scholarly journals Comparison Between Monochorionic and Dichorionic Placentas With Special Attention to Vascular Anastomoses and Placental Share

2016 ◽  
Vol 19 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Depeng Zhao ◽  
Michal Lipa ◽  
Miroslaw Wielgos ◽  
Danielle Cohen ◽  
Johanna M Middeldorp ◽  
...  
Keyword(s):  
The Netherlands ◽  
Laser Surgery ◽  
Medical Center ◽  
Interquartile Range ◽  
Medical University ◽  
Twin Pregnancies

Placental vascular anastomoses in twins lead to a shared circulation and may subsequently enable the development of severe complications such as twin–twin transfusion syndrome (TTTS) and twin anemia–polycythemia sequence (TAPS). The presence of vascular anastomoses has frequently and systematically been studied in monochorionic (MC) placentas, but only rarely in dichorionic (DC) placentas. The aim of this study was to compare the prevalence of vascular anastomoses and evaluate the sharing discordance in MC and DC placentas. All consecutive placentas of MC and DC twins delivered at the Leiden University Medical Center (the Netherlands) and Medical University of Warsaw (Poland) from 2012 to 2015 were routinely injected with colored dye and included in the study. We excluded twin pregnancies treated with fetoscopic laser surgery. A total of 258 placentas were analyzed in this study, including 134 MC placentas and 124 DC placentas. Vascular anastomoses were present in 99% (133/134) of MC placentas and 0% of DC placentas (p < .01). Placental share discordance between MC twins was significantly larger compared to DC twins, 19.8 (interquartile range [IQR] 8.1–33.3) and 10.8 (IQR 6.2–19.0), respectively (p < .01). Vascular anastomoses associated complications occurred in 16% (22/134) MC twins. Our findings show that vascular anastomoses are almost ubiquitous in MC placentas, but non-existent in DC placentas. In addition, unequal placental sharing appears to be more common in MC than in DC placentas.

Acute Schistosomiasis in Paediatric Travellers and Comparison with Their Companion Adults

2021 ◽  
Author(s):  
Shira Rabinowicz ◽  
Eyal Leshem ◽  
Eli Schwartz
Keyword(s):  
Medical Center ◽  
Acute Illness ◽  
Steroid Treatment ◽  
Interquartile Range ◽  
Short Exposure ◽  
High Infection Rate ◽  
Travel History ◽  
Asymptomatic Children ◽  
High Infection ◽  
Systemic Hypersensitivity

Abstract Background Schistosomiasis in non-immune travellers can cause acute schistosomiasis, a multi-systemic hypersensitivity reaction. Little is known regarding acute schistosomiasis in children. We describe acute schistosomiasis in paediatric travellers and compare them with adult travellers. Methods A retrospective study of paediatric travellers (0–18 years old) diagnosed with schistosomiasis at Sheba Medical Center. Patients’ findings are compared with those of adult travellers from the same travel groups. Results 18 children and 24 adults from five different trips to Tanzania, Uganda, Nigeria and Laos were infected (90% of the exposed travellers). The median bathing time of the infected children was 30 minutes (interquartile range 15–30 minutes). The most common presentations were respiratory symptoms in 13 (72%), eosinophilia in 13 (72%) and fever in 11 (61%). Acute illness included a median of 2.5 symptoms. Three children required hospitalization and three were asymptomatic. Fatigue was significantly less common in children compared with similarly exposed adults (33% vs 71%, p = 0.03). Rates of hospitalization and steroid treatment were similar. The median eosinophil count in children was 1045 cells/μL (interquartile range 625–2575), lower than adults [2900 cells/μL (interquartile range 1170-4584)], p = 0.02. Conclusions Children may develop acute schistosomiasis following a short exposure to contaminated freshwater, demonstrating a high infection rate. Severity seems to be similar to adults, although children report fatigue less commonly and show lower eosinophil counts. Disease should be suspected in children with multi-systemic illness and in asymptomatic children with a relevant travel history.

