig longcarcinoom. Nederlands Tijdschrift voor Oncologie 2008; 5(2):69-76.
Heron M, Grutters JC, Rijkers GT, Hijdra D, Claessen AME, van den Bosch JMM. CD4+Foxp3+ regulatory T cells from lungs of healthy subjects. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract 358.
Heron M, Slieker WA, Zanen P, van Lochem EG, Hooijkaas H, van den Bosch JM, van Velzen-Blad H. Evaluation of CD103 as a cellular marker for the diagnosis of pulmonary sarcoidosis. Clinical Immunology 2008; 126(3):338-344.
Abstract: A high CD4(+)/CD8(+) ratio in bronchoalveolar lavage fluid is indicative for the diagnosis pulmonary sarcoidosis but this ratio only does not fully discriminate pulmonary sarcoidosis from other interstitial lung diseases. Recently, the integrin CD103 has been implicated in the diagnostic evaluation of sarcoidosis. CD103 is expressed on intraepithelial lymphocytes in mucosal areas, including bronchi, and is possibly involved in the retention of lymphocytes to the mucosa. The Dutch BAL working party initiated an investigation to evaluate the diagnostic value of relative number of CD103 expressing CD4(+) T-lymphocytes in the BAL fluid of patients with a variety of interstitial lung diseases. The expression of CD103 was examined on bronchoalveolar lavage cells from 119 patients including 56 patients with pulmonary sarcoidosis. We redefined criteria for alveolar CD4(+) T-cell lymphocytosis and for the relative enumeration of CD103 expressing CD4(+) T-lymphocytes in the BAL fluid. Our data demonstrate that the combined use of the CD103(+)CD4(+)/CD4(+) ratio (<0.2) and the BAL CD4(+)/CD8(+) ratio (>3) or the relative alveolitis CD4(+)/CD8(+) BAL/PB ratio (>2) provides a specific tool for discriminating sarcoidosis, also without a clear CD4(+) alveolitis, from other interstitial lung diseases
Heron M, Grutters JC, van Velzen-Blad H, Veltkamp M, Claessen AM, van den Bosch JM. Increased Expression of CD16, CD69, and Very Late Antigen-1 on Blood Monocytes in Active Sarcoidosis. Chest 2008; 134(5):1001-1008.
Abstract: BACKGROUND: Different types of immune cells are involved in the formation of granulomas, a hallmark of pulmonary sarcoidosis. Proinflammatory monocytes are activated circulating monocytes thought to be related to the initial events of granuloma formation. We tested the hypothesis that peripheral blood monocytes in patients with active pulmonary sarcoidosis have an activated phenotype and, secondly, that measuring this activation status can provide a new tool for monitoring disease activity. METHODS: Blood was collected of 23 steroid-naive patients presenting with pulmonary sarcoidosis and 10 healthy control subjects. Expression of CD16 (Fc-gamma type III receptor), CD69 (a general activation marker of cells of the hematopoietic lineage), and the integrin very late antigen (VLA)-1 (on interaction with extracellular matrix compounds mediates cell adhesion) was measured by flow cytometry. RESULTS: Percentages of monocytes expressing CD16, CD69, and VLA-1 in patients vs control subjects were 56.2 +/- 4.1% vs 12.2 +/- 2.4% (p < 0.0001), 87.3 +/- 2.1% vs 8.6 +/- 3.3% (p < 0.0001), and 66.5 +/- 3.6% vs 11.2 +/- 2.3% (p < 0.0001), respectively. Moreover, the CD69(+)VLA-1(+) monocyte subset, abundantly present at disease presentation, was found to decrease to normal levels during follow-up with disease remission. CONCLUSIONS: Peripheral blood monocytes from patients with pulmonary sarcoidosis show a highly activated phenotype. Phenotyping circulating monocytes might be a promising tool for monitoring sarcoidosis disease activity but needs further investigation
Heron M, Grutters JC, Hijdra D, Claessen AME, van den Bosch JMM. Differently activated CD103- and CD103+ lymphocytes in lungs of healthy subjects. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract E4229.
Hirsch A, Nijveldt R, van der Vleuten PA, Tio RA, van der Giessen WJ, Marques KM, Doevendans PA, Waltenberger J, ten Berg JM, Aengevaeren, WR, Biemond BJ, Tijssen JG, van Rossum AC, Piek JJ, Zijlstra F. Intracoronary infusion of autologous mononuclear bone marrow cells in patients with acute myocardial infarction treated with primary PCI: Pilot study of the multicenter HEBE trial. Catheterization & Cardiovascular Interventions 2008; 71(3):273-281.
Abstract: Objective: This study was a pilot trial to determine safety and feasibility of intracoronary infusion of mononuclear bone marrow cells (MBMC) in patients with acute myocardial infarction (MI). Background: Studies reporting the effect of MBMC therapy on improvement of left ventricular (LV) function have shown variable results. The HEBE trial is a large multicenter, randomized trial that currently enrolls patients. Prior to this trial we performed a pilot study. Methods: Twenty-six patients with a first acute MI were prospectively enrolled in eight centers. Bone marrow aspiration was performed at a median of 6 days after primary PCI (interquartile range, 5-7 days). MBMC were isolated by gradient centrifugation and were infused intracoronary the same day. All patients underwent magnetic resonance imaging before cell infusion and after 4 months. Clinical events were assessed up to 12 months. Results: Within 10 hr after bone marrow aspiration, 246 +/- 133 x 10(6) MBMC were infused, of which 3.9 +/- 2.3 x 10(6) cells were CD34(+). In one patient, this procedure was complicated by local dissection. LV ejection fraction significantly increased from 45.0 +/- 6.3% to 47.2 +/- 6.5% (P = 0.03). Systolic wall thickening in dysfunctional segments at baseline improved with 0.9 +/- 0.7 mm (P < 0.001). Infarct size decreased 37% from 17.8 +/- 8.2 to 11.2 +/- 4.2 gram (P < 0.001). During 12-month follow-up, 3 additional revascularizations were performed and an ICD was implanted in one patient, 3 weeks after PCI. Conclusion: In patients with acute MI, intracoronary infusion of MBMC is safe in a multicenter setting. At 4-month follow-up, a modest increase in global and regional LV function was observed, with a concomitant decrease in infarct size. (c) 2008 Wiley-Liss, Inc
Hoekstra T, Bouman J, Rijkaart J. Handhygiëne in de praktijk. Tijdschrift voor Hygiëne en Infectiepreventie 2008; 27(6):145-147.
Hoekstra T, van Brakel I, Westerman C, Binnekamp P. Patiëntveiligheid in de praktijk. KIZ 2008; 1(5):12-16.
Hoekstra T, Jeschke Y, Neggers H, Scheurwater I, Stehouwer P, Weeda W. Ontwikkeling klinisch pad longchirurgie. Oncologica 2008; 25(1):16-19.
Hoogenboom LJ. Patient wordt niet wakker. In: Snijdelaar DG, Kalkman CJ, Scheffer GJ, editors. Probleemgeoriënteerd denken in de anesthesiologie. de Tijdstroom, 2008: 143-152.
Huisman P, Grutters JC, van den Bosch JM. Pulmonale alveolaire proteinose: ziekte door stapeling van surfactans en nieuwe behandeling met sargramostim. Nederlands Tijdschrift voor Geneeskunde 2008; 152(26):1450-1454.
Abstract: The acquired form of pulmonary alveolar proteinosis was determined in 3 patients, a woman of 31 and 2 men of48 and 38 years, respectively. Their symptoms consisted of progressive dyspnoea, with or without coughing and a tight feeling in the chest. Bronchoscopy with bronchoalveolar lavage yielded milky white, frothy material, and high resolution CT revealed parenchymal densification. All 3 patients were successfully treated with recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF; sargramostim); in addition, the first and last patient underwent total pulmonary lavage. During the pregnancy of the woman, the GM-CSF treatment was suspended; this was resumed after parturition, which took place via caesarean section. Pulmonary alveolar proteinosis is a rare disease characterised by accumulation of surfactant in the alveoli. Until recently, the treatment consisted only of total lung lavage under general anaesthesia. It has recently been discovered that IgG autoantibodies play an important role in the development ofthe disease, namely in the accumulation of surfactant in the alveoli. IgG autoantibodies appear to neutralise the biological activity of natural GM-CSF, which leads to accumulation of used surfactant in the alveoli and a decrease of the pulmonary diffusion capacity. These cases and other publications from the past few years underline the important role of GM-CSF, in addition to a total lung lavage, in the treatment of pulmonary alveolar proteinosis
Iijima R, Ndrepepa G, Mehilli J, Neumann FJ, Schulz S, ten Berg J, Bruskina O, Dotzer F, Dirschinger J, Berger P, Schömig A, Kastrati A . Troponin level and efficacy of abciximab in patients with acute coronary syndromes undergoing early intervention after clopidogrel pretreatment. Clinical Research in Cardiology 2008; 97(3):160-168.
Abstract: Abstract Objective We investigated how does troponin level (TnT) affect the benefit achieved by abciximab in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) after pretreatment with a high loading dose of clopidogrel. Methods The Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT 2) trial included 2,022 patients with non-ST elevation ACS undergoing PCI who were randomized to abciximab or placebo after pretreatment with 600 mg of clopidogrel. The patients were divided into groups with elevated TnT level (n = 1,049) and no elevated TnT level (n = 973). The primary end point of the trial was the composite of death, myocardial infarction and urgent reintervention at 30 days. Results In patients with elevated TnT level the incidence of the primary end point was 13.1% in the abciximab group Vs. 18.3% in the placebo group [relative risk (RR): 0.70; 95% confidence interval (CI), 0.52–0.95, P = 0.02]. The combined incidence of death or myocardial infarction was 12.9% in the abciximab group vs. 17.9% in the placebo group (RR: 0.71; 95% CI, 0.52–0.96, P = 0.03). In contrast, the incidence of the primary end point in patients with no elevated TnT level was identical in both treatment groups (4.6%). The risk of bleeding was not related to TnT level. Conclusions Baseline troponin level affects the benefit of abciximab in patients with ACS undergoing PCI after pretreatment with a high loading dose of clopidogrel. Abciximab reduces the risk of ischemic events only in patients with ACS and elevated troponin level
Ionita GM, Peeters W, Karia SS, Vink A, Schoneveld A, de Vries JP, Moll FL, Pasterkamp G, de Kleijn DP. Mrp8 and Mrp14, endogenous ligands of Toll-like receptor 4, are associated with rupture-prone human atherosclerotic plaques. European Heart Journal 2008; 29(Suppl 1):525.
Janssen MP, de Borst GJ, Mali WP, Kappelle LJ, Moll FL, Ackerstaff RG, Rothwell PM, Brown MM, van Sambeek MR, Buskens E. Carotid Stenting versus Carotid Endarterectomy: Evidence Basis and Cost Implications. European Journal of Vascular & Endovascular Surgery 2008; 36(3):258-266.
Abstract: OBJECTIVE: Carotid Angioplasty combined with Stenting (CAS) is increasingly performed because of its presumed benefits. A study was performed to identify key factors that determine the cost-effectiveness as compared to conventional carotid endarterectomy (CEA). METHODS: The incremental cost-effectiveness of CAS over CEA for different scenarios was estimated using a modeling approach. Treatment costs were based on actual costs of successful procedures whereas costs of complications were taken from the literature. Patient survival was modeled using the endarterectomy patients from the ECST trial. RESULTS: Procedural costs of CAS are higher than those of CEA, mainly as a result of the high material costs. Cost-effectiveness of CAS primarily depends on major stroke rates. One percent increase in the peri-operative major stroke rate causes a cost increase of euro1 051 and a loss of 0.06 quality adjusted life years. CONCLUSIONS: At present CAS is at best non-inferior to CEA in terms of clinical outcome. Cost savings due to shorter admission are offset by the high costs associated with catheter-based interventions. At present CAS should be restricted to controlled settings until clinical trials have shown a substantial clinical benefit
Janssen R, Krivokuca I, Kruize AA, Koenderman L, Lammers J-WJ. Adalimumab-induced bronchospasm: not a class effect. Thorax 2008; 63(5):472-473.
Janssen R, Vlaminckx BJ, Seldenrijk CA, Voorn GP, Grutters JC. Strongyloides stercoralis hyperinfection mimicking accelerated form of idiopathic pulmonary fibrosis. Lancet Infectious Diseases 2008; 8(7):456.
Judson MA, Baughman RP, Costabel U, Flavin S, Lo KH, Kavuru MS, Drent M, the Centocor T48 Sarcoidosis investigators, Grutters J. Efficacy of infliximab in extrapulmonary sarcoidosis: results from a randomised trial. European Respiratory Journal 2008; 31(6):1189-1196.
Abstract: The aim of the present study was to investigate the efficacy of infliximab for the treatment of extrapulmonary sarcoidosis. A prospective, randomised, double-blind, placebo-controlled trial was conducted, with infliximab at 3 and 5 mg{middle dot}kg-1 body weight administered over 24 weeks. Extrapulmonary organ severity was determined by a novel severity tool (extrapulmonary physician organ severity tool; ePOST) with an adjustment for the number of organs involved (ePOSTadj). In total, 138 patients enrolled in the trial of infliximab versus placebo for the treatment of chronic corticosteroid-dependent pulmonary sarcoidosis. The baseline severity of extrapulmonary organ involvement, as measured by ePOST, was similar across treatment groups. After 24 weeks of drug-therapy study, the change from baseline to week 24 in ePOST was greater for the combined infliximab group compared with the placebo group. After adjustment for the number of extrapulmonary organs involved, the improvement in ePOSTadj observed in the combined infliximab group was also greater than that observed in placebo-treated patients, after 24 weeks of therapy. The improvements in ePOST and ePOSTadj were not maintained during a subsequent 24-week washout period. Infliximab may be beneficial compared with placebo in the treatment of extrapulmonary sarcoidosis in patients already receiving corticosteroids, as assessed by the severity tool described in the present study
Kaljouw MJ, Vandeputte MLJHHM. Dokters willen de baas blijven. Medisch Contact 2008; 63(23):1008-1009.
Karthaus VLJ, Donkers HHLM, van Moorsel CHM, Grutters JC, van den Bosch JMM. Association of clusters of pulmonary function data with SNP polymorphisms in sarcoidosis patients. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract 3168.
Kastelein JJ, Akdim F, Stroes ES, Zwinderman AH, Bots ML, Stalenhoef AF, Visseren FL, Sijbrands EJ, Trip MD, Stein EA, Gaudet D, Duivenvoorden R, Veltri EP, Marais AD, de Groot E. Simvastatin with or without ezetimibe in familial hypercholesterolemia. New England Journal of Medicine 2008; 358(14):1431-1443.
Abstract: BACKGROUND: Ezetimibe, a cholesterol-absorption inhibitor, reduces levels of low-density lipoprotein (LDL) cholesterol when added to statin treatment. However, the effect of ezetimibe on the progression of atherosclerosis remains unknown. METHODS: We conducted a double-blind, randomized, 24-month trial comparing the effects of daily therapy with 80 mg of simvastatin either with placebo or with 10 mg of ezetimibe in 720 patients with familial hypercholesterolemia. Patients underwent B-mode ultrasonography to assess the intima-media thickness of the walls of the carotid and femoral arteries. The primary outcome measure was the change in the mean carotid-artery intima-media thickness, which was defined as the average of the means of the far-wall intima-media thickness of the right and left common carotid arteries, carotid bulbs, and internal carotid arteries. RESULTS: The primary outcome, the mean (+/-SE) change in the carotid-artery intima-media thickness, was 0.0058+/-0.0037 mm in the simvastatin-only group and 0.0111+/-0.0038 mm in the simvastatin-plus-ezetimibe (combined-therapy) group (P=0.29). Secondary outcomes (consisting of other variables regarding the intima-media thickness of the carotid and femoral arteries) did not differ significantly between the two groups. At the end of the study, the mean (+/-SD) LDL cholesterol level was 192.7+/-60.3 mg per deciliter (4.98+/-1.56 mmol per liter) in the simvastatin group and 141.3+/-52.6 mg per deciliter (3.65+/-1.36 mmol per liter) in the combined-therapy group (a between-group difference of 16.5%, P<0.01). The differences between the two groups in reductions in levels of triglycerides and C-reactive protein were 6.6% and 25.7%, respectively, with greater reductions in the combined-therapy group (P<0.01 for both comparisons). Side-effect and safety profiles were similar in the two groups. CONCLUSIONS: In patients with familial hypercholesterolemia, combined therapy with ezetimibe and simvastatin did not result in a significant difference in changes in intima-media thickness, as compared with simvastatin alone, despite decreases in levels of LDL cholesterol and C-reactive protein. (ClinicalTrials.gov number, NCT00552097 [ClinicalTrials.gov].)
Kastelijn EA, Zanen P, Ruven H, Cramer M-J, Lammers J-W, van de Graaf E. 55: Cotinine Levels in Serum and Urine and %HbCO as Exclusion Criteria in Lung Transplantation. Journal of Heart & Lung Transplantation 2008; 27(2 Suppl 1):S79.
Keijsers R, van Buul M, Lavalaye J, Verzijlbergen F. Klinisch denken en beslissen in de praktijk. Een man met een zwelling van beide kaakhoeken. Nederlands Tijdschrift voor Geneeskunde 2008; 152(30):1700-1701.
Keijsers RG, Verzijlbergen FJ, Rensing BJ, Grutters JC. Cardiac sarcoidosis: a challenge to measure disease activity. Journal of Nuclear Cardiology 2008; 15(4):595-598.
Keijsers RGM, Verzijlbergen JF, van Diepen DM, van den Bosch JMM, Grutters JC. 18F-FDG PET in sarcoidosis: an observational study in 12 patients treated with infliximab. Sarcoidosis Vasculitis & Diffuse Lung Diseases 2008; 2008(25):2-143-50.
Keijsers RGM, Verzijlbergen JF, van den Bosch JMM, Oyen W, Ruven HJT, Grutters JC. Correlatie van ACE en sIL2-R met 18F-FDG PET in 122 sarcoidose patiënten. Tijdschrift voor Nucleaire Geneeskunde 2008; 30(3):133-134.
Ketteler M, Floege J, Fernandez-Martin JL, London G, Locatelli F, Gorriz JL, Ferreira A, Rutkowski B, Teplan V, Covic A, Kramar R, Nagy J, Bos WJ, Tielemans C, Verbeelen D, Pavlovic D, Martin PY, Wüthrich R, Benedik M, Goldsmith D, Memos D, Cannata-Andia JB, COSMOS group. Differences in the management of secondary hyperparathyroidism and in patient characteristics among countries participating in cosmos. ERA-EDTA 2008.
Keunen RW, Hoogenboezem R, Wijnands R, van den Hengel AC, Ackerstaff RG. Introduction of an embolus detection system based on analysis of the transcranial Doppler audio-signal. Journal of Medical Engineering & Technology 2008; 32(4):296-304.
Abstract: A new embolus detection system (EDS) is presented, built with the intention of detecting ongoing cerebral embolization in patients at risk of transient ischaemic attacks or stroke. It is based on the analysis of the audio-Doppler signal of a transcranial Doppler machine. The algorithm of the EDS estimates the intensity, duration and zero-crossing dynamics of the audio signal. The EDS has a multi-layer neural network which classifies events into micro-emboli signals (MES) or artefacts. The decision-making component of the software has been validated against human experts. Data from patients in the post-operative phase of carotid surgery were used for the validation process. The results showed agreement in MES and artefact classification of > 93%. Apart from a monitoring display, the monitoring system includes a verification unit that allows the user to listen and to look at all data of individual MES and artefacts. Moreover, the system allows the user to record, store and re-calculate all data files. Data are stored using European Data Format, which allows data transportation over the Internet. The EDS may have a potential in stroke risk stratification, evaluating the effect of novel anti-thrombotic therapies, and in peri-operative and remote monitoring of carotid endarterectomy
Knaapen P, Germans T, Camici PG, Rimoldi OE, ten Cate FJ, ten Berg JM, Dijkmans PA, Boellaard R, van Dockum WG, Gotte MJ, Twisk JW, van Rossum AC, Lammertsma AA, Visser FC. Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy. American Journal of Physiology - Heart & Circulatory Physiology 2008; 294(2):H986-H993.
Abstract: Impaired hyperemic myocardial blood flow (MBF) in hypertrophic cardiomyopathy (HCM), despite normal epicardial coronary arteries, results in microvascular dysfunction. The aim of the present study was to determine the relative contribution of extravascular compressive forces to microvascular dysfunction in HCM. Eighteen patients with symptomatic HCM and normal coronary arteries and 10 age-matched healthy volunteers were studied with PET to quantify resting and hyperemic MBF at a subendocardial and subepicardial level. In HCM patients, MRI was performed to determine left ventricular (LV) mass index (LVMI) and volumes, echocardiography to assess diastolic perfusion time, heart catheterization to measure LV outflow tract gradient (LVOTG) and LV pressures, and serum NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP) as a biochemical marker of LV wall stress. Hyperemic MBF was blunted in HCM vs. controls (2.26 +/- 0.97 vs. 2.93 +/- 0.64 ml.min(-1).g(-1), P < 0.05). In contrast to controls (1.38 +/- 0.15 to 1.25 +/- 0.19, P = not significant), the endocardial-to-epicardial MBF ratio decreased significantly in HCM during hyperemia (1.20 +/- 0.11 to 0.88 +/- 0.18, P < 0.01). This pattern was similar for hypertrophied septum and lateral wall. Hyperemic MBF was inversely correlated with LVOTG, NT-proBNP, left atrial volume index, and LVMI (all P < 0.01). Multivariate regression analysis, however, revealed that only LVMI and NT-proBNP were independently related to hyperemic MBF, with greater impact at the subendocardial myocardial layer. Hyperemic MBF is more severely impaired at the subendocardial level in HCM patients. The level of impairment is related to markers of increased hemodynamic LV loading conditions and LV mass. These observations suggest that, in addition to reduced capillary density caused by hypertrophy, extravascular compressive forces contribute to microvascular dysfunction in HCM patients
Knibbe C, Peeters M. Response to "pharmacodynamics of propofol in critically ill patients". Clinical Pharmacology & Therapeutics 2008; 84(5):547.
Knibbe CA, Tjoeng MM. Clinical pharmacist on intensive care unit saves lives and reduces costs. Critical Care Medicine 2008; 36(12):3269-3270.
Koelemij R, Wille J. Diagnose in beeld (378). Een vrouw met een subunguale pigmentatie aan de linker hallux. Nederlands Tijdschrift voor Geneeskunde 2008; 152(25):1418.
Koelemij R, van der Waal RIF. Recalcitrant unilateraal eczeem op de borst ? Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(7):246.
Koelemij R, Wille J, de Vries JPPM, van der Waal RIF. Het subunguaal melanoom: ongewone lokalisatie, lastige diagnose. Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(7):243-245.
Kolditz DP, Wijffels MC, Blom NA, van der Laarse A, Hahurij ND, Lie-Venema H, Markwald RR, Poelmann RE, Schalij MJ, Gittenberger-de Groot AC. Epicardium-derived cells in development of annulus fibrosis and persistence of accessory pathways. Circulation 2008; 117(12):1508-1517.
Abstract: BACKGROUND: The developmental mechanisms underlying the persistence of myocardial accessory atrioventricular pathways (APs) that bypass the annulus fibrosis are mainly unknown. In the present study, we investigated the role of epicardium-derived cells (EPDCs) in annulus fibrosis formation and the occurrence of APs. METHODS AND RESULTS: EPDC migration was mechanically inhibited by in ovo microsurgery in quail embryos. In ovo ECGs were recorded in wild-type (n=12) and EPDC-inhibited (n=12) hearts at Hamburger-Hamilton (HH) stages 38 to 42. Subsequently, in these EPDC-inhibited hearts (n=12) and in additional wild-type hearts (n=45; HH 38-42), ex ovo extracellular electrograms were recorded. Electrophysiological data were correlated with differentiation markers for cardiomyocytes (MLC2a) and fibroblasts (periostin). In ovo ECGs showed significantly shorter PR intervals in EPDC-inhibited hearts (45+/-10 ms) than in wild-type hearts (55+/-8 ms, 95% CI 50 to 60 ms, P=0.030), whereas the QRS durations were significantly longer in EPDC-inhibited hearts (29+/-14 versus 19+/-2 ms, 95% CI 18 to 21 ms, P=0.011). Furthermore, ex ovo extracellular electrograms (HH 38-42) displayed base-first ventricular activation in 44% (20/45) of wild-type hearts, whereas in all EPDC-inhibited hearts (100%, 12/12), the ventricular base was activated first (P<0.001). Small periostin- and MLC2a-positive APs were found mainly in the posteroseptal region of both wild-type and EPDC-inhibited hearts. Interestingly, in all (n=10) EPDC-inhibited hearts, additional large periostin-negative and MLC2a-positive APs were found in the right and left lateral free wall coursing through marked isolation defects in the annulus fibrosis until the last stages of embryonic development. CONCLUSIONS: EPDCs play an important role in annulus fibrosis formation. EPDC outgrowth inhibition may result in marked defects in the fibrous annulus with persistence of large APs, which results in ventricular preexcitation on ECG. These APs may provide a substrate for postnatally persistent reentrant arrhythmias
Korthagen NM, van Moorsel CHM, Barlo NP, Ruven HJT, van den Bosch JMM, Grutters JC. High serum levels of YKL-40 in IPF. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract P3536.
Kranenborg H, Meinders AJ, Frequin STFM, Teunissen LL, Mauser HW, Vogels OJM. Bepalen van de prognose van een coma na reanimatie. Nederlands Tijdschrift voor Geneeskunde 2008; 152(22):1296-1297.
Kropman RH, de Vries JP, Segers MJ. Surgical repair of a gunshot injury to the left carotid artery: case report and review of literature. Vascular & Endovascular Surgery 2008; 42(2):180-183.
Abstract: We present a case of a 37-year-old man who sustained a single gunshot wound (penetrating zones I and II) and internal carotid artery injury. Optimal evaluation and management of vascular injury remains controversial. Literature on the operative techniques of carotid artery injuries is reviewed
Kruit A, Grutters JC, van den Bosch JMM, Ruven HJT. MUC1 568 A/G specific serum CA 15-3 levels in healthy Dutch women. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):68.
Kuijk LM, Mandey SH, Schellens I, Waterham HR, Rijkers GT, Coffer PJ, Frenkel J. Statin synergizes with LPS to induce IL-1beta release by THP-1 cells through activation of caspase-1. Molecular Immunology 2008; 45(8):2158-2165.
Abstract: Mevalonate kinase deficiency (MKD) is a hereditary syndrome characterized by recurring episodes of fever and inflammation. Peripheral blood mononuclear cells from MKD patients secrete high levels of interleukin (IL)-1beta when stimulated with lipopolysaccharide (LPS), which is thought to be a primary cause of the inflammation. However, the link between a deficient mevalonate kinase and excessive IL-1beta release remains unclear. To investigate this we made use of a model in which monocytic cells (THP-1) were treated with simvastatin. Statins are compounds that inhibit 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase and thereby artificially impair the isoprenoid biosynthesis pathway, mimicking mevalonate kinase deficiency. Our study revealed that LPS-stimulated THP-1 cells treated with simvastatin had an increased caspase-1 mediated processing of proIL-1beta. This increased processing was caused by enhanced autoprocessing of caspase-1, rather than enhanced transcription or translation of caspase-1 or proIL-1beta. Simvastatin-induced activation of caspase-1 was caused by an impairment of non-sterol isoprenoid biosynthesis, as the isoprenyl intermediate GGPP could block activation of caspase-1 and mIL-1beta release. In addition, inhibition of both farnesyl pyrophosphate synthase and geranylgeranyltransferase I also induce mIL-1beta release. Taken together, these results demonstrate that simvastatin augments LPS-induced IL-1beta release post-translationally, by inducing caspase-1 activity. These findings suggest that MKD patients may have overactive caspase-1, causing enhanced IL-1beta processing and subsequent inflammation in response to bacterial components
Kwakkel-van Erp JM, Otten HG, Paantjens AW, van Kessel DA, van Ginkel WG, van den Bosch JM, van de Graaf EA. Soluble CD30 measured after lung transplantation does not predict bronchiolitis obliterans syndrome in a tacrolimus/mycophenolate mofetil-based immunosuppressive regimen. Journal of Heart & Lung Transplantation 2008; 27(10):1172-1175.
Abstract: BACKGROUND: The purpose of this study was to determine the utility of post-transplant serum soluble CD30 levels as a biomarker for the development of the bronchiolitis obliterans syndrome (BOS) after lung transplantation during a tacrolimus/mycophenolate mofetil-based regimen. METHODS: Soluble CD30 (sCD30) concentrations were measured prior to transplantation and in 175 samples taken after transplantation in 7 patients developing BOS and 7 non-BOS patients closely matched for age, underlying diseases, follow-up and gender. RESULTS: High pre-transplant sCD30 levels dropped significantly after lung transplantation, but in the post-transplant samples no differences could be detected between patients developing BOS or not, and no changes were found prior to or during the development of BOS. CONCLUSIONS: After transplantation, sCD30 levels are consistently suppressed, but BOS is not prevented, indicating that sCD30 cannot be used as a biomarker to predict BOS after transplantation in the regimen employed
Kwakkel-van Erp JM, van de Graaf EA, Paantjens AAM, van Ginkel WGJ, Nossent GD, van Kessel DA, van den Bosch JMM. 527: KIR Gene Content Recipient Associated with the Development of BOS after Lung Transplantation. Journal of Heart & Lung Transplantation 2008; 27(2 Suppl 1):S249.
Kwakkel-van Erp JM, van de Graaf EA, Paantjens AW, van Ginkel WG, Schellekens J, van Kessel DA, van den Bosch JM, Otten HG. The killer immunoglobulin-like receptor (KIR) group A haplotype is associated with bronchiolitis obliterans syndrome after lung transplantation. Journal of Heart & Lung Transplantation 2008; 27(9):995-1001.
