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1.
Olgiati, Simone.
Genetics of Movement Disorders in the Next-Generation Sequencing Era.
Degree: 2016, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/80040 
► markdownabstractMovement disorders are neurologic syndromes in which there is either an excess of movements or a paucity of voluntary and automatic movements, unrelated to weakness…
(more)
▼ markdownabstractMovement disorders are neurologic syndromes in which there is either an excess of movements or a paucity of voluntary and automatic movements, unrelated to weakness or spasticity. These disorders are associated with dysfunctions of the basal ganglia and cerebellum, brain structures that together orchestrate the control of movements. During the last two decades, genetic studies of movement disorders identified many genetics factors associated with these diseases, including rare Mendelian factors, moderately-rare factors with moderate effect size, and common variants with low effect size. In the coming years, the application of novel DNA sequencing technologies to the study of movement disorders promises to unveil even more genetic factors, possibly leading to a full understanding of the genetic architecture of these disorders.
The introduction (Part I) of this thesis reviews the modern strategies for the identification of genetic factors associated with Mendelian forms of movement disorders. After a brief definition of these disorders, we focus on the use of the next-generation sequencing technologies to identify Mendelian mutations in movement disorders (chapter 1.1). Our experimental work is presented in the next three parts of this thesis. Part II is focused on the genetic studies of Parkinson’s disease (PD). In chapter 2.1, for the first time, we report the identification of DNAJC6 mutations in families with early-onset PD. Our work delineate a novel form of autosomal recessive early-onset PD, caused by mutations in the DNAJC6 gene, and has important implications for the diagnostic work-up and genetic counseling of early-onset PD patients. In chapter 2.2, we report genetic and clinical findings in a novel family with early-onset parkinsonism associated with triplication of the SNCA locus. This study contributes to the genetic and clinical characterization of this very rare form. In chapter 2.3, we perform a large exome sequencing project in the isolated population of Sardinia to identify novel risk factors for PD with intermediate or strong effect size. In this study we identify a list of candidate variants highly enriched or exclusively present in PD, a resource of candidates for future studies. Notably, this was the first study analyzing a large cohort of PD patients at exome-wide level.
Part III of this thesis focuses on the study of atypical forms of parkinsonisms. In chapter 3.1, we report the identification of a novel form of early-onset atypical parkinsonism caused by a homozygous mutation in SYNJ1. This study was the first to report the association between a SYNJ1 mutation and parkinsonism. In chapter 3.2, we identify a family with a milder phenotype caused by the same homozygous mutation in a different haplotype, suggesting that the two SYNJ1 mutations originated from different mutational events. Interestingly, the proteins encoded by SYNJ1 and DNAJC6 both act in the molecular pathway of the clathrin-mediated endocytosis, suggesting an involvement of this pathway in the pathogenesis…
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APA (6th Edition):
Olgiati, S. (2016). Genetics of Movement Disorders in the Next-Generation Sequencing Era. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/80040
Chicago Manual of Style (16th Edition):
Olgiati, Simone. “Genetics of Movement Disorders in the Next-Generation Sequencing Era.” 2016. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/80040.
MLA Handbook (7th Edition):
Olgiati, Simone. “Genetics of Movement Disorders in the Next-Generation Sequencing Era.” 2016. Web. 16 Aug 2018.
Vancouver:
Olgiati S. Genetics of Movement Disorders in the Next-Generation Sequencing Era. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2016. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/80040.
Council of Science Editors:
Olgiati S. Genetics of Movement Disorders in the Next-Generation Sequencing Era. [Doctoral Dissertation]. Erasmus University Medical Center; 2016. Available from: http://hdl.handle.net/1765/80040
2.
Michielsen, Marian.
Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function.
Degree: 2012, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/38200
► textabstractStroke is currently the second cause of death in the western world; one year following stroke, half of all patients have died. From the surviving…
(more)
▼ textabstractStroke is currently the second cause of death in the western world; one year following
stroke, half of all patients have died. From the surviving half, a large part
remains disabled and 55% to 75% of them have a paretic arm. This makes stroke
the main cause of acquired adult disability. Deficits after a stroke consist, amongst
other things, of motor problems, sensory problems and spasticity, and can range from
complete paralysis of the upper-extremity towards relatively minor coordination deficits.
Such impairments affect an individual’s ability to complete everyday activities
(disability) and affect participation in everyday life situations. As there is no cure
for stroke, rehabilitation is the primary means of increasing upper limb functioning.
…the Medical Ethical
Committee of the Erasmus University Medical Center.
Apparatus
The…
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APA (6th Edition):
Michielsen, M. (2012). Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/38200
Chicago Manual of Style (16th Edition):
Michielsen, Marian. “Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function.” 2012. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/38200.
MLA Handbook (7th Edition):
Michielsen, Marian. “Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function.” 2012. Web. 16 Aug 2018.
Vancouver:
Michielsen M. Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2012. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/38200.
Council of Science Editors:
Michielsen M. Reflections on mirror therapy in stroke: Mechanisms and effectiveness for improving hand function. [Doctoral Dissertation]. Erasmus University Medical Center; 2012. Available from: http://hdl.handle.net/1765/38200
3.
Wichers, Marc Jan.
Epidemiology of Cerebral Palsy in the Netherlands.
Degree: 2011, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/30655
► textabstractChildren with cerebral palsy (CP) and their families often make strong demands on diagnostic, therapeutic, technical and social facilities. Prevalence estimates are needed to improve…
(more)
▼ textabstractChildren with cerebral palsy (CP) and their families often make strong demands
on diagnostic, therapeutic, technical and social facilities. Prevalence estimates are
needed to improve treatment and services. As recent Dutch data are not available, the
present study aimed to assess the population prevalence of CP in the Netherlands. A
representative Dutch area with 1.2 million inhabitants of which 172,000 were born
between 1977 and 1988 was studied. To ascertain the children with CP from these
birth years, medical practices (such as rehabilitation centres, paediatric and child
neurological departments) were consecutively asked to contact their (supposed) CP
cases. Next, a parents’ organisation and finally regional news media assisted in the
ascertainment. In total, 170 ‘supposed’ CP cases underwent an expert examination.
Of these 170, 127 children proved to be definite CP-cases, yielding a ‘crude’ average
prevalence of 0.74 per 1000 inhabitants (95% CI: 0.61–0.87). Under-ascertainment
was recognised and quantified. Accordingly, the population prevalence of CP
over the birth year period 1977–1988 was calculated as 1.51 per 1000 inhabitants
(average over the 12 birth years). The calculated CP prevalence rose significantly
over time: from 0.77 (1977–1979) to 2.44 (1986–1988). This trend is in accordance
with other studies.
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APA (6th Edition):
Wichers, M. J. (2011). Epidemiology of Cerebral Palsy in the Netherlands. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/30655
Chicago Manual of Style (16th Edition):
Wichers, Marc Jan. “Epidemiology of Cerebral Palsy in the Netherlands.” 2011. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/30655.
MLA Handbook (7th Edition):
Wichers, Marc Jan. “Epidemiology of Cerebral Palsy in the Netherlands.” 2011. Web. 16 Aug 2018.
Vancouver:
Wichers MJ. Epidemiology of Cerebral Palsy in the Netherlands. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2011. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/30655.
Council of Science Editors:
Wichers MJ. Epidemiology of Cerebral Palsy in the Netherlands. [Doctoral Dissertation]. Erasmus University Medical Center; 2011. Available from: http://hdl.handle.net/1765/30655
4.
Nieuwenhuijsen, Channah.
Adults with Cerebral Palsy: Studies on physical activity, fitness and experienced problems.
Degree: 2011, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/30597
► textabstractCerebral palsy (CP) is a frequently occurring condition in childhood: in the Netherlands children with CP account for approximately 50% of pediatric rehabilitation patients. CP…
(more)
▼ textabstractCerebral palsy (CP) is a frequently occurring condition in childhood: in the Netherlands
children with CP account for approximately 50% of pediatric rehabilitation
patients. CP is defined as “a group of permanent disorders of the development of
movement and posture, causing activity limitation, that are attributed to non-progressive
disturbances that occurred in the developing fetal or infant brain. The motor
disorders of cerebral palsy are often accompanied by disturbances of sensation,
perception, cognition, communication, and behaviour, by epilepsy and by secondary
musculoskeletal problems”. Prevalence ranges from 1.39 to 2.80 per 1000 live births
in Europe. In a Dutch population-based study, the average prevalence over 12 birth
years (1977-1988) was 1.51 per 1000 inhabitants. The CP prevalence rose significantly
over time: from 0.77 per 1000 inhabitants in 1977-1979 to 2.44 per 1000 in
1986-1988. Over the past decades, life expectancy for well-functioning adults with
CP has increased and is close to that of the unaffected population.
