Peerbooms J.C.,Albert Schweitzer Ziekenhuis |
Van Laar W.,HAGA Ziekenhuis Den Haag |
Faber F.,HAGA Ziekenhuis Den Haag
BMC Musculoskeletal Disorders | Year: 2010
Background. If conservative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporarily pain reduction, but no healing. Blood platelets initiate the natural healing rate. GPS gives an eightfold concentrate platelets of patients own blood. Injection of these platelets in the attachment of the fascia to the os calcis might induce a healing rate. Methods and design. A randomized controlled multi centre trial will be performed. The study population consists of 120 patients of 18 years and older. Patients with chronic plantar fasciitis will be allocated randomly to have a steroid injection or an autologous platelet concentrate injections. Data will be collected before the procedure, 4,8,12,26 weeks and 1 year after the procedure. The main outcome measures of this study are pain and function measured with questionnaires. Conclusion. Recent literature show positive effects for the treatment of tendinosis with autologous platelet injections. The forthcoming trial will compare treatment for chronic plantar fasciitis with a steroid injection versus an autologous platelet injection. Our results will be published as soon as they become available. Trial Registration. Trial registration number: http://www.clinicaltrials.gov NCT00758641. © 2010 Peerbooms et al.
News Article | October 27, 2016
NEW PROVIDENCE, N.J.--(BUSINESS WIRE)--Svelte Medical Systems, Inc. today announced it received CE Mark certification of the DIRECT Sirolimus-Eluting Coronary Stent Rapid-Exchange (RX) System for the treatment of coronary artery disease. The first patient to receive DIRECT RX was treated by Auke Weevers, MD, a practicing interventional cardiologist at Albert Schweitzer Ziekenhuis in Dordrecht, The Netherlands. “DIRECT RX provides smooth delivery and the stent conforms well to native vasculature. With its low-compliant balloon and bioresorbable drug coating technology designed for direct stenting, it is a nice compliment to SLENDER IDS which we have already integrated into our practice,” said Dr. Weevers. Adding value in the modern healthcare environment requires new technologies to improve efficiency and reduce cost while enhancing patient outcomes and comfort. DIRECT RX employs DISCREET™ drug coating, composed of the well-studied drug sirolimus and a natural, amino acid-based polyesteramide (PEA) bioresorbable drug carrier proprietary to DSM Biomedical, a global leader in biomaterials science and regenerative medicine. This new class of drug coating is sufficiently tough to use with direct stenting, while higher durometer balloon material allows use of higher pressures to attain complete stent expansion, even in more highly calcified lesions. Use of the direct stenting approach minimizes use of pre-dilatation balloons, reducing the time and cost of stent procedures. DIRECT RX is specifically indicated for use with the direct stenting approach and in diabetic patients. “With more than four years of follow-up in clinical studies demonstrating no cases of stent thrombosis and low rates of neointimal proliferation, our DES continues to demonstrate exceptional and sustained outcomes. DIRECT RX compliments our SLENDER IDS technology, providing a more conventional stent delivery platform for cases where our stent-on-a-wire technology may not be optimally suited,” said Jack Darby, President and CEO of Svelte Medical Systems, Inc. “Svelte DES technologies can now be used to treat all lesions suitable for coronary stenting. We look forward to bringing this technology to more patients in Europe.” SLENDER IDS, which is commercially available at select accounts in Europe, combines Asahi guide wire technology and the same stent and balloon technology as DIRECT RX on a fixed-wire platform, creating an ‘all-in-one’ system to further streamline PCI. Both Svelte platforms will be evaluated in the large, randomized, controlled, multi-center OPTIMIZE study expected to commence next year in support of commercial approvals in the US and Japan. Headquartered in New Providence, New Jersey, Svelte Medical Systems (www.sveltemedical.com) is a privately-held company engaged in the development of highly deliverable balloon expandable stents. Statements made in this press release that look forward in time or that express beliefs, expectations or hopes regarding future occurrences or anticipated outcomes or benefits, are forward-looking statements. A number of risks and uncertainties, such as risks associated with product development and commercialization efforts, results of clinical trials, ultimate clinical outcomes and benefit of the company’s products to patients, market and physician acceptance of the products, intellectual property protection and competitive product offerings, could cause actual events to adversely differ from the expectations indicated in these forward looking statements.