Abstract: BACKGROUND: The development of bronchiolitis obliterans syndrome (BOS) after lung transplantation is associated with viral infections. Natural killer (NK) cells are involved in the lysis of viral infected cells, and their activation is largely controlled by activating and inhibitory killer immunoglobulin-like receptors (KIRs). We hypothesized that KIR ligand incompatibility and recipients' individual KIRs could influence the development of BOS and the incidence of cytomegalovirus reactivation after lung transplantation. METHODS: The KIR gene contents were determined in 48 patients who received a lung transplant, and human leukocyte antigen (HLA)-Cw and HLA-Bw4 typing was performed on their respective donors. RESULTS: BOS developed in 7 patients and cytomegalovirus reactivation occurred in 16. BOS developed in 5 of 19 patients homozygous for KIR haplotype A compared with 2 of 27 patients with KIR haplotype AB and B (homozygous; p = 0.03; log-rank test). In none of the patients with BOS was the activating KIR2DS5 gene detected, whereas it was present in 35% of patients without BOS (p = 0.04; log-rank test). No correlation was found between KIR gene content and cytomegalovirus reactivation. CONCLUSION: Our results suggest that the lack of activating KIRs may play an important role in the development of BOS but not in the control of cytomegalovirus reactivation after lung transplantation
Lameris W, van Randen A, Wiezer MJ, van Geloven AAW, Simons MP, Busch ORC, Gulikvan TM, Bossuyt PMM, Stoker J, Boermeester MA. De waarde van computed tomography bij vrouwen met verdenking acute appendicitis en een negative echografie voor appendicitis. Nederlands Tijdschrift voor Heelkunde 2008; 17(6).
Langenveld J, Veersema S, Bongers MY, Koks CA. Tubal perforation by Essure: three different clinical presentations. Fertility & Sterility 2008; 90(5):2011.e5-2011.e10.
Abstract: OBJECTIVE: To assess the convenience and safety of Essure sterilization in an outpatient setting and the use of ultrasound as diagnostic tool for verification of proper placement for the 3-month follow-up. DESIGN: Prospective cohort study. SETTING: Teaching hospital department of obstetrics and gynecology. PATIENT(S): Female patients with a request for permanent tubal sterilization. INTERVENTION(S): Essure sterilization. MAIN OUTCOME MEASURE(S): Bilateral tubal occlusion after Essure sterilization and complication rate. RESULT(S): A total of 149 patients were scheduled for Essure sterilization. Microinsert placement was attempted in 143 patients. Bilateral placement of the device was successful in 95% (95% confidence interval [CI] 92%-99%). Seven attempts were unsuccessful. The complication rate was 2% (n = 3), and all involved a perforation. These three cases are discussed in detail. Vaginal ultrasound was conclusive in 91.7% (95% CI 87%-96%); two perforations were not recognized on the ultrasound. CONCLUSION(S): Essure sterilization is a safe and reliable sterilization method in an outpatient setting. Perforation of the device is the most frequent complication. Vaginal ultrasound is reliable for verification after an uncomplicated procedure. When the procedure is difficult (e.g., higher resistance, more pain then average, more time or more than two devices needed), a hysterosalpingogram should be performed
Lavalaye J, Grutters JC, van de Garde EMW. Fibrose activiteit bij patiënten met longfibrose, mogelijkheden van molecular imaging. Tijdschrift voor Nucleaire Geneeskunde 2008; 30(4):193-197.
Le TTN, Meinders AJ, van Muilwijk J, de Jongh BM, Vlaminckx B. A case of fatal, undetected Haemophilus parainfluenzae endocarditis: the role of the bloodculture system. Nederlands Tijdschrift voor Medische Microbiologie 2008; 16(Suppl):S80-S81.
Leclercq E, Kremer LCM. Op de hoogte blijven van relevante literatuur: 'really simple syndication'(RSS)-feeds binnen PubMed. Nederlands Tijdschrift voor Geneeskunde 2008; 152(4):221-224.
Leliefeld HHJ. Afwijkingen aan penis en scrotum in beeld. Houten: Bohn Stafleu van Loghum, Healthcare Communications, 2008.
Letteboer TG, Mager HJ, Snijder RJ, Lindhout D, Ploos van Amstel HK, Zanen P, Westermann KJ. Genotype-phenotype relationship for localization and age distribution of telangiectases in hereditary hemorrhagic telangiectasia. American journal of medical genetics Part A 2008; 164A(21):2733-2739.
Abstract: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease characterized by arteriovenous malformations (AVMs) ranging from telangiectases to larger AVMs. Mutations in two genes cause HHT; ENG (HHT1) and ACVRL1 (HHT2). Although the hallmark for clinical diagnosis is the presence of telangiectases, there are few publications reporting the relative distribution and frequency of these features between HHT1 and HHT2. Here, the results of such analysis of telangiectases in 268 patients with HHT1 and 130 patients with HHT2 are described. Localization of the telangiectases is reported, and patients were clustered by age to estimate the site prevalence for different age categories. We show that telangiectases of the nasal mucosa are present at a higher prevalence and start to appear earlier in life than those of the oral mucosa or dermal sites in patients with either HHT1 or HHT2. Oral and nasal mucosal telangiectases are present earlier in life in patients with HHT1 compared to patients with HHT2, whereas dermal lesions are more frequent and appear earlier in life in patients with HHT2. In patients with either HHT1 or HHT2, the number of sites affected increases with age. In patients with HHT1, more women than men had skin telangiectases, particularly on the face. These results confirm that the frequency of AVMs differ between patients with HHT1 and HHT2, and that these differences can be detected on physical examination. (c) 2008 Wiley-Liss, Inc
Lie-Venema H, Eralp I, Markwald RR, van den Akker NM, Wijffels MC, Kolditz DP, van der Laarse A, Schalij MJ, Poelmann RE, Bogers AJ, Gittenberger-de Groot AC. Periostin expression by epicardium-derived cells is involved in the development of the atrioventricular valves and fibrous heart skeleton. Differentiation 2008; 76(7):809-819.
Abstract: The epicardium is embryologically formed by outgrowth of proepicardial cells over the naked heart tube. Epicardium-derived cells (EPDCs) migrate into the myocardium, contributing to myocardial architecture, valve development, and the coronary vasculature. Defective EPDC formation causes valve malformations, myocardial thinning, and coronary defects. In the atrioventricular (AV) valves and the fibrous heart skeleton isolating atrial from ventricular myocardium, EPDCs colocalize with periostin, a matrix molecule involved in remodeling. We investigated whether proepicardial outgrowth inhibition affected periostin expression and how this related to development of the AV valves and fibrous heart skeleton. Periostin expression by epicardium and EPDCs was confirmed in vitro in primary cultures of human and quail EPDCs. Disturbing EPDC formation in quail embryos reduced periostin expression in the endocardial cushions and AV junction. Disturbed fibrous tissue development resulted in AV myocardial connections reflected by preexcitation electrocardiographic patterns. We conclude that EPDCs are local producers of periostin. Disturbance of EPDC formation results in decreased cardiac periostin levels and hampers the development of fibrous tissue in AV junction and the developing AV valves. The resulting cardiac anomalies might link to Wolff-Parkinson White syndrome with persistent AV myocardial connections
Lind JS, Herder GJ, Smit EF. Nieuwe middelen voor de behandeling van gemetastaseerd niet-kleincellig longcarcinoom: remmers van de epidermale groeifactorreceptor en van de angiogenese. Nederlands Tijdschrift voor Geneeskunde 2008; 152(16):928-932.
Abstract: The recently developed 'targeted' therapies, epidermal growth factor receptor (EGFR) inhibitors and angiogenesis inhibitors, target specific tumour characteristics. EGFR inhibitors, such as gefitinib and erlotinib, can lead to remission, particularly in non-small cell lung cancer (NSCLC) with specific EGFR mutations. These mutations occur more frequently in Asians, women, non-smokers and those with adenocarcinomas. Other mutations in EGFR and K-ras genes lead to resistance. EGFR inhibitors offered no benefit to untreated patients with advanced NSCLC. In previously treated patients, however, erlotinib increased survival by 2 months. Optimal patient selection criteria for EGFR inhibitor therapy is still under investigation. The angiogenesis inhibitor bevacizumab is an antibody that targets vascular endothelial growth factor receptor. The addition of bevacizumab to chemotherapy increased median survival by 2 months when given as first-line therapy for advanced NSCLC. The combination of EGFR and angiogenesis inhibitors is a rational anticancer treatment and is being studied. These new therapies are expected to help improve and individualize the treatment of advanced NSCLC
Lokhorst H, van der Heul C, Roerdink H, de Weerdt O. An Observational Post Authorization Study on the Use of Bortezomib in Multiple Myeloma Patients in the Netherlands: Results of An Interim Analysis. Blood 2008; 112(ASH Annual Meeting Abstracts):5200.
Lokhorst HM, Schmidt-Wolf I, Sonneveld P, van der Holt B, Martin H, Barge R, Bertsch U, Schlenzka J, Bos GM, Croockewit S, Zweegman S, Breitkreuz I, Joosten P, Scheid C, van Marwijk-Kooy M, Salwender HJ, van Oers MH, Schaafsma R, Naumann R, Sinnige H, Blau I, Verhoef G, de Weerdt O, Wijermans P, Wittebol S, Duersen U, Vellenga E, Goldschmidt H, Dutch-Belgian HOVON, German GMMG. Thalidomide in induction treatment increases the very good partial response rate before and after high-dose therapy in previously untreated multiple myeloma. Haematologica 2008; 93(1):124-127.
Abstract: In the prospective phase 3 HOVON-50/GMMG-HD3 trial, patients randomized to TAD (thalidomide, doxorubicin, dexamethasone) had a significantly higher response rate (at least PR) after induction compared with patients randomized to VAD (vincristine, adriamycin, dexamethasone, 72% vs. 54%, p<0.001). Complete remission (CR) and very good partial remission (VGPR) were also higher after TAD. After High Dose melphalan 200mg/m(2) response was comparable in both arms, 76% and 79% respectively. However, CR plus VGPR were significantly higher in the patients randomized to TAD (49% vs. 32%, p<0.001). CTC grade 3-4 adverse events were similar in both arms
Luermans JG, Post MC, Temmerman F, Thijs V, Schonewille WJ, Plokker HW, Suttorp MJ, Budts WI. Closure of a patent foramen ovale is associated with a decrease in prevalence of migraine: a prospective observational study. Acta Cardiologica 2008; 63(5):571-577.
Abstract: BACKGROUND: A causal relationship between migraine and a right-to-left shunt, due to a patent foramen ovale (PFO), has been suggested. In mainly retrospective studies, percutaneous closure of a PFO has been associated with a decrease in the prevalence of migraine. OBJECTIVE: In this prospective observational study we evaluated whether percutaneous closure of a PFO is associated with a decrease in the prevalence of migraine. METHODS: Between November 2003 and August 2005, we included 92 patients (age >16 years) who underwent a percutaneous closure of a symptomatic PFO, which was considered to be related to a paradoxical embolism.They received a headache questionnaire before and six months after closure.Two neurologists diagnosed migraine, according to the International Headache Criteria. RESULTS: Eighty-nine of 92 patients (97%, mean age 51.6 +/- 12.3 years, 63 men) completed the questionnaire immediately before PFO closure.The overall prevalence of migraine was 27.0%, for migraine without aura (MA-) 15.7%, and for migraine with aura (MA+) 11.2%. After more than six months of follow-up 84 of 89 patients (94%, mean age 52.1 +/- 12.0 years, 60 men) returned the questionnaire. The overall prevalence of migraine in this group decreased from 28.6% to 10.7% (P = 0.001), for MA-from 16.7% to 8.3% (P = 0.07), and for MA+ from 11.9% to 2.4% (P = 0.02). CONCLUSIONS: Percutaneous PFO closure is related to a decrease in the prevalence of migraine in this prospective observational study. However, randomized placebo controlled trials have to confirm these findings
Luermans JG, Post MC, Schrader R, Sluysmans T, Vydt T, Vermeersch P, Chessa M, Onorato E, Goy JJ, Budts WI. Outcome after percutaneous closure of a patent foramen ovale using the Intrasept device: a multi-centre study. Catheterization & Cardiovascular Interventions 2008; 71(6):822-828.
Abstract: OBJECTIVES: This multi-centre study reports safety and efficacy of percutaneous patent foramen ovale (PFO) closure, using the fourth generation Intrasept device. BACKGROUND: PFO has been associated with paradoxical embolism and cryptogenic stroke. Percutaneous PFO closure seems to reduce the risk for recurrent paradoxical thrombo-embolism. Currently, different devices are used for PFO closure. METHODS: Patients, who underwent a PFO closure with the Intrasept device (Cardia, Eagan, MN) between July 2002 and September 2006, were included in the study. The primary endpoint was defined as reoccurrence of stroke, transient ischemic attack (TIA), or peripheral thrombo-embolism. Peri-procedural and mid-term complications were reported. RESULTS: Four-hundred thirty patients (mean age 50.7 +/- 13.0 years, 231 men) underwent closure. The indications were cryptogenic stroke (69.8%), TIA (23.5%), peripheral embolism (3.3%), and other (3.5%). The median follow-up time was 0.8 years, range 3.9 years. The primary endpoint occurred in 0.5% for stroke, in 2.5% for TIA, and in none for peripheral embolism. Peri-procedural complications were reported in 11.5% of cases, from which 0.2% was defined as major. No severe complications occurred during mid-term follow-up. A residual shunt was present in 12.5% of patients who did not suffer from a recurrent event, compared to 36.4% of patients who reached the primary endpoint (P = 0.04). CONCLUSION: This multi-centre study suggests that percutaneous closure of a symptomatic PFO with the fourth generation Intrasept device is safe and might be effective to prevent the recurrence of paradoxical thrombo-embolic events
Luermans JG, Post MC, Plokker HW, ten Berg JM, Suttorp MJ. Complications and mid-term outcome after percutaneous patent foramen ovale closure in patients with cryptogenic stroke. Netherlands Heart Journal 2008; 16(10):332-336.
Abstract: BACKGROUND: Percutaneous patent foramen ovale (PFO) closure seems to reduce the risk of recurrent thromboembolism. We report the safety and efficacy of percutaneous PFO closure in our centre. METHODS: All patients, >16 years of age, who underwent a percutaneous PFO closure in our centre were included. Reoccurrence of stroke, transient ischaemic attack (TIA) and peripheral thromboembolism were assessed. Periprocedural and midterm complications are reported. RESULTS: Eighty-three consecutive patients (mean age 49+/-13 years) were included. Indications for PFO closure were cryptogenic stroke (59.0%), TIA (33.7%), peripheral embolism (2.4%) and other (4.8%). For PFO closure, a Cardioseal/Starflex device was used in 63 patients and an Amplatzer PFO occluder device in 20 patients. Stroke recurred in 1.2%, TIA in 3.6%, peripheral embolism in 0% during a mean follow-up of 1.9+/-1.2 years. Major periprocedural complications occurred in 1.2%. The mid-term complication rate was 2.4% and only consisted of minor complications. During follow-up, a residual right-to-left shunt was present in 5.7% of the patients. No significant difference in outcome, complications or residual shunting could be documented between the two device types. CONCLUSION: In our centre, the percutaneous closure of a PFO seems to be a safe and effective procedure to prevent recurrence of paradoxical thrombo-embolic events. (Neth Heart J 2008;16:332-6.)
Luermans JGLM, Post MC, ten Berg JM, Plokker HWM, Suttorp MJ. No benefit of patent foramen closure in older patients with cryptogenic stroke. European Heart Journal 2008; 29(Suppl 1):579-580.
Lutgendorff F, Trulsson LM, van Minnen LP, Rijkers GT, Timmerman HM, Franzen LE, Gooszen HG, Akkermans LM, Soderholm JD, Sandstrom PA. Probiotics enhance pancreatic glutathione biosynthesis and reduce oxidative stress in experimental acute pancreatitis. American journal of physiology Gastrointestinal and liver physiology 2008; 295(5):G1111-G1121.
Abstract: Factors determining severity of acute pancreatitis (AP) are poorly understood. Oxidative stress causes acinar cell injury and contributes to the severity, whereas prophylactic probiotics ameliorate experimental pancreatitis. Our objective was to study how probiotics affect oxidative stress, inflammation, and acinar cell injury during the early phase of AP. Fifty-three male Sprague-Dawley rats were randomly allocated into groups: 1) control, 2) sham procedure, 3) AP with no treatment, 4) AP with probiotics, and 5) AP with placebo. AP was induced under general anesthesia by intraductal glycodeoxycholate infusion (15 mM) and intravenous cerulein (5 microg.kg(-1).h(-1), for 6 h). Daily probiotics or placebo were administered intragastrically, starting 5 days prior to AP. After cerulein infusion, pancreas samples were collected for analysis including lipid peroxidation, glutathione, glutamate-cysteine-ligase activity, histological grading of pancreatic injury, and NF-kappaB activation. The severity of pancreatic injury correlated to oxidative damage (r = 0.9) and was ameliorated by probiotics (1.5 vs. placebo 5.5; P = 0.014). AP-induced NF-kappaB activation was reduced by probiotics (0.20 vs. placebo 0.53 OD(450nm)/mg nuclear protein; P < 0.001). Probiotics attenuated AP-induced lipid peroxidation (0.25 vs. placebo 0.51 pmol malondialdehyde/mg protein; P < 0.001). Not only was AP-induced glutathione depletion prevented (8.81 vs. placebo 4.1 micromol/mg protein, P < 0.001), probiotic pretreatment even increased glutathione compared with sham rats (8.81 vs. sham 6.18 miccromol/mg protein, P < 0.001). Biosynthesis of glutathione (glutamate-cysteine-ligase activity) was enhanced in probiotic-pretreated animals. Probiotics enhanced the biosynthesis of glutathione, which may have reduced activation of inflammation and acinar cell injury and ameliorated experimental AP, via a reduction in oxidative stress
Maas KW, Sharouni SY, Phernambucq EC, Stigt JA, Groen HJ, van den Borne BE, Senan S, Paul RM, Smit EF, Schramel FM. A phase II study of weekly docetaxel/cisplatin and concurrent radiotherapy followed by surgery in patients with stage III non-small cell lung cancer (NSCLC). Journal of Clinical Oncology 2008; 26(15S Supplement):7586.
Maassen MS, Hendrix MJ, van Vugt HC, Veersema S, Smits F, Nijhuis JG. Operative Deliveries in Low-Risk Pregnancies in The Netherlands: Primary versus Secondary Care. Birth 2008; 35(4):277-282.
Abstract: Background: In The Netherlands, 35 percent of births take place in "primary care" to women considered at low risk and during labor, approximately 30 percent are referred to "secondary care." High-risk women and some low-risk women deliver in secondary care. This study sought to compare planned place of birth and incidence of operative delivery among women at low risk of complications at the time of onset of labor. Methods: A retrospective analysis was conducted of data about births in The Netherlands during 2003 that were recorded routinely in the Netherlands Perinatal Registry. Mode of delivery was analyzed for women classified as low risk at labor onset according to their planned place of birth (intention-to-treat analysis). The primary outcome was the rate of operative deliveries (vacuum or forceps extraction or cesarean section). Results: Women at low risk who planned to give birth, and therefore labored and delivered in secondary care, had a significantly higher rate of operative deliveries than women who began labor in primary care where they intended to give birth (18% [3,558/19,850] vs 9% [7,803/87,187]) (OR 2.25, 95% CI 2.00-2.52). For cesarean section, the rates were 12 percent (2,419/19,850) versus 3 percent (2,990/87,817) (OR 3.97, 95% CI 3.15-5.01), irrespective of parity. Conclusions: The rate of operative deliveries was significantly lower for low-risk pregnant women who gave birth in a primary care setting compared with similar women who planned birth in secondary care. As with any retrospective analysis, it was not possible to eliminate bias, such as possible differences between primary and secondary care in assignment of risk status. In addition, known risk factors for interventions, technologies such as induction of labor and fetal monitoring, are only available in secondary care. These findings clearly demonstrate the need for a prospective study to examine the relationship between planned place of birth and mode of delivery and neonatal and maternal outcomes
Marcheix B, Rousseau H, Bongard V, Heijmen RH, Nienaber CA, Ehrlich M, Amabile P, Beregi JP, Fattori R. Stent Grafting of Dissected Descending Aorta in Patients With Marfan's Syndrome: Mid-Term Results. Journal of the American College of Cardiology: Cardiovascular Interventions 2008; 1(6):673-680.
Meerveld-Eggink A, de Weerdt O, Rijkers GT, van Velzen-Blad H, Biesma DH. Vaccination coverage and awareness of infectious risks in patients with an absent or dysfunctional spleen in the Netherlands. Vaccine 2008; 26(52):6975-6979.
Abstract: OBJECTIVE: To evaluate the current practice to prevent infections in patients with an absent or dysfunctional spleen in a part of the Netherlands. To measure serum antibody levels against Streptococcus pneumoniae and Haemophilus influenzae type b. DESIGN: Observational study of vaccination coverage by analysis of questionnaires and serum antibody levels. SETTING: Primary care practices in the Utrecht area of the Netherlands, catchment area 750,000 inhabitants, period 2006-2007. PARTICIPANTS: One hundred and thirty adult patients with an absent or dysfunctional spleen. MAIN OUTCOME MEASURES: Percentage of patients informed about infectious risks and aware of the timely use of antimicrobial prophylaxis. Vaccine coverage against S. pneumoniae, H. influenzae type b and Neisseria meningitidis. Levels of serum antibodies against S. pneumoniae and H. influenzae type b. RESULTS: Fifty-six patients (43%) have not received up-to-date information about the infectious risks associated with their condition; 65 patients (50%) are not aware of the need to contact a physician immediately in case of high fever; 37 patients (28%) are keeping antimicrobial prophylaxis at home. Pneumococcal vaccination has been administered within the last 5 years to 103 of 130 patients, antibody levels above the threshold of >/=0.35mug/mL are found in 83 of the 101 patients (data lacking in 2 patients). Complete coverage against S. pneumoniae is only 64% (83/130). A minority of patients (respectively 32% and 27%) has been vaccinated against H. influenzae type b and N. meningitidis. CONCLUSIONS: Vaccination coverage and education about infectious risks in patients with an absent or dysfunctional spleen can be improved markedly in the Netherlands
Meijboom WB, Meijs MFL, Schuijf JD, Cramer MJ, Mollet NR, van Mieghem CAG, Nieman K, van Werkhoven JM, Pundziute G, Weustink AC, de Vos AM, Pugliese F, Rensing B, Jukema JW, Bax JJ, Prokop M, Doevendans PA, Hunink MGM, Krestin GP, de Feyter PJ. Diagnostic Accuracy of 64-Slice Computed Tomography Coronary Angiography: A Prospective, Multicenter, Multivendor Study. Journal of the American College of Cardiology 2008; 52(25):2135-2144.
Abstract: ObjectivesThis study sought to determine the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) to detect or rule out significant coronary artery disease (CAD). BackgroundCTCA is emerging as a noninvasive technique to detect coronary atherosclerosis. MethodsWe conducted a prospective, multicenter, multivendor study involving 360 symptomatic patients with acute and stable anginal syndromes who were between 50 and 70 years of age and were referred for diagnostic conventional coronary angiography (CCA) from September 2004 through June 2006. All patients underwent a nonenhanced calcium scan and a CTCA, which was compared with CCA. No patients or segments were excluded because of impaired image quality attributable to either coronary motion or calcifications. Patient-, vessel-, and segment-based sensitivities and specificities were calculated to detect or rule out significant CAD, defined as [≥]50% lumen diameter reduction. ResultsThe prevalence among patients of having at least 1 significant stenosis was 68%. In a patient-based analysis, the sensitivity for detecting patients with significant CAD was 99% (95% confidence interval [CI]: 98% to 100%), specificity was 64% (95% CI: 55% to 73%), positive predictive value was 86% (95% CI: 82% to 90%), and negative predictive value was 97% (95% CI: 94% to 100%). In a segment-based analysis, the sensitivity was 88% (95% CI: 85% to 91%), specificity was 90% (95% CI: 89% to 92%), positive predictive value was 47% (95% CI: 44% to 51%), and negative predictive value was 99% (95% CI: 98% to 99%). ConclusionsAmong patients in whom a decision had already been made to obtain CCA, 64-slice CTCA was reliable for ruling out significant CAD in patients with stable and unstable anginal syndromes. A positive 64-slice CTCA scan often overestimates the severity of atherosclerotic obstructions and requires further testing to guide patient management
Meijer BUGA, Vos JA. Pijn in de lies bij de dermatoloog? Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(6):203.
Meinders A-J, Meinders AE. Het lopen van de Nijmeegse Vierdaagse: schatting van de risico's. Nederlands Tijdschrift voor Geneeskunde 2008; 152(28):1557-1559.
Abstract: In 2006, the annual Four Days Marches in Nijmegen, the Netherlands, were cancelled after the first day because two participants had died, and many had become unwell while walking in unusually high ambient temperatures. During the 2007 edition, an observational study of the physiological impact and health risks for walkers was carried out. This time, the ambient conditions were mild. Most participants (90.7%) finished the march without serious complaints or clinical complications, despite significant disturbances in fluid balance and electrolytes. The training level of the participants varied considerably. If we compare the results of this physiological study with studies during marathons, similarities in physiological adaptions are found, most probably due to the same biological mechanisms. However, the participants of the Four Days Marches are incomparable with long-distance runners. There is as yet no well-founded advice concerning the fluid intake of Four Days Marches participants. Increase or decrease in body weight may be an interesting diagnostic tool to measure the risk of dehydration or overhydration.
Messa P, Macario F, Yaqoob M, Bouman K, Braun J, von Albertini B, Brink H, Maduell F, Graf H, Frazao JM, Bos WJ, Torregrosa V, Saha H, Reichel H, Wilkie M, Zani VJ, Molemans B, Carter D, Locatelli F. The OPTIMA study: assessing a new cinacalcet (Sensipar/Mimpara) treatment algorithm for secondary hyperparathyroidism. Clinical Journal of The American Society of Nephrology: CJASN 2008; 3(1):36-45.
Abstract: BACKGROUND AND OBJECTIVES: Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower parathyroid hormone (PTH), calcium, and phosphorus levels in dialysis patients with secondary hyperparathyroidism (SHPT). This study compared the efficacy of a cinacalcet-based regimen with unrestricted conventional care (vitamin D and phosphate binders) for achieving the stringent National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) targets for dialysis patients. Study design: In this multicenter, open-label study, hemodialysis patients with poorly controlled SHPT were randomized to receive conventional care (n = 184) or a cinacalcet-based regimen (n = 368). Doses of cinacalcet, vitamin D sterols, and phosphate binders were adjusted during a 16-wk dose-optimization phase with the use of algorithms that allowed cinacalcet to be used with adjusted doses of vitamin D. The primary end point was the proportion of patients with mean intact PTH < or =300 pg/ml during a 7-wk efficacy assessment phase. RESULTS: A higher proportion of patients receiving the cinacalcet-based regimen versus conventional care achieved the targets for PTH (71% versus 22%, respectively; P < 0.001), Ca x P (77% versus 58%, respectively; P < 0.001), calcium (76% versus 33%, respectively; P < 0.001), phosphorus (63% versus 50%, respectively; P = 0.002), and PTH and Ca x P (59% versus 16%, respectively, P < 0.001), and allowed a 22% reduction in vitamin D dosage in patients receiving vitamin D at baseline. Achievement of targets was greatest in patients with less severe disease (intact PTH range, 300 to 500 pg/ml) and the cinacalcet dose required was lower in these patients (median = 30 mg/d). CONCLUSIONS: Compared with conventional therapy, a cinacalcet-based treatment algorithm increased achievement of KDOQI treatment targets in dialysis patients in whom conventional therapy was no longer effective in controlling this disease
Met R, Janssen LI, Wille J, Langezaal A, van de Mortel R, van de Pavoordt ED, de Vries JP. Functional Results After Through-Knee and Above-Knee Amputations: Does More Length Mean Better Outcome? Vascular & Endovascular Surgery 2008; 42(5):456-461.
Abstract: The objective was to evaluate our results on functional outcome for both through-knee amputations and above-knee amputations. Functional outcome was measured using the Special Interest Group in Amputee Medicine score, which focuses on walking distance and use of prosthesis. From 1997 to 2006, 39 through-knee amputations (53%) and 34 above-knee amputations (47%) were performed. Eight (21%) of 39 through-knee amputations needed to be converted to above-knee amputations. Fifty patients (24 above-knee amputations, 26 through-knee amputations) were eligible for follow-up. During follow-up, 71% (of above-knee amputations) and 69% (of through-knee amputations) did not walk with a prosthesis, and 29% of above-knee amputations and 27% of through-knee amputations walked more or less than 50 m. In conclusion, only a minority of patients is able to walk with a prosthesis, and a lot of the through-knee amputations need conversion to a higher level. On the basis of this results, it would be preferable to perform a straight above-knee amputation instead of a through-knee amputation if the correct amputation level is in doubt in high-risk patients
Metz R, Verleisdonk EJ, van der Heijden GJ, Clevers GJ, Hammacher ER, Verhofstad MH, van der Werken C. Acute Achilles tendon rupture: minimally invasive surgery versus nonoperative treatment with immediate full weightbearing--a randomized controlled trial. American Journal of Sports Medicine 2008; 36(9):1688-1694.
Abstract: BACKGROUND: Surgical repair of acute Achilles tendon ruptures is considered superior to nonoperative treatment, but complications other than rerupture range up to 34%. Nonoperative treatment by functional bracing seems a promising alternative. HYPOTHESIS: Nonoperative treatment of acute Achilles tendon rupture with functional bracing reduces the number of complications compared with surgical treatment with a minimally invasive technique. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 2. METHOD: Using concealed random allocation, 83 patients with acute Achilles tendon rupture were assigned to nonoperative treatment by functional bracing or minimally invasive surgical treatment followed by tape bandage. Patients were allowed full weightbearing, and follow-up was 1 year. RESULTS: Complications risk other than rerupture by intention-to-treat basis was 9 in 42 patients (21%) for surgical treatment and 15 in 41 patients (36%) for nonoperative treatment (risk ratio, 0.59; 95% confidence interval, 0.29-1.19). Reruptures risk was 5 in 41 patients after nonoperative treatment and 3 in 42 patients for surgical treatment (risk ratio, 0.59; 95% confidence interval, 0.15-2.29). The mean time to work was 59 days (SD, 82) after surgical treatment and 108 days (SD, 115) after nonoperative treatment (difference, 49 days; 95% confidence interval, 4-94; P < .05). The difference between treatments for return to sports (risk ratio, 0.55; 95% confidence interval, 0.23-1.29), pain, and treatment satisfaction did not reach statistical significance. CONCLUSION: There appears to be a clinically important difference in the risk of complications between minimally invasive surgical treatment and nonoperative treatment for acute Achilles tendon ruptures, but this was not statistically significant
Miedema A, Stubenitsky BM, Jansen NJ, Mink van der Molen AB, van Vught AJ. Improving outcome in meningococcal disease: don't forget compartment syndrome! Pediatric critical care medicine 2008; 9(3):e20-e22.
