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Veldhoven, Netherlands

Buffart L.M.,VU University Amsterdam | Thong M.S.Y.,University of Tilburg | Thong M.S.Y.,Comprehensive Cancer Center South | Schep G.,Maxima Medical Center Veldhoven | And 4 more authors.
PLoS ONE | Year: 2012

Background: Physical activity (PA) is suggested to be an important non-pharmacologic means to improve health-related outcomes among cancer survivors. We aimed to describe the PA level, its correlates, and association with health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. Methods: CRC survivors identified from the Eindhoven Cancer Registry treated between 1998 and 2007 were included. Survivors completed validated questionnaires on PA, distress, fatigue, and HRQoL. Moderate-to-vigorous physical activity (MVPA) levels were calculated by summing the time spent on walking, bicycling, gardening and sports (≥3 MET). Multiple linear regression analyses were conducted to study which socio-demographic and clinical factors were associated with MVPA. Furthermore, we examined associations between MVPA and physical and mental HRQoL, and whether these associations were mediated by fatigue and distress. Results: Cross-sectional data of 1371 survivors (response: 82%) were analysed. Participants were 69.5 (SD 9.7) years old, 56% were male, and survival duration was 3.9 (SD 2.5) years. Participants self-reported on average 95.5 (SD 80.3) min on MVPA per day. Younger age, male sex, being employed, non-smoking, lower BMI, colon cancer (vs. rectal cancer), chemotherapy treatment and having no co-morbidities were associated with higher MVPA (p<0.05). MVPA was positively associated with physical HRQoL (regression coefficient of total association (c) = 0.030; se = 0.004) after adjusting for socio-demographic and clinical factors. Fatigue mediated this association between MVPA and physical HRQoL (44% mediated). The association between MVPA and mental HRQoL was not statistically significant after adjusting for socio-demographic and cancer-related factors (c = 0.005; se = 0.004). Conclusion: In CRC survivors, clinical factors including the absence of co-morbidity, tumour site and chemotherapy treatment were associated with higher MVPA, in addition to several socio-demographic factors. Higher MVPA was associated with higher physical HRQoL but not with mental HRQoL. Fatigue and distress mediated the association between MVPA and HRQoL. © 2012 Buffart et al. Source

Van Pul C.,University Utrecht | Van Pul C.,Maxima Medical Center Veldhoven | Van Pul C.,TU Eindhoven | Van Kooij B.J.M.,University Utrecht | And 4 more authors.
American Journal of Neuroradiology | Year: 2012

BACKGROUND AND PURPOSE: Signal-intensity abnormalities in the PLIC and thinning of the CC are often seen in preterm infants and associated with poor outcome. DTI is able to detect subtle abnormalities. We used FT to select bundles of interest (CC and PLIC) to acquire additional information on the WMI. MATERIALS AND METHODS: One hundred twenty preterm infants born at <31 weeks' gestation with 3T DTI at TEA entered this prospective study. Quantitative information (ie, volume, length, anisotropy, and MD) was obtained from fiber bundles passing through the PLIC and CC. A general linear model was used to assess the effects of factor (sex) and variables (GA, BW, HC, PMA, and WMI) on FT-segmented parameters. RESULTS: Seventy-two CC and 85 PLIC fiber bundles were assessed. For the CC, increasing WMI and decreasing FA (P = .038), bundle volume (P < .001), and length (P = .001) were observed, whereas MD increased (P = .001). For PLIC, MD increased with increasing WMI (P = .002). Higher anisotropy and larger bundle length were observed in the left PLIC compared with the right (P = .003, P = .018). CONCLUSIONS: We have shown that in the CC bundle, anisotropy was decreased and diffusivity was increased in infants with high WMI scores. A relation of PLIC with WMI was also shown but was less pronounced. Brain maturation is affected more if birth was more premature. Source

Van Hoek F.,Maxima Medical Center Veldhoven | Scheltinga M.R.,Maxima Medical Center Veldhoven | Houterman S.,MMC Academy | Beerenhout C.H.,Maxima Medical Center
Nephrology | Year: 2010

