Wetenschappelijk Jaaroverzicht 2012

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1 Wetenschappelijk Jaaroverzicht 2012 Onder redactie van: JMAH Jansen E Looije R Dacier ATM Dierick-van Daele L van Coppenolle Oplage: 400

2 Een uitgave van het Catharina Ziekenhuis Eindhoven, 2013 niets van deze uitgave mag worden gekopieerd zonder toestemming van de uitgever. 2

3 Inhoudsopgave Woord vooraf 5 Algemeen Klinisch Laboratorium 7 Anesthesiologie 15 Apotheek 25 Cardiologie 29 Cardiothoracale Chirurgie 59 Chirurgie 73 Dermatologie 125 ECC / Bloedmanagement 131 Geestelijke verzorging & Ethiek 133 Geriatrie 135 Gynaecologie 139 Intensive Care 149 Inwendige geneeskunde 153 Kindergeneeskunde 167 Klinische Fysica 173 Longgeneeskunde 181 Maag, darm, leverziekten 191 Mondziekten, kaak en aangezichtschirurgie 197 Neurologie 199 Nucleaire Geneeskunde 209 Onderwijs & Onderzoek 211 Operatiekamers 217 Orthopedie 219 Pamm 221 Plastische Chirurgie 229 Radiologie 233 Radiotherapie 245 Spoedeisende hulp 255 Urologie 257 Boeken 261 Promoties 267 Wetenschapsavond 2012 Catharina Ziekenhuis 271 Wetenschapsavond 2013 Catharina ziekenhuis 281 Tabellen 305 Auteursindex 311 3

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5 Woord Vooraf Het Catharina Ziekenhuis heeft een opleidings- en onderzoekstraditie hoog te houden. Daarvan getuigt ook dit jaaroverzicht met wetenschappelijke publicaties in Onze medewerkers hebben ook dit jaar weer meer gepubliceerd dan vorig jaar. In totaal in publicaties ten opzichte van 277 in In 2012 zijn elf collega s gepromoveerd en momenteel zijn 60 medewerkers, vooral medici, medischondersteunende professionals en verpleegkundigen, bezig met hun promotietraject. Daarnaast begeleiden medewerkers van het Catharina Ziekenhuis nog 20 promovendi die verbonden zijn aan universiteiten en zijn er vijf medisch specialisten, die tevens als hoogleraar werkzaam zijn. Deze professionals zorgen er voor dat er vele constructieve samenwerkingsverbanden zijn ontstaan tussen universiteiten, ziekenhuizen en expertiscecentra. De indrukwekkende wetenschappelijke output is reden genoeg om als succes gevierd te worden. Het zegt iets over de eigenschappen van onze professionals. Een goede onderzoeker is immers nieuwsgierig en kritisch en heeft het lef om buiten gebaande of gebruikelijke paden te treden. Dit alles om de kwaliteit en doelmatigheid van de patiëntenzorg te verbeteren. Dat neemt niet weg dat we ook als organisatie kritisch naar onze processen moeten kijken. Om als STZ ziekenhuis ook in de toekomst geaccrediteerd te blijven, moeten we aantonen hoe wij als organisatie het wetenschappelijk onderzoek stimuleren en faciliteren. Inhoudelijk hebben we stappen gemaakt; er is een wetenschapsbureau waar je terecht kunt voor inhoudelijke ondersteuning, er worden wetenschapsavonden georganiseerd en er wordt gewerkt aan het stimuleren van onderzoek door verpleegkundigen. Maar een wetenschappelijke onderzoekscultuur bestendigen vraagt ook investeren in de ruimste zin van het woord. Het gaat om het stroomlijnen van processen, faciliteiten, transparantie in financiering maar ook de ontwikkeling van een Onderzoeksfonds. Hoe we dat gaan organiseren, daar zijn we nu volop mee bezig, samen met de Medische Staf. Dat is wat wij gaan doen in Iedereen die direct of indirect een bijdrage heeft geleverd aan het wetenschappelijk onderzoek in het Catharina Ziekenhuis willen we hartelijk bedanken voor het mooie resultaat over We mogen met zijn allen trots zijn en we gaan deze lijn ook naar de toekomst verder uitbouwen en vast houden! Dr. P.L. Batenburg, Voorzitter Raad van Bestuur Dr. F. Haak- van der Lely Voorzitter Medische Staf

