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Bastings L, Westphal JR, Beerendonk CCM, Bekkers RLM, Zusterzeel PLM, Hendriks JCM, Braat DDM, Peek R. Clinically applied procedures for human ovarian tissue cryopreservation result in different levels of efficacy and efficiency. J Assist Reprod Genet 2016; 33:1605-1614. [PMID: 27714478 PMCID: PMC5171896 DOI: 10.1007/s10815-016-0816-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/15/2016] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Different protocols are being used worldwide for the cryopreservation of human ovarian tissue for fertility preservation purposes. The efficiency and efficacy of the majority of these protocols has not been extensively evaluated, possibly resulting in sub-optimally cryopreserved ovarian tissue. To address the impact of this issue, we assessed the effects of two clinically successful human ovarian tissue slow-freezing cryopreservation procedures on the quality of the cryopreserved tissue. METHODS To differentiate between cryopreservation (C) versus thawing (T) related effects, four combinations of these two (A and B) very different cryopreservation/thawing protocols (ACAT, ACBT, BCAT, BCBT) were studied. Before and after cryopreservation and thawing, the percentage of living and morphologically normal follicles, as well as the overall tissue viability, was assessed. RESULTS Our experiments revealed that the choice of the cryopreservation protocol noticeably affected the overall tissue viability and percentage of living follicles, with a higher viability after protocol BC when compared to AC. No statistically significant differences in tissue viability were observed between the two thawing protocols, but thawing protocol BT required considerably more human effort and materials than thawing protocol AT. Tissue morphology was best retained using the BCAT combination. CONCLUSION Our results indicate that extensive and systematical evaluation of clinically used protocols is warranted.
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Affiliation(s)
- Lobke Bastings
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Johan R Westphal
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Catharina C M Beerendonk
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Ruud L M Bekkers
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Petra L M Zusterzeel
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jan C M Hendriks
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Didi D M Braat
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Ronald Peek
- Department of Obstetrics and Gynecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Richters RJH, Uzunbajakava NE, Hendriks JCM, Bikker JW, van Erp PEJ, van de Kerkhof PCM. A model for perception-based identification of sensitive skin. J Eur Acad Dermatol Venereol 2016; 31:267-273. [PMID: 27653746 DOI: 10.1111/jdv.13829] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 05/19/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND With high prevalence of sensitive skin (SS), lack of strong evidence on pathomechanisms, consensus on associated symptoms, proof of existence of 'general' SS and tools to recruit subjects, this topic attracts increasing attention of research. OBJECTIVE To create a model for selecting subjects in studies on SS by identifying a complete set of self-reported SS characteristics and factors discriminatively describing it. METHODS A survey (n = 3058) was conducted, comprising questions regarding socio-demographics, atopy, skin characteristics, personal care, degree of self-assessed SS and subjective and objective reactions to endogenous and exogenous factors. Exploratory factor analysis on 481 questionnaires was performed to identify underlying dimensions and multivariate logistic regression to find contributing variables to the likelihood of reporting SS. RESULTS The prevalence of SS was found to be 41%, and 56% of SS subjects reports a concomitant atopic condition. The most discriminative were the eliciting factors toiletries and emotions, and not specific skin symptoms in general. CONCLUSION Triggers of different origins seem to elicit SS, it is not defined by concomitant skin diseases only, suggesting existence of 'general' SS. A multifactorial questionnaire could be a better diagnostic than a one-dimensional provocative test.
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Affiliation(s)
- R J H Richters
- Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - N E Uzunbajakava
- Philips Research Eindhoven, Philips Electronics Nederland B.V., Eindhoven, The Netherlands
| | - J C M Hendriks
- Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - P E J van Erp
- Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
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3
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Koene S, Hendriks JCM, Dirks I, de Boer L, de Vries MC, Janssen MCH, Smuts I, Fung CW, Wong VCN, de Coo IRFM, Vill K, Stendel C, Klopstock T, Falk MJ, McCormick EM, McFarland R, de Groot IJM, Smeitink JAM. International Paediatric Mitochondrial Disease Scale. J Inherit Metab Dis 2016; 39:705-712. [PMID: 27277220 PMCID: PMC4987390 DOI: 10.1007/s10545-016-9948-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/18/2016] [Accepted: 05/09/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE There is an urgent need for reliable and universally applicable outcome measures for children with mitochondrial diseases. In this study, we aimed to adapt the currently available Newcastle Paediatric Mitochondrial Disease Scale (NPMDS) to the International Paediatric Mitochondrial Disease Scale (IPMDS) during a Delphi-based process with input from international collaborators, patients and caretakers, as well as a pilot reliability study in eight patients. Subsequently, we aimed to test the feasibility, construct validity and reliability of the IPMDS in a multicentre study. METHODS A clinically, biochemically and genetically heterogeneous group of 17 patients (age 1.6-16 years) from five different expert centres from four different continents were evaluated in this study. RESULTS The feasibility of the IPMDS was good, as indicated by a low number of missing items (4 %) and the positive evaluation of patients, parents and users. Principal component analysis of our small sample identified three factors, which explained 57.9 % of the variance. Good construct validity was found using hypothesis testing. The overall interrater reliability was good [median intraclass correlation coefficient for agreement between raters (ICCagreement) 0.85; range 0.23-0.99). CONCLUSION In conclusion, we suggest using the IPMDS for assessing natural history in children with mitochondrial diseases. These data should be used to further explore construct validity of the IPMDS and to set age limits. In parallel, responsiveness and the minimal clinically important difference should be studied to facilitate sample size calculations in future clinical trials.
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Affiliation(s)
- Saskia Koene
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands.
| | - Jan C M Hendriks
- Department of Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Ilse Dirks
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands
| | - Lonneke de Boer
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands
| | - Maaike C de Vries
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands
| | - Mirian C H Janssen
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands
| | - Izelle Smuts
- Steve Biko Academic Hospital, Ludwig-Maximilians-of Pretoria, Pretoria, South Africa
| | - Cheuk-Wing Fung
- Department of Paediatrics & Adolescent Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Virginia C N Wong
- Department of Paediatrics & Adolescent Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | | | - Katharina Vill
- Department of Pediatric Neurology and Developmental Medicine, Dr. v. Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Claudia Stendel
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Marni J Falk
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Elizabeth M McCormick
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Robert McFarland
- Wellcome Trust Centre for Mitochondrial Research Newcastle, Newcastle upon Tyne, UK
| | - Imelda J M de Groot
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands
- Department of Rehabilitation, Radboudumc, Nijmegen, The Netherlands
| | - Jan A M Smeitink
- Radboudn Center for Mitochondrial Medicine at the Department of Paediatrics, Radboudumc, Geert Grooteplein 10. 6500 HB, PO BOX 9101, Nijmegen, The Netherlands
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Emmer PM, Joosten I, Schut MH, Zusterzeel PLM, Hendriks JCM, Steegers EAP. Shift in Expression of HLA-G mRNA Spliceforms in Pregnancies Complicated by Preeclampsia. ACTA ACUST UNITED AC 2016; 11:220-6. [PMID: 15120695 DOI: 10.1016/j.jsgi.2003.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Despite emerging data on the in vitro modulatory effects of trophoblast-associated human leukocyte antigen G (HLA-G), its in vivo function needs to be determined. Immunohistochemical studies show a decrease in protein expression of trophoblast HLA-G in preeclampsia. Such a decrease in protein might be the consequence of a shift in HLA-G mRNA spliceform patterns. In an exploratory pilot study we determined trophoblast HLA-G mRNA spliceform distribution in preeclampsia. METHODS Placental samples were collected immediately after cesarean delivery from pregnancies complicated by preeclampsia or the syndrome hemolysis, elevated liver enzymes, and low platelet count (HELLP) and uncomplicated normotensive pregnancies as controls. HLA-G mRNA spliceform distribution was analyzed using a semiquantitative reverse transcriptase polymerase chain reaction procedure. RESULTS Analysis of HLA-G spliceform distribution showed a significant increase in frequency of the G5 form encoding for a soluble HLA-G molecule in preeclampsia. This increase in G5 form was not found in pregnancies complicated by HELLP. CONCLUSION The increased frequency in the expression of the HLA-G G5 spliceform may play a role in the pathophysiology of preeclampsia, in particular through a recently suggested effect of this soluble HLA-G molecule on remodeling of the spiral arteries.
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Affiliation(s)
- Peter M Emmer
- Departments of Department of Blood Transfusion and Transplantation Immunology, University Medical Center Nijmegen, The Netherlands
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van der Vorm LN, Hendriks JCM, Laarakkers CM, Klaver S, Armitage AE, Bamberg A, Geurts-Moespot AJ, Girelli D, Herkert M, Itkonen O, Konrad RJ, Tomosugi N, Westerman M, Bansal SS, Campostrini N, Drakesmith H, Fillet M, Olbina G, Pasricha SR, Pitts KR, Sloan JH, Tagliaro F, Weykamp CW, Swinkels DW. Toward Worldwide Hepcidin Assay Harmonization: Identification of a Commutable Secondary Reference Material. Clin Chem 2016; 62:993-1001. [DOI: 10.1373/clinchem.2016.256768] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/07/2016] [Indexed: 11/06/2022]
Abstract
Abstract
BACKGROUND
Absolute plasma hepcidin concentrations measured by various procedures differ substantially, complicating interpretation of results and rendering reference intervals method dependent. We investigated the degree of equivalence achievable by harmonization and the identification of a commutable secondary reference material to accomplish this goal.
METHODS
We applied technical procedures to achieve harmonization developed by the Consortium for Harmonization of Clinical Laboratory Results. Eleven plasma hepcidin measurement procedures (5 mass spectrometry based and 6 immunochemical based) quantified native individual plasma samples (n = 32) and native plasma pools (n = 8) to assess analytical performance and current and achievable equivalence. In addition, 8 types of candidate reference materials (3 concentrations each, n = 24) were assessed for their suitability, most notably in terms of commutability, to serve as secondary reference material.
RESULTS
Absolute hepcidin values and reproducibility (intrameasurement procedure CVs 2.9%–8.7%) differed substantially between measurement procedures, but all were linear and correlated well. The current equivalence (intermeasurement procedure CV 28.6%) between the methods was mainly attributable to differences in calibration and could thus be improved by harmonization with a common calibrator. Linear regression analysis and standardized residuals showed that a candidate reference material consisting of native lyophilized plasma with cryolyoprotectant was commutable for all measurement procedures. Mathematically simulated harmonization with this calibrator resulted in a maximum achievable equivalence of 7.7%.
CONCLUSIONS
The secondary reference material identified in this study has the potential to substantially improve equivalence between hepcidin measurement procedures and contributes to the establishment of a traceability chain that will ultimately allow standardization of hepcidin measurement results.
