Deep learning on CT scans to predict checkpoint inhibitor treatment outcomes in advanced melanoma.

Immune checkpoint inhibitor (ICI) treatment has proven successful for advanced melanoma, but is associated with potentially severe toxicity and high costs. Accurate biomarkers for response are lacking. The present work is the first to investigate the value of deep learning on CT imaging of metastatic lesions for predicting ICI treatment outcomes in advanced melanoma.

[Group A-streptococcal infection during pregnancy].

Group A-streptococcal (GAS) infection can lead to various clinical presentations and is fulminant when it reaches the deep tissues, leading to a high morbidity and mortality. The severity of postpartum GAS infections is widely known. In this case report we describe the course of disease in a pregnant patient with GAS toxic shock syndrome with initial complaints of abdominal pain, diarrhea and fetal demise at first presentation.

[Increased menstrual bleeding among direct oral anticoagulant users].

Background: Two-thirds of users of oral anticoagulants use direct oral anticoagulants, among which increasingly women in their reproductive age. The risk of severe or abnormal menstrual bleeding doubles to 70% when using anticoagulants. With rivaroxaban especially the risk seems higher than with vitamin K antagonists; with dabigatran possibly lower.

Role of male partners in the long-term well-being of women who have experienced severe pre-eclampsia and eclampsia in rural Tanzania: a qualitative study.

Men can be essential sources of support in maternal health, even more so in case of severe acute maternal morbidity (SAMM), affecting 1-2% of childbearing women in low-resource settings. In a qualitative study using semi-structured interviews, we explored the perspectives of nine male partners of women who suffered from (pre-)eclampsia six to seven years earlier in rural Tanzania. Male partners considered their role to be pivotal regarding finances, decision-making in healthcare-seeking and family planning and provided physical and emotional support.

[Complications related to pessary use in the treatment of female pelvic organ prolapse].

Pelvic organ prolapse affects 40% of women over 40 years. Pessaries are often used as a first-line treatment and give high patient satisfaction. Complications of pessaries are rare, but vaginal erosions can lead to adhesions, haemorrhage, impaction and migration.

The contribution of Dutch doctors in Global Health and Tropical Medicine to research in global health in low- and middle-income countries: an exploration of the evidence.

Results from medical research from high-income countries may not apply to low- and middle-income countries. Some expatriate physicians combine clinical duties with research. We present global health research conducted by Dutch medical doctors in Global Health and Tropical Medicine in low- and middle-income countries and explore the value of their research.

Intracranial control after Cyberknife radiosurgery to the resection bed for large brain metastases.

Background: Stereotactic radiosurgery (SRS) is an alternative to post-operative whole brain radiation therapy (WBRT) following resection of brain metastases. At our institution, CyberKnife (CK) is considered for local treatment of large cavities ≥2 cm. In this study, we aimed to evaluate patterns of failure and characterize patients best suited to treatment with this approach.

Characteristics and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in Western Tanzania: a retrospective medical record study.

Background: Eclampsia and pre-eclampsia are well-recognized causes of maternal and neonatal mortality in low income countries, but are never studied in a district hospital. In order to get reliable data to facilitate the hospital's obstetric audit a retrospective medical record study was performed in Ndala Hospital, Tanzania.

Methods: All patients diagnosed with severe pre-eclampsia or eclampsia between July 2011 and December 2012 were included.

[Ectopic pregnancy].

An ectopic pregnancy is a pregnancy outside of the uterine cavity. An ectopic pregnancy can rupture and lead to hypovolaemic shock due to intraperitoneal bleeding. We describe 3 cases of women with ectopic pregnancy and discuss the diagnostic and therapeutic options.

[A young woman with acute abdominal pain].

A 17-year-old woman was operated in a Tanzanian hospital because of a suspected ruptured ectopic pregnancy. During laparatomy an interstitial ectopic pregnancy with an intact gestational sac was found. The ectopic pregnancy had ruptured into the abdominal cavity.

Validity of the Dutch version of the Amyotrophic Lateral Sclerosis Assessment Questionnaire, ALSAQ-40, ALSAQ-5.

The objective was to validate the Dutch translation of the 40-item and 5-item Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40, ALSAQ-5). Eighty-one ALS patients participated in this cross-sectional study. The measures used were the ALSAQ-40, the ALSAQ-5, MOS Short-Form-36 (SF-36) and Revised ALS Functional Rating Scale (ALSFRS-R).

Evaluation of dose delivery accuracy of Gamma Knife by polymer gel dosimetry.

The BANG polymer gel dosimeter was used to evaluate 3D absorbed dose distributions in tissue delivered with Gamma Knife stereotactic radiosurgery systems. We compared dose distributions calculated with Leksell GammaPlan (LGP) treatment-planning software with dose distributions measured with the polymer gel dosimeter for single-shot irradiations. Head-sized spherical glass vessels filled with the polymer gel were irradiated with Gamma Knife.

Heterogeneity phantoms for visualization of 3D dose distributions by MRI-based polymer gel dosimetry.

Heterogeneity corrections in dose calculations are necessary for radiation therapy treatment plans. Dosimetric measurements of the heterogeneity effects are hampered if the detectors are large and their radiological characteristics are not equivalent to water. Gel dosimetry can solve these problems.