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Search Results: 1 - 10 of 93502 matches for " Simon W Nienhuijs "
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Peritoneal carcinomatosis of colorectal origin: Incidence, prognosis and treatment options
Yvonne LB Klaver,Valery EPP Lemmens,Simon W Nienhuijs,Misha DP Luyer
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i39.5489
Abstract: Peritoneal carcinomatosis (PC) is one manifestation of metastatic colorectal cancer (CRC). Tumor growth on intestinal surfaces and associated fluid accumulation eventually result in bowel obstruction and incapacitating levels of ascites, which profoundly affect the quality of life for affected patients. PC appears resistant to traditional 5-fluorouracil-based chemotherapy, and surgery was formerly reserved for palliative purposes only. In the absence of effective treatment, the historical prognosis for these patients was extremely poor, with an invariably fatal outcome. These poor outcomes likely explain why PC secondary to CRC has received little attention from oncologic researchers. Thus, data are lacking regarding incidence, clinical disease course, and accurate treatment evaluation for patients with PC. Recently, population-based studies have revealed that PC occurs relatively frequently among patients with CRC. Risk factors for developing PC have been identified: right-sided tumor, advanced T-stage, advanced N-stage, poor differentiation grade, and younger age at diagnosis. During the past decade, both chemotherapeutical and surgical treatments have achieved promising results in these patients. A chance for long-term survival or even cure may now be offered to selected patients by combining radical surgical resection with intraperitoneal instillation of heated chemotherapy. This combined procedure has become known as hyperthermic intraperitoneal chemotherapy. This editorial outlines recent advancements in the medical and surgical treatment of PC and reviews the most recent information on incidence and prognosis of this disease. Given recent progress, treatment should now be considered in every patient presenting with PC.
Altered Cortical Responsiveness to Pain Stimuli after High Frequency Electrical Stimulation of the Skin in Patients with Persistent Pain after Inguinal Hernia Repair
Emanuel N. van den Broeke, Lonneke Koeslag, Laura J. Arendsen, Simon W. Nienhuijs, Camiel Rosman, Clementina M. van Rijn, Oliver H. G. Wilder-Smith, Harry van Goor
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082701
Abstract: Background High Frequency electrical Stimulation (HFS) of the skin induces enhanced brain responsiveness expressed as enhanced Event-Related Potential (ERP) N1 amplitude to stimuli applied to the surrounding unconditioned skin in healthy volunteers. The aim of the present study was to investigate whether this enhanced ERP N1 amplitude could be a potential marker for altered cortical sensory processing in patients with persistent pain after surgery. Materials and Methods Nineteen male patients; 9 with and 10 without persistent pain after inguinal hernia repair received HFS. Before, directly after and thirty minutes after HFS evoked potentials and the subjective pain intensity were measured in response to electric pain stimuli applied to the surrounding unconditioned skin. Results The results show that, thirty minutes after HFS, the ERP N1 amplitude observed at the conditioned arm was statistically significantly larger than the amplitude at the control arm across all patients. No statistically significant differences were observed regarding ERP N1 amplitude between patients with and without persistent pain. However, thirty minutes after HFS we did observe statistically significant differences of P2 amplitude at the conditioned arm between the two groups. The P2 amplitude decreased in comparison to baseline in the group of patients with pain. Conclusion The ERP N1 effect, induced after HFS, was not different between patients with vs. without persistent pain. The decreasing P2 amplitude was not observed in the patients without pain and also not in the previous healthy volunteer study and thus might be a marker for altered cortical sensory processing in patients with persistent pain after surgery.
Uncommon complications of biliary stones  [PDF]
S. Janssen, I. van Mierlo, L. P. L. Gilissen, S. W. Nienhuijs, J. Heemskerk
Open Journal of Internal Medicine (OJIM) , 2012, DOI: 10.4236/ojim.2012.21005
Abstract: Gallstone disease has a high incidence, and most common presentations are well known and recognized. Particulalry in the elderly population though, uncommon presentations of gallstone disease are more frequent, and can easily be missed or misinterpreted. In this article we present 5 such patients with an atypical presentation of gallstone disease. We will then discuss atypical gallstone disease in more detail.