Abstract: OBJECTIVE: To advocate a surgical intervention that can prevent the loss of limbs in patients with meningococcal disease. DESIGN: Case report. SETTING: Pediatric intensive care unit. PATIENT: A 4-month-old male infant presenting with acute circulatory failure due to meningococcal disease. INTERVENTIONS: Measurements of compartment pressures of all extremities and echo-Doppler of peripheral arteries were performed at regular intervals, starting at admittance to the pediatric intensive care unit. After compartment syndrome in the lower extremities was diagnosed, emergency surgical intervention (fasciotomy and arteriolysis) was performed in the intensive care unit. MEASUREMENTS AND MAIN RESULTS: During surgery, the compartments initially revealed pale, poorly perfused tissue. After decompression, immediate bulging of the muscles and restoration of microcirculation were seen. All digits were spared, and muscle compartments remained vital with exception of the tibialis anterior and extensor hallucis longus muscles in the left leg. Several ecchymoses and purpura of the lower extremities caused skin necrosis, necessitating skin transplants. No other surgical intervention was required. CONCLUSIONS: In meningococcal disease, compartment syndrome can occur within hours after initial presentation due to massive capillary leakage and circulatory failure. Immediate surgical intervention is the gold standard in treatment, making early recognition vital. In all patients presenting with meningococcal disease, compartment syndrome should be considered and early monitoring included in the initial evaluation
Mink van der Molen AB, Janssen K, Specken TF, Stubenitsky BM. The modified Honig velopharyngoplasty - a new technique to treat hypernasality by palatal lenghtening. Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS 2008; [Epub ahead of print].
Abstract: BACKGROUND: Palatal lengthening by pushback with a pharyngeal flap is a commonly used operative technique for the treatment of velopharyngeal insufficiency. The conventional Honig velopharyngoplasty uses full thickness mucoperiosteal flaps for the oral lining of the defect. PURPOSE: A modification is described using only mucosal flaps, thus preserving the periosteum and the palatine arteries. Vascularisation of the hard palate is preserved and bone is not exposed, avoiding potential detrimental scar formation overlying the hard palate, which may affect normal outgrowth of the maxilla. STUDY DESIGN: Eight patients with persisting hypernasality were included. Velopharyngeal closure was evaluated by nasendoscopy, nasometry and a Dutch speech test for cleft patients. RESULTS: Hypernasality was corrected in all cases. One patient developed a light hyponasality. In four patients the overall speech normalised and in the remaining four cases small errors persisted, but speech was well understandable. CONCLUSION: The procedure yields satisfactory speech results in this preliminary study, comparable to the conventional Honig velopharyngeaplasty. Long term follow up regarding maxillary growth and comparative studies with other operative techniques are now warranted
Mol F, Strandell A, Jurkovic D, Yalcinkaya T, Verhoeve HR, Koks CA, van der Linden PJ, Graziosi GC, Thurkow AL, Hoek A, Hogstrom L, Klinte I, Nilsson K, van Mello NM, Ankum WM, van der Veen F, Mol BW, Hajenius PJ, European Surgery in Ectopic Pregnancy study group. The ESEP study: salpingostomy versus salpingectomy for tubal ectopic pregnancy; the impact on future fertility: a randomised controlled trial. BMC Women's Health 2008; 8:11.
Abstract: ABSTRACT: BACKGROUND: For most tubal ectopic pregnancies (EP) surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy) or radically (salpingectomy) in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP. METHODS/DESIGN: International multi centre randomised controlled trial comparing salpingostomy versus salpingectomy in women with a tubal EP without contra lateral tubal pathology. Hemodynamically stable women with a presumptive diagnosis of tubal EP, scheduled for surgery, are eligible for inclusion. Patients pregnant after in vitro fertilisation (IVF) and/or known documented tubal pathology are excluded. At surgery, a tubal EP must be confirmed. Only women with a tubal EP amenable to both interventions and a healthy contra lateral tube are included. Salpingostomy and salpingectomy are performed according to standard procedures of participating hospitals. Up to 36 months after surgery, women will be contacted to assess their fertility status at six months intervals starting form the day of the operation.The primary outcome measure is the occurrence of spontaneous viable intra uterine pregnancy. Secondary outcome measures are persistent trophoblast, repeat EP, all pregnancies including those resulting from IVF and financial costs. The analysis will be performed according to the intention to treat principle. A cost-effectiveness analysis will be performed within a decision analysis framework, based on costs per live birth, including IVF treatment whenever a spontaneous pregnancy does not occur. Patients' preferences will be assessed using a discrete choice experiment. DISCUSSION: This trial will provide evidence on the trade off between salpingostomy and salpingectomy for tubal EP in view of the pros and cons of both interventions and will offer guidance to clinicians in making the right treatment choice. TRIAL REGISTRATION: Current Controlled Trials ISRCTN37002267
Mrazek F, Kvezereli M, Garr E, Kubistova Z, Kriegova E, Fillerova R, Arakelyan A, Ruven HJ, Drabek J, van den Bosch JM, Kolek V, Welsh KI, Grutters JC, du Bois RM, Petrek M. Complement receptor 1 single nucleotide polymorphisms in Czech and Dutch patients with sarcoidosis. Tissue Antigens 2008; 71(1):77-80.
Abstract: A single nucleotide polymorphism (SNP) C5507G of the complement receptor 1 (CR1) gene has been associated with genetic susceptibility to sarcoidosis in an Italian population. In order to provide further data on the possible involvement of CR1 gene polymorphisms in sarcoidosis, CR1 SNPs C5507G and A3650G were investigated in Czech (n = 210) and Dutch (n = 116) patients with sarcoidosis with ethnically matched groups of healthy control subjects (Czech, n = 203; Dutch, n = 112). CR1 C5507G and A3650G SNPs were not associated with susceptibility to sarcoidosis or its clinical course. Further, CR1 messenger RNA expression in bronchoalveolar lavage cells investigated by quantitative reverse transcriptase-polymerase chain reaction did not differ between sarcoidosis patients and control subjects and was not associated with the presence of the CR1 5507*G allele
Muhs BE, Vincken KL, Teutelink A, Verhoeven EL, Prokop M, Moll FL, Verhagen HJ. Dynamic cine-computed tomography angiography imaging of standard and fenestrated endografts: differing effects on renal artery motion. Vascular & Endovascular Surgery 2008; 42(1):25-31.
Abstract: Different endograft configurations (fenestrated, transrenal, infrarenal) may varyingly affect aortic side branch movement. Renal artery motion was evaluated with 64-slice dynamic cine-computed tomography angiography before and after endovascular aneurysm repair in 16 patients (46 renal arteries). Center-of-mass displacement of the renals was determined per heartbeat for before repair for 3 different endografts; differences were compared, with significance at P < 0.5. Preoperative renal artery motion is significant (1.2 [SD 0.5] mm, range, 0.6-2.). Neither transrenal nor infrarenal endografts alter renal artery motion compared with before repair (P < .05). Renal artery motion after fenestrated endovascular repair with renal stents reduces motion to 25% of the preoperative value (0.3 [SD, 0.1] mm, range, 0.2-0.5 mm; P = .01). Endograft implantation without stented side branches does not change renal artery motion, potentially allowing significant movement of the renal artery relative to the fenestration. Routine stenting of fenestrations limits postoperative renal artery motion to 0.3 mm, thereby preventing significant branch movement in relation the fenestration
Nagtegaal M, Hijdra D, van Moorsel C, Grutters J, van den Bosch J, Rijkers G. Cytokine and chemokine composition of bronchoalveolar lavage fluid and exhaled breath condensate of healthy individuals. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract E4236.
Ndrepepa G, Kastrati A, Mehilli J, Neumann FJ, ten Berg J, Bruskina O, Dotzer F, Seyfarth M, Pache J, Dirschinger J, Berger PB, Schomig A. One-year clinical outcomes with abciximab vs. placebo in patients with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention after pre-treatment with clopidogrel: results of the ISAR-REACT 2 randomized trial. European Heart Journal 2008; 29(4):455-461.
Abstract: AimsThe aim of this study is to investigate whether the benefit of abciximab in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) undergoing percutaneous coronary intervention (PCI) after pre-treatment with 600 mg clopidogrel is sustained at 1 year. Methods and resultsWe performed 1-year follow-up of 2022 high-risk patients with NSTE-ACS undergoing urgent PCI, who were randomized to abciximab or placebo after pre-treatment with 600 mg clopidogrel in the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 2 trial. The combined incidence of death, myocardial infarction, or target vessel revascularization at 1 year was the primary outcome analysis. At 1 year, the primary outcome was reached in 23.3% of patients allocated to abciximab vs. 28.0% of patients allocated to placebo [relative risk (RR) 0.80, 95% confidence interval (CI) 0.67-0.95, P = 0.012]. The combined incidence of death or myocardial infarction was 11.6% in patients allocated to abciximab vs. 15.3% in patients allocated to placebo (RR 0.74, 95% CI 0.59-0.94, P = 0.015). ConclusionIn high-risk patients with NSTE-ACS undergoing a PCI after pre-treatment with 600 mg clopidogrel, adverse events occurred less frequently with abciximab and the early benefit was maintained at 1 year after administration
Neubert A, Wong IC, Bonifazi A, Catapano M, Felisi M, Baiardi P, Giaquinto C, Knibbe CA, Sturkenboom MC, Ghaleb MA, Ceci A. Defining off-label and unlicensed use of medicines for children: Results of a Delphi survey. Pharmacological research 2008; 58(5-6):316-322.
Abstract: The aim of this Delphi survey is to develop common definitions for unlicensed and off-label drug use in children to be used for research and regulatory purposes. After a literature review on the current status of unlicensed/off-label definitions, a two-stage, web-based Delphi survey was conducted among experts in Europe. Their opinion on concerns, rules and scenarios regarding the unlicensed and off-label use of medicines were obtained. Results were then consulted with the European Medicines Agency (EMEA) before the final proposal was circulated to participants. Eighty-four experts were invited to participate (scientists, health professionals, pharmaceutical companies, regulatory agencies), 34 responded to the first round questionnaire and participated in subsequent rounds. Consensus was reached for the majority of questions. The lowest level of consensus reached was for questions related to a different formulation or if a drug was given although contraindicated. At the final step, 85% of the responding experts agreed on the proposed definition for off-label (use of a drug already covered by a Marketing Authorisation, in an unapproved way) and 80% on the definition for unlicensed (use of a drug not covered by a Marketing Authorisation as medicinal for human use), respectively. Results will facilitate the conduct of pharmacoepidemiological studies and allow comparison between different countries. The Delphi panel agreed that the definitions should be circulated within the scientific community and recommended to be adopted by relevant regulatory authorities
Nieuwenhuizen L, Verzijlbergen F, Wiltink E, Grutters C, Biesma DH. A relatively high incidence of rituximab-induced pneumonitis detected by positron emission tomography in patients treated with rituximab for non-Hodgkin's lymphoma. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;68.
Nieuwenhuizen L, Biesma DH. Central nervous system myelomatosis: review of the literature. European Journal of Haematology 2008; 80(1):1-9.
Abstract: Involvement of the central nervous system (CNS) in multiple myeloma (MM) is very uncommon; it has been observed in approximately 1% of the MM patients. This review summarizes the clinical and laboratory characteristics and treatment modalities of 109 patients with CNS myelomatosis (CNS MM) reported in the literature. CNS MM has a wide spectrum of neurological symptoms and signs. No guidelines for therapy of CNS MM are available, which has resulted in a large variation in the treatment schedules. Treatment options include intrathecal chemotherapy (IT), systemic chemotherapy (SC), cranial irradiation (CI) or a combination. The prognosis of CNS MM remains poor, with an overall median survival from the time of diagnosis to death of 2.0 months (range 0.1-25 months). Patients who were treated with CI had a significantly (P = 0.004) longer survival when compared with patients without CI
Nieuwenhuizen L, Biesma DH. Central nervous system myelomatosis: review of the literature. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;68-69.
Nieuwenhuizen L, Timmer R. Mycobacterium xenopi as an unusual cause for a infectious colitis: a case report. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;106.
Nieuwenhuizen L, Verzijlbergen FJ, Wiltink E, Grutters JC, Biesma DH. A possible role of 18F-FDG positron-emission tomography scanning in the early detection of rituximab-induced pneumonitis in patients with non-Hodgkin's lymphoma. Haematologica 2008; 93(8):1267-1269.
Nieuwenhuizen L, Verzijlbergen JF, Wiltink E, Grutters JC, Biesma DH. 18F-Fluorodeoxyglucose Positron-Emission Tomography abnormalities in patients with rituximab-induced pneumonitis. Tijdschrift voor Nucleaire Geneeskunde 2008; 30(3):139.
Nijdam ME, Plantinga Y, Hulsen HT, Bos WJ, Grobbee DE, van der Schouw YT, Bots ML. Pulse pressure amplification and risk of cardiovascular disease. American Journal of Hypertension 2008; 21(4):388-392.
Abstract: BackgroundWhether pulse pressure amplification (PPA) relates to established markers of cardiovascular risk is unknown. The purpose of this study was to investigate the relationship between PPA and cardiovascular risk factors and cardiovascular risk in a population-based sample of 40- to 80-year old men.MethodsA cross-sectional, single-center study was performed in 400 men aged 40-80 years. PPA was calculated as a ratio (brachial pulse pressure/central pulse pressure). Detailed information on vascular risk factors was obtained. Aortic pulse wave velocity (PWV) and common carotid intima-media thickness (CIMT), as markers of vascular risk, were measured. We calculated the absolute 10-year risk of coronary heart disease using the Framingham risk score. Regression analysis was used to evaluate the relations under study.ResultsIn models adjusted for age, mean arterial pressure (MAP), heart rate, and height, significant inverse relations with PPA were found for waist-to-hip ratio, triglycerides, smoking, pack-years, and hypertension. Furthermore, an increased PPA was significantly inversely related to aortic PWV, common CIMT, and history of symptomatic vascular disease. Finally, the Framingham risk score decreased with increasing PPA.ConclusionOur study shows that a higher PPA reflects a lower vascular risk in men between 40 and 80 years of age, as shown by a better cardiovascular risk profile, a reduced PWV, common CIMT, and a lower Framingham risk of coronary heart disease.American Journal of Hypertension (2008) doi:10.1038/ajh.2007.89American Journal of Hypertension (2008); 21 4. 388-392 doi:10.1038/ajh.2007.89
Nijveldt R, van der Vleuten RA, van der Laan AM, Afsharzada F, Piers LH, van der Giessen WJ, ten Berg JM, Waltenberg JL, Aengevaeren WR, Doevendans PA, Biemond BJ, Tio RA, van Rossum AC, Tijssen JG, Zijlstra F, Piek JJ . Intracoronary Infusion of Mononuclear Cells After Primary Percutaneous Coronary Intervention: The HEBE Trial. Circulation 2008; 118(22):2316.
Noordzij M, Bos WJ, Boeschoten EW, Dekker FW, Krediet RT, Korevaar JC. Vascular calcification is widespread and progresses over time in haemodialysis and peritoneal dialysis patients. ERA-EDTA 2008.
Noordzij M, Bos WJW, Boeschoten EW, Dekker FW, Krediet RT, Korevaar JC. Progression of vascular calcification from the start of dialysis treatment. Nephrology Dialysis Transplantation Plus 2008; 1(Suppl 2):ii341.
Noordzij M, Korevaar JC, Dekker FW, Boeschoten EW, Bos WJ, Krediet RT, Bossuyt PM, Geskus RB. Mineral Metabolism and Mortality in Dialysis Patients: A Reassessment of the K/DOQI Guideline. Blood Purification 2008; 26(3):231-237.
Abstract: Background: Several studies found associations between higher plasma calcium and phosphorus and mortality in dialysis patients. However, different predefined categories and reference values were applied and the precise shape of these relationships remains unclear. Methods: We evaluated 1,621 patients from NECOSAD, a prospective multicenter cohort study of incident dialysis patients (60 +/- 15 years, 61% male, 64% hemodialysis). We used multivariate Cox regression and restricted cubic spline regression to study the effects of time-updated plasma concentrations on mortality in a flexible manner. Results: 486 patients (30%) died during follow-up. Elevated phosphorus concentration was associated with higher mortality (p = 0.0009). The association of high calcium with mortality was borderline significant (p = 0.07). Within the studied ranges, we could not identify a threshold where an appreciable change in mortality risk occurred. Conclusions: Mortality risk started to increase at a relatively low phosphorus concentration (4.5 mg/dl). Low-normal calcium combined with low-normal phosphorus concentration was associated with the lowest mortality. Copyright (c) 2008 S. Karger AG, Basel
Noordzij M, Bos WJ, Boeschoten EW, Dekker FW, Krediet RT, Korevaar JC. Progression of Aortic Calcification during Dialysis Treatment is Widespread and Increases Mortality Risk. ASN 2008.
Onuta G, Westerweel PE, Zandvoort A, van Riezen M, Rozing J, Hillebrands JL, Verhaar MC. Angiogenic sprouting from the aortic vascular wall is impaired in the BB rat model of autoimmune diabetes. Microvascular research 2008; 75(3):420-425.
Abstract: BACKGROUND: Diabetes is associated with impaired neovascularization leading to reduced revascularization of ischemic tissue and impaired wound healing. Endothelial progenitor cells in diabetes were previously shown to be numerically reduced and functionally impaired. We hypothesize that diabetes also has a long-term effect on angiogenic cells residing in the vessel wall. To test this hypothesis, angiogenic sprout formation from ex vitro cultured aortic rings isolated from diabetic and non-diabetic BioBreeding (BB) rats was assessed. METHODS: Diabetes prone BB (BBDP) rats spontaneously develop autoimmune diabetes were suboptimally treated with insulin by subcutaneous implantation of slow-release insulin-pellets. Neonatally thymectomized BBDP rats, pre-diabetic BBDP rats and diabetes resistant BBDR rats served as non-diabetic controls. After follow-up thoracic aortas were harvested and cultured in vitro in Matrigel to induce sprout formation. Sprout length was quantified after 4, 7, 10 and 14 days of culture. The total number of sprout-derived cells was measured and in vitro proliferative capacity of sprout cells was quantified. Finally, expression of Flk-1, CD31 and smooth muscle alpha-actin on sprout cells was determined. RESULTS: Mean blood glucose levels in diabetics were significantly elevated compared with non-diabetics. Both long-term and short-term diabetes significantly reduced sprout formation (p<0.05 vs. non-diabetics). Reduced sprout length in diabetics was reflected by significantly reduced numbers of sprout cells that could be isolated (p<0.05 vs. non-diabetics). Isolated sprout cells from diabetics revealed significantly reduced proliferative capacity after in vitro culture (p<0.05 vs. non-diabetics). Immunofluorescent staining indicated an endothelial phenotype of both freshly isolated and in vitro cultured sprout cells as indicated by CD31 and Flk-1 expression and absence of smooth muscle alpha-actin expression. CONCLUSIONS: Diabetes in BB rats impairs angiogenic sprouting from cells residing in the vascular wall, independent of effects on circulating cells or circulating angiogenic/anti-angiogenic factors. The angiogenic impairment of diabetic sprout cells is, to some extent, imprinted upon the cells
Oosterheert JJ, Bonten MJM, Schneider MME, Buskens E, Lammers JWJ, Hustinx WNM, Kramer MHH, Prins JM, Slee PHThJ, Kaasjager K, Hoepelman IM. Vroege omschakeling van intraveneuze naar orale antibiotica even effectief als standaard intraveneuze therapie bij ernstige, buiten het ziekenhuis opgelopen pneumonie. Nederlands Tijdschrift voor Geneeskunde 2008; 152(5):269-274.
Oosterhuis WP, van der Horst M, Kootstra-Ros JE, van Loon D, Ulenkate HJLM, Wulkan RW. Start van een kwaliteitsprogramma met externe rondzending voor interpretatie van laboratoriumuitslagen. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):76.
Paantjens AW, Kwakkel-van Erp JM, van Ginkel WG, van Kessel DA, van den Bosch JM, van de Graaf EA, Otten HG. Serum thymus and activation regulated chemokine levels post-lung transplantation as a predictor for the bronchiolitis obliterans syndrome. Clinical & Experimental Immunology 2008; 154(2):202-208.
Abstract: The main reason for mortality after lung transplantation is the bronchiolitis obliterans syndrome (BOS), which represents chronic rejection. As soluble CD30, which is produced mainly by activated T helper 2 (Th2) cells, was shown to be related to development of BOS, we aimed to investigate the relation between development of BOS and Th2 chemoattractant thymus and activation regulated chemokine (TARC/CCL17). In 54 patients we measured serum TARC levels prior to transplantation by enzyme-linked immunosorbent assay, and in 44 of these patients sera were analysed at months 1, 2 and 3 after lung transplantation. In addition, longitudinal measurements were performed in sera from eight healthy controls and 14 patients, the latter taken over a period of 2 years post-transplantation from seven patients developing BOS plus seven clinically matched BOS-free patients. Median serum TARC levels post-transplantation of patients who developed BOS were significantly lower than those of the matched BOS-free patients (P = 0.05). A receiver operating characteristics analysis (area under the curve 0.77), together with a Kaplan-Meyer analysis, showed that serum TARC levels below 325 pg/ml in the first month post-transplantation can predict development of BOS post-transplantation (P = 0.001). In contrast, pretransplant serum TARC levels were not significantly different between patients developing BOS, BOS-free patients or healthy controls. In conclusion, pretransplantation serum TARC levels do not predict the development of BOS post-transplantation, but measurement of the serum TARC levels in the first month directly after transplantation can provide us with a tool to identify the group at risk of developing BOS
Peeters MY, Bras LJ, DeJongh J, Wesselink RM, Aarts LP, Danhof M, Knibbe CA. Disease Severity Is a Major Determinant for the Pharmacodynamics of Propofol in Critically Ill Patients. Clinical Pharmacology & Therapeutics 2008; 83(3):443-4.
Abstract: As oversedation is still common and significant variability between and within critically ill patients makes empiric dosing difficult, the population pharmacokinetics and pharmacodynamics of propofol upon long-term use are characterized, particularly focused on the varying disease state as determinant of the effect. Twenty-six critically ill patients were evaluated during 0.7-9.5 days (median 1.9 days) using the Ramsay scale and the bispectral index as pharmacodynamic end points. NONMEM V was applied for population pharmacokinetic and pharmacodynamic modeling. Propofol pharmacokinetics was described by a two-compartment model, in which cardiac patients had a 38% lower clearance. Severity of illness, expressed as a Sequential Organ Failure Assessment (SOFA) score, particularly influenced the pharmacodynamics and to a minor degree the pharmacokinetics. Deeper levels of sedation were found with an increasing SOFA score. With severe illness, critically ill patients will need downward titration of propofol. In patients with cardiac failure, the propofol dosages should be reduced by 38%.Clinical Pharmacology & Therapeutics advance online publication 8 August 2007. doi:10.1038/sj.clpt.6100309
Peeters MY, Aarts LP, Boom FA, Bras LJ, Tibboel D, Danhof M, Knibbe CA. Pilot study on the influence of liver blood flow and cardiac output on the clearance of propofol in critically ill patients. European Journal of Clinical Pharmacology 2008; 64(3):329-334.
Abstract: OBJECTIVE: To investigate the effect of cardiac output and liver blood flow on propofol concentrations in critically ill patients in the intensive care unit. METHODS: Five medical/surgical critically ill patients were enrolled in this preliminary study. Liver blood flow was measured using sorbitol. The cardiac output was measured by bolus thermodilution. NONMEM: ver. V was applied for propofol pharmacokinetic analysis. RESULTS: The clearance of propofol was positively influenced by the liver blood flow (P < 0.005), whereas no significant correlation between cardiac output and propofol clearance was found. A correlation between liver blood flow and cardiac output or cardiac index could not be assumed in this patient group. CONCLUSIONS: Liver blood flow is a more predictive indicator than cardiac output for propofol clearance in critically ill patients when the techniques of hepatic sorbitol clearance and bolus thermodilution, respectively, are used. Further study is needed to determine the role played by liver blood flow and cardiac output on the pharmacokinetics of highly extracted drugs in order to reduce the observed high interindividual variabilities in response in critically ill patients
Peeters MYM, Knibbe CAJ, Tibboel D, Danhof M. Individueel sederen bij kwetsbare groepen. PK-PD-modellen voor midazolam en propofol. Pharmaceutisch Weekblad 2008; 35:34-35.
Peeters W, Hellings WE, de Kleijn DPV, Schoneveld A, de Vries JPPM, Moll FL, Pasterkamp G. Symptomatic carotid atherosclerotic plaques stabilize following stroke; insights into the natural process of atherosclerotic plaque stabilization following ischemic events. European Heart Journal 2008; 29(Suppl 1):628.
Peeters W, Hellings WE, de Kleijn DP, Moll FL, Schoneveld A, de Vries JP, Pasterkamp G. Natural history of carotid atherosclerotic plaque emodeling after tia or stroke. Atherosclerosis Supplements 2008; 9(1):5.
Peeters W, de Kleijn DP, Moll FL, Hellings WE, Vons K, Velema E, de Vries JP, Pasterkamp G. Acetylsalicylic acid use is associated with increased cytokine expression in atherosclerotic carotid plaques. Atherosclerosis Supplements 2008; 9(1):47-48.
Pellikaan W, Hoekstra T, Vogels O, Schonewille W. Time is brain : onderzoek naar 'door-to-needle' tijd bij het herseninfarct. Cordiaal 2008; 29(2):50-53.
Petrov MS, van Santvoort HC, Besselink MG, van der Heijden GJ, Windsor JA, Gooszen HG. Enteral Nutrition and the Risk of Mortality and Infectious Complications in Patients With Severe Acute Pancreatitis: A Meta-analysis of Randomized Trials. Archives of Surgery 2008; 143(11):1111-1117.
Abstract: OBJECTIVE: To compare the effect of enteral vs parenteral nutrition in patients with severe acute pancreatitis for clinically relevant outcomes. DATA SOURCES: A computerized literature search was performed in the MEDLINE, EMBASE, and Cochrane databases for articles published from January 1, 1966, until December 15, 2006. STUDY SELECTION: From 253 publications screened, 5 randomized controlled trials comparing enteral and parenteral nutrition in patients with predicted severe acute pancreatitis met the inclusion criteria. DATA EXTRACTION: Information on study design, patient characteristics, and acute pancreatitis outcomes were independently extracted by two of us using a standardized protocol. DATA SYNTHESIS: A meta-analysis of randomized controlled trials was performed using a random-effects model. Enteral feeding reduced the risk of infectious complications (relative risk, 0.47; 95% confidence interval, 0.28-0.77; P < .001), pancreatic infections (0.48; 0.26-0.91; P = .02), and mortality (0.32; 0.11-0.98; P = .03). The risk reduction for organ failure was not statistically significant (0.67; 0.30-1.52; P = .34). CONCLUSIONS: Enteral nutrition results in clinically relevant and statistically significant risk reduction for infectious complications, pancreatic infections, and mortality in patients with predicted severe acute pancreatitis
Petrov MS, van Santvoort HC, Besselink MG, van der Heijden GJ, van Erpecum KJ, Gooszen HG. Early Endoscopic Retrograde Cholangiopancreatography Versus Conservative Management in Acute Biliary Pancreatitis Without Cholangitis: A Meta-Analysis of Randomized Trials. Annals of Surgery 2008; 247(2):250-257.
Abstract: BACKGROUND:: Early endoscopic retrograde cholangiopancreatography (ERCP) should be performed in all patients with acute biliary pancreatitis (ABP) and coexisting acute cholangitis. In patients without cholangitis and predicted mild ABP it is generally accepted that early ERCP should not be performed. Nevertheless, there is a controversy regarding the role of early ERCP in the treatment of patients with predicted severe ABP without cholangitis. We reviewed randomized trials on early ERCP versus conservative management in patients with ABP without acute cholangitis. METHODS:: Relevant publications in 3 electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials) were systematically reviewed and meta-analyzed. RESULTS:: Seven randomized trials on ERCP in acute pancreatitis were found, of which 3 including a total of 450 patients (230 in the invasive arm and 220 in the control arm) qualified for a meta-analysis according to predefined criteria. In all patients with ABP (predicted mild and severe), early ERCP was associated with a nonsignificant reduction in overall complications [risk ratio (RR) 0.76; 95% confidence interval (CI) 0.41-1.04; P = 0.38] and a nonsignificant increase in mortality (RR 1.13; 95% CI 0.23-5.63; P = 0.88). Subgroup analysis based on predicted severity did not affect these outcomes (overall complications: predicted mild: RR 0.86; 95% CI 0.62-1.19; P = 0.36; predicted severe: RR 0.82; 95% CI 0.32-2.10; P = 0.68; mortality: predicted mild: RR 1.90; 95% CI 0.25-14.55; P = 0.53; predicted severe: RR 1.28; 95% CI 0.20-8.06; P = 0.80). CONCLUSION:: In this meta-analysis, early ERCP in patients with predicted mild and predicted severe ABP without acute cholangitis did not lead to a significant reduction in the risk of overall complications and mortality
Petrov MS, Besselink MG, van Santvoort HC, Gooszen HG. Acute Biliary Pancreatitis Without Cholangitis: The Growing Role of EUS. Annals of Surgery 2008; 248(2):345-347.
Post MC, van Gent MWF, Snijder RJ, Mager JJ, Schonewille WJ, Plokker HWM, Westermann CJJ. Pulmonary Arteriovenous Malformations and Migraine: A New Vision. Respiration 2008; 76(2):228-233.
Post MC, Plokker HWM, Kelder JC, Snijder RJ. Long-term efficacy of bosentan therapy in inoperable chronic thromboembolic pulmonary hypertension. European Heart Journal 2008; 29(Suppl 1):562.
Post S, Boomsma MF, Biesma DH, Eland I. A potentially deceptive complication of an orbital fracture. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;57-58.
Post S, van den Broek A, van Oostrom O, Sluijter J, Rensing B, Smits A, Verhaar M, Goumans M-J, Doevendans P. Increased availability but defective homing capacities of circulating cells in patients with acute myocardial infarction. Circulation Research 2008;(Late-Breaking Basic Science Abstracts From the American Heart Association Scientific Sessions, 2008 New Orleans, Louisiana November 8 - 12, 2008):Abst. 3531.
Postma S, van Werkum JW, Parlak E, Bouman HJ, Elsenburg EHAM, ten Berg JM, Hackeng CM. Assessing different determinants of platelet function as potential risk factors for coronary stent thrombosis: a case-control study. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):80.
Postma S, Elsenberg EHAM, van Werkum JW, ten Berg JM, Hackeng CM. Clopidogrel-ongevoeligheid: to test or not to test? Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(4):265-270.
