The therapy of choice in patients suffering from differentiated thyroid cancer (DTC), subdivided into papillary and follicular thyroid carcinoma, is (near-)total thyroidectomy. This is routinely... Show moreThe therapy of choice in patients suffering from differentiated thyroid cancer (DTC), subdivided into papillary and follicular thyroid carcinoma, is (near-)total thyroidectomy. This is routinely followed by the administration of radioiodine (RaI)-131 (131I) to destroy any remaining benign or malignant thyroid tissue, so-called ablation. This thesis has addressed some important clinical questions, related to the application of conventional (131I) and experimental therapies with radionuclides in DTC. Iodine-131 has been used for many years to ablate thyroid remnants following thyroid surgery, but a single optimal activity has not yet been established. Two protocols are commonly used in the Netherlands: the uptake-related ablation strategy in which relatively low activities of 131I are used and the fixed-dose or tumor-related ablation strategy in which higher ablation activities are used. The main aim of this thesis was to study the short-term and long-term outcome parameters in DTC according to the uptake-related ablation protocol and to compare the success rates of both ablation strategies. Furthermore, we investigated whether there was a relation between ablation failure and pre-ablation 24-hour uptake measurement of 131I (by the so-called stunning effect). By assessing the prevalence of second primary tumors in patients treated for thyroid cancer we wanted to confirm that 131I can be used safely regarding long-term effects. Finally, this thesis focused on 111In-DTPA-octreotide scintigraphy and therapy as an alternative tool in progressive radioiodine non-responsive thyroid cancer. Show less
This thesis focuses on patients with Binge Eating Disorder. The thesis consists of three parts. In the first part the validity of the diagnosis of BED will be discussed. The results of two... Show moreThis thesis focuses on patients with Binge Eating Disorder. The thesis consists of three parts. In the first part the validity of the diagnosis of BED will be discussed. The results of two literature reviews and an empirical cross-sectional study suggested that BED is a distinct eating disorder and should be added to a next version of the DSM. In the second part results of a randomized controlled trial were described. The effectiveness of cognitive behavioural therapy was compared to a waiting list control group. As expected, objective binge eating frequency, eating disordered psychopathology, and comorbid psychopathology decreased significantly in the CBT group whereas no reduction was found in the control (WLC) group. Mediator analyses indicated that abstinence from binge eating at post treatment was fully mediated by changes in weight concerns and marginally by changes in concerns about shape and eating, depressive symptoms, and more general psychopathological symptoms. In the third and last part the results of two experimental studies were presented. The purpose of the studies was to investigate the causal relationship between negative mood and binge eating. Both experimental studies found evidence for the fact that in individuals with BED depressive symptoms and caloric intake are positively related. Show less