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7 Algemeen Klinisch Laboratorium

8 Berkel M van Moderate elevations of high-sensitivity cardiac troponin I and B-type natriuretic peptide in chronic hemodialysis patients are associated with mortality Geerse DA, Berkel M van*, Vogels S, Kooman JP, Konings CJ*, Scharnhorst V* Clin Chem Lab Med Dec 10:1-8 Background: Several biomarkers are associated with mortality in hemodialysis patients. In particular, elevated cardiac troponin T and B-type natriuretic peptide (BNP) are strong predictors of mortality; however, less is known about cardiac troponin I (ctni). Elevated troponin I is detected in many hemodialysis patients, but the association of moderate elevations with mortality is unclear. Methods: The relation between mortality and ctni, using a high-sensitivity ctni assay, as well as BNP and Creactive protein (CRP) was evaluated in 206 chronic hemodialysis patients. Results: Median follow-up was 28 months with a total mortality of 35%. Mortality was significantly associated with elevated ctni, BNP and CRP. Even patients with only moderate elevation of ctni ( g/l) showed 2.5-fold increased mortality. Interestingly, hazard ratios for mortality for single (random) measurements were comparable to those for mean/median measurements. Subsequently, subgroup analysis based on combined markers was performed. Patients with both ctni <0.01 g/l and BNP in the first quartile had 100% survival. Patients with either ctni <0.01 g/l or BNP in the lowest quartile had significantly lower mortality (12% and 13%, respectively) than patients with BNP levels in the second quartile or higher and ctni of g/l and patients with ctni e 0.05 g/l (mortality 46 and 58%, respectively). Conclusions: A combination of moderate elevation of ctni and BNP provided additional prognostic value. A single measurement of these biomarkers performed comparably to the mean/median of multiple measurements. Impactfactor: Boer AK The new Roche Vitamin D Total assay: fit for its purpose? Emmen JM, Wielders JP, Boer AK*, Ouweland JM van den, Vader HL Clin Chem Lab Med Jun 8;0(0):1-4 Background: Measurement of serum 25-hydroxyvitamin D [25(OH)D] is used to assess vitamin D status. We evaluated the analytical performance of a new automated assay, Elecsys Vitamin D Total (Roche Diagnostics, Mannheim, Germany), based on competitive protein binding. Methods: The Elecsys assay was tested for imprecision, linearity and functional sensitivity at three test-sites and compared to a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, a highperformance liquid chromatography (HPLC) method and the Liaison 25(OH) Vitamin D Total immunoassay (Diasorin). Results: Imprecision testing with human serum specimens showed within-run CVs of d 6% and between-run CVs of d 8%. The assay was linear from 33 up to at least 111 nmol/l and showed equivalent 25(OH)D levels for matched serum and heparinized plasma samples. The assay correlated reasonable to well with LC-MS/MS (r=0.93; y=1.07x-5.04 nmol/l), HPLC (r=0.91, y=0.90x+3.03 nmol/l) and the Liaison assay (r=0.86, y=1.19x+2.80 nmol/l). Some of the samples showed large between-method differences. Conclusions: The new Elecsys assay fulfilled present analytical performance requirements and showed close agreement to other well-established methods for 25(OH)D analysis, making it fit for routine assessment of vitamin D status. Impactfactor:-- 8