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APA (6th Edition):
Nieuwenhuijsen, C. (2011). Adults with Cerebral Palsy: Studies on physical activity, fitness and experienced problems. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/30597
Chicago Manual of Style (16th Edition):
Nieuwenhuijsen, Channah. “Adults with Cerebral Palsy: Studies on physical activity, fitness and experienced problems.” 2011. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/30597.
MLA Handbook (7th Edition):
Nieuwenhuijsen, Channah. “Adults with Cerebral Palsy: Studies on physical activity, fitness and experienced problems.” 2011. Web. 16 Aug 2018.
Vancouver:
Nieuwenhuijsen C. Adults with Cerebral Palsy: Studies on physical activity, fitness and experienced problems. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2011. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/30597.
Council of Science Editors:
Nieuwenhuijsen C. Adults with Cerebral Palsy: Studies on physical activity, fitness and experienced problems. [Doctoral Dissertation]. Erasmus University Medical Center; 2011. Available from: http://hdl.handle.net/1765/30597
5.
Slaman, Jorrit.
Promoting a Healthy Lifestyle: Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy.
Degree: 2014, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/77202
► markdownabstract__Abstract__ In this thesis, the effectiveness of the Active Lifestyle and Sports participation intervention was evaluated among youth with Cerebral Palsy (CP). This intervention consisted…
(more)
▼ markdownabstract__Abstract__
In this thesis, the effectiveness of the Active Lifestyle and Sports participation intervention was evaluated among youth with Cerebral Palsy (CP). This intervention consisted of ADL counselling, fitness training and sports counselling. It was hypothesised that this lifestyle intervention would have added value for improving physical behaviour and physical fitness compared to regular therapy. We found that persons with CP had significantly lower levels of physical fitness and physical activity compared to a reference sample. These reduced levels were accompanied by increased levels of fatigue. The longitudinal analyses showed that the lifestyle intervention had favourable effects on self-reported physical activity and various components of physical fitness. Furthermore, fatigue severity was reduced after following the intervention. No effects for the intervention were found on objectively measured physical activity, quality of life and socila participation. Exploratory results of the cost-utility analysis showed that offering a lifestyle intervention for CP-populations might be cost-effective or cost-saving as compared to offering no intervention to improve physical behaviour and fitness.
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APA (6th Edition):
Slaman, J. (2014). Promoting a Healthy Lifestyle: Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/77202
Chicago Manual of Style (16th Edition):
Slaman, Jorrit. “Promoting a Healthy Lifestyle: Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy.” 2014. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/77202.
MLA Handbook (7th Edition):
Slaman, Jorrit. “Promoting a Healthy Lifestyle: Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy.” 2014. Web. 16 Aug 2018.
Vancouver:
Slaman J. Promoting a Healthy Lifestyle: Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2014. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/77202.
Council of Science Editors:
Slaman J. Promoting a Healthy Lifestyle: Effectiveness of an intervention on physical behaviour and physical fitness among adolescents and young adults with spastic cerebral palsy. [Doctoral Dissertation]. Erasmus University Medical Center; 2014. Available from: http://hdl.handle.net/1765/77202
6.
Korstanje, Jan-Wiebe.
Sound Findings on Hand Dynamics: Validation and Application of Ultrasound Speckle Tracking of Tendon and Nerve Dynamics.
Degree: Department of Plastic and Reconstructive Surgery, 2011, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/26875
► textabstractDynamic imaging of the hand and wrist would give valuable insight in the complex interaction between tendons, nerves, and their surrounding tissue also called subsynovial…
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▼ textabstractDynamic imaging of the hand and wrist would give valuable insight in the complex interaction between tendons, nerves, and their surrounding tissue also called subsynovial connective tissue (SSCT) during hand movements. Furthermore, it could provide clinicians and therapists with valuable information to objectively diagnose patients, or to follow progress in patients over time making it easier to intervene when necessary. However, the dynamic behavior of the hand and its tendons and nerves is hard to capture with a clinical imaging modality, let alone to quantify its behavior. Therefore we have developed an ultrasound tracking algorithm capable of quantifying tendon, nerve, and their surrounding tissue excursions with an accuracy of less than 300μm. We have assessed the added clinical value of our algorithm in two major groups of hand injuries, namely CTS and hand tendon injuries.
It is hypothesized that patients suffering from CTS have changes in the SSCT thereby altering the tendon and nerve dynamics. Using our algorithm we found that patients having carpal tunnel syndrome (CTS) had a different approach in using their hand flexor tendons to make a fist. These differences allowed us to classify up to 86% of the patients as having CTS.
Different mobilization protocols have been proposed for rehabilitation after hand flexor tendon surgery that aim at adhesion prevention by adequate tendon excursion exercises. Although almost all mobilization protocols only focus on the injured finger, studies have suggested that the position of the neighboring injured fingers influences tendon excursions of the injured finger. We found that the position of the adjacent fingers has a significant influence on the hand flexor tendon excursion of the injured finger, increasing tendon excursion up to 44% and possibly decrease tendon adhesions.
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APA (6th Edition):
Korstanje, J. (2011). Sound Findings on Hand Dynamics: Validation and Application of Ultrasound Speckle Tracking of Tendon and Nerve Dynamics. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/26875
Chicago Manual of Style (16th Edition):
Korstanje, Jan-Wiebe. “Sound Findings on Hand Dynamics: Validation and Application of Ultrasound Speckle Tracking of Tendon and Nerve Dynamics.” 2011. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/26875.
MLA Handbook (7th Edition):
Korstanje, Jan-Wiebe. “Sound Findings on Hand Dynamics: Validation and Application of Ultrasound Speckle Tracking of Tendon and Nerve Dynamics.” 2011. Web. 16 Aug 2018.
Vancouver:
Korstanje J. Sound Findings on Hand Dynamics: Validation and Application of Ultrasound Speckle Tracking of Tendon and Nerve Dynamics. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2011. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/26875.
Council of Science Editors:
Korstanje J. Sound Findings on Hand Dynamics: Validation and Application of Ultrasound Speckle Tracking of Tendon and Nerve Dynamics. [Doctoral Dissertation]. Erasmus University Medical Center; 2011. Available from: http://hdl.handle.net/1765/26875
7.
Haisma, Janneke.
Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury.
Degree: 2008, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/12216
► textabstractA spinal cord injury (SCI) is an interruption of the neural pathways in the spinal canal and is characterized by muscle weakness, loss of sensation…
(more)
▼ textabstractA spinal cord injury (SCI) is an interruption of the neural pathways in the spinal canal
and is characterized by muscle weakness, loss of sensation and autonomic dysfunction
below the level of the lesion. The extent of these neurological deficits is determined
by both the level and completeness of the lesion. A complete lesion results in loss
of motor function and sensation in the lowest sacral segment whereas, following an
incomplete lesion function in this segment is maintained.1 The SCI can either have
a traumatic or a non-traumatic cause. In traumatic cases, injury is typically the result
of a traffic or sporting accident, but an increasing number of injuries result from
a low impact fall, for example, in those with osteoporosis.2,3 A non-traumatic SCI
may be caused by metastasis, infection and spinal haemorrhage or infarction.3,4 An
estimated 183 new traumatic SCI occur in The Netherlands per year, of whom 154
survive hospitalization, which corresponds to an incidence of over 10 per 1,000,000
per year.2 The incidence of non-traumatic SCI is easily underestimated because many
are not registered as SCI, but this incidence largely exceeds the incidence of traumatic
injuries.2,4‑6 As compared to the able-bodied population, the life expectancy of those
with SCI is reduced. For example, a 20-year-old man with a traumatic paraplegia has
an estimated life expectancy of 46 years, whereas an able-bodied man the same age,
will have another 58 years to live.3,7 However, because the treatment of complications
has improved over the past decades, the life expectancy following SCI has increased.2
Although the life expectancy may have improved, many patients report a low level of
functioning and well-being.8‑10 Functioning following SCI may be threatened because
most patients have complications, have a low physical capacity, and depend on others
for daily activities.6,9,11,12 Therefore, it is important to investigate opportunities to
optimize functioning following SCI.
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APA (6th Edition):
Haisma, J. (2008). Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/12216
Chicago Manual of Style (16th Edition):
Haisma, Janneke. “Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury.” 2008. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/12216.
MLA Handbook (7th Edition):
Haisma, Janneke. “Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury.” 2008. Web. 16 Aug 2018.
Vancouver:
Haisma J. Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2008. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/12216.
Council of Science Editors:
Haisma J. Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury. [Doctoral Dissertation]. Erasmus University Medical Center; 2008. Available from: http://hdl.handle.net/1765/12216
8.
Meulenbeld, Hielke.
Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC).
