Morbid obesity and asthma : co-morbidity or causal relationship?

This thesis consists of three parts. Part A describes in chapter 2 the complex diagnosis of asthma in the morbidly obese, and especially focuses on underdiagnosis and overdiagnosis of asthma in this patient group. Part B investigates bronchial and systemic inflammation. It starts in chapter 3 with a review on the association between obesity and asthma, where the metabolic syndrome __ as state of systemic inflammation - is mentioned as possible explanation for the association between obesity and asthma. In chapter 4 systemic inflammation and the metabolic syndrome and impaired lung function in morbidly obese subjects are discussed. This is followed by chapter 5, in which the presence and possible relationship between bronchial and systemic inflammation in morbidly obese asthma subjects are discussed. Part C focuses on bariatric surgery, first pulmonary function testing and complications of bariatric surgery are discussed in chapter 6. In chapter 7 the effect of bariatric surgery on asthma is described. And finally, in chapter 8, a summary and general discussion of these studies is presented.UBL - phd migration 201

Shifting the Focus:A Pilot Study on the Effects of Positive Body Exposure on Body Satisfaction, Body Attitude, Eating Pathology and Depressive Symptoms in Female Patients with Eating Disorders

One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE

Shifting the Focus: A Pilot Study on the Effects of Positive Body Exposure on Body Satisfaction, Body Attitude, Eating Pathology and Depressive Symptoms in Female Patients with Eating Disorders

One of the most commonly used techniques for the treatment of body image problems in eating disorders (ED) is body exposure (BE). However, evidence of its effectiveness in clinical populations is scarce. In the Positive Body Experience (PBE) protocol, the focus of positive BE is on aesthetic, functional and tactile aspects of the body. The current study evaluates the outcomes of positive BE with regard to changes in attitudinal body image and eating pathology, as well as the factors that influence these changes, in a sample of 84 adult female patients with different EDs who did not receive any other treatment for their EDs during the period in which BE treatment occurred. The results show significant positive changes in attitudinal body image, ED behaviors and depressive symptoms, with depressive symptoms at baseline mediating the changes in attitudinal body image. This study indicates that the PBE protocol is a suitable intervention for reducing negative attitudinal body image in anorexia and bulimia nervosa patients, as well as those with binge eating disorder. Furthermore, the results suggest that positive non-weight-related and functional body satisfaction are strong catalysts for change and that depressive symptoms play an important role in the ability to change. Additional RCTs are needed to gain more insight into the effects of PBE

Medical treatment of early-onset mild gestational hypertension reduces total peripheral vascular resistance and influences maternal and fetal complications

OBJECTIVE: Complications in early-onset mild gestational hypertension (GH) are better predicted by total peripheral vascular resistance (TPVR) > 1350 dyne than by blood pressure. We therefore aimed to assess the possible reduction of severe complications by lowering TPVR with nitric oxide (NO) donors, oral fluids and standard antihypertensive therapy in women with early-onset mild GH. METHODS: A group of 400 patients with early-onset (20-27 weeks' gestation) mild GH (systolic and diastolic blood pressure < 170/110 mmHg) and TPVR > 1350 dyne were enrolled in a prospective non-randomized trial with sequential allocation: 100 patients were treated with nifedipine (Group A); 100 with nifedipine and NO donors (Group B); 100 with nifedipine and oral fluids (Group C); and 100 with nifedipine, NO donors and oral fluids (Group D). TPVR was checked 1 month after initiation of therapy, and the number of patients with severe maternal and fetal complications was recorded in each group. The relationship between reduction in TPVR and the frequency of severe complications was assessed. RESULTS: Severe complications developed in 51% of patients in Group A, 48% in Group B, 53% in Group C and 35% in Group D, the frequency in Group D being significantly lower than that in the other treatment groups (P < 0.05). A reduction in TPVR of < 15% predicted the occurrence of severe complications with sensitivity 95.2% and specificity 88.3%. In Group D a reduction in TPVR of ≥ 15% was more probable (odds ratio (OR) = 2.03; 95% CI, 1.15-3.60; P < 0.015) and severe complications were less probable (OR = 0.52; 95% CI, 0.29-0.91; P < 0.023). CONCLUSION: In women with early-onset mild GH, combined treatment with NO donors, oral fluids and nifedipine optimally reduces TPVR and seems to reduce maternal and fetal complications