Update and external validation of a multivariable prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6040-6040
Author(s):  
Anna C. H. Willemsen ◽  
Annemieke Kok ◽  
Laura W.J. Baijens ◽  
J. P. De Boer ◽  
Remco de Bree ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Radiation Dose ◽  
The Netherlands ◽  
Prediction Model ◽  
Head And Neck ◽  
Neck Cancer ◽  
Predictive Value ◽  
Medical Center ◽  
External Validation ◽  
Tube Feeding

6040 Background: Patients who receive chemoradiation or bioradiation (CRT/BRT) for locally advanced head and neck squamous cell carcinoma (LAHNSCC) often experience high toxicity rates, which may interfere with oral intake, leading to (temporary) tube feeding (TF) dependency. International guidelines recommend gastrostomy insertion when the expected use of TF exceeds four weeks. In this study we aimed to update and externally validate a prediction model to identify patients in need for TF for at least four weeks, meeting the international criteria for prophylactic gastrostomy insertion. Methods: This retrospective multicenter cohort study was performed in four tertiary referral head and neck cancer centers in the Netherlands. The prediction model was developed using data from the University Medical Center Utrecht and the Netherlands Cancer Institute. The model was externally validated in patients from the Maastricht University Medical Center and Radboud University Medical Center. The primary endpoint was TF, initiated during or within 30 days after completion of CRT/BRT, and administered for at least four weeks. Potential predictors were retrieved from patient medical records and radiotherapy dose-volume parameters were calculated. Results: The developmental and validation cohort included 409 and 334 patients respectively. Multivariable analysis showed significant predictive value (p < 0.05) for adjusted diet at start of CRT/BRT, percentage weight change prior to treatment initiation, WHO performance status, tumor-site, nodal stage, mean radiation dose to the contralateral parotid gland, and mean radiation dose to the oral cavity. The area under the receiver operating characteristics curve for the updated model was 0.73 and after external validation 0.64. Positive and negative predictive value at 90% cut off were 80.0% and 48.2% respectively. Conclusions: This externally validated prediction model to estimate TF-dependency for at least four weeks in LAHNSCC patients performs well. This model, which will be presented, can be used in clinical practice to guide personalized decision making on prophylactic gastrostomy insertion.

scholarly journals The Lifelines COVID-19 Cohort: a questionnaire-based study to investigate COVID-19 infection and its health and societal impacts in a Dutch population-based cohort

2020 ◽  
Author(s):  
Kate Mc Intyre ◽  
Pauline Lanting ◽  
Patrick Deelen ◽  
Henry Wiersma ◽  
Judith M. Vonk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Informed Consent ◽  
The Netherlands ◽  
Disease Susceptibility ◽  
Medical Center ◽  
Dutch Population ◽  
Physical And Mental Health ◽  
Weekly Basis ◽  
Wide Range ◽  
Societal Impacts

AbstractThe COVID-19 pandemic has affected billions of people around the world not only through the infection itself but also through its wider impact on public health and daily life. To assess the effects of the pandemic, a team of researchers across a wide range of disciplines developed and implemented the Lifelines COVID-19 questionnaire, leading to the development of the Lifelines COVID-19 cohort. This cohort is recruited from participants of the Lifelines prospective population cohort and the Lifelines NEXT birth cohort, and participants were asked to fill out detailed questionnaires about their physical and mental health and experiences on a weekly basis starting in late March of 2020 and on a bi-weekly basis staring in June 2020. The Lifelines region covers the three Northern provinces of the Netherlands— Drenthe, Groningen and Friesland—which together account for ∼10% of the Dutch population. To date, >70,000 people have responded to the questionnaires at least once, and the questionnaire program is still ongoing. Data collected by the questionnaires will be used to address four aspects of the outbreak: (1) how the COVID-19 pandemic developed in the three northern provinces of the Netherlands, (2) which environmental risk factors predict disease susceptibility and severity, (3) which genetic risk factors predict disease susceptibility and severity and (4) what are the psychological and societal impacts of the crisis.Informed consentAll Lifelines and Lifelines NEXT participants have provided informed consent that provide the opportunity for add-on research.Research involving human participantsBoth the Lifelines and the Lifelines NEXT studies were approved by the ethics committee of the University Medical Center Groningen.

scholarly journals Proceedings of the International Forensic Radiology Research Summit May 10–11, 2016, Amsterdam, The Netherlands

2017 ◽  
Author(s):  
Nicole S. Jones ◽  
Jeri D. Ropero-Miller ◽  
Heather Waltke ◽  
Danielle McLeod-Henning ◽  
Danielle Weiss ◽  
...  
Keyword(s):  
The Netherlands ◽  
International Association ◽  
Medical Center ◽  
Academic Medical Center ◽  
Forensic Radiology ◽  
Professional Staff ◽  
Road Map ◽  
National Institute Of Justice ◽  
Operational Information ◽  
Radiology Research

