Publicaties Jeroen Bosch Ziekenhuis 2006

Transcription

1 Publicaties Jeroen Bosch Ziekenhuis 2006 Samengesteld door: Wetenschapsbureau en Wetenschapscommissie s-hertogenbosch,

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3 Inhoudsopgave Voorwoord... 5 ANESTHESIOLOGIE... 6 CHIRURGIE DERMATOLOGIE GYNAECOLOGIE INTERNE GENEESKUNDE KINDERGENEESKUNDE LONGZIEKTEN MEDISCHE MICROBIOLOGIE NEUROLOGIE NUCLEAIRE GENEESKUNDE PSYCHIATRIE RADIOLOGIE REUMATOLOGIE UROLOGIE ZIEKENHUISFARMACIE OVERIGE STAFDIENSTEN Dialyse PMA Fysiotherapie Logopedie PROEFSCHRIFTEN Auteur Index Tijdschriften Index

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5 Voorwoord Voor u ligt de eerste uitgave van publicatieboekje Resultaat in beeld, een initiatief van het Wetenschapsbureau van het cluster Leerhuis en de Wetenschapscommissie. In deze uitgave zijn alle wetenschappelijke publicaties uit het jaar 2006 van medewerkers van het Jeroen Bosch Ziekenhuis opgenomen. Hiermee zijn de wetenschappelijke ambities van het Jeroen Bosch Ziekenhuis goed voor het voetlicht gebracht. In deze eerste uitgave zijn 178 artikelen opgenomen waarvan er 96 in PubMed geciteerd worden. Tevens is er meegewerkt aan 9 boeken en zijn er 3 proefschriften verschenen. Het is belangrijk dat zowel de kwaliteit als de kwantiteit van het wetenschappelijk onderzoek binnen het Jeroen Bosch Ziekenhuis zich verder kunnen ontwikkelen. Het creëren van de randvoorwaarden daarvoor en het volgen van deze ontwikkeling zijn onderdeel van de doelstellingen die de Wetenschapcommissie en het Wetenschapsbureau zich hebben gesteld. Door de inventarisatie jaarlijks te herhalen zal zichtbaar worden of dit zich onder meer heeft vertaald in een toename van het aantal publicaties en daarnaast of ook de kwaliteit daarvan is toegenomen. Velen van u hebben zich voor de totstandkoming van dit overzicht ingespannen. Een extra compliment geldt voor het secretariaat van het Wetenschapsbureau. Helaas kan het zijn dat ondanks alle inspanningen deze uitgave misschien niet geheel volledig is. Voor eventuele opmerkingen of suggesties kunt u zich richten tot het secretariaat van het Wetenschapsbureau: m.everaars@jbz.nl of Wij spreken gezamenlijk de hoop uit dat deze uitgave u inspireert om hier blijvend uw bijdrage aan te willen leveren. Namens de Wetenschapscommissie en het Wetenschapsbureau, Judie van den Elshout, MSc. Staffunctionaris Wetenschapsbureau/cluster Leerhuis 5

6 ANESTHESIOLOGIE VOORDRACHTEN & POSTERS Lechner T, De acoustisch geleide epidurale punctie. Refereeravond UMCU en St. Radboud

7 CARDIOLOGIE ARTIKELEN Elsman P van t Hof AW, Hoorntje JCA, Suryapranata H, de Boer M, Dambrink JE, Borm GF, Ottervanger JP, Gosselink AT, Zijlstra F. Impact of infarct location on left ventricular ejection fraction after correction for enzymatic infarct size in acute myocardial infarction treated with primary coronary intervention. Am Heart J 2006 Jun;151(6):1239.e9-14. Department of Cardiology, Isala Klinieken, location Weezenlanden, Zwolle, The Netherlands. pelsman@hli.azu.nl BACKGROUND: Left ventricular function and infarct size are strong predictors for prognosis after acute myocardial infarction (MI). Anterior MI is associated with greater reduction of left ventricular ejection fraction (LVEF) and worse prognosis. Our objective was to study whether the impact of infarct size on global LVEF is dependent of infarct location. METHODS: We analyzed 888 patients treated with primary percutaneous coronary intervention for acute MI. Enzymatic infarct size and LVEF within 1 week were measured. In 490 patients (55%), LVEF was measured a second time at 6 months. RESULTS: Every 1000 U/L of cumulative lactate dehydrogense release corresponded to a decrease of 4.7% (95% CI ) in LVEF measured within 1 week post MI for left anterior descending coronary artery (LAD)-related infarcts and to a decrease of 2.4% (95% CI ) in LVEF measured within 1 week post MI for non-lad-related infarcts (P <.0001). Left ventricular ejection fraction measured 6 months post MI showed a decrease for every 1000 U/L cumulative lactate dehydrogense release of 4.8% (95% CI ) for LAD and 2.4% (95% CI ) for non- LAD-related infarcts (P <.0001). Multivariate correction for relevant clinical and angiographic data did not change these results. CONCLUSION: In patients with a first acute MI treated with primary percutaneous coronary intervention, LAD-related infarcts show for a similar amount of myocardial necrosis as determined by enzymatic infarct size, a lower residual LVEF when compared with non-lad-related infarcts. PMID: [PubMed - indexed for MEDLINE] Elsman P, van t Hof AW, Hoorntje JCA, de Boer M, Borm GF, Suryapranata H, Ottervanger JP, Gosselink AT, Dambrink JE, Zijlstra F. Effect of occlusion site on angiographic and clinical outcome in acute myocardial infarction patients treated with early coronary intervention. Am J Cardiol Apr 15;97(8): Epub 2006 Feb 28. Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands. pelsman@hli.azu.nl In acute myocardial infarction that is treated with thrombolysis, proximal coronary artery occlusion is associated with worse prognosis, irrespective of the infarcted artery. Primary percutaneous coronary intervention (PCI) is currently the treatment of choice for ST-segment elevation acute myocardial infarction. Therefore, we evaluated the prognostic significance of proximal versus distal coronary artery occlusion in patients with acute myocardial infarction that was treated with primary PCI. Between 1994 and 2001, patients with a first acute 7

