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  • 1
    In: Journal of Psychopharmacology, SAGE Publications, Vol. 25, No. 3 ( 2011-03), p. 353-360
    Abstract: Arginine-vasopressin (AVP) is a physiological co-activator of the hypothalamus–pituitary–adrenal (HPA) axis, together with corticotrophin releasing hormone (CRH). A synthetic analogue of AVP, desmopressin (dDAVP), is often used as a pharmacological tool to assess co-activation in health and disease. The relation between dDAVP’s neuroendocrine, cardiovascular, pro-coagulatory, anti-diuretic and non-specific stress effects has not been studied. A randomized, double-blind, placebo-controlled, three-way crossover study was performed in 12 healthy male and female volunteers (6 : 6). dDAVP was administered intravenously as a 10 μg bolus (over 1 min) or a 30 μg incremental infusion (over 60 min). Neuroendocrine, cardiovascular, pro-coagulatory, anti-diuretic effects and adverse events (AEs) were recorded, and autonomic nervous system (ANS) activation evaluated. The incremental infusion reached 1.8-fold higher dDAVP concentrations than the bolus. Neuroendocrine effects were similar for the 10 μg dDAVP bolus and the 30 μg incremental infusion, while cardiovascular and coagulatory effects were greater with the 30 µg dose. Osmolality and ANS activity remained uninfluenced. AEs corresponded to dDAVP’s side-effect profile. In conclusion, the neuroendocrine effects of a 10 μg dDAVP bolus administered over 1 min are similar to those of a 30 μg incremental infusion administered over one hour, despite higher dDAVP concentrations after the infusion. Cardiovascular and coagulatory effects showed clear dose-related responses. A 10 μg dDAVP bolus is considered a safe vasopressinergic function test at which no confounding effects of systemic or autonomic stress were seen.
    Type of Medium: Online Resource
    ISSN: 0269-8811 , 1461-7285
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2028926-1
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  • 2
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC, Vol. 28, No. 6 ( 2021-06), p. 3243-3253
    Abstract: The added value of surgery in breast cancer patients with pathological complete response (pCR) after neoadjuvant systemic therapy (NST) is uncertain. The accuracy of imaging identifying pCR for omission of surgery, however, is insufficient. We investigated the accuracy of ultrasound-guided biopsies identifying breast pCR (ypT0) after NST in patients with radiological partial (rPR) or complete response (rCR) on MRI. Methods We performed a multicenter, prospective single-arm study in three Dutch hospitals. Patients with T1–4(N0 or N +) breast cancer with MRI rPR and enhancement ≤ 2.0 cm or MRI rCR after NST were enrolled. Eight ultrasound-guided 14-G core biopsies were obtained in the operating room before surgery close to the marker placed centrally in the tumor area at diagnosis (no attempt was made to remove the marker), and compared with the surgical specimen of the breast. Primary outcome was the false-negative rate (FNR). Results Between April 2016 and June 2019, 202 patients fulfilled eligibility criteria. Pre-surgical biopsies were obtained in 167 patients, of whom 136 had rCR and 31 had rPR on MRI. Forty-three (26%) tumors were hormone receptor (HR)-positive/HER2-negative, 64 (38%) were HER2-positive, and 60 (36%) were triple-negative. Eighty-nine patients had pCR (53%; 95% CI 45–61) and 78 had residual disease. Biopsies were false-negative in 29 (37%; 95% CI 27–49) of 78 patients. The multivariable associated with false-negative biopsies was rCR (FNR 47%; OR 9.81, 95% CI 1.72–55.89; p  = 0.01); a trend was observed for HR-negative tumors (FNR 71% in HER2-positive and 55% in triple-negative tumors; OR 4.55, 95% CI 0.95–21.73; p  = 0.058) and smaller pathological lesions (6 mm vs 15 mm; OR 0.93, 95% CI 0.87–1.00; p  = 0.051). Conclusion The MICRA trial showed that ultrasound-guided core biopsies are not accurate enough to identify breast pCR in patients with good response on MRI after NST. Therefore, breast surgery cannot safely be omitted relying on the results of core biopsies in these patients.
