Human placental lactogen en alfa-foetoproteine in serum van zwangeren :een klinisch onderzoek in de tweede helft van de zwangerschap

"Het ideaal van de verloskunde bestaat uit het toevoegen aan de mensheid van een gezond kind, met behoud van de gezondheid van de moeder, als resultaat van iedere zwangerschap" (Holmer, 1956). In de moderne verloskunde draagt de prenatale zorg in zeer belangrijke mate bij aan de verwerkelijking van dit ideaal. Het doel van de prenatale zorg is het opsporen, herkennen en zo mogelijk behandelen van storingen in het fysiologische verloop van de zwangerschap. De hoeksteen van de prenatale zorg wordt nog steeds gevormd door het door iedere verloskundige uit te voeren manuele en auscultatoire verloskundige onderzoek, het bepalen van de bloeddruk en het gewicht van de zwangere, en het eenvoudige biochemische onderzoek van bloed en urine. Daarnaast zijn in de afgelopen 20 jaar in snelle opeenvolging biochemische en fysische methoden ter beschikking gekomen voor evaluatie van de toestand van de foetus en foetoplacentaire eenheid. Sinds ongeveer 1970 staat van de biochemische methoden de bepaling van Human Placental Lactogen (HPL) in moederlijk plasma of serum sterk in de belangstelling. Deze belangstelling is zeker ook gestimuleerd door het in de handel komen van complete pakketten (Kits) voor de radioimmunologische bepaling van dit in de syncytiatrafoblast gevormde eiwithormoon. Hierdoor is deze bepaling binnen het bereik van een groot aantal laboratoria gekomen. In een aantal publicaties (Letchworth e.a., 1972a; Yates, 1973 en England e.a., 1974) wordt zelfs gesuggereerd dat hiermee een mogelijkheid zou zijn gegeven om elke zwangerschap met behulp van deze relatief eenvoudige bepaling te "screenen" op het bestaan van (nog) niet ontdekte placentaire insufficientie en/of foetale nood. England e.a. (,1974) spreken zelfs van "HPL: the wateh-dog of fetal distress" Hetzelfde geldt mutatis mutandis, zij het minder uitgesproken, voor de bepaling van de concentratie van Alfa-foetoproteine (AFP) in moederlijk plasma of serum. Dit alfaglobuline wordt gevormd in de foetale lever en komt via de placenta in vrij geringe hoeveelheid in de moederlijke circulatie. De HPL-concentratie zou dus een maat kunnen zijn voor de functie van de placenta, het AFP-gehalte voor de toestand van de foetus

Galactic Plane Hα\alpha Surveys: IPHAS & VPHAS+

The optical Galactic Plane H$\alpha$ surveys IPHAS and VPHAS+ are dramatically improving our understanding of Galactic stellar populations and stellar evolution by providing large samples of stars in short lived, but important, evolutionary phases, and high quality homogeneous photometry and images over the entire Galactic Plane. Here I summarise some of the contributions these surveys have already made to our understanding of a number of key areas of stellar and Galactic astronomy.Comment: 5 pages, 2 figures, refereed proceeding of the "The Universe of Digital Sky Surveys" conference, November 2014, to be published in the Astrophysics and Space Science Proceeding

Arbeidsvoorwaardenvorming in het onderwijs: een vergelijking tussen Nederland en Vlaanderen

Hervorming Sociale Regelgevin

A 3D extinction map of the northern Galactic plane based on IPHAS photometry

This article has been accepted for publication in Monthly Notices of the Royal Astronomical Society. ©: 2014 The Author(s). Published by Oxford University Press on behalf of the Royal Astronomical Society. All rights reserved.We present a 3D map of extinction in the northern Galactic plane derived using photometry from the INT/WFC Photometric Hα Survey of the northern Galactic plane. The map has fine angular (~10 arcmin) and distance (100 pc) sampling allied to a significant depth (≳5 kpc). We construct the map using a method based on a hierarchical Bayesian model described in a previous article by Sale. In addition to mean extinction, we also measure differential extinction, which arises from the fractal nature of the interstellar medium, and show that it will be the dominant source of uncertainty in estimates of extinction to some arbitrary position. The method applied also furnishes us with photometric estimates of the distance, extinction, effective temperature, surface gravity, and mass for ~38 million stars. Both the extinction map and the catalogue of stellar parameters are made publicly available via http://www.iphas.org/extinction.Peer reviewe