Degree: 2012, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/38019
► textabstractIn the Western countries prostate cancer is the most frequently diagnosed cancer, except for skin cancer, and the second leading cause of male cancer deaths.…
(more)
▼ textabstractIn the Western countries prostate cancer is the most frequently diagnosed cancer, except
for skin cancer, and the second leading cause of male cancer deaths. Prostate
cancer tends to develop in men over the age of fifty and although it is one of the most
prevalent types of cancer in men, many patients may never have symptoms, undergo
no therapy, and eventually die from other causes. This is because cancer of the prostate
is, in many cases, slow-growing, symptom-free, and since men with the condition are
older they often die from causes unrelated to the prostate cancer. Men diagnosed with
clinically localized prostate cancer have several treatment options available, including
watchful waiting, definitive radiation therapy and surgery. However, a significant proportion
of patients who present with cancer that appears to be localized will eventually
develop incurable metastatic disease and ultimately succumb to death as a result of
advanced disease. In patients with advanced disease androgen-deprivation therapies
typically result in rapid responses, but eventually nearly all patients develop progressive
castration-resistant disease. Historically, clinical management for metastatic castration
resistant prostate cancer (CRPC) has been primarily focused on relieving symptoms. In
the last decade the therapeutic spectrum has changed dramatically, and our understanding
of the biology of patients with prostate cancer has become far more sophisticated.
The treatment paradigm first changed with the publication of 2 pivotal randomized
clinical trials in 2004, which demonstrated for the first time a survival benefit with
docetaxel-based therapy in patients with metastatic CRPC. Since then, docetaxel chemotherapy
has become the standard first-line treatment in patients with CRPC (Chapter
2). Recently, the landscape for CRPC treatment has changed again with the FDA approval
of three additional therapies, sipuleucel-T5, cabazitaxel6 and abiraterone acetate7.
While the addition of these new treatment options is a great advance for patients with
metastatic CRPC, there are many new questions arising regarding the optimal sequencing
of these treatments as well as potential combinations of and old drugs.
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APA (6th Edition):
Meulenbeld, H. (2012). Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC). (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/38019
Chicago Manual of Style (16th Edition):
Meulenbeld, Hielke. “Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC).” 2012. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/38019.
MLA Handbook (7th Edition):
Meulenbeld, Hielke. “Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC).” 2012. Web. 16 Aug 2018.
Vancouver:
Meulenbeld H. Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC). [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2012. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/38019.
Council of Science Editors:
Meulenbeld H. Clinical and Preclinical Treatment Aspects of Castration Resistant Prostate Cancer (CRPC). [Doctoral Dissertation]. Erasmus University Medical Center; 2012. Available from: http://hdl.handle.net/1765/38019
9.
Sonnenschein-Voort, Agnes.
Fetal and Infant Origins of Childhood Asthma: The Generation R Study.
Degree: 2014, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/50263
► markdownabstract__Abstract__ Asthma is a chronic inflammatory disorder of the airways. Accumulating evidence suggest that childhood asthma has at least part of its origins in fetal…
(more)
▼ markdownabstract__Abstract__
Asthma is a chronic inflammatory disorder of the airways. Accumulating evidence suggest that childhood asthma has at least part of its origins in fetal life and infancy. The developmental plasticity hypothesis suggests that adverse exposures in early life lead to developmental adaptations of various organ systems, including of the respiratory tract to enhance survival in the short term. We observed that rapid infant growth is, independent of fetal growth, associated with an increased risk of childhood asthma. Also maternal gestational weight gain and psychological distress were associated with increased risks. A longer duration and exclusive breastfeeding were associated with a reduced risk of childhood asthma.
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APA (6th Edition):
Sonnenschein-Voort, A. (2014). Fetal and Infant Origins of Childhood Asthma: The Generation R Study. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/50263
Chicago Manual of Style (16th Edition):
Sonnenschein-Voort, Agnes. “Fetal and Infant Origins of Childhood Asthma: The Generation R Study.” 2014. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/50263.
MLA Handbook (7th Edition):
Sonnenschein-Voort, Agnes. “Fetal and Infant Origins of Childhood Asthma: The Generation R Study.” 2014. Web. 16 Aug 2018.
Vancouver:
Sonnenschein-Voort A. Fetal and Infant Origins of Childhood Asthma: The Generation R Study. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2014. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/50263.
Council of Science Editors:
Sonnenschein-Voort A. Fetal and Infant Origins of Childhood Asthma: The Generation R Study. [Doctoral Dissertation]. Erasmus University Medical Center; 2014. Available from: http://hdl.handle.net/1765/50263
10.
Toorn, Leon.
Airway inflammation during clinical remission of atopic asthma : effect of anti-inflammatory therapy.
Degree: 2002, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/32056
► textabstractAs stated in the introductory remarks, various questions arise from the epidemiological fact that a great deal of subjects with apparently outgrown asthma experiences a…
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▼ textabstractAs stated in the introductory remarks, various questions arise from the epidemiological
fact that a great deal of subjects with apparently outgrown asthma experiences a relapse
of symptoms of asthma later in life. ln the present thesis, the next questions will be
addressed:
Are we able to produce convincing arguments of ongoing airway inflammation
and/or remodeling in subjects who are believed to have outgrown their asthma?
To address this question, we measured spirometry values, bronchial responsiveness to
different inhaled stimuli, and exhaled nitric oxide levels in adolescents in clinical
remission of atopic asthma. Clinical remission was defined as complete absence of
symptoms without the use of any medication in the year preceding the study. Chapter 3
describes the results of this study, wherein subjects in clinical remission were compared
with subjects with symptomatic asthma and healthy controls. In Chapter 4 invasively
obtained "proof' of ongoing airway inflammation and remodeling during clinical
remission of atopic asthma is discussed. By means of flexible bronchoscopy, biopsies were obtained from the airway walls in all subjects from the three study groups. A
comparison of biopsy findings, including inflammatory cell type density and various
indices of airway remodeling, was made between the groups. Also, data were compared
with noninvasive markers of airway disease, such as exhaled nitric oxide levels and
bronchial responsiveness to inhaled stimuli.
2 If persistent airway inflammation can be demonstrated during clinical remission,
could blunted symptom perception explain the discrepancy between the lack of
symptoms and ongoing disease?
This question will be dealt with in chapter 5, where a study is described in which we
obtained "BORG" dyspnea scores from subjects in clinical remission and subjects with
symptomatic asthma during MCh and AMP provocation.
3 Would subjects with subclinical airway inflammation and remodelling benefit from
antiinflammatory treatment in the short-term?
In chapter 6, a double blind, longitudinal, placebo controlled study is described in which
subjects in clinical remission of atopic asthma are treated for three months with either the
salmeterol/flixotide propionate combination product (Seretide) or placebo. Again,
invasive- as well as non-invasive indices were obtained from all subjects before and after
treatment.
4 Asthma remission- does it exist?
This question will be dealt with in chapter 7. Whether "true" remission of asthma can be
reached with or without the aid of prolonged anti-inflammatory treatment is as yet
unknown. A review of relevant literature as well as a proposal to deal with subjects with
apparently outgrown asthma is given.
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APA (6th Edition):
Toorn, L. (2002). Airway inflammation during clinical remission of atopic asthma : effect of anti-inflammatory therapy. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/32056
Chicago Manual of Style (16th Edition):
Toorn, Leon. “Airway inflammation during clinical remission of atopic asthma : effect of anti-inflammatory therapy.” 2002. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/32056.
MLA Handbook (7th Edition):
Toorn, Leon. “Airway inflammation during clinical remission of atopic asthma : effect of anti-inflammatory therapy.” 2002. Web. 16 Aug 2018.
Vancouver:
Toorn L. Airway inflammation during clinical remission of atopic asthma : effect of anti-inflammatory therapy. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2002. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/32056.
Council of Science Editors:
Toorn L. Airway inflammation during clinical remission of atopic asthma : effect of anti-inflammatory therapy. [Doctoral Dissertation]. Erasmus University Medical Center; 2002. Available from: http://hdl.handle.net/1765/32056
11.
Janssens, Hettie.
Aerosol therapy in young children.
Degree: Department of Pediatrics, 2001, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/23517
► textabstractInhalation of aerosolized drugs has become an established means for treatment of pulmonary diseases in the last fifiy years. The majoriry of aerosol therapy in…
(more)
▼ textabstractInhalation of aerosolized drugs has become an established means for treatment
of pulmonary diseases in the last fifiy years. The majoriry of aerosol therapy in
childhood concerns inhaled corticosteroids and bronchodilators in the management
of asthma. Administration of drugs via the inhaled route has major advantages
over the oral route. The drug is targeted directly to its site of action, which results in
a more rapid effect and a lower dose needed with less systemic side effects.
However, to deliver the drug into the lungs reliably and reproducibly is difficult,
especially in children. It requires understanding of the mechanisms of aerosol
deposition in the lungs and knowledge about the factors affecting delivery and
deposition of aerosols. There are several ways to deliver therapeutic aerosols to the lungs.
