Maastricht University

About: Maastricht University is a education organization based out in Maastricht, Limburg, Netherlands. It is known for research contribution in the topics: Population & Health care. The organization has 19263 authors who have published 53291 publications receiving 2266866 citations. The organization is also known as: Universiteit Maastricht & UM.

Preoperative anxiety and catastrophizing: a systematic review and meta-analysis of the association with chronic postsurgical pain.

Abstract: Objectives: Anxiety and pain catastrophizing predict acute postoperative pain. However, it is not well established whether they also predict chronic postsurgical pain (CPSP). The aim of this systematic review and meta-analysis was to investigate whether high levels of preoperative anxiety or pain catastrophizing are associated with an increased risk of CPSP. Methods: Electronic search databases included PubMed and PsychINFO. Additional literature was obtained by reference tracking and expert consultation. Studies from 1958 until October 2010, investigating the association between preoperative anxiety or pain catastrophizing and CPSP in adult surgery patients, were assessed. The primary outcome was the presence of pain at least 3 months postoperatively. Results: Twenty-nine studies were included; 14 instruments were used to assess anxiety or pain catastrophizing. Sixteen studies (55%) reported a statistically significant association between anxiety or pain catastrophizing and CPSP. The proportion of studies reporting a statistically significant association was 67% for studies of musculoskeletal surgery and 36% for other types of surgery. There was no association with study quality, but larger studies were more likely to report a statistically significant relationship. The overall pooled odds ratio, on the basis of 15 studies, ranged from 1.55 (95% confidence interval, 1.10-2.20) to 2.10 (95% confidence interval, 1.49-2.95). Pain catastrophizing might be of higher predictive utility compared with general anxiety or more specific pain-related anxiety. Discussion: There is evidence that anxiety and catastrophizing play a role in the development of CPSP. We recommend that anxiety measures should be incorporated in future studies investigating the prediction and transition from acute to chronic postoperative pain.

Nomograms for Predicting Local Recurrence, Distant Metastases, and Overall Survival for Patients With Locally Advanced Rectal Cancer on the Basis of European Randomized Clinical Trials

Abstract: Purpose The purpose of this study was to develop accurate models and nomograms to predict local recurrence, distant metastases, and survival for patients with locally advanced rectal cancer treated with long-course chemoradiotherapy (CRT) followed by surgery and to allow for a selection of patients who may benefit most from postoperative adjuvant chemotherapy and close follow-up. Patients and Methods All data (N = 2,795) from five major European clinical trials for rectal cancer were pooled and used to perform an extensive survival analysis and to develop multivariate nomograms based on Cox regression. Data from one trial was used as an external validation set. The variables used in the analysis were sex, age, clinical tumor stage stage, tumor location, radiotherapy dose, concurrent and adjuvant chemotherapy, surgery procedure, and pTNM stage. Model performance was evaluated by the concordance index (c-index). Risk group stratification was proposed for the nomograms. Results The nomograms are able to pred...

Human intestinal microbiota composition is associated with local and systemic inflammation in obesity

Abstract: Objective Intestinal microbiota have been suggested to contribute to the development of obesity, but the mechanism remains elusive. The relationship between microbiota composition, intestinal permeability, and inflammation in nonobese and obese subjects was investigated. Design and Methods Fecal microbiota composition of 28 subjects (BMI 18.6-60.3 kg m−2) was analyzed by a phylogenetic profiling microarray. Fecal calprotectin and plasma C-reactive protein levels were determined to evaluate intestinal and systemic inflammation. Furthermore, HbA1c, and plasma levels of transaminases and lipids were analyzed. Gastroduodenal, small intestinal, and colonic permeability were assessed by a multisaccharide test. Results Based on microbiota composition, the study population segregated into two clusters with predominantly obese (15/19) or exclusively nonobese (9/9) subjects. Whereas intestinal permeability did not differ between clusters, the obese cluster showed reduced bacterial diversity, a decreased Bacteroidetes/Firmicutes ratio, and an increased abundance of potential proinflammatory Proteobacteria. Interestingly, fecal calprotectin was only detectable in subjects within the obese microbiota cluster (n = 8/19, P = 0.02). Plasma C-reactive protein was also increased in these subjects (P = 0.0005), and correlated with the Bacteroidetes/Firmicutes ratio (rs = −0.41, P = 0.03). Conclusions Intestinal microbiota alterations in obese subjects are associated with local and systemic inflammation, suggesting that the obesity-related microbiota composition has a proinflammatory effect.

Innovation and Productivity: An Update

Abstract: This paper reviews the existing evidence regarding the effects of technological and non-technological innovations on the productivity of firms and the existence of possible complementarities between these different forms of innovation.