45 research outputs found
Remedial effects of motivational incentive on declining cognitive control in healthy aging and Parkinsonβs disease
Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΠΈΡΡΠ΅ΠΌΡ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΠΏΡΠΈΡ ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π² ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ΅ Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ
ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π² ΠΎΠ±Π»Π°ΡΡΠΈ Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΏΡΠΈΡ
ΠΎΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΊΠΎΡΠΎΡΠΎΠ΅ Π²ΠΊΠ»ΡΡΠ°Π»ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΈΡ
ΠΎΡΠΌΠΎΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ, Π»ΠΈΡΠ½ΠΎΡΡΠ½ΡΡ
ΠΈ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΎΠ½ΠΊΠΎΠ±ΠΎΠ»ΡΠ½ΡΡ
Π΄Π΅ΡΠ΅ΠΉ ΠΈ ΠΈΡ
ΡΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ, ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ ΡΠ΅Π°Π³ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π½Π° ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅, ΡΠ΅ΠΌΠ΅ΠΉΠ½ΠΎΠ΅ ΡΡΠ½ΠΊΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ ΡΠ°ΠΊΡΠΎΡΡ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΡΡΡΠ΅ΡΡΠ° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΠ°Π±ΠΎΡΠ½ΠΈΠΊΠΎΠ² ΠΈ Π²ΠΎΠ»ΠΎΠ½ΡΠ΅ΡΠΎΠ². ΠΠ° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΡΠ΅Π»ΠΎΡΡΠ½Π°Ρ ΡΠΈΡΡΠ΅ΠΌΠ° ΠΌΠ΅Π΄ΠΈΠΊΠΎβΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΎΡΠ΅Π½ΠΊΠ° Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ.ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π΅ Π΄ΠΎΡΠ»ΡΠ΄ΠΆΠ΅Π½Π½Ρ Π² Π³Π°Π»ΡΠ·Ρ Π΄ΠΈΡΡΡΠΎΡ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΡΡ, ΡΠΎ ΠΌΡΡΡΠΈΠ»ΠΎ Π²ΠΈΠ²ΡΠ΅Π½Π½Ρ ΠΏΡΠΈΡ
ΠΎΠ΅ΠΌΠΎΡΡΠΉΠ½ΠΎΠ³ΠΎ ΡΡΠ°Π½Ρ, ΠΎΡΠΎΠ±ΠΈΡΡΡΡΠ½ΠΈΡ
Ρ ΠΏΠΎΠ²Π΅Π΄ΡΠ½ΠΊΠΎΠ²ΠΈΡ
ΠΎΡΠΎΠ±Π»ΠΈΠ²ΠΎΡΡΠ΅ΠΉ ΠΎΠ½ΠΊΠΎΡ
Π²ΠΎΡΠΈΡ
Π΄ΡΡΠ΅ΠΉ ΡΠ° ΡΡ
Π½ΡΡ
Π±Π°ΡΡΠΊΡΠ², ΠΏΠΎΠ²'ΡΠ·Π°Π½ΠΈΡ
ΡΠ· ΡΠ΅Π°Π³ΡΠ²Π°Π½Π½ΡΠΌ Π½Π° ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΡΡΠ½Π΅ Π·Π°Ρ
Π²ΠΎΡΡΠ²Π°Π½Π½Ρ, ΡΡΠΌΠ΅ΠΉΠ½Π΅ ΡΡΠ½ΠΊΡΡΠΎΠ½ΡΠ²Π°Π½Π½Ρ. ΠΠΈΠ·Π½Π°ΡΠ΅Π½ΠΎ ΡΠΈΠ½Π½ΠΈΠΊΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠΉΠ½ΠΎΠ³ΠΎ Π΄ΠΈΡΡΡΠ΅ΡΡ ΠΌΠ΅Π΄ΠΈΡΠ½ΠΈΡ
ΠΏΡΠ°ΡΡΠ²Π½ΠΈΠΊΡΠ² ΡΠ° Π²ΠΎΠ»ΠΎΠ½ΡΠ΅ΡΡΠ². ΠΠ° ΠΎΡΠ½ΠΎΠ²Ρ ΠΎΡΡΠΈΠΌΠ°Π½ΠΈΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡΠ² ΡΠΎΠ·ΡΠΎΠ±Π»Π΅Π½ΠΎ ΡΡΠ»ΡΡΠ½Ρ ΡΠΈΡΡΠ΅ΠΌΡ ΠΌΠ΅Π΄ΠΈΠΊΠΎβΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΡΡΠ½ΠΎΡ Π΄ΠΎΠΏΠΎΠΌΠΎΠ³ΠΈ Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΎΡΡΠ½ΠΊΡ ΡΡ Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ.A complex investigation in the area of pediatric psychooncology including investigation of the psychoemotional state, personality and behavior peculiarities of cancer children and their parents, associated with reaction to cancer and family function, was performed. The factors of professional distress of medical staff and volunteers were determined. The obtained findings were used to work out a comprehensive system of medical psychological aid and to assess its efficacy
Surgical treatment of childhood hepatoblastoma in the Netherlands (1990β2013)
Background: Achievement of complete surgical resection plays a key role in the successful treatment of children with hepatoblastoma. The aim of this study is to assess the surgical outcomes after partial liver resections for hepatoblastoma, focusing on postoperative complications, resection margins, 30-day mortality, and long-term survival. Method: Chart reviews were carried out on all patients treated for hepatoblastoma in the Netherlands between 1990 and 2013. Results: A total of 103 patients were included, of whom 94 underwent surgery. Partial hepatectomy was performed in 76 patients and 18 patients received a liver transplant as a primary procedure. In 42 of 73 (58 %) patients, one or more complications were reported. In 3 patients, information regarding complications was not