Pouw RE, Gondrie JJ, Sondermeijer CM, ten Kate FJ, van Gulik TM, Krishnadath KK, Fockens P, Weusten BL, Bergman JJ. Eradication of Barrett Esophagus with Early Neoplasia by Radiofrequency Ablation, with or without Endoscopic Resection. Journal of Gastrointestinal Surgery 2008; 12(10):1627-1637.
Abstract: BACKGROUND: Radiofrequency ablation is safe and effective for complete eradication of nondysplastic Barrett esophagus (BE). The aim was to report the combined results of two published and two ongoing studies on radiofrequency ablation of BE with early neoplasia, as presented at SSAT presidential plenary session DDW 2008. METHODS: Enrolled patients had BE </=12 cm with early neoplasia. Visible lesions were endoscopically resected. A balloon-based catheter was used for circumferential ablation and an endoscope-based catheter for focal ablation. Ablation was repeated every 2 months until the entire Barrett epithelium was endoscopically and histologically eradicated. RESULTS: Forty-four patients were included (35 men, median age 68 years, median BE 7 cm). Thirty-one patients first underwent endoscopic resection [early cancer (n = 16), high-grade dysplasia (n = 12), low-grade dysplasia (n = 3)]. Worst histology remaining after resection was high-grade (n = 32), low-grade (n = 10), or no (n = 2) dysplasia. After ablation, complete histological eradication of all dysplasia and intestinal metaplasia was achieved in 43 patients (98%). Complications following ablation were mucosal laceration at resection site (n = 3) and transient dysphagia (n = 4). After 21 months of follow-up (interquartile range 10-27), no dysplasia had recurred. CONCLUSIONS: Radiofrequency ablation, with or without prior endoscopic resection for visible abnormalities, is effective and safe in eradicating BE and associated neoplasia
Rahel BM, Suttorp MJ, Laarman GJ, ten Berg JM, Kelder JC, Bosschaert MAR. Three-year Clinical Outcome After Primary Stenting of Totally Occluded Native Coronary Arteries: PRISON II Study. Journal of the American College of Cardiology 2008; 51(10 suppl 2):B19.
Ridwan BU, Koning CJ, Besselink MG, Timmerman HM, Brouwer EC, Verhoef J, Gooszen HG, Akkermans LM. Antimicrobial activity of a multispecies probiotic (Ecologic 641) against pathogens isolated from infected pancreatic necrosis. Letters in Applied Microbiology 2008; 46(1):61-67.
Abstract: Aims: Although probiotic prophylaxis has been suggested to prevent small bowel bacterial overgrowth, bacterial translocation and infection of pancreatic necrosis in severe acute pancreatitis, limited data are available on their antimicrobial activity. Methods and Results: Using the well-diffusion method, we studied the antimicrobial properties of a multispecies probiotic product (Ecologic 641) against a collection of pathogens cultured from infected pancreatic necrosis. All individual probiotic strains included in the multispecies preparation were able to inhibit the growth of the pathogens to some extent. However, the combination of the individual strains (i.e. the multispecies preparation) was able to inhibit all pathogenic isolates. Probiotic-free supernatants adjusted to pH 7 were not able to inhibit pathogen growth. Conclusion: Ecologic 641 is capable of inhibiting growth of a wide variety of pathogens isolated from infected pancreatic necrosis. The antimicrobial properties are to a large extent explained by the production of organic acids. Significance and Impact of the Study: Ecologic 641 is currently being used in a Dutch nationwide double-blind, placebo-controlled, randomized multicentre trial in patients with predicted severe acute pancreatitis (PROPATRIA, ISRCTN38327949)
Riezebos RK, Ronner E, ter Bals E, Slagboom T, Smits PC, ten Berg JM, Kiemeneij F, Amoroso G, Patterson MS, Suttorp MJ, Tijssen JG, Laarman GJ. Immediate versus deferred coronary angioplasty in non-ST-elevation acute coronary syndromes. Heart 2008; [Epub ahead of print].
Abstract: OBJECTIVES: The purpose of the study was to compare immediate versus deferred angioplasty in patients with non-ST-segment- elevation acute coronary syndromes BACKGROUND: The field of acute coronary syndromes is currently characterized by an increasing tendency towards early invasive catheter based diagnostics and therapeutics. However, this practice is based on merely observational and retrospective data. METHODS: A randomized and prospective multicenter trial was performed in patients admitted with NSTE-ACS, eligible for PCI. 251 patients with acute coronary angiography were enrolled. The coronary anatomy was appropriate for PCI in 142 patients. These patients were randomized to immediate PCI (n=73) or deferred PCI (24-48 hours) (n=69). Patients received protocol driven glycoprotein 2b3a blockers, aspirin and clopidogrel. The primary endpoint was a composite of death, nonfatal myocardial infarction (MI)or unplanned revascularization, at 30 days. After hospital discharge out-patient follow up was performed at 30 days and 6 months. RESULTS: The incidence at 30 days of the primary endpoint was 60 percent in the group assigned to immediate PCI and 39 percent in the group assigned to deferred PCI. (Relative risk 1.5, 95 percent, CI 1.09-2.15; p=0.004). Myocardial infarction was significantly more frequent in the group assigned to immediate PCI (60 percent vs 37 percent, relative risk 1.6, CI 1.12-2.28, p=0.005). The observed difference was preserved over a 6 month follow up period. CONCLUSIONS: Immediate PCI was associated with an increased rate of MI as compared to a 24-48 hours deferred strategy, in spite of an aggressive antithrombotic treatment. The results suggest that PCI for high-risk, non-refractory NSTE-ACS should be delayed for at least 24 hours after hospital admission
Rijkers GT, Kroese FGM, Kallenberg CGM, Derksen RHWM. Immunologie. Houten: Bohn Stafleu van Loghum, 2008.
Robertson AGN, Griffin SM, Ward C, Pearson JP, Bredenoord AJ, Dark JH, Fisher AJ, Lordan J, Corris PA. Qualitative and quantitative assessments of aspiration in the immediate post-lung transplantation period. Thorax 2008; 63(Suppl VII):A10-A11.
Robroeks CM, van de Kant KD, van Vliet D, Kester AD, Hendriks HJ, Damoiseaux JG, Wodzig WK, Rijkers GT, Dompeling E, Jobsis Q. Comparison of the anti-inflammatory effects of extra-fine hydrofluoroalkane-beclomethasone vs fluticasone dry powder inhaler on exhaled inflammatory markers in childhood asthma. Annals of allergy, asthma & immunology 2008; 100(6):601-607.
Abstract: BACKGROUND: Extra-fine hydrofluoroalkane-beclomethasone differs from other inhaled corticosteroids by its fine aerosol characteristics. Therefore, extra-fine hydrofluoroalkane-beclomethasone may be particularly useful for treating peripheral airway inflammation in asthma. OBJECTIVE: To analyze the anti-inflammatory effects of extra-fine hydrofluoroalkane-beclomethasone vs fluticasone dry powder inhaler (DPI) in asthmatic children by measuring bronchial and alveolar nitric oxide (NO) and inflammatory markers in exhaled breath condensate (EBC). METHODS: In a 6-month crossover study, 33 children aged 6 to 12 years with moderate persistent asthma were randomly treated with extra-fine hydrofluoroalkane-beclomethasone (200 microg daily via an Autohaler) and fluticasone DPI (200 microg daily via a Diskus). The primary outcome variables were alveolar NO concentration and bronchial NO flux. The secondary outcome variables were levels of inflammatory markers in EBC, lung function indices, symptoms, exacerbations, and adverse effects. All the variables were recorded at baseline and after each treatment period. RESULTS: Mean +/- SE alveolar NO concentration and bronchial NO flux were comparable after treatment with hydrofluoroalkane-beclomethasone vs fluticasone DPI (4.7 +/- 0.5 vs 4.3 +/- 0.5 ppb, P = .55, and 1,124.3 +/- 253.6 vs 1,029.1 +/- 195.5 pL/s, P = .70, respectively). In addition, levels of inflammatory markers in EBC, lung function indices, and symptoms did not differ between treatments. Patients used fewer beta2-agonists during the last 2 weeks of hydrofluoroalkane-beclomethasone treatment. CONCLUSION: The anti-inflammatory effects of hydrofluoroalkane-beclomethasone are similar to those of fluticasone DPI in children with moderate persistent asthma
Rodriguez-Feo JA, Hellings WE, Moll FL, de Vries JP, van Middelaar BJ, Algra A, Sluijter J, Velema E, van der Broek T, Sessa WC, de Kleijn DP, Pasterkamp G. Caveolin-1 influences vascular protease activity and is a potential stabilizing factor in human atherosclerotic disease. PLoS ONE 2008; 3(7):e2612.
Abstract: Caveolin-1 (Cav-1) is a regulatory protein of the arterial wall, but its role in human atherosclerosis remains unknown. We have studied the relationships between Cav-1 abundance, atherosclerotic plaque characteristics and clinical manisfestations of atherosclerotic disease.We determined Cav-1 expression by western blotting in atherosclerotic plaques harvested from 378 subjects that underwent carotid endarterectomy. Cav-1 levels were significantly lower in carotid plaques than non-atherosclerotic vascular specimens. Low Cav-1 expression was associated with features of plaque instability such as large lipid core, thrombus formation, macrophage infiltration, high IL-6, IL-8 levels and elevated MMP-9 activity. Clinically, a down-regulation of Cav-1 was observed in plaques obtained from men, patients with a history of myocardial infarction and restenotic lesions. Cav-1 levels above the median were associated with absence of new vascular events within 30 days after surgery [0% vs. 4%] and a trend towards lower incidence of new cardiovascular events during longer follow-up. Consistent with these clinical data, Cav-1 null mice revealed elevated intimal hyperplasia response following arterial injury that was significantly attenuated after MMP inhibition. Recombinant peptides mimicking Cav-1 scaffolding domain (Cavtratin) reduced gelatinase activity in cultured porcine arteries and impaired MMP-9 activity and COX-2 in LPS-challenged macrophages. Administration of Cavtratin strongly impaired flow-induced expansive remodeling in mice.This is the first study that identifies Cav-1 as a novel potential stabilizing factor in human atherosclerosis. Our findings support the hypothesis that local down-regulation of Cav-1 in atherosclerotic lesions contributes to plaque formation and/or instability accelerating the occurrence of adverse clinical outcomes. Therefore, given the large number of patients studied, we believe that Cav-1 may be considered as a novel target in the prevention of human atherosclerotic disease and the loss of Cav-1 may be a novel biomarker of vulnerable plaque with prognostic value
Rosias PP, Robroeks CM, Kester A, den Hartog GJ, Wodzig WK, Rijkers GT, Zimmermann LJ, van Schayck CP, Jobsis Q, Dompeling E. Biomarker reproducibility in exhaled breath condensate collected with different condensers. European Respiratory Journal 2008; 31(5):934-942.
Abstract: Optimal collection and analysis of exhaled breath condensate (EBC) are prerequisites for standardisation and reproducibility of assessments. The present study aimed to assess reproducibility of EBC volume, hydrogen peroxide (H(2)O(2)), 8-isoprostane and cytokine measurements using different condensers, including a newly developed glass condenser. At four points in time, 30 healthy subjects performed sequential EBC collections randomly using the following four condensers: glass, silicone, EcoScreen (Erich Jaeger GmbH, Hoechberg, Germany) and an optimised glass condenser. In small EBC samples, H(2)O(2) was measured by spectrophotometer, 8-isoprostane by enzyme immunoassay, and cytokines by multiplexed xMAP technology (Luminex Corporation, Austin, TX, USA). The optimised glass condenser yielded significantly more EBC volume (median 2,025 microL, interquartile range 1,600-2,525). The reproducibility of EBC volume, yielded by the new glass condenser, was comparable with EcoScreen (19-20 coefficients of variation (CV)%), but was significantly better compared with silicone and glass (29-37 CV%). The new condenser was associated with significantly more detections of H(2)O(2), 8-isoprostane, interleukin-2, -4, -5 and -13, and tumour necrosis factor-alpha. Isoprostane concentrations were significantly higher using the new condenser, whereas H(2)O(2) and cytokine concentrations were not. Reproducibility of biomarkers was equally variable for all condenser types. In conclusion, significantly more exhaled breath condensate volume and biomarker detections were found using the optimised glass condenser, including higher 8-isoprostane levels. However, biomarker reproducibility in exhaled breath condensate in healthy adults was not influenced by the type of condenser
Rutten A, de Vos AM, van der Zaag H, Zijlstra F, Rensing B, Mosterd A, Mali WPTM, Prokop M, Bots ML, Oudkerk M. Coronary calcium scoring in cardiac asymptomatic patients with peripheral arterial disease: Is it useful? ESR 2008 2008;Abstract B-442.
Ruven HJT, Deneer VHM, van Kessel DA, van den Bosch JMM. TPMT, MDR-1 and CYP3A5*3 genotype frequencies in lung transplantation patients. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):85.
Sanders L, van Gullik L, Knibbe C, Driessen A, Bruins P, Morshuis WJ. Pain on the intensive care after sternotomy is predictive for chronic thoracic pain. 28th International Symposium on Intensive Care and Emergency Medicine Brussels March 18-23 2008 2008.
Saouti N, Morshuis WJ, Heijmen RH, Snijder RJ. Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: single institution experience. Interactive Cardiovascular and Thoracic Surgery 2008; 7(Suppl 3):S209.
Schaaij G, Hoekstra T. De zorgassistent werkzaam op een afdeling hartchirurgie. Onderwijs en gezondheidszorg 2008; 32(3):15-18.
Schaepkens FFJM. Waardering van vaste activa van ziekenhuizen. HEADline 2008;(107):10-13.
Schagen van Leeuwen JH, Lange RR, Jonasson AF, Chen WJ, Viktrup L. Efficacy and safety of duloxetine in elderly women with stress urinary incontinence or stress-predominant mixed urinary incontinence. Maturitas 2008; 60(2):138-147.
Abstract: OBJECTIVES: To evaluate the efficacy and safety of duloxetine in community-dwelling women >/=65 years with stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (S-MUI) versus placebo. METHODS: Patients were randomly assigned for 12 weeks to placebo (N=134) or duloxetine (N=131) (20mg twice daily [BID] for 2 weeks and 40mg BID for an additional 10 weeks), followed by a double-blind 4-week dose de-escalation/discontinuation phase. The primary efficacy variable was the percent change in incontinence episode frequency (IEF) from baseline to endpoint. Other variables included absolute IEF change, responder rate, changes in mean time between voids (MTBV), weekly continence pad usage, the impact of treatment on quality of life, patient's global impression of improvement (PGI-I), and changes in depression and cognition. RESULTS: Duloxetine-treated patients had a significantly greater decrease from baseline to endpoint in mean IEF/week than placebo-treated patients (-52.47% vs. -36.70%, P<0.001). The IEF responder rate (>/=50% reduction in IEF/week) was 57.1% in the duloxetine group and 35.2% in the placebo group (P<0.001). Significant benefits of duloxetine were also demonstrated for weekly continence pad usage (P=0.011), MTBV (P<0.001), incontinence quality of life questionnaire (I-QOL) scores (P<0.001), and PGI-I ratings (P<0.001). Patients with depressive symptoms and cognitive impairments were few and changes were insignificant. The proportion of patients with >/=1 treatment-emergent adverse event (TEAE) was similar with both treatments, but dry mouth, fatigue, constipation, and hyperhidrosis were significantly more common in women taking duloxetine. CONCLUSIONS: Duloxetine is a safe and effective treatment for elderly women with symptoms of SUI or S-MUI
Schelfhout V, Van De Velde V, Pauwels R, Joos G. The effect of the leukotriene receptor antagonist zafirlukast on neurokinin A-induced bronchoconstriction in patients with asthma--A comparison with leukotriene D4 induced broncoconstriction. Pulmonary pharmacology & therapeutics 2008; 21(2):276-284.
Abstract: The bronchoconstriction caused by inhaled neurokinin A (NKA) in patients with asthma is indirect. The mediators involved in NKA-induced bronchoconstriction are unknown. Studies with various H1 receptor antagonists were negative, making an important contribution of histamine unlikely. To study the role of cysteinyl leukotrienes in neurokinin A-induced bronchoconstriction, we performed a randomised, double-blind, cross-over, placebo controlled trial in 12 patients with mild to moderate asthma. Zafirlukast and matching placebo were given orally, 40 mg the evening before and 40 mg the morning of assessment. In one period NKA was administered, in the other period leukotriene D4 (LTD4). Increasing concentrations of NKA and LTD4 were inhaled from a 30 L bag, after nebulization via a Mallinckrodt nebuliser. The difference between log10PC20LTD4 after treatment with placebo or zafirlukast was highly significant (p<0.0001). A trend was observed towards a difference between log10PC20 neurokinin A after treatment with placebo or zafirlukast (p=0.0741). The dose ratio for the neurokinin A provocation was 4.4 and for the LTD4 provocation 67.7. In conclusion, zafirlukast had a large inhibitory effect on LTD4-induced bronchoconstriction, but offered only limited protective effect against neurokinin A-induced bronchoconstriction. We suggest that leukotrienes play a limited role in the bronchoconstrictor effect of neurokinin A in patients with asthma
Schepens M. Management of thoracoabdominal aortic disease: surgical challenge. Annals of Vascular Diseases 2008; 1:S28.
Schepens M. Cerebral and spinal cord protection in aortic surgery. Annals of Vascular Diseases 2008; 1:S27.
Schepens M, Waanders F. Monitoring the Brain: Near Infrared Spectroscopy. In: Coselli JS, LeMaire SA, editors. Aortic Arch Surgery: Principles, Stategies and Outcomes. Wiley-Blackwell, 2008.
Schepens MA. Re: "thoracic aortic endografting in patients with connective tissue disease". Journal of Endovascular Therapy 2008; 15(5):626-627.
Schepens MA. Invited commentary. Annals of Thoracic Surgery 2008; 86(2):489-490.
Schijf LJ, Becx MC, de Bruin PC, van der Vegt SG. Whipple's disease: easily diagnosed, if considered. Netherlands Journal of Medicine 2008; 66(9):392-395.
Abstract: Patients present with arthralgia, abdominal pain, diarrhoea and weight loss. The disease is commonly diagnosed by histological examination of small bowel biopsies, especially after staining with periodic acid-Schiff. Because of the rarity of the disease, its diagnosis is not often considered. Therefore the necessary investigations might be omitted. This case report might serve as a reminder for internists or gastroenterologists to consider Whipple's disease in patients with abdominal, articular or other symptoms after having excluded common differentials. We also review the current literature on Whipple's disease. Whipple's disease is an infectious disorder caused by Tropheryma whipplei
Schiphorst AH, Besselink MG, Boerma D, Timmer R, Wiezer MJ, van Erpecum KJ, Broeders IA, van Ramshorst B. Timing of cholecystectomy after endoscopic sphincterotomy for common bile duct stones. Surgical Endoscopy 2008; 22(9):2046-2050.
Abstract: BACKGROUND: According to the literature, the conversion rate for laparoscopic cholecystectomy (LC) after endoscopic sphincterotomy (ES) for cholecystodocholithiasis reaches 20%, at least when LC is performed 6 to 8 weeks afterward. It is hypothesized that early planned LC after ES prevents recurrent biliary complications and reduces operative morbidity and hospital stay. METHODS: All consecutive patients who underwent LC after ES between 2001 and 2004 were retrospectively evaluated. Recurrent biliary complications during the waiting time for LC, conversion rate, postoperative complications, and hospital stay were documented. RESULTS: This study analyzed 167 consecutive patients (59 men) with a median age of 54 years. The median interval between ES and LC was 7 weeks (range, 1-49 weeks). During the waiting time for LC, 33 patients (20%) had recurrent biliary complications including cholecystitis (n = 18, 11%), recurrent choledocholithiasis (n = 9, 5%), cholangitis (n = 4, 2%), and biliary pancreatitis (n = 2, 1%). Of these 33 patients, 15 underwent a second endoscopic retrograde cholangiography (ERC). The median time between ES and the development of recurrent complications was 22 days (range, 3-225 days). Most of the biliary complications (76%) occurred more than 1 week after ES. Conversion to open cholecystectomy occurred for 7 of 33 patients with recurrent complications during the waiting period, compared with 13 of 134 patients with an uncomplicated waiting period (p = 0.14). This concurred with doubled postoperative morbidity (24% vs 11%; p = 0.09) and a longer hospital stay (median, 4 vs 2 days; p < 0.001). CONCLUSION: In this retrospective analysis, 20% of all patients had recurrent biliary complications during the waiting period for cholecystectomy after ES. These recurrent complications were associated with a significantly longer hospital stay. Cholecystectomy within 1 week after ES may prevent recurrent biliary complications in the majority of cases and reduce the postoperative hospital stay
Scholzel BE, Swaans MJ, Idzerda HHD, Bergmeijer T, Kelder JC, Yilmaz A, Schepens MAAM, ten Berg JM. Morrow septal myectomy and percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy, a single centre comparison. European Heart Journal 2008; 29(Suppl 1):56.
Schrover IM, Weusten BL, Besselink MG, Bollen TL, van Ramshorst B, Timmer R. EUS-guided endoscopic transgastric necrosectomy in patients with infected necrosis in acute pancreatitis. Pancreatology 2008; 8(3):271-276.
Abstract: BACKGROUND: Infected pancreatic and peripancreatic necrosis in acute pancreatitis is potentially lethal, with mortality rates up to 35%. Therefore, there is growing interest in minimally invasive treatment options, such as (EUS-guided) endoscopic transgastric necrosectomy. METHODS: Retrospective cohort study on EUS-guided endoscopic transgastric necrosectomy in patients with infected necrosis in acute pancreatitis. RESULTS: 8 patients (age 38-75, mean 50 years) with documented infected peripancreatic or pancreatic necrosis were included. Median time to first intervention was 33 days (range 17-62) after onset of symptoms. At the time of first intervention 2 patients had organ failure. All patients were managed on the patient ward. Initial endoscopic drainage was successful in all patients, a median of 4 (range 2-6) subsequent endoscopic necrosectomies were needed to remove all necrotic tissue. Two patients needed additional surgical intervention because of pneumoperitoneum (n = 1) and insufficient endoscopic drainage (n = 1). Six patients recovered, with 1 mild relapse during follow-up (median 12, range 8-60 months). One patient died. CONCLUSION: EUS-guided endoscopic transgastric necrosectomy of infected necrosis in acute pancreatitis appears to be a feasible and relatively safe treatment option in patients who are not critically ill. Further randomized comparison with the current 'gold standard' is warranted to determine the place of this treatment modality
Schuurman JP, Go PM, Bleys RL. Anatomical branches of the superior rectal artery in the distal rectum. Colorectal Disease 2008; [Epub ahead of print].
Schuurman JP, Go PMNY, Bleys RLAW. Anatomical study of the arterial vascularisation of the corpus cavernosum recti questions the use of a Doppler probe in hemorrhoidal ligation therapy: F036. Colorectal Disease 2008; 10(Supplement 2):6.
Schuurman JP, Go PMNY. Results of the hemorrhoidal ligation therapy from a patient perspective: P336. Colorectal Disease 2008; 10(Supplement 2):60.
Scicluna BP, Remme CA, Verkerk AO, Amin AS, Tanck MW, Beerkman L, Deneer VH, Chevalier C, Oyama F, Miyazaki H, Nukina N, Escande D, Houlgatte R, de Bakker JM, Veldkamp M, Tan HL, Wilde AA, Bezzina CR. Abstract 1504: Scn4b Is A Genetic Modifier Of Cardiac Conduction Disease In Mice. Circulation 2008; 118(Suppl):S339.
Sengers FB, Niers LE, Rijkers GT, Hoekstra MO. Pre- en probiotica bij allergie: huidige klinische inzichten. Nederlands Tijdschrift voor Allergie 2008; 8(6):201-211.
Sharouni SYE, Aerts JGJV, Sesan S, de Ruysscher DKM, Groen HJM, Paul MA, Smit EF, Vonk EJA, Verhagen AF, Schramel FMNH. Behandeling van patiënten met niet-kleincellig longcarcinoom stadium III: gelijktijdig hooggedoseerde chemotherapie en radiotherapie. Nederlands Tijdschrift voor Geneeskunde 2008; 152(50):2714-2717.
Siebenga J, Leferink VJ, Segers MJ, Elzinga MJ, Bakker FC, Ten DH, Rommens PM, Patka P. A prospective cohort study comparing the VAS spine score and Roland-Morris disability questionnaire in patients with a type A traumatic thoracolumbar spinal fracture. European Spine Journal 2008; 17(8):1096-1100.
Abstract: The Roland Morris Disability Questionnaire (RMDQ-24) and the VAS spine score have been regularly used to measure functional outcome in patients with back pain. The RMDQ-24 is primarily used in degenerative disease of the spine and the VAS Spine is used in trauma patients. The aim of this study is to compare these scores and to see if there is a correlation in patients with a traumatic thoracolumbar spinal fracture. Prospective cohort study comparing the RMDQ-24 and the VAS spine score in patients with a traumatic type A fracture thoracolumbar spine fracture. Fifteen non-operatively patients (group one) completed 118 questionnaires and 17 operatively treated patients (group two) completed 140 questionnaires. Group one scored an average of 6.6 and 65.9 for the RMDQ-24 and VAS Spine, in group two this was 5.1 and 82.9. Spearman's correlation test showed a significant correlation, in group one 0.83 and for the second group 0.87. RMDQ-24 and VAS Spine have a strong positive correlation in measuring disability in a group of patients with back pain because of a spinal fracture. In both non-operatively and operatively treated groups this correlation is significant
Sijssens KM, Rijkers GT, Rothova A, Stilma JS, de Boer JH. Distinct cytokine patterns in the aqueous humor of children, adolescents and adults with uveitis. Ocular immunology and inflammation 2008; 16(5):211-216.
Abstract: PURPOSE: To determine the immune mediator profile in relation to age in the aqueous humor (AqH) of patients with uveitis. METHODS: AqH of children, adolescents, and adults with uveitis was analyzed for 16 immune mediators. RESULTS: No significant differences were found for IL-8, RANTES, and IP-10. The concentrations of the remaining 13 mediators were significant lower in adults compared with children and adolescents, except for IL-6, which was higher. CONCLUSIONS: Various immune mediators are present in higher concentrations in AqH of children and adolescents with different uveitis entities compared with that of adults, except IL-6, which was higher in adults
Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Netherlands Heart Journal 2008; 16(6):191-196.
Slee PHThJ. Casuïstiek in de inwendige geneeskunde: medische vignetten. Houten: Bohn Stafleu van Loghum, 2008.
Slieker MG. Prognose van taaislijmziekte; trends en voorspellers. Nederlands Tijdschrift voor Allergie 2008; 8(6):231-233.
Slieker MG. Prognosis in cystic fibrosis : trends and predictors. s.l.: s.n., 2008.
Ref ID: 9095
Slim FJ, Hoeksma AF, Maas M, Faber WR. A clinical and radiological follow-up study in leprosy patients with asymptomatic neuropathic feet. Leprosy Review 2008; 79(2):183-192.
Abstract: OBJECTIVES: An MRI study done in 2000 on 10 leprosy patients with neuropathic feet, without clinical complications such as ulcerations, osteomyelitis or Charcot deformities revealed abnormalities in nine patients, with degradation, interruption of subcutaneous fat and effusion/synovitis, all located in the first metatarsophalangeal (MTP) region. Since these MRI abnormalities may precede clinical complications of the foot, a follow-up study was performed. DESIGN: A new evaluation was based on a clinical examination and an MRI of the same patients who participated in the initial study. RESULTS: Four patients were lost to follow-up. Average follow-up period was 4-6 years. MRI abnormalities in the MTP 1 region in the first study were no longer visible in three patients, but were still present in two patients. In six patients new MRI findings were found, without clinical evidence of ulceration, osteomyelitis or Charcot deformity. No relationship was found between MRI findings in the MTP 1 region at the start of the study and the development of foot ulcers, callus or skin fissures in the MTP 1 region during follow-up. CONCLUSION: MRI findings of interruption and infiltration of the subcutaneous fat in leprosy patients with uncomplicated neuropathic feet do not necessarily have any clinical implication for the development of future foot problems
Sluman MA, ten Berg JM, Westerveld HE. Pathofysiologie, risicofactoren, diagnostiek en therapie van hart- en vaatziekten: mannen en vrouwen zijn anders. Bijblijven 2008; 24(7):13-22.
Sluman MA, de Weerdt O, ten Berg JM. Amyloidosis mimicking hypertrophic obstructive cardiomyopathy. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;77-78.
Sluman M. Hollands Dagboek cardioloog i.o. Maayke Sluman. NRC Handelsblad 2008;(september 27/28).
Snijder RJ. Porto-pulmonary hypertension. In: Benecke NI, editor. Yearbook Pulmonary Hypertension. 2008: 53-65.
Snijders TJ, Notermans NC. Progressieve, opstijgende neurologische uitval: een spinaal epiduraal abces dat zich presenteert als het syndroom van Guillain-Barré. Nederlands Tijdschrift voor Geneeskunde 2008; 152(25):1436-1439.
Abstract: Over the course of 4 days, a 65-year-old man developed fever and thoracic back pain, followed by weakness and sensory changes in both legs. Physical examination revealed dyspnoea, subfebrile temperature, neck pain withoutnuchal rigidity, sensory impairment, areflexia and weakness in both legs (and arms to a lesser extent). Guillain-Barre syndrome was considered, and treatment with intravenous immunoglobulins was started. The patient nevertheless developed respiratory insufficiency, progressive leg paresis and nuchal rigidity. Spinal MRI revealed an extensive cervicothoracic epidural abscess. Surgical decompression and drainage were performed, followed by antibiotic treatment; the patient recovered and was able to walk with assistance. A spinal epidural abscess can be difficult to recognise and is potentially lethal. The diagnosis should be considered in patients with fever and back pain, especially when these coincide with symptoms of neurological impairment. The efficacy of therapy depends on timely recognition; to this end, neuroimaging with MRI is essential
Sondermeijer BM, Macgillavry MR, Tan HL. Left superior vena cava, a remnant of embryological development. Netherlands Heart Journal 2008; 16(5):173-174.
Sonke GS, Beerepoot LV, Los M. A patient with subdiaphragmatic air. Netherlands Journal of Medicine 2008; 66(2):89-90.
Steenhuis TJ, van Aalderen WM, Bloksma N, Nijkamp FP, van der Laag J, van Loveren H, Rijkers GT, Kuis W, Hoekstra MO. Bacille-Calmette-Guerin vaccination and the development of allergic disease in children: a randomized, prospective, single-blind study. Clinical & Experimental Allergy 2008; 38(1):79-85.