Background: During haemodialysis, some patients experience intensification of symptoms of haemodialysis access-induced distal ischaemia. Aim of this study is to compare the effects of two different regimens of arterial blood flow in patients with an arteriovenous access. Methods: A questionnaire identified 10 patients that subjectively experienced ischaemic symptoms during haemodialysis. Systolic blood pressure, heart rate, finger pressure (Pdig), finger temperature (Tdig), oxygen saturation and ischaemic scores were monitored during two different arterial blood flow dialysis sessions. Results: Before dialysis, Pdig and Tdig of the arteriovenous access hand were significantly lower compared with the other hand. Haemodialysis induced a drop of Pdig in both hands. All changes in Pdig occurred independent of the artificial kidney's blood flow level. Conclusion: Systemic hypotension following onset of haemodialysis further intensifies an already diminished hand perfusion. Measures preventing dialytic hypotension will likely attenuate symptoms associated with haemodialysis access-induced distal ischaemia during haemodialysis. © 2010 The Authors. Source

Niemarkt H.J.,Maxima Medical Center Veldhoven | Niemarkt H.J.,Maastricht University | De Meij T.G.,VU University Amsterdam | Van De Velde M.E.,VU University Amsterdam | And 5 more authors.
Inflammatory Bowel Diseases | Year: 2015

Necrotizing enterocolitis (NEC) remains one of the most frequent gastrointestinal diseases in the neonatal intensive care unit, with a continuing unacceptable high mortality and morbidity rates. Up to 20% to 40% of infants with NEC will need surgical intervention at some point. Although the exact pathophysiology is not yet elucidated, prematurity, use of formula feeding, and an altered intestinal microbiota are supposed to induce an inflammatory response of the immature intestine. The clinical picture of NEC has been well described. However, an early diagnosis and differentiation against sepsis is challenging. Besides, it is difficult to timely identify NEC cases that will deteriorate and need surgical intervention. This may interfere with the most optimal treatment of infants with NEC. In this review, we discuss the pathogenesis, diagnosis, and treatment of NEC with a focus on the role of microbiota in the development of NEC. An overview of different clinical prediction models and biomarkers is given. Some of these are promising tools for accurate diagnosis of NEC and selection of appropriate therapy. Copyright © 2014 Crohn's & Colitis Foundation of America, Inc. Source

Scheltinga M.R.,Maxima Medical Center Veldhoven | Bruijninckx C.M.A.,Maxima Medical Center Veldhoven
European Journal of Vascular and Endovascular Surgery | Year: 2012

Objectives: Some haemodialysis patients with an arteriovenous fistula (AVF) suffer from chronic hand ischaemia (haemodialysis access-induced distal ischaemia, HAIDI). This overview discusses pathophysiological mechanisms of chronic HAIDI with emphasis on the role of steal and loco-regional hypotension. Materials and methods: The literature obtained from Medline and Google using various terms including steal and hand ischaemia was studied for clues on pathophysiology of hand ischaemia in the presence of an AVF. Results: Constructing an arteriovenous anastomosis as in a haemodialysis access leads to augmented blood flows in arm arteries. Due to increased shear stress, these arteries will remodel while hand perfusion pressures are maintained. However, arteries of some dialysis patients with diabetes mellitus and/or severe arteriosclerosis demonstrate insufficient remodelling leading to a gradual loss of perfusion pressures towards the periphery. A blood pressure drop associated with turbulent flow at the arteriovenous anastomosis intensifies the distal hypotension. By contrast, steal (reversal of blood flow) may reflect an upstream arterial stenosis and patent collaterals but its presence has no pathophysiological significance related to hand ischaemia. Conclusion: HAIDI is caused by too low forearm and hand blood pressures. Therapy should focus on attenuating the loss of arterial pressure including optimalisation of inflow arteries and/or ligation of the AVF's venous side branches. Surgery aimed at access flow reduction or distal revascularisation is only indicated if these measures fail. © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. Source

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