Over grenzen van de curatieve gezondheidszorg

Afscheidscollege als gewoon hoogleraar neurochirurgie aan de Erasmus Universiteit te Rotterdam op 13 juni 198

Op Gegist Bestek: een poging tot plaatsbepaling van de neuro-chirurgie in het medisch onderwijs

Rede, uitgesproken bij de aanvaarding van het ambt van Gewoon Hoogleraar in d Neuro-chirurgie aan de Medische Faculteit te Rotterdam, op donderdag 30 oktober 196

Aging and stability of microporous sol-gel-modified ceramic membranes

Aging experiments on microporous sol-gel-derived nonsupported Si02 membranes were performed. Microstructure characterization was performed using nitrogen physisorption. It is found that both chemical aging and thermal aging result in densification of the microstructure, without pore growth. The influence of aging on supported SiO2-modified membranes was investigated using gas permeation and separation experiments. As for the nonsupported materials, some densification takes place. This leads to lower permeation rates, but a strong positive effect was observed on the separation properties. This might be attributed to a decrease of the pore size. Separation factors ranging from 50 to 125 have been measured for H2/CH4 at temperatures in the order of 250°C

Biochemical evaluation of the nutrition status of Urban Primary school children: riboflavin status

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Biochemical investigation of the nutrition status of urban school children aged 12 -15 years: Protein status

No Abstract

Mental Condition and Ventricular Size in Arrested Hydrocephalus: an Analysis of 29 Shunt‐independent Children

Measurement of the diameter of the ventricular system, in a series of 29 patients with arrested hydrocephalus who had become shunt‐independent, showed that enlargement of the ventricles does not necessarily play a part in the arrest of hydrocephalus, for in many of these cases the ventricles were normal or only slightly enlarged. A study was made of the relationship between ventricular width and intelligence. Although children with the lowest IQS usually had a very wide ventricular system and those with the highest IQS a ventricular system of normal size, normal intelligence was compatible with ventricles of any size. It is concluded from these findings, and from the fact that removal of the drainage system did not appear to increase the size of the ventricles, that shunt independence in these children did not result in diminished intelligence. Etat mental et dimension ventriculaire dans les hydrocéphalies stabilisées La mesure du diamètre du système ventriculaire chez 29 sujets avec hydrocéphalic stabilisée, devenus autonomes de shunts, a montré que l'élargissement des ventricules ne joue pas nécessairement un r̂ole dans l'évolution de l'hydrocéphalie, car dans de nombreux cas les ventricules étaient normaux ou tres légèrement élargis. Une étude a été faite de la relation existant entre la dimension ventriculaire et Intelligence. En général, les enfants avec les plus bas QI avaient un système ventriculaire très élargi tandis que celui‐ci était de taille normale dans les cas de QI élevé; cependant, une intelligence correcte peut s'observer avec un système ventriculaire de n'importe quelle dimension. A partir de ces données et du fait que la suppression du drain décroit plus qu'elle n'accroit la taille des ventricules, les auteurs concluent que l'autonomie de shunt chez ces enfants ne risque pas de diminuer l'intelligence. Geistige Verfassung und Ventrikelgröβe bei versperrtem Hydrocephalus In einer Serie von 29 Patienten mit versperrtem Hydrocephalus, die vom Shunt unabhängig geworden waren, zeigte die Messung des Durchmessers im Ventrikelsystem, daß die Vergrößerung der Ventrikel nicht unbedingt bei der Versperrung des Hydrocephalus eine Rolle spielen muß, da in vielen Fällen die Ventrikel normal oder nur gering vergrößert waren. Uber die Beziehung zwischen der Weite der Ventrikel und der Intelligenz wurde eine Studie durchgeführt. Obwohl die Kinder mit den niedrigsten IQS gewöhnlich ein sehr weites Ventrikelsystem haben, die mit den höchsten IQS ein Ventrikelsystem von normaler Größe, kann die Intelligenz doch bei alien Ventrikelgrößen festgestellt werden. Aus diesen Befunden und aus der Tatsache, daß die Entfernung des Drainagesystems die Ventrikel eher zu verengen als zu erweitern schien, wurde abgeleitet, daß die Shunt‐Unabhängigkeit bei diesen Kindern nicht eine Verringerung der Intelligenz bewirkte. Estado mental y tamaño ventricular en la hidrocefalia detenida La medición del diámetro del sistema ventricular en una serie de 29 pacientes con hidrocefalia detenida y que se habían convertido en independientes del shunt, mostró que el aumento de volumen de los ventriculos no juega necesariamente una parte en la detentión de la hidrocefalia, ya que en muchos de estos casos los ventriculos eran normales o solo ligeramente aumentados. Se estudió la relacion entre la anchura ventricular y la inteligencia. Aunque los niños con c.i. más bajo generalmente tenian un sistema ventricular muy grande y los de c.i. más alto poseian un sistema ventricular de tamaño normal, la inteligencia era compatible con cualquier tamaño ventricular. Se concluye de estos hallazgos y del hecho de que al eliminar el sistema de drenaje disminuía más bien que aumentaba el tamaño de los ventriculos, que la independencia del shunt en estos niños no daba lugar a una inteligencia disminuida. Copyrigh

