Wetenschappelijk Jaaroverzicht 2013
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Wetenschappelijk Jaaroverzicht 2013 Onder redactie van: JMAH Jansen E Looije R Dacier ATM Dierick-van Daele L van Coppenolle Een uitgave van het Catharina Ziekenhuis Eindhoven, 2014 © niets van deze uitgave mag worden gekopieerd zonder toestemming van de uitgever. 2 Inhoudsopgave Woord vooraf 5 Algemeen Klinisch Laboratorium 7 Anesthesiologie 13 Apotheek 23 Cardiologie 29 Cardiothoracale Chirurgie 63 Chirurgie 79 Dermatologie 145 Geriatrie 155 Gynaecologie 157 ICMT-KFD 177 Inwendige geneeskunde 179 Kindergeneeskunde 195 Klinische Fysica 201 Longgeneeskunde 205 Maag, darm, leverziekten 215 Medische Psychologie 221 Mondziekten, kaak en aangezichtschirurgie 225 Neurologie 227 Nucleaire Geneeskunde 231 Onderwijs & Onderzoek 233 Oogheelkunde 237 Operatiekamers 239 Orthopedie 241 Pamm 243 Plastische Chirurgie 249 Radiologie 251 Radiotherapie 259 Spoedeisende hulp 267 Urologie 271 Boeken 277 Promoties 281 Wetenschapsavond 2014 Catharina Ziekenhuis 285 Tabellen 303 Auteursindex 311 3 4 6 Algemeen Klinisch Laboratorium Berkel M van Instrument-dependent interference of Howell-Jolly bodies in reticulocyte enumeration Berkel M van *, Besselaar E*, Kuijper P, Scharnhorst V* Clin Chem Lab Med. 2013 Jun;51(6):e137-9 Geen abstract beschikbaar Impactfactor: 3.009 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. 2013 Jun;51(6):1321-8 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 (0.01-0.10 μg/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 μg/L and BNP in the first quartile had 100% survival. Patients with either cTnI <0.01 μg/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 0.01-0.05 μg/L and patients with cTnI =0.05 μg/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: 2.150 Boonen KJ Transfusion reaction caused by anti-Vr, the first case reported Boonen K*, Stokker A van der *, Folman C, Kerkhof D van de * Transfus Med. 2013 Jun;23(3):204-5 Geen abstract beschikbaar Impactfactor: 1.259 8 Boonen KJ Urine flow cytometry as a primary screening method to exclude urinary tract infections Boonen KJ*, Koldewijn EL*, Arents NL, Raaymakers PA, Scharnhorst V* World J Urol. 2013 Jun;31(3):547-51. Epub 2012 May 16 PURPOSE: To exclude urinary tract infections, culture is the gold standard method, although it is time consuming and costly. Current strategies using dipstick analysis are unsatisfactory as screening methods, because of inadequate sensitivity/specificity. Urine flow cytometry is an attractive alternative. To exclude urinary tract infections, a cutoff value to screen for negative cultures was determined. METHODS: 281 outpatients (51 % male) of a general population visiting the urology department were included. Urine samples were measured by flow cytometry and compared with culture results and dipstick analysis. ROC analysis was performed to evaluate the screening performance of flow cytometry and dipstick analysis compared to culture. RESULTS: 18 % of cultures were positive, defined as >10(4) colony forming units/mL. Bacterial count by flow cytometry alone provides the best sensitivity and specificity to exclude a urinary tract infection. A cutoff value of 60 bacteria/μL urine leads to a sensitivity of 100 % and a specificity of 60 %. Retrospectively, with a cutoff value of 60 bacteria/μL urine, 49 % of the cultures would have been redundant. 20 % of patients receiving antibiotics possibly had received those unnecessarily. The calculated percentage of false negatives was 0 % (95 % confidence interval 0-3.3 %). CONCLUSIONS: Urine flow cytometry is a reliable screening method to exclude urinary tract infections. With a cutoff value of 60 bacteria/μL urine, negative predictive value is 100 % and the calculated percentage of false negatives is 0 % (95 % confidence interval 0-3.3 %). Using flow cytometry as a screening method could lead to a reduction in cultures and antibiotics. Impactfactor: 2.888 Broek N van den Reference intervals of reticulated platelets and other platelet parameters and their associations Hoffmann JJ, van den Broek NM*, Curvers J* Arch Pathol Lab Med. 2013 Nov;137(11):1635-40 Context.