available. Hemorrhage necessitating blood transfusion occurred in 33 (45 %) patients and 9 (12 %) patients developed biliary complications, of whom 8 needed one or more additional surgical interventions. Overall, 5-year disease-specific survival was 82, 92 % in the group of patients who underwent partial hepatectomy, and 77 % in the group of patients who underwent liver transplantation. Conclusions: Partial hepatectomy after chemotherapy in children with hepatoblastoma offers good chances of survival. This type of major surgery is associated with a high rate of surgical complications (58 %), which is not detrimental to survival
Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood
Background: Sacrococcygeal teratoma resection often brings changes in pelvic anatomy and physiology with possible consequences for defecation, micturition and sexual function. It is unknown, whether these changes have any gynecological and obstetric sequelae. Until now four pregnancies after sacrococcygeal teratoma resection have been described and cesarean section has been suggested to be the method of choice for delivery. We evaluated the pregnancy course and mode of delivery in women previously treated for a sacrococcygeal teratoma. Methods: The records of all patients who underwent sacrococcygeal teratoma resection after 1970 in one of the six pediatric surgical centers in the Netherlands were reviewed retrospectively. Women aged 18 years and older were eligible for participation. Patient characteristics, details about the performed operation and tumor histology were retrieved from the records. Consenting participants completed a questionnaire addressing fertility, pregnancy and delivery details. Results: Eighty-nine women were eligible for participation; 20 could not be traced. Informed consent was received from 41, of whom 38 returned the completed questionnaire (92.7%). Thirteen of these 38 women conceived, all but one spontaneously. In total 20 infants were born, 17 by vaginal delivery and 3 by cesarean section, in one necessitated by previous intra-abdominal surgery as a consequence of sacrococcygeal teratoma resection. Conversion to a cesarean section was never necessary. None of the 25 women without offspring reported involuntary childlessness. Conclusions: There are no indications that resection of a sacrococcygeal teratoma in female patients is associated with reduced fertility: spontaneous pregnancy is possible and vaginal delivery is safe for mother and child, irrespective of the sacrococcygeal teratoma classification or tumor histology
Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT)
Objective To compare the effect of induction of labour with a policy of expectant monitoring for intrauterine growth restriction near term
Induction versus expectant monitoring for intrauterine growth restriction at term: Randomised equivalence trial (DIGITAT)
Objective: To compare the effect of induction of labour with a policy of expectant monitoring for intrauterine growth restriction near term. Design: Multicentre randomised equivalence trial (the Disproportionate Intrauterine Growth Intervention Trial At Term (DIGITAT)). Setting: Eight academic and 44 non-academic hospitals in the Netherlands between November 2004 and November 2008. Participants: Pregnant women who had a singleton pregnancy beyond 36+0 weeks' g
Ultrasound markers for prediction of complex gastroschisis and adverse outcome: longitudinal prospective nationwide cohort study
