136 results match your criteria: "Rijnstate Hospital Arnhem[Affiliation]"

Cost Effectiveness of Endovascular Revascularisation vs. Exercise Therapy for Intermittent Claudication Due to Iliac Artery Obstruction.

Eur J Vasc Endovasc Surg

March 2022

Department of Surgery, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Objective: To compare cost effectiveness of endovascular revascularisation (ER) and supervised exercise therapy (SET) as primary treatment for patients with intermittent claudication (IC) due to iliac artery obstruction.

Methods: Cost utility analysis from a restricted societal perspective and time horizon of 12 months. Patients were included in a multicentre randomised controlled trial (SUPER study, NCT01385774, NTR2648) which compared effectiveness of ER and SET.

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Background: We evaluated data from all patients in the Netherlands who underwent endovascular treatment for acute ischemic stroke in the past 3.5 years, to identify nationwide trends in time to treatment and procedural success, and assess their effect on clinical outcomes.

Methods: We included patients with proximal occlusions of the anterior circulation from the second and first cohorts of the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry (March 2014 to June 2016; June 2016 to November 2017, respectively).

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Introduction: Complex pathologies involving the aortic arch can be treated using the frozen elephant trunk (FET) technique, which is versatile and continues to be improved with different innovations to further reduce, for example, circulatory arrest time and the need for hypothermia. FET may or may not be a definitive repair, however. Distal extension or completion-especially endovascular-is common but not well described in the literature.

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Subjective cognition in adults with common psychiatric classifications; a systematic review.

Psychiatry Res

February 2022

Dutch Autism & ADHD Research Center, Department of Psychology, Univeersity of Amsterdam, Amsterdam, Netherlands; Department of Psychology, University of Amsterdam, Amsterdam, Netherlands; Dr. Leo Kannerhuis, autism clinic (Youz/Parnassia Group), Amsterdam, Netherlands.

The aim is to assess whether instruments developed to measure subjective cognitive complaints (SCCs) and in neurology and aging can reliably be used in ADHD and other common psychiatric classifications. MEDLINE, PsycINFO, CINAHL and EMBASE+EMBASE CLASSIC were searched for relevant work on SCCs in psychiatric classifications (ADHD, autism, mood disorders, schizophrenia) in two phases: 1 identify instruments, 2 relevant studies. 35 studies with varying study quality were included.

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Article Synopsis
  • - The study aims to enhance HIV care by standardizing the measurement of patient-reported outcomes alongside traditional clinical markers, responding to a global trend emphasizing what matters most to patients.
  • - An international group of 37 experts and patients collaborated to identify and agree on a core set of outcomes, using a literature review and interviews, ultimately narrowing it down to 156 identified outcomes.
  • - The newly developed HIV360 outcome set includes a combination of patient-reported and clinician-reported measures, along with risk-adjustment variables, allowing for improved recording and comparison across treatment sites to enhance quality in HIV care.
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Background: Laparoscopic hysterectomy is accepted worldwide as the standard treatment option for early-stage endometrial cancer. However, there are limited data on long-term survival, particularly when no lymphadenectomy is performed. We compared the survival outcomes of total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH), both without lymphadenectomy, for early-stage endometrial cancer up to 5 years postoperatively.

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Adequate follow-up in celiac disease is important to improve dietary compliance and treat disease-related symptoms and possible complications. However, data on the follow-up of celiac children is scarce. We aimed to assess current pediatric celiac follow-up practices across Europe.

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Article Synopsis
  • - The study focuses on patients who developed cerebral venous sinus thrombosis (CVST) after receiving SARS-CoV-2 vaccines, specifically ChAdOx1 (Oxford-AstraZeneca) and Ad26.COV2.S (Johnson & Johnson), particularly looking at those with thrombosis with thrombocytopenia syndrome (TTS) versus those without.
  • - Data was gathered from an international registry from 81 hospitals spanning 19 countries, highlighting the clinical characteristics and mortality rates of patients with CVST in relation to their vaccination status.
  • - Of 116 postvaccination CVST patients, 67.2% had TTS, predominantly after the ChAdOx1 vaccine, with a notable percentage of female patients and
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A Swallowing Screening Test Enhances a Better Recognition of Patients with a Hip Fracture at Risk for Oropharyngeal Dysphagia.

Orthop Nurs

August 2021

Hugo Wijnen, MD, is Geriatrician, Department of Orthopedics, Geriatrics and Speech-Language Pathology, Rijnstate Hospital Arnhem, Arnhem, the Netherlands.

Oropharyngeal dysphagia (OD) is commonly encountered in elderly patients with hip fracture. It is easily overlooked and predisposes patients to life-threatening postoperative pneumonia. The aim of this study was to evaluate whether OD screening by nurses results in a better recognition of patients at risk for OD.

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Postanoxic encephalopathy is the key determinant of death or disability after successful cardiopulmonary resuscitation. Animal studies have provided proof-of-principle evidence of efficacy of divergent classes of neuroprotective treatments to promote brain recovery. However, apart from targeted temperature management (TTM), neuroprotective treatments are not included in current care of patients with postanoxic encephalopathy after cardiac arrest.

