Real-world Aspects of Colorectal Cancer Survival in the Netherlands

This thesis reports numerous real-world aspects of colorectal cancer survival in the Netherlands. The population-based studies in this thesis are based on data from the nationwide Netherlands Cancer Registry (NCR), managed by the Netherlands Comprehensive Cancer Organisation. Colorectal cancer survival has improved in the Netherlands in the past 25 years, due to advancements in diagnostics and treatment. It is shown that when elderly patients survived the first year after surgery, survival was comparable to younger patients. It is also shown that the presence of synchronous colorectal cancers is associated with a decrease in survival. We also demonstrate the effect of variation in demographic determinants (hospital volume and timing to adjuvant chemotherapy) on colorectal cancer survival

Effects of Bupropion on Sign-tracking

Sign-tracking is defined as the tendency of an organism to engage with a conditioned stimulus that has been paired with a rewarding unconditioned stimulus. Sign-tracking behavior may be comparable to the behavior drug addicts demonstrate when going through a period of relapse after being exposed to a stimulus they associate with drug use. A medication that reduces sign-tracking could be used to aid in drug addiction treatment. In this study, we investigate the effect of bupropion on sign tracking behavior, hoping to explore if this drug can aid in drug addiction treatment. Subjects were 48 male Sprague Dawley rats. In order to measure sign tracking, operant chambers were used. Subjects were conditioned over the course of 5 days to associate the presence of a lever with food delivery. Then subjects were tested under the influence of 0, 20,40, or 60 Mg/kg of Bupropion. In the present study, Significant differences were found and Bupropion was found to reduce sign tracking

Effects of Memantine on Sign-Tracking

Sign tracking is an organism approaching a signal for an appetitive stimulus. An example of this in humans is an addict interacting with drug paraphernalia when coming across it without consciously understanding why or knowingly intending to get high. This contributes to relapse and finding a pharmaceutical that reduces sign tracking could help addicts in recovery. We replicated this kind of signtracking in rats and administered three different doses of Memantine to test how this affects their signtracking. We first got the rats to associate a lever popping out with a treat pellet being given. We tracked how often the rats interreacted with the lever and food receptacle to determine if they are signtrackers (interact a lot with the lever) goal-trackers (interact a lot with the food receptacle) or Intermediate (Interacted with both).A mixed model ANOVA showed a significant interaction between dose and behavioral phenotype, but post hoc test showed no significant differences between pairs. These results are unusual but promising and more research is needed

Effects of Escitalopram on Sign-Tracking

Sign tracking is a phenomenon in organisms in which they are likely to approach a cue for appetitive stimuli. This behavior is important in drug addiction and likelihood of relapse. The aim of the current 32 study is to examine the sign tracking and goal tracking behaviors of rats when different doses of Escitalopram are administered to them. We hypothesize that sign tracking behaviors will decrease when Escitalopram is administered. Subjects are 31 male Sprague Dawley rats. Sign and goal tracking behaviors are measured using operant chambers. Upon analyzing the data with a repeated measures ANOVA, we found that among the strongest sign trackers, administration of escitalopram reduced their sign tracking as hypothesized. Implications of these findings can be applied to drug addiction rehabilitation and relapse in humans. Further research needs to be done, but SSRIs may be an effective adjunctive treatment for drug addiction

Regional and temporal variability in Puget Sound zooplankton: bottom-up links to juvenile salmon

We use data from the Puget Sound Zooplankton Monitoring Program to explore patterns of spatial and interannual variability in zooplankton communities in response to environmental change during 2014-2017. This program is a collaborative effort involving 10 tribal, county, state, federal, academic, and nonprofit entities initiated via the Salish Sea Marine Survival Project with the goal of understanding the key role of zooplankton in food webs and ecosystems. Large interannual differences in the environment over this period strong effects on zooplankton community structure and abundance. 2014 began as a fairly normal year in Puget Sound until the Pacific Warm Anomaly event nicknamed “The Blob” began to affect the region during late summer and fall. Unprecedented warm anomalies occurred in summer 2015, persisting through 2016. Off the coast of Washington and Oregon, clear effects on zooplankton community structure were observed, with rare oceanic species occurring in coastal samples concurrent with decreased overall biomass. In sharp contrast, few rare species were collected in Puget Sound, and zooplankton increased in 2015 and 2016 relative to 2014, including increases in nearly all taxa that are important juvenile salmon prey. A few taxa, most notably the dinoflagellate Noctiluca and numerous species of small jellyfish, decreased during the warm years, and shifts in the seasonal phenology of some taxa were observed. These and other findings from the Puget Sound Zooplankton Monitoring Program will be presented in the context of the implications of environmental change for juvenile salmon growth and survival

Bioelectrical Impedance Analysis Overestimates Fat-Free Mass in Breast Cancer Patients Undergoing Treatment