The current methods can be classified in three categoties: nebulizers, pressurized metered
dose inhales (pMDI's) with or without spacer, and dry powder inhalers (DPT's). Not all systems are suirable for use in young children. Application
of aerosol therapy in young children requires a different approach compared vvith adults
and older children. Factors such as age, co-operation, breathing pattern, nose breathing
and size of the airways should be raken into account as they can have substantial effect
on the dose delivered to the lungs. Nebulizers have long been the mainstay of aerosol
therapy in children. Currently, the pMDI combined with spacer is
recommended as the first choice for asthma therapy in young children.
However, the pMDIIspacer and most other aerosol delivery systems were primarily
designed for use in adults, and subsequently adapted for use in children.
Furthermore, studying efficiency of aerosol delivery systems in young children is difficult
and has ethical limitations. This explains why there is extended information available
on the performance of aerosol delivery systems in adults, but only limited data in
children. The use of drugs with potential side effects, such as corticosteroids,
requires precise dosing with the administration of the lowest effective dose. Therefore,
knowledge about the dose inhaled and factors affecting this dose for each particular
drug, device and patient is necessary for optimal application of aerosol therapy. Better
understanding of aerosol therapy in children is urgently needed.
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APA (6th Edition):
Janssens, H. (2001). Aerosol therapy in young children. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/23517
Chicago Manual of Style (16th Edition):
Janssens, Hettie. “Aerosol therapy in young children.” 2001. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/23517.
MLA Handbook (7th Edition):
Janssens, Hettie. “Aerosol therapy in young children.” 2001. Web. 16 Aug 2018.
Vancouver:
Janssens H. Aerosol therapy in young children. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2001. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/23517.
Council of Science Editors:
Janssens H. Aerosol therapy in young children. [Doctoral Dissertation]. Erasmus University Medical Center; 2001. Available from: http://hdl.handle.net/1765/23517
12.
Caudri, Daan.
Asthma and Wheezing in Childhood: perinatal risk factors and early detection.
Degree: 2010, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/22971
► textabstractThe prevalence of childhood asthma and atopic disease have increased dramatically during the end of the last century, especially in Western countries.1 Presently, asthma is…
(more)
▼ textabstractThe prevalence of childhood asthma and atopic disease have increased dramatically
during the end of the last century, especially in Western countries.1 Presently, asthma is
the most frequent chronic disorder in childhood, with a high burden in terms of morbidity,
health care costs, absenteeism from school, and reduced quality of life, despite
the availability of effective and safe treatment.2 Two major challenges in the fi eld of
childhood asthma, have still been insuffi ciently addressed. In this thesis we focused on
both these issues.
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APA (6th Edition):
Caudri, D. (2010). Asthma and Wheezing in Childhood: perinatal risk factors and early detection. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/22971
Chicago Manual of Style (16th Edition):
Caudri, Daan. “Asthma and Wheezing in Childhood: perinatal risk factors and early detection.” 2010. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/22971.
MLA Handbook (7th Edition):
Caudri, Daan. “Asthma and Wheezing in Childhood: perinatal risk factors and early detection.” 2010. Web. 16 Aug 2018.
Vancouver:
Caudri D. Asthma and Wheezing in Childhood: perinatal risk factors and early detection. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2010. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/22971.
Council of Science Editors:
Caudri D. Asthma and Wheezing in Childhood: perinatal risk factors and early detection. [Doctoral Dissertation]. Erasmus University Medical Center; 2010. Available from: http://hdl.handle.net/1765/22971
13.
Gabriele, Carmelo.
Respiratory Morbidity and Exhaled Nitric Oxide in the First 2 Years of Life: the Generation R Study.
Degree: 2009, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/22656
► textabstractAsthma is a lung disease characterized by chronic inflammation of the airways associated with bronchial hyperresponsiveness. The airflow obstruction within the lungs is responsible of…
(more)
▼ textabstractAsthma is a lung disease characterized by chronic inflammation of the airways
associated with bronchial hyperresponsiveness. The airflow obstruction within the
lungs is responsible of recurrent episodes of wheezing, breathlessness, chest tightness
and coughing. The physiopathological changes of the airways in asthma are mediated
by many cells and cellular elements. It has been argued that asthma is a syndrome
comprising a number of separate conditions, rather than a single disease with a broad
range of severity. It has long been thought that the inappropriate response of the
specific immune system to harmless antigens leading to the polarization of T‐cells
toward a T‐helper 2 (Th2) phenotype was the central mechanism of asthma. However,
in the last years the hypothesis of asthma as one unifying disease concept has
disappeare. Novel disease and bronchial inflammation pathways, many of
which are independent of adaptive immunity, have been reported. The concept of
disease endotypes has been recently introduced and subtypes of asthma with
different and specific pathophysiology, immunology, clinical features and response to
treatment have been described. A simple categorization of the different
inflammatory patterns in asthmatics based on sputum eosinophil and neutrophil
proportions has been provided and four inflammatory subtypes have been identified:
neutrophilic, eosinophilic, mixed granulocytic and paucigranulocytic asthma. A
recent review by Haldar and Pavord suggested that non‐eosinophilic asthma
represents a stable phenotype associated with distinct etiologic factors and less
airway pathology. Also, it has been suggested that severe asthma should no longer
be considered as the result of a progressive process, but rather as a separate
pathological entity with distinct physiologic and clinical characteristics. These
heterogeneous inflammatory patterns have been also reported by Brasier et al, who
evaluated bronchoalveolar lavage (BAL) samples in mild to severe asthmatic patients.
They showed that cytokine expression patterns in BAL could be used to identify
distinct types of asthma and identify distinct subsets of methacholine
hyperresponders. Despite improved understanding of pathophysiology,
immunology and genetics of asthma in childhood, we still do not know the basic
mechanisms underlying the development of the disease.
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APA (6th Edition):
Gabriele, C. (2009). Respiratory Morbidity and Exhaled Nitric Oxide in the First 2 Years of Life: the Generation R Study. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/22656
Chicago Manual of Style (16th Edition):
Gabriele, Carmelo. “Respiratory Morbidity and Exhaled Nitric Oxide in the First 2 Years of Life: the Generation R Study.” 2009. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/22656.
MLA Handbook (7th Edition):
Gabriele, Carmelo. “Respiratory Morbidity and Exhaled Nitric Oxide in the First 2 Years of Life: the Generation R Study.” 2009. Web. 16 Aug 2018.
Vancouver:
Gabriele C. Respiratory Morbidity and Exhaled Nitric Oxide in the First 2 Years of Life: the Generation R Study. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2009. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/22656.
Council of Science Editors:
Gabriele C. Respiratory Morbidity and Exhaled Nitric Oxide in the First 2 Years of Life: the Generation R Study. [Doctoral Dissertation]. Erasmus University Medical Center; 2009. Available from: http://hdl.handle.net/1765/22656
14.
Jobsis, Quirijn.
Exhaled nitric oxide and hydrogen peroxide as markers of airway inflammation in children.
Degree: 2000, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/20990
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APA (6th Edition):
Jobsis, Q. (2000). Exhaled nitric oxide and hydrogen peroxide as markers of airway inflammation in children. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/20990
Chicago Manual of Style (16th Edition):
Jobsis, Quirijn. “Exhaled nitric oxide and hydrogen peroxide as markers of airway inflammation in children.” 2000. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/20990.
MLA Handbook (7th Edition):
Jobsis, Quirijn. “Exhaled nitric oxide and hydrogen peroxide as markers of airway inflammation in children.” 2000. Web. 16 Aug 2018.
Vancouver:
Jobsis Q. Exhaled nitric oxide and hydrogen peroxide as markers of airway inflammation in children. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2000. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/20990.
Council of Science Editors:
Jobsis Q. Exhaled nitric oxide and hydrogen peroxide as markers of airway inflammation in children. [Doctoral Dissertation]. Erasmus University Medical Center; 2000. Available from: http://hdl.handle.net/1765/20990
15.
Tasche, Marjolein.
Prophylactic inhalation therapy in preschool children with asthma.
Degree: 1999, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/19736
► textabstractRespiratory diseases are a major cause of morbidity in preschool children. Confronted with young children with respiratory symptoms the physician faces many uncertainties regarding the…
(more)
▼ textabstractRespiratory diseases are a major cause of morbidity in preschool children.
Confronted with young children with respiratory symptoms the physician
faces many uncertainties regarding the diagnosis, treatment and prognosis,
namely:
• labelling of chronic and recurrent respiratory symptoms and defining 'asthma';
• the natural course of respiratory symptoms and the relation with future asthma;
the effectivity and side-effects of anti-asthma treatment, for both relief and prophylaxis;
• the feasibility of and compliance with prophylactic inhalation therapy.
