4 research outputs found
Varens in de Lickebaert
Vanaf eind jaren ’80 van de vorige eeuw zijn grote delen van het buitengebied tussen Maassluis en Vlaardingen (de Lickebaert) bebost. Varens verschenen pas vrij laat in de nieuwe bosjes, achtereenvolgens Dryopteris dilatata (zeer algemeen in Nederland), D. filix-mas (algemeen, zeldzaam in H), Asplenium scolopendrium (zeer zeldzaam buiten Ur), D. carthusiana (zeer algemeen) en Athyrium filix-femina (algemeen). In de winter van 2014–2015 werden Polypodium vulgare (zeer zeldzaam in H) en 14 respectievelijk 5 exemplaren van Polystichum setiferum en P. aculeatum gevonden. Beide Polystichum-soorten zijn zeer zeldzaam in Y, Ur en Z, maar zijn ook van elders gemeld. Dryopteris affinis subsp. affinis en D. a. subsp. borreri (beide zeer zeldzaam) volgden in 2015. Polypodium interjectum (zeldzaam buiten R) werd alleen aangetroffen in de eendenkooi Aalkeetbuiten. Ophioglossum vulgatum (zeer zeldzaam buiten Du) groeit talrijk op de noordflank van de eeuwenoude Maassluisse Dijk. Een circa 70 m2 groot veld Pteridium aquilinum (zeer zeldzaam in onder andere H) staat op een dijkje van de Rietputten. Op muren van het gemaal aan het eind van de Boonervliet groeit Asplenium ruta-muraria (plaatselijk vrij algemeen in Ur). Azolla filiculoides (plaatselijk algemeen in het westen van H) komt voor in verscheidene sloten in het gebied
Associations of life events during pregnancy with longitudinal change in symptoms of antenatal anxiety and depression
Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction
Background: Although self-expandable metal stent (SEMS) placement as bridge to surgery (BTS) in patients with left-sided obstructing colonic cancer has shown promising short-term results, it is used infrequently owing to uncertainty about its oncological safety. This population study compared long-term oncological outcomes between emergency resection and SEMS placement as BTS.Methods: Through a national collaborative research project, long-term outcome data were collected for all patients who underwent resection for left-sided obstructing colonic cancer between 2009 and 2016 in 75 Dutch hospitals. Patients were identified from the Dutch Colorectal Audit database. SEMS as BTS was compared with emergency resection in the curative setting after 1: 2 propensity score matching.Results: Some 222 patients who had a stent placed were matched to 444 who underwent emergency resection. The overall SEMS-related perforation rate was 7.7 per cent (17 of 222). Three-year locoregional recurrence rates after SEMS insertion and emergency resection were 11-4 and 13.6 per cent (P= 0-457), disease-free survival rates were 58-8 and 52.6 per cent (P= 0-175), and overall survival rates were 74-0 and 68-3 per cent (P= 0.231), respectively. SEMS placement resulted in significantly fewer permanent stomas (23.9 versus 45.3 per cent; P < 0-001), especially in elderly patients (29.0 versus 57.9 per cent; P < 0-001). For patients in the SEMS group with or without perforation, 3-year locoregional recurrence rates were 18 and 11.0 per cent (P= 0.432), disease-free survival rates were 49 and 59.6 per cent (P= 0-717), and overall survival rates 61 and 75.1 per cent (P= 0.529), respectively.Conclusion: Overall, SEMS as BTS seems an oncologically safe alternative to emergency resection with fewer permanent stomas. Nevertheless, the risk of SEMS-related perforation, as well as permanent stoma, might influence shared decision-making for individual patients.Research into fetal development and medicin