Van Deurzen B.,TU Eindhoven |
Ceulen R.P.,Albert Schweitzer Ziekenhuis |
Tellings S.S.,Erasmus Medisch Centrum Rotterdam |
Van Der Geld C.,TU Eindhoven |
Nijsten T.,Erasmus Medisch Centrum Rotterdam
Dermatologic Surgery | Year: 2011
BACKGROUND: How foam is created for sclerotherapy varies and is not standardized. Moreover, the effect of several factors on the quality of the foam is not well studied. OBJECTIVE To investigate the effects of different parameters on foam stability and bubble size. METHODS As a measure of foam stability, foam half time (FHT) and bubble size distribution were determined for various parameters (polidocanol (POL) concentration, freshness of the POL, syringe size, liquid-to-air ratio, number of pump cycles, and needle size) in the foam creation process. RESULTS FHT was 115 to 157 seconds for POL 1% and 143 to 192 seconds for POL 3%. The other parameters had a limited effect on FHT. POL foam 1% (t=0 seconds) had a mean bubble size of 71 ± 9 μm that increased when the foam was maintained horizontally in the syringe: 102 ± 12 μm) at 30 seconds and 121 ± 20 μm at 60 seconds. The other parameters had no significant influence on bubble size distribution. CONCLUSIONS Higher concentration of POL and rapid injection optimize foam stability and bubble size distribution, but other important foam characteristics are largely independent of differences in the generation and injection of foam. © 2011 by the American Society for Dermatologic Surgery, Inc.
van Geuns R.-J.,Erasmus Medical Center |
Awad K.,STENTYS SA |
Ijsselmuiden A.,Albert Schweitzer Ziekenhuis |
Koch K.,Academisch Medisch Centrum
Interventional Cardiology Review | Year: 2014
Despite advances with new generation stents, there remains some atypical coronary anatomy where optimal stenting continues to be a challenge; such as stent sizing in large, ectatic or aneurysmal vessels; tapered vessels; and in vasoconstricted arteries such as in ST-segment elevation myocardial infarction or chronic total occlusions. Balloon-expandable stents are tubular and cannot easily accommodate vessel diameter variations; thrombotic vessels increase the risk of distal embolisation and no-reflow; positive remodelling and vasodilation often result in subsequent malapposition; and patients with bifurcation lesions have a higher risk of adverse events. The STENTYS BMS and DES(P) stents have a self-expanding design, which enables a better anatomical fit to the vessel, even with diameter variations (up to 6.0 millimetres [mm]), and can adapt to changes in vessel size over time. The stents deploy atraumatically from distal to proximal, which could reduce distal embolisation and contain disconnectable bridges, which can be opened up at a side branch. Self-apposing technology could therefore provide a potential solution to current challenges with balloon-expandable stent technology. © Radcliffe cardiology 2014.
Timmermans L.,Erasmus Medical Center |
Deerenberg E.B.,Erasmus Medical Center |
Lamme B.,Albert Schweitzer Ziekenhuis |
Jeekel J.,Erasmus Medical Center |
Lange J.F.,Erasmus Medical Center
Surgery (United States) | Year: 2014
Background. Incisional hernia (IH) is the most frequent complication after abdominal operation, with an incidence of 11-20% and up to 35% in risk groups. Known risk groups for IH are abdominal aortic aneurysm and obesity. Our hypothesis is that parastomal hernia (PH) might also represent a risk factor for developing IH. Identifying risk factors can help determine the need for preventive measures such as primary mesh augmentation. Methods. In a multicenter cross-sectional study, all patients who were operated between 2002 and 2010 by means of a Hartmann procedure or abdominoperineal resection were invited for a follow-up visit to our outpatient clinic. Primary outcome measures were the prevalence of IH and PH. All possible risk factors for IH were scored. A physical examination was performed and, when available, computed tomography was scored for IH and PH. Results. A total of 150 patients were seen in the outpatient clinic. The median follow-up was 49 months (range, 30-75). IH had a prevalence of 37.1%, and PH had a prevalence of 52.3% during physical examination. On CT the prevalence was even greater, ie, 48.3% and 52.9%. IH and PH were both present in the same patient in 30% of all examined and in 35.6% after CT examination. PH was found to be a risk factor for IH on univariate and multivariate logistic regression analyses of variance, with an odds ratio of 7.2 (95% confidence interval 3.3-15.7). In addition, an emergency operation was found to be a risk factor for IH with an odds ratio of 5.8 in the multivariate analyses. Conclusion. Patients with a PH have a 7 times greater chance of developing an IH compared to patients without PH. © 2014 Mosby, Inc. All rights reserved.