8 myocardial infarction that was treated with primary PCI were analyzed. A lesion was considered proximal if it was located proximal to the first diagonal branch in the left anterior descending coronary artery (LAD), the first marginal obtuse branch in the left circumflex coronary artery, and the first right acute marginal branch in the right coronary artery. Lesions distal of these side branches were considered distal. In total, 1,468 patients were analyzed. Left ventricular ejection fraction (LVEF) for proximal LAD lesions was lower than that for distal ones (37 +/- 11% vs 42 +/- 11%, p <0.0001). Adjusted relative risk of 3-year mortality for proximal versus distal LAD was 4.04 (95% confidence interval 1.95 to 8.38). In patients with infarcts related to the right or left circumflex coronary artery, no significant association between lesion location and LVEF or mortality was seen. No difference was seen in adjusted 3-year mortality between distal LAD and non-lad-related infarcts (p = 0.145). In conclusion, our analysis shows that, even in patients with acute myocardial infarction that is treated with primary PCI, infarcts related to the proximal LAD have the worst 3-year survival and lowest residual LVEF compared with distal LAD or non-lad-related infarcts. PMID: [PubMed - indexed for MEDLINE] de Kort E, Thijssen JM, Daniels O, de Korte CL, Kapusta L. Improvement of heart function after balloon dilatation of congenital valvar aortic stenosis: a pilot study with Ultrasound Tissue Doppler and Strain Rate Imaging. Ultrasound Med & Biol 2006;32(7): Children's Heart Center, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. The aim was to investigate the effects of balloon dilation of congenital valvar aortic (Ao) stenosis on heart function with conventional and with new echocardiographic techniques. Nine patients, preballoon and 1 to 4 d postballoon dilation of Ao-valve, were included in the study. Assessment of heart function was made by using conventional echo/doppler, tissue Doppler imaging (TDI) and strain rate imaging (SRI). Mean (and standard deviation) of posttreatment drop of aortic valve pressure gradient was 34.1 (sd 14.0) mmhg, p < Conventional echo/doppler end-diastolic left ventricular posterior wall (LVPW) thickness and interventricular septum (IVS) thickness did not change significantly. Mean change of LV fractional shortening (FS) was -5.2 (sd 3.2)%, p < The observed changes of FS did not significantly correlate to the magnitude of pressure gradient changes. Changes of TDI and SRI parameters indicated that an increase in absolute value is observed in most cases, but correlation to pressure gradient change remains poor, with a few exceptions, both in LV free wall (LVFW) and IVS. Data from IVS are more consistent than of LVFW. It is concluded that the global functional parameter FS assessed by conventional echo/doppler has diagnostic value for the assessment of (improved) heart function already shortly after intervention, when compared with the pretreatment value. Local parameters from the new echographic techniques show less significant short-term effects attributable to the intervention. Improvement of the precision of SRI measurements is needed. A larger study is indicated to fully investigate the expected potentials of TDI and SRI for the assessment of local improvement of heart function early after intervention, as well as for revealing eventual late effects on these functional parameters. PMID: [PubMed - indexed for MEDLINE] 8

9 VOORDRACHTEN & POSTERS Jansen HJ, Gerritsen R, Beutler JJ, Louwerse ES, van Loenhout RM, Daniëls MC. Benefit of a secondary prevention clinic for cardiovascular disease. Neth. Heart J. 2006; 14:2. Daniëls MC. Organisatie GZG Cardiologie Symposium voor Huisartsen met voordracht: Stabiele Coronaire Syndromen Daniëls MC. Voordracht Medicamenteuze Behandeling Hartfalen: meer dan ACE remmers en B-blokkers? Symposium Catharina Ziekenhuis Eindhoven, November Daniëls MC. Voordracht HAIO s: Stabiele en Acute Coronaire Syndromen. Universiteit Maastricht, December Kolff M. Hartfalen. Nascholing huisartsen (geaccrediteerd) Kolff M, Bots L. Acuut Coronair Syndroom. Samenscholingdagen Kolff M. Cardiovasculair risico. Districsduodagen de Kort E, Bambang Oetomo S, Zegers B. Antenatale hydronefrose: tot 15 mm is een afwachtend beleid geoorloofd. NVK Congres, 2006; november 1-3, Veldhoven 9

10 CHIRURGIE ARTIKELEN Phernambucq EC, Biesma B, Smit EF, Paul MA, vd Tol A, Schramel FM, Bolhuis RJ, Postmus PE. Multicenter phase II trial of accelerated cisplatin and high dose epirubicin followed by surgery or radiotherapy in patients with stage IIIa-N2 non-small cell lung cancer (NSCLC). British Journal of Cancer (2006) 95, Department of Pulmonary Diseases, VU Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. To assess the therapeutic activity of accelerated cisplatin and high-dose epirubicin with erythropoietin and G-CSF support as induction therapy for patients with stage IIIa-N2 nonsmall-cell lung cancer (NSCLC). Patients with stage IIIa-N2 NSCLC were enrolled in a phase II trial. They received cisplatin 60 mg m(-2) and epirubicin 135 mg m(-2) every 2 weeks for three courses combined with erythropoietin and G-CSF. Depending on results of clinical response to induction therapy and restaging, patients were treated with surgery or radiotherapy. In total, 61 patients entered from March 2001 to April During 169 courses of induction chemotherapy, National Cancer Institute of Canada (NCI-C) grade III/IV leucocytopenia was reported in 35 courses (20.7%), NCI-C grade III/IV thrombocytopenia in 26 courses (15.4%) and NCI-C grade III/IV anaemia in six courses (3.6%). Main cause of cisplatin dose reduction was nephrotoxicity (12 courses). Most patients received three courses. There were no chemotherapy-related deaths. Three patients were not evaluable for clinical response. Twenty-eight patients had a partial response (48.3%, 95% CI: %), 24 stable disease and six progressive disease. After induction therapy, 30 patients underwent surgery; complete resection was achieved in 19 procedures (31.1%). Radical radiotherapy was delivered to 25 patients (41%). Six patients were considered unfit for further treatment. Median survival for all patients was 18 months. Response rate of accelerated cisplatin and high-dose epirubicin as induction chemotherapy for stage IIIa-N2 NSCLC patients is not different from more commonly used cisplatin-based regimen. PMID: [PubMed - indexed for MEDLINE] Bochove-Overgaauw DM, Beerlage HP, Bosscha K, Gelderman WA. Transanal endoscopic microsurgery for correction of rectourethral fistulae. J Endourol 2006; 20 (12): Department of Urology, Jeroen Bosch Ziekenhuis, 's-hertogenbosch, The Netherlands. BACKGROUND: Rectourethral fistula is a rare complication of radical prostatectomy. Transanal endoscopic microsurgery (TEM) is a minimally invasive technique available for its surgical correction, although currently, TEM is used more commonly for excision of adenomas and stage T(1) carcinomas of the rectum. PATIENTS AND METHODS: We report two patients with rectourethral fistulae after laparoscopic radical prostatectomy in whom TEM was used for closure. The surgical procedure included microscopic full-thickness excision of the rectal wall around the fistula with a 1-cm margin and endoscopic suturing of the defect in the urethral and rectal walls. RESULTS: In one case, the rectourethral fistula was 10