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Nuclear medicine plays an increasingly important role in the management neuroendocrine neoplasms (NEN). Somatostatin analogue (SSA)-based positron emission tomography/computed tomography (PET/CT) and peptide receptor radionuclide therapy (PRRT) have been used in clinical trials and approved by the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). European Association of Nuclear Medicine (EANM) Focus 3 performed a multidisciplinary Delphi process to deliver a balanced perspective on molecular imaging and radionuclide therapy in well-differentiated neuroendocrine tumours (NETs).

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Background: In premenopausal women, treatment with direct oral factor Xa inhibitors is associated with an increased risk of heavy menstrual bleeding (HMB) compared with vitamin K antagonists (VKA). Treatment with the direct oral thrombin inhibitor dabigatran appears to be associated with a reduced risk of HMB compared with VKA. These findings come from small observational studies or post hoc analyses of trials in which HMB was not a primary outcome.

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If the lymphocyte count is still low enough, the first part of the wait-and-see approach for asymptomatic Rai stage 0 classical B-CLL can be used to find out if the lymphocyte counts follow an exponential growth curve. If they do, the whole food, plant-based (WFPB) diet intervention can be started.

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Study Questions: The objective of this study is to evaluate the effectiveness and cost-effectiveness of surgical treatment of women suffering from pain due to an ovarian endometrioma when compared to treatment with medication (analgesia and/or hormones). The primary outcome is defined as successful pain reduction (-30% reduction of pain) measured by the numeric rating scale (NRS) after 6 months. Secondary outcomes include successful pain reduction after 12 and 18 months, quality of life, affective symptoms, cost-effectiveness, recurrence rate, need of adjuvant medication after surgery, ovarian reserve, adjuvant surgery and budget impact.

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Article Synopsis
  • The study aimed to gather a consensus among 44 expert bariatric surgeons on how to safely resume Bariatric and Metabolic Surgery during the COVID-19 pandemic.
  • A modified Delphi method was used, allowing the experts to review and agree on 111 proposed statements across two rounds, with a consensus defined as at least 70% agreement.
  • The results include 38 key recommendations that can help medical teams resume surgeries and guide future research in the field.
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A randomized controlled trial of a standard 4-week protocol of repetitive transcranial magnetic stimulation in severe treatment resistant depression.

J Affect Disord

September 2020

Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, The Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.

Background: Treatment options for major depressive disorder (MDD) in individuals who are depressed for at least 2 years and failed two or more different types of therapeutic intervention, remain scarce. Being less invasive than electroconvulsive therapy, repetitive transcranial magnetic stimulation (rTMS) might be an alternative treatment option.

Research Question: Does high frequency rTMS applied over the left prefrontal cortex ameliorate depressive symptoms in patients with treatment resistant major depressive disorder and is the efficacy dependent on treatment resistance?

Method: We performed a randomized controlled trial investigating the effect of twenty sessions of real or sham-rTMS, during 4 consecutive weeks.

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A case of co-occurrence of radiation-induced leukoencephalopathy and CADASIL.

Neurol Clin Pract

June 2020

Department of Clinical Genetics (LDK, FB, SAMJLO), Leiden University Medical Center; Department of Neurology (LDK, JECB), Erasmus MC University Medical Center Rotterdam; Department of Neurology (JCFW-J), Rijnstate Hospital Arnhem; and Department of Radiology (MCK), Leiden University Medical Center.

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Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is used for (re)staging prostate cancer (PCa) and as a biomarker for evaluating response to therapy, but lacks established response criteria. A panel of PCa experts in nuclear medicine, radiology, and/or urology met on February 21, 2020, in Amsterdam, The Netherlands, to formulate criteria for PSMA PET/CT-based response in patients treated for metastatic PCa and optimal timing to use it.

Methods: Panelists received thematic topics and relevant literature prior to the meeting.

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Introduction: Older adults undergoing elective surgery have a high risk of developing postoperative delirium (POD). Validated models predicting POD are scarce. This study investigated whether preoperative impairment of attentional function predicts POD in older adults without previously diagnosed cognitive impairment.

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Background: Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is the surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as pericoronitis, root resorption, gum and alveolar bone disease (periodontitis), caries and the development of cysts and tumours. When surgical removal is performed in older people, the risk of postoperative complications, pain and discomfort is increased.

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Background: The therapeutic landscape for non-small-cell lung cancer (NSCLC) patients that have common epidermal growth factor receptor (EGFR) mutations has changed radically in the last decade. The availability of these treatment options has an economic impact, therefore a budget impact analysis was performed.

Methods: A budget impact analysis was conducted from a Dutch healthcare perspective over a 5-year time horizon in EGFR-mutant NSCLC patients receiving first-line afatinib (Gilotrif) versus first-line osimertinib (Tagrisso), followed by subsequent treatments.

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Purpose: To assess the success rate and complications of sialendoscopy and sialolithotripsy for parotid sialolithiasis.

Materials And Methods: A total of 228 articles were identified by the electronic database search regarding the topics sialendoscopy and sialolithotripsy. Following independent then joint review of titles and abstracts, 109 articles were selected for the full review.

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Objective: Chronic pain is a prevalent condition which has a significant effect on the lives of those it impacts. High-frequency 10 kHz spinal cord stimulation (10 kHz SCS) has been shown to provide paresthesia-free pain relief for a wide variety of pain indications. This article summarizes the current and emerging data as they relate to the clinical use of the therapy in various pain syndromes.

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