Objectives: To identify antenatal ultrasound markers that can differentiate between simple and complex gastroschisis and assess their predictive value. Methods: This was a prospective nationwide study of pregnancies with isolated fetal gastroschisis that underwent serial longitudinal ultrasound examination at regular specified intervals between 20 and 37 weeks' gestation. The primary outcome was simple or complex (i.e. involving bowel atresia, volvulus, perforation or necrosis) gastroschisis at birth. Fetal biometry (abdominal circumference and estimated fetal weight), the occurrence of polyhydramnios, intra- and extra-abdominal bowel diameters and the pulsatility index (PI) of the superior mesenteric artery (SMA) were assessed. Linear mixed modeling was used to compare the individual trajectories of cases with simple and those with complex gastroschisis, and logistic regression analysis was used to estimate the strength of association between the ultrasound parameters and outcome. Results: Of 104 pregnancies with isolated fetal gastroschisis included, four ended in intrauterine death. Eighty-one (81%) liveborn infants with simple and 19 (19%) with complex gastroschisis were included in the analysis. We found no relationship between fetal biometric variables and complex gastroschisis. The SMA-PI was significantly lower in fetuses with gastroschisis than in healthy controls, but did not differentiate between simple and complex gastroschisis. Both intra- and extra-abdominal bowel diameters were larger in cases with complex, compared to those with simple, gastroschisis (P < 0.001 and P < 0.005, respectively). The presence of intra-abdominal bowel diameter β₯ 97.7th percentile on at least three occasions, not necessarily on successive examinations, was associated with an increased risk of the fetus having complex gastroschisis (relative risk, 1.56 (95% CI, 1.02β2.10); P = 0.006; positive predictive value, 50.0%; negative predictive value, 81.4%). Conclusions: This large prospective longitudinal study found that intra-abdominal bowel dilatation when present repeatedly during fetal development can differentiate between simple and complex gastroschisis; however, the positive predictive value is low, and therefore the clinical usefulness of this marker is limited
Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with 'refractoriness to treatment': a cohort study
Background: The absence of a uniform and clinically relevant definition of severe postpartum haemorrhage
hampers comparative studies and optimization of clinical management. The concept of persistent postpartum
haemorrhage, based on refractoriness to initial first-line treatment, was proposed as an alternative to common
definitions that are either based on estimations of blood loss or transfused units of packed red blood cells
(RBC). We compared characteristics and outcomes of women with severe postpartum haemorrhage captured
by these three types of definitions.
Methods: In this large retrospective cohort study in 61 hospitals in the Netherlands we included 1391 consecutive
women with postpartum haemorrhage who received either β₯4 units of RBC or a multicomponent transfusion. Clinical
characteristics and outcomes of women with severe postpartum haemorrhage defined as persistent postpartum
haemorrhage were compared to definitions based on estimated blood loss or transfused units of RBC within 24 h
following birth. Adverse maternal outcome was a composite of maternal mortality, hysterectomy, arterial embolisation
and intensive care unit admission.
Results: One thousand two hundred sixty out of 1391 women (90.6%) with postpartum haemorrhage fulfilled the
definition of persistent postpartum haemorrhage. The majority, 820/1260 (65.1%), fulfilled this definition within 1 h
following birth, compared to 819/1391 (58.7%) applying the definition of β₯1 L blood loss and 37/845 (4.4%) applying
the definition of β₯4 units of RBC. The definition persistent postpartum haemorrhage captured 430/471 adverse maternal
outcomes (91.3%), compared to 471/471 (100%) for β₯1 L blood loss and 383/471 (81.3%) for β₯4 units of RBC. Persistent
postpartum haemorrhage did not capture all adverse outcomes because of missing data on timing of initial, first-line
treatment.
Conclusion: The definition persistent postpartum haemo