Abstract: BACKGROUND: The increase in the prevalence of allergic diseases in countries with a so-called western lifestyle may be due to a decrease in exposure to infectious agents in early life. OBJECTIVE: To establish the effect of Bacille-Calmette-Guerin (BCG) vaccination in 6-week-old high-risk infants in a prospective single-blind, randomized, placebo-controlled trial on the prevalence of allergic disease at the age of 4 and 18 months. METHODS: Subjects were 121 predominantly Caucasian high-risk newborns, having either a mother, or both a father and at least one sibling with past or present allergic disease. BCG or placebo was administered at the age of 6 weeks, and repeated once when both a post-vaccination scar and a positive TB skin test were absent at the age of 4 months. RESULTS: At the age of 18 months, the prevalence of allergic disease was not significantly different between the two groups. A trend towards less eczema (P=0.07) and significantly less use of medication for eczema was shown in the BCG group compared with the placebo group (P=0.04). CONCLUSION: A single (or once repeated) BCG vaccination in 6-week-old high-risk Caucasian infants was not associated with a 50% reduction in the prevalence of allergic disease. However, there could be a smaller beneficial effect of BCG, especially because a trend towards less eczema and significantly less use of medication for eczema was shown. For definite proof, a larger study should be carried out
Stekelenburg J, Janszen EWM, Lagro MGP, Hulsbergen MH, van Lonkhuijzen LRCW, Schagen van Leeuwen JH, van Diem M, van Roosmalen J, van Dillen J. Obstetrische ectoscopie : terugdringen moedersterfte vereist naar buiten gerichte blik. Medisch Contact 2008; 63(8):321-325.
Stettler C, Allemann S, Wandel S, Kastrati A, Morice M-C, Schomig A, Pfisterer ME, Stone GW, Leon MB, Suárez de Lezo J, Goy JJ, Park SJ, Sabate M, Suttorp MJ, Kelbaek H, Spaulding C, Menichelli M, Vermeersch P, Dirksen MT, Cervinka P, de Carlo M, Erglis A, Chechi T, Ortolani P, Schalij MJ, Diem P, Meier B, Windecker S, Juni P. Drug eluting and bare metal stents in people with and without diabetes: collaborative network meta-analysis. British Medical Journal 2008; 337:a1331.
Stevens WBC, Koene HR, Novotný VMJ. Trombocytengroeifactoren als behandeling van idiopathische trombocytopenische purpura. Nederlands Tijdschrift voor Hematologie 2008; 5(1):28-30.
Stolk M. Moeten patiënten die lang geleden een Billroth-I- of -II-operatie hebben ondergaan in verband met ulcuslijden, regelmatig gastroscopisch worden gecontroleerd? Vademecum permanente nascholing huisartsen 2008;(Augustus).
Swaans MJ, Braam RL, Heijmen RH, Plokker HWM, Jaarsma W. Three-Dimensional Transesophageal Echocardiography in a Patient With Early Failure of Mitral Valve Repair: Why Are We Still Looking at a Three-Dimensional Structure in 2 Dimensions? Circulation: Cardiovascular Imaging 2008; 1(3):282-283.
Swen JJ, Wilting I, de Goede AL, Grandia L, Mulder H, Touw DJ, de Boer A, Conemans JM, Egberts TC, Klungel OH, Koopmans R, van der Weide J, Wilffert B, Guchelaar HJ, Deneer VH. Pharmacogenetics: from bench to byte. Clinical Pharmacology & Therapeutics 2008; 83(5):781-787.
Abstract: Despite initial enthusiasm, the use of pharmacogenetics has remained limited to investigation in only a few clinical fields such as oncology and psychiatry. The main reason is the paucity of scientific evidence to show that pharmacogenetic testing leads to improved clinical outcomes. Moreover, for most pharmacogenetic tests (such as tests for genetic variants of cytochrome P450 enzymes) a detailed knowledge of pharmacology is a prerequisite for application in clinical practice, and both physicians and pharmacists might find it difficult to interpret the clinical value of pharmacogenetic test results. Guidelines that link the result of a pharmacogenetic test to therapeutic recommendations might help to overcome these problems, but such guidelines are only sparsely available. In 2001, an early step was taken to develop such guidelines for the therapeutic use of antidepressants, and these included CYP2D6-related dose recommendations drawn from pharmacokinetic study data. However, the use of such recommendations in routine clinical practice remains difficult, because they are currently outside the ambit of the clinical environment and are not accessible during the decision-making process by physicians and pharmacists, namely the prescription and dispensing of drugs
Swinkels BM, Braam RL, Rensing BJWM, Jaarsma W, Defauw JJAM, Plokker HWM. Onverklaarde rechtsdecompensatie na een openhartoperatie: denk aan het hartzakje. Nederlands Tijdschrift voor Geneeskunde 2008; 152(45):2482.
Swinkels BM, ten Cate TJF, Haenen NA, Rensing BJWM, Defauw JJAM, Jaarsma W. Myocardial perforation by a guidewire crossing a stenotic aortic valve during cardiac catheterization. International Journal of Cardiology 2008; [Epub ahead of print].
Abstract: Myocardial perforation by a guidewire after retrograde crossing of a stenotic aortic valve during cardiac catheterization is rare. We present a patient with calcific aortic stenosis who suffered this potentially life-threatening complication and in whom conservative treatment was successful. Early recognition of this complication is important for the operator performing cardiac catheterizations in patients with calcific aortic stenosis
Swinkels BM, Braam RL, Rensing BJWM, Jaarsma W, Defauw JJAM, Plokker HWM. Onverklaarde rechtsdecompensatie na een openhartoperatie: denk aan het hartzakje. Nederlands Tijdschrift voor Geneeskunde 2008; 152(35):1901-1906.
te Boome LCJ, Koene HR. An exceptional case of the return of Polycythemia Vera after reduced intensity allogeneic hematopoietic stem cell transplantation for myelofibrosis. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;28-29.
te Riele WW, Vogten JM, Boerma D, Wiezer MJ, van Ramshorst B. Comparison of weight loss and morbidity after gastric bypass and gastric banding. A single center European experience. Obesity Surgery 2008; 18(1):11-16.
Abstract: BACKGROUND: Gastric bypass and gastric banding are widely used to treat morbid obesity and both procedures offer certain advantages. The indication for these two treatment options continue to be subject to debate. METHODS: A single-center case-controlled matched-pair cohort study was performed. Fifty-three primary gastric bypass patients (GB) operated between January 2002 and May 2005 were matched by gender, age, race, and initial bodyweight to 53 patients who underwent laparoscopic adjustable gastric banding (LAGB) in the same time period. RESULTS: Both groups were comparable regarding age, race, gender, preoperative body mass index, and excessive weight. Severe early complications occurred in six patients (11.3%) in the GB group and were not seen in the LAGB group. Severe late complications occurred in three patients (5.7%) in the GB group and one patient (1.9%) in the LAGB group. No mortality occurred in either group. Weight loss was significantly lower in the LAGB group than in the GB group at all time points during the follow-up. Significantly more patients were treated successfully (excess weight loss >50%) in the GB group than in the LAGB group. After 2 years, 76% of the patients in the GB group were treated successfully versus 40% of the patients in the LAGB group (P = 0.03). CONCLUSION: Gastric bypass and gastric banding are safe and without mortality. Gastric bypass is more effective in terms of weight loss and the number of successfully treated patients. Gastric banding is a procedure with less severe complications
te Riele WW, Sze YK, Wiezer MJ, van Ramshorst B. Conversion of failed laparoscopic gastric banding to gastric bypass as safe and effective as primary gastric bypass in morbidly obese patients. Surgery for obesity and related diseases 2008; 4(6):735-739.
Abstract: BACKGROUND: To determine whether the medium-term outcome of secondary gastric bypass (SGB) after laparoscopic adjustable gastric banding (LAGB) is comparable to the outcome of primary gastric bypass (PGB) in morbidly obese patients in terms of complications and weight loss. Controversy exists among bariatric surgeons regarding the choice of primary operation for morbid obesity. Some prefer to start with LAGB as a low-risk operation for all patients and perform revisional surgery in the case of failure. Others prefer to tailor the primary operation to the individual patient. METHODS: A total of 55 patients who had undergone SGB after failed LAGB from 2002 to 2006 were compared with 81 patients who had undergone PGB for morbid obesity during the same period in our hospital by a single surgeon. RESULTS: The mean operative time in the PGB group was shorter (73 +/- 22 min, range 50-100) compared with the SGB group (99 +/- 32 min, range 55-180; P <.001). The median length of admission did not differ significantly between the PGB and SGB groups (4 +/- 6.6 d, range 3-55, versus 4 +/- 2.9 d, range 3-16, respectively; P = .13). No significant differences were found in the occurrence of complications between the PGB and SGB groups (29.6% versus 30.9%, respectively, P = .87). No patient died. At 2 and 3 years postoperatively, no significant difference was found in percentage of patients treated with good or excellent outcomes using the criteria of MacLean (2 y, PGB 60.0% versus SGB 58.8%, P = .94; 3 y, PGB 75.0% versus SGB 72.7%, P = .91). CONCLUSION: In this series, gastric bypass as a secondary procedure after failed LAGB was as safe and effective as PGB. Conversion to gastric bypass appears to be the treatment of choice after failed LAGB
ten Berg JM. Patiënten met diabetes mellitus niet dotteren? HealthDirect Cardiologie 2008; 4(4):8.
ten Berg JM, van Werkum JW. Point-of-care platelet function testing in patients undergoing PCI: is it ready for use in clinical practice? EuroIntervention 2008; 4 Suppl C:C72-C74.
ten Berg JM. Bij wie glycoproteïne-IIb/IIIa-blokkers? HealthDirect Cardiologie 2008; 4(3):8-9.
ten Berg JM. Pericardziekten. In: van der Wall EE, van de Werf F, Zijlstra F, editors. Cardiologie. Houten: Bohn Stafleu van Loghum, 2008: 423-429.
ten Bruggenkate CM, Schulten EA, Zijderveld SA. Chirurgische dilemma's. De sinusbodemelevatie. Nederlands Tijdschrift voor Tandheelkunde 2008; 115(12):668-672.
Abstract: Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.
ten Cate TJ, Scheffer MG, Sutherland GR, Verzijlbergen FJ, van Hemel NM. Right ventricular outflow and apical pacing comparably worsen the echocardioghraphic normal left ventricle. European Journal of Echocardiography 2008; 9(5):672-677.
Abstract: AIMS: A depressed left ventricular function (LVF) is sometimes observed during right ventricular apical (RVA) pacing, but any prediction of this adverse effect cannot be done. Right ventricular outflow tract (RVOT) pacing is thought to deteriorate LVF less frequently because of a more normal LV activation pattern. This study aims to assess the acute effects of RVA and RVOT pacing on LVF in order to determine the contribution of echocardiography for the selection of the optimum pacing site during pacemaker (PM) implantation. METHODS AND RESULTS: Fourteen patients with a DDD-pacemaker (7 RVA, 7 RVOT) and normal LVF without other cardiac abnormalities were studied. PM dependency, because of sick sinus syndrome with normal atrioventricular and intraventricular conduction, was absent in all, allowing acute programming changes. Wall motion score (WMS), longitudinal LV strain, and tissue Doppler imaging for electromechanical delay were assessed with echocardiography during AAI pacing constituting baseline and DDD pacing. The WMS was normal at baseline (AAI pacing) in all patients and LV dyssynchrony was absent. Acute RVA and RVOT pacing deteriorated WMS, electromechanical delay, and longitudinal LV strain, but no difference of the deterioration between both pacing sites was present and dyssynchrony did not emerge. CONCLUSION: Both acute RVA and RVOT pacing negatively affect WMS, longitudinal LV strain, and mechanical activation times, without clear differences between both pacing sites. Thus echocardiographic techniques do not facilitate the selection between RVOT and RVA pacing to exclude adverse effects on LVF during PM implantation in patients with a normal LVF
ten Cate TJF, van Hemel NM, Backus BE, Jaarsma W, Verzijlbergen JF. A novel approach to identify patients at high coronary risk in the presence of abnormal activated left ventricles. Journal of Nuclear Cardiology 2008; 15(4):S33.
ten Cate TJF, van Hemel NM, Boogaard MD, Verzijlbergen JF. How to appreciate perfusion defects in patients with left bundle branch block and right ventricular apical pacing. Tijdschrift voor Nucleaire Geneeskunde 2008; 30(1):40.
ten Rouwelaar H, Schaepkens FFJM. More effective by involvement in management: An empirical study about Dutch Financial Controllers working in the Health care sector. PREBEM working paper 2008; 15.
ter Borg EJ, Slee PHThJ, Seldenrijk CA. Monoarthritis of the elbow due to metastatic colon carcinoma: diagnosis based on the presence of adenocarcinoma cells in synovial fluid. Rheumatology International 2008; 28(11):1177-1178.
Teunissen L, Vlam L, Vogels OJ, Notermans NC. Severity but not prevalence of restless legs syndrome is higher in chronic idiopathic axonal polyneuropathy: P71. Journal of Sleep Research 2008; 17(Supplement 1):114.
Timmer-de Mik L, van der Waal RIF, Canninga-van Dijk MR, Dikland WJ, Bruijnzeel-Koomen CAFM. Een patiënt met nodulaire amyloïdose op basis van MGUS. Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(3):93-96.
Timmermans A, van Dongen H, Mol BW, Veersema S, Jansen FW. Hysteroscopy and removal of endometrial polyps: A Dutch survey. European Journal of Obstetrics, Gynecology, & Reproductive Biology 2008; 138(1):76-79.
Abstract: OBJECTIVE: To evaluate current practice of Dutch gynecologists in polyp removal. STUDY DESIGN: All practicing gynecologists in The Netherlands in 2003 were surveyed by a mailed self-administered questionnaire about polypectomy. Gynecologists were asked about their individual performance of polypectomy: setting, form of anesthesia, method and instrument used. RESULTS: The response rate was 74% (553 of 752 gynecologists). Among the respondents, 455 (83%) stated that they removed polyps themselves. Polyps were most commonly removed in an inpatient setting (71%), under general or regional anesthesia (77%), and under direct hysteroscopic visualization (69%). Gynecologists working in a teaching hospital removed polyps more often in an outpatient setting compared to gynecologists working in a non-teaching hospital (93 (39%) versus 36 (19%) p<0.001). CONCLUSION: In the Netherlands, outpatient polyp removal is not practiced on a large scale. However, teaching hospitals are more often performing polypectomy in an outpatient setting. Therefore, we expect that there must be a tendency towards outpatient hysteroscopic removal of polyps for the future. Further research is required to assess the efficacy polyp removal
Timmermans A, Veersema S. Poliepverwijderen. In: Jansen FW, Trimbos-Kemper T, editors. Hysteroscopische chirurgie : de basis. Noordwijk: Laurier, 2008: 133-141.
Timmermans A, Opmeer BC, Veersema S, Mol BW. Re: Pain experienced during transvaginal ultrasound, saline contrast sonohysterography, hysteroscopy and office sampling: a comparative study. Ultrasound in Obstetrics & Gynecology 2008; 32(1):118-119.
Timmermans A, Gerritsen MBE, Brent C, Opmeer PhD, Jansen FW, Mol BWJ, Veersema S. Diagnostic accuracy of endometrial thickness to exclude polyps in women with postmenopausal bleeding. Journal of clinical ultrasound 2008; 36(5):286-290.
Timmermans A, Opmeer BC, Veersema S, Mol BW. Author response to: Hysteroscopy is not warrented as a first line investigation for postmenopausal bleeding. BJOG 2008; 115(3):411-412.
Tromp SC. KNF bij bewegingsstoornissen. Van tremorregistratie tot botuline toxine injectie. Elektronische syllabus na- en bijscholingscursus Nederlandse Vereniging van Laboranten Klinische Neurofysiologie 2008 2008;10-15.
Tromp SC, Mess WH. Transcraniële echografie bij extrapiramidale aandoeningen. KNF dagen 2008 Nascholing KNF centraal KNF 2008;35-44.
Tuinman PR, de Nes LC, Blaauwgeers JL, Koene HR, Peters SH, Hart W. Klinisch denken en beslissen in de praktijk. Een man met pijn in de heup en koorts. Nederlands Tijdschrift voor Geneeskunde 2008; 152(28):1560-1567.
Abstract: A 42-year-old man was admitted to the hospital because of pain in the left hip. On examination he was febrile at 38 degrees C and he walked with a limp. The chest, abdomen and extremities were normal. Laboratory tests showed an elevated ESR and CRP. The ANA test was positive. CT-scan of the abdomen revealed a mass in the psoas region and some dilatation of the left renal pelvis. Following the histological results of the first and second diagnostic percutaneous biopsies, the clinicians suspected idiopathic retroperitoneal fibrosis. They treated the patient with corticosteroids for a period of 4 weeks. After a short interval of improvement this treatment failed and a third biopsy was taken. Subsequently, the diagnosis of anaplastic large cell lymphoma (ALCL) was made. The patient was successfully treated with combination chemotherapy. Usually, in practice, clinical reasoning and decision-making is carried out in accordance with Bayes' theorem. But when the a priori probability of disease is unknown and the likelihood ratio of a diagnostic test unavailable, one has to combine the available 'evidence' with critical thinking, interdisciplinary communication, judgement, intuition and common sense
Tupker RA. Pathofysiologie van nachtelijk krabben bij kinderen met atopisch eczeem: rol van 'brain-derived neurotrophic factor' en 'substance P'. Nederlands Tijdschrift voor Allergie 2008; 8(1):24-25.
Tupker RA. Richtlijn 'constitutioneel eczeem'. Nederlands Tijdschrift voor Allergie 2008; 8(2):57-64.
Tupker RA. Nieuwe ontwikkelingen bij urticaria. Nederlands Tijdschrift voor Allergie 2008;(Suppl : Praktische toepassingen en nieuwe inzichten in de allergologie):6-9.
Tupker RA. Mestcelgestuurde huidinflammatie is verminderd bij afwezigheid van sensibele zenuwen. Nederlands Tijdschrift voor Allergie 2008; 8(4):141-142.
Valkering KP, van der Hoeven H, Pijnenburg BC. Posterolateral elbow impingement in professional boxers. American Journal of Sports Medicine 2008; 36(2):328-332.
Abstract: BACKGROUND: Elbow injury is common in boxing, but it has not been reported in the literature. The onset is often a hyperextension trauma caused by a missed hit. Clinically the boxers complain of pain, stiffness, and an extension deficit. PURPOSE: To evaluate the pathogenesis, diagnostic approach, and arthroscopic treatment of elbow injury in boxers, and to compare these with other sports-related elbow injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 2003 and 2005, a group of 5 professional boxers received a diagnosis of posterior elbow impingement. An arthroscopic debridement was performed. All patients were evaluated preoperatively and 1 year postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. RESULTS: An arthroscopic partial resection of the posterior olecranon tip was performed, and osteophytes and fibrous tissue were removed in this area. Loose bodies were removed from the elbow in 3 patients. They were present in the posterior compartment in 2 patients and the anterior compartment in 1. The Hospital for Special Surgery score showed satisfactory to good improvement after 1 year in all 5 cases. They all showed a normal function at follow-up and had a full return to their sports activities. In contrast with the valgus extension overload syndrome, our patients did not show any signs of concomitant ulnar collateral ligament injury. CONCLUSION: Posterolateral elbow impingement in boxers is caused by hyperextension trauma. Concomitant medial elbow instability was not present. Standard arthroscopic debridement showed good results
van 't Hof AWJ, ten Berg J, Heestermans T, Dill T, Funck RC, van Werkum JW, Dambrink JH, Suryapranata H, van Houwelingen G, Ottervanger JP, Stella P, Giannitsis E, Hamm C. Prehospital initiation of tirofiban in patients with ST-elevation myocardial infarction undergoing primary angioplasty (On-TIME 2): a multicentre, double-blind, randomised controlled trial. Lancet 2008; 372(9638):537-546.
Abstract: BACKGROUND: The most effective magnitude and timing of antiplatelet therapy is important in patients with acute ST-elevation myocardial infarction (STEMI). We investigated whether the results of primary coronary angioplasty (PCI) can be improved by the early administration of the glycoprotein IIb/IIIa blocker tirofiban at first medical contact in the ambulance or referral centre. METHODS: We undertook a double-blind, randomised, placebo-controlled trial in 24 centres in the Netherlands, Germany, and Belgium. Between June 29, 2006, and Nov 13, 2007, 984 patients with STEMI who were candidates to undergo PCI were randomly assigned to either high-bolus dose tirofiban (n=491) or placebo (N=493) in addition to aspirin (500 mg), heparin (5000 IU), and clopidogrel (600 mg). Randomisation was by blinded sealed kits with study drug, in blocks of four. The primary endpoint was the extent of residual ST-segment deviation 1 h after PCI. Analysis was by intention to treat. The trial is registered, number ISRCTN06195297. FINDINGS: 936 (95%) patients were randomly assigned to treatment after a prehospital diagnosis of myocardial infarction in the ambulance. Median time from onset of symptoms to diagnosis was 76 min (IQR 35-150). Mean residual ST deviation before PCI (10.9 mm [SD 9.2] vs 12.1 mm [9.4], p=0.028) and 1 h after PCI (3.6 mm [4.6] vs 4.8 mm [6.3], p=0.003) was significantly lower in patients pretreated with high-bolus dose tirofiban than in those assigned to placebo. The rate of major bleeding did not differ significantly between the two groups (19 [4%] vs 14 [3%]; p=0.36). INTERPRETATION: Our finding that routine prehospital initiation of high-bolus dose tirofiban improved ST-segment resolution and clinical outcome after PCI, emphasises that further platelet aggregation inhibition besides high-dose clopidogrel is mandated in patients with STEMI undergoing PCI
van Asbeck EC, Hoepelman AI, Scharringa J, Herpers BL, Verhoef J. Mannose binding lectin plays a crucial role in innate immunity against yeast by enhanced complement activation and enhanced uptake of polymorphonuclear cells. BMC Microbiology 2008; 8(1):229.
Abstract: ABSTRACT: BACKGROUND: Mannose binding lectin (MBL) is an important host defense protein against opportunistic fungal pathogens. This carbohydrate-binding protein, an opsonin and lectin pathway activator, binds through multiple lectin domains to the repeating sugar arrays displayed on the surface of a wide range of clinically relevant microbial species. We investigated the contribution of MBL to antifungal innate immunity towards C. parapsilosis in vitro. RESULTS: High avidity binding was observed between MBL and C. albicans and C. parapsilosis. Addition of MBL to MBL deficient serum increased the deposition of C4 and C3b and enhanced the uptake of C. albicans, C. parapsilosis and acapsular C. neoformance by polymorphonuclear cells (PMNs). Compared to other microorganisms, such as Escherichia coli, Staphylococcus aureus and Cryptococcus neoformans, C. parapsilosis and Candida albicans were potent activators of the lectin pathway. CONCLUSION: Our results suggest that MBL plays a crucial role in the innate immunity against infections caused by yeast by increasing uptake by PMN
van Asch CJ, Balemans WA, Rovers MM, Schilder AG, van der Ent CK. Atopic disease and exhaled nitric oxide in an unselected population of young adults. Annals Allergy, Asthma & Immunology 2008; 100(1):59-65.
Abstract: BACKGROUND: Several studies have reported elevated levels of fractional exhaled nitric oxide (FeNO) in atopic patients, particularly in asthmatic patients, suggesting that FeNO is a marker of bronchial inflammation. However, the independent influence of different atopic entities (eczema, allergic rhinitis, and asthma) on FeNO has never been studied in the general population. OBJECTIVE: To study the influence of a questionnaire-based diagnosis of atopic diseases and IgE and lung function measurements on FeNO levels. METHODS: This study was part of a follow-up on otitis media of a birth cohort of 1,328 children born in Nijmegen, the Netherlands, between September 1, 1982, and August 31, 1983. Within the birth cohort, the incidence of asthma, allergic rhinitis, and eczema was determined, and off-line FeNO, spirometry, and IgE measurements were performed at the age of 21 years. RESULTS: FeNO measurements were successfully performed in 361 participants. Median FeNO levels were significantly higher in those with vs without eczema (23.6 vs 18.0 ppb; P < .0001), those with vs without allergic rhinitis (20.7 vs 17.8 ppb; P = .0001), and those with vs without atopic asthma (23.3 vs 18.1 ppb; P = .02) but not in those with vs without asthma (20.8 vs 18.3 ppb; P = .24). Eczema, allergic rhinitis, smoking, sex, and atopic sensitization appeared to be independently associated with log FeNO in this population sample, whereas (atopic) asthma was not. No effect on FeNO levels was observed for lung function parameters. CONCLUSION: Eczema, allergic rhinitis, and atopic status were all independently associated with elevated FeNO levels, whereas (atopic) asthma was not. This finding implies that future studies into the role of FeNO in asthma should consider the influence of atopic disease outside the lungs
van Boven WJ, Gerritsen WB, Driessen AH, Morshuis WJ, Waanders FG, Haas FJ, van Dongen EP, Aarts LP. Myocardial oxidative stress, and cell injury comparing three different techniques for coronary artery bypass grafting. European Journal of Cardio-Thoracic Surgery 2008; 34(5):969-975.
Abstract: Objective: Oxidative stress as a result of reperfusion injury is a known causative factor of cardiac muscle injury. In the peripheral blood as well in the coronary sinus, oxidative stress parameters and cardiac biomarkers were measured to investigate the different levels of oxidative stress during three different CABG techniques; MCABG (with minimal prime volume and warm blood cardioplegia) that was newly introduced in our hospital, versus OPCAB, versus our current standard, conventional CABG (CCABG, consisting of high volume prime and cold crystalloid cardioplegia). Concomitantly, cardiac biomarkers were measured to detect myocardial cell injury. Methods: Thirty patients scheduled for CABG with the intention to treat three-vessel disease were randomly assigned for CCABG, MCABG or OPCAB. Perioperatively, plasma levels of malondialdehyde (MDA) as a marker of oxidative stress, and the allantoin/uric acid ratio (A/U ratio) as a marker of antioxidant activity were measured in the ascending aorta (Aa), and in the coronary sinus (Cs), simultaneously. Additionally peripheral (Aa) blood levels of heart fatty acid binding protein (HFABP), troponin T, CPK and CKMB as markers of myocardial injury were obtained. Results: The MCABG group had significantly lower MDA levels in the Cs compared to the CCABG group, respectively, to the OPCAB group (pá=á0.04 and pá=á0.03). At all time points the A/U ratio in the CCABG group remained significantly higher in the Cs as well in the Aa samples compared to the MCABG and the OPCAB group (pá<á0.001, respectively, pá<á0.001, for both groups). HFABP and troponin T showed consistent curves compared to the CPK figure over time in all groups. Conclusion: In this study coronary sinus blood levels of oxidative stress parameters were consistently higher compared to peripheral blood levels. The levels were lowest in the MCABG study group. In this group also the lowest levels cardiac biomarkers of myocardial injury were found
van de Garde E, Deneer V, Souverein P, van den Bosch J, Leufkens H. Validation of community-acquired pneumonia: high positive predictive value for ICD-9 codes. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract P2203.
van de Garde EM, Endeman H, van Hemert RN, Voorn GP, Deneer VH, Leufkens HG, van den Bosch JM, Biesma DH. Prior outpatient antibiotic use as predictor for microbial aetiology of community-acquired pneumonia: hospital-based study. European Journal of Clinical Pharmacology 2008; 64(4):405-410.
Abstract: OBJECTIVE: The causative micro-organism in community-acquired pneumonia (CAP) is often difficult to predict. Different studies have examined chronic morbidity and clinical symptoms as predictors for microbial aetiology of pneumonia. The aim of our study was to assess whether prior outpatient antimicrobial treatment is predictive for determining the microbial aetiology of CAP. METHODS: This was a hospital-based prospective observational study including all patients admitted with CAP between 1 October 2004 and 1 August 2006. Microbial investigations included sputum, blood culture, sputum PCR, antigen testing and serology. Exposure to antimicrobial drugs prior to hospital admission was ascertained through community pharmacy dispensing records. Multivariate logistic regression analysis was conducted to assess whether prior outpatient antimicrobial treatment is a predictor of microbial aetiology. Patient demographics, co-morbidities and pneumonia severity were considered to be other potential predictors. RESULTS: Overall, 201 patients were included in the study. The microbial aetiology was determined in 64% of the patients. The five most prevalent pathogens were Streptococcus pneumoniae, Heamophilus influenzae, Legionella spp., Mycoplasma pneumoniae and Influenza virus A+B. Forty-seven of the patients (23%) had received initial antimicrobial treatment as outpatients. Multivariate analyses revealed that initial outpatient beta-lactam treatment was associated with a threefold increased chance of finding atypical pathogens and a threefold decreased probability of pneumococcal infection; the corresponding odds ratios were 3.51 (95% CI 1.25-9.99) and 0.30 (95% CI 0.10-0.90), respectively. Patients who received macrolides prior to hospitalisation had an increased probability of viral pneumonia. CONCLUSION: Prior outpatient antimicrobial therapy has a predictive value in the diagnostic workup aimed at identifying the causative pathogen and planning corresponding antimicrobial treatment in patients hospitalised for pneumonia
van de Garde EM, Endeman H, Deneer VH, Biesma DH, Sayed-Tabatabaei FA, Ruven HJ, Leufkens HG, van den Bosch JM. Angiotensin-converting enzyme insertion/deletion polymorphism and risk and outcome of pneumonia. Chest 2008; 133(1):220-225.