On May 10–11, 2016, the US Department of Justice (DOJ) National Institute of Justice (NIJ), the Netherlands Forensic Institute (NFI; Dutch Ministry of Security and Justice of the Netherlands), the International Society for Forensic Radiology and Imaging (ISFRI), the International Association of Forensic Radiographers (IAFR), and NIJ’s Forensic Technology Center of Excellence (FTCoE) at RTI International organized and convened the International Forensic Radiology Research Summit (IFRRS) at the Academic Medical Center in Amsterdam. The summit assembled 40 international subject matter experts in forensic radiology, to include researchers, practitioners, government employees, and professional staff from 14 countries. The goal of this 2-day summit was to identify gaps, challenges, and research needs to produce a road map to success regarding the state of forensic radiology, including formulating a plan to address the obstacles to implementation of advanced imaging technologies in medicolegal investigations. These proceedings summarize the meeting’s important exchange of technical and operational information, ideas, and solutions for the community and other stakeholders of forensic radiology.

scholarly journals Effects of TPMT, NUDT15, and ITPA Genetic Variants on 6-Mercaptopurine Toxicity for Pediatric Patients With Acute Lymphoblastic Leukemia in Yunnan of China

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiaoyan Mao ◽  
Runxiu Yin ◽  
Gaoyuan Sun ◽  
Yan Zhou ◽  
Chunhui Yang ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Yunnan Province ◽  
Medical Center ◽  
Lymphoblastic Leukemia ◽  
Free Survival ◽  
Ethnic Populations ◽  
Significant Difference ◽  
Pediatric All ◽  
Medical University ◽  
Tolerable Dose

Background: 6-Mercaptopurine (6-MP) is the cornerstone of current antileukemia regimen and contributes greatly to improve the survival of pediatric acute lymphoblastic leukemia (ALL) patients. However, 6-MP dose-related toxicities limit its application. TPMT, NUDT15, and ITPA are pharmacogenetic markers predicting 6-MP-related toxicities, but their genetic polymorphisms differ from those of ethnic populations. In Yunnan province, a multiethnic region of China, we had no genetic data to predict 6-MP toxicities. In this study, we evaluated the most common variants involved in 6-MP metabolism—TPMT*3C (rs1142345), NUDT15 c.415C&gt;T (rs116855232), and ITPA c.94C&gt;A (rs1127354) variants—in our cohort of pediatric ALL patients.Methods: A total of 149 pediatric ALL patients in the Affiliated Children's Hospital of Kunming Medical University (Yunnan Children's Medical Center) from 2017 to 2019 were enrolled in this retrospective study. We assessed the TPMT*3C (rs1142345), NUDT15 c.415C&gt;T (rs116855232), and ITPA c.94C&gt;A (rs1127354) frequencies and evaluated association between genotypes and 6-MP toxicities, 6-MP dose, and event-free survival (EFS) in these ALL patients.Results: The allele frequencies of TPMT*3C (rs1142345), NUDT15 c.415C&gt;T (rs116855232), and ITPA c.94C&gt;A (rs1127354) were 1.34%, 14.43%, and 18.79%, respectively. Only NUDT15 c.415C&gt;T (rs116855232) was strongly associated with 6-MP toxicity and 6-MP tolerable dose. NUDT15 c.415C&gt;T was related to leukopenia, p = 0.008, OR = 2.743 (95% CI: 1.305–5.768). The T allele was significantly correlated with 6-MP tolerable dose, dose of NUDT15 c.415C&gt;T wild genotype CC 39.80 ± 1.32 mg/m2, heterozygotes CT 35.20 ± 2.29 mg/m2, and homozygotes TT 18.95 ± 3.95 mg/m2. 6-MP tolerable dose between CC and TT had a significant difference, p = 0.009. Between CC and CT, and CT and TT, they had no significant difference. EFS showed no significant difference among NUDT15 c.415C&gt;T genotypes.Conclusion:NUDT15 c.415C&gt;T (rs116855232) was an optimal predictor for 6-MP toxicity and tolerable dose in pediatric ALL patients from Yunnan province, a multiethnic region in China, and would play an important role in precise therapy for ALL.