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Affiliation(s)
| | - Jan C M Hendriks
- Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Coby M Laarakkers
- Department of Laboratory Medicine and
- Hepcidinanalysis.com, Nijmegen, the Netherlands
| | | | - Andrew E Armitage
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK, and Blood Theme, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | | | | | | | | | - Outi Itkonen
- Helsinki University Central Hospital, Laboratory Division HUSLAB, Helsinki, Finland
| | | | - Naohisa Tomosugi
- Division of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | | | | | | | - Hal Drakesmith
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK, and Blood Theme, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Marianne Fillet
- Department of Analytical Pharmaceutical Chemistry, Institute of Pharmacy, University of Liège, Liège, Belgium
| | | | - Sant-Rayn Pasricha
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK, and Blood Theme, NIHR Oxford Biomedical Research Centre, Oxford, UK
| | | | | | - Franco Tagliaro
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Cas W Weykamp
- Department of Clinical Chemistry, Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - Dorine W Swinkels
- Department of Laboratory Medicine and
- Hepcidinanalysis.com, Nijmegen, the Netherlands
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6
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Peppelman M, Nguyen KP, Alkemade HAC, Maessen-Visch B, Hendriks JCM, van Erp PEJ, Adang EMM, Gerritsen MJP. Diagnosis of Basal Cell Carcinoma by Reflectance Confocal Microscopy: Study Design and Protocol of a Randomized Controlled Multicenter Trial. JMIR Res Protoc 2016; 5:e114. [PMID: 27363577 PMCID: PMC4945846 DOI: 10.2196/resprot.5757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 01/24/2023] Open
Abstract
Background Skin cancer, including basal cell carcinoma (BCC), has become a major health care problem. The limitations of a punch biopsy (at present the gold standard) as diagnostic method together with the increasing incidence of skin cancer point out the need for more accurate, cost-effective, and patient friendly diagnostic tools. In vivo reflectance confocal microscopy (RCM) is a noninvasive imaging technique that has great potential for skin cancer diagnosis. Objective To investigate whether in vivo RCM can correctly identify the subtype of BCC and to determine the cost-effectiveness of RCM compared with punch biopsy (usual care). Study design: Randomized controlled multicenter trial. Methods On the basis of 80% power and an alpha of 0.05, 329 patients with lesions clinically suspicious for BCC will be included in this study. Patients will be randomized for RCM or for a punch biopsy (usual care). When a BCC is diagnosed, surgical excision will follow and a follow-up visit will be planned 3 months later. Several questionnaires will be filled in (EQ-5D, EQ-5D VAS, iMTA PCQ, and TSQM-9). We will perform statistical analysis, cost-effectiveness, and patient outcome analysis after data collection. Results This research started in January 2016 and is ethically approved. We expect to finish this study at the end of 2018. Conclusions In this study, we will investigate whether RCM is at least as good in identifying BCC subtypes as conventional pathological investigation of skin biopsies. Anticipating that RCM is found to be a cost-effective alternative, it saves on direct medical consumption like labor of the pathologist and other medical personnel as well as materials related to treatment failure with at least equal effectiveness. Trial Registration Clinicaltrials.gov NCT02623101; https://clinicaltrials.gov/ct2/show/NCT02623101 (Archived by WebCite at http://www.webcitation.org/6id54WQa2)
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Affiliation(s)
- Malou Peppelman
- Radboud University Medical Center, Department of Dermatology, Nijmegen, Netherlands.
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7
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Hoek PD, Schers HJ, Hendriks JCM, Vissers KCP, Hasselaar JGJ. Palliative care consultations in primary care: a cross-sectional survey among Dutch general practitioners. BMJ Support Palliat Care 2016; 9:e30. [PMID: 27316637 DOI: 10.1136/bmjspcare-2015-000967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 04/25/2016] [Accepted: 05/31/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Expert consultation supports general practitioners (GPs) in delivering adequate palliative homecare. Insight into consultation practices from a GP's perspective is needed in order to shape consultation services to their wishes and needs. AIM To explore palliative care consultation practices from a GP's perspective. DESIGN AND SETTING Cross-sectional web-based survey among all GPs (n=235) in the region of Nijmegen, the Netherlands. METHODS Our questionnaire contained questions about the delivery of palliative care by GPs, their consultation practices and satisfaction with current services. Questions consisted mainly of 5-point Likert scales. We transformed these scales into numerical values to calculate mean scores. Linear mixed models for repeated measurements were used to study differences in scores. RESULTS GPs most often consulted informal caregivers (mean score 3.6) or fellow GPs (mean score 3.3). Physical problems were discussed the most (mean score 3.5), while social and existential issues were discussed least (mean score 1.9 for both). In their choice of a particular consultation service, GPs considered the quality of the provided advice to be the most important factor. GPs were satisfied with current consultation services, with fellow GPs receiving the highest satisfaction scores (mean score 4.6). Finally, when recalling their last palliative patient, most GPs started requesting consultation during this patient's last month of life. CONCLUSIONS Next to informal caregivers, GPs preferably seek advice from fellow GPs. Physical issues receive much attention during consultations; however, other vital aspects of palliative care seem to remain relatively neglected, such as social and existential issues and a proactive care approach.
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Affiliation(s)
- Patrick D Hoek
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henk J Schers
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan C M Hendriks
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kris C P Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen G J Hasselaar
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Janssen MMHP, Hendriks JCM, Geurts ACH, de Groot IJM. Variables associated with upper extremity function in patients with Duchenne muscular dystrophy. J Neurol 2016; 263:1810-8. [PMID: 27314968 PMCID: PMC5010825 DOI: 10.1007/s00415-016-8193-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/18/2016] [Accepted: 06/02/2016] [Indexed: 02/06/2023]
Abstract
Preserving upper extremity (UE) function in patients with Duchenne muscular dystrophy (DMD) is extremely important as it is related to independence and quality of life. For clinical decision making, knowledge of variables associated with UE function is necessary. This knowledge is, however, limited. Therefore, this study aims to gain more insight into the variables associated with UE function in DMD. Data from an international web-based questionnaire on UE function, obtained from 213 DMD patients, were used. Six dependent variables regarding UE function were used in multivariable linear regression analyses. In addition, 26 independent variables regarding patient characteristics, medication, therapy, supportive aids, pain, stiffness and participation were used. Twelve independent variables showed a significant relation to UE function. Variables with a negative relation to UE function were: later disease stage, occurrence of scoliosis, higher age, use of UE splints, more frequent stiffness complaints, more limitations due to stiffness, more frequent elbow pain, and having physical therapy. A positive relation with UE function was seen for going to school or work, use of corticosteroids, higher BMI, and higher age at diagnosis. These variables explained 56–81 % of the variation of the different measures of UE function. Knowledge of variables associated with UE function is very important in the clinical management of DMD patients. The results of this study suggest that corticosteroid use and participation in school and work related activities are positively related to UE function in DMD patients, as well as reducing pain and stiffness and preventing scoliosis.
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Affiliation(s)
- Mariska M H P Janssen
- Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands.
| | - Jan C M Hendriks
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alexander C H Geurts
- Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands
| | - Imelda J M de Groot
- Donders Centre for Neuroscience, Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands
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9
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Richters RJH, Uzunbajakava NE, Falcone D, Hendriks JCM, Jaspers EJ, van de Kerkhof PCM, van Erp PEJ. Clinical, biophysical and immunohistochemical analysis of skin reactions to acute skin barrier disruption - a comparative trial between participants with sensitive skin and those with nonsensitive skin. Br J Dermatol 2016; 174:1126-33. [PMID: 26595057 DOI: 10.1111/bjd.14307] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- R J H Richters
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, the Netherlands
| | - N E Uzunbajakava
- Philips Research, Philips Electronics Nederland B.V., Eindhoven, the Netherlands
| | - D Falcone
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, the Netherlands
| | - J C M Hendriks
- Radboud Institute for Health Sciences (RIHS), Nijmegen, the Netherlands
| | - E J Jaspers
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, the Netherlands
| | | | - P E J van Erp
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, the Netherlands
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Richters RJH, Hendriks JCM, Uzunbajakava NE, Janssen LD, Falcone D, van Erp PEJ, van de Kerkhof PCM. Responses to sodium dodecyl sulphate as an in vivo human model to study the pathomechanisms underlying sensitive skin. Exp Dermatol 2016; 25:407-9. [PMID: 26896835 DOI: 10.1111/exd.12973] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Renée J H Richters
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands
| | - Jan C M Hendriks
- Radboud Institute for Health Sciences (RIHS), Nijmegen, The Netherlands
| | | | - Lisanne D Janssen
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands
| | - Denise Falcone
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands
| | - Piet E J van Erp
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands
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11
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de Swart L, Hendriks JCM, van der Vorm LN, Cabantchik ZI, Evans PJ, Hod EA, Brittenham GM, Furman Y, Wojczyk B, Janssen MCH, Porter JB, Mattijssen VEJM, Biemond BJ, MacKenzie MA, Origa R, Galanello R, Hider RC, Swinkels DW. Second international round robin for the quantification of serum non-transferrin-bound iron and labile plasma iron in patients with iron-overload disorders. Haematologica 2015; 101:38-45. [PMID: 26385212 DOI: 10.3324/haematol.2015.133983] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 09/18/2015] [Indexed: 01/19/2023] Open
Abstract
Non-transferrin-bound iron and its labile (redox active) plasma iron component are thought to be potentially toxic forms of iron originally identified in the serum of patients with iron overload. We compared ten worldwide leading assays (6 for non-transferrin-bound iron and 4 for labile plasma iron) as part of an international inter-laboratory study. Serum samples from 60 patients with four different iron-overload disorders in various treatment phases were coded and sent in duplicate for analysis to five different laboratories worldwide. Some laboratories provided multiple assays. Overall, highest assay levels were observed for patients with untreated hereditary hemochromatosis and β-thalassemia intermedia, patients with transfusion-dependent myelodysplastic syndromes and patients with transfusion-dependent and chelated β-thalassemia major. Absolute levels differed considerably between assays and were lower for labile plasma iron than for non-transferrin-bound iron. Four assays also reported negative values. Assays were reproducible with high between-sample and low within-sample variation. Assays correlated and correlations were highest within the group of non-transferrin-bound iron assays and within that of labile plasma iron assays. Increased transferrin saturation, but not ferritin, was a good indicator of the presence of forms of circulating non-transferrin-bound iron. The possibility of using non-transferrin-bound iron and labile plasma iron measures as clinical indicators of overt iron overload and/or of treatment efficacy would largely depend on the rigorous validation and standardization of assays.