-Reticulated platelets are platelets recently released from the bone marrow, and they can serve as a noninvasive indicator of recent megakaryopoietic activity. Widespread clinical use has been hampered by laborious methods and lack of standardization. Recently, a fully automated method was released on the Abbott CELL-DYN Sapphire hematology analyzer. Objective.-To establish reference ranges for reticulated platelets. Secondary aims were to investigate associations between reticulated platelets and other platelet parameters like mean platelet volume, plateletcrit, and platelet distribution width. Design.-Reticulated platelets and other platelet parameters were measured in an unselected cohort of 8089 subjects visiting a primary health care laboratory. The reticulated platelet data were analyzed using the Bhattacharya technique. In addition, a nonparametric method was used in selected subjects with normal platelet counts for providing reference ranges. Results.- Reticulated platelets ranged from 0.4% to 6.0% or from 1 to 18 × 10(3)/ L. Reticulated platelets increased significantly with the subjects' age. Statistically, males had slightly higher values than females, but the differences were negligible. Reticulated platelets were 9 positively correlated with platelet count and negatively with mean platelet volume. Conclusions.-Reference ranges have been established for reticulated platelets as measured on the CELL-DYN Sapphire hematology analyzer. There were no relevant differences between the sexes, but there was a clear effect of age. An individual's reticulated platelets are associated with the platelet count as well as mean platelet volume. Impactfactor: 2.781 Curvers J Diabetes mellitus at the time of diagnosis of cirrhosis is associated with higher incidence of spontaneous bacterial peritonitis, but not with increased mortality Wlazlo N*, van Greevenbroek M, Curvers J*, Schoon EJ*, Friederich P*, Twisk J, Bravenboer B, Stehouwer CD Clin Sci (Lond). 2013 Oct;125(7):341-8 Voor abstract zie: Inwendige geneeskunde - Wlazlo N Impactfactor: 4.859 Curvers J Reference intervals of reticulated platelets and other platelet parameters and their associations Hoffmann JJ, van den Broek NM*, Curvers J* Arch Pathol Lab Med. 2013 Nov;137(11):1635-40 Voor abstract zie: Algemeen Klinisch Laboratorium Broek N van den Impactfactor: 2.781 Kerkhof D van de Transfusion reaction caused by anti-Vr, the first case reported Boonen K*, van der Stokker A*, Folman C, van de Kerkhof D* Transfus Med. 2013 Jun;23(3):204-5 Voor abstract zie: Algemeen Klinisch Laboratorium - Boonen KJ Impactfactor: 1.259 Kerkhof D van de Two novel mutations in the prothrombin gene identified in a patient with compound heterozygous type 1/2 prothrombin deficiency Kuijper PH, Schellings MW, van de Kerkhof D*, Nicolaes GA, Reitsma P, Halbertsma F, Dors N* Haemophilia 2013 Sep;19(5):e304-6. Epub 2013 May 28 Geen abstract beschikbaar Impactfactor: 3.17 Scharnhorst V Instrument-dependent interference of Howell-Jolly bodies in reticulocyte enumeration van Berkel M*, Besselaar E*, Kuijper P, Scharnhorst V* Clin Chem Lab Med. 2013 Jun;51(6):e137-9 10 Voor abstract zie: Algemeen Klinisch Laboratorium - Berkel M van Impactfactor: 3.009 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. 2013 Jun;51(6):1321-8. Voor abstract zie: Algemeen Klinisch Laboratorium - Berkel M van Impactfactor: 2.150 Scharnhorst V Urine flow cytometry as a primary screening method to exclude urinary tract infections Boonen KJ*, Koldewijn EL*, Arents NL, Raaymakers PA, Scharnhorst V* World J Urol. 2013 Jun;31(3):547-51. Epub 2012 May 16 Voor abstract zie: Algemeen Klinisch Laboratorium - Boonen KJ Impactfactor: 2.888 Stokker A van der Transfusion reaction caused by anti-Vr, the first case reported Boonen K*, van der Stokker A*, Folman C, van de Kerkhof D*