11 closed using TEM. In the other patient, the procedure, performed after failure of a graciloplasty, was difficult because of extensive scar tissue, and the fistula persisted. CONCLUSIONS: The TEM procedure is a minimally invasive technique that may be considered for surgical repair of rectourethral fistulae. PMID: [PubMed - indexed for MEDLINE] Streefkerk HJ, Bremmer JP, van Weelden M, van Dijk RR, de Winter E, Beck RJ, Tulleken CA. The excimer laser-assisted nonocclusive anastomosis practice model: development and application of a tool for practicing microvascular anastomosis techniques. Neurosurgery Feb;58(1 Suppl):ONS148-56; discussion ONS OBJECTIVE: To practice microsurgical skills, several experimental models are available that diminish the need for experimental animals. We defined criteria with which such models should comply, and we tested whether the models described in literature, as well as our own practice model, comply with these criteria. METHODS: We defined the criteria to which these models should comply, and we performed a literature search on microvascular practice models. During the development of the Excimer laser-assisted nonocclusive anastomosis technique, we designed our own Excimer laser-assisted nonocclusive anastomosis Practice Model (EPM) according to those criteria, and we compared that model with the models described in the literature. RESULTS: All practice models could be categorized into three groups: beginner, moderate, and advanced. Our EPM complies with almost all criteria defined in the beginner and moderate groups and has much in common with the models that are categorized in the advanced group. CONCLUSION: In consideration of the methods to learn microvascular surgical techniques, the EPM can be used for a very long time before the need for living animals arises. This last aspect remains an inescapable condition for practicing microsurgical skills. However, with use of the EPM or another practice model, the amount of experimental animals can be drastically reduced. PMID: [PubMed - indexed for MEDLINE] Janssen-Heijnen ML, Houterman S, Verheij KD, van Geffen HJ, Smeenk FW, Rodrigus PT, Coebergh JW. Higher postoperative mortality rate in elderly stage I or II resected non-small cell lung cancer patients compared to younger patients: a population-based study Koning OH, Oudegeest OR, Valstar ER, Garling EH, van der Linden E, Hinnen JW, Hamming JF, Vossepoel AM, van Bockel JH. Roentgen stereophotogrammetric analysis: an accurate tool to assess stent-graft migration. J Endovasc Ther Aug;13(4): Department of Surgery, Division of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands. koning@lumc.nl 11

12 PURPOSE: To evaluate in an in vitro model the feasibility and accuracy of Roentgen stereophotogrammetric analysis (RSA) versus computed tomography (CT) for the ability to detect stent-graft migration. METHODS: An aortic model was constructed from a 22-mmdiameter Plexiglas tube with 6-mm polytetrafluoroethylene inlays to mimic the renal arteries. Six tantalum markers were placed in the wall of the aortic tube proximal to the renal arteries. Another 6 markers were added to a Gianturco stent, which was cast in Plexiglas and placed inside the aorta and fixed to a micromanipulator to precisely control displacement of the stent along the longitudinal axis. Sixteen migrations were analyzed with RSA software and compared to the micromanipulator. Thirty-two migrations were measured by 3 observers from CT images acquired with 16x0.5-mm beam collimation and reconstructed with a 0.5-mm slice thickness and a 0.4-mm reconstruction interval. Measurements were made with Vitrea postprocessing software using a standard clinical protocol and central lumen line reconstruction. Results of CT were also compared to the micromanipulator. RESULTS: The mean RSA measurement error compared to the micromanipulator was / mm, and the maximum error was 0.10 mm. There was no statistically significant interobserver variability for CT (p=0.17). The pooled mean (maximum) measurement error of CT was 0.14+/-0.29 (1.00) mm, which was significantly different from the RSA measurement error (p<0.0001). CONCLUSION: Detection of endograft migration by RSA is feasible and was significantly more accurate than CT in this nonpulsatile in vitro model. PMID: [PubMed - indexed for MEDLINE] Hinnen JW, Koning OH, Vlaanderen E, van Bockel JH, Hamming JF. Aneurysm sac pressure monitoring: effect of pulsatile motion of the pressure sensor on the interpretation of measurements. J Endovasc Ther Apr;13(2): Comment in: J Endovasc Ther Aug;13(4):565; author reply Department of Surgery, Section Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands. PURPOSE: To determine the effect of pulsatile motion of graft-attached pressure sensors on the accuracy of aneurysm sac pressure measurement. METHODS: Pressure inside a pressure box was measured with a sensor attached to a stent-graft (Sensorgraft) facing a sensor in fixed position (Sensorbox). Maximum inter-sensor variation of Sensorgraft and Sensorbox was determined in static experiments. Experiments with pulsatile circulation were performed with a compliant and a noncompliant stent-graft at 120/80 mmhg and 160/95 mmhg. Pressure measurements in the box were repeated after the box pressure was increased from 0 to 120 mmhg. Sensorgraft motion was measured by ultrasound. Measurements with Sensorgraft were compared to those with Sensorbox using Pearson correlation coefficients to determine the concordance between the sensors. RESULTS: The maximum inter-sensor variation was 4 mmhg. Increased box pressure induced progressive pulsatile graft and sensor motion during all experiments. During the experiments with the compliant graft at systemic pressures of 120/80 and 160/95 mmhg, the maximum inter-sensor variation was exceeded at box pressures of 65 and 75 mmhg, respectively. The sensor motion at these box pressures was 214+/-2.70 microm and 210+/-0.93 microm, respectively. Measurements of Sensorgraft were higher than Sensorbox, up to 13 mmhg at a box pressure of 120 mmhg. The Pearson correlation coefficients during these experiments were 0.99 and 1.00 (p < 0.001), respectively. In the experiments with the noncompliant graft, the maximum inter-sensor variation was not exceeded, and sensor motion was only 7 +/ microm and 26 +/ microm, respectively. The Pearson correlation coefficient during these experiments was 1.00 (p < 12

