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Sanders M.E.,International Scientific Association for Probiotics and Prebiotics | Lenoir-Wijnkoop I.,University Utrecht | Salminen S.,University of Turku | Merenstein D.J.,Georgetown University | And 7 more authors.
Annals of the New York Academy of Sciences | Year: 2014

Probiotics and prebiotics are useful interventions for improving human health through direct or indirect effects on the colonizing microbiota. However, translation of these research findings into nutritional recommendations and public health policy endorsements has not been achieved in a manner consistent with the strength of the evidence. More progress has been made with clinical recommendations. Conclusions include that beneficial cultures, including probiotics and live cultures in fermented foods, can contribute towards the health of the general population; prebiotics, in part due to their function as a special type of soluble fiber, can contribute to the health of the general population; and a number of challenges must be addressed in order to fully realize probiotic and prebiotic benefits, including the need for greater awareness of the accumulated evidence on probiotics and prebiotics among policy makers, strategies to cope with regulatory roadblocks to research, and high-quality human trials that address outstanding research questions in the field. © 2014 New York Academy of Sciences.

PubMed | AMC UvA, University of Twente and NKI AVL
Type: Journal Article | Journal: Urology annals | Year: 2015

Currently, (multiple) biopsies are taken to obtain histopathological diagnosis of suspicious lesions of the penile skin. Optical coherence tomography (OCT) provides noninvasive in vivo images from which epidermal layer thickness and attenuation coefficient (oct) can be quantified. We hypothesize that qualitative (image assessment) and quantitative (epidermal layer thickness and attenuation coefficient, oct) analysis of penile skin with OCT is possible and may differentiate benign penile tissue from (pre) malignant penile tissue.Optical coherence tomography-imaging was performed prior to punch biopsy in 18 consecutive patients with a suspicious lesion at the outpatient clinic of the NKI-AVL. Qualitative analysis consisted of visual assessment of clear layers and a visible lower border of the lesions, quantitative analysis comprised of determination of the epidermal layer thickness and oct. Results were grouped according to histopathology reports.Qualitative analysis showed a statistically significant difference (P = 0.047) between benign and (pre) malignant lesions. Quantitative analysis showed that epidermal layer thickness and attenuation coefficient was significantly different between benign and (pre) malignant tissue, respectively, P = 0.001 and P < 0.001.In this preliminary study, qualitative and quantitative analysis of OCT-images of suspicious penile lesions shows differences between benign lesions and (pre) malignant lesions. These results encourage further research in a larger study population.

Chevalier X.,University Paris Est Creteil | Jerosch J.,Klinik fur Orthopadie | Goupille P.,French Institute of Health and Medical Research | Van Dijk N.,AMC UVA | And 4 more authors.
Annals of the Rheumatic Diseases | Year: 2010

Objectives: The primary objective was to compare a single, 6 ml, intra-articular injection of hylan G-F 20 with placebo in patients with symptomatic knee osteoarthritis. The safety of a repeat injection of hylan G-F 20 was also assessed. Methods: Patients with primary osteoarthritis knee pain were randomly assigned to arthrocentesis plus a 6 ml intra-articular injection of either hylan G-F 20 or placebo in a prospective, double-blind (one injector/one blinded observer) study. Results were evaluated at 4, 8, 12, 18 and 26 weeks post-injection. The primary outcome criterion was change from baseline over 26 weeks in Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index A pain. Secondary outcome measures included WOMAC A1 and C, patient global assessment (PGA) and clinical observer global assessment (COGA) and Outcome Measures in Rheumatology, Osteoarthritis Research Society International responder rates. A 4-week, open, repeat treatment phase evaluated safety only. Results: A total of 253 patients (Kellgren-Lawrence grade II or III) was randomly assigned. Patients receiving hylan G-F 20 experienced statistically significantly greater improvements in WOMAC A pain scores (20.15, SE 0.076, p = 0.047), and several of the secondary outcome measures (WOMAC A1, PGA and COGA), than patients receiving placebo. There was no difference between the safety results of the two groups. No increased risk of local adverse events was observed in the open, repeat treatment phase. Conclusions: This placebo-controlled study demonstrated that, in patients with knee osteoarthritis, a single 6 ml intra-articular injection of hylan G-F 20 is safe and effective in providing statistically significant, clinically relevant pain relief over 26 weeks, with a modest difference versus placebo. Trial registration number: NCT00131352.

Perry M.,Radboudumc | Moll Van Charante E.P.,AMC UvA
Nederlands Tijdschrift voor Geneeskunde | Year: 2015

The updated Dementia guideline of the Dutch Geriatrics Society (NVKG) recommends additional testing (e.g. EEG, cerebrospinal fluid, CT/MRI or SPECT scans) only in cases of persisting significant diagnostic uncertainty. This more parsimonious use of tests appears to contrast with the current trend for specialist memory assessment services to favour full test batteries for all patients, and may be more efficient and less burdensome for patients. However, unlike the benchmark Dementia guideline of the Dutch College of General Practitioners (NHG), the NVKG guideline recommends treatment of Alzheimer's disease patients with cholinesterase inhibitors or memantine. Although metaanalyses yield significant beneficial treatment effects, in our opinion these are not clinically relevant and are mostly short-lived and counterbalanced by the burden of adverse effects. Nevertheless, the NVKG guideline also devotes considerable attention to psychosocial interventions that are valuable for the quality of life of both patients and their carers.