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Affiliation(s)
- Louise de Swart
- Departments of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan C M Hendriks
- Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lisa N van der Vorm
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Z Ioav Cabantchik
- Department of Biochemical Chemistry, Hebrew University of Jerusalem, Israel
| | | | - Eldad A Hod
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Gary M Brittenham
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | | | - Boguslaw Wojczyk
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Mirian C H Janssen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - John B Porter
- Department of Haematology, University College London, UK
| | | | - Bart J Biemond
- Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands
| | - Marius A MacKenzie
- Departments of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raffaella Origa
- Department of Biomedical Science and Biotechnology, Regional Microcythemia Hospital, University of Cagliari, Italy
| | - Renzo Galanello
- Department of Biomedical Science and Biotechnology, Regional Microcythemia Hospital, University of Cagliari, Italy
| | - Robert C Hider
- Institute of Pharmaceutical Science, King's College London, UK
| | - Dorine W Swinkels
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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van den Berg MGA, Kalf JG, Hendriks JCM, Takes RP, van Herpen CML, Wanten GJA, Drenth JPH, Kaanders JHAM, Merkx MAW. Normalcy of food intake in patients with head and neck cancer supported by combined dietary counseling and swallowing therapy: A randomized clinical trial. Head Neck 2015; 38 Suppl 1:E198-206. [PMID: 25533021 DOI: 10.1002/hed.23970] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2014] [Indexed: 11/12/2022] Open
Affiliation(s)
- Manon G. A. van den Berg
- Department of Gastroenterology and Hepatology - Dietetics and Intestinal Failure; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Johanna G. Kalf
- Nijmegen Centre of Evidence-Based Practice Department of Rehabilitation/Speech and Language Pathology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Jan C. M. Hendriks
- Department for Health Evidence; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Robert P. Takes
- Department of Otolaryngology and Head and Neck Surgery; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Carla M. L. van Herpen
- Department of Medical Oncology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Geert J. A. Wanten
- Department of Gastroenterology and Hepatology - Dietetics and Intestinal Failure; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Joost P. H. Drenth
- Department of Gastroenterology and Hepatology; Radboud University Medical Centre; Nijmegen The Netherlands
| | | | - Matthias A. W. Merkx
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Centre; Nijmegen The Netherlands
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13
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Veenhuizen Y, Cup EHC, Groothuis JT, Hendriks JCM, Adang EMM, van Engelen BGM, Geurts ACH. Effectiveness and cost-effectiveness of a self-management group program to improve social participation in patients with neuromuscular disease and chronic fatigue: protocol of the Energetic study. BMC Neurol 2015; 15:58. [PMID: 25913823 PMCID: PMC4411708 DOI: 10.1186/s12883-015-0314-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/08/2015] [Indexed: 11/10/2022] Open
Abstract
Background Chronic fatigue is present in more than 60% of the patients with a neuromuscular disease and can be their most disabling symptom. In combination with other impairments, fatigue often results in low levels of physical activity and decreased social participation, leading to high societal costs. ‘Energetic’ is a self-management group program aimed at improving social participation, physical endurance and alleviating fatigue in these patients. The primary aim of this study is to evaluate the effectiveness and cost-effectiveness of the Energetic program. Methods/Design A multicentered, assessor-blinded, two-armed randomized controlled trial is conducted with evaluations at inclusion and four, seven and fifteen months later. The study includes patients with a neuromuscular disease and chronic fatigue and, when present, their caregivers. The participants are randomized (ratio 1:1) to either an intervention group, receiving the Energetic program, or a control group, receiving usual care (i.e., no specific intervention). The Energetic program covers four months and includes four modules: 1) individually tailored aerobic exercise training; 2) education about aerobic exercise; 3) self-management training in applying energy conservation strategies; and 4) implementation and relapse prevention in daily life. Two months after cessation of the program a booster session is provided. The primary outcome is the perceived performance score of the Canadian Occupational Performance Measure (COPM). Secondary outcomes include the COPM-satisfaction score, and measures of fatigue, physical endurance, activity engagement, mood, and self-efficacy. Caregiver burden is also evaluated as a secondary outcome. Health-related quality of life and medical and societal costs are assessed to estimate cost-effectiveness of the program. Discussion The Energetic study is the first randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical and self-management group training program for improving social participation, physical endurance and alleviating fatigue in patients with neuromuscular diseases. It will generate new insights in (cost-)effective rehabilitation strategies for these incurable conditions. Trial registration Clinicaltrials.gov NCT02208687.
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Affiliation(s)
- Yvonne Veenhuizen
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Edith H C Cup
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Jan T Groothuis
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Jan C M Hendriks
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Eddy M M Adang
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Baziel G M van Engelen
- Department of Neurology, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Alexander C H Geurts
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
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Woitha K, Hasselaar J, van Beek K, Ahmed N, Jaspers B, Hendriks JCM, Radbruch L, Vissers K, Engels Y. Testing feasibility and reliability of a set of quality indicators to evaluate the organization of palliative care across Europe: a pilot study in 25 countries. Palliat Med 2015; 29:157-63. [PMID: 25634899 DOI: 10.1177/0269216314562100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A well-organized palliative care service is a prerequisite for offering good palliative care. Reliable and feasible quality indicators are needed to monitor the quality of their organization. AIM To test feasibility and reliability of a previously developed set of quality indicators in settings and services that provide palliative care across Europe. METHODS A total of 38 quality indicators, applicable in all types of settings, rated in a RAND Delphi process, and operationalized into 38 yes/no questions, were used. Descriptives statistics, factor and reliability analyses, analysis of variance, and chi-square analyses were used. DESIGN Cross-sectional online survey. SETTING/PARTICIPANTS Questionnaires were sent to representatives of 217 palliative care settings in 25 countries. Included settings were hospices, inpatient dedicated palliative care beds, palliative care outpatient clinics, palliative care units, day care centers for palliative care, palliative care home support teams, inpatient palliative care support teams, care homes, and nursing homes. RESULTS All invited 25 European Association of Palliative Care countries took part. In total, 107 out of 217 participants responded (57%). The quality indicators were reduced to four coherent sub-scales, being "equipment and continuity of care," "structured documentation of essential palliative care elements in the medical record," "training and appraisal of personnel," and "availability of controlled drugs." No significant differences in quality criteria between the different types of settings and services were identified. CONCLUSION The set of quality indicators appeared to measure four reliable domains that assess the organization of different palliative care settings. It can be used as a starting point for quality improvement activities.
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Affiliation(s)
- Kathrin Woitha
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Karen van Beek
- Department of Radiotherapy-Oncology and Palliative Medicine, University Hospital Leuven, Leuven, Belgium
| | - Nisar Ahmed
- Academic Unit of Supportive Care, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK
| | - Birgit Jaspers
- Palliative Care Centre, Department of Palliative Medicine, Malteser Hospital Bonn/Rhein-Sieg, University of Bonn, Bonn, Germany Department of Palliative Medicine, Georg-August-University of Göttingen, Göttingen, Germany
| | - Jan C M Hendriks
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lukas Radbruch
- Palliative Care Centre, Department of Palliative Medicine, Malteser Hospital Bonn/Rhein-Sieg, University of Bonn, Bonn, Germany
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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van Hartingsveldt MJ, Cup EHC, Hendriks JCM, de Vries L, de Groot IJM, Nijhuis-van der Sanden MWG. Predictive validity of kindergarten assessments on handwriting readiness. Res Dev Disabil 2015; 36C:114-124. [PMID: 25462472 DOI: 10.1016/j.ridd.2014.08.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 08/06/2014] [Accepted: 08/12/2014] [Indexed: 06/04/2023]
Abstract
We investigated the predictive value of a new kindergarten assessment of handwriting readiness on handwriting performance in first grade as evaluated by the Systematic Screening for Handwriting Difficulties (Dutch abbreviation: SOS). The kindergarten assessment consisted of the Writing Readiness Inventory Tool In Context (WRITIC), the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI) and the Nine-Hole Peg Test (9-HPT). The WRITIC evaluates in kindergarten children (aged 5-6 years) prewriting skills, the Beery™VMI and 9-HPT evaluate visual motor integration and fine-motor coordination, all elements important for handwriting readiness. In kindergarten, 109 children (55 boys; mean age 70 months, SD 4.8 months) were tested with the WRITIC, Beery™VMI and 9-HPT and one year later in first grade (mean age 85 months, SD 4.5 months) with the SOS. A multivariable linear mixed model was used to identify variables that independently predict outcomes in first grade (SOS): baseline scores on WRITIC-TP, Beery™VMI, 9-HPT, 'sustained attention,' 'gender,' 'age' and 'intervention' in the intermediate period. The results showed that WRITIC-TP, Beery™VMI, and 9-HPT, 'sustained attention,' 'gender' and 'intervention' had all predictive value on the handwriting outcome. Thereby WRITIC-TP was the main predictor for outcome of SOS-Quality, and Beery™VMI and 9-HPT were the main predictors of SOS-Speed. This kindergarten assessment of WRITIC-TP, Beery™VMI, and 9-HPT contributes to the detection of children at risk for developing handwriting problems.
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Affiliation(s)
- Margo J van Hartingsveldt
- Radboud University Medical Centre, Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Postbox 9101, 6500 HB Nijmegen, The Netherlands; Amsterdam University of Applied Sciences, Institute of Health, Occupational Therapy, Tafelbergweg 51, 1105 BD Amsterdam, The Netherlands.
| | - Edith H C Cup
- Radboud University Medical Centre, Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Postbox 9101, 6500 HB Nijmegen, The Netherlands
| | - Jan C M Hendriks
- Radboud University Medical Centre, Department for Health Evidence, Nijmegen Centre for Evidence Based Practice, Postbox 9101, 6500 HB Nijmegen, The Netherlands
| | - Liesbeth de Vries
- University Medical Centre Groningen, Centre for Rehabilitation Beatrixoord, Dilgtweg 5, 9751 ND Haren, The Netherlands
| | - Imelda J M de Groot
- Radboud University Medical Centre, Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Postbox 9101, 6500 HB Nijmegen, The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Radboud University Medical Centre, Department of Rehabilitation, Nijmegen Centre for Evidence Based Practice, Postbox 9101, 6500 HB Nijmegen, The Netherlands; Radboud University Medical Centre, Scientific Institute for Quality of Healthcare, Postbox 9101, 6500 HB Nijmegen, The Netherlands
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16
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van den Berg MGA, Kalf JG, Hendriks JCM, Takes RP, van Herpen CML, Wanten GJA, Drenth JPH, Kaanders JHAM, Merkx MAW. Normalcy of food intake in patients with head and neck cancer supported by combined dietary counseling and swallowing therapy: A randomized clinical trial. Head Neck 2014. [PMID: 25533021 DOI: 10.1002/hed.23970.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Dysphagia resulting in altered food intake is common among patients with head and neck cancer. This randomized trial investigated the effect of combined individual dietary counseling with individualized swallowing therapy (intervention) compared to individual dietary counseling (control) on normalcy of food intake (NFI). METHODS Patients with stage II to IV head and neck cancer treated with postoperative (chemo)radiation were randomly assigned to this study. NFI, dysphagia severity, social eating, and nutritional status were measured at the start of treatment and in weeks 6, 10, 18, and 30. RESULTS One hundred twenty patients, 60 in each group, were recruited. No overall estimated difference was detected for NFI, dysphagia severity, social eating, or nutritional status. At week 10, the intervention group slightly improved dysphagia recovery 0.6 (95% confidence interval [CI] = 0.1-1.1). This difference diminished by week 30. CONCLUSION Adding individualized swallowing therapy to individual dietary counseling did not improve NFI but slightly accelerate swallowing recovery. © 2015 Wiley Periodicals, Inc. Head Neck 38: E198-E206, 2016.