13 0.001). CONCLUSION: Pulsatile sensor motion can influence the accuracy of pressure measurement. More compliant grafts are more susceptible to this phenomenon. Despite false high pressure measurements, stent-graft-attached pressure sensors seem appropriate to follow pressure trends in the aneurysm sac. PMID: [PubMed - indexed for MEDLINE] Koning OH, Hinnen JW, van Baalen JM. Technique for safe removal of an aortic endograft with suprarenal fixation. J Vasc Surg Apr;43(4): Department of Surgery, Division of Vascular Surgery, Leiden University Medical Center, The Netherlands. koning@lumc.nl Complete removal of an aortic endograft with suprarenal fixation is difficult. We report the use of a simple device to extract a Zenith endograft. This device is made by cutting off the tip of the cylinder of a 20-mL syringe and rounding off the edges. The main body of the graft is resheathed by advancing the cylinder cranially while keeping the graft in a stable position. This way, the graft collapses and the hooks are withdrawn without tearing the wall of the aorta. The supraceliac clamping time in our patient was less than 2 minutes. This technique offers a safe and fast solution to the potentially hazardous removal of an aortic endograft with suprarenal fixation. PMID: [PubMed - indexed for MEDLINE] Hinnen JW, Rixen DJ, Koning OH, van Bockel JH, Hamming JF. Development of fibrinous thrombus analogue for in-vitro abdominal aortic aneurysm studies. J Biomech. 2007;40(2): Epub 2006 Mar 6. Department of Surgery, Section of Vascular Surgery, Leiden University Medical Center, Postbox 9600, K6-R, 2300 RC Leiden, The Netherlands. j.w.hinnen@lumc.nl PURPOSE: To develop different thrombus analogues, with mechanical properties similar to those of human fibrinous thrombus, for in-vitro aneurysm sac pressure studies. METHODS: Using dynamic mechanical analysis we determined the E-modulus (/E(*)/) at 0.8, 1.0, 1.5 and 3.9 Hz of ten different human fibrinous thrombus samples. We also determined loss and storage modulus to quantify the visco-elastic properties. For comparison, we measured the E- modulus ( E(*) ), loss and storage modulus of gelatin, Novalyse ST8, ST14 and ST20 with and without contrast agent. RESULTS: Mean E-modulus of the thrombus samples (SD) at 0.8, 1.0, 1.5 and 3.9 Hz was 39 (16), 37 (15), 37 (15) and 38 (14)kPa, respectively. Median (SD) storage and loss modulus were 35 (12) and 8 (4)kPa, respectively. Median (SD) tandelta was 0.25 (0.06). The E-modulus of gelatin, Novalyse ST8, ST14 and ST20 was 4, 27, 48 and 60 kpa, respectively. The E-modulus of Novalyse ST8, ST14 and ST20 mixed with contrast agent was 18, 23 and 33 kpa, respectively. Median (SD) storage, loss modulus and tan delta of the six Novalyse samples were 30 (15), 3 (1) and (0.04), respectively. CONCLUSION: All the thrombus analogues, except gelatin, had an E-modulus in the range of human fibrinous thrombi. Novalyse samples are validated thrombus analogues for in-vitro aneurysm sac pressure studies. Gelatin is not appropriate to simulate fibrinous thrombus. PMID: [PubMed - in process] 13

14 Duijff JW, Koning OH, van Baalen JM. Pseudoaneurysma van de arteria dorsalis pedis veroorzaakt door een exostose op de talus bij een hemofilie A patiënt. Case report en review van de literatuur. Ned Tijdschrift voor Heelkunde Dec;15(8): van la Parra RF, Mirck PG, Lohuis PJ. Otoliquorroe als gevolg van een arachnoidale cyste van de canalis facialis. NTVKNO, 2006 (1). van la Parra RF, Kon M, Schellekens PP, Braunius W, Pameijer F. Radiographic evaluation of neopharyngeal leakage after ablative surgery: an image-based grading system and its use in clinical practice. Submitted for publication (2006) by Cancer Imaging. van la Parra RF, Mirck PG, Lohuis PJ An arachnoid cyst of the Fallopian canal. Accepted for publication (2006) by Otology and Neurotology. van la Parra RF, Ruurda JP, Koning OH. Traumatic trachea rupture. Submitted for publication (2006) by NEJM. Draaisma A, Ruurda JP, Scheffer RC, Simmermacher RK, Gooszen HG, Rijnhart-de Jong HG, Buskens E, Broeders IA. Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Br J Surg Nov;93(11): Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands. BACKGROUND: Robotic systems for minimally invasive surgery may be of added value during extensive dissection and suturing in confined spaces, such as laparoscopic Nissen fundoplication (LNF). The purpose of this trial was to compare standard LNF with robotassisted Nissen fundoplication (RNF). METHODS: Between 2003 and 2005, 50 patients with confirmed refractory gastro-oesophageal reflux disease were assigned to LNF (25) or RNF (25). Patients who had undergone previous antireflux surgery were excluded. Independent assessment of dysphagia, regurgitation, heartburn and general well-being was performed before and 6 months after surgery using questionnaires. Objective outcome was studied 6 months after surgery by oesophageal manometry, 24-h ph monitoring, barium oesophagram series and upper endoscopy. RESULTS: Operating time, blood loss, postoperative pain scores, hospital stay and complication rates did not differ significantly between the two groups. Reoperation rates were the same (one incisional hernia after LNF and one patient with repeat Nissen after RNF because of persistent dysphagia). Postoperative self-rated change in 14