The Netherlands: University Medical Center, Utrecht

2010 ◽  
pp. 217-223
Author(s):  
Ina M. Jürgenliemk-Schulz ◽  
Astrid A. C. deLeeuw
Keyword(s):  
The Netherlands ◽  
Medical Center

scholarly journals Twin-Twin Transfusion Syndrome with Anemia-Polycythemia: Prevalence, Characteristics, and Outcome

2019 ◽  
Vol 8 (8) ◽  
pp. 1129 ◽  
Author(s):  
Lisanne S. A. Tollenaar ◽  
Femke Slaghekke ◽  
Jeanine M. M. van Klink ◽  
Sophie G. Groene ◽  
Johanna M. Middeldorp ◽  
...  
Keyword(s):  
Laser Surgery ◽  
Primary Outcome ◽  
Disease Free Survival ◽  
Peak Systolic Velocity ◽  
Neonatal Morbidity ◽  
Free Survival ◽  
Neurodevelopmental Impairment ◽  
Twin Pregnancies ◽  
Disease Free ◽  
Perinatal Survival

The aim of this study was to estimate the prevalence of co-existing anemia-polycythemia (AP) in twin pregnancies with twin-twin transfusion syndrome (TTTS) prior to laser surgery, and to evaluate the characteristics and outcomes in TTTS twins with and without AP. All TTTS cases treated with laser between 2001 and 2019 were retrospectively reviewed for the presence of AP before surgery. AP was defined as delta middle cerebral artery–peak systolic velocity > 0.5 multiples of the median. The primary outcome was a composite of perinatal survival and severe neurodevelopmental impairment (NDI). Secondary outcomes included procedure-related characteristics, severe neonatal morbidity, and disease-free survival. In total, 66% (461/696) of TTTS twin pregnancies were eligible for analysis. AP was detected in 15% (70/461) of the TTTS twins prior to laser surgery. Gestational age at laser was higher in the TTTS+AP group compared to the TTTS-only group—21.0 weeks (interquartile rage (IQR): 18.8–24.0) versus 19.3 weeks (IQR: 17.3–21.9), respectively (p < 0.0001). Fewer placental anastomoses were detected in the TTTS+AP group than in the TTTS-only group—five (IQR: 4–6) versus six (IQR: 5–8), respectively (p < 0.0001). Perinatal survival was 77% (599/782) in the TTTS-only group and 83% (118/142) in the TTTS+AP group (p = 0.130). Severe NDI was 8% (28/370) in TTTS-only and 3% (2/74) in TTTS+AP. TTTS-only twins showed more severe neonatal morbidity than twins with TTTS+AP—23% (132/575) versus 11% (13/115), respectively (p = 0.005). Disease-free survival was lower in the TTTS-only group compared to the TTTS+AP group—62% (341/548) versus 73% (72/98), respectively (p = 0.046). Thus, AP complicates 15% of TTTS twins prior to laser. TTTS+AP twins show a different placental angioarchitecture, a later time of onset of the disease, and a more favorable outcome.

scholarly journals Mode of Conception of Twin Pregnancies: Willingness to Reply to Survey Items and Comparison of Survey Data to Hospital Records

2008 ◽  
Vol 11 (3) ◽  
pp. 349-351 ◽  
Author(s):  
C. E. M. Toos van Beijsterveldt ◽  
Chantal Hoekstra ◽  
Roel Schats ◽  
Grant W. Montgomery ◽  
Gonneke Willemsen ◽  
...  
Keyword(s):  
Data Collection ◽  
The Netherlands ◽  
Survey Data ◽  
Survey Study ◽  
Hospital Records ◽  
Assisted Reproduction Techniques ◽  
Twin Registry ◽  
Using Data ◽  
Large Survey ◽  
Twin Pregnancies

AbstractBased on results from a survey study in a sample of Australian parents of twins, Raj and Morley (2007) reported that questions concerning the mode of conception of twins may be offensive to parents. We looked at the willingness to reply to questions about mode of conception of twin pregnancies in a large survey study that was completed by 20,150 mothers of twins from the Netherlands Twin Registry. Data collection took place in 2005/2006. The amount of missing data was examined and by using data from earlier survey studies, responders and nonresponders were compared with respect to their answers to questions on assisted reproduction techniques. In addition, we assessed the reliability of the question on mode of conception by comparing the survey data with hospital records in a subsample of 80 mothers of twins. We found no indication that mothers of twins were not prepared to reply to questions on mode of conception. Only a small number of mothers did not fill in the question on mode of conception (0.8%). Also, the use of artificial fertility techniques did not differ between mothers who returned and mothers who did not return the 2005/2006 survey. The comparison of the survey data with the hospital records showed that mothers can accurately report on the mode of conception of their twins.

Sign in / Sign up

Export Citation Format

Share Document