In studying effectivity of anti-asthma drugs, the investigator has additional problems:
• symptoms as outcome measure;
• the difficulty of conducting clinical trials, finding the appropriate setting and
considering the ethical aspects of research in young children.
In this chapter, the background of these uncertainties for physicians and investigators
will be explored further. The place of sodium cromoglycate in prophylactic
therapy will be discussed in detail because it is the main focus of the studies in
this thesis. The results of this research will be presented in the following chapters
together with results of studies on preschool asthma in general practice and on
the feasibility of and adherence to maintenance inhalation therapy.
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APA (6th Edition):
Tasche, M. (1999). Prophylactic inhalation therapy in preschool children with asthma. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/19736
Chicago Manual of Style (16th Edition):
Tasche, Marjolein. “Prophylactic inhalation therapy in preschool children with asthma.” 1999. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/19736.
MLA Handbook (7th Edition):
Tasche, Marjolein. “Prophylactic inhalation therapy in preschool children with asthma.” 1999. Web. 16 Aug 2018.
Vancouver:
Tasche M. Prophylactic inhalation therapy in preschool children with asthma. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 1999. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/19736.
Council of Science Editors:
Tasche M. Prophylactic inhalation therapy in preschool children with asthma. [Doctoral Dissertation]. Erasmus University Medical Center; 1999. Available from: http://hdl.handle.net/1765/19736
16.
Tiddens, Harm.
Structure and Function of Chronically Inflamed Human Airways of Chronically Inflamed Human Airways.
Degree: 1998, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/17643
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APA (6th Edition):
Tiddens, H. (1998). Structure and Function of Chronically Inflamed Human Airways of Chronically Inflamed Human Airways. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/17643
Chicago Manual of Style (16th Edition):
Tiddens, Harm. “Structure and Function of Chronically Inflamed Human Airways of Chronically Inflamed Human Airways.” 1998. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/17643.
MLA Handbook (7th Edition):
Tiddens, Harm. “Structure and Function of Chronically Inflamed Human Airways of Chronically Inflamed Human Airways.” 1998. Web. 16 Aug 2018.
Vancouver:
Tiddens H. Structure and Function of Chronically Inflamed Human Airways of Chronically Inflamed Human Airways. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 1998. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/17643.
Council of Science Editors:
Tiddens H. Structure and Function of Chronically Inflamed Human Airways of Chronically Inflamed Human Airways. [Doctoral Dissertation]. Erasmus University Medical Center; 1998. Available from: http://hdl.handle.net/1765/17643
17.
McKay, Sue.
Airway smooth muscle cell responses in relation to mediators of asthma.
Degree: 2001, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/16165
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APA (6th Edition):
McKay, S. (2001). Airway smooth muscle cell responses in relation to mediators of asthma. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/16165
Chicago Manual of Style (16th Edition):
McKay, Sue. “Airway smooth muscle cell responses in relation to mediators of asthma.” 2001. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/16165.
MLA Handbook (7th Edition):
McKay, Sue. “Airway smooth muscle cell responses in relation to mediators of asthma.” 2001. Web. 16 Aug 2018.
Vancouver:
McKay S. Airway smooth muscle cell responses in relation to mediators of asthma. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2001. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/16165.
Council of Science Editors:
McKay S. Airway smooth muscle cell responses in relation to mediators of asthma. [Doctoral Dissertation]. Erasmus University Medical Center; 2001. Available from: http://hdl.handle.net/1765/16165
18.
Hofhuis, Ward.
Clinical applications of infant lung function testing.
Degree: Department of Pediatrics, 2004, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/51680
► textabstractThe studies in this thesis show that research in the field of lung function testing in infants has moved from methodological issues towards clinical applications.…
(more)
▼ textabstractThe studies in this thesis show that research in the field of lung function
testing in infants has moved from methodological issues towards clinical applications.
This development is mainly the result of publications of guidelines for
infant lung function testing and standardization of the equipment used, by the
European Respiratory Society en de American Thoracic Society (ERS/ATS)
(7-10). As a result, normative data have become available for different lung
function methods, allowing comparison of data from different centers. In
addition, several biomedical engineering companies have marketed equipment
with specifications according to the guidelines given by the ERS/ATS. These
developments are a necessity for wide applications of infant lung function
testing in a clinical setting, such as collaborative studies and multicenter drug
trials in infants with airway disease (II). On the other hand, there are high costs
for buying complete recording systems and training the staff. In addition, most
methods require sedation of the infant. Therefore, infant lung function
measurements will probably be established primarily in larger, mostly academic,
centers. The forthcoming challenges for those involved in this field will
be to develop methods that are cheap to buy and simple to use, still providing
essential information. These methods should be applicable in infants without
sedation. When this has been achieved, infant lung function testing may even move out of the clinic (II).
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APA (6th Edition):
Hofhuis, W. (2004). Clinical applications of infant lung function testing. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/51680
Chicago Manual of Style (16th Edition):
Hofhuis, Ward. “Clinical applications of infant lung function testing.” 2004. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/51680.
MLA Handbook (7th Edition):
Hofhuis, Ward. “Clinical applications of infant lung function testing.” 2004. Web. 16 Aug 2018.
Vancouver:
Hofhuis W. Clinical applications of infant lung function testing. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2004. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/51680.
Council of Science Editors:
Hofhuis W. Clinical applications of infant lung function testing. [Doctoral Dissertation]. Erasmus University Medical Center; 2004. Available from: http://hdl.handle.net/1765/51680
19.
Hafkamp-De Groen, Esther.
Asthma Symptoms in Early Childhood: A public health perspective.
Degree: 2014, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/51373
► markdownabstract__Abstract__ This thesis focuses on asthma symptoms in early childhood. From a public health perspective, we aim to improve health and health-related quality of life…
(more)
▼ markdownabstract__Abstract__
This thesis focuses on asthma symptoms in early childhood. From a public health perspective, we aim to improve health and health-related quality of life through the prevention of asthma symptoms and by signaling, counselling or management of children who are at a high risk of developing asthma. The public health approach that we used in this thesis provides a useful framework to study the association between social indicators and asthma symptoms in early childhood and the underlying pathways. This thesis also studies the impact of asthma on the child’s health-related quality of life and evaluates the systematic assessment of asthma symptoms and environmental tobacco smoke exposure at preventive youth healthcare centers. Finally, we developed an asthma risk appraisal tool to assess the risk on asthma at school age in preschool children who present with asthma symptoms at well-child care.
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APA (6th Edition):
Hafkamp-De Groen, E. (2014). Asthma Symptoms in Early Childhood: A public health perspective. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/51373
Chicago Manual of Style (16th Edition):
Hafkamp-De Groen, Esther. “Asthma Symptoms in Early Childhood: A public health perspective.” 2014. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/51373.
MLA Handbook (7th Edition):
Hafkamp-De Groen, Esther. “Asthma Symptoms in Early Childhood: A public health perspective.” 2014. Web. 16 Aug 2018.
Vancouver:
Hafkamp-De Groen E. Asthma Symptoms in Early Childhood: A public health perspective. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2014. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/51373.
Council of Science Editors:
Hafkamp-De Groen E. Asthma Symptoms in Early Childhood: A public health perspective. [Doctoral Dissertation]. Erasmus University Medical Center; 2014. Available from: http://hdl.handle.net/1765/51373
20.
Hess, Johanna.
Epidemiology of asthma in the Netherlands with special reference to childhood.
Degree: Department of Pediatrics, 2003, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/51321
► textabstractThe aim of this thesis is to examine trends in mortality and morbidity attributed to asthma in the Netherlands in the light of the changing…
(more)
▼ textabstractThe aim of this thesis is to examine trends in mortality and morbidity attributed to
asthma in the Netherlands in the light of the changing concepts of asthma and the
improved pharmacotherapy, against the background of other airway disorders. We
analysed national statistics on asthma and COPD from 1980 to 1999, which data are
presented in the first part of the thesis. Chapter 2 presents the data on mortality in
different age groups. Chapter 3 presents the data on hospital admissions in different age
groups. Complementary, chapter 4 presents trends in consultations and prescriptions of
anti-asthma drugs in patients having ambulatory care for asthma and COPD over the
period 1981 to 1993, reflecting prevalence and (changes in) disease management in the
Netherlands. Chapter 5 describes the pharmacotherapy for asthma in the Netherlands
from 1999 through 2001.
The second part of this thesis deals with clinical registration on asthma in children aged
0-4 years, carried out at the Juliana Children's Hospital in The Hague. In this age group,
the rising morbidity from asthma is of great concern. Studies pointed to increasing
hospital admissions for asthma especially in children aged 0-4 years [86-88], which age
group appeared to be at highest risk for hospital readmissions as well [88-90]. Early
recognition of risk of (severe) asthma in clinical practice and improvement of asthma
management could help to reduce morbidity in children. The aim of the registration
study was to examine prognostic characteristics of asthma diagnosis, to identify
predisposing risk factors related to exacerbations and hospital admissions, and to assess
whether threshold of admission and severity of episode differed in fust admissions and
readmissions.