15 reflux symptoms and quality of life improved equally in both groups. The reduction in oesophageal acid exposure, increase in lower oesophageal sphincter tone and mucosal healing were comparable in both groups at follow-up. CONCLUSION: RNF yielded similar subjective and objective results to LNF in this study. Therefore no additive value of robotic systems for this procedure was detected up to 6 months after surgery. PMID: [PubMed - indexed for MEDLINE] Van Schaik PM, Gelderman WA, Ernst MF, van der Linden JC, Bosscha K. Ex-vivo sentinel lymph node mapping in patients with colorectal cancer. European Journal of Surgical Oncology: 2006;32(1):S Eur J Surg Oncol Apr 19; [Epub ahead of print] Department of Surgery, Jeroen Bosch Hospital, Tolbrugstraat 11, 5211 RW 's- Hertogenbosch, The Netherlands. BACKGROUND: The purpose of this study was to evaluate the feasibility and reliability of ex vivo sentinel lymph node mapping in patients with colorectal cancer. METHODS: In the period January-June 2006, 44 consecutive patients underwent curative surgery for colorectal cancer. In patients with colon and rectal cancer, 0.5-2ml of Patent Blue Dye was injected submucosally. The injection sites where then gently massaged for 5min. RESULTS: In 96% of the patients with colon cancer and 94% of the patients with rectal cancer, at least one sentinel lymph node was found. There were no patients with a false negative sentinel node. The sensitivity was 100% with a negative predictive value of 100%. In 19% of the patients with colon cancer and 18% of the patients with rectal cancer the sentinel node was the exclusive site of lymph node metastases. After additional sectioning and staining, 7 of the 23 patients (30%) with a Dukes B colorectal cancer were upstaged. CONCLUSION: The technique of ex vivo sentinel lymph node mapping is technically feasible with high sensitivity, high negative predictive value and a high rate of upstaging. The next step is to investigate, if detection of micro-metastases is associated with decreased survival and/or increased local recurrence rates. PMID: [PubMed - as supplied by publisher] Van Schaik PM, Kouwenhoven EA, Bolhuis RJ, Biesma B, Bosscha K. Pulmonary resection for metastases from colorectal cancer. Accepted for publication (2006) by Journal of Thoracic Oncology. Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Outcome after abdomino-perineal resections: short and long term results. Submitted for publication (2006) by Digestive Surgery (under review). Van Schaik PM, Gelderman WA, Bosscha K. Quality of life after abdomino-perineal resection and (low) - anterior resection. Submitted for publication (2006) by European Journal of Surgical Oncology (under review). 15

16 Van Schaik PM, Gelderman WA, Meijer HA, Bosscha K. Melanoma of the rectum: a rare entity. Submitted for publication (2006) by Diseases of the Colon and Rectum (under review). BOEKEN Van Geffen HJ, Kreb DL, Simmermacher RK, Olsman JG, Van der Werken Chr. Long term results of reconstructing large abdominal wall defects with the Components Separation Method. In: Recurrent Hernia; Prevention and Treatment (4th Expert Meeting on Hernia Surgery, St. Moritz, February Editors: Prof. Dr. V. Schumpelick and Prof. Dr. Robert J. Fitzgibbons. Springer- Verlag. ISBN: VOORDRACHTEN & POSTERS Kokke MC, Ernst MF, Eijckeler F, van der Linden JC, Barneveld PC, Gelderman WA, Wissing JC, Bosscha K. Axillary recurrence after negative sentinel node in breast cancer. Abstract. European Journal of Surgical Oncology 2006;32 (1): S79 Kokke MC, Ernst MF, Rutten MC, Wissing JC, Bosscha K. Magnetic Resonance Imaging (MRI) in the preoperative assessment of patients with lobular carcinoma. Abstract. European Journal of Surgical Oncology 2006;32 (1): S2 Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. Role of (18)-FDG-PET-scan in preooperative management of oesophogeal carcinoma. Abstract. European Journal of Surgical Oncology 2006;32 (1): S39 Berende CA, Ernst MF, Gelderman WA, Bosscha K. Effectiveness and morbidity of 68 needle catheter jejunostomies installed after major abdominal surgery. Abstract. European Journal of Surgical Oncology 2006;32 (1): 16

17 Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. Effectiveness and morbidity of 68 needle catheter jejunostomies installed after major abdominal surgery. Abstract. Eur J Gastroenterol Hepatology 2006; Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. Role of (18)-FDG-PET-scan in preooperative management of oesophogeal carcinoma.. Abstract. Eur J Gastroenterol Hepatology 2006; Kreb DL, Rutten MC, van der Linden JC, Pruijt JF, Bosscha K. Ultrasound-guided radiofrequency ablation of early breast cancer in a resection specimen: first results of a feasibility study. Abstract. European Journal of Surgical Oncology 2006;32 (1): S Steenbruggen JJ, Ernst MF, Bosscha K, Gelderman WA. Transanal enscopic microsurgery: experience of the first 70 cases. Abstract. European Journal of Surgical Oncology 2006;32 (1): S115. Kokke MC, Ernst MF, Rutten MC, Wissing JC, Bosscha K. Magnetic Resonance Imaging (MRI) in the preoperative assessment of patients with lobular carcinoma. ESSO 2006, 30 nov - 2 dec 2006, Venetië, Italië. Kokke, MC, Ernst MF, Rutten MC, Wissing JC, Bosscha K. Aanvullende waarde van MRI bij premenopausale patienten met mammacarcinoom. 25 ste oncologiedagen voor verpleegkundigen, 10 november Berende CA, Ernst MF, Gelderman WA, Bosscha K. Effectiveness and morbidity of 68 needle catheter jejunostomies installed after major abdominal surgery. Najaarsvergadering NVGE / NVGIC, 5-6 oktober 2006, Veldhoven. Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. Role of (18)-FDG-PET-scan in preooperative management of oesophageal carcinoma. Najaarsvergadering NVGE / NVGIC, 5-6 oktober 2006, Veldhoven. 17

18 Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. Role of (18)-FDG-PET-scan in preoperative management of oesophageal carcinoma. OESO World Congres, Avignon, September 2006, Frankrijk. Kreb DL, Rutten MC, van der Linden JC, Pruijt JF, Bosscha K. Eerste resultaten van echogeleide radiofrequente ablatie van mammacarcinomen. Najaarsvergadering NVvH, 24 november 2006, Ede. Kreb DL, Rutten MC, van der Linden JC, Pruijt JF, Bosscha K. Histologische evaluatie van mammacarcinoom behandeld met radiofrequente ablatie. Vereniging Analisten Pathologie, maart 2006, Utrecht Van la Parra RF, Ernst MF, Barneveld PC, Broekman J, Bosscha K. Schildwachtklierbiopsie bij DCIS. Najaarsvergadering NVvH, 24 november, Ede Van Wensen RJ, Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. De rol van PET bij de stadiëring van het oesophaguscarcinoom. Najaarsvergadering NVvH, 24 november 2006, Ede. Kokke MC, Ernst MF, Eijckeler F, van der Linden JC, Barneveld PC, Gelderman WA, Wissing JC, Bosscha K. Axillary recurrence after negative sentinel node in breast cancer. ESSO, 30 nov - 2 dec 2006, Venetië, Italië. Berende CA, Ernst MF, Gelderman WA, Bosscha K. Effectiveness and morbidity of 68 needle catheter jejunostomies installed after major abdominal surgery. ESSO 2006, 30 nov - 2 dec 2006, Venetië, Italië. Berende CA, Hoekstra C, Claessens RA, Van Munster I, Bosscha K. Role of (18)-FDG-PET-scan in preoperative management of oesophogeal carcinoma. ESSO 2006, 30 nov - 2 dec 2006, Venetië, Italië. 18

