Institution
Radboud University Nijmegen
Education•Nijmegen, Gelderland, Netherlands•
About: Radboud University Nijmegen is a education organization based out in Nijmegen, Gelderland, Netherlands. It is known for research contribution in the topics: Population & Context (language use). The organization has 35417 authors who have published 83035 publications receiving 3285064 citations. The organization is also known as: Catholic University of Nijmegen & Radboud University.
Papers published on a yearly basis
Papers
More filters
••
TL;DR: The quality of trials and lack of sufficient other outcome parameters do not justify implementation of ERAS as the standard of care, but analysis shows a reduction in overall complications, but major complications were not reduced.
Abstract: Background
In recent years the Enhanced Recovery after Surgery (ERAS) postoperative pathway in (ileo-)colorectal surgery, aiming at improving perioperative care and decreasing postoperative complications, has become more common.
Objectives
We investigated the effectiveness and safety of the ERAS multimodal strategy, compared to conventional care after (ileo-)colorectal surgery. The primary research question was whether ERAS protocols lead to less morbidity and secondary whether length of stay was reduced.
Search methods
To answer the research question we entered search strings containing keywords like "fast track", "colorectal and surgery" and "enhanced recovery" into major databases. We also hand searched references in identified reviews concerning ERAS.
Selection criteria
We included published randomised clinical trials, in any language, comparing ERAS to conventional treatment in patients with (ileo-) colorectal disease requiring a resection. RCT's including at least 7 ERAS items in the ERAS group and no more than 2 in the conventional arm were included.
Data collection and analysis
Data of included trials were independently extracted by the reviewers. Analyses were performed using "REVMAN 5.0.22". Data were pooled and rate differences as well as weighted mean differences with their 95% confidence intervals were calculated using either fixed or random effects models, depending on heterogeneity (I2).
Main results
4 RCTs were included and analysed. Methodological quality of included studies was considered low, when scored according to GRADE methodology. Total numbers of inclusion were limited. The trials included in primary analysis reported 237 patients, (119 ERAS vs 118 conventional). Baseline characteristics were comparable. The primary outcome measure, complications, showed a significant risk reduction for all complications (RR 0.50; 95% CI 0.35 to 0.72). This difference was not due to reduction in major complications. Length of hospital stay was significantly reduced in the ERAS group (MD -2.94 days; 95% CI -3.69 to -2.19), and readmission rates were equal in both groups. Other outcome parameters were unsuitable for meta-analysis, but seemed to favour ERAS.
Authors' conclusions
The quantity and especially quality of data are low. Analysis shows a reduction in overall complications, but major complications were not reduced. Length of stay was reduced significantly. We state that ERAS seems safe, but the quality of trials and lack of sufficient other outcome parameters do not justify implementation of ERAS as the standard of care. Within ERAS protocols included, no answer regarding the role for minimally invasive surgery (i.e. laparoscopy) was found. Furthermore, protocol compliance within ERAS programs has not been investigated, while this seems a known problem in the field. Therefore, more specific and large RCT's are needed.
691 citations
••
University of Washington1, University of Geneva2, Ghent University3, Salisbury University4, University Hospital Southampton NHS Foundation Trust5, Katholieke Universiteit Leuven6, Radboud University Nijmegen7, University College London8, University of Amsterdam9, University of Manchester10, University of Bern11, University of Naples Federico II12, University of Glasgow13, Pompeu Fabra University14, Utrecht University15, University of Oxford16, Wellcome Trust Sanger Institute17, University of Chicago18, Vanderbilt University19, Cold Spring Harbor Laboratory20, Howard Hughes Medical Institute21
TL;DR: Recurrent molecular lesions that elude syndromic classification and whose disease manifestations must be considered in a broader context of development as opposed to being assigned to a specific disease are identified.