9 Boer AK Verbeterde Cushing speekseldiagnostiek m.b.v. eigen UPLC MS/MS methode die onderscheid maakt tussen cortison en cortisol Boer AK*, Heuvel D van den*, Lentjes E Ned Tijdschr Klin Chem Labgeneesk 2012; 37: Impactfactor: -- Boonen KJ Trueness in the measurement of haemoglobin: consensus or reference method? Boonen KJ*, Curvers J*, Timmerman AA, Steurs D, Kerkhof D van de* Clin Chem Lab Med. 2012;50(3): Epub 2011 Nov 10 Background: For the measurement of haemoglobin a reference method exists: the haemiglobincyanide method. However, a Dutch external quality assessment organization does not use this method in the evaluation of trueness of results. The aim of this work was to assess whether trueness was compromised by the use of a consensus value. Methods: Five Cell Dyn Sapphires (Abbott) in three independent locations were used to measure haemoglobin concentration. Results were compared to the reference method (haemiglobincyanide). Patient samples with a distribution over clinically relevant concentrations (Hb 2.5?10.2 mmol/l) were used next to samples from external quality assessment rounds. Passing and Bablok regression analysis and Bland-Altman plots were used to evaluate any systematic deviation. Results: Results measured on the Cell Dyn Sapphires deviated significantly from the results obtained with the reference method. Remarkably, consensus results from external quality control samples also deviated significantly from the reference method. Conclusions: A significant negative bias exists in the measurement of haemoglobin on Cell Dyn Sapphires. Additionally, the consensus value as reported in external quality control assessment also shows an even greater significant negative bias compared to the reference method. As a reference method is available, external quality assessment would benefit from using this method instead of a consensus value to evaluate trueness. Impactfactor: Curvers J Blood group genotyping in a multitrauma patient: a case report Curvers J*, Scharnhorst V*, Haas M de, Warnier-Wandel L, Kerkhof D van de* Immunohematology Sep;28(3):85-7 Impactfactor: -- Curvers J Measuring direct thrombin inhibitors with routine and dedicated coagulation assays: which assay is helpful? Curvers J*, Kerkhof D van de*, Stroobants AK, Dool EJ van den, Scharnhorst V* Am J Clin Pathol Oct;138(4):551-8 The use of direct thrombin inhibitors (DTIs) for prophylactic or therapeutic anticoagulation is increasing because of the predictable bioavailability and short half-life of these DTIs. However, in certain situations, indication of the concentration is warranted. We investigated the effects of 3 DTIs (lepirudin, argatroban, and bivalirudin) in 6 pooled plasma specimens on routine coagulation assays (activated partial thromboplastin time [aptt], prothrombin time [PT], and thrombin time [TT]) and dedicated DTI assays (Hemoclot, HemosIL, the ecarin 9

10 clotting time, and a chromogenic ecarin clotting time) on 2 coagulation analyzers. We found routine tests to be nondiscriminative between concentrations of different DTIs in the aptt. Moreover, for PT and TT, the responses for different DTIs differed. This was similar for ecarin clotting assays. The Hemoclot and HemosIL assays showed identical linear increases for all 3 DTIs. We conclude that dedicated calibrated assays based on a diluted TT (Hemoclot and HemosIL) appear to be the most suitable for monitoring purposes. Impactfactor: Curvers J Reference intervals of extended erythrocyte and reticulocyte parameters Hoffmann JJ, Broek NM van den, Curvers J* Clin Chem Lab Med Mar 2;50(5):941-8 Background: Optical analysis of erythrocytes can provide information on the haemoglobin concentration and content of reticulocytes and mature erythrocytes. Such parameters have proven clinical utility in anemia diagnosis and therapy monitoring. For interpretation, reliable reference ranges are needed. The aim of this study was to establish reference intervals for extended erythrocyte andreticulocyte parameters as measured with the Abbott CELL-DYN Sapphire hematology analyzer. Secondary aims were to study sample stability and to investigate gender- and age dependency of the reference ranges. Methods: Extended RBC parameters were measured in routine samples of a primary health care laboratory. The study cohort included 8161 samples of unique individuals, which were nalyzed using Bhattacharya statistics. As a comparison, reference intervals were calculated in a subset of individuals without iron depletion. Results: The majority of erythrocyte and reticulocyte para\xadmeters were normally distributed, allowing calculation of reference intervals. Only for hypo- and hyperchromic erythrocytes non-parametric statistics had to be used. The reference range for mean cellular hemoglobin content of reticulocytes (MCHr) was pg ( fmol) in the entire study group and pg ( fmol) in the non iron-depleted subgroup. No differences between sexes were found. Most parameters showed significant age effects in children and adolescents. Conclusions: Reference intervals have been established for extended RBC and reticulocyte parameters for the CELL-DYN Sapphire. Gender effects could not be demonstrated and age effects were of limited size, except for individuals younger than 18 years. Extended RBC parameters are stable for at least 6 h after blood collection. Impactfactor: Curvers J Trueness in the measurement of haemoglobin: consensus or reference method? Boonen KJ*, Curvers J*, Timmerman AA, Steurs D, Kerkhof D van de* Clin Chem Lab Med. 2012;50(3): Epub 2011 Nov 10 Voor abstract zie: Algemeen Klinisch Laboratorium - Boonen KJ Impactfactor: Heuvel D van den Verbeterde Cushing speekseldiagnostiek m.b.v. eigen UPLC MS/MS methode die onderscheid maakt tussen cortison en cortisol Boer AK*, Heuvel D van den*, Lentjes E Ned Tijdschr Klin Chem Labgeneesk 2012; 37: Impactfactor:-- 10