19 Kreb DL, Rutten MC, van der Linden JC, Pruijt JF, Bosscha K. Ultrasound-guided radiofrequency ablation of small breast cancer in a resection specimen; a feasibility study. From gene to cure. February 2006, Amsterdam Kreb DL, Rutten MC, van der Linden JC, Pruijt JF, Bosscha K. Ultrasound-guided radiofrequency ablation of early breast cancer in a resection specimen: first results of a feasibility study. ESSO 2006, 30 nov - 2 dec 2006, Venetië, Italië. Van Geffen HJ. Long term results of reconstructing large abdominal wall defects with the Components Separation Method. Experts meeting, St. Moritz, Zwitserland, 2 februari Van Geffen HJ. De gecontamineerde littekenbreuk; wél of geen mat? Chirurgendagen NVvH, Veldhoven. 18 mei 2006 Berende CA, Ruurda JP, Olsman JG, van Geffen HJ. Inguinal hernia treatment with the Prolene Hernia System in a Dutch regional teaching hospital. American Hernia Society, Boston, 10 juni Van Geffen HJ. Tension free inguinal hernia repair. European Surgical Panel meeting, Praag, 23 november van la Parra RF, Ernst MF, Barneveld PC, Broekman J, Bosscha K. Schildwachtklierbiopsie bij DCIS. Najaarsvergadering NVvH, Ede, november Ruurda JP. Succesvolle behandeling van miltbloedingen door selectieve catheterisatie en embolisatie van de arteria lienalis Wetenschappelijke vergadering chirurgie JBZ, Vught, Nederland, 9 december

20 Van Schaik PM, van der Linden JC, Ernst MF, Gelderman WA, Bosscha K. Ex-vivo sentinel lymph node mapping in patients with colorectal cancer. Abstract Journal of Gastroenterology and Hepatology Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Low local recurrence rate with multimodality treatment for distal rectal cancer. Abstract. European Journal of Surgical Oncology. 2006;32(1):S5, Top scoring abstract ESSO Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Low local recurrence rate with multimodality treatment for distal rectal cancer. Abstract. Annals of Oncology. 2006;17(1):i33. Van Schaik PM, van der Linden JC, Ernst MF, Gelderman WA, Bosscha K. Ex-vivo sentinel lymph node mapping in patients with colorectal cancer. Poster European Society of Surgical Oncology, 30 nov - 2 dec 2006, Venetië, Italië. Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Low local recurrence rate with multimodality treatment for distal rectal cancer. European Society of Surgical Oncology, 30 nov - 2 dec 2006, Venetië, Italië. Van Schaik PM, van der Linden JC, Ernst MF, Gelderman WA, Bosscha K. Ex-vivo sentinel lymph node mapping in patients with colorectal cancer. Najaarsvergadering NVGE / NVGIC, 5-6 oktober 2006, Veldhoven. Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Low local recurrence rate with multimodality treatment for distal rectal cancer. Poster European Multidisciplinary Colorectal Cancer Congress 2006, februari 2006, Berlijn, Duitsland. Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Abdomino-perineale resecties: korte en lange termijn resultaten. Regionale refereeravond UMC Utrecht, 7 februari

21 Van Schaik PM, Gelderman WA, Kouwenhoven EA, Bosscha K. Outcome after abdomino-perineal resections: short and long term results. Submitted for publication (2006) by Digestive Surgery. Van Schaik PM, Gelderman WA, Bosscha K. Quality of life after abdomino-perineal resection and (low) - anterior resection. Submitted for publication (2006) by European Journal of Surgical Oncology. Van Schaik PM, Gelderman WA, Meijer HA, Bosscha K. Melanoma of the rectum: a rare entity. Submitted for publication (2006) by Diseases of the Colon and Rectum. Steenbruggen JJ, Ernst MF, Bosscha K, Gelderman WA. Transanale Endoscopische Microchirurgie in de IKZ Regio. Resultaten van de eerste 70 patiënten. Voorjaarsvergadering Heelkunde, 2006; mei Veldhoven. Steenbruggen JJ, Ernst MF, Bosscha K, Gelderman WA. Transanal Endoscopic Microsurgery: experience of the first 70 cases. ESSO, 2006; November-december 30,1-2, Venetië. Van Wensen RJ, Berende CA, Hoekstra C, van Munster I, Bosscha K. Rol van (18)-FDG-PET-scan in preoperatief management bij oesophagus carcinoom. Najaarsvergadering NVvH 2006 Van Wensen RJ, Dautzenberg PL, Olsman JG, Bosscha K. Delier binnen het JBZ Wetenschapsmiddag JBZ, afdeling chirurgie, 8 december DIVERSEN Steenbruggen JJ, Ernst MF, Bosscha K, Gelderman WA. Transanale Endoscopische Microchirurgie. In CURA

22 Van Wensen RJ, Dautzenberg PL, Olsman JG, Bosscha K. Start DELTa-S en DELTa-G studie. Investigatorsmeeting aula Jeroen Bosch Ziekenhuis 30 juni

23 DERMATOLOGIE ARTIKELEN Blokx WA, Lesterhuis WJ, Andriessen MP, Verdijk MA, Punt CJ, Ligtenberg MJ. CDKN2A (INK4A-ARF) mutation analysis to distinguish cutaneous melanoma metastasis from a second primary melanoma. Accepted for publication (2006) by Am J Surg Pathol. Van de Kerkhof PC, Kleinpenning MM, de Jong EM, Gerritsen RM, van Dooren-Greebe RJ, Alkemade HA. Current and future treatment options for acne. J Dermatolog Treat 2006; 17: Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherland. p.vandekerkhof@derma.umcn.nl Acne is a frequent skin disease with abnormalities in the process of keratinization, sebaceous gland functioning and inflammation. In this review, our understanding of the pathogenesis of acne has been updated. An overview of efficacy and side effects of available anti-acne treatments is presented. Based on the present overview a recommendation for the treatment of various manifestations of acne is provided, also reconciling beneficial combinations of treatments. It is attractive to speculate that the increased insight into the pathogenesis of acne will create new treatment options. Challenging new options comprise blue light, photodynamic therapy, retinoic acid metabolism blocking agents and inhibitors of Th-1 cytokines. PMID: [PubMed - indexed for MEDLINE] Sibelt LA, Hulshof MC, van de Kerkhof PC, van Dooren-Greebe RJ. Palliatieve radiotherapie met adjuvante hyperthermie bij een gemetastaseerd melanoom. Ned Tijdschr. Derm Venereol 2006, 16; Sibelt LA, Lokhorst HM, van de Kerkhof PC, van Dooren-Greebe RJ. A muscle' man without exercise: muscle pseudohypertrophy in myeloma associated generalized amyloidosis. Accepted for publication (2006) by EJD. Bovenschen HJ, Tjioe M, Vermaat H, de Hoop D, Witteman BM, Janssens RW, Stoof TJ, van de Kerkhof PC. 23

