Identification and prevention of the Lynch syndrome

Colorectal cancer is one of the most common malignancies in the world. A family history of colon cancer has been shown to increase an individual’s risk of developing the disease. Approximately 2-3% of all colorectal cancers occur in the setting of a well described autosomal dominant inherited syndrome: The Lynch syndrome. It is essential to identify individuals at increased risk to offer adequate surveillance programs to prevent the development of tumors or recognize them at an early stage. This thesis gives a laboratory workup of suspected Lynch syndrome, including analysis of tumor tissue by microsatellite instability analysis and immunohistochemistry, and germline DNA analysis. Several aspects of surveillance in Lynch syndrome are described. The appropriate screening interval is discussed and the effect on mortality because of surveillance is shown. Further, we sought to establish whether individuals from dominant families without mismatch repair deficiency are also at increased risk by examining the incidence of advanced neoplasia during surveillance. Finally, the prevalence of the frequency of a positive family history for CRC, within a random cohort among the Dutch population is presented and also the prevalence of adenomas among young individuals at average risk for colorectal cancer is shown.LEI Universiteit LeidenThe Netherlands Organization for Health, Research and Development: ZonMW funded the research described in the thesis.Regulatieprocessen in de basale en klinische gastroenterologi

Штанги для горизонтально направленного бурения

В статті наведено технічні дані про конструкцію та експлуатаційні вимоги до бурових штанг горизонтально спрямованого буріння свердловин

Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study

In both men and women, circulating androgen levels decline with advancing age. Until now, results of several small studies on the relationship between endogenous androgen levels and atherosclerosis have been inconsistent. In the population-based Rotterdam Study, we investigated the association of levels of dehydroepiandrosterone sulfate (DHEAS) and total and bioavailable testosterone with aortic atherosclerosis among 1,032 nonsmoking men and women aged 55 yr and over. Aortic atherosclerosis was assessed by radiographic detection of calcified deposits in the abdominal aorta, which have been shown to reflect intimal atherosclerosis. Relative to men with levels of total and bioavailable testosterone in the lowest tertile, men with levels of these hormones in the highest tertile had age-adjusted relative risks of 0.4 [95% confidence interval (CI), 0.2-0.9] and 0.2 (CI, 0.1-0.7), respectively, for the presence of severe aortic atherosclerosis. The corresponding relative risks for women were 3.7 (CI, 1.2-11.6) and 2.3 (CI, 0.7-7.8). Additional adjustment for cardiovascular disease risk factors did not materially affect the results in men, whereas in women the associations diluted. Men with levels of total and bioavailable testosterone in subsequent tertiles were also protected against progression of aortic atherosclerosis measured after 6.5 yr (SD +/- 0.5 yr) of follow-up (P for trend = 0.02). No clear association between levels of DHEAS and presence of severe aortic atherosclerosis was found, either in men or in women. In men, a protective effect of higher levels of DHEAS against progression of aortic atherosclerosis was suggested, but the corresponding test for trend did not reach statistical significance. In conclusion, we found an independent inverse association between levels of testosterone and aortic atherosclerosis in men. In women, positive associations between levels of testosterone and aortic atherosclerosis were largely due to adverse cardiovascular disease risk factors

The Challenges of Managing Inflammatory Bowel Diseases in Older Patients

Pathophysiology, epidemiology and therapy of agein

A review of mental health treatment dropout by ethnic minority youth

New methods for child psychiatric diagnosis and treatment outcome evaluatio

Dirac gaugino as leptophilic dark matter

We investigate the leptophilic properties of Dirac gauginos in an R--symmetric N=2 supersymmetric model with extended gauge and Higgs sectors. The annihilation of Dirac gauginos to leptons requires no chirality flip in the final states so that it is not suppressed as in the Majorana case. This implies that it can be sizable enough to explain the positron excess observed by the PAMELA experiment with moderate or no boost factors. When squark masses are heavy, the annihilation of Dirac gauginos to hadrons is controlled by their Higgsino fraction and is driven by the $hZ$ and $W^+W^-$ final states. Moreover, at variance with the Majorana case, Dirac gauginos with a non-vanishing higgsino fraction can also have a vector coupling with the $Z$ gauge boson leading to a sizable spin--independent scattering cross section off nuclei. Saturating the current antiproton limit, we show that Dirac gauginos can leave a signal in direct detection experiments at the level of the sensitivity of dark matter searches at present and in the near future.Comment: 24 pages, 10 figures, typos corrected, final version published on JCA

Infant embodiment and interembodiment

This article brings together a range of research and scholarship from various disciplines which have investigated and theorised social and cultural aspects of infants’ bodies within the context of contemporary western societies. It begins with a theoretical overview of dominant concepts of infants’ bodies, including discussion of the concepts of the unfinished body, civility and the Self/Other binary opposition as well as that of interembodiment, drawn from the work of Merleau-Ponty. Then follows discussion of the pleasures and challenging aspects of interembodiment in relation to caregivers’ interactions with infants’ bodies, purity, danger and infant embodiment and lastly practices of surveilling the vulnerable, ‘at risk’ infant body