11 Kerkhof D van de Blood group genotyping in a multitrauma patient: a case report Curvers J*, Scharnhorst V*, Haas M de, Warnier-Wandel L, Kerkhof D van de* Immunohematology Sep;28(3):85-7 Impactfactor: -- Kerkhof D van de Early double stent thrombosis associated with clopidogrel hyporesponsivenesss Rademakers LM*, Dewilde W*, Kerkhof D van de * Neth Heart J Jan;20(1): Epub 2011 May 21 Voor abstract zie: Cardiologie - Rademakers LM Impactfactor: Kerkhof D van de Measuring direct thrombin inhibitors with routine and dedicated coagulation assays: which assay is helpful? Curvers J*, Kerkhof D van de*, Stroobants AK, Dool EJ van den, Scharnhorst V* Am J Clin Pathol Oct;138(4):551-8 Voor abstract zie: Algemeen Klinisch Laboratorium - Curvers J Impactfactor: Kerkhof D van de Trueness in the measurement of haemoglobin: consensus or reference method? Boonen KJ*, Curvers J*, Timmerman AA, Steurs D, Kerkhof D van de * Clin Chem Lab Med. 2012;50(3): Epub 2011 Nov 10 Voor abstract zie: Algemeen Klinisch Laboratorium - Boonen KJ Impactfactor: Scharnhorst V Blood group genotyping in a multitrauma patient: a case report Curvers J*, Scharnhorst V*, Haas M de, Warnier-Wandel L, Kerkhof D van de* Immunohematology Sep;28(3):85-7 Impactfactor: -- Scharnhorst V Measuring direct thrombin inhibitors with routine and dedicated coagulation assays: which assay is helpful? Curvers J*, Kerkhof D van de*, Stroobants AK, Dool EJ van den, Scharnhorst V* Am J Clin Pathol Oct;138(4):551-8 Voor abstract zie: Algemeen klinisch laboratorium Curvers J Impactfactor:

12 Scharnhorst V Moderate elevations of high-sensitivity cardiac troponin I and B-type natriuretic peptide in chronic hemodialysis patients are associated with mortality Geerse DA, Berkel M van*, Vogels S, Kooman JP, Konings CJ*, Scharnhorst V* Clin Chem Lab Med Dec 10:1-8 Voor abstract zie: AKL - BerkeL M van Impactfactor: Scharnhorst V Molecular detection of Plasmodium knowlesi in a Dutch traveler by real-time PCR Link L*, Bart A, Verhaar N, Gool T van, Pronk M, Scharnhorst V* J Clin Microbiol Jul;50(7): Epub 2012 May 9 Voor abstract zie: Inwendige geneeskunde - Link L Impactfactor: Scharnhorst V Prophylactic treatment with alkaline phosphatase in cardiac surgery induces endogenous alkaline phosphatase release Kats S, Brands R, Soliman Hamad MA*, Seinen W, Scharnhorst V*, Wulkan RW, Schönberger JP*, Oeveren W van Int J Artif Organs Feb;35(2): Voor abstract zie: Cardiothoracale Chirurgie- Soliman Hamad MA Impactfactor: Scharnhorst V Variation of cardiac troponin I and T measured with sensitive assays in emergency department patients with noncardiac chest pain Scharnhorst V*, Krasznai K*, Veer M van 't*, Michels RH* Clin Chem Aug;58(8): BACKGROUND: New-generation high-sensitivity assays for cardiac troponin have lower detection limits these new assays are also lower, leading to higher frequencies of positive test results. When cardiac troponin concentrations are minimally increased, serial testing allows discrimination of myocardial infarction from other causes of increased cardiac troponin. We assessed various measures of short-term variation, including absolute concentration changes, reference change values (RCVs), and indices of individuality (II) for 2 cardiac troponin assays in emergency department (ED) patients. METHODS: We collected blood from patients presenting with cardiac chest pain upon arrival in the ED and 2, 6, and 12 h later. Cardiac troponin was measured with the high-sensitivity cardiac troponin T (hsctnt) assay (Roche Diagnostics) and a sensitive ctni assay (Siemens Diagnostics). Cardiac troponin results from 67 patients without acute coronary syndrome or stable angina were used in calculating absolute changes in cardiac troponin, RCVs, and II. RESULTS: The 95th percentiles for absolute change in cardiac troponin were 8.3 ng/l for hsctnt and 28 ng/l for ctni. Within-individual and total CVs were 11% and 14% for hs-ctnt and 18% and 21% for ctni, respectively. RCVs were 38% (hs-ctnt) and 57% (ctni). The corresponding log-normal RCVs were +46%/-32% for hs-ctnt and +76%/-43% for ctni. II values were 0.31 (ctni) and 0.12 (hs-ctnt). CONCLUSIONS: The short-term variations and IIs of cardiac troponin were low in ED patients free of ischemic myocardial necrosis. The detection of cardiac troponin variation exceeding 12

13 reference thresholds can help to identify ED patients with acute myocardial necrosis whereas variation within these limits renders acute coronary syndrome unlikely. Impactfactor: * = Werkzaam in het Catharina Ziekenhuis 13

14 14

15 Anesthesiologie

16 Beckers A Inadvertent epidural injection of drugs for intravenous use. A review Beckers A*, Verelst P*, Zundert A van* Acta Anaesthesiol Belg. 2012;63(2):75-9 INTRODUCTION: The frequency of inadvertent injection of drugs in the epidural space is probably underestimated and underreported, but it can cause serious morbidity and possibly mortality. OBJECTIVE: The aim of this review is to collate reported incidents of this type, to describe the potential mechanisms of occurrence and to identify possible therapeutic solutions. METHODS: We searched into medical databases and reviewed reference lists of papers retrieved. RESULTS: A list is reported of more than 50 drugs that were inadvertently injected into the epidural space. This list includes drugs which produce no, little or short-lasting neurological deficits, but also includes drugs that may be more etching and can result in temporary or even permanent neurological deficit. DISCUSSION: Most drugs do not lead to sequelae other than pain during injection or transient neurological complaints. Other drugs may have more deleterious consequences, such as paraplegia. Both the dose of the inadvertent injected drug and the time frame play an important role in the patient's outcome. "Syringe swap", "ampoule error", and epidural/intravenous line confusion due to inaccurate or absent colour coding of epidural catheters were the main sources of error. Preventive strategies, including non Luer-lock epidural injection ports, might increase safety. Impactfactor: -- Buise MP Bariatric surgery with operating room teams that stayed fixed during the day: a multicenter study analyzing the effects on patient outcomes, teamwork and safety climate, and procedure duration Stepaniak PS*, Heij C, Buise MP*, Mannaerts GH, Smulders F, Nienhuijs SW* Anesth Analg Dec;115(6): Epub 2012 Nov 9 Voor abstract zie: Anesthesiologie - Stepaniak PS Impactfactor: Gaag A van der Intervention techniques for chronic postherniorrhaphy pain Thomassen I*, Suijlekom HA van*, Gaag A van der*, Nienhuijs SW* European Surgery 2012;44(3):132-7 Voor abstract zie: Chirurgie - Thomassen I Impactfactor: Haanschoten MC Fast-track practice in cardiac surgery: results and predictors of outcome. Haanschoten MC*, Straten AH van*, Woorst JF ter*, Stepaniak PS*, Meer AD van der*, Zundert AA van*, Soliman Hamad MA* Interact Cardiovasc Thorac Surg Dec;15(6): Epub 2012 Sep 5 OBJECTIVES: Various studies have shown different parameters as independent risk factors in predicting the success of fast-track postoperative management in cardiac surgery. In the 16