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Affiliation(s)
- Manon G A van den Berg
- Department of Gastroenterology and Hepatology - Dietetics and Intestinal Failure, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johanna G Kalf
- Nijmegen Centre of Evidence-Based Practice Department of Rehabilitation/Speech and Language Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jan C M Hendriks
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Geert J A Wanten
- Department of Gastroenterology and Hepatology - Dietetics and Intestinal Failure, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johannes H A M Kaanders
- Department of Radiation Oncology, Nijmegen Radboud University Medical Centre, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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17
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Arends TJH, Falke J, Lammers RJM, Somford DM, Hendriks JCM, de Weijert MCA, Arentsen HC, van der Heijden AG, Oosterwijk E, Alfred Witjes J. Urinary cytokines in patients treated with intravesical mitomycin-C with and without hyperthermia. World J Urol 2014; 33:1411-7. [DOI: 10.1007/s00345-014-1458-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 11/27/2014] [Indexed: 10/24/2022] Open
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van den Hoven L, Hendriks JCM, Verbeet JGM, Westphal JR, Wetzels AMM. Status of sperm morphology assessment: an evaluation of methodology and clinical value. Fertil Steril 2014; 103:53-8. [PMID: 25450299 DOI: 10.1016/j.fertnstert.2014.09.036] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/23/2014] [Accepted: 09/25/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To characterize methodological changes in sperm morphology assessment and to correlate sperm morphology with clinical outcome. DESIGN In this observational study, sperm morphology profiles of patients were analyzed. The percentages of morphologically normal spermatozoa were evaluated with respect to changes in morphology assessment criteria; male aging; and prognostic value for outcomes after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). SETTING Diagnostic and clinical laboratories. PATIENT(S) A total of 8,846 men who visited the diagnostic laboratory; 133 samples from a sperm bank; and 3,676 IVF/ICSI couples. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The percentage of morphologically normal spermatozoa in semen samples. The regression of the individual morphologically normal cell profiles. The relation between the percentage of normal forms with pregnancy outcome after IVF/ICSI. RESULT(S) The percentage of morphologically normal spermatozoa showed a decrease from roughly 30%-80% in 1984 to 0%-10% since 2004. With added evidence from sperm bank samples, this decrease was found to be attributable mainly to changes in morphology assessment criteria. Furthermore, an intraindividual aging effect of 0.51% per year was observed. A statistically significant relationship was found between decreases in percentage of normal forms and a lower probability of ongoing pregnancies after IVF, although the area under the curve was only 54%. CONCLUSION(S) Methodological changes had a strong effect on the percentage of morphologically normal spermatozoa over the past few decades. In addition, male aging results in decreasing sperm morphology. The percentage of morphologically normal spermatozoa has no prognostic value for individual IVF/ICSI patients.
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Affiliation(s)
- Leonie van den Hoven
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.
| | - Jan C M Hendriks
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Jozé G M Verbeet
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Johan R Westphal
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Alex M M Wetzels
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands
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Rijken NHM, van der Kooi EL, Hendriks JCM, van Asseldonk RJGP, Padberg GW, Geurts ACH, van Engelen BGM. Skeletal muscle imaging in facioscapulohumeral muscular dystrophy, pattern and asymmetry of individual muscle involvement. Neuromuscul Disord 2014; 24:1087-96. [PMID: 25176503 DOI: 10.1016/j.nmd.2014.05.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/24/2014] [Accepted: 05/30/2014] [Indexed: 01/05/2023]
Abstract
To better understand postural and movement disabilities, the pattern of total body muscle fat infiltration was analyzed in a large group of patients with facioscapulohumeral muscular dystrophy. Additionally, we studied whether residual D4Z4 repeat array length adjusted for age and gender could predict the degree of muscle involvement. Total body computed tomography scans of 70 patients were used to assess the degree of fat infiltration of 42 muscles from neck to ankle level on a semi-quantitative scale. Groups of muscles that highly correlated regarding fat infiltration were identified using factor analysis. Linear regression analysis was performed using muscle fat infiltration as the dependent variable and D4Z4 repeat length and age as independent variables. A pattern of muscle fat infiltration in facioscapulohumeral muscular dystrophy could be constructed. Trunk muscles were most frequently affected. Of these, back extensors were more frequently affected than previously reported. Asymmetry in muscle involvement was seen in 45% of the muscles that were infiltrated with fat. The right-sided upper extremity showed significantly higher scores for fat infiltration compared to the left side, which could not be explained by handedness. It was possible to explain 29% of the fat infiltration based on D4Z4 repeat length, corrected for age and gender. Based on our results we conclude that frequent involvement of fat infiltration in back extensors, in addition to the abdominal muscles, emphasizes the extent of trunk involvement, which may have a profound impact on postural control even in otherwise mildly affected patients.
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Affiliation(s)
- N H M Rijken
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E L van der Kooi
- Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - J C M Hendriks
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R J G P van Asseldonk
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G W Padberg
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A C H Geurts
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B G M van Engelen
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.
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20
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Sturkenboom IHWM, Graff MJL, Hendriks JCM, Veenhuizen Y, Munneke M, Bloem BR, Nijhuis-van der Sanden MW. Efficacy of occupational therapy for patients with Parkinson's disease: a randomised controlled trial. Lancet Neurol 2014; 13:557-66. [PMID: 24726066 DOI: 10.1016/s1474-4422(14)70055-9] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is insufficient evidence to support use of occupational therapy interventions for patients with Parkinson's disease. We aimed to assess the efficacy of occupational therapy in improving daily activities of patients with Parkinson's disease. METHODS We did a multicentre, assessor-masked, randomised controlled clinical trial in ten hospitals in nine Dutch regional networks of specialised health-care professionals (ParkinsonNet), with assessment at 3 months and 6 months. Patients with Parkinson's disease with self-reported difficulties in daily activities were included, along with their primary caregivers. Patients were randomly assigned (2:1) to the intervention or control group by a computer-generated minimisation algorithm. The intervention consisted of 10 weeks of home-based occupational therapy according to national practice guidelines; control individuals received usual care with no occupational therapy. The primary outcome was self-perceived performance in daily activities at 3 months, assessed with the Canadian Occupational Performance Measure (score 1-10). Data were analysed using linear mixed models for repeated measures (intention-to-treat principle). Assessors monitored safety by asking patients about any unusual health events during the preceding 3 months. This trial is registered with ClinicalTrials.gov, NCT01336127. FINDINGS Between April 14, 2011, and Nov 2, 2012, 191 patients were randomly assigned to the intervention group (n=124) or the control group (n=67). 117 (94%) of 124 patients in the intervention group and 63 (94%) of 67 in the control group had a participating caregiver. At baseline, the median score on the Canadian Occupational Performance Measure was 4·3 (IQR 3·5-5·0) in the intervention group and 4·4 (3·8-5·0) in the control group. At 3 months, these scores were 5·8 (5·0-6·4) and 4·6 (4·6-6·6), respectively. The adjusted mean difference in score between groups at 3 months was in favour of the intervention group (1·2; 95% CI 0·8-1·6; p<0·0001). There were no adverse events associated with the study. INTERPRETATION Home-based, individualised occupational therapy led to an improvement in self-perceived performance in daily activities in patients with Parkinson's disease. Further work should identify which factors related to the patient, environmental context, or therapist might predict which patients are most likely to benefit from occupational therapy. FUNDING Prinses Beatrix Spierfonds and Parkinson Vereniging.
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Affiliation(s)
| | - Maud J L Graff
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands; Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jan C M Hendriks
- Department of Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | - Yvonne Veenhuizen
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marten Munneke
- Department of Neurology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Maria W Nijhuis-van der Sanden
- Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands; Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
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Kiewiet JJS, Andeweg CS, Laurell H, Daniels L, Laméris W, Reitsma JB, Hendriks JCM, Bleichrodt RP, van Goor H, Boermeester MA. External validation of two tools for the clinical diagnosis of acute diverticulitis without imaging. Dig Liver Dis 2014; 46:119-24. [PMID: 24252579 DOI: 10.1016/j.dld.2013.09.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 08/13/2013] [Accepted: 09/17/2013] [Indexed: 12/11/2022]
Abstract
AIM External validation and comparison of the diagnostic accuracy of two predictive tools, the emergency department triad and the clinical scoring tool in diagnosing acute diverticulitis. METHODS Two derivation datasets were used crosswise for external validation. In addition, both tools were validated in a third independent cohort. Predictive values were reassessed and the Area Under the Curve expressed discriminatory capacity. Performance was compared by calculating positive predictive values of the emergency department triad in the validation cohorts and with a cut-off analysis for the clinical scoring tool at a positive predictive value of 90%. RESULTS Predictive value of the emergency department triad was comparable to the clinical scoring tool. The positive predictive value of the emergency department triad (97%) decreased in the clinical scoring tool cohort (81%) and was excellent in the independent cohort (100%), identifying 24%, 20% and 14% of the patients. A smaller proportion of patients with diverticulitis could be identified with the clinical scoring tool (6%, 19% and 9%). CONCLUSION The emergency department triad as well as the clinical scoring tool have significant predictive value in external cohorts of patients suspected of diverticulitis. These tools can be used to select patients in whom additional imaging to diagnose acute diverticulitis may be omitted.
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Affiliation(s)
- Jordy J S Kiewiet
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
| | - Caroline S Andeweg
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Lidewine Daniels
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - Wytze Laméris
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - Johannes B Reitsma
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
| | - Jan C M Hendriks
- Department of Epidemiology, Biostatistics and HTA, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Robert P Bleichrodt
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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De Vos MJ, Wagener ML, Hendriks JCM, Eygendaal D, Verdonschot N. Linking of total elbow prosthesis during surgery; a biomechanical analysis. J Shoulder Elbow Surg 2013; 22:1236-41. [PMID: 23664743 DOI: 10.1016/j.jse.2013.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/03/2013] [Accepted: 02/18/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND Presently, 2 types of elbow prostheses are used: unlinked and linked. The Latitude total elbow prosthesis allows the surgeon to decide during the implantation whether the prosthesis is placed unlinked or linked, and whether the native radial head is retained, resected, or replaced. The purpose of this study is to assess and to compare the varus and valgus laxity of the unlinked and linked version of the latitude total elbow prosthesis with: (1) the native radial head preserved, (2) the native radial head excised, and (3) the native radial head replaced by a radial head component. METHODS Biomechanical testing was performed on 14 fresh-frozen upper limb specimens. RESULTS Linking the prosthesis predominantly influences the valgus laxity of the elbow. DISCUSSION/CONCLUSION Linking the Latitude total elbow prosthesis results in increased valgus stability. In the linked version of the total elbow prosthesis, the radial head only plays a small part in both valgus and varus stability. An unlinked situation is not advised in absence of a native radial head or in case of inability to replace the radial head.