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2074021-9
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  • 3
    In: Journal of Psychopharmacology, SAGE Publications, Vol. 25, No. 3 ( 2011-03), p. 361-369
    Abstract: Pharmacological function tests consisting of 100 µg hCRH (corticorelin) and 10 µg dDAVP (desmopressin) mimic endogenous hypothalamus–pituitary–adrenal (HPA) axis activation. However, physiological CRH concentrations preclude informative vasopressinergic co-activation (using dDAVP) and independent quantification of both corticotrophinergic (using hCRH) and vasopressinergic (using dDAVP) activation is limited due to administration on separate occasions. This randomized, double-blind, placebo-controlled, partial five-way crossover study in healthy males and females (six : six) examined whether (1) concomitant administration of dDAVP and hCRH provides more informative vasopressinergic co-activation than dDAVP alone; and (2) whether the administration of dDAVP followed two hours later by hCRH can quantify both vasopressinergic and corticotrophinergic activation on a single test day. Combining 10 µg dDAVP with 10 µg and 30 µg hCRH caused dose-related ACTH and cortisol release which was larger than with 10 µg dDAVP alone and respectively comparable to and greater than that induced by 100 µg hCRH. Using 10 µg dDAVP alone demonstrated limited ACTH release while the effects of 100 µg hCRH two hours later were three times as large. ACTH and cortisol released by 10 µg dDAVP returned to baseline prior to 100 µg hCRH administration and dDAVP did not influence the response to subsequent hCRH administration. Dose-related vasopressinergic co-activation of the HPA axis was induced by combining 10 µg dDAVP with 10 µg and 30 µg hCRH. Combining 10 µg dDAVP with 10 µg hCRH induced the potentially most informative vasopressinergic co-activation since it is not restricted by ceiling or flooring effects. The hCRH response was not affected by prior dDAVP, allowing for a practical function test examining both HPA activation routes on the same day.
    Type of Medium: Online Resource
    ISSN: 0269-8811 , 1461-7285
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2028926-1
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  • 4
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 72, No. 8_Supplement ( 2012-04-15), p. 4072-4072
    Abstract: Introduction Molecular characterization of CTC holds considerable promise for the identification and monitoring of therapeutic targets in cancer patients under systemic treatment. Molecular profiling of CTC is however frustrated by white blood cell (WBC) signatures overwhelming those emanating from the CTC minority. In this study, we investigated the feasibility to isolate and molecularly characterize single tumor cells (TC) and small pools of up to 10 pure TC from immunomagnetically enriched blood samples using a semi-automated platform for dielectrophoretic cell sorting (DEPArray, Silicon Biosystems, Bologna, IT). Methods MDA-MB-231 human breast cancer cells were spiked into healthy donor blood at a concentration of 1000 cells/7.5 ml blood. Clinical patient samples were obtained from patients with metastatic breast cancer. Blood samples were subjected to EpCAM based immunomagnetic enrichment using the CellSearch Profile Kit (CellSearch, Veridex, Raritan, NJ, USA). Enriched samples were immunofluorescently stained for EpCAM-PE, CD45-APC and Hoechst and subsequently further purified using a DEPArray cell sorter. Single TC, pools of 5 TC, pools of 10 TC and pools of 20 WBC were recovered into individual reaction tubes. Molecular analyses consisting of whole genome amplification followed by K-ras mutation analysis and RT-qPCR for an in-house selected panel of breast cancer related transcripts were performed. Results Genomic DNA (gDNA) was succesfully amplified and detected in 3/5 (60%) single MDA-MB-231 TC and 4/4 (100%) pools of 5-10 TC and 20 WBC. K-ras mutation analysis revealed the G13D mutation - heterozygously present in the MDA-MB-231 cell line - in all TC samples and in none of two WBC samples, indicating 