To Sleeve or NOT to Sleeve in Bariatric Surgery?
P. W. J. van Rutte,M. D. P. Luyer,I. H. J. T. de Hingh,S. W. Nienhuijs
ISRN Surgery , 2012, DOI: 10.5402/2012/674042
Abstract:
The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037)
Hilko A Swank, Jefrey Vermeulen, Johan F Lange, Irene M Mulder, Joost AB van der Hoeven, Laurents PS Stassen, Rogier MPH Crolla, Meindert N Sosef, Simon W Nienhuijs, Robbert JI Bosker, Maarten J Boom, Philip M Kruyt, Dingeman J Swank, Willem H Steup, Eelco JR de Graaf, Wibo F Weidema, Robert EGJM Pierik, Hubert A Prins, Hein BAC Stockmann, Rob AEM Tollenaar, Bart A van Wagensveld, Peter-Paul LO Coene, Gerrit D Slooter, Esther CJ Consten, Eino B van Duijn, Michael F Gerhards, Anton GM Hoofwijk, Thomas M Karsten, Peter A Neijenhuis, Charlotte FJM Blanken-Peeters
BMC Surgery , 2010, DOI: 10.1186/1471-2482-10-29
Abstract: The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective treatment for patients with purulent peritonitis (LOLA-arm) and to determine the optimal resectional strategy in patients with a purulent or faecal peritonitis (DIVA-arm: perforated DIVerticulitis: sigmoidresection with or without Anastomosis).In this multicentre randomised trial all patients with perforated diverticulitis are included. Upon laparoscopy, patients with purulent peritonitis are treated with laparoscopic lavage and drainage, Hartmann's procedure or sigmoidectomy with primary anastomosis in a ratio of 2:1:1 (LOLA-arm). Patients with faecal peritonitis will be randomised 1:1 between Hartmann's procedure and resection with primary anastomosis (DIVA-arm). The primary combined endpoint of the LOLA-arm is major morbidity and mortality. A sample size of 132:66:66 patients will be able to detect a difference in the primary endpoint from 25% in resectional groups compared to 10% in the laparoscopic lavage group (two sided alpha = 5%, power = 90%). Endpoint of the DIVA-arm is stoma free survival one year after initial surgery. In this arm 212 patients are needed to significantly demonstrate a difference of 30% (log rank test two sided alpha = 5% and power = 90%) in favour of the patients with resection with primary anastomosis. Secondary endpoints for both arms are the number of days alive and outside the hospital, health related quality of life, health care utilisation and associated costs.The Ladies trial is a nationwide multicentre randomised trial on perforated diverticulitis that will provide evidence on the merits of laparoscopic lavage and drainage for purulent generalised peritonitis and on the optimal resectional strategy for both purulent and faecal generalised peritonitis.Nederlands Trial Register NTR2037Diverticular disease is an important condition in terms of healthcare utilisation and it is one of the five most costly gastrointestinal disor
Endothelin but Not Angiotensin II May Mediate Hypertension-Induced Coronary Vascular Calcification in Chronic Kidney Disease
Simon W. Rabkin
International Journal of Nephrology , 2011, DOI: 10.4061/2011/516237
Abstract: To understand the relationship between putative neurohormonal factors operative in hypertension and coronary artery calcification (CAC), the relevant cellular actions of angiotensin (Ang II) and endothelin-1 (ET-1) are reviewed. There is compelling evidence to implicate ET-1 in CAC. ET-1 increases phosphate transport with a 42 to 73% increase in . Increased cellular phosphate may induce CAC through increased Ca x phosphate product, transformation of vascular smooth muscle cells into a bone-producing phenotype or cell apoptosis that releases procalcific substances. ET-1 is increased in several models of vascular calcification. ET-1 inhibits inhibitors of calcification, matrix Gla and osteoprotegerin, while enhancing pro-calcific factors such as BMP-2 and osteopontin. In contrast, Ang II inhibits phosphate transport decreasing by 38% and increases matrix Gla. Ang II also stimulates bone resorption. Vascular calcification is reduced by ET-1 A receptor antagonists and to a greater extent than angiotensin receptor blockade although both agents reduce blood pressure. 