Biochemical evaluation of the nutrition status of urban school children of 12-15 years - riboflavin status

No Abstract

AIDS in the Netherlands, clinical and microbiological data in 36 cases

Contains fulltext : 4450.pdf (publisher's version ) (Open Access

Effects of propranolol on fear of dental extraction: Study protocol for a randomized controlled trial

Background: Undergoing an extraction has been shown to pose a significantly increased risk for the development of chronic apprehension for dental surgical procedures, disproportionate forms of dental anxiety (that is, dental phobia), and symptoms of post-traumatic stress. Evidence suggests that intrusive emotional memories of these events both induce and maintain these forms of anxiety. Addressing these problems effectively requires an intervention that durably reduces both the intrusiveness of key fear-related memories and state anxiety during surgery. Moreover, evidence suggests that propranolol is capable of inhibiting "memory reconsolidation" (that is, it blocks the process of storing a recently retrieved fear memory). Hence, the purpose of this trial is to determine the anxiolytic and fear memory reconsolidation inhibiting effects of the ß-adrenoreceptor antagonist propranolol on patients with high levels of fear in anticipation of a dental extraction. Methods/Design: This trial is designed as a multicenter, randomized, placebo-controlled, two-group, parallel, double-blind trial of 34 participants. Consecutive patients who have been referred by their dentist to the departments of oral and maxillofacial surgery of a University hospital or a secondary referral hospital in the Netherlands for at least two tooth and/or molar removals and with self-reported high to extreme fear in anticipation of a dental extraction will be recruited. The intervention is the administration of two 40 mg propranolol capsules 1 hour prior to a dental extraction, followed by one 40 mg capsule directly postoperatively. Placebo capsules will be used as a comparator. The primary outcome will be dental trait anxiety score reduction from baseline to 4-weeks follow-up. The secondary outcomes will be self-reported anxiety during surgery, physiological parameters (heart rate and blood pressure) during recall of the crucial fear-related memory, self-reported vividness, and emotional charge of the crucial fear-related memory. Discussion: This randomized trial is the first to test the efficacy of 120 mg of perioperative propranolol versus placebo in reducing short-term ("state") anxiety during dental extraction, fear memory reconsolidation, and lasting dental ("trait") anxiety in a clinical population. If the results show a reduction in anxiety, this would offer support for routinely prescribing propranolol in patients who are fearful of undergoing dental extractions. Trial registration: ClinicalTrials.gov identifier: NCT02268357 , registered on 7 October 2014. The Netherlands National Trial Register identifier: NTR5364 , registered on 16 August 2015