24 Induction of eruptive benign melanocytic naevi by immune suppressive agents, including biologicals. British Journal of Dermatology 2006 May;154(5): Vermaat H, Bovenschen HJ, Tjioe M, de Hoop D, Janssens RW, Stoof TJ. Eruptieve naevi en immunosuppressie. Ned Tijdschr Dermatol en Venereol 2006;16: VOORDRACHTEN & POSTERS Van Dooren-Greebe RJ. Vulvaire Dermatosen. Jeroen Bosch Ziekenhuis. Voordracht voor werkgroep Bekkenbodemfysiotherapeuten Regio Brabant. Den Bosch, 8 februari Van Dooren-Greebe RJ. Vakoverstijgend Co-assistenten onderwijs JBZ. "Ulcus cruris", Den Bosch, 1 Maart 2006 en 13 September Van Dooren-Greebe RJ. Ulcus Cruris Venosum. Voordracht tijdens intoductiebijeenkomst transmurale richtlijn ulcus cruris regio Den Bosch. Den Bosch, 1 Juni 2006 en 14 September Van Dooren-Greebe RJ. Teledermatologie. Voordracht tijdens introductiebijeenkomst Teledermatologie regio Den Bosch i.s.m. TCCN. Den Bosch, 29 Juni Van Dooren-Greebe RJ. Therapie van atopisch eczeem. Jeroen Bosch Ziekenhuis, afd. Kindergeneeskunde, Den Bosch, 16 Augustus Van Dooren-Greebe RJ. Veneuze pathologie en pijnbestrijding. Jeroen Bosch Ziekenhuis, afdeling dagverpleging locatie Carolus, 4 December

25 Van Geest A. "Bulleus pemphigoid tijdens radiotherapie", refereeravond radiotherapie, Academisch Ziekenhuis Maastricht, 1 februari

26 GERIATRIE ARTIKELEN Dautzenberg PL. Medicamenteuze behandeling van gedrags- en psychiatrische problemen bij dementie (BPSD). De Ark 2006;15(3):13-7. Dautzenberg PL. De geheugenpolikliniek: wanneer doorverwijzen? Modern Medicine 2006;6: Baron M, Braamhorst W, Koek HL, Dautzenberg PL. Patients and relatives desire their physician to give a judgement about driving abilities: a survey by questionnaire on a Dutch memory clinic. Int J Ger Psychiatry 2006;21: Rovers JM, Dautzenberg PL, ter Bruggen JP. Rivastigmine als ondersteuning bij het dilemma van de behandeling van hallucinaties optredend bij ziekte van Parkinson. TGG 2006;37: Dautzenberg PL, Wouters CJ, Bootsma JE. Observations from a 14-week open-label trial with memantine suggest variable response on behavioral symptoms and cognition, depending on former treatment of AD. Int Psychogeriatr Mar;18(1): PMID: [PubMed - indexed for MEDLINE] Dautzenberg PL, Wouters CJ, Bootsma JE. Observations from a 14-week open label trial with memantine suggest variable response on behavioural symptoms and cognition, depending on former treatment of AD. Int Psychogeriatr Feb 15;:1-3 [Epub ahead of print] Department of Geriatrics, Jeroen Bosch Hospital, GV's-Hertogenbosch, The Netherlands. E- mail: p.dautzenberg@jbz.nl. 26

27 Memantine, an uncompetitive N-methyl D-aspartate (NMDA) receptor antagonist, is currently the only treatment licenced for moderately severe to severe Alzheimer's Disease (AD). Memantine is effective on cognitive symptoms (Reisberg et al., 2003 Tariot et al., 2004 Winblad and Portis, 1999), and in a post-hoc analysis of behavioural symptoms, memantine showed beneficial effects particularly on agitation/aggression (Gauthier et al., 2005). PMID: [PubMed - as supplied by publisher] 27

28 GYNAECOLOGIE ARTIKELEN De Reu, PA, Snijders RJ, Oosterbaan HP, Smits LJ, de Reu-Cuppens MJ, Nijhuis JG. Zijn de in Nederland gebruikte echografische groeicurven vergelijkbaar en correct? NTOG vol 119 (6) (2006). Roes EM, Hendriks JC, Raijmakers MT, Steegers-Theunissen RP, Groenen PM, Peters WH, Steegers EA. A longitudinal study of antioxidant status during uncomplicated and hypertensive pregnancies. Acta Obstet Gynecol Scand. 2006;85(2): Department of Obstetrics & Gynaecology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. BACKGROUND: To study the possible involvement of an (im)balance between oxidants and antioxidants in pre-eclampsia concentrations of intra- and extracellular blood antioxidants in women with uncomplicated and hypertensive pregnancies, they were studied preconceptionally and throughout pregnancy. METHODS: In uncomplicated pregnancies (n = 19) and hypertensive pregnancies (n = 6) concentrations of whole blood and plasma thiols, plasma vitamins/e and C, hemoglobin, and hematocrit were assessed at preconception, 6, 10, 20, and 37 weeks of gestational age, as well as six weeks postpartum. A repeated mixed model was used for statistical analysis. RESULTS: Vitamin C and most whole blood and plasma thiol concentrations decreased during pregnancy, while vitamin E, whole blood oxidized cysteinyl-glycine and the ratio of free to oxidized homocysteine revealed a linear increase during pregnancy. Postpartum plasma cysteine and vitamin C levels and the ratio of free to oxidized levels of cysteine, cysteinyl-glycine, and glutathione were significantly (p <0.05) lower as compared to preconceptional levels, whereas whole blood oxidized cysteine, cysteinyl-glycine and glutathione levels, and whole blood and plasma homocysteine levels were significantly (p <0.05) higher six weeks after delivery. Plasma cysteine and homocysteine, and whole blood oxidized cysteine and homocysteine levels were significantly (p <0.05) higher at 37 weeks of gestational age in the hypertensive group compared to those in the uncomplicated group. There were no other differences between the hypertensive and uncomplicated groups. CONCLUSION: In normal pregnancy there seems a balance between antioxidant and oxidant concentrations despite modest oxidative stress. In mildly hypertensive pregnancies a marginal imbalance may occur. PMID: [PubMed - indexed for MEDLINE] Zuurendonk LD, Smit RA, Mol BW, Feijen HW, de Graaff J, Sykora D, de Winter KA, vd Wurff A, Snijders MP, Kruitwagen RF. Routine pelvic lymphadenectomy in apparently early stage endometrial cancer. 28