1. Introduction The presence and severity of coronary artery calcification (CAC) is a predictor of an increased probability of serious clinical cardiac events including death [1–4]. Chronic kidney disease is associated with increased CAC, and in general the more advanced the stage of kidney disease, the greater is the amount of CAC [5–9]. The possible causal linkage between end-stage kidney diseases producing CAC that in turn accelerates coronary atherosclerotic events has focused attention on the pathophysiology of CAC in end stage renal disease with the objective of determining steps in the process that might be amenable to a suitable intervention to reduce the high mortality seen in patient with chronic kidney disease. While the precise mechanisms producing vascular calcification are still being elucidated, investigators contend that the processes likely involve calcium and phosphorus metabolic dysfunction, changes of vascular cells, especially vascular smooth cells (VSMC), into an osteoblastic phenotype and an imbalance between procalcification and anti-calcification factors [10]. Vascular calcification in chronic kidney disease vessels is also strongly associated with vascular smooth muscle cell death resulting from calcium- and phosphate-induced apoptosis [11, 12]. Vascular calcification induced in aortas cultured in a high phosphate medium occurs concomitantly with cell death of VSMC via apoptosis [13]. Inhibition of apoptosis with a general caspase inhibitor reduces calcification [13].
Strange Decays of Nonstrange Baryons
Simon Capstick,W. Roberts
Physics , 1998, DOI: 10.1103/PhysRevD.58.074011
Abstract: The strong decays of excited nonstrange baryons into the final states Lambda K, Sigma K, and for the first time into Lambda(1405) K, Lambda(1520) K, Sigma(1385) K, Lambda K*, and Sigma K*, are examined in a relativized quark pair creation model. The wave functions and parameters of the model are fixed by previous calculations of N pi and N pi pi, etc., decays. Our results show that it should be possible to discover several new negative parity excited baryons and confirm the discovery of several others by analyzing these final states in kaon production experiments. We also establish clear predictions for the relative strengths of certain states to decay to Lambda(1405) K and Lambda(1520) K, which can be tested to determine if a three-quark model of the Lambda(1405) K is valid. Our results compare favorably with the results of partial wave analyses of the limited existing data for the Lambda K and Sigma K channels. We do not find large Sigma K decay amplitudes for a substantial group of predicted and weakly established negative-parity states, in contrast to the only previous work to consider decays of these states into the strange final states Lambda K and Sigma K.
New Baryons in the Delta eta and Delta omega Channels
Simon Capstick,W. Roberts
Physics , 1997, DOI: 10.1103/PhysRevD.57.4301
Abstract: The decays of excited nonstrange baryons into the final states Delta eta and Delta omega are examined in a relativized quark pair creation model. The wavefunctions and parameters of the model are fixed by previous calculations of N pi and N pi pi, etc., decays through various quasi-two body channels including N eta and N omega. Our results show that the combination of thresholds just below the region of interest and the isospin selectivity of these channels should allow the discovery of several new baryons in such experiments.
Approach to Equilibrium for a Forced Burgers Equation
W. Kirsch,B. Simon
Physics , 2001,
Abstract: We show that approach to equilibrium in certain forced Burgers equations is implied by a decay estimate on a suitable intrinsic semigroup estimate, and we verify this estimate in a variety of cases including a periodic force.
Quark Models of Baryon Masses and Decays
Simon Capstick,W. Roberts
Physics , 2000,
Abstract: The application of quark models to the spectra and strong and electromagnetic couplings of baryons is reviewed. This review focuses on calculations which attempt a global description of the masses and decay properties of baryons, although recent developments in applying large N_c QCD and lattice QCD to the baryon spectrum are described. After outlining the conventional one-gluon-exchange picture, models which consider extensions to this approach are contrasted with dynamical quark models based on Goldstone-boson exchange and an algebraic collective-excitation approach. The spectra and electromagnetic and strong couplings that result from these models are compared with the quantities extracted from the data and each other, and the impact of various model assumptions on these properties is emphasized. Prospects for the resolution of the important issues raised by these comparisons are discussed.
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