Ruygenhoek: Plaats voor vrijeteijdsbesteding en consumptie

Het huidige klimaat in Nederland voor het maken van grootschalige Leisure wordt geleid door een ontwikkelaars mentaliteit van korte termijn planning en snelle resultaten. Grond wordt op overzichtelijke wijze verkaveld en kan op deze manier voor op korte termijn ontwikkeld worden zonder dat er op een overzichtelijke manier een duidelijke visie wordt neergelegd. Door vooronderzoek te doen in mijn ontwerpstudio, Territory in Transit, waar ingezoomd werd op specifieke gevallen van bebouwing in de tussengebieden van de Randstad, ben ik erachter gekomen dat een zeer grote concentratie met een zeer gemakkelijke aan en afvoer van personen een gewenste oplossing is voor grootschalige leisure te bedrijven in de Randstad. Als locatie voor dit plan is gekozen voor de Haarlemmermeer, op het punt van benzinestation "Den Ruygen Hoek. Een op zich zelf staande plaats gelegen aan de snelweg A4 tussen Schiphol en knooppunt de Hoek richting Leiden. Deze plek is vooral interessant vanwege zijn afsluiting van de overige wereld. Het is alleen toegankelijk via de snelweg en schept daarom een specifieke dynamiek. Het project wat ik voorstel is een grootschalig Leisure gebied dat voorzien is van entertainment, cultuur, consumptie en winkelen. Gelijktijdig fungeert het als groene oversteek over de snelweg en een transformatiepunt van snelweg naar (gecultiveerde) natuur. Dit geheel wordt ontworpen en gepresenteerd als entiteit.Architectur

Formerly preeclamptic women with a subnormal plasma volume are unable to maintain a rise in stroke volume during moderate exercise.

Contains fulltext : 47812.pdf (publisher's version ) (Open Access)INTRODUCTION: In formerly preeclamptic women with a low plasma volume, the recurrence rate of preeclampsia is higher than in women with a normal prepregnant plasma volume. In a recent study, we demonstrated that the low plasma volume subgroup also had a subnormal venous capacitance. In the present study, we determined the impact of subnormal plasma volume on the hemodynamic response to moderate exercise. PATIENTS AND METHODS: We performed this study in the follicular phase of the menstrual cycle, in 31 formerly preeclamptic women with a subnormal plasma volume (low-PV) and eight parous controls. The exercise consisted of 60 minutes of cycling in the supine position at 35% of the individualized maximum capacity. Before, during, and after cycling, we measured the percentage change in heart rate, stroke volume, and cardiac output. Before and after exercise, we measured the effective renal plasma flow (ERPF, para-amino-hippurate [PAH] clearance), glomerular filtration rate (GFR, inulin clearance), circulating levels of alpha-atrial natriuretic peptide (alpha-ANP), and active plasma renin concentration (APRC). RESULTS: The response to exercise of formerly preeclamptic women with a subnormal plasma volume differed from that in controls by a lack of rise in stroke volume, a smaller rise in cardiac output and alpha-ANP, and a greater fall in GFR. The responses in heart rate, ERPF, and APRC did not differ between the two groups. CONCLUSION: The response to moderate exercise of formerly preeclamptic women with a subnormal plasma volume differs from that in healthy parous controls with a normal plasma volume and suggests a lower capacity to raise venous return in conditions of a higher demand for systemic flow. The lower capacity to raise venous return in these conditions is associated with more cardiovascular drift. The physiologic consequence is a lower aerobic endurance performance during moderate exercise

Thorax-Pelvis Coordination During Gait

Gait kinematics and kinetics of fifteen healthy subjects and fifteen subjects with chronic low back pain. Supplementary data of the journal article (Open Access): "Axial Thorax-Pelvis Coordination During Gait is not Predictive of Apparent Trunk Stiffness" In Nature Scientific Reports DOI:10.1038/s41598-018-37549-9 By Maarten R. Prins, Sjoerd M. Bruijn, Onno G. Meijer, Peter van der Wurff and Jaap H. van Dieën The methods of data collection are described in the journal article. The .mat file ("ExperimentalData") and .csv file contain identical information. Dataset consists of [Units] (Variable Names): - Subject characteristics Weight [kg] (Weight) Height [m] (Height) Thorax inertia around longitudinal axis [kgm2] (InertiaThorax) - Kinematics in 100 [samples/s] 3D Thorax angular velocity in [rad/sec] (KinematicsThoraxOmega) 3D Pelvis angular velocity [rad/sec] (KinematicsPelvisOmega) 3D Trunk angle [rad] (KinematicsTrunkPhi) 3D Left and right arm center of mass trajectory [m] (KinematicsRArmCOMX) - Kinetics in 100 [samples/s] 1D Arm swing moment around longitudinal axis trunk through L5S1 [Nm] (KineticsRArmIAlphaL5S1X) 3D Net trunk torque [Nm] (KineticsTrunkTorqueX