17 present study, we evaluated our 7-year experience with the fast-track protocol and investigated the preoperative predictors of successful outcome. METHODS: Between 2004 and 2010, 5367 consecutive patients undergoing cardiac surgery were preoperatively selected for postoperative admission in the postanaesthesia care unit (PACU) and were included in this study. These patients were then transferred to the ordinary ward on the same day of the operation. The primary end-point of the study was the success of the PACU protocol, defined as discharge to the ward on the same day, no further admission to the intensive care unit and no operative mortality. Logistic regression analysis was performed to detect the independent risk factors for failure of the PACU pathway. RESULTS: Of patients undergoing cardiac surgery, 5367 (45.2%) were postoperatively admitted to the PACU. The protocol was successful in 4510 patients (84.0%). Using the multivariate logistic regression analysis, older age and left ventricular dysfunction were found to be independent risk factors for failure of the PACU protocol [odds ratio of 0.98/year ( ) and 0.31 ( ), respectively]. CONCLUSIONS: Our fast-track management, called the PACU protocol, is efficient and safe for the postoperative management of selected patients undergoing cardiac surgery. Age and left ventricular dysfunction are significant preoperative predictors of failure of this protocol. Impactfactor: -- Korsten HH An electronic system to document reasons for medication discontinuation and to flag unwanted represcriptions in geriatric patients Linden CM van der*, Jansen PA*, Marum RJ van, Grouls RJ*, Egberts TC, Korsten EH* Drugs Aging Dec;29(12): Epub 2012 Nov 10 Voor abstract zie: Geriatrie - Linden CM van der Impactfactor: Korsten HH Cardiac herniation after operative management of lung cancer: a rare and dangerous complication Ponten JE*, Elenbaas TW*, Woorst JF ter *, Korsten EH*, Borne BE van den*, Straten AH van* Gen Thorac Cardiovasc Surg Oct;60(10): Epub 2012 May 25 Voor abstract zie: Cardiothoracale chirurgie - Ponten JE Impactfactor: -- Korsten HH Inability to ventilate after tube exchange postoperative to pneumonectomy Verstraeten SE*, Straten AH van*, Korsten HH*, Weber EW*, Wielders PL*, Berreklouw E* Case Rep Anesthesiol. 2012;2012: Epub 2012 Apr 5 Voor abstract zie: Cardiothoracale chirurgie - Verstraeten SE Impactfactor: -- 17