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Affiliation(s)
- Maarten J De Vos
- Department of Orthopaedics, Ter Gooi Hospital, Hilversum, The Netherlands
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Kroot JJC, van Herwaarden AE, Tjalsma H, Jansen RTP, Hendriks JCM, Swinkels DW. Second round robin for plasma hepcidin methods: first steps toward harmonization. Am J Hematol 2012; 87:977-83. [PMID: 22886770 DOI: 10.1002/ajh.23289] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 05/25/2012] [Accepted: 06/05/2012] [Indexed: 12/18/2022]
Abstract
Measurements of the iron regulatory hormone hepcidin by various methodologies and laboratories are not harmonized. As a result different numeric results are obtained for the same clinical sample. We investigated whether better agreement between plasma hepcidin methods can be achieved by harmonization. Native plasma pools (n = 11) of a variety of hepcidin concentrations and blank plasma spiked with three different quantities of synthetic hepcidin-25 purchased from two different commercial sources (n = 6), were distributed in duplicate among 21 methods worldwide. We assessed commutability by comparing results from synthetic hepcidin with those from native samples in various method couples by Bland-Altman plots. Methods differed substantially in absolute values and reproducibility. For the majority of methods we found that samples with synthetic hepcidin-25 were noncommutable with the native samples. In an attempt to harmonize by using native hepcidin results, we selected two methods that showed good mutual agreement of native results and calculated consensus values as the medians for the 11 duplicate native samples obtained by these two methods. Finally, we constructed algorithms enabling the laboratories to calculate the hepcidin consensus (HEPCON) value using their own native hepcidin results. We found that the use of these algorithms substantially reduced the between-method CV. Until commutable materials are defined, hepcidin harmonization can be achieved by exploiting specific algorithms, allowing each lab to report their native hepcidin concentrations in HEPCON values. This study represents the first step toward harmonization of plasma hepcidin methods and facilitates aggregation of hepcidin data from different research investigations.
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Affiliation(s)
- Joyce J C Kroot
- Department of Laboratory Medicine, Laboratory of Genetic Endocrine and Metabolic Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Weikamp JG, Schelhaas HJ, Hendriks JCM, de Swart BJM, Geurts ACH. Prognostic value of decreased tongue strength on survival time in patients with amyotrophic lateral sclerosis. J Neurol 2012; 259:2360-5. [PMID: 22527240 PMCID: PMC3484270 DOI: 10.1007/s00415-012-6503-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 03/27/2012] [Accepted: 03/27/2012] [Indexed: 12/11/2022]
Abstract
Decreased tongue strength (TS) might herald bulbar involvement in patients with amyotrophic lateral sclerosis (ALS) well before dysarthria or dysphagia occur, and as such might be prognostic of short survival. The purpose of this study was to investigate the prognostic value of a decreased TS, in addition to other prognostic factors, such as site of onset, bulbar symptoms, bulbar signs, age, sex, maximum phonation time, time from symptoms to diagnosis, and gastrostomy, for survival time in patients with ALS. TS was measured in four directions in 111 patients who attended the diagnostic outpatient motor neuron clinic of our university hospital. Of these patients, 54 were diagnosed with ALS. TS was considered abnormal if the strength in minimally one direction was at least two standard deviations below the reference values obtained from comparable age category and sex-groups of healthy controls (n = 119). Twenty of the patients with ALS had a decreased TS. Multivariable analysis showed that, in addition to age, TS was an independent prognostic factor for survival time in patients with ALS.
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Affiliation(s)
- J G Weikamp
- Department of Rehabilitation (898), Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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25
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Hinten F, van den Einden LCG, Hendriks JCM, van der Zee AGJ, Bulten J, Massuger LFAG, van de Nieuwenhof HP, de Hullu JA. Risk factors for short- and long-term complications after groin surgery in vulvar cancer. Br J Cancer 2011; 105:1279-87. [PMID: 21970884 PMCID: PMC3241565 DOI: 10.1038/bjc.2011.407] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: The cornerstone of treatment in early-stage squamous cell carcinoma (SCC) of the vulva is surgery, predominantly consisting of wide local excision with elective uni- or bi-lateral inguinofemoral lymphadenectomy. This strategy is associated with a good prognosis, but also with impressive treatment-related morbidity. The aim of this study was to determine risk factors for the short-term (wound breakdown, infection and lymphocele) and long-term (lymphoedema and cellulitis/erysipelas) complications after groin surgery as part of the treatment of vulvar SCC. Methods: Between January 1988 and June 2009, 164 consecutive patients underwent an inguinofemoral lymphadenectomy as part of their surgical treatment for vulvar SCC at the Department of Gynaecologic Oncology at the Radboud University Nijmegen Medical Centre. The clinical and histopathological data were retrospectively analysed. Results: Multivariate analysis showed that older age, diabetes, ‘en bloc’ surgery and higher drain production on the last day of drain in situ gave a higher risk of developing short-term complications. Younger age and lymphocele gave higher risk of developing long-term complications. Higher number of lymph nodes dissected seems to protect against developing any long-term complications. Conclusion: Our analysis shows that patient characteristics, extension of surgery and postoperative management influence short- and/or long-term complications after inguinofemoral lymphadenectomy in vulvar SCC patients. Further research of postoperative management is necessary to analyse possibilities to decrease the complication rate of inguinofemoral lymphadenectomy; although the sentinel lymph node procedure appears to be a promising technique, in ∼50% of the patients an inguinofemoral lymphadenectomy is still indicated.
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Affiliation(s)
- F Hinten
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, HB Nijmegen, The Netherlands.
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Lammers K, Lince SL, Spath MA, van Kempen LCLT, Hendriks JCM, Vierhout ME, Kluivers KB. Pelvic organ prolapse and collagen-associated disorders. Int Urogynecol J 2011; 23:313-9. [PMID: 21811768 PMCID: PMC3282004 DOI: 10.1007/s00192-011-1532-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 07/21/2011] [Indexed: 02/03/2023]
Abstract
Introduction and hypothesis Pelvic organ prolapse (POP) and other disorders, such as varicose veins and joint hypermobility, have been associated with changes in collagen strength and metabolism. We hypothesized that these various disorders were more prevalent in both POP patients and their family members. Methods In this study, the prevalence of various collagen-associated disorders, including POP, was compared between POP patients (n = 110) and control patients (n = 100) and their first and second degree family members. Results POP patients reported a higher prevalence of varicose veins, joint hypermobility and rectal prolapse and were more likely to have family members with POP as compared to the control group (p < 0.01). In contrast, the family members of the POP group did not report a higher prevalence of collagen-associated disorders compared to the family members of the control group (p = 0.82). Conclusions POP and other collagen-associated disorders may have a common aetiology, originating at the molecular level of the collagens.
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Affiliation(s)
- Karin Lammers
- Department of Obstetrics and Gynaecology (791), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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Kluivers KB, Ten Cate FA, Bongers MY, Brölmann HAM, Hendriks JCM. Total laparoscopic hysterectomy versus total abdominal hysterectomy with bilateral salpingo-oophorectomy for endometrial carcinoma: a randomised controlled trial with 5-year follow-up. ACTA ACUST UNITED AC 2011; 8:427-434. [PMID: 22081769 PMCID: PMC3205270 DOI: 10.1007/s10397-011-0668-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 02/13/2011] [Indexed: 11/24/2022]
Abstract
This report is on recovery and long-term outcomes in a small-scale randomised controlled trial (RCT) after total laparoscopic hysterectomy versus total abdominal hysterectomy in (potential) endometrial carcinoma patients. An RCT was performed among women with atypical endometrial hyperplasia and endometrial carcinoma scheduled for hysterectomy in a teaching hospital in The Netherlands. Women were randomised to total laparoscopic hysterectomy versus total abdominal hysterectomy both with bilateral salpingo-oophorectomy and were followed until 5 years after the intervention. Patients completed the RAND 36-Item Short Form Health Survey (RAND-36), Quality of Recovery-40 (QoR-40) and Recovery Index-10 (RI-10) until 12 weeks after surgery. Main outcome measure was quality of life and recovery in the first 12 weeks after surgery. A linear mixed model was used for statistical analysis while accounting for baseline values where applicable. Seventeen women were included, of whom 11 allocated to the laparoscopic arm and 6 to the abdominal arm. Laparoscopic hysterectomy performed better on all scales and subscales used in the study. A statistically significant treatment effect, favouring laparoscopic hysterectomy, was found in the total RAND-36 (difference between groups 142 units, 95% confidence interval 46; 236). Clinical follow-up was completed after median 60 months, but this study was too small for conclusions regarding the safety and survival. Laparoscopic hysterectomy results in better postoperative quality of life in the first 12 weeks after surgery when compared with abdominal hysterectomy.
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Affiliation(s)
- Kirsten B. Kluivers
- Department of Obstetrics & Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Florien A. Ten Cate
- Department of Obstetrics & Gynaecology, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Marlies Y. Bongers
- Department of Obstetrics & Gynaecology, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Hans A. M. Brölmann
- Department of Obstetrics & Gynaecology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Jan C. M. Hendriks
- Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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Woldringh GH, Hendriks JCM, van Klingeren J, van Buuren S, Kollée LAA, Zielhuis GA, Kremer JAM. Weight of in vitro fertilization and intracytoplasmic sperm injection singletons in early childhood. Fertil Steril 2011; 95:2775-7. [PMID: 21269612 DOI: 10.1016/j.fertnstert.2010.12.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 12/14/2010] [Accepted: 12/16/2010] [Indexed: 11/18/2022]
Abstract
Birth weight and longitudinal growth in the first 4 years of life of term singletons conceived with the use of IVF and intracytoplasmic sperm injection (ICSI) were compared with those of naturally conceived singletons. Although IVF and ICSI singletons had a statistically significantly lower birth weight than naturally conceived singletons, the average individual weight curves showed that this difference was lost before the age of 4 years in all subgroups: IVF, ICSI, boys, and girls.
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Affiliation(s)
- Gwendolyn H Woldringh
- Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
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29
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Botma A, Nagengast FM, Braem MGM, Hendriks JCM, Kleibeuker JH, Vasen HFA, Kampman E. Body mass index increases risk of colorectal adenomas in men with Lynch syndrome: the GEOLynch cohort study. J Clin Oncol 2010; 28:4346-53. [PMID: 20733131 DOI: 10.1200/jco.2010.28.0453] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE High body mass index (BMI) is an established risk factor for sporadic colorectal cancer. Still, the influence of BMI on hereditary colorectal cancer (eg, Lynch syndrome [LS]), is unknown. The objective of this study was to assess whether BMI is associated with colorectal adenoma occurrence in persons with LS. PATIENTS AND METHODS A prospective cohort study of 486 patients with LS was conducted. Cox regression models with robust sandwich estimates controlling for age, sex, extent of colon surgery, smoking, and alcohol intake were used to evaluate associations between BMI, height, weight, weight change, and risk of colorectal adenomas. Analyses were performed separately for those without (incident cohort; n = 243) and those with (prevalent cohort; n = 243) a history of colorectal cancer neoplasms at baseline. RESULTS A statistically significant association between current overweight (≥ 25 kg/m(2)) and developing colorectal adenomas was seen among men in the incident cohort (overweight v normal weight hazard ratio [HR], 8.72; 95% CI, 2.06 to 36.96). This association was not observed among women (overweight v normal weight HR, 0.75; 95% CI, 0.19 to 3.07), nor was it observed in the prevalent cohort. In the incident cohort, height was statistically significantly associated with a decreased risk of adenomatous polyps among men (per 5 cm HR, 0.43; 95% CI, 0.23 to 0.83), but the association between weight and adenomatous polyps among men was of marginal significance (per 5 kg HR, 1.17; 95% CI, 1.00 to 1.37). No statistically significant associations were observed among women in either the incident cohort or the prevalent cohort. CONCLUSION Excess body weight increased the risk of incident colorectal adenomas in people with LS. This increased risk was seen only in men.
