Sociale ondersteuning en kwaliteit van leven bij patienten met kanker.

In dit proefschrift wordt een onderzoek beschreven waarin de relatie centraal staat tussen stress, sociale steun en kwaliteit van leven bij een patiëntengroep, mensen die kanker hebben, en bij een controlegroep bestaande uit 'gezonde' mensen. ... Zie: Samenvattin

Clinical aspects of cardiac pacing for bradyarrhythmias

Since 1977, technological advances have made it possible, to incorporate a microprocessor in an implantable pacemaker. In 1980, the first devices with a microprocessor became available for patient use. At present, a single chip measuring a few square millimeters, contains more than a million active elements. The development of these micro-circuits is very expensive and therefore economically risky for small and medium sized pacemaker companies. Large investments in funds, design and evaluation time forced the pacemaker industry to employ multi-purpose micro-circuits. Microtechnology renders the feasibility to produce almost fully programmable pacemakers and provide the physician with the ability to adapt the device to specific patients needs. Telemetry functions are bidirectional, from programmer to pacemaker and visa versa. Real time intracardiac electrograms can be analyzed and malfunctions of battery or lead performance can be detected. Telemetry and programming functions have significantly decreased the need for surgical reinterventions. Clearly, microtechnology has created the progression from single-chamber fixed rate stimulation to dual-sensor rate- mediated dual-chamber pacing. Optimal cardiac pacing is critically dependent on the pacing mode, the underlying conduction disturbance and the myocardial function. Predictors of patient survival, hemodynamic and electrophysiological factors and the possibility of an adequate follow-up are factors to be considered for selection of the optimal pacing modality

Sociale ondersteuning en kwaliteit van leven bij patienten met kanker.

In dit proefschrift wordt een onderzoek beschreven waarin de relatie centraal staat tussen stress, sociale steun en kwaliteit van leven bij een patiëntengroep, mensen die kanker hebben, en bij een controlegroep bestaande uit 'gezonde' mensen. ... Zie: Samenvattin

Differential Effects of Neonatal Testosterone Treatment on Aggression in Two Selection Lines of Mice

Selection lines of mice, artificially selected for aggression based upon the attack latency score (ALS), were used. In order to determine the relative contribution of neonatal testosterone (T) in the development of aggression, we vary the plasma-T level in males of both selection lines on the day of birth. At 14 weeks the ALS was measured. Neonatal T treatment results in a reduction of aggression in the long attack latency (LAL) line, whereas aggressive behaviour of the short attack latency (SAL) line is not affected. Both selection lines show reduction in testicular weight, although the total amount of T-producing Leydig cells was not affected. Neonatal T may cause a permanent reduction in aggressive behaviour in the LAL line only, probably due to differential appearance of critical periods. It is suggested that the difference in aggressive behaviour between SAL and LAL selection lines is due to a prenatally determined difference in neonatal T sensitivity of the brain.

Adding a subjective dimension to an ICF-based disability measure for people with multiple sclerosis: development and use of a measure for perception of disabilities

OBJECTIVE: The subjective dimension of disability, the perception of disability, is a dimension missing from the International Classification of Functioning, Disability and Health (ICF), and from health-related quality of life (HRQOL) instruments. However, it is a highly relevant dimension for clinical practice as perceived disability may identify care needs. We therefore developed a measure for this subjective dimension of disability in multiple sclerosis (MS) and examined the contribution of this dimension to QOL. METHOD: A measure named the Multiple Sclerosis Impact Profile-Disability Perception (MSIP-DP) was developed to reflect a person's perception of disabilities reported using the original MSIP-disability (MSIP-D) items. MS patients (n=530) completed both MSIP sections, the medical outcome study short form questionnaire (SF-36), the World Health Organisation Quality Of Life-BREF (WHOQOL-BREF) and questions concerning disease severity. The contribution of disability perception (DP) to QOL in MS was estimated using hierarchical multiple regression analyses after controlling for MS severity. RESULTS: Confirmative factor analysis confirmed the hypothesised disability perception domains that correspond with the related disability domains in the MSIP. DP scales yielded sufficient reliability. DP explained a unique and substantial part of the variance in QOL, particularly the perception of impairments in mental functions. DISCUSSION: Results indicated that the subjective dimension of functioning and health operationalised in the MSIP-DP is a relevant concept in explaining QOL in MS. In clinical practice psychological interventions addressing a patient's perception of disability, particularly of impairments in mental functioning, may contribute to QOL

Submuscular transposition with musculofascial lengthening for persistent or recurrent cubital tunnel syndrome in 34 patients

The two main surgical options for patients with persistent or recurrent cubital tunnel syndrome are subcutaneous and submuscular transposition. We retrospectively analysed the results of 34 patients with recalcitrant cubital tunnel syndrome who underwent submuscular transposition with musculofascial lengthening at our institutions. Of the 34 patients, 21 improved clinically after submuscular transposition with musculofascial lengthening, of which 16 were still satisfied at a mean follow-up of four years. In addition, all articles published between 1974 and January 2015 on subcutaneous and/or submuscular transposition of the ulnar nerve for recalcitrant cubital tunnel syndrome were reviewed. We found that previously published studies on this subject are too heterogeneous to compare. No recommendation can thus be made regarding the surgical technique for persistent or recurrent cubital tunnel syndrome. Our series shows that the musculofascial lengthening technique for submuscular transposition is a good option. More research is needed to compare the different surgical treatments. Level of evidence: IV

Enhanced sensitivity of postsynaptic serotonin-1A receptors in rats and mice with high trait aggression

Individual differences in aggressive behaviour have been linked to variability in central serotonergic activity, both in humans and animals. A previous experiment in mice, selectively bred for high or low levels of aggression, showed an up-regulation of postsynaptic serotonin-1A (5-HT1A) receptors, both in receptor binding and in mRNA levels, in the aggressive line. The aim of this experiment was to study whether similar differences in 5-HT1A receptors exist in individuals from a random-bred rat strain, varying in aggressiveness. In addition, because little is known about the functional consequences of these receptor differences, a response mediated via postsynaptic 5-HT1A receptors (i.e., hypothermia) was studied both in the selection lines of mice and in the randomly bred rats. The difference in receptor binding, as demonstrated in mice previously, could not be shown in rats. However, both in rats and mice, the hypothermic response to the 5-HT1A agonist alnespirone was larger in aggressive individuals. So, in the rat strain as well as in the mouse lines, there is, to a greater or lesser extent, an enhanced sensitivity of postsynaptic 5-HT1A receptors in aggressive individuals. This could be a compensatory up-regulation induced by a lower basal 5-HT neurotransmission, which is in agreement with the serotonin deficiency hypothesis of aggression.