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51.
Rutger C. Lalieu Robin J. Brouwer Dirk T. Ubbink Rigo Hoencamp Ren Bol Raap Rob A. van Hulst 《Wound repair and regeneration》2020,28(2):266-275
Diabetic foot ulcers are a common complication of diabetes, which affects 25% of patients and may ultimately lead to amputation of affected limbs. Research suggests hyperbaric oxygen therapy improves healing of these ulcers. However, this has not been reflected in previous reviews, possibly because they did not differentiate between patients with and without peripheral arterial occlusive disease. Therefore, we performed a systematic review of published literature in the MEDLINE, Embase, and Cochrane CENTRAL databases on nonischemic diabetic foot ulcers with outcome measures including complete ulcer healing, amputation rate (major and minor), and mortality. Seven studies were included, of which two were randomized clinical trials. Two studies found no difference in major amputation rate, whereas one large retrospective study found 2% more major amputations in the hyperbaric oxygen group. However, this study did not correct for baseline differences. Two studies showed no significant difference in minor amputation rate. Five studies reporting on complete wound healing showed no significant differences. In conclusion, the current evidence suggests that hyperbaric oxygen therapy does not accelerate wound healing and does not prevent major or minor amputations in patients with a diabetic foot ulcer without peripheral arterial occlusive disease. Based on the available evidence, routine clinical use of this therapy cannot be recommended. However, the available research for this specific subgroup of patients is scarce, and physicians should counsel patients on expected risks and benefits. Additional research, focusing especially on patient selection criteria, is needed to better identify patients that might profit from this therapy modality. 相似文献
52.
Oscar R. Brouwer Nynke S. van den Berg Hanna M. Mathéron Henk G. van der Poel Bas W. van Rhijn Axel Bex Harm van Tinteren Renato A. Valdés Olmos Fijs W.B. van Leeuwen Simon Horenblas 《European urology》2014
Background
Sentinel node (SN) biopsy in penile cancer is typically performed using a combination of radiocolloid and blue dye. Recently, the hybrid radioactive and fluorescent tracer indocyanine green (ICG)-99mTc-nanocolloid was developed to combine the beneficial properties of both radio-guidance and fluorescence imaging.Objective
To explore the added value of SN biopsy using ICG-99mTc-nanocolloid in patients with penile carcinoma.Design, setting, and participants
Sixty-five patients with penile squamous cell carcinoma were prospectively included (January 2011 to December 2012). Preoperative SN mapping was performed using lymphoscintigraphy and single-proton emission computed tomography supplemented with computed tomography (SPECT/CT) after peritumoural injection of ICG-99mTc-nanocolloid. During surgery, SNs were initially approached using a gamma probe, followed by patent blue dye and/or fluorescence imaging. A portable gamma camera was used to confirm excision of all SNs.Surgical procedure
Patients underwent SN biopsy of the cN0 groin and treatment of the primary tumour.Outcome measurements and statistical analysis
The number and location of preoperatively identified SNs were documented. Intraoperative SN identification rates using radio- and/or fluorescence guidance were assessed and compared with blue dye. Statistical evaluation was performed using a two-sample test for equality of proportions with continuity correction.Results and limitations
Preoperative imaging after injection of ICG-99mTc-nanocolloid enabled SN identification in all patients (a total of 183 SNs dispersed over 119 groins). Intraoperatively, all SNs identified by preoperative SN mapping were localised using combined radio-, fluorescence-, and blue dye guidance. Fluorescence imaging enabled visualisation of 96.8% of SNs, while only 55.7% was stained by blue dye (p < 0.0001). The tissue penetration of the fluorescent signal, and the rapid flow of blue dye limited the detection sensitivity. A tumour-positive SN was found in seven patients.Conclusions
ICG-99mTc-nanocolloid allows for both preoperative SN mapping and combined radio- and fluorescence-guided SN biopsy in penile carcinoma patients and significantly improves optical SN detection compared with blue dye. 相似文献53.
Martje E. van Egmond MD Corien C. Verschuuren‐Bemelmans MD Esther A. Nibbeling MSc Jan Willem J. Elting MD PhD Deborah A. Sival MD PhD Oebele F. Brouwer MD PhD Jeroen J. de Vries MD Hubertus P. Kremer MD PhD Richard J. Sinke PhD Marina A. Tijssen MD PhD Tom J. de Koning MD PhD 《Movement disorders》2014,29(1):139-143
54.
55.
Base-pair substitution hotspots in GAG and GCG nucleotide sequences in Escherichia coli K-12 induced by cis-diamminedichloroplatinum (II). 总被引:13,自引:4,他引:13 下载免费PDF全文
J Brouwer P van de Putte A M Fichtinger-Schepman J Reedijk 《Proceedings of the National Academy of Sciences of the United States of America》1981,78(11):7010-7014
Cell killing and mutation induction by cis- and trans-Pt(NH3)2Cl2 in Escherichia coli were examined by studying forward mutagenesis in the lacI gene in cells with different repair capacities. Survival experiments showed that repair-proficient cells were slightly more sensitive for the cis isomer than for the trans isomer, whereas repair-deficient RecA and UvrB cells were extremely sensitive only for the cis compound. cis-Pt(NH3)2Cl2 induced mutagenesis in both wild-type cells and RecA cells but not in UvrB cells; whereas no detectable mutagenesis was induced by treatment with the trans compound. Examination of the nature of the mutations induced by cis-Pt(NH3)2Cl2, by using the LacI system, revealed that base-pair substitutions leading to nonsense mutants are only induced in wild-type cells, suggesting that the intact products of both the uvrB and the recA gene are necessary for the repair responsible for this type of mutagenesis. Investigation of the nonsense mutants reveals that 70% of these mutations result from GC leads to TA or GC leads to AT substitutions at sites where the guanine is part of a GAG or GCG sequence. These results are discussed in relation to existing theories on the interaction between Pt compounds and DNA. A model for Pt--DNA adducts, leading to base-pair substitutions, is proposed. 相似文献
56.