100% purity of the sorted cell samples. In addition, gDNA was succesfully detected and amplified in 5/9 (55%) single TC and 5/6 (83%) pools of 5-10 TC and 20 WBC from a clinical patient sample. Transcriptional profiles of pools of 5-10 MDA-MB-231 TC samples, were consistently correlated with publicly available gene expression profiles of MDA-MB-231 cells (Spearman R2=0.36±0.03) and inversely correlated with gene expression profiles of MCF-7 cells (Spearman R2=−0.09±0.03), indicating correct classification according to molecular subtypes. In a clinical patient sample, transcriptional profiles of pools of CTC could be correctly distinguished from WBC. Discussion We show the feasibility of an integrated workflow for the molecular characterization of single TC and small pools of up to 10 pure TC isolated from immunomagnetically enriched blood samples using a semi-automated dielectrophoretic cell sorting technique. Further optimization is being undertaken to allow for single cell transcriptional profiling and results will be expanded in clinical patient samples in order to gain insight into in vivo CTC heterogeneity. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4072. doi:1538-7445.AM2012-4072
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2012
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 5
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2008
    In:  Human Genetics Vol. 124, No. 4 ( 2008-11), p. 431-436
    In: Human Genetics, Springer Science and Business Media LLC, Vol. 124, No. 4 ( 2008-11), p. 431-436
    Type of Medium: Online Resource
    ISSN: 0340-6717 , 1432-1203
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2008
    detail.hit.zdb_id: 1459188-1
    SSG: 12
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  • 6
    Online Resource
    Online Resource
    American Psychological Association (APA) ; 2021
    In:  Psychology of Aesthetics, Creativity, and the Arts ( 2021-10-07)
    In: Psychology of Aesthetics, Creativity, and the Arts, American Psychological Association (APA), ( 2021-10-07)
    Type of Medium: Online Resource
    ISSN: 1931-390X , 1931-3896
    Language: English
    Publisher: American Psychological Association (APA)
    Publication Date: 2021
    detail.hit.zdb_id: 2260425-X
    SSG: 5,2
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  • 7
    In: Cancer Letters, Elsevier BV, Vol. 356, No. 2 ( 2015-01), p. 872-879
    Type of Medium: Online Resource
    ISSN: 0304-3835
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 195674-7
    detail.hit.zdb_id: 2004212-7
    SSG: 12
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  • 8
    In: Clinical Rehabilitation, SAGE Publications, Vol. 31, No. 9 ( 2017-09), p. 1215-1225
    Abstract: To explore the reliability and feasibility of electronic visual analogue scales in people with multiple sclerosis (MS) and healthy individuals. Design: Cross-sectional observational study Setting: Clinical setting Subjects: Convenience sample of 52 people with MS and 52 matched healthy controls Interventions: NA Main measures: Participants scored 15 statements assessing fatigue, pain, anxiety and quality of life on an electronic visual analogue scale (eVAS), either using a smartphone or a tablet (randomly allocated). To check for test-retest reliability, statements were administered in two separate randomly ordered groups. Subjects completed a feasibility questionnaire. Results: Mean (SD) eVAS scores ranged from 35 (28.1) to 80 (22.1) in MS group, and from 57 (28.0) to 86 (13.2) in controls. Intra Class Correlations ranged from 0.73 to 0.95 in MS sample; 0.61 to 0.92 in controls. For most statements, Bland-Altman plots indicated no systematic error, but relatively large random error of the eVAS scores (exceeding 20mm). Considerable ceiling effects (i.e. better health) were found in healthy controls. Similar reliability was found among smartphone or tablet, different demographic groups and the experience-groups. Conclusion: Electronic visual analogue scales are reliable and useful for people with MS to register fatigue, pain, anxiety and quality of life.