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APA (6th Edition):
Hess, J. (2003). Epidemiology of asthma in the Netherlands with special reference to childhood. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/51321
Chicago Manual of Style (16th Edition):
Hess, Johanna. “Epidemiology of asthma in the Netherlands with special reference to childhood.” 2003. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/51321.
MLA Handbook (7th Edition):
Hess, Johanna. “Epidemiology of asthma in the Netherlands with special reference to childhood.” 2003. Web. 16 Aug 2018.
Vancouver:
Hess J. Epidemiology of asthma in the Netherlands with special reference to childhood. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2003. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/51321.
Council of Science Editors:
Hess J. Epidemiology of asthma in the Netherlands with special reference to childhood. [Doctoral Dissertation]. Erasmus University Medical Center; 2003. Available from: http://hdl.handle.net/1765/51321
21.
Jongste, Johan.
Human airway smooth muscle.
Degree: Department of Pharmacology, 1987, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/51195
► textabstractThe function of airway smooth muscle in normal subjects is not evident. Possible physiological roles include maintenance of optimal regional ventilation/perfusion ratios, reduction of anatomic…
(more)
▼ textabstractThe function of airway smooth muscle in normal subjects is not evident. Possible
physiological roles include maintenance of optimal regional ventilation/perfusion
ratios, reduction of anatomic dead space, stabilisation of cartilaginous bronchi,
defense against impurities and, less likely, squeezing mucus out of mucous glands
and pulling open the alveoli next to the airways1
. Any role of airway smooth
muscle is necessarily limited, because an important degree of contraction will
lead to airway narrowing and to an increased work of breathing. There is, however,
no doubt that in asthma the acute bronchoconstriction following exposure to
nonspecific or allergic stimuli is due to airway smooth muscle contraction. Most
research on airway smooth muscle function has therefore concentrated on
clarifying its role in bronchial hyperresponsiveness, airway obstruction and
allergy.
From the foregoing chapters it can be concluded that many factors may be
involved in the pathogenesis of the abnormal responsiveness of airway smooth
muscle in patients with asthma or chronic bronchitis. One of these factors is
an intrinsic abnormality of the airway smooth muscle cells. In order to examine
this, several animal models have been developed, most of which have features
in common with human allergic bronchoconstriction2
• Because of important
differences between species, and because there is no satisfactory animal model
of spontaneous, non-allergic asthma, it is crucial to study human airway smooth
muscle from subjects with and without airway hyperresponsiveness. The research
on human lung tissue in vitro has been limited by the supply, and by difficulties
in obtaining stable and reproducible responses of airway smooth muscle in vitro.
Moreover, it is very difficult to obtain lung tissue from asthmatic subjects.
This chapter will give a summary of the research on airway smooth muscle
hyperresponsiveness in experimental animals and man. From these data, the
aims of the studies to be presented in parts II and III will be derived and briefly
outlined.
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APA (6th Edition):
Jongste, J. (1987). Human airway smooth muscle. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/51195
Chicago Manual of Style (16th Edition):
Jongste, Johan. “Human airway smooth muscle.” 1987. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/51195.
MLA Handbook (7th Edition):
Jongste, Johan. “Human airway smooth muscle.” 1987. Web. 16 Aug 2018.
Vancouver:
Jongste J. Human airway smooth muscle. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 1987. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/51195.
Council of Science Editors:
Jongste J. Human airway smooth muscle. [Doctoral Dissertation]. Erasmus University Medical Center; 1987. Available from: http://hdl.handle.net/1765/51195
22.
Tibboel, Jeroen.
Lung Injury and Repair In Search of New Treatment Modalities.
Degree: 2013, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/50513
► markdownabstract__Abstract__ The lung contains the largest surface of our body that is exposed to the environment. Day in, day out, our lungs are being exposed…
(more)
▼ markdownabstract__Abstract__
The lung contains the largest surface of our body that is exposed to the environment. Day
in, day out, our lungs are being exposed to many injurious components, ranging from
noxious gasses and particles caused by traffic and chemical industries to a multitude of
microorganisms. The lung has a host of defense mechanisms to combat this constant
invasion, ranging from the simplest, the nasopharyngeal barrier, to the most intricate
one, the immune system1. This natural defense mechanism of the lung is dependent on
an intact pulmonary epithelium, abundance of pulmonary macrophages, neutrophils and
dendritic cells. But even with all these barriers, exogenous factors can still lead to lung
injury. This thesis will characterize lung injury, and most importantly, lung repair, using
animal models of two lung diseases: Bronchopulmonary Dysplasia and Chronic Obstructive
Pulmonary Disease.
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APA (6th Edition):
Tibboel, J. (2013). Lung Injury and Repair In Search of New Treatment Modalities. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/50513
Chicago Manual of Style (16th Edition):
Tibboel, Jeroen. “Lung Injury and Repair In Search of New Treatment Modalities.” 2013. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/50513.
MLA Handbook (7th Edition):
Tibboel, Jeroen. “Lung Injury and Repair In Search of New Treatment Modalities.” 2013. Web. 16 Aug 2018.
Vancouver:
Tibboel J. Lung Injury and Repair In Search of New Treatment Modalities. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2013. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/50513.
Council of Science Editors:
Tibboel J. Lung Injury and Repair In Search of New Treatment Modalities. [Doctoral Dissertation]. Erasmus University Medical Center; 2013. Available from: http://hdl.handle.net/1765/50513
23.
Breteler, Monique.
Cognitive decline in the elderly : epidemiologic studies on cognitive function and dementia.
Degree: 1993, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/39402
► textabstractIn the last decades, the awareness has grown among the public, as well as among health politicians, that dementia is highly prevalent in older age,…
(more)
▼ textabstractIn the last decades, the awareness has grown among the public, as well as among
health politicians, that dementia is highly prevalent in older age, that it causes much
distress to patients and their families, and that it poses a large burden on public health
care resources.Initially, research focused chiefly on Alzheimer's disease, the most
frequent type of dementia. In recent years, there is also increasing interest in vascular
dementia. The reasons for this are that vascular dementia may be more prevalent
than previously recognized, that vascular causes may be involved in the clinical picture
of other dementia syndromes as well, and, perhaps most importantly, that vascular
causes of cognitive decline can potentially be influenced by available measures of
intervention.
In studies of the frequency and etiology of dementia, much emphasis has been
put on differentiating demented subjects from cognitively unimpaired individuals.
However, there is little evidence to support the idea of a sharp distinction between
demented and non-demented persons. Cognitive impairment is a quantitative rather
than a qualitative characteristic, and consequently its distribution in the population
shows a continuum of severity. The fact that cognitive dysfunction is common in
old age does not imply that it is intrinsic to aging; it may be normal in the sense of
usual, not in the sense of natural
This thesis focuses on epidemiologic studies on cognitive function and dementia.
The main part is devoted to investigations of the relation between vascular risk factors
and cognitive function; in these studies cognitive function was evaluated as a
continuously distributed variable. In the other studies in this thesis, risk factors for
dementia were investigated with dementia as a dichotomous outcome variable.
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APA (6th Edition):
Breteler, M. (1993). Cognitive decline in the elderly : epidemiologic studies on cognitive function and dementia. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/39402
Chicago Manual of Style (16th Edition):
Breteler, Monique. “Cognitive decline in the elderly : epidemiologic studies on cognitive function and dementia.” 1993. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/39402.
MLA Handbook (7th Edition):
Breteler, Monique. “Cognitive decline in the elderly : epidemiologic studies on cognitive function and dementia.” 1993. Web. 16 Aug 2018.
Vancouver:
Breteler M. Cognitive decline in the elderly : epidemiologic studies on cognitive function and dementia. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 1993. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/39402.
Council of Science Editors:
Breteler M. Cognitive decline in the elderly : epidemiologic studies on cognitive function and dementia. [Doctoral Dissertation]. Erasmus University Medical Center; 1993. Available from: http://hdl.handle.net/1765/39402
24.
Wieberdink, Renske.
Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study.
Degree: 2012, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/32496
► textabstractStroke is a frequent disorder in elderly people. Despite improvements in primary prevention, the burden of stroke remains high and is predicted to even increase…
(more)
▼ textabstractStroke is a frequent disorder in elderly people. Despite improvements in primary prevention, the burden of stroke remains high and is predicted to even increase in the near future due to aging of the population. Therefore, additional targets for primary prevention are urgently needed. Most previous epidemiological studies have not specifically studied the two main subtypes of stroke, i.e., cerebral infarction and intracerebral hemorrhage, whereas differences in etiology between these subtypes suggest that they may have different risk profiles. Therefore, primary prevention may benefit from the identification of subtype-specific determinants. The aims of this thesis were to study trends in stroke incidence rates and stroke risk factors in the past twenty years, and to identify new determinants for any stroke, cerebral infarction, and intracerebral hemorrhage. The studies described in this thesis were part of the Rotterdam Study, a large population-based cohort study among elderly people who were followed from 1990 up to the present day for the occurrence of stroke and other diseases that are frequent in the elderly.