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Affiliation(s)
- Akke Botma
- Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands
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Woldringh GH, Besselink DE, Tillema AHJ, Hendriks JCM, Kremer JAM. Karyotyping, congenital anomalies and follow-up of children after intracytoplasmic sperm injection with non-ejaculated sperm: a systematic review. Hum Reprod Update 2010; 16:12-9. [PMID: 19700489 DOI: 10.1093/humupd/dmp030] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND For men with azoospermia, it is possible to father their own progeny by intracytoplasmic sperm injection (ICSI) with epididymal or testicular sperm. Some studies show that children born after assisted reproductive technology (ART) are at increased risk of birth defects, other studies suggest that there is no extra concern about ICSI children conceived with epididymal or testicular sperm. METHODS Studies about the karyotypes of fetuses, congenital anomalies and the follow-up of the children born after ICSI with non-ejaculated sperm were identified by means of a systematic literature search. RESULTS Eight relevant studies were identified; two studies reported karyotype, five reported malformations and one reported follow-up of children after ICSI. In total, there were 55 out of 1973 (2.8%) abnormal karyotypes in the ICSI with ejaculated sperm group, 0 out of 31 in the ICSI with epididymal sperm group and 5 out of 191 (2.6%) in the ICSI with testicular sperm group. Major malformations were found in 543 out of 12 377 (4.4%) in the ICSI with ejaculated sperm group, 17 out of 533 (3.2%) in the ICSI with epididymal sperm group and 31 out of 670 (4.6%) in the ICSI with testicular sperm group. CONCLUSIONS Although there were no statistical differences, the study groups were small and heterogenic, with a number of potential biases. We therefore recommend a standardized methodology of follow-up studies after ART, with well-defined groups of ICSI with ejaculated sperm, ICSI with epididymal sperm and ICSI with testicular sperm, and a control group of naturally conceived children.
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Affiliation(s)
- G H Woldringh
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, The Netherlands.
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Kroot JJC, Kemna EHJM, Bansal SS, Busbridge M, Campostrini N, Girelli D, Hider RC, Koliaraki V, Mamalaki A, Olbina G, Tomosugi N, Tselepis C, Ward DG, Ganz T, Hendriks JCM, Swinkels DW. Results of the first international round robin for the quantification of urinary and plasma hepcidin assays: need for standardization. Haematologica 2010; 94:1748-52. [PMID: 19996119 DOI: 10.3324/haematol.2009.010322] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The recently discovered iron regulatory peptide hormone hepcidin holds promise as a novel biomarker in iron metabolism disorders. To date, various mass spectrometry and immunochemical methods have been developed for its quantification in plasma and urine. Differences in methodology and analytical performance hinder the comparability of data. As a first step towards method harmonization, several hepcidin assays were compared. Worldwide eight laboratories participated in a urinary and plasma round robin in which hepcidin was analyzed. For both urine and plasma: (i) the absolute hepcidin concentrations differed widely between methods, (ii) the between-sample variation and the analytical variation of the methods are similar. Importantly, the analytical variation as percentage of the total variance is low for all methods, indicating their suitability to distinguish hepcidin levels of different samples. Spearman correlations between methods were generally high. The round robin results inform the scientific and medical community on the status and agreement of the current hepcidin methods. Ongoing initiatives should facilitate standardization by exchanging calibrators and representative samples.
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Affiliation(s)
- Joyce J C Kroot
- Department of Clinical Chemistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Broekhuis SR, Hendriks JCM, Fütterer JJ, Vierhout ME, Barentsz JO, Kluivers KB. Perineal descent and patients' symptoms of anorectal dysfunction, pelvic organ prolapse, and urinary incontinence. Int Urogynecol J 2010; 21:721-9. [PMID: 20135303 PMCID: PMC2858277 DOI: 10.1007/s00192-010-1099-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 01/01/2010] [Indexed: 12/02/2022]
Abstract
Introduction and hypothesis The aim of this dynamic magnetic resonance (MR) imaging study was to assess the relation between the position and mobility of the perineum and patients’ symptoms of pelvic floor dysfunction. Methods Patients’ symptoms were measured with the use of validated questionnaires. Univariate logistic regression analyses were used to study the relationship between the questionnaires domain scores and the perineal position on dynamic MR imaging, as well as baseline characteristics (age, body mass index, and parity). Results Sixty-nine women were included in the analysis. Only the domain score genital prolapse was associated with the perineal position on dynamic MR imaging. This association was strongest at rest. Conclusions Pelvic organ prolapse symptoms were associated with the degree of descent of the perineum on dynamic MR imaging. Perineal descent was not related to anorectal and/or urinary incontinence symptoms.
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Affiliation(s)
- Suzan R Broekhuis
- 791 Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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Broekhuis SR, Fütterer JJ, Hendriks JCM, Barentsz JO, Vierhout ME, Kluivers KB. Symptoms of pelvic floor dysfunction are poorly correlated with findings on clinical examination and dynamic MR imaging of the pelvic floor. Int Urogynecol J 2009; 20:1169-74. [PMID: 19597719 PMCID: PMC2744799 DOI: 10.1007/s00192-009-0938-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 06/04/2009] [Indexed: 12/02/2022]
Abstract
Introduction and hypothesis The aim of the study was to determine whether patients’ symptoms agree with findings on clinical examination and dynamic MR imaging of the pelvic floor. Methods Symptoms of pelvic organ dysfunction were measured with the use of three validated questionnaires. The domain scores were compared with POP-Q and dynamic MR imaging measurements. The Spearman’s rank correlation coefficient (rs) was used to assess agreement. Results Only the domain score genital prolapse was significantly correlated in the positive direction with the degree of pelvic organ prolapse as assessed by POP-Q and dynamic MR imaging (rs = 0.64 and 0.27, respectively), whereas the domain score urinary incontinence was inversely correlated (rs = −0.32 and −0.35, respectively). Conclusions The sensation or visualization of a bulge in the vagina was the only symptom which correlated positively with the degree of pelvic organ prolapse, and clinical examination and dynamic MR imaging showed similar correlation in this respect.
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Affiliation(s)
- Suzan R Broekhuis
- 791 Department of Obstetrics & Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Kluivers KB, Dijkstra JR, Hendriks JCM, Lince SL, Vierhout ME, van Kempen LCL. COL3A1 2209G>A is a predictor of pelvic organ prolapse. Int Urogynecol J 2009; 20:1113-8. [PMID: 19444361 DOI: 10.1007/s00192-009-0913-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 05/04/2009] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND HYPOTHESIS A familial tendency has been demonstrated in the etiology of pelvic organ prolapse (POP), but the specific genetic defects have not been identified. Type III collagen is an important factor in the repair of connective tissue, and gene polymorphisms may impair the tensile strength. We hypothesized that polymorphisms in the alpha I chain of the type III collagen protein-encoding gene (COL3A1) pose women at risk for POP. METHODS In this case-control study, the prevalence of type III collagen polymorphisms was compared in women with and without signs and symptoms of POP. RESULTS Two hundred and two POP patients and 102 normal parous controls were included. A homozygous single-nucleotide substitution in the coding region of type III collagen (COL3A1 2209G>A, rs1800255) was identified in 27 (13%) POP patients and three (3%) controls (odds ratio, 5.0; 95% confidence interval, 1.4-17.1). CONCLUSIONS The probability of POP was higher in women with COL3A1 2209G>A. This polymorphism showed to be a relevant risk factor for POP.
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Affiliation(s)
- Kirsten B Kluivers
- Department of Obstetrics and Gynecology (791), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Broekhuis SR, Kluivers KB, Hendriks JCM, Fütterer JJ, Barentsz JO, Vierhout ME. POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse? Int Urogynecol J 2009; 20:541-9. [DOI: 10.1007/s00192-009-0821-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 01/25/2009] [Indexed: 05/25/2023]
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Jacobs EMG, Hendriks JCM, van Deursen CTBM, Kreeftenberg HG, de Vries RA, Marx JJM, Stalenhoef AFH, Verbeek ALM, Swinkels DW. Severity of iron overload of proband determines serum ferritin levels in families with HFE-related hemochromatosis: the HEmochromatosis FAmily Study. J Hepatol 2009; 50:174-83. [PMID: 19008010 DOI: 10.1016/j.jhep.2008.08.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 07/24/2008] [Accepted: 08/26/2008] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS In families of patients with clinically detected hereditary hemochromatosis (HH) early screening has been suggested to prevent morbidity and mortality. Here, we aim to identify determinants for iron overload in first-degree family members of C282Y homozygous probands with clinically detected HH. METHODS Data on HFE-genotype, iron parameters, demographics, lifestyle factors and health, were collected from 224 Dutch C282Y homozygous patients with clinically diagnosed HH and 735 of their first-degree family members (FDFM), all participating in the HEmochromatosis FAmily Study (HEFAS). RESULTS The best predictive multivariable model forecasted 45% of variation of the serum ferritin levels. In this model severity of iron overload in the proband significantly predicted serum ferritin levels in FDFM. Other significant determinants in this model consisted of C282Y homozygosity, compound heterozygosity, age at testing for serum ferritin and supplemental iron intake, whereas a low body mass index showed a protective effect. CONCLUSIONS This study provides a model to assess the risk of development of iron overload for relatives of probands with HH. These results might be instrumental in the development of an optimal strategy for future family screening programs.
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Affiliation(s)
- Esther M G Jacobs
- Department of Clinical Chemistry 441, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Punt–van der Zalm JPEM, Hendriks JCM, Westphal JR, Kremer JAM, Teerenstra S, Wetzels AMM. Toxicity testing of human assisted reproduction devices using the mouse embryo assay. Reprod Biomed Online 2009; 18:529-35. [DOI: 10.1016/s1472-6483(10)60130-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Broekhuis SR, Kluivers KB, Hendriks JCM, Vierhout ME, Barentsz JO, Fütterer JJ. Dynamic magnetic resonance imaging: reliability of anatomical landmarks and reference lines used to assess pelvic organ prolapse. Int Urogynecol J 2008; 20:141-8. [PMID: 19002366 DOI: 10.1007/s00192-008-0760-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Accepted: 10/21/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study was to determine the intra- and interobserver reliability of dynamic magnetic resonance (MR) staging in pelvic organ prolapse patients. In 30 patients with pelvic organ prolapse, dynamic MR images were assessed independently by two observers. Various anatomical landmarks to asses pelvic organ prolapse were used in relation to the pubococcygeal line, H-line, and mid-pubic line. Clinical measurement points were assessed in relation to the mid-pubic line. The intraclass correlation coefficients (ICC) were calculated to describe the intra- and interobserver reliability. Overall, the intra- and interobserver reliability of MR imaging measurements was excellent to good. The pubococcygeal line showed superior reliability (ICC range 0.70-0.99). The reliability of clinical measurement points, however, were only moderate (ICC range 0.20-0.96). The intra- and interobserver reliability of quantitative prolapse staging on dynamic MR imaging were good to excellent. The pubococcygeal line appears the most reliable to use.