Das P.K.,AMC UvA | Das P.K.,University of Birmingham | Elliott G.,AMC UvA
Immunotherapy | Year: 2011

Autoimmune diseases are a group of maladies in which the patient's immune homeostasis becomes so deregulated that it mounts a destructive attack against the hosts tissues. Such diseases are characterized by an activation of autoreactive T and B cells and are associated, in some cases, with the production of pathogenic antibodies against self-molecules, culminating in inflammation and tissue damage. Target tissues can be from immune-vulnerable and immune-privileged sites. In view of the complex nature of autoimmune diseases, it is not surprising that they have long baffled immunologists, physicians and basic biomedical scientists who are struggling to combine known immunoinflammatory mechanisms into a unified general theory. The present seminar, organized by Euroscion, hosted a group of national and international scientists, affiliated to both academic and industrial research, to discuss state-of-the-art animal models for investigating pathomechanisms of autoimmune diseases, novel laboratory-based diagnostics and novel therapeutic prospects. The timely event on this important topic covered significant features of the basic pathomechanisms of autoimmune disease per se, the development of diagnostic and prognostic tests using functional biomarkers for monitoring patients and the development of targeted therapies. The absence of several prescheduled speakers allowed younger scientists, Stefan Küten, Liliane Fossati-Jimack and Allan Holmes to shine. We are grateful for their participation. This meeting report describes key points and themes arising from this conference. © 2011 Future Medicine Ltd.

Hasman A.,AMC UvA
Studies in Health Technology and Informatics | Year: 2014

This contribution introduces the Technology Acceptance model. Since information systems are still underutilized, application of models of user acceptance can provide important clues about what can be done to increase system usage. © 2014 The authors and IOS Press. All rights reserved.

Wessels R.,NKI AvL | De Bruin D.M.,AMC UvA | Relyveld G.N.,NKI AvL | Faber D.J.,AMC UvA | And 5 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2015

Background Cutaneous melanomas are diagnosed worldwide in 231 130 patients per year. The sensitivity and specificity of melanoma diagnosis expresses the need for an additional diagnostic method. Optical coherence tomography (OCT) has shown that it allows morphological (qualitative) description of image features and quantitative analysis of pathology related light scattering by means of the attenuation coefficient (μoct). Objective We hypothesize that OCT images of nevi will differ qualitatively and quantitatively from melanomas. Methods Forty lesions from 33 consecutive patients were imaged with OCT. After data acquisition, excision was performed. Epidermal layer thickness was measured and values of μoct were extracted from 200 OCT images of pigmented lesions. Results Morphologically, absence of the lower border of the lesion was characteristic for melanoma (P = 0.02). Also, the μoct was different between benign and malignant lesions (P = 0.02). There were no differences in epidermal layer thickness of benign lesions and melanoma. Conclusion Although this preliminary study comprised a small number of patients, quantitative analysis of OCT images in pigmented skin lesions give valuable additional information about lesions characteristics. When using the attenuation coefficient, it might be possible to distinguish between benign lesions and melanomas. © 2014 European Academy of Dermatology and Venereology.

Jochemsen-van der Leeuw R.,AMC UVA
Huisarts en Wetenschap | Year: 2015

Jochemsen-van der Leeuw HGA, Wieringa-de Waard M, Van Dijk N. The general practitioner as positive role model. Huisarts Wet 2015;58(12):638-40. The general practitioner is a role model for GP trainees during their GP placement, not only with regard to education but also with regard to patient care, practice organization, and personal aspects. Many clinical trainers are not aware that they function as role model, which can lead to them passing on negative behaviour to trainees. In her PhD thesis, the first author investigated the characteristics of a positive role model, and which characteristics facilitate the best transfer of information. After educating GP trainees, information – in the form of knowledge, attitude, and skills – is not always passed from clinical trainer to trainees to patient in an ideal ordered fashion. This is why, during the training of GP trainers, it would be a good idea to pay attention to the positive behaviour of role models and to factors that influence knowledge transfer to trainees. In addition, it is also helpful to provide feedback on role model behaviour. © 2015, Bohn Stafleu van Loghum.

PubMed | AMC UvA
Type: | Journal: Studies in health technology and informatics | Year: 2014

This contribution introduces the Technology Acceptance model. Since information systems are still underutilized, application of models of user acceptance can provide important clues about what can be done to increase system usage.

PubMed | AMC UvA
Type: | Journal: Nederlands tijdschrift voor geneeskunde | Year: 2015

Recent studies show that HIV-infected persons who start directly with their anti-retroviral therapy (ART) have better outcomes in terms of morbidity and mortality than those who wait till their CD4 count decreases. In the Netherlands 24-34% is unaware of their HIV infection and 43% present late, especially migrants. Implementing proactive early case-finding will benefit both individual wellbeing as well as public health, as ART will also reduce or eliminate onward transmission to partners.

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