Changes in stroke incidence rates and stroke risk factors in Rotterdam in the Netherlands between 1990 and 2008 were described in chapter 2. The major finding was a 34% decrease in stroke incidence rates in men, but no change in women. The prevalence of risk factors, such as hypertension and obesity had increased, although cigarette smoking had decreased in men. Other risk factors, such as atrial fibrillation, low high-density lipoprotein cholesterol and diabetes mellitus were unchanged. However, the proportion of men and women taking preventive medication had increased enormously. The divergent trends in stroke incidence rates in men and women stress the need for adequate recognition and treatment of stroke risk factors in women.
In chapter 3, I reported my findings regarding the association of the plasma protein von Willebrand factor, which plays an important role in hemostasis but also marks the presence of endothelial dysfunction, with stroke and its subtype cerebral infarction. Higher von Willebrand factor levels were associated with an increased risk of stroke and cerebral infarction (chapter 3.1).
However, genetic determinants of von Willebrand factor levels were not associated with stroke risk, either individually or joint in a weighted sum score (chapter 3.2). These findings suggest that von Willebrand factor is a marker for stroke risk, but probably not an important causal factor.
Chapter 4 includes three studies concerning the association between retinal characteristics and risk of any stroke, cerebral infarction and intracerebral hemorrhage. The first study showed that wider retinal venular calibers were not only associated with an increased risk of cerebral infarction, but also with an increased risk of intracerebral hemorrhage (chapter 4.1). Furthermore, these associations were stronger for lobar than deep intracerebral hemorrhages. Both narrower arteriolar calibers and…
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APA (6th Edition):
Wieberdink, R. (2012). Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/32496
Chicago Manual of Style (16th Edition):
Wieberdink, Renske. “Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study.” 2012. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/32496.
MLA Handbook (7th Edition):
Wieberdink, Renske. “Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study.” 2012. Web. 16 Aug 2018.
Vancouver:
Wieberdink R. Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2012. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/32496.
Council of Science Editors:
Wieberdink R. Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study. [Doctoral Dissertation]. Erasmus University Medical Center; 2012. Available from: http://hdl.handle.net/1765/32496
25.
Schrijvers, Elisabeth M. C.
Biomarkers and Risk Factors of Dementia.
Degree: Department of Neurology, 2011, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/30742
► textabstractDementia is a devastating disease that is common in elderly people. The prevalence increases from almost 1% at age 65 to over 40% of people…
(more)
▼ textabstractDementia is a devastating disease that is common in elderly people. The prevalence increases from almost 1% at age 65 to over 40% of people older than 90 years.1 Because the population is aging, the number of people living with dementia world- wide is expected to double every 20 years with an expected number of 81 million people with dementia in 2040.2 Currently, dementia is still a clinical diagnosis of disturbances in cognitive functions that interfere with normal daily functioning.3,4 The major subtype of dementia is Alzheimer disease, which based on a clinical diag- nosis, accounts for around 70% of all dementia. The second most common subtype is vascular dementia, which is diagnosed in about 15% of dementia cases.1 Nowadays, however, we know that most patients with dementia have a mix of the neurodegen- erative changes that typically occur in Alzheimer disease, vascular pathology and other pathological signs, like Lewy bodies.5,6 In addition, vascular risk factors have repeatedly been associated with not only vascular dementia, but also with Alzheim- er disease,7 supporting the neuropathological findings of mixed brain pathologies. Although many risk factors for dementia have been identified in the past decades, the exact mechanisms that lead to dementia are still unclear. When the clinical di- agnosis of dementia is made, the actual neuropathological processes that have lead to dementia have already been ongoing for many years. Biomarkers that can detect these processes before a clinical diagnosis can be made are strongly needed in order to identify persons who will develop dementia, to gain more insight in the pathogen- esis of dementia and ultimately to help find new therapeutic agents that may alter or stop the disease. Currently, the most explored biomarkers are imaging markers and the proteins β-Amyloid (Aβ)-42 and tau that are altered in the cerebrospinal fluid of patients with Alzheimer disease early in the disease process.8,9 A lumbar puncture, required to obtain cerebrospinal fluid, is a relative invasive procedure that is not easily performed on large numbers of patients or in the general population, and imaging methods such as PET are not routinely available in all clinical settings. Less invasive biomarkers of dementia are therefore wanted.
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APA (6th Edition):
Schrijvers, E. M. C. (2011). Biomarkers and Risk Factors of Dementia. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/30742
Chicago Manual of Style (16th Edition):
Schrijvers, Elisabeth M C. “Biomarkers and Risk Factors of Dementia.” 2011. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/30742.
MLA Handbook (7th Edition):
Schrijvers, Elisabeth M C. “Biomarkers and Risk Factors of Dementia.” 2011. Web. 16 Aug 2018.
Vancouver:
Schrijvers EMC. Biomarkers and Risk Factors of Dementia. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2011. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/30742.
Council of Science Editors:
Schrijvers EMC. Biomarkers and Risk Factors of Dementia. [Doctoral Dissertation]. Erasmus University Medical Center; 2011. Available from: http://hdl.handle.net/1765/30742
26.
Bos, Michiel.
Causes and Risk of Stroke: the Rotterdam Study.
Degree: 2008, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/18613
► textabstractIt is not easy to imagine that the essence of our being is enclosed in a single organ: the brain. In addition to its miraculous…
(more)
▼ textabstractIt is not easy to imagine that the essence of our being is enclosed in a single organ: the
brain. In addition to its miraculous function, also the immensely delicate anatomical and
chemical structure of the brain is astounding. In order to maintain its structure and function,
the brain needs a constant supply of blood. If the blood flow is interrupted by the occlusion
of an artery, the affected part of the brain immediately stops functioning. The brain tissue
becomes irreversibly damaged within seconds and the area of irreversible brain damage
expands in the course of several hours, resulting in what is called an ischemic stroke (figure
1). A hemorrhagic stroke occurs when blood leaks from an artery into the brain, which has
the same detrimental effect on brain tissue as ischemia.
Strokes usually take patients completely by surprise. In the normal brain, the input
from all of our senses is collected, thoughts and emotions arise, and all voluntary body
actions are initiated and coordinated, therefore all these functions can be affected by a stroke.
For example, a patient who has a stroke may become unable to utter or understand language,
become paralyzed on one side of the body, experience half-sided blindness or difficulties
with swallowing, and his or her personality may change dramatically.
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APA (6th Edition):
Bos, M. (2008). Causes and Risk of Stroke: the Rotterdam Study. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/18613
Chicago Manual of Style (16th Edition):
Bos, Michiel. “Causes and Risk of Stroke: the Rotterdam Study.” 2008. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/18613.
MLA Handbook (7th Edition):
Bos, Michiel. “Causes and Risk of Stroke: the Rotterdam Study.” 2008. Web. 16 Aug 2018.
Vancouver:
Bos M. Causes and Risk of Stroke: the Rotterdam Study. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2008. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/18613.
Council of Science Editors:
Bos M. Causes and Risk of Stroke: the Rotterdam Study. [Doctoral Dissertation]. Erasmus University Medical Center; 2008. Available from: http://hdl.handle.net/1765/18613
27.
Vernooij, Meike.
Imaging of Age-related Brain Changes: A Population-based Approach.
Degree: 2009, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/15054
► textabstractThe objective of the studies described in this thesis was to investigate with magnetic resonance imaging (MRI) brain changes that may function as preclinical imaging…
(more)
▼ textabstractThe objective of the studies described in this thesis was to investigate with magnetic resonance imaging (MRI) brain changes that may function as preclinical imaging markers for neurodegenerative and cerebrovascular disease. For this goal, advanced MRI techniques were applied in the Rotterdam Scan Study, a large population-based brain imaging study among middle-aged and elderly persons. We studied the prevalence and distribution of age-related brain changes on MRI, investigated associated risk factors and related these brain changes to cognitive functioning.
We found that cerebral microbleeds were present in 1 in 5 persons over age of 60. This prevalence is much higher than reported previously, which in part may be explained by the use of a more sensitive MRI sequence. Furthermore, we showed that risk factors for microbleeds varied according to the location of microbleeds in the brain.
By measuring cerebral blood flow, we assessed that persons with low total brain perfusion had significantly more white matter lesions compared to those with high total brain perfusion. This suggests that tissue hypoperfusion may contribute to white matter lesion pathogenesis.
