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Het CPT is een onafhankelijk comité ingesteld in het kader van de Raad van Europa, dat bevoegd is plaatsen te bezoeken waar personen van overheidswege van hun vrijheid beroofd worden vastgehouden. Naar aanleiding van zo’n inspectiebezoek rapporteert het CPT aan de betrokken lidstaat en doet het waar nodig aanbevelingen de geconstateerde detentiesituatie in dat land te verbeteren. Dit alles ter voorkoming van foltering en onmenselijke of vernederende behandeling of bestraffing.
De centrale onderzoekvraag in deze dissertatie is wat de invloed is van het werk van het CPT voor de wijze waarop gedetineerden in Nederland worden vastgehouden
Correction to: Durability of treatment effects of the sleep position trainer versus oral appliance therapy in positional OSA
The article “Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial”, written by Maurits H. T. de Ruiter, Linda B. L. Benoist, Nico de Vries, and Jan de Lange, was originally published electronically on the publisher’s internet portal SpringerLink on 15 September 2017 without open access.
With the authors’ decision to opt for Open Choice the copyright of the article changed on October 2017 to © The Author(s) 2017 and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made
Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA
__Purpose:__ The Sleep Position Trainer (SPT) is a new option for treating patients with positional obstructive sleep apnea (POSA). This study investigated long-term efficacy, adherence, and quality of life during use of the SPT device compared with oral appliance therapy (OAT) in patients with POSA.
__Methods:__ This prospective, multicenter trial randomized patients with mild to moderate POSA (apnea-hypopnea index [AHI] 5–30/h) to SPT or OAT. Polysomnography was performed at baseline and after 3 and 12 months’ follow-up. The primary endpoint was OSA severity; adherence, quality of life, and adverse events were also assessed.
__Results:__ Ninety-nine patients were randomized and 58 completed the study (29 in each group). Median AHI in the SPT group decreased from 13.2/h at baseline to 7.1/h after 12 months; corresponding values in the OAT group were 13.4/h and 5.0/h, with no significant between-group difference. Improvements throughout the study were maintained at 12 months. Long-term median adherence was also similar in the two treatment groups; the proportion of patients who used their device for ≥ 4 h for 5 days in a week was 100% in the SPT group and 97.0% in the OAT group.
__Conclusions:__ The efficacy of SPT therapy was maintained over 12 months and was comparable to that of OAT in patients with mild to moderate POSA. Adherence was relatively high, and similar in the two groups.
Trial registration: _www.clinicaltrials.gov(NCT02045576).
Anti-inflammatory actions of acupuncture.
Acupuncture has a beneficial effect when treating many diseases and painful conditions, and therefore is thought to be useful as a complementary therapy or to replace generally accepted pharmacological intervention. The attributive effect of acupuncture has been investigated in inflammatory diseases, including asthma, rhinitis, inflammatory bowel disease, rheumatoid arthritis, epicondylitis, complex regional pain syndrome type 1 and vasculitis. Large randomised trials demonstrating the immediate and sustained effect of acupuncture are missing. Mechanisms underlying the ascribed immunosuppressive actions of acupuncture are reviewed in this communication. The acupuncture-controlled release of neuropeptides from nerve endings and subsequent vasodilative and anti-inflammatory effects through calcitonine gene-related peptide is hypothesised. The complex interactions with substance P, the analgesic contribution of beta-endorphin and the balance between cell-specific pro-inflammatory and anti-inflammatory cytokines tumour necrosis factor-alpha and interleukin-10 are discussed
Evaluation of blood-brain barrier transport and CNS drug metabolism in diseased and control brain after intravenous L-DOPA in a unilateral rat model of Parkinson's disease
Abstract Background Changes in blood-brain barrier (BBB) functionality have been implicated in Parkinson's disease. This study aimed to investigate BBB transport of L-DOPA transport in conjunction with its intra-brain conversion, in both control and diseased cerebral hemispheres in the unilateral rat rotenone model of Parkinson's disease. Methods In Lewis rats, at 14 days after unilateral infusion of rotenone into the medial forebrain bundle, L-DOPA was administered intravenously (10, 25 or 50 mg/kg). Serial blood samples and brain striatal microdialysates were analysed for L-DOPA, and the dopamine metabolites DOPAC and HVA. Ex-vivo brain tissue was analyzed for changes in tyrosine hydroxylase staining as a biomarker for Parkinson's disease severity. Data were analysed by population pharmacokinetic analysis (NONMEM) to compare BBB transport of L-DOPA in conjunction with the conversion of L-DOPA into DOPAC and HVA, in control and diseased cerebral hemisphere. Results Plasma pharmacokinetics of L-DOPA could be described by a 3-compartmental model. In rotenone responders (71%), no difference in L-DOPA BBB transport was found between diseased and control cerebral hemisphere. However, in the diseased compared with the control side, basal microdialysate levels of DOPAC and HVA were substantially lower, whereas following L-DOPA administration their elimination rates were higher. Conclusions Parkinson's disease-like pathology, indicated by a huge reduction of tyrosine hydroxylase as well as by substantially reduced levels and higher elimination rates of DOPAC and HVA, does not result in changes in BBB transport of L-DOPA. Taking the results of this study and that of previous ones, it can be concluded that changes in BBB functionality are not a specific characteristic of Parkinson's disease, and cannot account for the decreased benefit of L-DOPA at later stages of Parkinson's disease.</p
