Beeldcommunicatie in de GGZ:onderzoeksrapport over Fase 1 en 2

De geestelijke gezondheidszorg (GGZ) staat, net zoals andere sectoren in de zorg, voor een grote maatschappelijke opgave: er moet fors bezuinigd worden terwijl de kwaliteit van de zorg gehandhaafd moet blijven. Verwacht wordt dat de inzet van beeldcommunicatie in de zorg hieraan een bijdrage kan leveren. Beeldcommunicatie is echter iets dat de zorgverleners “overkomt”: ze zijn er vanuit de genoten opleidingen niet of nauwelijks op toegerust, terwijl ze juist geoefend zijn om subtiele signalen te interpreteren die via beeldcommunicatie niet of veel moeilijker waarneembaar zijn. GGZ-zorgverleners zitten dus klem tussen de maatschappelijke opgave van bezuinigen enerzijds, en de verantwoordelijkheid die ze voelen voor hun cliënten anderzijds

Stronger relation between impairment and manual capacity in the non-dominant hand than the dominant hand in congenital hand differences; Implications for surgical and therapeutic interventions

Objectives To evaluate manual activity capacity (i.e. activity capacity to perform hand activities) and its relation with body functions of the hand and forearm in children with congenital hand differences (CHD) Methods We assessed 10-14 year-old children with CHD (N = 106) using a functional handgrips test. Measurements of body functions included joint mobility and muscle strength. Patient characteristics were hand dominance and severity. Results We found a stronger relation between body functions and manual activity capacity in non-dominant hands than dominant hands. Dominant hands scored significantly higher on manual activity capacity than nondominant hands that were similarly impaired at body functions level. Severity of the CHD and body functions had only small effects on manual activity capacity. Conclusion The relation between body functions and manual activity capacity is stronger in non-dominant hands than dominant hands, indicating that improvement in body functions lead to larger changes in manual activity capacity in the non-dominant hand. This may suggest that in bilaterally-affected children surgery should be done at the non-dominant hand first since this hand would benefit most from surgery-induced body functions improvement

High INDO (indoleamine 2,3-dioxygenase) mRNA level in blasts of acute myeloid leukemic patients predicts poor clinical outcome

Indoleamine 2,3-dioxygenase degrades the amino acid tryptophan which is essential for T cells. Tryptophan depletion causes T-cell cycle arrest and solid tumors that express high levels of indoleamine 2,3-dioxygenase can create immune suppression. Recently, blasts of patients with acute myeloid leukemia were shown to express indoleamine 2,3-dioxygenase. We determined INDO (encoding gene for indoleamine 2,3-dioxygenase) mRNA expression in leukemic blasts of 286 patients with acute myeloid leukemia by gene-expression profiling. Results were validated by quantitative polymerase chain reaction analysis in blasts of an independent cohort of 71 patients. High INDO expression was correlated to significantly shortened overall and relapse-free survival. Correlation of INDO expression to relevant known prognostic factors and survival identified high INDO expression as a strong negative independent predicting variable for overall and relapse-free survival. Inhibition of indoleamine 2,3-dioxygenase expressed by myeloid leukemic blasts may result in breaking immune tolerance and offers new therapeutic options for patients with acute myeloid leukemia