29 Eur J Surg Oncol May;32(4): Epub 2006 Mar 20. Department of Obstetrics and Gynaecology, St Elisabeth Hospital Tilburg, Tilburg, The Netherlands. AIMS: Controversial issues with respect to the treatment of patients with endometrial cancer include indications for lymphadenectomy and adjuvant radiotherapy. PATIENT AND METHODS: Between 1998 and 2004 all women with endometrial cancer stage I were included (n = 335). They all underwent total abdominal hysterectomy and bilateral salpingooöphorectomy. Two hundred and thirty-seven women also had a pelvic lymphadenectomy. When pelvic lymphadenectomy was performed, radiotherapy was administered only to patients with lymph-node metastases. Otherwise, adjuvant radiotherapy was based on the presence of risk factors. RESULTS: Eleven patients had lymph-node metastases. The overall absolute and relative survival-estimate at 5 years was 85.0 and 93.7%, respectively. Locoregional recurrence was 8.5%. In the group with pelvic lymphadenectomy and negative lymph nodes these rates were 88.2, 93.9 and 5.6%, respectively. In 58 patients without any of the risk factors tumour grade III, deep myometrial invasion, or age > or =60 years, no lymphnode metastases were found. CONCLUSION: In patients with endometrial cancer FIGO stage I without risk-factors, a phenomenon which occurs in about 25% of patients with clinical stage I endometrial cancer, a lymphadenectomy can be omitted. In other patients, the debate regarding the optimal treatment will remain. PMID: [PubMed - indexed for MEDLINE] BOEKEN Smits, G. Waas, B, Kerkhof M. Biologie voor jou, Hoofdstuk over voortplanting en ontwikkeling, Malmberg ISBN VOORDRACHTEN & POSTERS De Reu PA, Smits LJ, Oosterbaan HP, de Reu-Cuppens MJ, Nijhuis JG. Gender and parity specific reference charts for fetal size in low-risk singleton pregnancies at the start of the third trimester. J. Mat. Fet. and Neonat. Med., suppl. 1; 19:98-99(2006) Poster XXth European Congress of Perinatal Medicine, Praag. Tjechoslovakije De Reu PA, Smits LJ, Oosterbaan HP, de Reu-Cuppens MJ, Nijhuis JG. Is there a place for a single biometry check at the start of the third trimester of pregnancy for the early detection of IUGR or macrosomie. Ultrasound Obstet Gynecol 28:S P591(2006) Poster ISUOG, London, Engeland 29

30 Kerkhof M. Dat gaat naar den Bosch toe. Voortplantingsgeneeskunde, Gynaecologencongres Arnhem 16 november Kerkhof M. Communicatie binnen het verloskundig samenwerkingsverband VSV s- Hertogenbosch 31 januari

31 INTENSIVE CARE GENEESKUNDE ARTIKELEN Westra SW, de Jager CP, Angioedema of the tongue. New England Journal of Medicine Jul 20;355(3):295 Strobbe L, de Jager CP, Intensive insulin therapy in the medical ICU, Neth J Crit Care,volume 10, no 3, june 2006 Jansen HJ, Spaargaren GJ, de Jager CP. Right subclavian vein cannulation? Insertion of a central venous catheter with inadvertent cannulation of the subclavian artery. Neth J Med Dec;64(11): Berends M, Boelens JJ, Erol-Yilmaz A, Haverman J, de Jager CP, Pruijt JF. Haemophagocytic lymphohistiocytosis (HLH); still a diagnosis in question. Abstract NIV, 2006, nr 88 pag 49 Zuidema X, Duenser MW, Wenzel V, Rozendaal FW, de Jager CP. Terlipressin as an adjunct vasopressor in refractory hypotension after tricyclic antidepressant intoxication. Resuscitation, e-pub VOORDRACHTEN & POSTERS de Jager CP. Regionale onderwijsdagen Intensive Care, RODIN onderwijs Interne Geneeskunde, UMCN,

32 Errol-Yilmaz A, Boelens JJ, de Jager CP. IC JBZ: Case Records of the Jeroen Bosch Hospital, case : A 21 year old female with Fever, Arthralgias and Acute Respiratory Distress Syndrome, Hemofagocytosis and Sepsis, Strobbe L, de Jager CP. IC JBZ, Strikte Glucose regulatie op de Intensive Care, Wever P, de Jager CP. IC JBZ, Emerging infections on our ICU, Streptococcus group A infections and Toxic Shock Syndrome, Welmers A, Dinkelman M, de Jager CP. IC JBZ, Darm Ischaemie, Rovers J, de Jager CP. IC JBZ, een 50 jarige man met bewustzijnsverlies, COMA en ADEM (Acute Demyeliniseerende Encephalomyelitis), Rybak- de Rouw ME, de Jager CP. IC JBZ, komt dat schot!, maligne tumorembolieen, Lammers J, de Jager CP. IC JBZ, De Hugo Walker WK prijs en een ongewone ritmestoornis, catheterthrombectomie bij massale recidiverende longembolieen, Louwerse E, de Jager CP. IC JBZ, Reanimatie en dan. Over de behandeling en prognose na OHCA, Kok E, van Niekerk J, de Jager CP. IC JBZ, Zeg een Aaa, Alles wat u moet weten over luchtwegmanagement, Dekker D, Dautzenberg PL, de Jager CP. IC JBZ, de oudere patiënt op de intensive care,

33 Pegueriaux N, Wollersheim J, de Jager CP. IC JBZ, TRALI: Transfusion Related Lung Injury, Renders N, de Jager CP. IC/ Medische Microbiologie JBZ, Emerge of MDR gram-negative bacterie during selective decontamination of the digestive tract on an ICU, Wever PC, van de Veerdonk F, Schellekens JJ, Huijsmans CJ, de Jager CP, Hermans MH. Presence of Legionella pneumophila DNA in serum samples during Legionnaires disease in relation to C-reactive protein levels. Poster NVMM, DIVERSEN de Jager CP. Elke patiënt met een sepsis dient op de IC opgenomen te worden, een pro-con debat, symposium klinische chemie JBZ,