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Affiliation(s)
- Suzan R Broekhuis
- Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Lenselink CH, Schmeink CE, Melchers WJG, Massuger LFAG, Hendriks JCM, van Hamont D, Bekkers RLM. Young adults and acceptance of the human papillomavirus vaccine. Public Health 2008; 122:1295-301. [PMID: 18619631 DOI: 10.1016/j.puhe.2008.02.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2007] [Revised: 12/06/2007] [Accepted: 02/27/2008] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine whether young Dutch adults had ever heard of human papillomavirus (HPV) and whether they would accept vaccination, and to assess the factors influencing their decision. STUDY DESIGN Cross-sectional survey. METHODS Six hundred participants aged 18-25 years were recruited from two university departments and one non-university technical college. RESULTS One hundred and six (17.7%) participants had heard of HPV and 536 (94%) had heard of cervical carcinoma. Women had significantly more knowledge of cervical carcinoma than men. A medical education, knowledge of HPV, knowledge of cervical cancer and knowledge of the cervical screening programme were not significantly associated with acceptance of HPV vaccination, whereas gender and age did show a significant relationship. In total, 61% of the female participants and 48% of the male participants were willing to accept a 'catch-up' HPV vaccination. CONCLUSIONS This study found that average knowledge levels of HPV and cervical cancer were low. Despite this lack of knowledge, a small majority of the study population would accept a 'catch-up' HPV vaccination. Women and younger participants were significantly more willing to accept HPV vaccination. However, in these subgroups, acceptance of HPV vaccination seems to be affected by other, still unidentified, factors. These factors could be evaluated in a more qualitative orientated study. An educational campaign is needed to cover knowledge about HPV and cervical carcinoma, and beliefs and behaviours associated with the acceptance of vaccination.
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Affiliation(s)
- C H Lenselink
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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40
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Kluivers KB, Hendriks JCM, Mol BWJ, Bongers MY, Vierhout ME, Brölmann HAM, de Vet HCW. Clinimetric properties of 3 instruments measuring postoperative recovery in a gynecologic surgical population. Surgery 2008; 144:12-21. [PMID: 18571580 DOI: 10.1016/j.surg.2008.03.027] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2007] [Accepted: 03/30/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND General, health-related quality-of-life questionnaires and recovery-specific questionnaires have been used to measure recovery in surgical patients. The aim of this study was to evaluate the clinimetric properties of 3 recovery instruments and to examine whether recovery-specific instruments are useful. METHODS The Quality of Recovery-40 (QoR-40), Recovery Index-10 (RI-10), and RAND-36 health survey were used to measure recovery in women undergoing different types of hysterectomy in the first 12 weeks after operation. Construct validity was assessed by testing predefined hypotheses. The changes observed during the postoperative period were used as indicators for responsiveness. RESULTS One hundred and sixty-one women were included. Response rate and internal consistency were found satisfactory. The highest number of hypotheses used for assessment of construct validity was confirmed in the RI-10. The RI-10 was more responsive compared with the QoR-40 and the RAND-36. CONCLUSIONS Because construct validity and responsiveness were greatest in the RI-10, we conclude that this short recovery-specific instrument is useful in studies evaluating postoperative recovery. We recommend the use of the RI-10, unless the immediate postoperative days are of interest in which the QoR-40 was valid.
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Affiliation(s)
- Kirsten B Kluivers
- Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Postbus 9101, 6500 HB Nijmegen, the Netherlands.
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Jacobs EMG, Hendriks JCM, Marx JJM, van Deursen CTBM, Kreeftenberg HG, de Vries RA, Stalenhoef AFH, Verbeek ALM, Swinkels DW. Morbidity and mortality in first-degree relatives of C282Y homozygous probands with clinically detected haemochromatosis compared with the general population: the HEmochromatosis FAmily Study (HEFAS). Neth J Med 2007; 65:425-433. [PMID: 18079565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Family screening has been suggested as a sophisticated model for the early detection of HFE-related hereditary haemochromatosis (HH). However, until now, controlled studies on the morbidity and mortality in families with HH are lacking. METHODS Data on iron parameters, morbidity and mortality were collected from 224 dutch C282Y-homozygous probands with clinically overt HH and 735 of their first-degree family members, all participating in the HEmochromatosis fAmily study (HEfAs). These data were compared with results obtained from an age- and gender-matched normal population. HEfAs and controls filled in similar questionnaires on demographics, lifestyle factors, health, morbidity and mortality. RESULTS A significantly higher proportion of the HEfAs first-degree family members reported to be diagnosed with haemochromatosis-related diseases: 45.7 vs 19.4% of the matched normal population (McNemar p<0.001). Mortality among siblings, children and parents in the HEFAS population was similar to that in the relatives of matched control. CONCLUSION In this study we show that, morbidity among first-degree family members of C282Y-homozygous probands previously diagnosed with clinically proven HH is higher than that in an age- and gender-matched normal population. Further studies are needed to definitely connect these increase morbidity figures to increase prevalenc of the C282Y mutated HFE-gene and elevated serum iron indices.
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Affiliation(s)
- E M G Jacobs
- Department of Clinical Chemistry, Radboud University Nijmegen Medical Centre, the Netherlands
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Bousema JT, Drakeley CJ, Kihonda J, Hendriks JCM, Akim NIJ, Roeffen W, Sauerwein RW. A longitudinal study of immune responses to Plasmodium falciparum sexual stage antigens in Tanzanian adults. Parasite Immunol 2007; 29:309-17. [PMID: 17518949 DOI: 10.1111/j.1365-3024.2007.00948.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Next to children, adults form a substantial part of the infectious reservoir that is responsible for the spread of malaria. In this longitudinal study, we determined sexual stage immune responses to Plasmodium falciparum and infectiousness to mosquitoes in adults from an area with intense malaria transmission. A cohort of 43 Tanzanian adults was followed for 18 months. Parasitological data were collected monthly; serum once every three months. Antibody prevalences were determined for sexual stage antigens Pfs230 and Pfs48/45 and circumsporozoite protein (NANP5)(n = 199). Functional transmission reducing activity (TRA) was assessed by standard membrane feeding assay (SMFA; n = 85). Cumulative parasite prevalence was 67.4% (29/43) for asexual stages and 34.9% (15/43) for gametocytes. Enrolment antibody prevalence was 95.3% (41/43) for NANP5, 18.9% (7/37) for Pfs230 and 7% (3/43) for Pfs48/45 epitope 3. TRA > 50% reduction was seen in 48.2% (41/85) and TRA > 90% reduction in 4.7% (4/85) of the samples. Our findings of low and inconsistent sexual stage immune responses are likely to be the result of a low exposure to gametocytes in this older age group. This may in turn be caused by effective asexual stage immunity. We conclude that the infectivity of older individuals is less likely to be affected by sexual stage immunity.
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Affiliation(s)
- J T Bousema
- Department of Medical Microbiology, University Medical Centre, Nijmegen, The Netherlands.
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van der Kooi EL, Kalkman JS, Lindeman E, Hendriks JCM, van Engelen BGM, Bleijenberg G, Padberg GW. Effects of training and albuterol on pain and fatigue in facioscapulohumeral muscular dystrophy. J Neurol 2007; 254:931-40. [PMID: 17361345 PMCID: PMC2779375 DOI: 10.1007/s00415-006-0432-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2005] [Revised: 02/06/2006] [Accepted: 03/22/2006] [Indexed: 11/30/2022]
Abstract
Background We recently
reported a randomised
controlled trial on the efficacy of
strength training and the β 2-adrenergic agonist albuterol in
patients with facioscapulohumeral
muscular dystrophy (FSHD).
Strength training and albuterol
appeared safe interventions with
limited positive effect on muscle
strength and volume. We concurrently
explored the prevalence and
the characteristics of pain and
fatigue in the participating FSHD
patients, because these are probably
underreported but clinically
relevant symptoms in this disorder.
Next, we studied the effects of
albuterol and strength training on
pain, experienced fatigue, healthrelated
functional status and psychological
distress. Methods Sixty-five patients were randomised to
strength training of elbow flexors
and ankle dorsiflexors or nontraining.
After 26 weeks, albuterol
(sustained-release, 8 mg bid) was
added in a randomised, doubleblind,
placebo-controlled design.
Outcomes comprised self-reported
pain, experienced fatigue, functional
status and psychological
distress obtained with validated
questionnaires at 52 weeks. Results Eighty percent of patients
reported chronic persistent or
periodic, multifocal pains. Thirtyfour
percent of the participants
were severely fatigued. Strength
training and albuterol failed to
have a significant effect on all
outcomes. Conclusions Pain and
fatigue are important features in
FSHD. Strength training and
albuterol do not have a positive or
negative effect on pain, experienced
fatigue, functional status
and psychological distress.
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Affiliation(s)
- E L van der Kooi
- Neuromuscular Center Nijmegen, Radboud University Nijmegen Medical Center, 6500 HB Nijmegen, The Netherlands.
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Kluivers KB, Hendriks JCM, Mol BWJ, Bongers MY, Bremer GL, de Vet HCW, Vierhout ME, Brolmann HAM. Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: A randomized, controlled trial. J Minim Invasive Gynecol 2007; 14:145-52. [PMID: 17368247 DOI: 10.1016/j.jmig.2006.08.009] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2006] [Revised: 08/08/2006] [Accepted: 08/12/2006] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE Minimally invasive surgery aims to achieve at least a similar clinical effectiveness with a quicker recovery than traditional open techniques. Although there have been numerous randomized clinical trials comparing laparoscopic hysterectomy with hysterectomy by laparotomy, only a few studies have compared quality of life after different types of hysterectomy. None of these studies evaluated total laparoscopic hysterectomy. In this paper, we report on a randomized comparison of quality of life after total laparoscopic versus total abdominal hysterectomy. DESIGN Randomized, controlled trial (Canadian Task Force classification I). SETTING Single-center teaching hospital in The Netherlands. PATIENTS Patients scheduled for hysterectomy for a benign condition, in whom a vaginal hysterectomy was not possible and laparoscopic hysterectomy was feasible (mobile uterus not exceeding the size of 18 weeks' gestation). INTERVENTIONS Abdominal versus laparoscopic hysterectomy. MEASUREMENTS AND MAIN RESULTS Patients completed the Dutch version RAND-36 health survey preoperatively as well as at 5 time points in the first 12 weeks after surgery. The primary outcome of the study was quality of life as measured by the RAND-36. A linear mixed model was used for statistical analysis while accounting for baseline values. Secondary outcomes were hospital stay and complications. There were 88 patients eligible, of whom 59 gave consent for randomization. Twenty-seven women were allocated to the laparoscopic arm and 32 to the abdominal arm. We found a significant treatment effect favoring laparoscopic hysterectomy in the RAND-36 scale for vitality. Laparoscopic hysterectomy performed better on all other scales of the RAND-36, but these differences were not statistically significant. CONCLUSIONS Laparoscopic hysterectomy results in more postoperative vitality when compared with abdominal hysterectomy. For this reason, all women with a benign condition requiring abdominal hysterectomy, in whom the laparoscopic approach is feasible, should have the chance to choose laparoscopic hysterectomy.