van der Meijden W.A.,Albert Schweitzer ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2013
Renal function is currently estimated using the Modification of Diet in Renal Disease (MDRD) formula, which is partly based on the serum creatinine level. Patients with impaired renal function are referred to nephrologists in accordance with the Dutch national transmural agreement for 'Chronic renal impairment'. A 54-year-old woman without significant history was referred to analyse a coincidentally found decline in the estimated glomerular filtration rate (eGFR). The patient had no complaints and used no medication except creatine supplements. Additional diagnostic testing showed no abnormalities. After cessation of creatine supplementation, the calculated renal function normalized. Serum creatinine is a reflection of muscle mass. The use of creatine-containing dietary supplements, such as creatine ethyl ester, can influence serum creatinine levels and therefore the eGFR as calculated with the MDRD formula. The use of supplements deserves attention when taking the history.
Koenraads M.,Albert Schweitzer Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2011
McArdle disease is a hereditary myopathy caused by muscle phosphorylase deficiency. Patients experience painful muscle cramps after strenuous exercise; the condition is sometimes associated with rhabdomyolysis, myoglobinuria and resulting acute renal failure. A 12-year-old boy visited the Paediatric and Neurology outpatients' departments with symptoms of leg myalgia, occurring during the warming-up phase of soccer practice, which disappeared after a short rest. Detailed history-taking revealed that he already experienced pain while walking during early childhood. An elevated serum creatine kinase concentration in combination with the typical presentation led to the presumptive diagnosis 'McArdle disease', which was confirmed by molecular genetic analysis. There is no effective gene therapy; a multidisciplinary approach by a neurologist, paediatrician, physiotherapist and nutritionist is advised.
Post I.C.,Albert Schweitzer Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2010
A 73-year-old man had a firm node on his right upper arm, which was caused by a Merkel cell carcinoma (MCC). The diagnosis was made on the basis of characteristic histopathological findings and a surgical excision with wide margins followed. Twenty months later a considerable swelling manifested in the right armpit due to a metastasis. During a CT scan of the thorax and abdomen, 2 suspicious abnormalities were seen in the mesenterial adipose tissue of the left lower abdomen and left perirenal adipose tissue. A tissue sample of the last abnormality taken under CT guidance confirmed this to be a metastasis of the MCC. The patient was irradiated but chose not to have chemotherapy. He died 2 years after the diagnosis. Merkel cell carcinoma is a rare and aggressive malignant skin neoplasm. Early recognition facilitates cure of the disease. Treatment is multidisciplinary, but surgery, either alone or in combination with radiotherapy, forms the basis of treating both the localised and regionalized forms of the disease. Chemotherapy may be used in case of disseminated disease and has a reasonable, albeit temporary, effect. The 10-year survival rate varies from 20-70%, dependent on the stage of the disease.
Kouloubis N.,Albert Schweitzer ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2013
A 22-year-old women visited the dermatologist with hypertrophic finger- and toenails, palmoplantar keratoderma and oral leukokeratosis since her childhood. The diagnosis 'pachyonychia congenita type 1' was made. This is a rare dermatosis with an autosomal dominant inheritance pattern. The treatment is symptomatic.
Hooker I.D.,Albert Schweitzer ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2011
A 54-year-old woman was referred to the radiology department for an X-ray of her shoulder because of shoulder ache. Coincidentally, the X-ray showed an abnormality in the right lung. The abnormality was confirmed on chest X-ray, and a CT-scan showed a branching tubular structure with distal air trapping. This finding is pathognomonic for congenital bronchial atresia, a rare congenital abnormality. Usually this is a coincidental finding, because it is not associated with any clinical symptoms or signs. Treatment or follow-up is not necessary.