Background: Bioelectrical impedance analysis (BIA) is commonly used to assess fat-free mass (FFM) and fat mass (FM) in breast cancer patients. However, because of the prevalence of overweight, obesity and variable hydration status in these patients, assumptions for existing prediction equations developed in healthy adults may be violated, resulting in inaccurate body composition assessment. Methods:We measured whole-body FFM using single-frequency BIA (50 kHz) and dual-energy x-ray absorptiometry (DXA) in 48 patients undergoing treatment for breast cancer.We applied raw BIA data to 18 previously published FFM prediction equations (FFMBIA) and compared these estimates to DXA (FFMDXA; reference method). Results: On average, patients were 52 ± 10 (mean ± SD) years of age and overweight (body mass index: 27.5 ± 5.5 kg/m2; body fat by DXA: 40.1% ± 6.6%). Relative to DXA, BIA overestimated FFM by 4.1 ± 3.4 kg (FFMDXA: 42.0 ± 5.9 kg; FFMBIA: 46.1 ± 3.4 kg). Individual equation-generated predictions of FFMBIA ranged from 39.6 ± 6.7 to 52.2 ± 5.6 kg, with 16 equations overestimating and 2 equations underestimating FFMBIA compared with FFMDXA. Based on equivalence testing, no equation-generated estimates were equivalent to DXA. Conclusion: Compared with DXA, BIA overestimated FFM in breast cancer patients during treatment. Although several equations performed better than others, none produced values that aligned closely with DXA. Caution should be used when interpreting BIA measurements in this clinical population, and future studies should develop prediction equations specific to breast cancer patients. (Nutr Clin Pract. 2019;00:1–12)Financial disclosure: This work was funded by a Canadian Institutes of Health Research grant, an Ontario Ministry of Research and Innovation Early Researcher Award, and the Canadian Foundation for Innovation (all to M. Mourtzakis)

Glycemic Control for Colorectal Cancer Survivors Compared to Those without Cancer in the Dutch Primary Care for Type 2 Diabetes:A Prospective Cohort Study

SIMPLE SUMMARY: A growing number of colorectal cancer survivors live with type 2 diabetes, as a result of improved cancer diagnosis and treatment. These patients might have worse glycemic control after their cancer diagnosis, which may increase the risk of cardiovascular diseases. This prospective cohort study evaluated the quality of glycemic control for colorectal cancer survivors, as compared to those without cancer in Dutch primary care for diabetes. During a 10-year follow-up for 57,330 patients, there were 705 patients diagnosed with colorectal cancer. No clinically relevant difference on the probability of reaching the target HbA1c was observed between colorectal cancer survivors and patients with no history of cancer. These results showed a robust diabetes care system, implying that the glycemic control for colorectal cancer survivors can be delegated to the primary care professionals. ABSTRACT: Cancer survivors with diabetes tend to have worse glycemic control after their cancer diagnosis, which may increase the risk of cardiovascular diseases. We aimed to investigate whether glycemic control differs between colorectal cancer (CRC) survivors and those without cancer, among patients with type 2 diabetes being treated in the Dutch primary care. The Zwolle Outpatient Diabetes project Integrating Available Care database was linked with the Dutch Cancer Registry (n = 71,648, 1998–2014). The cases were those with stage 0–III CRC, and the controls were those without cancer history. The primary and secondary outcomes were the probability of reaching the glycated hemoglobin (HbA1c) target and the mean of HbA1c during follow-up, respectively. Mixed linear modeling was applied, where the status of CRC was a time-varying variable. Among the 57,330 patients included, 705 developed CRC during follow-up. The mean probability of reaching the HbA1c target during follow-up was 73% versus 74% (p = 0.157) for CRC survivors versus those without cancer, respectively. The mean HbA1c was 51.1 versus 50.8 mmol/mol (p = 0.045) among CRC survivors versus those without cancer, respectively. We observed a clinically comparable glycemic control among the CRC survivors without cancer, indicating that glycemic control for CRC survivors can be delegated to primary care professionals

Measurement of psychological entitlement in 28 countries

This article presents the cross-cultural validation of the Entitlement Attitudes Questionnaire, a tool designed to measure three facets of psychological entitlement: active, passive, and revenge entitlement. Active entitlement was defined as the tendency to protect individual rights based on self-worthiness. Passive entitlement was defined as the belief in obligations to and expectations toward other people and institutions for the fulfillment of the individual’s needs. Revenge entitlement was defined as the tendency to protect one’s individual rights when violated by others and the tendency to reciprocate insults. The 15-item EAQ was validated in a series of three studies: the first one on a general Polish sample (N = 1,900), the second one on a sample of Polish students (N = 199), and the third one on student samples from 28 countries (N = 5,979). A three-factor solution was confirmed across all samples. Examination of measurement equivalence indicated partial metric invariance of EAQ for all national samples. Discriminant and convergent validity of the EAQ was also confirmed

Selective serotonin reuptake inhibitor prescribing before, during and after pregnancy:a population-based study in six European regions

Objective To explore the prescribing patterns of selective serotonin reuptake inhibitors (SSRIs) before, during and after pregnancy in six European population-based databases. Design Descriptive drug utilisation study. Setting Six electronic healthcare databases in Denmark, the Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Population All women with a pregnancy ending in a live or stillbirth starting and ending between 2004 and 2010. Methods A common protocol was implemented across databases to identify SSRI prescriptions issued (UK) or dispensed (non-UK) in the year before, during or in the year following pregnancy. Main outcome measures The percentage of deliveries in which the woman received an SSRI prescription in the year before, during or in the year following pregnancy. We also compared the choice of SSRIs and changes in prescribing over the study period. Results In total, 721 632 women and 862 943 deliveries were identified. In the year preceding pregnancy, the prevalence of SSRI prescribing was highest in Wales [9.6%; 95% confidence interval (CI95), 9.4-9.8%] and lowest in Emilia Romagna (3.3%; CI95, 3.2-3.4%). During pregnancy, SSRI prescribing had dropped to between 1.2% (CI95, 1.1-1.3%) in Emilia Romagna and 4.5% (CI95, 4.3-4.6%) in Wales. The higher UK pre-pregnancy prescribing rates resulted in higher first trimester exposures. After pregnancy, SSRI prescribing increased most rapidly in the UK. Paroxetine was more commonly prescribed in the Netherlands and Italian regions than in Denmark and the UK. Conclusions The higher SSRI prescribing rates in the UK, compared with other European regions, raise questions about differences in the prevalence and severity of depression and its management in pregnancy across Europe. Keywords Drug utilisation, electronic health records, pregnancy, serotonin uptake inhibitors