Abstract: BACKGROUND: Recent studies have suggested involvement of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism in the susceptibility to and severity of community-acquired pneumonia (CAP) in Asian populations. We have explored the hypothesis that the ACE I/D polymorphism affects the risk and outcome of CAP in a Dutch white population. METHODS: This is a hospital-based prospective observational study including patients with CAP admitted between October 2004 and August 2006. All patients were genotyped, and pneumonia severity and clinical outcome were compared between patients with II, ID, and DD genotypes of the ACE gene. Pneumonia severity was assessed on day of hospital admission and consecutively on days 2, 3, 5, and 10 of hospital stay using the acute physiology score (APS). Outcomes evaluated were duration of hospital stay, ICU admittance, and in-hospital and 28-day mortality rates. To study the association between ACE genotype and risk of pneumonia, the distribution of the ACE I/D polymorphism was compared with healthy control subjects from the same geographic region. RESULTS: In total, 200 patients with pneumonia and 200 control subjects were included in the study. Mean age of the patients was 63 years. APS scores were not different between the genotype groups on any of the days, and all clinical outcomes (duration of hospital stay, ICU admittance, in-hospital and 28-day mortality rates) were comparable between the three genotype groups. The ACE I/D genotype distribution was identical for patients and control subjects (p = 0.973). CONCLUSIONS: The ACE I/D polymorphism is not associated with risk and outcome of CAP in the Dutch white population
van de Garde EMW, Endeman H, van Hemert RN, Voorn GP, Deneer VHM, Leufkens HGM, van den Bosch JMM, Biesma DH. Antibioticagebruik voor ziekenhuisopname voorspelt microbiologische etiologie van pneumonie. PW Wetenschappelijk Platform 2008; 2(5):109-111.
van de Garde E. Statines ter preventie van pneumonie. Huisarts en wetenschap 2008; 51(4).
van de Mortel RH, Vahl AC, Balm R, Buth J, Hamming JF, Schurink GW, de Vries JP. Collective experience with hybrid procedures for suprarenal and thoracoabdominal aneurysms. Vascular 2008; 16(3):140-146.
Abstract: Not every patient is fit for open thoracoabdominal aortic aneurysm (TAAA) repair, nor is every TAAA or juxtarenal abdominal aortic aneurysm suitable for branched or fenestrated endovascular exclusion. The hybrid procedure consists of debranching of the renal and visceral arteries followed by endovascular exclusion of the aneurysm and might be an alternative in these patients. Between May 2004 and March 2006, 16 patients were treated with a hybrid procedure. The indications were recurrent suprarenal or thoracoabdominal aneurysms after previous abdominal and/or thoracic aortic surgery (n = 8), type I to III TAAAs (n = 3), proximal type I endoleak after endovascular repair (n = 2), penetrating ulcer of the juxtarenal aorta (n = 1), visceral patch aneurysm after type IV open repair (n = 1), and primary suprarenal aneurysm (n = 1). Eight (50%) of 16 patients were judged to be unfit for open TAAA repair. The hospital mortality rate was 31% (5 of 16). Four of five deceased patients were unfit for thoracophrenic laparotomy. Two patients died from cardiac complications and three from visceral ischemia. No spinal cord ischemia was detected, and temporary renal failure occurred in four patients (25%). The mean follow-up was 13 months (range 6-28 months). During follow-up, no additional grafts occluded and no patients died. Hybrid procedures are technically feasible but have substantial mortality (31%), especially in patients unfit for open repair (80%). They might be indicated when urgent TAAA surgery is required or when vascular anatomy is unfavorable for fenestrated endografts in patients with extensive previous open aortic surgery
van de Veire NR, Marsan NA, Schuijf JD, Bleeker GB, Wijffels MC, van Erven L, Holman ER, de Sutter J, van der Wall EE, Schalij MJ, Bax JJ. Noninvasive imaging of cardiac venous anatomy with 64-slice multi-slice computed tomography and noninvasive assessment of left ventricular dyssynchrony by 3-dimensional tissue synchronization imaging in patients with heart failure scheduled for cardiac resynchronization therapy. American Journal of Cardiology 2008; 101(7):1023-1029.
Abstract: Objectives of this study were to perform a prospective head-to-head comparison between multi-slice computed tomography (MSCT) venography and invasive venography in cardiac resynchronization therapy (CRT) candidates as well as to evaluate the relation between left ventricular (LV) lead position and effect on LV dyssynchrony and immediate response to CRT. Twenty-one consecutive heart failure patients scheduled for CRT implantation were prospectively enrolled to undergo 64-slice MSCT to visualize the venous system, invasive venography during device implantation, and tri-plane tissue synchronization imaging (TSI) before and after implantation. Excellent agreement between MSCT and invasive venography was noted. No significant differences were observed between both techniques regarding vessel diameters. In 12 patients, a match was observed between the area of latest mechanical activation (on TSI) and LV lead position. These patients showed a significant decrease in LV dyssynchrony (43 +/- 7 ms to 11 +/- 9 ms, p <0.0001) with acute reduction in LV end-systolic volume (188 +/- 54 ml to 162 +/- 48 ml, p <0.01) and improvement in LV ejection fraction (22% +/- 9% to 34% +/- 9%, p <0.01). Patients with a mismatch between area of latest activation and LV lead position remained dyssynchronous without improvement in LV function. In conclusion, visualization of major tributaries of the coronary sinus was comparable between invasive venography and MSCT venography. Optimal LV lead positioning in a vein draining the area of latest mechanical activation (determined from tri-plane TSI) resulted in acute improvement of LV dyssynchrony and systolic function after CRT implantation
van de Wal RMA, Plokker HWM, Voors AA. Stabiele angina pectoris : katheter of pil? Hart Bulletin 2008; 39(4):91-94.
van den Berg MM, Voskuijl WP, Boeckxstaens GE, Benninga MA . Rectal compliance and rectal sensation in constipated adolescents, recovered adolescents and healthy volunteers. Gut 2008; 57(5):599-603.
Abstract: OBJECTIVES: A subgroup of children with functional constipation (FC) are unresponsive to conventional treatment. Abnormal rectal function due to increased distensibility (compliance) might be an underlying mechanism of therapy-resistant FC. It is hypothesised that rectal compliance is normal in patients who are successfully recovered from FC (RC). METHODS: Using a barostat, a pressure-controlled intermittent distension protocol was performed in FC patients, RC subjects free of symptoms for at least 4 years and healthy volunteers (HVs). Rectal compliance was calculated using a non-linear mixed-effect model for volume-pressure curves. RESULTS: Forty-seven FC patients, median (range) age of 12 (11-17) years, and 20 RC subjects, 15 (11-18) years, were studied and compared with 22 HVs, 14 (8-16) years. The median (5th-95th percentile) rectal compliance in HVs was 16 (12-20) ml/mm Hg. FC patients had a median rectal compliance of 25 (13-47) ml/mm Hg and RC subjects 20 (12-35) ml/mm Hg, which was significantly higher compared with HVs (p<0.001 and p = 0.003). RC subjects had lower rectal compliance when compared with FC patients (p = 0.02). Forty-five percent of RC subjects had a rectal compliance above the upper limit of normal (>95th percentile of HVs), which was significantly less compared with 75% of FC patients (p = 0.02). CONCLUSION: While rectal compliance in RC subjects is lower when compared with adolescents with FC, almost half of the RC subjects showed an increased rectal compliance. The role of rectal compliance in therapy-resistant FC seems limited, because recovery is possible despite an increased rectal compliance
van den Bergh RC, Moll FL, de Vries JP, Yeung KK, Lock TM. Arterio-ureteral fistula: 11 new cases of a wolf in sheep's clothing. Journal of Urology 2008; 179(2):578-581.
Abstract: PURPOSE: We provide insight into the presentation, diagnostics, treatment, and accompanying clinical difficulties and complications of an arterio-ureteral fistula and add 11 patients with arterio-ureteral fistula to the 90 described in the literature. MATERIALS AND METHODS: A retrospective search was done for confirmed cases of arterio-ureteral fistula that were treated at 3 medical centers. RESULTS: A total of 11 cases of arterio-ureteral fistula were reviewed from 1980 to 2006. A history of major abdominal surgery had an essential role in 10 of the 11 cases, especially vascular intervention in 8. All patients presented with varying manifestations of hematuria. Ureteral contrast studies and nonprovocative angiography provided the most valuable diagnostic information with all 5 and 3 of 5 showing positive results, respectively. In 4 of 11 patients (36%) the diagnosis of arterio-ureteral fistula was only made during laparotomy. Ten patients were treated with a classic open surgical approach (vascular and urological) and in 1 endovascular stents were inserted. Two of 11 patients (18%) needed acute surgical intervention because of hemodynamic instability. The in hospital mortality rate was 9%. At a mean followup of 17 months 3 other patients (27%) had died of causes unrelated to the arterio-ureteral fistula. CONCLUSIONS: The diagnosis of arterio-ureteral fistula should be considered in patients with persistent hematuria who have a history of major abdominal vascular surgery even when diagnostic test results are negative for a fistula, because in 36% of our patients the diagnosis could only be made at operation. The in hospital morbidity and mortality rates are considerable and, therefore, a timely diagnosis and elective multidisciplinary treatment are preferred
van den Besselaar AMHP, Haas FJLM, van der Graaf F, Kuypers AWHM. Harmonization of fibrinogen assay results: study within the framework of the Dutch project 'Calibration 2000'. International Journal of Laboratory Hematology 2008; [Epub ahead of print].
van den Bosch WF, Graafmans WC, Pieter D, Westert GP. Hartcentra en het effect van bijzondere medische verrichtingen op het gestandaardiseerde ziekenhuissterftecijfer. Nederlands Tijdschrift voor Geneeskunde 2008; 152(21):1221-1227.
Abstract: OBJECTIVE: To examine the impact of specialised medical procedures (SMPs) on the hospital standardized mortality ratio (HSMR) in Dutch cardiac centres. DESIGN: Retrospective, calculation of the HSMR. METHOD: Data from 2004 from the National Medical Registration (LMR) were used to calculate the HSMR in 12 cardiac centres and all other hospitals in the Netherlands. The HSMRwas then recalculated for the 12 cardiac centres excluding either percutaneous transluminal coronary angioplasty (PTCA) or open heart surgery or both to determine the impact of these SMPs on the HSMR. RESULTS: Exclusion of SMPs from the HSMR calculation changed the HSMR for individual cardiac centres, ranging from a 4.7% decrease to a 5.3% increase. Change in HSMR was related to the relative frequency of the two procedures at each cardiac centre. Mortality risk was lower than average for PTCA and higher than average for open heart surgery. PTCA accounted for 5.6%-20.2% of total admissions in the 12 cardiac centres. A relatively high proportion of PTCA procedures was associated with a lower HSMR, to a maximum decrease of nearly 7% in one cardiac centre. Open heart surgery accounted for 2.1%-12.6% of total admissions per cardiac centre. A relatively high proportion ofopen heart procedures was associated with an increased HSMR, to a maximum increase of nearly 8% in one cardiac centre. CONCLUSION: Specialised medical procedures for heart conditions influence the HSMR of cardiac centres. The increase or decrease in HSMR is related to the relative frequency of PTCA and open heart surgery. These results can be used to help interpret the differences in HSMR among cardiac centres and other hospitals
van den Branden BJL, Post MC, Jaarsma W, ten Berg JM, Suttorp MJ. New bioabsorbable septal repair implant for percutaneous closure of a patent foramen ovale: short-term results of a single-centre experience. European Heart Journal 2008; 29(Suppl 1):579.
van den Branden BJ, Post M, Jaarsma W, ten Berg JM, Suttorp MJ. Abstract 3050: New Bioabsorbable Septal Repair Implant for Percutaneous Closure of a Patent Foramen Ovale : Short-Term Results of a Single-Centre Experience. Circulation 2008; 118(18):S808.
van den Branden BJ, Bruggeling WA, Corbeij HM, Dunselman PH. Spontaneous coronary artery dissection in the postpartum period. Netherlands Heart Journal 2008; 16(12):412-414.
Abstract: Spontaneous coronary artery dissection is a very uncommon cause of acute coronary syndrome. It occurs predominantly in young to middle-aged women during or after pregnancy. The aetiology remains uncertain. Possible factors are hormonal changes, haemodynamic stress and changes in autoimmune status. In case of single-vessel dissection and normal blood flow, conservative treatment often leads to complete angiographic resolution. This case report describes the clinical presentation, diagnosis and therapy of spontaneous coronary artery dissection in a 37-year-old woman in the postpartum period. (Neth Heart J 2008;16:412-4.).
van der Bruggen T, Kaan JA, Heddema ER, van Hannen EJ, de Jongh BM. Snelle diagnostiek van psittacose met behulp van een recent ontwikkelde realtime-PCR. Nederlands Tijdschrift voor Geneeskunde 2008; 152(34):1886-1888.
van der Heyden J, Lans HW, van Werkum JW, Schepens M, Ackerstaff RG, Suttorp MJ. Will Carotid Angioplasty Become the Preferred Alternative to Staged Or Synchronous Carotid Endarterectomy in Patients Undergoing Cardiac Surgery? European Journal of Vascular & Endovascular Surgery 2008; 36(4):379-384.
Abstract: In the absence of randomized trials, the optimal management of patients who present with concomitant carotid and coronary artery disease remains an enduring controversy, with much of the debate revolving around whether staged or synchronous carotid endarterectomy (CEA) will reduce peri-operative morbidity and mortality after cardiac surgery. Although encouraging results have been reported using either strategy, there remains no consensus as to which is preferable. More recently, however, carotid artery angioplasty with stenting (CAS) has emerged as a potential alternative to CEA. In 'high-risk for CEA' patients, CAS has shown comparable short and long-term outcome rates to CEA. Accordingly, CAS followed by cardiac surgery could offer a less invasive (and safer) therapeutic option in cardiac patients. This paper reviews the evidence to date supporting the use of CAS+CABG, while highlighting potential situations where such a strategy might be harmful. In particular, it will focus on how the need for dual antiplatelet therapy after CAS can be balanced with avoiding unnecessary bleeding complications after cardiac surgery
van der Laan A, Hirsch A, Nijveldt R, van der Vleuten PA, van der Giessen WJ, Doevendans PA, Waltenberger J, ten Berg JM, Aengevaeren WR, Zwaginga JJ, Biemond BJ, van Rossum AC, Tijssen JG, Zijlstra F, Piek JJ. Bone marrow cell therapy after acute myocardial infarction: the HEBE trial in perspective, first results. Netherlands Heart Journal 2008; 16(12):436-439.
Abstract: During the last decennium, the role of bone marrow mononuclear cells (BMMC) has been underscored in the healing process after acute myocardial infarction (AMI). Although these cells improve left ventricular recovery after AMI in experimental studies, results from large-scale randomised trials investigating BMMC therapy in patients with AMI have shown contradictory results. To address this issue the HEBE study was designed, a multicentre, randomised trial, evaluating the effects of intracoronary infusion of BMMCs and the effects of intracoronary infusion of peripheral blood mononuclear cells after primary percutaneous coronary intervention. The primary endpoint of the HEBE trial is the change in regional myocardial function in dysfunctional segments at four months relative to baseline, based on segmental analysis as measured by magnetic resonance imaging. The results from the HEBE trial will provide detailed information about the effects of intracoronary BMMC therapy on post-infarct left ventricular recovery. In addition, further analysis of the data and material obtained may provide important mechanistic insights into the contribution of BMMCs to natural recovery from AMI as well as the response to cell therapy. This may significantly contribute to the development of improved cell-based therapies, aiming at optimising post-infarct recovery and preventing heart failure. (Neth Heart J 2008;16:436-9.).
van der Lee C, Scholzel B, ten Berg JM, Geleijnse ML, Idzerda HH, van Domburg RT, Vletter WB, Serruys PW, ten Cate FJ. Usefulness of clinical, echocardiographic, and procedural characteristics to predict outcome after percutaneous transluminal septal myocardial ablation. American Journal of Cardiology 2008; 101(9):1315-1320.
Abstract: This study was conducted to assess outcomes after percutaneous transluminal septal myocardial ablation (PTSMA) treatment in 131 patients (mean age 56 +/- 16 years) with obstructive hypertrophic cardiomyopathy. In-hospital and follow-up complications as well as late PTSMA failure (defined as unsatisfactory clinical outcome and a significant residual outflow tract gradient, necessitating reintervention) were noted. Baseline clinical, echocardiographic, and PTSMA characteristics were examined as determinants of outcomes. Also, the effect of ethanol volume and the role of a learning curve were investigated. PTSMA was successful in 90% of the patients. In-hospital and follow-up cardiac events were noted in 20 patients, including cardiac death (in-hospital n = 4, follow-up n = 1), acute myocardial infarction due to ethanol leakage (n = 1), coronary dissection (n = 2), nonfatal cardiac tamponade (n = 1), and permanent pacemaker (n = 6) or cardiac defibrillator (in-hospital n = 4, follow-up n = 1) implantation. Late PTSMA failure was noted in 12 patients. All baseline characteristics were comparable between successful and failed PTSMA. Ethanol volume was related to peak creatinine kinase value (p <0.0001) but not to late PTSMA failure or greater need for pacemaker implantation. Late PTSMA failure occurred more frequently in PTSMA procedures performed in the early, less experienced time period (p <0.001). In conclusion, this study confirms that PTSMA, although effective, has a relatively high complication rate. Late PTSMA failure could not be predicted by baseline characteristics but could partially be explained by a learning-curve effect. This finding implies that PTSMA procedures should be restricted to experienced centers
van der Waal RIF, van der Waal I. Knobbels op de tong. Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(1):21.
van Deurzen CH, Seldenrijk CA, Koelemij R, van Hillegersberg R, Hobbelink MG, van Diest PJ. The microanatomic location of metastatic breast cancer in sentinel lymph nodes predicts nonsentinel lymph node involvement. Annals of Surgical Oncology 2008; 15(5):1309-1315.
Abstract: BACKGROUND: The majority of sentinel node (SN) positive breast cancer patients do not have additional non-SN involvement and may not benefit from axillary lymph node dissection (ALND). Previous studies in melanoma have suggested that microanatomic localization of SN metastases may predict non-SN involvement. The present study was designed to assess whether these criteria might also be used to be more restrictive in selecting breast cancer patients who would benefit from an ALND. METHODS: A consecutive series of 357 patients with invasive breast cancer and a tumor-positive axillary SN, followed by an ALND, was reviewed. Microanatomic SN tumor features (subcapsular, combined subcapsular and parenchymal, parenchymal, extensive localization, multifocality, and the penetrative depth from the SN capsule) were evaluated for their predictive value for non-SN involvement. RESULTS: Non-SN metastases were found in 136/357 cases (38%). Microanatomic location and penetrative depth of SN metastases were significant predictors for non-SN involvement (<0.001); limited penetrative depth was associated with a low frequency of non-SN involvement with a minimal of 10%. CONCLUSIONS: Microanatomic location and penetrative depth of breast cancer SN metastases predict non-SN involvement. However, based on these features no subgroup of patients could be selected with less than 10% non-SN involvement
van Duynhoven YT, Friesema IH, Schuurman T, Roovers A, van Zwet AA, Sabbe LJ, van der Zwaluw WK, Notermans DW, Mulder B, van Hannen EJ, Heilmann FG, Buiting A, Jansen R, Kooistra-Smid AM. Prevalence, characterisation and clinical profiles of Shiga toxin-producing Escherichia coli in The Netherlands. Clinical Microbiology & Infection 2008; 14(5):437-445.
Abstract: Detection of Shiga toxin-producing Escherichia coli (STEC) in The Netherlands is traditionally limited to serogroup O157. To assess the relative importance of STEC, including non-O157 serogroups, stool samples submitted nationwide for investigation of enteric pathogens or diarrhoea were screened with real-time PCR for the presence of the Shiga toxin genes. Patients were selected if their stool contained blood upon macroscopic examination, if they had a history of bloody diarrhoea, were diagnosed with haemolytic uraemic syndrome, or were aged <6 years (irrespective of the bloody aspect of the stool). PCR-positive stools were forwarded to a central laboratory for STEC isolation and typing. In total, 4069 stools were examined, with 68 (1.7%) positive PCR results. The highest prevalence was for stools containing macroscopic blood (3.5%), followed by stools from patients with a history of bloody diarrhoea (2.4%). Among young children, the prevalence (1.0%) was not significantly higher than among random, non-bloody, stool samples from diarrhoeal patients (1.4%). STEC strains were isolated from 25 (38%) PCR-positive stools. Eleven O-serogroups were detected, including five STEC O157 strains. As serogroup O157 represented only 20% of the STEC isolates, laboratories should be encouraged to use techniques enabling them to detect non-O157 serogroups, in parallel with culture, for isolation and subsequent characterisation of STEC strains for public health surveillance and detection of outbreaks
van Eck JW, van Hemel NM, Kelder JC, van den Bos AA, Taks W, Grobbee DE, Moons KG. Poor health-related quality of life of patients with indication for chronic cardiac pacemaker therapy. Pacing & Clinical Electrophysiology 2008; 31(4):480-486.
Abstract: BACKGROUND: Studies on health-related quality of life (HRQoL) of patients awaiting pacemaker (PM) implantation are scarce, or executed in specific patient subgroups (regarding age or specific cardiac rhythm disorders). The purpose of this study was to systematically assess the HRQoL in a large unselected cohort of patients with a conventional indication for PM therapy. METHODS: Pre-PM implantation HRQoL (measured with the SF-36 questionnaire, completed at hospital admission) of 818 consecutive Dutch patients included in the FOLLOWPACE study was compared with the HRQoL in a sample of the general Dutch population, and with several cohorts of patients with other conditions. Linear regression analysis was performed to analyze determinants of this HRQoL. RESULTS: Almost all SF-36 subscale scores were substantially and significantly lower in the PM patients compared to the general population, with P-values < 0.001 in all SF-36 subscales except for "pain" and "general health perception." In the PM patients, presence of comorbidities, gender, and age were significantly associated with the overall physical component summary score (mean 38.8 +/- 27 standard deviation) whereas the overall mental component summary score (46.8 +/- 27.0) was associated with gender and age. CONCLUSION: The HRQoL of patients before first PM implantation is significantly lower than that of a general population and also various other patient populations. Physicians should be aware of this unfavorable condition and keep the time interval between the diagnosis of a cardiac rhythm disorder requiring PM implantation and the implantation procedure as short as possible
van Eck JWM, van Hemel NM, van den Bos A, Taks W, Grobbee DE, Moons KGM. Predictors of improved quality of life 1 year after pacemaker implantation. American Heart Journal 2008; 156(3):491-497.
Abstract: Background Patient's health-related quality of life (HRQoL) of pacemaker (PM) patients has increasingly become an important issue of health care evaluation. Currently, knowledge of pacing performance and technology is more or less outlined. However, determinants of poor or good HRQoL of paced patients require further elucidation.Objectives The purpose of this study is to determine the HRQoL 1 year after PM implantation and predictors of differences in HRQoL between pre- and post-PM implantation.Methods We quantified the mean differences between HRQoL before implantation (baseline) and 1 year later, assessed with the generic Medical Outcomes Survey 36-Item Short-Form Survey and EuroQol (EQ5D), and the PM patient-specific AQUAREL (Assessment of QUality of life And RELated events) questionnaires, in 501 consecutively included patients in the Dutch multicenter longitudinal FOLLOWPACE cohort study. Multivariable linear regression modeling was then performed to determine predictive factors of the HRQoL 1 year after implantation.Results The HRQoL of the patients increased markedly in the first year after implantation. Seventy percent of the patients considered their health improved, whereas 11% experienced a complete recovery in HRQoL. The most important predictors for improved HRQoL after 1 year were HRQoL at baseline, age, presence of cardiac comorbidities, and atrial fibrillation with slow ventricular response as indication for chronic pacing.Conclusion In most patients receiving a PM, HRQoL increased in the first year after PM implantation. Knowledge of the predictors of this increase may aid physicians to timely differentiate between patients who most likely will benefit most from PM implantation in terms of HRQoL
van Es HW, van Heesewijk JPM, Rensing BJWM, van der heijden J. Niet-ischemische cardiomyopathieën: myocarditis, hypertrofische, restrictive en geditaleerde cardiomuopathie. Edurad 2008; 60:16-19.
van Everdingen J, Dom G, Giesbers AAGM, Gisolf KWH, Grutters JC, Haas FJLM, van der Heyden JAS, van Buul MMC, Wijffels MCEF, [et al.]. Medisch onderzoek van A tot Z : het hoe en waarom van 100 belangrijke tests. Den Haag: Consumentenbond, 2008.
van Gent MWF, Kuiper MA, Manschot Th, Jerzewsky A, Rommes JH, Spronk PE. Subarachnoïdale bloeding met de klinische presentatie van een circulatiestilstand bij acuut myocardinfarct. Nederlands Tijdschrift voor Geneeskunde 2008; 152(6):331-335.
van Gent MWF, Post MC, Snijder RJ, Swaans MJ, Plokker HWM, Westermann CJJ, Overtoom TT, Mager JJ. Grading of Pulmonary Right-To-Left Shunt With Transthoracic Contrast Echocardiography: Does It Predict the Indication for Embolotherapy? Chest 2008; [Epub ahead of print].
Abstract: RationalePulmonary arteriovenous malformations (PAVMs) are associated with severe neurologic complications in patients with hereditary hemorrhagic telangiectasia (HHT). Therefore screening is warranted. Transthoracic contrast echocardiography (TTCE) can effectively detect pulmonary right-to-left shunting (RLS). ObjectivesTo prospectively determine the predictive value of TTCE grading to detect PAVMs on chest HRCT and the indication for embolotherapy. MethodsThree hundred and seventeen patients, referred for possible HHT, were screened for PAVMs. Patients who underwent both chest HRCT and TTCE were included in the study (n = 281). For the purposes of this study we used a 3-point grading scale, and shunt grades 3 and 4 according to Barzilai's classification model were combined. Embolotherapy was performed of all PAVMs judged large enough for treatment. ResultsEchocardiographic criteria for a pulmonary RLS were present in 105 (41%) patients (mean age 43.7 {+/-} 15.7 years; 63% female). Chest HRCT was positive in 55 (52%) patients of this group. The positive predictive value of shunt grade for the presence of PAVMs on chest HRCT was 22.9% for grade 1 (n = 35), 34.8% for grade 2 (n = 23) and 83.0% for grade 3 (n = 47), respectively. None of the patients with PAVMs on chest HRCT and a TTCE grade 1 (n = 8) or 2 (n = 8) were candidates for embolotherapy. Of 39 patients with TTCE grade 3 and PAVMs on chest HRCT, 26 (67%) underwent embolotherapy. ConclusionAn increased echocardiographic shunt grade correlates with increased probability of PAVMs on chest HRCT. Only patients with a TTCE grade 3 displayed PAVMs on chest HRCT large enough for embolotherapy
van Goor A. 11th Annual Scientific Meeting. Heart Failure Society of America, Washington, DC, 16-19 september 2007. Cordiaal 2008; 29(1):22-23.
van Hannen EJ, van Oostveen C, Kool L, Vlaminckx BJM. Epidemiology and molecular screening of ESBL-producing Enterobacteriaceae in a Dutch hospital: P619. Clinical Microbiology & Infection 2008; 14(Supplement 7):S149.
van Hannen EJ, van Oostveen C, Kool L, Vlaminckx BJM. Epidemiology and molecular screening of E SBL producing Enterobacteriaceae in a Dutch hospital. Nederlands Tijdschrift voor Medische Microbiologie 2008; 16(Suppl):S91.
van Hees BC, de Ruiter G, Wiltink EH, de Jongh BM, Tersmette M. Optimizing use of ciprofloxacin: a prospective intervention study. Journal of Antimicrobial Chemotherapy 2008; 61(1):210-213.
Abstract: Objectives Antimicrobial resistance to ciprofloxacin is increasing. The objective of this study was to reduce the number of inappropriate prescriptions and to improve the quality of ciprofloxacin prescriptions by means of educational intervention. Methods In a teaching hospital five units of the Departments of Internal Medicine, Gastro-Enterology, Surgery, Urology and Pulmonary Diseases, selected because of a high rate of ciprofloxacin prescription, participated in a prospective intervention study. The quantity and the quality of prescriptions were reviewed before and after educational intervention and during follow-up. The quality of each ciprofloxacin prescription was independently evaluated by two medical microbiologists. During the intervention period, a medical microbiologist discussed the appropriateness of prescribing ciprofloxacin with prescribing clinicians, and educational presentations were given to clinicians of participating units. Regression analysis was used to analyse trends in time-series data. Results The number of ciprofloxacin prescriptions decreased from 81 prescriptions/1000 admissions before intervention to 32 prescriptions/1000 admissions after intervention, a significant reduction of 60.5%. Appropriate prescriptions significantly increased. Significantly fewer inappropriate prescriptions were prescribed after intervention and/or during follow-up. At this time, 23 ciprofloxacin prescriptions/1000 admissions were prescribed, a total reduction of 71.3% compared with baseline. Conclusions In a hospital with relatively low baseline ciprofloxacin consumption, intervention by direct consultation of a medical microbiologist and educational presentations led to 3-4-fold sustained reduction in the use of ciprofloxacin and significant improvement in quality of ciprofloxacin prescriptions. Close collaboration between clinicians and medical microbiologists can provide a major contribution to the prudent hospital use of antimicrobial agents
van Hemel NM. Chronische en tijdelijke hartstimulatie met pacemakers. In: van der Wall EE, van de Werf F, Zijlstra F, editors. Cardiologie. Houten: Bohn Stafleu van Loghum, 2008: 313-321.
van Hooft JE, Fockens P, Marinelli AW, Timmer R, van Berkel AM, Bossuyt PM, Bemelman WA, Dutch Colorectal Stent Group. Early closure of a multicenter randomized clinical trial of endoscopic stenting versus surgery for stage IV left-sided colorectal cancer. Endoscopy 2008; 40(3):184-191.
Abstract: BACKGROUND AND STUDY AIMS: The introduction of self-expandable metal stents has offered a promising alternative for palliation of malignant left-sided colonic obstruction. This randomized clinical trial aimed to assess whether a nonsurgical policy, with endoluminal stenting, is superior to surgical treatment in patients with stage IV left-sided colorectal cancer and imminent obstruction. PATIENTS AND METHODS: Patients with incurable left-sided colorectal cancer who fulfilled the study criteria were randomly assigned to nonsurgical or surgical treatment. The primary outcome measure was survival in good health out of hospital (World Health Organization performance scores 0 or 1). RESULTS: A high number of serious adverse events in the nonsurgical arm led to premature closure of the trial. Ten patients were allocated to surgical treatment and 11 patients to nonsurgical palliation. The median survival in good health out of hospital during the first year was 56 days (interquartile range 7.5 - 338.5 days) in the surgical arm vs. 38 days (interquartile range 5.25 - 288.75 days) in the nonsurgical arm (P = 0.68). Eleven adverse events (six perforations) occurred in the nonsurgical arm vs. one adverse event in the surgical arm (P < 0.001). Of the six perforations, two were stent-related because they occurred at the proximal edge of the stent by erosion through a normal colon wall; one was probably stent-related (it was located in the region of the proximal half of the stent); one was a colon blowout; and two were late tumor perforations in patients on chemotherapy. CONCLUSIONS: The unexpected high rate of perforation in the nonsurgical arm might be specifically WallFlex-related or enteral stent-related in patients on chemotherapy and warrants attention
van Houte M, Harmsze AM, Deneer VH, Tupker RA. Effect of oxybutynin on exercise-induced sweating in healthy individuals. Journal of Dermatological Treatment 2008; 19(2):101-104.
