Quality of life, developmental milestones, and self-esteem of young adults with congenital hypothyroidism diagnosed by neonatal screening

Contains fulltext : 71281.pdf (publisher's version ) (Closed access)CONTEXT: With advances in the treatment of congenital hypothyroidism (CH), the neuropsychological functioning of CH patients is considerably improved. Although much is written about cognitive and motor development, little is known about emotional and social consequences for patients growing up with CH, diagnosed by neonatal screening. OBJECTIVES: The objectives of the study were to: 1) compare health-related quality of life (HRQoL), developmental milestones also called course of life (CoL), sociodemographical outcomes, and self-esteem of CH patients with the general population; and 2) explore whether severity of CH was related to these outcomes. DESIGN/SETTING/PATIENTS: A total of 69 young adults with CH, born in The Netherlands in 1981-1982, completed the "TNO-AZL Questionnaire for Adult's Health related Quality of Life" questionnaire, the CoL survey (developmental milestones and sociodemographical outcomes), and a self-esteem questionnaire. MAIN OUTCOME MEASURES: HRQoL, CoL, social demographical outcomes, and self-esteem in young adults with CH were determined. RESULTS: CH patients are more often at risk for HRQoL impairment and reported lower HRQoL on several domains (cognitive functioning, P < 0.0001; sleeping, P < 0.004; pain, P < 0.0001; daily activities, P < 0.004; vitality, P < 0.0001; aggressiveness, P < 0.0001; and depressive moods, P < 0.0001) compared with healthy adults. Patients reported a lower self-esteem (P < 0.005) and had a delayed CoL on the domain of social development (P < 0.016). There were no significant within-group differences between the severity groups for HRQoL, CoL, and self-esteem. CONCLUSIONS: Negative consequences in terms of HRQoL, development, and self-esteem are prevalent in young adults with CH. Health care physicians should be attentive to these consequences and provide additional support (emotional and educational guidance) if necessary

Health- related quality of life and self-worth in 10-year old children with congenital hypothyroidism diagnosed by neonatal screening

Contains fulltext : 108082.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Much is written about cognitive and motor development; less is known about social and emotional consequences of growing up with congenital hypothyroidism (CH).The objectives of the study were: (1) to compare health related quality of life (HRQoL) and self-worth of 10 year old patients with CH with the general population; (2) to explore associations of disease factors, IQ and motor skills with the outcomes. METHODS: Children with CH and their parents completed several questionnaires. Patients were classified to 'severe CH, n = 41' or 'moderate/mild CH, n = 41' based on pre-treatment FT4 concentration.Differences between CH and the general population were tested by analysis of covariance and one sample t-tests (mean scale scores HRQoL and self-worth), chi-square tests and binomial tests (% at risk of impaired HRQoL and self-worth). Linear regression analyses corrected for gender were conducted to explore associations of the outcomes with disease factors, IQ and motor skills. RESULTS: Patients with CH reported lower mean HRQoL on motor, cognitive and social functioning, and on autonomy and positive emotions (p < 0.0001). Patients were also more often at risk for impaired HRQoL and self-worth. No differences were found between the severity groups. Lower IQ was only significant associated with worse cognitive HRQoL. Initial FT4 plasma, age at onset of therapy, initial T4 dose and motor skills were not significantly associated with HRQoL and self-worth. CONCLUSIONS: Negative consequences in terms of HRQoL and self-worth are prevalent in children with CH, independent of disease factors, IQ and motor skills. Physicians should to be attentive to these consequences and provide attention and supportive care

Numerical modelling of physical processes governing larval transport in the southern North Sea

A three-dimensional hydrodynamic model (GETM) was coupled with a particle tracking routine (GITM) to study the inter-annual variability in transport paths of particles in the North Sea and English Channel. For validation, a comparison with observed drifter trajectories is also presented here. This research investigated to what extent variability in the hydrodynamic conditions alone (reflecting passive particle transport) contributed to inter-annual variability in the transport of eggs and larvae. In this idealised study, no a priori selection of specific spawning grounds or periods was made and no active behaviour (vertical migration) or mortality was included. In this study, egg and larval development towards coastal nursery areas was based solely on sea water temperature, while settlement areas were defined by a threshold water depth. Results showed strong inter-annual variability in drift direction and distance, caused by a combination of wind speed and direction. Strong inter-annual variability was observed both in absolute amount of settlement in several coastal areas, and in the relative importance of the different areas. The effects of wind and temperature variability are minor for settlement along the western shores of the North Sea and in the English Channel, but have a very significant impact on settlement along the eastern shores of the North Sea. Years with strong south-westerly winds across the Dover Straight resulted in higher settlement figures along its eastern shores of the North Sea (standard deviation 37% of the mean annual settlement value). Settlement in the western Dutch Wadden Sea did not only show inter-annual variability, but patterns were also variable within each year and revealed seasonal changes in the origin of particles: during winter, stronger currents along with colder temperatures generally result in particles originating from further away

Adjuvant treatment in colorectal cancer

British Journal of Cancer (2002) 86, 1525–1526. DOI: 10.1038/sj/bjc/6600280 www.bjcancer.co

Intellectual and motor development of young adults with congenital hypothyroidism diagnosed by neonatal screening

