Aangeboren afwijkingen in Nederland 1996-2006 gebaseerd op de landelijke verloskunde en neonatale registraties

JPB. P&Z

Deregulation of the miRNAs Expression in Cervical Cancer: Human Papillomavirus Implications

MicroRNAs (miRNAs) are a class of small non coding RNAs of 18–25 nucleotides in length. The temporal or short-lived expression of the miRNAs modulates gene expression post transcriptionally. Studies have revealed that miRNAs deregulation correlates and is involved with the initiation and progression of human tumors. Cervical cancer (CC) displays notably increased or decreased expression of a large number of cellular oncogenic or tumor suppressive miRNAs, respectively. However, understanding the potential role of miRNAs in CC is still limited. In CC, the high-risk human papillomaviruses (HR-HPVs) infection can affect the miRNAs expression through oncoprotein E6 and E7 that contribute to viral pathogenesis, although other viral proteins might also be involved. This deregulation in the miRNAs expression has an important role in the hallmarks of CC. Interestingly, the miRNA expression profile in CC can discriminate between normal and tumor tissue and the extraordinary stability of miRNAs makes it suitable to serve as diagnostic and prognostic biomarkers of cancer. In this review, we will summarize the role of the HR-HPVs in miRNA expression, the role of miRNAs in the hallmarks of CC, and the use of miRNAs as potential prognostic biomarkers in CC

Level of agreement between patient self-report and observer ratings of health-related quality of life communication in oncology

Objective: To determine the level of agreement between patients and observers regarding the frequency with which health-related quality of life topics are discussed during outpatient clinical oncology visits. Methods: The sample (n = 50) consisted of a consecutive series of cancer patients undergoing chemotherapy. Both the patients and observers used a checklist to report which HRQL topics had been discussed during the consultation. Percentage of agreement, kappa and adjust-kappa statistics were calculated. Results: The percentage agreement between patients' and observers' ratings was generally high, ranging from 74% for fatigue to 96% for sleep problems and cognitive functioning. The average percentage of agreement over the 13 HRQL topics rated was 86%. Cohen's kappa varied between 0.41 (for pain) and 0.78 (for sleep problems). Prevalence-adjusted kappa's were generally higher, ranging from 0.48 (for fatigue) to 0.92 (for sleep problems and social functioning). The average Cohen's kappa and prevalence-adjusted kappa over the 13 HRQL topics were 0.56 and 0.71, respectively. Level of agreement was not found to vary significantly as a function of patients' background characteristics. Conclusion: Oncology patients' self-reports of the HRQL-related topics discussed during outpatient chemotherapy visits are in reasonably close agreement with those provided by observers. Practice implications: Our results indicate that the patient is a legitimate source of information about the HRQL-related content of medical encounters, and thus can be used in communication studies where the collection of observational data (e.g., via audio- or videotaping) is either too costly or logistically impractical. © 2006 Elsevier Ireland Ltd. All rights reserved. Chemicals / CAS: Antineoplastic Agent

Infertility care in the Netherlands for Turkish and Moroccan migrants: the role of religion in focus

Infertility treatments are difficult to understand, and doubly so for migrants because of religious and language factors. Previous studies showed that religion plays an important role in infertility care for Muslim couples that doctors do not always understand. The data presented here come from two exploratory studies that aimed to identify the main problems with infertility care for Turkish and Moroccan couples living in the Netherlands. In the first study, 105 Turkish, Moroccan and Dutch men and women were interviewed. In the second study, twenty general practitioners, gynaecologists and andrologists were interviewed by telephone. Additionally, three gynaecologists were interviewed in Morocco. A thematic analysis was conducted of the qualitative data. Almost all migrants had experienced problems with infertility treatments because they felt insecure about what was allowed by their religion. Moroccan men in particular doubt whether Dutch doctors are sufficiently acquainted with Islam and so they turn to Morocco for information and advice. Men stick to the rules and their agency is to follow the dictates of their religion. Women seem willing to be more flexible about the rules and navigate their agency. Doctors assumed that they took the religion of their patients into account, but they were not always fully aware of the importance of religious prohibitions. Others failed to take into account the agency of their patients. Conclusion: The situation in a new country challenges couples to shape their own agency in respect of reproductive treatment. Doctors are not always aware of the importance of religious doctrine about infertility treatment