Abstract: Objectives: Oxybutynin has been proven to be effective in patients with generalized hyperhidrosis. Some dermatoses aggravate as a result of sweating. Therefore, oxybutynin might also be useful in such normohidrotic patients. The aim was to evaluate the efficacy and safety of different doses of oxybutynin on exercise-induced sweating in healthy individuals. Methods: Two randomized, double-blind, placebo-controlled, cross-over studies were performed, in which two different dosages (2.5 and 5 mg) of oxybutynin were tested. The degree of sweating was determined by transepidermal water loss (TEWL) measurement on the forearm and the hand during exercise. Furthermore, the effectiveness was evaluated by means of the individual's global assessment score, and side effects were noted. Results: No significant differences between oxybutynin and placebo were found on the forearm and the hand at both dosages of oxybutynin with respect to TEWL values and the individual's global assessment score. Side effects consisted of diarrhoea, dizziness, dry mouth and dry eyes. Conclusions: In this model, oxybutynin did not result in inhibition of exercise-induced sweating in healthy volunteers
van Kuijk AWR, Goedkoop AY. De medicamenteuze behandeling van artritis psoriatica. Farmacotherapie online 2008.
van Laarhoven A, Kaan JA, Schippers HM, Mager JJ, van der Meulen MF. Drie patienten met tuberculeuze meningitis; behandeling al starten bij waarschijnlijkheidsdiagnose. Nederlands Tijdschrift voor Geneeskunde 2008; 152(25):1445-1446.
van Loon D, Ruven H, van Schaik H. 6-Sigma en validatie van apparatuur. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):77.
van Loon K, Slee PHThJ. Twee mannelijke patiënten met hypogonadisme: een laatgestelde diagnose. Nederlands Tijdschrift voor Geneeskunde Studenten-editie 2008; 11(2):32-35.
van Meeuwen JA, van Son O, Piersma AH, de Jong PC, van den Berg M. Aromatase inhibiting and combined estrogenic effects of parabens and estrogenic effects of other additives in cosmetics. Toxicology & Applied Pharmacology 2008; 230(3):372-382.
van Meeuwen JA, Nijmeijer S, Mutarapat T, Ruchirawat S, de Jong PC, Piersma AH, van den Berg M. Aromatase inhibition by synthetic lactones and flavonoids in human placental microsomes and breast fibroblasts -- A comparative study. Toxicology & Applied Pharmacology 2008; 228(3):269-276.
van Moorsel CHM, Grutters JC, Karthaus VLJ, Ruven HJT, van den Bosch JMM. A haplotype of HLA-class II and BTNL2 associates with the diagnosis of extrinsic allergic alveolitis (EAA). European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract E409.
van Moorsel CHM, van Kessel DA, Grutters JC, Ruven HJT, van den Bosch JMM. The occurrence of CFTR mutations in patients with bronchiectasis. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(2):87.
van Moorsel CHM, van den Bosch JMM, Grutters JC, Ruven HJT, van Kessel DA. The occurrence of CFTR mutations in patients with bronchiectasis. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(3):190-191.
van Muiswinkel KW, Meuzelaar JJ. Het papillair fibro-elastoom van het hart als zeldzame oorzaak van een hersenembolie. Nederlands Tijdschrift voor Geneeskunde 2008; 152(27):1532-1536.
Abstract: A 39-year-old woman presented with weakness in the right arm and leg, and a 64-year-old woman was referred after a transient ischaemic attack. Neurological examination raised the suspicion of cerebral ischaemia due to an embolism. In both patients transthoracic echocardiography was performed to rule out the heart as a source of emboli. One patient had a stalked tumour of the mitral valve and the other had a spherical tumour of the aortic valve which was clearly seen on ultrasound examination, both tumours presumably a papillary fibroelastoma. The tumours were removed surgically while sparing the heart valves. Pathological examination confirmed the diagnosis of papillary fibroelastoma in both patients. Papillary fibroelastoma is a rare benign primary cardiac tumour that is usually noticed when it has caused cerebrovascular ischaemia. Surgical excision of the tumour is the treatment of choice
van Putte BP, Bantal N, Snijder R, Morshuis WJ, van Boven WJ. Acute massive pulmonary embolism treated by thrombo-embolectomy using intermittent deep hypothermic circulatory arrest. Interactive Cardiovascular and Thoracic Surgery 2008; 7(3):412-413.
Abstract: Acute massive pulmonary embolism is a life threatening medical emergency resulting in a high mortality rate. Usually, urgent thrombo-embolectomy is performed using double venous cannulation without circulatory arrest. We describe a patient suffering from acute massive pulmonary embolism that was treated by emergency thrombo-embolectomy. Due to back-bleeding the view into the lobar and segmental pulmonary arteries was severely compromised. In order to achieve complete thrombo-embolectomy, intermittent deep hypothermic circulatory arrest was performed
van Putte BP, Schepens MA. Ascending-descending aortic bypass for the treatment of concomitant severe co-arctation, aortic valve disease and hypoplastic aortic arch. Acta Chirurgica Belgica 2008; 108(2):244-246.
Abstract: This report describes a one-stage treatment of a 30-year-old patient suffering from severe aortic valve insufficiency, aortic co-arctation, dilatation of the ascending aorta and arcus hypoplasia. The patient underwent aortic valve, ascending aorta and arch replacement through median sternotomy. The aorta was ligated at the level of the co-arctation, which was located in the proximal part of the descending aorta, and an ascending-descending bypass was created using a transhiatic approach. The postoperative course was complicated by a cerebrovascular accident
van Putte BP, Grootenboers M, van Boven WJ, Hendriks JM, van Schil PE, Guetens G, de Boeck G, Pasterkamp G, Schramel F, Folkerts G. Pharmacokinetics of Gemcitabine when delivered by Selective Pulmonary Artery Perfusion for the Treatment of Lung Cancer. Drug Metabolism and Disposition 2008; 36(4):676-681.
Abstract: Lung cancer represents a major health problem. Cytostatic and radio-therapeutic treatment are both limited due to dose-limiting systemic toxicity and surgery due to its invasive nature. Therefore, we developed a catheterisation model of selective pulmonary artery perfusion (SPAP) combining the properties of isolated lung perfusion and intravenous treatment to achieve higher local drug levels and equivalent systemic exposure. Sixteen pigs underwent SPAP using a clinically applied dose of gemcitabine (1g/m(2)). They furthermore underwent thoracotomy for tissue sampling. Three groups were treated with SPAP for two minutes with normal pulmonary blood flow, 50% and 90% flow reduction. Another group had SPAP for ten minutes with normal blood flow. All SPAP groups underwent catheterisation of the left pulmonary artery. An additional group (n=4) was infused intravenously (IV) for thirty minutes using the same dose. Concentrations were analysed with ANOVA. Pulmonary peak concentrations (p=0.01) and areas under the curve (AUC) (p=0.001) of SPAP for two and ten minutes were significantly higher compared to IV while SPAP for ten minutes resulted in the highest AUC (p=0.045) compared to SPAP for two minutes. Flow reduction during SPAP resulted in inhomogeneous distribution. Liver levels, AUC (serum) and wet-to-dry ratios of all SPAP groups were not significantly different compared to IV. SPAP resulted in higher lung concentrations while systemic exposure was comparable with IV. Therefore, we advocate SPAP as a new method to be tested clinically to achieve down-staging of the tumour (T) and lymph node (N) status in lung cancer
van Randen A, Laméris W, van Es HW, ten Hove W, van Keulen EM, Henneman OD, van Leeuwen MS, Bossuyt PMM, Boermeester MA, Stoker J. Radiological features of the diagnosis acute appendicitis on ultrasonography and CT. European Radiology 2008; 18(Suppl 2):B25-B26.
van Riessen S, Wasowicz-Kemps DK, Besselink MGH, Bollen TL, Vos JA, Onaca MG, Segers MJM. Massive portal vein thrombosis and kidney rupture following blunt abdominal trauma: A diagnostic and therapeutic dilemma. Injury Extra 2008; 39(2):71-75.
van Santvoort HC, Besselink MG, Gooszen HG. Het verkrijgen van medisch-ethische goedkeuring voor een multicentrische, gerandomiseerde trial: prospectieve evaluatie van een moeizaam proces. Nederlands Tijdschrift voor Geneeskunde 2008; 152(38):2077-2083.
Abstract: OBJECTIVE: To evaluate the procedure to obtain medical ethical approval for a multicentre study in the Netherlands. DESIGN: Prospective and descriptive. METHOD: The application procedure for medical ethical approval of a nationwide randomised multicentre trial (the 'Pancreatitis: surgical necrosectomy versus step up approach' (PANTER)-trial) from the ethics committees (EC) of 9 Dutch hospitals during 2004-2007, was prospectively evaluated. Several predefined variables regarding the duration of the ethical review process, the time invested and material and the type of queries raised by the ECs in all centres were collected. RESULTS: Primary approval by the central EC of the coordinating hospital was obtained after 192 days. The duration of the review process for each of the 18 local participating centres was 105 days (range: 35-361). The maximum review term of 30 days, as defined in the national guideline, was reached by only one centre. It took two years to obtain approval for all participating centres. A median of 14 different documents (range: 5-23) were submitted to the EC of each participating centre. A total of 8314 A4 size papers (about 42 kg) were sent by post, 172 telephone calls were made and 136 e-mail messages were sent by the research fellow coordinating the application procedure. Of the local ECs in the participating centers, 95% requested additional revision of the patient information sheet and 78% requested changes in the informed consent form. CONCLUSION: Obtaining medical ethical approval for this multicentre trial in the Netherlands was a long and inefficient process, requiring a considerable investment of time and resources. Streamlining the application procedure may lead to a substantial reduction in the current unnecessary delay of starting a multicentre study
van Santvoort HC, Bollen TL, Besselink MG, Banks PA, Boermeester MA, van Eijck CH, Evans J, Freeny PC, Grenacher L, Hermans JJ, Horvath KD, Hough DM, Lameris JS, van Leeuwen MS, Mortele KJ, Neoptolemos JP, Sarr MG, Vege SS, Werner J, Gooszen HG. Describing peripancreatic collections in severe acute pancreatitis using morphologic terms: an international interobserver agreement study. Pancreatology 2008; 8(6):593-599.
Abstract: BACKGROUND/AIMS: The current terminology for describing peripancreatic collections in acute pancreatitis (AP) derived from the Atlanta Symposium (e.g. pseudocyst, pancreatic abscess) has shown a very poor interobserver agreement, creating the potential for patient mismanagement. A study was undertaken to determine the interobserver agreement for a new set of morphologic terms to describe peripancreatic collections in AP. METHODS: An international, interobserver agreement study was performed: 7 gastrointestinal surgeons, 2 gastroenterologists and 8 radiologists in 3 US and 5 European tertiary referral hospitals independently evaluated 55 computed tomography (CT) scans of patients with predicted severe AP. The percentage agreement [median, interquartile range (IQR)] for 9 clinically relevant morphologic terms was calculated among all reviewers, and separately among radiologists and clinicians. The percentage agreement was defined as poor (<0.50), moderate (0.51-0.70), good (0.71-0.90), and excellent (0.91-1.00). RESULTS: Overall agreement was good to excellent for the terms collection (percentage agreement = 1; IQR 0.68-1), relation with pancreas (1; 0.68-1), content (0.88; 0.87-1), shape (1; 0.78-1), mass effect (0.78; 0.62-1), loculated gas bubbles (1; 1-1), and air-fluid levels (1; 1-1). Overall agreement was moderate for extent of pancreatic nonenhancement (0.60; 0.46-0.88) and encapsulation (0.56; 0.48-0.69). The percentage agreement was greater among radiologists than clinicians for extent of pancreatic nonenhancement (0.75 vs. 0.57, p = 0.008), encapsulation (0.67 vs. 0.46, p = 0.001), and content (1 vs. 0.78, p = 0.008). CONCLUSION: Interobserver agreement for the new set of morphologic terms to describe peripancreatic collections in AP is good to excellent. Therefore, we recommend that current clinically based definitions for CT findings in AP (e.g. pancreatic abscess) should no longer be used. Copyright 2008 S. Karger AG, Basel and IAP
van Santvoort HC, Besselink MG, Timmerman HM, van Minnen LP, Akkermans LM, Gooszen HG. Probiotics in surgery. Surgery 2008; 143(1):1-7.
van Schaik RHN, Grandia L, de Goede A, Bet PM, Bekers O, Duchelaar H-J, Goldschmidt HMJ, Meijer MMC, Mulder H, van der Weide J, Deneer VHM . Nederlandse consensus: CYP2D6 genotype '1-0' ingedeeld als intermediaire metaboliseerder. Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde 2008; 33(1):52-53.
van Schil PE, Hendriks JM, van Putte BP, Stockman BA, Lauwers PR, ten Broecke PW, Grootenboers MJ, Schramel FM. Isolated lung perfusion and related techniques for the treatment of pulmonary metastases. European Journal of Cardio-Thoracic Surgery 2008; 33(3):487-496.
Abstract: Surgical resection is a widely accepted treatment for pulmonary metastases on the condition that a complete resection can be obtained. However, many patients will develop recurrent disease in the thorax despite the use of systemic chemotherapy, dosage of which is limited because of systemic toxicity. Similar to the basic principles of isolated limb and liver perfusion, isolated lung perfusion is an attractive and promising surgical technique for the delivery of high-dose chemotherapy with minimal systemic toxicity. The use of biological response modifiers, like tumour necrosis factor, is also feasible. Other related methods of delivering high-dose locoregional chemotherapy include embolic trapping (chemo-embolisation) and pulmonary artery infusion without control of the venous effluent. Isolated lung perfusion has proven to be highly effective in experimental models of pulmonary metastases with a clear survival advantage. Lung levels of cytostatic drugs are significantly higher after isolated lung perfusion compared to intravenous therapy without systemic exposure. Phase I human studies have shown that isolated lung perfusion is technically feasible with low morbidity and without compromising the patient's pulmonary function. Further clinical studies are necessary to determine its definitive effect on local recurrence, long-term toxicity, pulmonary function and survival
van Selm S, Overtoom ThC, van Heesewijk JPM, van Es HW, Giesbers AAGM, Vijverberg PLM. Behandeling van UPJ-stenose met een nieuw ontwikkelde ballonkatheter: de Overtoom-stent. Nederlands Tijdschrift voor Urologie 2008; 7:189.
van Vulpen LFD, Koene HR, de Weerdt O. A complicated course in the treatment of ATLL in an HTLV-1 positive woman from the Dominican Republic. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;73.
van Werkum JW, Heestermans AA, Suttorp MJ, Kelder JC, Koolen JJ, Brueren BR, van 't Hof AWJ, Dambrink JH, Verheugt FWA, ten Berg JM. The Dutch stent thrombosis registry: case-control study in 437 patients with stent thrombosis. European Heart Journal 2008; 29(Suppl 1):582.
van Werkum JW, Harmsze AM, Elsenberg EH, Bouman HJ, ten Berg JM, Hackeng CM. The use of the VerifyNow system to monitor antiplatelet therapy: A review of the current evidence. Platelets 2008; 19(7):479-488.
Abstract: Multiple studies have demonstrated the effectiveness of dual or triple antiplatelet therapy with aspirin, clopidogrel and glycoprotein (GP) IIb/IIIa therapy in patients with acute coronary syndromes as well as in patients undergoing coronary stent implantation. In the last few years, it is becoming clear that not all patients receive the full benefits with the current standard dosages of antiplatelet therapy. Specifically, numerous studies have revealed a wide interindividual variability in the response to these antiplatelet agents and, more importantly, both nonresponsiveness as well as a heightened residual platelet reactivity have been linked to the occurrence of adverse cardiovascular events. Therefore, assays that identify those patients with an impaired responsiveness or a heightened platelet reactivity despite dual antiplatelet therapy may contribute to better risk stratification and will probably improve clinical outcome when appropriate action is initiated. Likewise, a considerable number of patients do not achieve the minimal inhibition of aggregation threshold with the current recommended weight-adjusted dosages of GP IIb/IIIa therapy. Identifying and optimizing the absolute degree of platelet inhibition in this subgroup of patients will probably improve clinical outcome. The VerifyNow platform is one of the most user friendly point-of-care platelet function test systems because it produces rapid results at the patient bedside. The purpose of the present paper is to give insight into the principal mechanisms of the VerifyNow system, to discuss its clinical utility for the monitoring of antiplatelet therapy and to discuss the proposed cut-off levels to segregate responders from non-responders for the different types of antiplatelet therapy
van Werkum JW, Topcu Y, Postma S, Kelder JC, Hackeng CM, ten Berg JM, Verheugt FW. Effects of diabetes mellitus on platelet reactivity after dual antiplatelet therapy with aspirin and clopidogrel. Thrombosis & Haemostasis 2008; 99(3):637-639.
van Werkum JW, ten Berg JM, Plokker THW, Kelder JC, Suttorp MJ, Rensing BJ, Tersmette M. Staphylococcus aureus infection complicating percutaneous coronary interventions. International Journal of Cardiology 2008; 128(2):201-206.
Abstract: BACKGROUND: This study sought to determine the incidence, risk factors, and characteristics of Staphylococcus (S.) aureus infections complicating percutaneous coronary interventions (PCI). METHODS: Between January 1999 and December 2002, 7640 PCI's were evaluated from 1 to 16 days post-PCI for the occurrence of a documented S. aureus infection. A case-control study was used to identify risk factors for the development of S. aureus infection in patients undergoing PCI. RESULTS: In total 21 S. aureus infections (0.27%) were documented at 1 to 16 days after the index PCI. The overall incidence of PCI-related infection was 0.14% (11 cases), 0.13% (10 cases) were intravascular line related. All 21 cases with S. aureus infections were matched with 63 controls randomly selected among patients who underwent a PCI but did not have S. aureus infections. Among the patients with S. aureus infections, the duration of hospital stay was significantly increased (24 vs 5 days). The overall mortality rate in the 21 patients with S. aureus infections was 4/21 [19%] (controls 2/42 [3%]). Congestive heart failure, alcohol abuse, emergency PCI, more than 1 PCI in three months and the presence of a sheath in the femoral artery and/or vein for the duration of more than 1 day after the procedure were independent risk factors for S. aureus infection after PCI. CONCLUSIONS: S. aureus infection is a rare but potentially serious complication of PCI. Additional precautions should be considered in patients with these risk factors
van Werkum JW, Hackeng CM, Smit J-JJ, van 't Hof AWJ, Verheugt FWA, ten Berg JM. Monitoring antiplatelet therapy with point-of-care platelet function assays: a review of the evidence. Future Cardiology 2008; 4(1):33-55.
van Werkum JW, ten Berg JM. Platelet reactivity as a risk-factor for stent thrombosis: can this be one of the currently available appropriate methods to determine platelet reactivity? EuroIntervention 2008; 4 Suppl C:C11-C16.
van Werkum JW, Witte OA, ten Berg JM, Verheugt FWA. Late coronaire stenttrombose als complicatie van drug-eluting stents. Hart Bulletin 2008; 39(1):4-9.
van Werkum MH, Vos JA. Retinal embolization during carotid angioplasty and stenting. Cardiovascular and Interventional Radiology Society of Europe Annual Scientific meeting Copenhagen, Denmark 2008.
Veersema S, Vleugels MP, Moolenaar LM, Janssen CA, Brolmann HA. Unintended pregnancies after Essure sterilization in the Netherlands. Fertility & Sterility 2008; [Epub ahead of print].
Abstract: OBJECTIVE: To analyze the data of cases of unintended pregnancies after Essure sterilization. DESIGN: Retrospective case series analysis. SETTING: National multicenter. PATIENT(S): Ten cases of unintended pregnancies after Essure sterilization in the Netherlands were reported from August 2002 through May 2008. INTERVENTION(S): Data on the hysteroscopic Essure sterilization procedures and postprocedure confirmation tests of the reported cases were reviewed and analyzed by two authors. The causes of the unintended pregnancies were determined in agreement with the physicians who performed the sterilizations. MAIN OUTCOME MEASURE(S): Most pregnancies occurred in patients with only one device placement and bilateral occlusion on hysterosalpingography (HSG). Other cases included misinterpretation of HSG, undetected abnormal device position by ultrasound, one undetected preprocedure pregnancy, and two patient failures to follow up with the physician advice. CONCLUSION(S): The risk of pregnancy after hysteroscopic sterilization may be reduced by strictly following the follow-up protocol, performing a urinary pregnancy test on the day of the procedure, and instructing the patient to return for the follow-up visit. A procedure with only a single device placement in a patient without a history of tubectomy of the heterolateral tube should be considered unsuccessful
Veersema S. Sterilisatie. In: Jansen FW, Trimbos-Kemper T, editors. Hysteroscopische chirurgie : de basis. Noordwijk: Laurier, 2008: 187-193.
Veld U. Slikken, een vak apart. Critical care : multidisciplinair vakblad 2008; 5(4):11-13.
Veltkamp M, Grutters J, van Moorsel C, Rijkers G, Ruven H, van den Bosch J. A possible role for toll-like receptor (TLR) 5 in fibrotic pulmonary sarcoidosis. European Respiratory Journal - Supplement 2008; 32(Suppl 52):Abstract 199.
Veneman ThF, Eland IA, Storms GEMG. Insulinetherapie bij type 2 diabetes : waar slaat de wegschaal heen? Nederlands Tijdschrift voor Diabetologie 2008; 6(4):168-174.
Venhuizen AC, Hustinx WN, van Houte AJ, Veth G, van der Griend R. Three cases of Pneumocystis jirovecii pneumonia (PCP) during first-line treatment with rituximab in combination with CHOP-14 for aggressive B-cell non-Hodgkin's lymphoma. European Journal of Haematology 2008; 80(3):275-276.
Verbeek WH, van de Water JM, Al-Toma A, Oudejans JJ, Mulder CJ, Coupe VM. Incidence of enteropathy--associated T-cell lymphoma: a nation-wide study of a population-based registry in The Netherlands. Scandinavian Journal of Gastroenterology 2008; 43(11):1322-1328.
Abstract: OBJECTIVE: Enteropathy-associated T-cell lymphomas (EATLs) are T-cell non-Hodgkin lymphomas of the small bowel, which are specifically associated with coeliac disease (CD). To our knowledge no studies have previously reported on the overall incidence of EATLs in the general population. The aim of this study was to investigate the incidence of EATL and the demographic characteristics of patients with EATL in The Netherlands. MATERIAL AND METHODS: A survey of the nation-wide network and registry of histo- and cytopathology reports in The Netherlands (PALGA) was performed. We included all T-cell lymphomas detected between January 2000 and December 2006 that initially presented in the small bowel. Crude and world standardized incidence rates were computed as well as gender- and age-specific incidence rates. Finally, the distribution of characteristics such as the localization, the Marsh classification and method of diagnosis are described. RESULTS: Clinicopathological data were gathered for 116 cases of EATL. The mean age at primary presentation of EATL was 64 years. The crude incidence in the total Dutch population was 0.10/100,000 with an incidence of 2.08/100,000 in the over 50-year-olds. Age-specific incidences were 1.44/100,000 in the 50-59 years age group, 2.92/100,000 in the 60-69 years age group, and 2.53/100,000 in the 70-79 years age group. There was a significant predominance of males (64%, p=0.004, CI 54-72); above the age of 50 the gender-specific incidence was 2.95/100,000 in males versus 1.09/100,000 in females. Most EATLs were localized in the proximal small intestine and the diagnosis was made by surgical resection in the majority of cases. CONCLUSIONS: EATL is a rare disease with an incidence of 0.10 per 100,000 inhabitants per year, occurring in older age, with a peak incidence in the 7th decade. The tumour is mainly localized in the proximal small intestine. Although uncomplicated CD is twice as frequent in female patients, EATL is more prevalent in males
Verbeek WH, Goerres MS, von Blomberg BM, Oudejans JJ, Scholten PE, Hadithi M, Al-Toma A, Schreurs MW, Mulder CJ. Flow cytometric determination of aberrant intra-epithelial lymphocytes predicts T-cell lymphoma development more accurately than T-cell clonality analysis in Refractory Celiac Disease. Clinical Immunology 2008; 126(1):48-56.
Abstract: BACKGROUND:: Refractory celiac disease (RCD) patients with aberrant, often clonal, intraepithelial T-cells are at high risk for development of enteropathy associated T-cell lymphoma (EATL). Early detection of those patients that actually develop EATL is of utmost importance for curative intervention. AIM:: First, to establish an optimal cut-off value for the percentage of aberrant lymphocytes, previously determined based on clinical observations, via reference ranges for aberrant T-cells in the duodenal mucosa of celiac disease patient and control groups. Secondly, to compare aberrancy with intestinal T-cell clonality as a prognostic parameter for EATL development in RCD. METHODS:: Immunophenotyping using flow cytometry was performed on small intestinal biopsy-derived lymphocytes, obtained from distinct celiac disease (CD) patient and control groups (N=167 in total). T-cell clonality in duodenal biopsy specimens was assessed by PCR in RCD, ulcerative jejunitis and EATL patients (N=31 in total). RESULTS:: In 95% of non-refractory CD patients, the highest percentage aberrant T-cells was 20%. Using this cut-off value, EATL development was exclusively seen in RCD with more than 20% aberrant T-cells (median 52% aberrant T-cells, range 27-94%). When compared with T-cell clonality analysis, >20% aberrancy showed a much higher negative predictive value and sensitivity (both 100%) for EATL development in RCD patients than T-cell clonality analysis (respectively 75% and 78%). CONCLUSIONS:: Quantification of aberrant T-cells by flow cytometry is preferable to T-cell clonality analysis for identification of RCD patients at risk for EATL development. A cut-off value of 20% is of use in risk stratification, therapeutic options and subsequent follow-up of RCD patients
Vergeer WJF, Wiltink EH, Geers AB. Nierfunctiestoornissen bij ouderen : gevolgen voor het toedienen van medicatie. Tijdschrift voor Verpleeghuiskunde 2008; 33(1):6-9.
Vergeer WJF, Wiltink EH, Achterberg WP. Medicatievoorschrijfgedrag bij verpleeghuispatiënten met nierfunctiestoornissen. Tijdschrift voor Verpleeghuiskunde 2008; 33(4):110-113.
Vernooij CM, Braak SJ, Verweij BH, Frequin STFM. Een acute dwarslaesie op basis van een spontaan acuut spinaal subduraal hematoom. Tijdschrift voor neurologie & neurochirurgie 2008; 109(1):27-31.
Verrij E, van Montfrans G, Bos WJW. Reintroduction of Riva-Rocci measurements to determine systolic blood pressure? Netherlands Journal of Medicine 2008; 66(11):480-482.
Verrij EA, ter Borg EJ. Een pijnlijke verdikking van de derde teen. Nederlands Tijdschrift voor Reumatologie 2008;(3):31-32.
Verrij EA, Geers ABM, Biesma DH. Unusual presentations of an Epstein-Barr virus infection. 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;80.
Verrij EA, Vincent HH, Bos WJ. Rule of thumb to calculate mean arterial pressure at the brachial artery level. Journal of Hypertension 2008; 26(5):1043-1045.
Verstappen SM, Jacobs JW, van der Veen MJ, Heurkens AH, Schenk Y, ter Borg EJ, Blaauw AA, Bijlsma JW, on the behalf of the Utrecht Rheumatoid Arthritis Cohort study group. Intensive treatment with methotrexate in early rheumatoid arthritis: aiming for remission. Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA, an open-label strategy trial). Reumatologie 2008; 3(1):9.
Verzijlbergen F, Conemans E, van Eck-Smit BLF, Oyen W, Heitbrink M, Ophof PJA, van Waes PFGM. Multimodality (MM) imaging: Enhancement through interlacing. European journal of nuclear medicine and molecular imaging 2008; 35(6):1222-1229.
Verzijlbergen JF, Keijsers RG, Grutters JC, Lavalaye J, van Buul MMC, van den Bosch JMM. The TEM classification of sarcoidosis based on F-18 DG-PET. Indian Journal of Nuclear Medicine 2008; 23(2):204.
Verzijlbergen JF. Reactie op het inspectierapport 'Nucleaire Geneeskunde nog niet op orde'. Tijdschrift voor Nucleaire Geneeskunde 2008; 30(3):141-142.
Vis JC, Timmermans J, Post MC, Budts W, Schepens MA, Thijs V, Schonewille WJ, de Bie RM, Plokker HW, Tijssen JG, Mulder BJ. Increased prevalence of migraine in Marfan syndrome. International Journal of Cardiology 2008; [Epub ahead of print].
Abstract: OBJECTIVE: A high prevalence of migraine has been described in various forms of congenital heart disease, with and without shunt. In this study we investigated the prevalence of migraine in patients with Marfan syndrome (MFS). METHODS: All 457 adult patients with MFS from the participating centres and 194 controls received a validated questionnaire about headache. Migraine was diagnosed according to the International Headache Society criteria, by three independent neurologists, blinded to patient files. RESULTS: Response rate was 68% and 56% in Marfan patients and controls, respectively. Forty percent of the 309 responding MFS patients (mean age 40+/-14 years; 51% females) and 28% of the 102 controls (mean age 43+/-15 years; 58% females), suffered from migraine (p=0.03). The prevalence of migraine with aura (MA) was 22% in MFS patients and 14% in controls (p=0.06). We found MFS to be an independent risk factor for having overall migraine (OR 1.7; 95%CI 1.1-2.8), also after adjustment for age and gender (OR 1.9; 95%CI 1.1-3.1; p=0.02) and for MA after adjustment for gender (OR 2.0; 95%CI 1.1-3.7; p=0.04). In patient with MFS, previous aortic root surgery appeared to be an independent risk factor for having MA (OR 2.2; 95%CI; 1.2.-4.0, p=0.01) adjusted for gender. CONCLUSION: MFS is an independent risk factor for having overall migraine and MA. Moreover, we found that a history of aortic root surgery seems to be associated with an increased risk of MA
Visscher S, Schurink CA, Melsen WG, Lucas PJ, Bonten MJ. Effects of systemic antibiotic therapy on bacterial persistence in the respiratory tract of mechanically ventilated patients. Intensive Care Medicine 2008; 34(4):692-699.
