Neonatal health care is provided with medication and protocols for almost all morbidities. Before the use of these medicines is allowed, they are extensively studied and tested for efficacy and... Show moreNeonatal health care is provided with medication and protocols for almost all morbidities. Before the use of these medicines is allowed, they are extensively studied and tested for efficacy and safety. As patient population and knowledge on specific diseases changes with time, repeated evaluation of efficacy and safety of current used policies is of paramount importance. In this thesis six __Neonatal Pearls__ are presented: six relatively rare clinical conditions, of which a retrospective study evaluates the efficacy, safety and/or long term consequences of the current protocol. Despite their retrospective design and relatively small sample size, they are all of significant value and may serve as potential foundations for future protocol adjustments and randomized controlled trials. The evaluated clinical conditions and policies include: -Fetal, neonatal and developmental outcomes of lithium exposed pregnancies -Neonatal outcome in allo-immune thrombocytopenia after maternal treatment with antenatal intravenous immunoglobulin - Repeated courses of ibuprofen for closure of a patent ductus arteriosus - Use of rifampin in persistent coagulase negative staphylococcal bacteremia in neonates - Outcome and management in neonatal thrombocytopenia due to maternal idiopathic thrombocytopenic purpura - Short and long term outcome of neonatal hyperglycemia in very preterm infants Show less
Lugt, N.M. van der; Maat, J.S. van de; Kamp, I.L. van; Knoppert-van der Klein, E.A.M.; Hovens, J.G.F.M.; Walther, F.J. 2012
Differentiated thyroid carcinoma (DTC) has favorable prognosis with high cure rate under treatment of thyroidectomy followed by radiotherapy. However, therapeutic efficiency decreases when... Show moreDifferentiated thyroid carcinoma (DTC) has favorable prognosis with high cure rate under treatment of thyroidectomy followed by radiotherapy. However, therapeutic efficiency decreases when dedifferentiation occurs. One of the purposes in this study is to use pharmaceuticals intervention to promote therapeutic responsiveness in thyroid carcinomas. Lithium compound and retinoid derivatives have been applied in thyroid cancer patients and in normal and thyroid cancer cell lines. The results indicate that Lithium compound doesn__t influence either iodine uptake in vivo and in vitro conditions or iodine efflux in cell lines observed. Retinoid, Bexarotene, slightly increases iodine uptake in thyroid cancer patients but does not reach the therapeutic level. In attempt to find efficient diagnostic markers, 156 patient samples including subsets of thyroid carcinomas and benign thyroid disorders have been investigated using immunohistochemistry in tissue micro-array sections. The results indicate that combination of protein expression of NIS, FN and Gal-3 may distinguish benign tumors from malignant thyroid carcinomas with high accuracy. As thyroid cancer patients have high survival rate, efficient and sensitive screening tool is crucial for follow up in DTC. In this study, thyroglobulin (Tg) of over 600 patients has been studies at unicenter with uniformed treatment. The results prove that multiple tests of Tg at fix time points may predict DTC prognosis and death. Show less