Decreased ligand affinity rather than glucocorticoid receptor down-regulation in patients with endogenous Cushing's syndrome
OBJECTIVE: Glucocorticoids (GCs) serve a variety of important functions
throughout the body. The synthesis and secretion of GCs are under the
strict influence of the hypothalamo-pituitary-adrenal axis. The mechanisms
of action of GCs are mediated by the intracellular glucocorticoid receptor
(GR). Over the years, many studies have been performed concerning th
Bromine counts from XRF scanning as an estimate of the marine organic carbon content of sediment cores
XRF sediment core scanning technology is increasingly used to quantify sediment composition. The overall good correlation between biophilic halogen bromine (Br) and sedimentary total organic carbon (TOC) potentially allows the fast estimation of down core TOC profiles by XRF scanning. In order to test this approach we present data from the Arabian Sea and a Mediterranean brine basin, comparing XRF core scanning Br data with discrete sample TOC analyses. Overall, Br counts and TOC show a clear correlation, except when stable carbon isotope and C/N data indicate intervals characterized by enhanced input of terrestrial organic matter. Hence, solid phase Br is exclusively associated with marine organic matter (MOC) and can be used as a direct estimate of this parameter after a calibration is established. High pore water Br in the brine core steepens the Br/TOC correlation but after salt correction shows a nearly identical gradient to that of the Arabian Sea cor
Human adrenocorticotropin-secreting pituitary adenomas show frequent loss of heterozygosity at the glucocorticoid receptor gene locus
Corticotropinomas are characterized by a relative resistance to the
negative feedback action of cortisol on ACTH secretion. In this respect
there is a similarity with the clinical syndrome of cortisol resistance.
As cortisol resistance can be caused by genetic abnormalities in the
glucocorticoid receptor (GR) gene, we investigated whether the
insensitivity of corticotropinomas to cortisol is also caused by de novo
mutations in the GR gene. We screened for the GR gene in leukocyte and
tumor DNA from 22 patients with Cushing's disease for mutations using
PCR/single strand conformation polymorphism analysis. In a previous study,
we identified 5 polymorphisms in the GR gene in a normal population. These
polymorphisms were used as markers for the possible occurrence of loss of
heterozygosity (LOH) at the GR gene locus. Except for 1 silent point
mutation, we did not identify novel mutations in the GR gene in leukocytes
or corticotropinomas from these patients. Of the 22 patients, 18 were
heterozygous for at least 1 of the polymorphisms. In 6 of these patients,
LOH had occurred in the tumor DNA. Of 21 patients examined for LOH on
chromosome 11q13, only 1, with a corticotroph carcinoma, showed allelic
deletion. As controls we studied 28 pituitary tumors of other subtypes (11
clinically nonfunctioning, 8 prolactinomas, and 9 GH-producing adenomas)
and found evidence for LOH in only 1 prolactinoma. In six patients LOH was
found at the GR gene locus (chromosome 5) in DNA derived from adenoma
cells. Our observations indicate for the first time that LOH at the GR
gene locus is a relatively frequent phenomenon in pituitary adenomas of
patients with Cushing's disease. This might explain the relative
resistance of the adenoma cells to the inhibitory feedback action of
cortisol on ACTH secretion. The specificity of the GR LOH to
corticotropinomas supports this concept. Somatic mutations of the GR are
not a frequent cause of relative cortisol resistance in these cells
Sensing remote nuclear spins
Sensing single nuclear spins is a central challenge in magnetic resonance
based imaging techniques. Although different methods and especially diamond
defect based sensing and imaging techniques in principle have shown sufficient
sensitivity, signals from single nuclear spins are usually too weak to be
distinguished from background noise. Here, we present the detection and
identification of remote single C-13 nuclear spins embedded in nuclear spin
baths surrounding a single electron spins of a nitrogen-vacancy centre in
diamond. With dynamical decoupling control of the centre electron spin, the
weak magnetic field ~10 nT from a single nuclear spin located ~3 nm from the
centre with hyperfine coupling as weak as ~500 Hz is amplified and detected.
The quantum nature of the coupling is confirmed and precise position and the
vector components of the nuclear field are determined. Given the distance over
which nuclear magnetic fields can be detected the technique marks a firm step
towards imaging, detecting and controlling nuclear spin species external to the
diamond sensor
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