Abstract: OBJECTIVE: Bacterial respiratory tract colonization predisposes critically ill patients to intensive care unit (ICU)-acquired infections. It is unclear to what extent systemic antibiotics affect colonization persistence. Persistence of respiratory tract colonization, and the effects of systemic antibiotics hereon, were determined in a cohort of ICU patients. DESIGN: Clinical and microbiological data were collected from 715 admitted mechanically ventilated ICU patients with bacterial growth documented in respiratory tract samples. First day of colonization, persistence of colonization and antibiotic effects hereon were analyzed for six groups of pathogens: Pseudomonas aeruginosa, Acinetobacter species, Enterobacteriaceae, Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae. Systemic antibiotics were grouped into 'effective' and 'ineffective' antibiotics, based on in-vitro susceptibility data for the relevant bacteria. The effects of antibiotics were quantified as relative risk (RR) of bacterial persistence in the absence of effective antibiotics. MEASUREMENTS AND RESULTS: Persistence of colonization differed significantly between pathogens, ranging from 4 days (median) for H. influenzae and Strep. pneumoniae to 8 days for P. aeruginosa. Systemic antibiotics were administered on 7,102 (61%) of patient days. Antibiotic use was associated with non-persistence for all pathogens, except Acinetobacter species and P. aeruginosa. RR for non-persistence (as compared to ineffective or no antibiotics) ranged from 3.1 (95% CI 1.4-6.6) for H. influenzae to 0.5 (0.3-1.0) for Acinetobacter species. CONCLUSIONS: In mechanically ventilated patients, persistence dynamics of bacterial respiratory tract colonization, and the effects of (in-vitro) effective antibiotics hereon, are pathogen-specific
Visser LE, Kyei-Faried S, Belcher DW, Geelhoed DW, Schagen van Leeuwen JH, van Roosmalen J. Failure of a new antivenom to treat Echis ocellatus snake bite in rural Ghana: the importance of quality surveillance. Transactions of the Royal Society of Tropical Medicine and Hygiene 2008; 102(5):445-450.
Abstract: This study compares two antivenoms used to treat Echis ocellatus snake bite patients at Mathias Hospital, Yeji, central Ghana. FAV-Afriquetrade mark antivenom (Aventis Pasteur) was given to 278 patients during 2001-2003, whilst Asna Antivenom C (Bharat Serum and Vaccines Ltd) was used in 2004 to treat 66 patients. The two groups had comparable patient attributes, time from snake bite to treatment and staff adherence to the tested treatment protocol. The antivenom C group required more repeat doses and twice the amount of antivenom to treat coagulopathy. Of greater concern, the antivenom C mortality rate was 12.1%, a marked rise from the 1.8% rate in the earlier FAV-Afriquetrade mark antivenom group. In this study, antivenom C was ineffective as treatment for West African E. ocellatus snake venom. This illustrates the absolute need for regional pilot tests to assess the effectiveness of a new antivenom against local snake venoms before its sole and general distribution in a region is initiated
Vlaar AM, de Nijs T, van Kroonenburgh MJ, Mess WH, Winogrodzka A, Tromp SC, Weber WE. The predictive value of transcranial duplex sonography for the clinical diagnosis in undiagnosed parkinsonian syndromes: comparison with SPECT scans. BMC Neurology 2008; 8:42.
Abstract: ABSTRACT: BACKGROUND: Transcranial duplex sonography (TCD) of the substantia nigra has emerged as a promising, non-invasive tool to diagnose idiopathic Parkinson's disease (IPD). However, its diagnostic accuracy in patients with undefined parkinsonism remains to be determined.In this study we determined the predictive value of TCD for the clinical diagnosis in undiagnosed parkinsonian syndromes. Additionally we compared the predictive value of TCD with that of presynaptic and postsynaptic single photon emission computer tomography (SPECT) scans. METHODS: We studied 82 patients with an unclassified parkinsonian syndrome. All 82 patients were subjected to a TCD, 59 of them underwent a presynaptic SPECT scans and 32 underwent a postsynaptic SPECT scan.We determined the diagnostic accuracy of TCD and SPECT scans in differentiating:1) IPD patients from patients without nigrostriatal degeneration and 2) IPD patients from patients with atypical parkinsonian syndromes (APS).To compare the diagnostic accuracy of TCD and SPECT scans, we used the clinical diagnosis after follow-up according to generally accepted clinical criteria as the gold standard. This clinical diagnosis was determined by a movement disorder specialist.3) Finally, we ascertained the predictive value of the TCD for the SPECT result. RESULTS: The clinical diagnoses after follow-up resulted in 51 cases of IPD, 7 patients with APS and 17 patients without nigrostriatal degeneration. In total 7 patients remained undiagnosed.1) The accuracy of TCD, assessed by sensitivity and specificity, to differentiate IPD patients from patients without nigrostriatal degeneration was 50% and 82% respectively.For the presynaptic SPECT scans sensitivity was 97% and specificity 100%.2) In differentiating IPD patients from APS patients, the sensitivity and specificity of TCD was 50% and 43% respectively. For presynaptic SPECT scans this was 97% and 0%. For the postsynaptic SPECT scans the sensitivity was 75% and the specificity 81%.3) The positive predictive value (PPV) of an abnormal TCD for an abnormal presynaptic SPECT scan was 88%. CONCLUSION: Presynaptic SPECT scanning has a higher predictive value for the clinical diagnosis than TCD. However, since the PPV of an abnormal TCD for parkinsonism with nigrostriatal degeneration is high, TCD might be used as screening tool, before ordering a presynaptic SPECT
Vlaar AM, de Nijs T, Kessels AG, Vreeling FW, Winogrodzka A, Mess WH, Tromp SC, van Kroonenburgh MJ, Weber WE. Diagnostic Value of I-Ioflupane and (123)I-Iodobenzamide SPECT Scans in 248 Patients with Parkinsonian Syndromes. European Neurology 2008; 59(5):258-266.
Abstract: Background: SPECT is one of the most employed techniques in the diagnostic workup of idiopathic Parkinson's disease (IPD). Despite its widespread use, the exact diagnostic accuracy of this technique in parkinsonian syndromes remains controversial. Methods: In this study, we investigated the diagnostic accuracy of an initial (123)I-ioflupane (FP-CIT) and/or (123)I-iodobenzamide (IBZM) SPECT to differentiate between IPD and other parkinsonian disorders. 248 patients underwent a SPECT scan because of an as yet unclassified parkinsonian syndrome in our clinic between 2001 and 2006. Gold standard was the clinical diagnosis derived from the latest available clinical record, or, when this was not possible, a new complete physical and neurological examination by a blinded movement disorder specialist neurologist. Mean follow-up between SPECT and the latest clinical information was 18 months (range 3 months to 5 years). Results: 223 of the 248 patients were clinically definitely diagnosed after follow-up: IPD 127, atypical parkinsonian syndromes (APS) 27, essential tremor (ET) 22, vascular parkinsonism (VP) 16, drug-induced parkinsonism (DIP) 5, doubt between PD and APS 2, other diseases without dopaminergic involvement 24. The mean odds ratio (95% CI) for FP-CIT SPECT's ability to distinguish between IPD and ET was 82 (11-674); between IPD and VP 61 (8-490); between IPD and DIP 36 (2-697) and between IPD and APS was 1 (0-4). The odds ratio for the IBZM SPECT tracer to differentiate between IPD and APS was 7 (2-17). Conclusions: FP-CIT SPECT is accurate to differentiate patients with IPD from those with ET, and IPD from VP and DIP. The accuracy of both FP-CIT and IBZM SPECT scans to differentiate between IPD and APS is low. Copyright (c) 2008 S. Karger AG, Basel
Vlieger AM, Blink M, Tromp E, Benninga MA. Use of Complementary and Alternative Medicine by Pediatric Patients With Functional and Organic Gastrointestinal Diseases: Results From a Multicenter Survey. Pediatrics 2008; 122:e446-e452.
Vlieger AM, Benninga MA. Complementary therapies for pediatric functional gastrointestinal disorders. Journal of Pediatric Gastroenterology Nutrition 2008; 47(5):707-709.
Vlot EA, Ruven HJ, Biemond-Moeniralam HS. Hypoglycemia counterregulatory response in critically ill patients. Intensive Care Medicine 2008; 34(suppl 1):S97.
Voet A, Luermans JG, Thijs V, Herroelen L, Post MC, Troost E, Budts W. New-onset and persistent migraine early after percutaneous atrial septal defect closure disappear at follow-up. Acta clinica Belgica 2008; 63(4):262-268.
Abstract: AIMS: Recently we reported that percutaneous atrial septal defect (ASD) closure had no influence on the prevalence of migraine during a short followup period. 12 % of patients however developed a new-onset migraine after the ASD closure. As it has been suggested that the closing device might induce or maintain migraine temporarily, we were interested in the prevalence of migraine at longer follow-up. METHODS: All 75 patients included in the previous study, received the same structured headache questionnaire. A neurologist, blinded to previous data, diagnosed migraine with or without aura (MA+ or MA-) according to the International Headache Criteria. McNemar paired X2 test was used to evaluate changes in the occurrence of migraine. RESULTS: Seventy-one patients (94.7%) answer the questionnaire (55 women, mean age at closure 51 +/- 18 years). Mean follow-up time was 52 +/- 13 months. The overall migraine prevalence decreased from 30.7% before to 22.5% after closure (P=0.21). A significant reduction was noted in patients with new-onset migraine early after closure (n=7), where migraine disappeared in 6 patients (P=0.031). In the group with persistent migraine early after closure (n=13), another 6 patients became migraine-free (P=0.031). CONCLUSION: Percutaneous ASD closure was not related to a significant decrease in overall migraine prevalence. However, new-onset and persistent migraine early after closure disappeared
Vogten JM, Gerritsen WB, Ackerstaff RG, van Dongen EP, de Vries JP. Perioperative microemboli and platelet aggregation in patients undergoing carotid endarterectomy. Vascular 2008; 16(3):154-160.
Abstract: In carotid endarterectomy (CEA) patients, platelet aggregation is increased despite heparinization. We investigated whether this phenomenon correlates with the occurrence of perioperative microemboli. Of 27 CEA patients, 18 (67%) used aspirin and 9 also used clopidogrel. Blood was collected at multiple time points before, during, and after CEA. Platelet aggregation and P-selectin expression were determined. Transcranial Doppler monitoring was used to measure microemboli. Platelet aggregation showed a significant increase 5 minutes postheparinization compared with preheparinization (19.7 +/- 2.8% vs 8.9 +/- 0.9% in the aspirin group and 22.5 +/- 4.4% vs 8.7 +/- 1.2% in the clopidogrel group; p < .01 and p < .05, respectively). P-selectin expression showed a tendency to increase postheparinization in both groups (p = .07 and p = .09, respectively). The number of microemboli ranged from 0 to 50. Clopidogrel patients displayed fewer microemboli than aspirin patients (4.1 +/- 2.3 vs 17.6 +/- 18.2; p < .01). Patients with a high number of microemboli displayed had a tendency toward higher baseline platelet aggregation than patients with a low number of microemboli (p = .08). In conclusion, platelet aggregation is transiently increased during CEA despite the administration of antiplatelet agents. Clopidogrel is associated with a decreased number of perioperative microemboli. The exact relationships between these findings, postoperative microemboli formation, and the risk for thromboembolic complications after CEA remain to be determined
Vonk MC, Broers B, Heijdra YF, Ton E, Snijder R, van Dijk AP, van Laar JM, Bootsma H, van Hal PT, van den Hoogen FH, van Daele PL. Systemic sclerosis and its pulmonary complications in the Netherlands An epidemiological study. Annals of the Rheumatic Diseases 2008; [Epub ahead of print].
Abstract: The prevalence and incidence of systemic sclerosis (SSc) in the Netherlands is unknown. The same holds true for its leading causes of death: pulmonary fibrosis and pulmonary arterial hypertension (PAH), for which effective treatment options have become available recently. Objective: to establish the prevalence and incidence of SSc and its pulmonary complications. Methods: detailed information of patients in the POEMAS registry, "Pulmonary Hypertension Screening, a Multidisciplinary Approach in Scleroderma", consisting of 819 patients, was combined with a nationwide questionnaire. Results: By combining the two sources we found the prevalence of SSc to be 8.9 per 105 adults. The incidence was 0.77 patients per 105 per year. PAH was diagnosed in 9.9% of the SSc patients. The prevalence of interstitial lung disease in SSc varied from 19 to 47% depending on the definition used. Conclusion: This study clarifies the epidemiology of SSc in the Netherlands and confirms the frequent occurrence of pulmonary complications, based on 654 cases. This can and will be further studied in the ongoing POEMAS study
Waasdorp E, van Herwaarden JA, van de Mortel RH, Moll FL, de Vries JP. Early computed tomographic angiography after endovascular aneurysm repair: worthwhile or worthless? Vascular 2008; 16(5):253-257.
Abstract: This study evaluated the value of computed tomographic angiography (CTA) early after an endovascular aneurysm repair (EVAR) in relation to CTA 3 months after EVAR. We retrospectively reviewed all elective EVAR patients with available postprocedural and 3-month follow-up CTAs who were treated between 1996 and 2006. CTAs were analyzed for EVAR-related complications in terms of endoleaks, migration, and stent graft thrombosis. Secondary procedures and other complications within a 4-month time interval after EVAR were noted and analyzed for any association with the postprocedural CTA. During the study period, 291 patients (275 men), with a mean age of 71 years, underwent elective EVAR. All had postprocedural and 3-month follow-up CTAs, which detected 93 (32%) endoleaks (8 type I, 84 type II, 1 type III) and 1 stent graft thrombosis. These findings resulted in four secondary interventions (one interposition cuff, two extension cuffs, one conversion). All reinterventions were successfully done in an elective setting. During the first 3 postoperative months, five other reinterventions were required for acute ischemia in four patients (three Fogarty procedures, one femorofemoral crossover bypass) or groin infection in one patient. Eight patients died, but none of the deaths were related to abdominal aortic aneurysm or EVAR (four cardiac, two pulmonary, one gastric bleeding, one carcinoma). At 3 months, 43 endoleaks (3 type I, 40 type II), 3 stent graft thromboses, and 1 stent graft migration were seen. In two patients (0.7%), a new endoleak was diagnosed compared with the postprocedural CTAs. In 287 (99%) of 291 patients, the postprocedural CTA did not influence our treatment policy in the first 3 months after EVAR. More than half of the early endoleaks were self-limiting, and new endoleaks were seen in only two patients (< 1%) at the 3-month follow-up CTA. After an uneventful EVAR procedure, it is safe to leave out the early postprocedural CTA. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=fulltext&NEWS=n&D=prem&AUTOALERT=30157514%7c1
Walhout RJ, Plokker HW, Meijboom EJ, Doevendans PA. Advances in the management and surveillance of patients with aortic coarctation. Acta Cardiologica 2008; 63(6):771-782.
Wasowicz-Kemps DK, Slootmaker SM, Kemps HM, Borel-Rinkes IH, Biesma DH, van Ramshorst B. Resumption of daily physical activity after day-case laparoscopic cholecystectomy. Surgical Endoscopy 2008; [Epub ahead of print].
Abstract: BACKGROUND: Laparoscopic cholecystectomy has been proven to be safe and feasible as a day-case procedure. Few studies investigated postoperative activity resumption. The goal of this study was to objectively assess daily physical activity after day-case laparoscopic cholecystectomy and evaluate the effect of encouragement of patients. METHODS: This prospective controlled study measured daily physical activity in an unselected patient population undergoing day-case laparoscopic cholecystectomy by using an accelerometer for 1 week before surgery to 1 week after. First, a control group received standard care. Subsequently, an intervention group was encouraged to swift resumption of daily physical activity by means of standardized advice combined with individualized activity goals. Outcome measures were activity scores, visual analogue scores (VAS) for pain and nausea and subjective factors limiting activity. RESULTS: Sixty-four patients completed the study (n = 28 in the control group, n = 36 in the intervention group). In the control group, 36% of the patients reached their preoperative activity level after 1 week, as compared to 50% in the intervention group (p = 0.19). Resumption of daily physical activity during the first postoperative week in the intervention group was not significantly different from the control group [repeated measures analysis of variance (MANOVA), p = 0.05]. However, in contrast with men, women in the intervention group did show a faster recovery of daily physical activity as compared to the control group (MANOVA, p = 0.02). Although there was no significant difference in postoperative VAS scores for pain and nausea between both groups, patients in the intervention group experienced pain less often as a limiting factor (p = 0.006). CONCLUSION: Recovery of daily physical activity exceeded 1 week in most patients undergoing day-case laparoscopic cholecystectomy. The use of an accelerometer and standardized encouragement accelerated recovery in women
Wasowicz-Kemps DK. Trends in day surgery in the Netherlands. s.l.: s.n., 2008.
Ref ID: 9074
Weda M, Zanen P, de Boer AH, Barends DM, Frijlink HW. The therapeutic index of locally acting inhaled drugs as a function of their fine particle mass and particle size distribution: a literature review. Current drug delivery 2008; 5(2):142-147.
Abstract: The therapeutic index (TI) of locally acting inhaled drug products depends on a number of parameters and processes: the particle size distribution of the inhaled aerosol, the dose-efficacy response curves at the deposition sites, the amount of drug absorbed into the systemic circulation from the lung as well as the gastrointestinal (GI) tract, and the dose-effect curves for the different adverse drug reactions. In this review, we present qualitative scenarios, combining these effects and showing the possible influence of an envisaged change in the particle size distribution in the inhaled dose of a locally acting drug product on the TI. These scenarios are a valuable tool in the development of inhalation drug products. As a surrogate for the inhaled dose in vivo, we use the fine particle mass (FPM), measured by in vitro measurements. Using these scenarios, we reviewed the literature on bronchodilators and corticosteroids for reported associations between a change in the FPM and/or particle size distribution within the FPM, and the TI. We conclude that decreasing the particle size of an inhalation product may alter the TI both in a positive as well as a negative sense. So, smaller particle are not always better
Westerhof BE, Guelen I, Stok WJ, Lasance HA, Ascoop CA, Wesseling KH, Westerhof N, Bos WJ, Stergiopulos N, Spaan JA. Individualization of transfer function in estimation of central aortic pressure from the peripheral pulse is not required in patients at rest. Journal of Applied Physiology 2008; 105(6):1858-1863.
Abstract: Central aortic pressure gives better insight into ventriculo-arterial coupling and better prognosis of cardiovascular complications than peripheral pressures. Therefore transfer functions (TF), reconstructing aortic pressure from non-invasively measured peripheral pressures, are of great interest. Generalized TFs (GTF) give useful results, especially in larger study populations, but detailed information on aortic pressure might be improved by individualization of the TF. We found earlier that the time delay, representing the travel time of the pressure wave between measurement site and aorta is the main determinant of the TF. Therefore, we hypothesized that the TF might be individualized (ITF) using this time delay. In a group of 50 patients at rest, aged 28-66 years (43 men) undergoing diagnostic angiography, ascending aortic pressure was 119+/-20/70+/-9 mmHg (systolic/diastolic). Brachial pressure, almost simultaneously measured using catheter pullback, was 131+/-18/67+/-9 mmHg. We obtained brachial-to-aorta ITFs using time delays optimized for the individual and a GTF using averaged delay. Using ITFs, reconstructed aortic pressure was 121+/-19/69+/-9 mmHg and the Root Mean Square Error, RMSE, as measure of difference in wave shape was 4.1+/-2.0 mmHg. Using the GTF, reconstructed pressure was 122+/-19/69+/-9 mmHg and RMSE 4.4+/-2.0 mmHg. The augmentation index (AI) of the measured pressure was 26+/-13%, with ITF and GTF the AIs were 28+/-12% and 30+/-11%, respectively. Details of the wave shape were reproduced slightly better with ITF but not significantly, thus individualization of pressure transfer is not effective in resting patients. Key words: aortic pressure, brachial pressure, transfer function, augmentation index
Westerhof BE, Mattace-Raso FU, Guelen I, van Popele NM, Hofman A, Witteman JC, Bos WJ. Potential association between aortic stiffness, diastolic/systolic pressure time index and the balance between cardiac oxygen supply and demand: a word of caution. Journal of Hypertension 2008; 26(11):2251-2252.
Westerweel PE, Verhaar MC. Directing myogenic mesenchymal stem cell differentiation. Circulation Research 2008; 103(6):560-561.
Westerweel PE, den Ouden K, Nguyen TQ, Goldschmeding R, Joles JA, Verhaar MC. Amelioration of anti-Thy1-glomerulonephritis by PPAR-gamma agonism without increase of endothelial progenitor cell homing. American Journal of Physiology - Renal Physiology 2008; 294(2):F379-F384.
Abstract: Impaired glomerular endothelial integrity is pivotal in various renal diseases and depends on both the degree of glomerular endothelial injury and the effectiveness of glomerular endothelial repair. Glomerular endothelial repair is, in part, mediated by bone marrow-derived endothelial progenitor cells. Peroxisome proliferator activated receptor-gamma (PPAR-gamma) agonists have therapeutic actions independent of their insulin-sensitizing effects, including enhancement of endothelial progenitor cell function and differentiation. We evaluated the effect of PPAR-gamma agonist rosiglitazone (4 mg.kg(-1).day(-1)) on the course of anti-Thy1-glomerulonephritis in rats. Rosiglitazone limited the development of proteinuria and prevented plasma urea elevation (8.1 +/- 0.4 vs. 12.5 +/- 1.1 mmol/l, P = 0.002). Histologically, inflammatory cell influx was not affected, but rosiglitazone-treated rats did show fewer microaneurysmatic glomeruli on day 7 (26 +/- 3 vs. 41 +/- 5%, P = 0.01) and reduced activation of matrix production with reduced renal cortical transforming growth factor-beta, plasminogen activator inhibitor type 1, and fibronectin-1 mRNA expression. However, bone marrow-derived endothelial cell glomerular incorporation was not enhanced (3.1 +/- 0.4 vs. 3.6 +/- 0.3 cells/glomerular cross section; P = 0.31). Rosiglitazone treatment in nonnephritic rats did not influence proteinuria, urea, or renal histology. In conclusion, treatment with PPAR-gamma agonist rosiglitazone ameliorates the course of experimental glomerulonephritis in a nondiabetic model, but not through enhancing incorporation of bone marrow-derived endothelial cells in the glomerulus
Westerweel PE, Rabelink TJ, Rookmaaker MB, Grone HJ, Verhaar MC. RANTES is required for ischaemia-induced angiogenesis, which may hamper RANTES-targeted anti-atherosclerotic therapy. Thrombosis & Haemostasis 2008; 99(4):794-795.
Westerweel PE. Vascular progenitor cells in renal and cardiovascular disease. s.l.: s.n., 2008.
Ref ID: 9217
Widdershoven JC, Beemer FA, Kon M, Dejonckere PH, Mink van der Molen AB. Possible mechanisms and gene involvement in speech problems in the 22q11.2 deletion syndrome. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2008; 61(9):1016-1023.
Abstract: SUMMARY: The 22q11.2 deletion syndrome represents a contiguous gene syndrome with a highly variable phenotype. To date, over 180 clinical features have been described. Studies have been done in order to identify the responsible genes. Several candidate genes such as TBX1 and COMT seem to be important in the development of the phenotype. One of the prevalent and serious problems encountered by patients with the 22q11.2 deletion is difficulty with speech. This may be due to a number of factors such as adenoid hypoplasia, muscle hypotonia, platybasia, upper airway asymmetry, and neuroanatomical abnormalities. The complex interaction of these factors leads to less favourable results after surgery to correct velopharyngeal insufficiency. This article offers a theoretical overview and proposes future research to investigate which factors are indeed responsible for the speech problems encountered by patients with the 22q11.2 deletion and identify responsible genes
Wijffels MCEF, van Oosterhout MF, Vos MA, Beekman JD, Boersma LVA. Characterization of lesions in swine atrium using novel multi-electrode ablation catheters. European Heart Journal 2008; 29(Suppl 1):412.
Wille J, van der Waal RIF. Furunkels na vakantie in Costa Rica. Nederlands Tijdschrift voor Dermatologie en Venereologie 2008; 18(2):69.
Wille J, van der Waal RIF. Diagnose in beeld (381). Een man met pijnlijke, rode vlekken op de voet. Nederlands Tijdschrift voor Geneeskunde 2008; 152(29):1626-1627.
Wolzak H, van der Wagen L, van Kuilenburg ABP, Ruven HJT, Los M. Extreme toxicity after first course of oxaliplatin and capecitabine; implication for DPD analysis? 20e Internistendagen Abstractboek (Abstracts submitted to the Annual Meeting of the Netherlands Association of Internal Medicine, 23-25 April 2008, Maastricht, the Netherlands) 2008;84.
Yang KG, Raijmakers NJ, van Arkel ER, Caron JJ, Rijk PC, Willems WJ, Zijl JA, Verbout AJ, Dhert WJ, Saris DB. Autologous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial. Osteoarthritis Cartilage 2008; 16(4):498-505.
Abstract: INTRODUCTION: Incubation of blood with CrSO(4)-coated glass beads stimulates the synthesis of anti-inflammatory cytokines, such as interleukin-1 receptor antagonist (IL-1ra), IL-4, IL-10, and IL-13. As IL-1beta is thought to play a key role in the development of osteoarthritis (OA), this product, also known as Orthokin, might be a viable treatment for symptomatic knee OA. The aim of the current study was to evaluate the efficacy of Orthokin for treatment of symptomatic knee OA in a randomized, multicentre, double-blind, placebo-controlled trial. PATIENTS AND METHODS: One hundred and sixty-seven patients received six intra-articular injections either with Orthokin or physiological saline. The primary efficacy objective consisted of 30% superiority on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 3, 6, 9, and 12 months post-treatment. Additionally, the patients completed the visual analogue scale for pain, the Knee injury and Osteoarthritis Outcome Score (KOOS) and Knee Society Clinical Rating System. RESULTS: Orthokin and placebo treatment resulted in similar improvements on the WOMAC (16.8% vs 16.5%, respectively; n.s.). Orthokin resulted in significantly more improvement for KOOS symptom (P = 0.002) and KOOS sport (P = 0.042) parameters as compared to placebo treatment. For most other outcome parameters, Orthokin-treated patients consistently showed higher improvement compared to placebo-treated patients, although none of these differences were statistically significant. Two serious adverse events were observed in the Orthokin group: one patient with repeated severe inflammatory reactions of the knee joint within hours after the injection and one patient with septic arthritis which was attributed to the injection procedure rather than the product. CONCLUSION: The statistically significant improvement of KOOS symptom and sport parameters together with the consistently higher, though non-statistically significant, improvement of most other parameters demonstrates that Orthokin clearly induces a biological response different from placebo treatment and warrant future investigations into the possible chondroprotective effect of Orthokin. However, in the current study the primary efficacy objective was not met and, therefore, the use of Orthokin currently cannot yet be recommended for the treatment of OA
Yilmaz A, van Putte BP, van Boven WJ. Completely thoracoscopic bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation. Journal of Thoracic & Cardiovascular Surgery 2008; 136(2):521-522.
Zhang J, Regieli JJ, Schipper M, Entius MM, Liang F, Koerselman J, Ruven HJ, van der Graaf Y, Grobbee DE, Doevendans PA. Inflammatory gene haplotype-interaction networks involved in coronary collateral formation. Human Heredity 2008; 66(4):252-264.
Abstract: OBJECTIVES: Formation of collateral circulation is an endogenous response to atherosclerosis, and is a natural escape mechanism by re-routing blood. Inflammatory response- related genes underlie the formation of coronary collaterals. We explored the genetic basis of collateral formation in man postulating interaction networks between functional Single Nucleotide Polymorphisms (SNPs) in these inflammatory gene candidates. METHODS: The contribution of 41 genes as well as the interactions among them was examined in a cohort of 226 coronary artery disease patients, genotyped for 54 candidate SNPs. Patients were classified to the extent of collateral circulation. Stepwise logistic regression analysis and a haplotype entropy procedure were applied to search for haplotype interactions among all 54 polymorphisms. Multiple testing was addressed by using the false discovery rate (FDR) method. RESULTS: The population comprised 84 patients with and 142 without visible collaterals. Among the 41 genes, 16 pairs of SNPs were implicated in the development of collaterals with the FDR of 0.19. Nine SNPs were found to potentially have main effects on collateral formation. Two sets of coupling haplotypes that predispose to collateral formation were suggested. CONCLUSIONS: These findings suggest that collateral formation may arise from the interactions between several SNPs in inflammatory response related genes, which may represent targets in future studies of collateral formation. This may enhance developing strategies for risk stratification and therapeutic stimulation of arteriogenesis. Copyright (c) 2008 S. Karger AG, Basel
Zijderveld SA, van den Bergh JP, Schulten EA, ten Bruggenkate CM. Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures. Journal of Oral & Maxillofacial Surgery 2008; 66(7):1426-1438.
Abstract: PURPOSE: To investigate the prevalence of anatomical and surgical findings and complications in maxillary sinus floor elevation surgery, and to describe the clinical implications. PATIENTS AND METHODS: One hundred consecutive patients scheduled for maxillary sinus floor elevation were included. The patients consisted of 36 men (36%) and 64 women (64%), with a mean age of 50 years (range, 17 to 73 years). In 18 patients, a bilateral procedure was performed. Patients were treated with a top hinge door in the lateral maxillary sinus wall, as described by Tatum (Dent Clin North Am 30:207, 1986). In bilateral cases, only the first site treated was evaluated. RESULTS: In most cases, an anatomical or surgical finding forced a deviation from Tatum's standard procedure. A thin or thick lateral maxillary sinus wall was found in 78% and 4% of patients, respectively. In 6%, a strong convexity of the lateral sinus wall called for an alternative method of releasing the trapdoor. The same method was used in 4% of cases involving a narrow sinus. The sinus floor elevation procedure was hindered by septa in 48%. In regard to complications, the most common complication, a perforation of the Schneiderian membrane, occurred in 11% of patients. In 2%, visualization of the trapdoor preparation was compromised because of hemorrhages. The initial incision design, ie, slightly palatal, was responsible for a local dehiscence in 3%. CONCLUSION: To avoid unnecessary surgical complications, detailed knowledge and timely identification of the anatomic structures inherent to the maxillary sinus are required
Zijlstra H, Larsen JK, de Ridder DT, van Ramshorst B, Geenen R. Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome. Obesity Surgery 2008; [Epub ahead of print].
Zonnevylle EDH, van der Waal RIF. Diagnose in beeld (368). Een kind met een zwelling in het gelaat na een hondenbeet. Nederlands Tijdschrift voor Geneeskunde 2008; 152(15):874-875.
Zwart B, van Werkum JW, Heestermans AA, Kelder JC, Zomer AC, van 't Hof AW, Verheugt FW, ten Berg JM. Abstract 4480: Triggering Mechanisms of Coronary Stent Thrombosis: Data from the Dutch Stent Thrombosis Registry. Circulation 2008; 118(Suppl):S896.