Photometry of K2 Campaign 9 bulge data

In its Campaign 9, K2 observed dense regions toward the Galactic bulge in order to constrain the microlensing parallaxes and probe for free-floating planets. Photometric reduction of the \emph{K2} bulge data poses a significant challenge due to a combination of the very high stellar density, large pixels of the Kepler camera, and the pointing drift of the spacecraft. Here we present a new method to extract K2 photometry in dense stellar regions. We extended the Causal Pixel Model developed for less-crowded fields, first by using the pixel response function together with accurate astrometric grids, second by combining signals from a few pixels, and third by simultaneously fitting for an astrophysical model. We tested the method on two microlensing events and a long-period eclipsing binary. The extracted K2 photometry is an order of magnitude more precise than the photometry from other method

Determinants of first prescription of hormone replacement therapy. A follow-up study among 1689 women aged 45-60 years

The aim of the present study was to ascertain the cumulative incidence of first hormone replacement therapy (HRT) and the factors that predict its prescription. In a general population 1689 women were followed for 9 months in order to trace first HRT prescriptions. Determinants (well-being, attitude towards menopause, menopausal status and another 9 variables) were measured by means of a questionnaire. Data analyses were performed for all women and for women with or without typical climacteric complaints. The cumulative 9 month incidence of HRT was 6.2%. For women without typical complaints a lower level of well-being (odds ratio 5.5; 95% Cl 1.9–15.5) and the former use of the contraceptive pill (odds ratio 4.6; 95% CI 1.0–20.5) were independently associated with HRT prescription. For women with typical complaints a positive attitude towards ‘menopause should be treated' (odds ratio 3.8; 95% Cl 1.8–8.0) was a determinant of HRT prescription. The cumulative incidence of HRT prescription is high, but from additional data it is apparent that within a period of 1 year and 9 months the majority of women stop taking HRT. For women without typical complaints, physicians prescribe HRT five times more often to those with a lower level of well-being. For women with typical complaints the physician's prescription is primarily related to the woman's attitude towards (medical) treatment of the menopause

Vasomotor symptoms and well-being in the climacteric years

Objectives: To determine more closely the relationship between vasomotor symptoms, well-being and climacteric status according to the last menstrual bleeding and according to the women themselves. Methods: A population-based cross-sectional study was executed using a postal questionnaire. Well-being of women with and without vasomotor symptoms was compared, for the different menopausal statuses. All 2729 women living in a commuter suburb of Rotterdam aged 45-60 years were approached of whom 1947 (71.3%) responded. Well-being was measured by the Inventory of Subjective Health (ISH) and three subscales of the Sickness Impact Profile (SIP). Results: The results showed that the relationship between vasomotor symptoms and well-being was dependent on climacteric status. Pre- and (middle and late) postmenopausal women with vasomotor symptoms more often experienced a relatively lower level of well- being compared to women without these symptoms. However, when the prevalence of vasomotor symptoms is as its peak, i.e. in late perimenopause, a difference in the level of well-being between women with and without vasomotor symptoms was absent. Conclusions: It is concluded that well-being and vasomotor symptoms were inversely related in all menopausal statuses except for the (late) perimenopausal phase. For this no somatic explanation seems plausible. A more social scientific explanation is suggested

Duration of hormonal replacement therapy in general practice; a follow- up study

Objectives: To assess the mean duration of use of HRT in general practice and to identify determinants of the duration of HRT use. Methods: A general population of 1689 women aged 45-60 years and enlisted in five group practices of general practitioners were followed for 9 months to trace first HRT prescriptions. All 103 women who were prescribed HRT were followed for a period of 2.25 years. Duration of HRT was assessed by using the data provided on the dispensing of HRT. Possible determinants of duration of use, such as attitude towards menopause, menopausal status and another six variables were measured by means of a questionnaire. Results: None of the 103 women received HRT for a preventive purpose; the main indication was menopausal complaints. More than 60% of the women stopped their HRT within 6 months and only 8% of the women remained on HRT for more than 2 years. The mean duration of use was 7 months. Determinants that significantly predicted the duration of HRT use were age, attitude towards treatment of the menopause and the group practice. Conclusions: The mean duration of HRT use is very short, despite the fact that the most prevalent indication is the alleviation of menopausal symptoms. Apparently, Dutch women are presently unwilling to take HRT for longer periods