A double blind, randomised, multicentre comparison of two doses of intravenous iloprost in the treatment of Raynaud''s phenomenon secondary to connective tissue diseases. 下载免费PDF全文
H I Torley R Madhok H A Capell R M Brouwer P J Maddison C M Black H Englert J A Dormandy H R Watson 《Annals of the rheumatic diseases》1991,50(11):800-804
OBJECTIVE--To compare low (0.5 ng/kg/min) and standard dose (2 ng/kg/min) iloprost (a stable carbacyclin analogue of prostacyclin) in patients with Raynaud''s phenomenon secondary to connective tissue disorders. DESIGN--Double blind, random allocation, three six hour infusions on consecutive days. Follow up period eight weeks. SETTING--Rheumatology units, five teaching hospitals. PATIENTS--55 Patients with Raynaud''s phenomenon (greater than seven attacks per week), 32 secondary to well documented classical progressive systemic sclerosis (American Rheumatism Association criteria), 11 CREST syndrome, 5 mixed connective tissue disease, 1 rheumatoid arthritis, 1 Sjögren''s syndrome, 1 childhood dermatomyositis, and 4 abnormal nailfold capillaroscopy and antibody profiles but no definite diagnosis. INTERVENTIONS--All other treatment for Raynaud''s phenomenon was discontinued two weeks before entry. 28 Patients were randomly allocated to receive the low dose, 27 the standard dose. Differing dilutions allowed infusion rates to be started at 10 ml/h with increments of 10 ml/h every 15 minutes until infusion rates reached 0.5 ng/kg/min and 2 ng/kg/min respectively. MAIN OUTCOME MEASURE(s)--Reduction in frequency, duration, and severity of attacks of Raynaud''s phenomenon. Assessment of ulcer and ischaemic lesion healing. RESULTS--Both dosage regimens were equally effective in reducing severity, frequency, and duration of Raynaud''s attacks. Ulcer healing occurred to similar degree in both treatment groups (standard dose 44%, low dose 39%). Low dose was associated with significantly fewer side effects. CONCLUSIONS--Both dosage regimens reduce severity of Raynaud''s phenomenon and encourage ulcer healing. Low dose was associated with fewer side effects and was better tolerated by the patients. 相似文献
57.
S. Coosje Dijkstra J. E. Neter I. A. Brouwer M. Huisman M. Visser 《The journal of nutrition, health & aging》2014,18(2):115-121
Objectives
Little is known about socio-economic differences in dietary intake among older adults. In this study we describe self-reported dietary adherence to the fruit, vegetables and fish guidelines among older Dutch adults and investigate the independent associations of three socio-economic status (SES) indicators with adherence to these guidelines.Design
Cross sectional data-analyses.Settings
The Longitudinal Aging Study Amsterdam (LASA), the Netherlands.Subjects
1057 community dwelling older adults, aged 55–85 years.Measurements
Fruit, vegetable and fish intake was assessed using a short food frequency questionnaire. We measured SES using self-reported levels of education, household income and occupational prestige.Results
82.5% of the respondents reported to adhere to the fruit guideline, 65.1% to the vegetables guideline, and 31.7% to the fish guideline. After adjustment for confounders and the other two SES indicators, respondents in the lowest education group adhered less often to the vegetables guideline (OR 0.39 (95% CI 0.22–0.70)) compared to those in the highest education group. Respondents in the lowest income group adhered less often to the fruit (0.44 (95 % CI 0.22–0.91) and fish guideline (OR 0.55 (95% CI 0.33–0.91) compared to those in the highest groups. Occupational prestige was not independently associated with adherence any the guidelines.Conclusion
Selfreported adherence to the fruit, vegetables and fish guidelines among older adults can be improved and particularly in those with a low SES. Education and income have independent and unique contributions to dietary adherence. Future research should investigate potential pathways through which these specific SES indicators influence dietary adherence. 相似文献58.
Background
Productivity costs are often ignored in economic evaluations. In order to facilitate productivity cost inclusion, it has been suggested to estimate productivity costs indirectly using quality of life data.Objective
This study aimed to derive and validate an algorithm for predicting productivity losses on the basis of quality-of-life data using the EQ-5D-3L.Methods
A large representative sample of the Dutch general public (n = 1,100) was asked in a web-based questionnaire to state their expected level of productivity in terms of absenteeism and presenteeism for multiple EQ-5D health states. Based on these data, two generalized estimating equations (GEE) models were constructed: (1) a model predicting levels of absenteeism and (2) a model predicting presenteeism. The models were validated by comparing model predictions with conventionally measured productivity within a group of low back pain patients.Results
Predicted absenteeism levels based on EQ-5D health state closely resembled conventionally measured absenteeism levels. Productivity losses related to presenteeism seemed somewhat overestimated by our prediction model. Measured and predicted productivity were moderately but highly significantly correlated.Conclusions
Overall, it appears possible to make reasonable productivity predictions based on EQ-5D data. Further exploration and validation of prediction algorithms remains necessary, however, especially for presenteeism. 相似文献59.