    Type of Medium: Online Resource
    ISSN: 0269-2155 , 1477-0873
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2028323-4
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  • 9
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 9_Supplement ( 2015-05-01), p. P4-01-14-P4-01-14
    Abstract: Introduction: Circulating tumour cells (CTC) found in the blood of patients with cancer offer the potential to provide a repeatedly accessible source of tumour cells for the real-time assessment of tumour characteristics in patients with metastatic breast cancer (MBC). Questions remain to what extent CTC are truly representative of the actually present tumour mass in a patient at a specific moment in time and the molecular heterogeneity within the CTC population is only now being explored. Here, we report on the first results of an ongoing comparative study of mutation profiles of CTC and synchronously isolated disseminated tumour cells (DTC) from metastatic effusions or biopsies of solid metastases of patients with clinically progressive MBC. Materials and methods: For this project CTC are isolated from 7.5 ml blood samples of patients with MBC using the CellSearch system. CellSearch enriched CTC samples are subsequently further purified and sorted into several batches of 1-125 CTC per patient using the DEPArray system. DNA is isolated and amplified using the Ampli1 whole genome amplification (WGA) kit and subjected to whole exome paired-end sequencing (WES). DTC from metastatic effusions, fresh frozen tissue from solid metastases or the primary tumour, or - in patients with extremely high CTC counts ( & gt;10.000/7.5 ml) - pooled CTC from the CellSearch Profile sample, are sequenced as a comparator for mutation profiles. DNA from the buffy coat of white blood cells are sequenced to enable somatic mutation analysis. Results: Eight samples of 1-125 CTC and a CellSearch Profile sample of one patient with MBC who had ca. 30.000 CTC/7.5 ml of blood (patient 1) and 4 CTC samples of 5-10 CTC, 2 temporally matched DTC samples of 10 and 20 DTC from a pleural effusion and a fresh frozen tissue sample of the primary tumour of a second patient (patient 2) have been sequenced so far. Average base coverages were 13.6x (patient 1) and 11.8x (patient 2) for CTC/DTC samples and 175x and 120x for the CellSearch profile sample (patient 1) and the primary tumour sample (patient 2) respectively. Between 29.64% and 53.57% of the exomes of amplification products of CTC/DTC DNA were uncovered, probably due to technical limitations of the WGA procedure. Overall, if adequately covered, good concordances were observed for variants identified with MuTect in 28 frequently mutated genes in breast cancer between samples of amplification products of 1-125 CTC and the CellSearch Profile sample of patient 1. In patient 2, the same H1047R PIK3CA mutation was identified in the primary tumour and all CTC and DTC samples. In-depth analyses of the full exome data are being conducted. Discussion: Our data provide insight into clinically relevant questions to what extent CTC reflect mutational profiles in temporally matched metastatic tumour cells, and – by analysing multiple CTC samples of the same patient – genetic heterogeneity between CTC in patients with MBC. Sample accrual and analysis is being expanded and updated results will be presented at the conference. Citation Format: Dieter JE Peeters, Ken Op De Beeck, Anja Brouwer, Geert Vandeweyer, Patrick Pauwels, Marc Peeters, Peter B Vermeulen, Peter A van Dam, Steven J Van Laere, Guy Van Camp, Luc Y Dirix. Whole exome sequencing of circulating and disseminated tumour cells in patients with metastatic breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-01-14.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 10
    In: Digestive Surgery, S. Karger AG, Vol. 22, No. 3 ( 2005), p. 168-173
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 Since 1996, a standard registration is used to obtain a clear understanding of the complications that occur after colorectal surgery. In our registration system the cause of a complication and the detrimental effect to the patient’s health are coded. 〈 i 〉 Methods: 〈 /i 〉 The treatment of colorectal diseases was evaluated to analyze the quality of medical care. 〈 i 〉 Results: 〈 /i 〉 From 1996 to 2000, a total of 169 complications were documented in 108 of the 353 patients operated on. Leakage of the anastomosis occurred in 22 cases (6%) and wound infection occurred in 11 cases (3%). Most of the complications required no or little medical attention (n = 101, 59%). 51% of the complications could be attributed to the physical condition of the patient. Surgical complications were the cause in 31% of the cases and management problems in 16% of the cases. 〈 i 〉 Conclusion: 〈 /i 〉 A registration system provides good insight into the frequency and severity of the complications after colorectal surgery. Extensive registration is mandatory to provide reliable information, comparing the results year by year. This provides the basis for continuous improvement of medical protocols on the surgical ward.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1468560-7
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