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Affiliation(s)
- Kirsten B Kluivers
- Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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van de Langerijt B, Gijtenbeek JM, de Reus HPM, Sweep FCGJ, Geurts-Moespot A, Hendriks JCM, Kappelle AC, Verbeek MM. CSF levels of growth factors and plasminogen activators in leptomeningeal metastases. Neurology 2006; 67:114-9. [PMID: 16832089 DOI: 10.1212/01.wnl.0000223348.42106.97] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the diagnostic value of transforming growth factor beta(1) (TGFbeta(1)), vascular endothelial growth factor (VEGF), urokinase-type plasminogen activator (uPA), and tissue-type plasminogen activator (tPA) in CSF for leptomeningeal metastasis (LM). METHODS The authors measured concentrations of biomarkers by ELISA in matched samples of CSF and serum, collected from 132 patients with a solid malignancy with LM (n = 19) and without LM (n = 54) and patients with viral (n = 16) and bacterial (n = 16) meningitis and a variety of nonmalignant, noninfectious neurologic disorders (n = 27). Indexes of the biomarkers (CSF/serum value relative to CSF/serum albumin ratios) were calculated to correct for the serum contribution to the CSF marker concentration. RESULTS CSF VEGF concentration was significantly higher in LM than in all other groups. VEGF indexes were also higher, although not significant. In contrast, the tPA index was significantly decreased in LM compared with all other groups. The combination of the VEGF and tPA indexes resulted in a sensitivity of 100% for LM and a specificity of 73% for the patient group with a primary tumor but without LM. CONCLUSION Patients with leptomeningeal metastasis have high vascular endothelial growth factor (VEGF) indexes and low tissue-type plasminogen activator (tPA) indexes. As cytologic examination of CSF lacks 100% sensitivity for the diagnosis of leptomeningeal metastasis (LM), the combination VEGF and tPA index analysis may be of additional value in the diagnostic workup of patients suspected of having LM.
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Affiliation(s)
- B van de Langerijt
- Department of Neurology, Laboratory of Pediatrics and Neurology, Radboud University Nijmegen Medical Centre, 830 LKN, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands
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van Hamont D, Nissen LHC, Siebers AG, Hendriks JCM, Melchers WJG, Kremer JAM, Massuger LFAG. Abnormal cervical cytology in women eligible for IVF. Hum Reprod 2006; 21:2359-63. [PMID: 16684844 DOI: 10.1093/humrep/del132] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis is more prevalent in subfertile women than in the general population and is the leading cause of tubal factor subfertility. As C. trachomatis infections are sexually transmitted, it can be expected that infections with human papillomavirus (HPV) are also more prevalent in this group of women. HPV is a necessary cause for the development of cervical (pre-)malignancies. We therefore hypothesized that subfertile women are more likely to have HPV-induced cervical abnormalities compared to the general population. METHODS In this retrospective case-control study, all cervical smears of women visiting the fertility clinic for IVF (cases) and of women attending the population-based screening programme for cervical cancer (controls) were retrieved from an electronic database and assessed. RESULTS The cases (n = 669) showed significantly more abnormal cervical smears compared to the controls (77,055) (6.1 and 3.9%, respectively, P < 0.02). CONCLUSIONS The probability that subfertile women eligible for IVF are diagnosed with a high-grade cervical lesion is almost twice as high compared to women in the general population. We therefore suggest to take a cervical smear from all women referred for fertility problems.
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Affiliation(s)
- D van Hamont
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Abstract
OBJECTIVE To study the outcome and complications of surgical treatment for vulvar vestibulitis syndrome and to identify patient characteristics that may have influenced the outcome. METHODS Relevant patient characteristics were extracted retrospectively from the medical records of 155 women aged 40 years or younger who had received surgical treatment for vulvar vestibulitis syndrome. To assess outcome and complications, 126 of these 155 women (81%) participated in a telephone interview, conducted 1 to 4 years after surgery. RESULTS After surgery 93% of the patients could have sexual intercourse compared with 78% before surgery; this increase was statistically significant (Mantel-Haenszel odds ratio 3.43, 95% confidence interval [CI] 1.48-7.96). In 62% of the women (95% CI 53-70%), sexual intercourse was painless after surgery. Eighty-nine percent (95% CI 84-95%) would recommend surgical treatment to other women experiencing vulvar vestibulitis syndrome. There were no major complications. Decreased lubrication during sexual arousal was the most frequently reported adverse effect (24%, 95% CI 16-32%), followed by the development of a Bartholin's cyst (6%, 95% CI 2-10%). More of the women aged 30 years or younger reported that they could have sexual intercourse after surgery, and more of them would recommend surgical treatment to other patients than women aged 31 years or older. CONCLUSION Surgical treatment for vulvar vestibulitis syndrome achieved high success rates with an acceptable rate of complications. Age of 30 years or younger was associated with a better outcome. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Maaike A F Traas
- Department of Obstetrics and Gynecology, Rijnstate Hospital, Arnhem, the Netherlands.
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van der Kooi EL, de Leeuw GE, Vlak MHM, Hendriks JCM, Padberg GW, Vogels OJM. An unbiased and efficient computerised tomography method to quantify muscle and adipose tissue volume in neuromuscular patients. Neurol Sci 2006; 26:423-9. [PMID: 16601935 DOI: 10.1007/s10072-006-0526-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2005] [Accepted: 11/16/2005] [Indexed: 11/30/2022]
Abstract
The objective was to evaluate the applicability and reliability of an unbiased stereological computerised tomography (CT) method for estimating total human body (HB), skeletal muscle (SM) and adipose tissue (AT) volumes in groups of neuromuscular patients. In 10 neuromuscular patients HB, SM and AT volumes were estimated using systematic sampling on equidistant CT sections throughout the total body axis using a counting grid with systematically ordered intersection points. Each intersection point hitting HB, SM or AT represented a known volume dependent on intersection point distance and sum of section thickness and gap. Random and systematic intra- and interobserver errors for volume estimates were below 0.035. These errors were negligible to the coefficient of variation of the group mean, being 0.190 for HB, 0.323 for SM and 0.471 for AT. Even in the presence of intrafascicular and intramuscular fat in neuromuscular patients, unbiased and reliable quantification of HB, SM and AT is possible.
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49
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Roes EM, Hendriks JCM, Raijmakers MTM, Steegers-Theunissen RPM, Groenen P, Peters WHM, Steegers EAP. A longitudinal study of antioxidant status during uncomplicated and hypertensive pregnancies. Acta Obstet Gynecol Scand 2006; 85:148-55. [PMID: 16532906 DOI: 10.1080/00016340500345832] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND To study the possible involvement of an (im)balance between oxidants and antioxidants in pre-eclampsia concentrations of intra- and extracellular blood antioxidants in women with uncomplicated and hypertensive pregnancies, they were studied preconceptionally and throughout pregnancy. METHODS In uncomplicated pregnancies (n = 19) and hypertensive pregnancies (n = 6) concentrations of whole blood and plasma thiols, plasma vitamins/E and C, hemoglobin, and hematocrit were assessed at preconception, 6, 10, 20, and 37 weeks of gestational age, as well as six weeks postpartum. A repeated mixed model was used for statistical analysis. RESULTS Vitamin C and most whole blood and plasma thiol concentrations decreased during pregnancy, while vitamin E, whole blood oxidized cysteinyl-glycine and the ratio of free to oxidized homocysteine revealed a linear increase during pregnancy. Postpartum plasma cysteine and vitamin C levels and the ratio of free to oxidized levels of cysteine, cysteinyl-glycine, and glutathione were significantly (p <0.05) lower as compared to preconceptional levels, whereas whole blood oxidized cysteine, cysteinyl-glycine and glutathione levels, and whole blood and plasma homocysteine levels were significantly (p <0.05) higher six weeks after delivery. Plasma cysteine and homocysteine, and whole blood oxidized cysteine and homocysteine levels were significantly (p <0.05) higher at 37 weeks of gestational age in the hypertensive group compared to those in the uncomplicated group. There were no other differences between the hypertensive and uncomplicated groups. CONCLUSION In normal pregnancy there seems a balance between antioxidant and oxidant concentrations despite modest oxidative stress. In mildly hypertensive pregnancies a marginal imbalance may occur.
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Affiliation(s)
- Eva Maria Roes
- Department of Obstetrics & Gynaecology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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50
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Jacobs EMG, Hendriks JCM, van Tits BLJH, Evans PJ, Breuer W, Liu DY, Jansen EHJM, Jauhiainen K, Sturm B, Porter JB, Scheiber-Mojdehkar B, von Bonsdorff L, Cabantchik ZI, Hider RC, Swinkels DW. Results of an international round robin for the quantification of serum non-transferrin-bound iron: Need for defining standardization and a clinically relevant isoform. Anal Biochem 2005; 341:241-50. [PMID: 15907869 DOI: 10.1016/j.ab.2005.03.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2004] [Indexed: 12/12/2022]
Abstract
Non-transferrin-bound iron (NTBI) appears in the circulation of patients with iron overload. Various methods to measure NTBI were comparatively assessed as part of an international interlaboratory study. Six laboratories participated in the study, using methods based on iron mobilization and detection with iron chelators or on reactivity with bleomycin. Serum samples of 12 patients with hereditary (n=11) and secondary (n=1) hemochromatosis were measured during a 3-day analysis using 4 determinations per sample per day, making a total of 144 measurements per laboratory. Bland-Altman plots for repeated measurements are presented. The methods differed widely in mean serum NTBI level (range 0.12-4.32mumol/L), between-sample variation (SD range 0.20-2.13mumol/L and CV range 49.3-391.3%), and within-sample variation (SD range 0.02-0.45mumol/L and CV range 4.4-193.2%). The results obtained with methods based on chelators correlated significantly (R(2) range 0.86-0.99). On the other hand, NTBI values obtained by the various methods related differently from those of serum transferrin saturation (TS) when expressed in terms of both regression coefficients and NTBI levels at TS of 50%. Recent studies underscore the clinical relevance of NTBI in the management of iron-overloaded patients. However, before measurement of NTBI can be introduced into clinical practice, there is a need for more reproducible protocols as well as information on which method best represents the pathophysiological phenomenon and is most pertinent for diagnostic and therapeutic purposes.
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Affiliation(s)
- Esther M G Jacobs
- Department of Clinical Chemistry, Radboud University Nijmegen Medical Center, 6500 HB Nijmegen, The Netherlands
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