18 Maassen RL Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope Lee RA, Zundert AA van*, Maassen RL*, Wieringa PA Acta Anaesthesiol Scand Feb;56(2): Epub 2011 Oct 14 Voor abstract zie: Anesthesiologie - Zundert AA van Impactfactor: Meer AD van der Fast-track practice in cardiac surgery: results and predictors of outcome Haanschoten MC*, Straten AH van*, Woorst JF ter*, Stepaniak PS, Meer AD van der*, Zundert AA van*, Soliman Hamad MA* Interact Cardiovasc Thorac Surg Dec;15(6): Epub 2012 Sep 5 Voor abstract zie: Anesthesiologie - Haanschoten MC Impactfactor: -- Pieters B Avoiding palatopharyngeal trauma during videolaryngoscopy: do not forget the 'blind spots' Zundert AA van*, Pieters B*, Zundert T van, Gatt S Acta Anaesthesiol Scand Apr;56(4): Epub 2012 Jan 31 Impactfactor: Pieters B Combined technique using videolaryngoscopy and Bonfils for a difficult airway intubation Zundert AA van*, Pieters BM* Br J Anaesth Feb;108(2):327-8 Impactfactor: Pieters B Videolaryngoscopy allows a better view of the pharynx and larynx than classic laryngoscopy Zundert A van*, Pieters B*, Doerges V, Gatt S Br J Anaesth Dec;109(6): Impactfactor: Pieters B Videolaryngoscopy offers advantages over classic laryngoscopy in a patient with seriously limited lip opening Zundert AA van*, Pieters B*, Hoogbergen M* J Anesth Jun;26(3): Epub 2012 Jan 12 Impactfactor:

19 Suijlekom JA van Effect of spinal cord stimulation in refractory angina pectoris Suijlekom HA van*, Strijbosch-Wilderbeek L, Tielen-van Laarhoven T, Lammers J, Botman CJ Asean Heart Journal 2012;2:47-8 Impactfactor: -- Suijlekom JA van Intervention techniques for chronic postherniorrhaphy pain Thomassen I*, Suijlekom HA van*, Gaag A van der*, Nienhuijs SW* European Surgery 2012;44(3):132-7 Voor abstract zie: Chirurgie - Thomassen I Impactfactor: Verelst P Inadvertent epidural injection of drugs for intravenous use. A review Beckers A*, Verelst P*, Zundert A van* Acta Anaesthesiol Belg. 2012;63(2):75-9 Voor abstract zie: Anesthesiologie - Beckers A Impactfactor: -- Weber EW Inability to ventilate after tube exchange postoperative to pneumonectomy Verstraeten SE*, Straten AH van *, Korsten HH*, Weber EW*, Wielders PL*, Berreklouw E* Case Rep Anesthesiol. 2012;2012: Epub 2012 Apr 5 Voor abstract zie: Cardiothoracale chirurgie - Verstraeten SE Impactfactor: -- Zundert AA van Applied pharmacology in anaesthesiology and critical care / Analee Milner, Ernest Welch Zundert A van* Acta Anaesthesiol Belg 2012: 63 Impactfactor: -- Zundert AA van Avoiding palatopharyngeal trauma during videolaryngoscopy: do not forget the 'blind spots' Zundert A van*, Pieters B*, Zundert T van, Gatt S Acta Anaesthesiol Scand Apr;56(4): Epub 2012 Jan 31 Impactfactor:

20 Zundert AA van Carl koller gold medal award to prof joseph m. Neal Zundert AA van Reg Anesth Pain Med Nov;37(6):645-6 Impactfactor: -- Zundert AA van Carl Koller, cocaine, and local anesthesia: some less known and forgotten facts Goerig M, Bacon D, Zundert AA van* Reg Anesth Pain Med May-Jun;37(3): Modern-day local anesthesia began in 1884 with a discovery by a young unknown ophthalmologist from Vienna named Carl Koller, who placed a cocaine solution on the cornea, thus producing insensibility. The news of his discovery spread throughout the world in less than a month. "Not surprisingly," a controversial priority discussion emerged. There is little information about this "dark side" of Koller's discovery and only sparse data about the personalities involved in this controversy. In addition, Carl Koller's decision to leave Vienna is also surrounded in secrecy. The story surrounding the revelation of the local anesthetic effect of cocaine and the personalities involved is fascinating and relatively unknown. Impactfactor: Zundert AA van Combined technique using videolaryngoscopy and Bonfils for a difficult airway intubation Zundert AA van*, Pieters BM* Br J Anaesth Feb;108(2):327-8 Impactfactor: Zundert AA van Comparison of forces applied to the maxillary incisors by direct and indirect laryngoscopes Lee RA, Zundert AA van* Acta Anaesthesiol Scand 2012; 56: Impactfactor: Zundert AA van Ensuring direct laryngoscopy will not become an extinct skill Comment on GlideScope videolaryngoscope vs. Macintosh direct laryngoscope for intubation of morbidly obese patients: a randomized trial. [Acta Anaesthesiol Scand. 2011] Lee RA, Zundert AA van* Acta Anaesthesiol Scand Jul;56(6):803. Epub 2012 May 10 Impactfactor:

21 Zundert AA van Evaluation of the Mediseus epidural simulator Lee RA, Zundert TC van, Koesveld JJ van, Zundert AA van*, Stolker RJ, Wieringa PA, Gatt SP Anaesth Intensive Care Mar;40(2):311-8 The demand for increased patient safety has led to greater use of simulation training of health professionals performing medical procedures. The study aim was to evaluate the usefulness of the Mediseus Epidural Simulator in teaching basic epidural needle-handling skills. Three groups of 15 anaesthetists (Novice=zero to two year anaesthesia trainees; Intermediate=three- to five-year anaesthesia trainees; Expert=consultants and regionalspecialist anaesthetists) from three different medical centres participated. Each participant performed 20 simulated epidural needle insertions and was scored on several parameters (e.g. time, success of the insertion, bone collisions). Following familiarisation with the simulator and the needle insertions, participants answered seven questions on the applicability of the simulator to the teaching of basic epidural needle-handling skills. There was a clear learning effect with regard to the simulation procedure time, this decreasing throughout the experiment (P=0.037). There was no significant influence of either group or experience with the simulator in the study on the number or type of errors made. The quality of the simulation was scored 2.3 out of 5.0 (for bone simulation) and 4.7 (for loss-ofresistance simulation). All groups considered that the simulator was best suited for training prospective anaesthetists. Each group rated the usefulness of the simulator for training novices at greater than 3.0 out of 5.0. The Mediseus Epidural Simulator seems to be an appropriate training device for an introduction to epidural needle insertion. For medical professionals with procedural knowledge, the simulation is not realistic enough and the simulator did not distinguish between the groups based on the errors made. Impactfactor: Zundert AA van Fast-track practice in cardiac surgery: results and predictors of outcome Haanschoten MC*, Straten AH van*, Woorst JF ter*, Stepaniak PS, Meer AD van der*, Zundert AA van*, Soliman Hamad MA* Interact Cardiovasc Thorac Surg Dec;15(6): Epub 2012 Sep 5 Voor abstract zie: Anesthesiologie - Haanschoten MC Impactfactor: -- Zundert AA van Forces applied to the maxillary incisors by video laryngoscopes and the Macintosh laryngoscope Lee RA, Zundert AA van*, Maassen RL*, Wieringa PA Acta Anaesthesiol Scand Feb;56(2): Epub 2011 Oct 14 BACKGROUND: Modern video laryngoscopes (VLSs) provide a superior view of the glottis, facilitating easier intubations. This study evaluates the forces applied to the maxillary incisors when using various VLSs and a Macintosh blade. METHODS: Fifty consecutive surgery patients were randomly assigned to receive laryngoscopy from a pair of four blades investigated in the study - the VLS GlideScope( ) (Verathon Inc., Bothell, WA, USA), V-Mac" Storz( ) (Karl Storz, Tuttlingen, Germany), and McGrath" (Aircraft Medical, Edinburgh, United Kingdom); and the classic Macintosh blade also from Storz( ) (Karl Storz). An endotracheal tube (ETT) was brought into position anterior 21

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