Abstract: BACKGROUND: Duplications and deletions in the human genome can cause disease or predispose persons to disease. Advances in technologies to detect these changes allow for the routine identification of submicroscopic imbalances in large numbers of patients. METHODS: We tested for the presence of microdeletions and microduplications at a specific region of chromosome 1q21.1 in two groups of patients with unexplained mental retardation, autism, or congenital anomalies and in unaffected persons. RESULTS: We identified 25 persons with a recurrent 1.35-Mb deletion within 1q21.1 from screening 5218 patients. The microdeletions had arisen de novo in eight patients, were inherited from a mildly affected parent in three patients, were inherited from an apparently unaffected parent in six patients, and were of unknown inheritance in eight patients. The deletion was absent in a series of 4737 control persons (P=1.1x10(-7)). We found considerable variability in the level of phenotypic expression of the microdeletion; phenotypes included mild-to-moderate mental retardation, microcephaly, cardiac abnormalities, and cataracts. The reciprocal duplication was enriched in nine children with mental retardation or autism spectrum disorder and other variable features (P=0.02). We identified three deletions and three duplications of the 1q21.1 region in an independent sample of 788 patients with mental retardation and congenital anomalies. CONCLUSIONS: We have identified recurrent molecular lesions that elude syndromic classification and whose disease manifestations must be considered in a broader context of development as opposed to being assigned to a specific disease. Clinical diagnosis in patients with these lesions may be most readily achieved on the basis of genotype rather than phenotype.
690 citations
••
TL;DR: This article examined the connections between attitudes, group norms, and students' behaviour in bullying situations (bullying others, assisting the bully, reinforcing a bully, defending the victim, or staying outside bullying situations).
Abstract: We examined the connections between attitudes, group norms, and students’ behaviour in bullying situations (bullying others, assisting the bully, reinforcing the bully, defending the victim, or staying outside bullying situations). The participants were 1220 elementary school children (600 girls and 620 boys) from 48 school classes from Grades four, five, and six, i.e., 9–10, 10–11, and 11–12 years of age. Whereas attitudes did predict behaviour at the student level in most cases (although the effects were moderate after controlling for gender), the group norms could be used in explaining variance at the classroom level, especially in the upper grades. The class context (even if not classroom norms specifically) had more effect on girls’ than on boys’ bullying-related behaviours.
689 citations
••
Catholic University of the Sacred Heart1, Memorial Sloan Kettering Cancer Center2, International Agency for Research on Cancer3, University Health Network4, University of Lausanne5, Centre Hospitalier Universitaire de Grenoble6, Utrecht University7, Charité8, University of Texas MD Anderson Cancer Center9, Technische Universität München10, Belfast Health and Social Care Trust11, University of Zurich12, University of Nottingham13, Beatson West of Scotland Cancer Centre14, Tohoku University15, University of Verona16, Institut Gustave Roussy17, University of Bologna18, Radboud University Nijmegen19
TL;DR: This work believes this conceptual approach can form the basis for the next generation of NEN classifications and will allow more consistent taxonomy to understand how neoplasms from different organ systems inter-relate clinically and genetically.
688 citations
••
University of Oxford1, Moorfields Eye Hospital2, National Institutes of Health3, Nationwide Children's Hospital4, Ohio State University5, Radboud University Nijmegen6, Central Manchester University Hospitals NHS Foundation Trust7, University of Southampton8, UCL Institute of Ophthalmology9, Universidade Nova de Lisboa10
TL;DR: The initial results of this retinal gene therapy trial are consistent with improved rod and cone function that overcome any negative effects of retinal detachment, and lend support to further assessment of gene therapy in the treatment of choroideremia and other diseases, such as age-related macular degeneration, for which intervention should ideally be applied before the onset ofretinal thinning.
685 citations
Authors
Showing all 35749 results
Name | H-index | Papers | Citations |
---|---|---|---|
Charles A. Dinarello | 190 | 1058 | 139668 |
Richard H. Friend | 169 | 1182 | 140032 |
Yang Gao | 168 | 2047 | 146301 |
Ian J. Deary | 166 | 1795 | 114161 |
David T. Felson | 153 | 861 | 133514 |
Margaret A. Pericak-Vance | 149 | 826 | 118672 |
Fernando Rivadeneira | 146 | 628 | 86582 |
Shah Ebrahim | 146 | 733 | 96807 |
Mihai G. Netea | 142 | 1170 | 86908 |
Mingshui Chen | 141 | 1543 | 125369 |
George Alverson | 140 | 1653 | 105074 |
Barry Blumenfeld | 140 | 1909 | 105694 |
Harvey B Newman | 139 | 1594 | 88308 |
Tariq Aziz | 138 | 1646 | 96586 |
Stylianos E. Antonarakis | 138 | 746 | 93605 |