Microstructural integrity within white matter lesions or normal-appearing white matter was associated with cognitive function, even when taking into account volume of white matter lesions and white matter atrophy. This indicates that the deleterious effect of white matter changes on cognition not only depends on lesion burden or amount of atrophy, but also on characteristics that are not easily evaluated by conventional MRI.
The studies described in this thesis have identified several age-related brain changes that have potential to serve as imaging markers for neurodegenerative or cerebrovascular disease.
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APA (6th Edition):
Vernooij, M. (2009). Imaging of Age-related Brain Changes: A Population-based Approach. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/15054
Chicago Manual of Style (16th Edition):
Vernooij, Meike. “Imaging of Age-related Brain Changes: A Population-based Approach.” 2009. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/15054.
MLA Handbook (7th Edition):
Vernooij, Meike. “Imaging of Age-related Brain Changes: A Population-based Approach.” 2009. Web. 16 Aug 2018.
Vancouver:
Vernooij M. Imaging of Age-related Brain Changes: A Population-based Approach. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2009. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/15054.
Council of Science Editors:
Vernooij M. Imaging of Age-related Brain Changes: A Population-based Approach. [Doctoral Dissertation]. Erasmus University Medical Center; 2009. Available from: http://hdl.handle.net/1765/15054
28.
Euser, Sjoerd.
Determinants of Cognitive Decline and Dementia in the Very Old.
Degree: 2008, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/14187
► textabstractThe devastating impact of the loss of cognitive abilities that often accompanies the aging process is feared by many. Despite an increasing number of studies,…
(more)
▼ textabstractThe devastating impact of the loss of cognitive abilities that often accompanies the aging process is feared by many. Despite an increasing number of studies, the precise etiology of the disease is not known yet. There is accumulating evidence that a variety of causes, rather than a single factor, result in impaired cognitive function and the clinical symptoms of dementia. Glucose metabolism, vascular pathology and inflammation have all been suggested to play a role in the development of cognitive impairment and dementia.
The main objective of the work described in this thesis was the investigation of potentially modifiable risk factors, including factors involved in glucose metabolism, vascular pathology and inflammation in especially the early stages of the disease process. Furthermore, there have been studies that suggested that in general, possible risk factors that play a role at younger ages may not be important anymore when people survive until higher ages. Therefore, I additionally studied the age-specific effects of these risk factors in several large prospective studies including the Rotterdam Study, the Leiden 85-plus Study, and the PROSPER study, that were complementary with respect to the age of the participants and consequently allowed me to study the association between several potentially modifiable risk factors and cognitive function and decline over a wide age range in the general population. Finally, I investigated suggested preclinical biomarkers of dementia that might be !
used to identify people who are at increased risk of developing dementia.
I first explored the measurement of cognitive function, with respect to the effect of selection by health and survival on the estimation of cognitive function and decline in epidemiological studies. Chapter 2 showed that selection for health and survival resulted in better age-specific cognitive test scores and less cognitive decline, and that this selection affects both cross-sectional and longitudinal studies. Subsequently, statistical methods handling multiple and missing data did not seem to fully correct for this bias. These results indicated that assessments of cognitive function in the elderly must take particular care in considering possible biases from health selection.
In chapter 3, the results from studies on the relation between glucose metabolism and cognitive function were presented. First, I investigated the influence of fasting glucose levels and insulin resistance on cognitive function in non-diabetic elderly from two independent prospective studies: the PROSPER study and the Rotterdam Study (chapter 3.1). Elevated fasting glucose levels and insulin resistance were not associated with worse cognitive function or a higher rate of cognitive decline in elderly subjects without a history of diabetes. These data suggest either a threshold for effects of dysglycaemia on cognitive function, or that factors other than hyperglycaemia-related pathways impair cognition in individuals with frank diabetes. In chapter 3.2, I described the…
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APA (6th Edition):
Euser, S. (2008). Determinants of Cognitive Decline and Dementia in the Very Old. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/14187
Chicago Manual of Style (16th Edition):
Euser, Sjoerd. “Determinants of Cognitive Decline and Dementia in the Very Old.” 2008. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/14187.
MLA Handbook (7th Edition):
Euser, Sjoerd. “Determinants of Cognitive Decline and Dementia in the Very Old.” 2008. Web. 16 Aug 2018.
Vancouver:
Euser S. Determinants of Cognitive Decline and Dementia in the Very Old. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2008. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/14187.
Council of Science Editors:
Euser S. Determinants of Cognitive Decline and Dementia in the Very Old. [Doctoral Dissertation]. Erasmus University Medical Center; 2008. Available from: http://hdl.handle.net/1765/14187
29.
Jong, Frank Jan.
Endocrine Factors, Retinal Vessels, and Risk of Dementia.
Degree: 2007, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/13953
► textabstractFirst described 100 years ago by Alois Alzheimer, the clinico-pathological entity that we now call Alzheimer disease was initially presented as a clinically unusual type…
(more)
▼ textabstractFirst described 100 years ago by Alois Alzheimer, the clinico-pathological entity that we
now call Alzheimer disease was initially presented as a clinically unusual type of dementia.
1 Nowadays, Alzheimer disease is recognized as the main cause of dementia and one
of the most disabling and burdensome health conditions worldwide.2,3 The number of
people affected by dementia is estimated to double every 20 years to over 80 million by
2040.3 This will not only affect patients and their caregivers, but will also put an enormous
demand on health care and welfare resources.
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APA (6th Edition):
Jong, F. J. (2007). Endocrine Factors, Retinal Vessels, and Risk of Dementia. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/13953
Chicago Manual of Style (16th Edition):
Jong, Frank Jan. “Endocrine Factors, Retinal Vessels, and Risk of Dementia.” 2007. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/13953.
MLA Handbook (7th Edition):
Jong, Frank Jan. “Endocrine Factors, Retinal Vessels, and Risk of Dementia.” 2007. Web. 16 Aug 2018.
Vancouver:
Jong FJ. Endocrine Factors, Retinal Vessels, and Risk of Dementia. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2007. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/13953.
Council of Science Editors:
Jong FJ. Endocrine Factors, Retinal Vessels, and Risk of Dementia. [Doctoral Dissertation]. Erasmus University Medical Center; 2007. Available from: http://hdl.handle.net/1765/13953
30.
Reitz, Christiane.
Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease.
Degree: 2006, Erasmus University Medical Center
URL: http://hdl.handle.net/1765/13309
► textabstractOne of the earliest known written reports on dementia is attributed to Pythagoras in the 7th century BC, who described old age as a period…
(more)
▼ textabstractOne of the earliest known written reports on dementia is attributed to Pythagoras in the 7th
century BC, who described old age as a period of decline and decay of the human body and
regression of mental capacities. In 1907, Alois Alzheimer, a german psychiatrist and scientist,
observed at necropsy an overload of - at that time still unknown - amyloid plaques and
neurofi brillary tangles in the brain of a 51 year old woman who had suff ered during her life
course from progressive cognitive decline. Nowadays, amyloid plaques and neurofi brillary
tangles are considered the main neuropathological hallmarks of Alzheimer’s disease, which is
regarded the most frequent subtype of dementia.
Over the past two decades evidence has been accumulating that dementia is a heterogeneous
and multifactorial disorder, and that besides accumulation of beta amyloid and neurofi brillary
tangles, other factors, in particular vascular risk factors and cerebrovascular disease, may
be involved, especially in late-onset dementia. Observational studies reported associations
between several vascular risk factors and cognitive decline and dementia. In autopsy studies,
about 35% of the brains of elderly persons, who had been diagnosed with dementia during
their lifetime, had not only a higher burden of amyloid plaques and neurofi brillar tangles but
rather a mixed pathology also consisting of signifi cant cerebrovascular disease. Stroke has
been reported to considerably increase the risk of dementia, with prevalence rates of poststroke
dementia of about 30%, refl ecting a 3.6 to 5.8-fold increased risk of dementia compared
to stroke-free subjects. Cerebral small-vessel disease, which is defi ned as cerebral white matter
lesions and asymptomatic lacunar brain infarcts and is a common fi nding on brain scans of
elderly persons, has been reported to more than double the risk of dementia.
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APA (6th Edition):
Reitz, C. (2006). Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/13309
Chicago Manual of Style (16th Edition):
Reitz, Christiane. “Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease.” 2006. Doctoral Dissertation, Erasmus University Medical Center. Accessed August 16, 2018.
http://hdl.handle.net/1765/13309.
MLA Handbook (7th Edition):
Reitz, Christiane. “Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease.” 2006. Web. 16 Aug 2018.
Vancouver:
Reitz C. Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 2006. [cited 2018 Aug 16].
Available from: http://hdl.handle.net/1765/13309.
Council of Science Editors:
Reitz C. Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease. [Doctoral Dissertation]. Erasmus University Medical Center; 2006. Available from: http://hdl.handle.net/1765/13309
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Open Access Theses and Dissertations