Contains fulltext : 35756.pdf (publisher's version ) (Open Access)CONTEXT: Long-term follow-up data on cognitive and motor functioning in adult patients with congenital hypothyroidism, diagnosed by neonatal screening, are scarce. Hence, it is still unclear whether the frequently reported cognitive and motor deficits observed during childhood persist in adulthood. OBJECTIVE: The objective of this study was to examine cognitive and motor functioning in young adults with congenital hypothyroidism, born in the first 2 yr after the introduction of the Dutch neonatal screening program. DESIGN/SETTING/PATIENTS: Seventy patients were tested (mean age, 21.5 yr); 49 of them were previously tested at 9.5 yr. The median age at the start of treatment was 28 d (range, 4-293 d). Congenital hypothyroidism was classified as severe, moderate, or mild, according to pretreatment T(4) concentrations. MAIN OUTCOME MEASUREMENT: The main outcome measurement was the influence of the severity of congenital hypothyroidism and age at which T(4) supplementation was started on cognitive and motor outcome. RESULTS: Patients, particularly those with severe congenital hypothyroidism, had significantly higher (i.e. worse) motor scores (total score, 7.8; ball skills, 2.0; balance, 4.1) compared with controls (total score, 3.2; ball skills, 0.7; balance, 1.1), and lower full-scale (95.8), verbal (96.4), and performance (95.6) intelligence quotient (IQ) scores than the normal population. No significant change in IQ from childhood to adulthood was found, and for the majority of patients, motor score classification remained the same. The severity of congenital hypothyroidism, but not the starting day of treatment, was correlated with IQ and motor scores. CONCLUSIONS: It is concluded that the severity of congenital hypothyroidism, but not the timing of treatment initiation, is an important factor determining long-term cognitive and motor outcome. Clearly, detrimental effects on developmental outcome in patients with congenital hypothyroidism persist over time

Bewonersparticipatie in het openbaar groenbeheer : 'State of the art' na vijf jaar zelfbeheer in de wijk EVA-Lanxmeer (Culemborg)

De wijk EVA-Lanxmeer (1997) is een duurzame woon- en werkwijk in Culemborg, op een grondwaterwingebied van Vitens. Het is een voorbeeldproject op het gebied van duurzame stedenbouw en participatief beleid. Het wordt door gemeenten en groepen burgers in binnen- en buitenland gebruikt om inspiratie, kennis en ervaring op te doen en uit te wisselen op het gebied van innovatief denken binnen de eigen gemeentelijke organisatie. Bewoners onderhouden zelf een belangrijk deel van het wijkgroen op een ecologische wijze. Zij doen dat in samenwerking en overleg met de gemeente Culemborg en Waterwinbedrijf Vitens. De meeste bewoners hebben sterk het gevoel dat het zelfbeheer de kwaliteit en diversiteit van het groen in de wijk verhoogt. De gezamenlijke werkzaamheden maken ongedwongen ontmoetingen met andere bewoners in de wijk mogelijk

Photometric Analysis of Recently Discovered Eclipsing Binary GSC 00008-00901

Photometric analysis of $BVR_C$ light curves of newly discovered eclipsing binary GSC 0008-00901 is presented. The orbital period is improved to 0.28948(11) days. Photometric parameters are determined, as well. The analysis yielded to conclusion that system is an over-contact binary of W UMa type with components not in thermal contact. The light curves from 2005 show the presence of a spot on the surface of one of the components, while light curves from 2006 are not affected by maculation.Comment: Accepted for publication in Astrophysics & Space Scienc

Mammographic screening detects low-risk tumor biology breast cancers.

Overdiagnosis of breast cancer, i.e. the detection of slow-growing tumors that would never have caused symptoms or death, became more prevalent with the implementation of population-based screening. Only rough estimates have been made of the proportion of patients that are overdiagnosed and identification of those patients is difficult. Therefore, the aim of this study is to evaluate whether tumor biology can help identify patients with screen-detected tumors at such a low risk of recurrence that they are likely to be overdiagnosed. Furthermore, we wish to evaluate the impact of the transition from film-screen mammography (FSM) to the more sensitive full-field digital mammography (FFDM) on the biology of the tumors detected by each screening-modality. All Dutch breast cancer patients enrolled in the MINDACT trial (EORTC-10041) accrued 2007-2011, who participated in the national screening program (biennial screening ages 50-75) were included (n = 1,165). We calculated the proportions of high-, low- and among those the ultralow-risk tumors according to the 70-gene signature for patients with screen-detected (n = 775) and interval (n = 390) cancers for FSM and FFDM. Screen-detected cancers had significantly more often a low-risk tumor biology (68 %) of which 54 % even an ultralow-risk compared to interval cancers (53 % low-, of which 45 % ultralow-risk (p = 0.001) with an OR of 2.33 (p &lt; 0.0001; 95 % CI 1.73-3.15). FFDM detected significantly more high-risk tumors (35 %) compared to FSM (27 %) (p = 0.011). Aside from favorable clinico-pathological factors, screen-detected cancers were also more likely to have a biologically low-risk or even ultralow-risk tumor. Especially for patients with screen-detected cancers the use of tools, such as the 70-gene signature, to differentiate breast cancers by risk of recurrence may minimize overtreatment. The recent transition in screening-modalities led to an increase in the detection of biologically high-risk cancers using FFDM

Statistical expression deconvolution from mixed tissue samples

Motivation: Global expression patterns within cells are used for purposes ranging from the identification of disease biomarkers to basic understanding of cellular processes. Unfortunately, tissue samples used in cancer studies are usually composed of multiple cell types and the non-cancerous portions can significantly affect expression profiles. This severely limits the conclusions that can be made about the specificity of gene expression in the cell-type of interest. However, statistical analysis can be used to identify differentially expressed genes that are related to the biological question being studied