6 juli 2010

 
Patiënten met de longaandoening COPD en een inspanningsbeperking hebben baat bij een op maat gesneden, transmuraal programma voor longrevalidatie. Dit concludeert promovendus Carel van Wetering.

 
Van Wetering toont aan dat een dergelijk programma na twee jaar leidt tot meer kwaliteit van leven en een verbeterde inspanningscapaciteit bij patiënten met COPD. Bovendien zijn de kosten laag en het rendement hoog.

 
Kostenefficiënt

De Maastrichtse promovendus voert aan dat de kosten van het programma virtueel worden terugverdiend, omdat de patiënten minder vaak in het ziekenhuis worden opgenomen.

 
COPD

 
COPD (Chronic Obstructive Pulmonary Disease) is een veel voorkomende, progressieve en invaliderende longziekte. Uit eerder onderzoek bleek dat COPD de kans op longkanker bij patiënten vergroot.

 
Proefschrift

 
Carel van Wetering promoveert aan de Universiteit Maastricht op zijn proefschrift: 'Clinical evaluation and cost-effectiveness of a community based COPD management program'.

 
Bron: Universiteit Maastricht

Belangrijkste oorzaken van hartfalen

Belangrijke klachten van hartfalen zijn: 

• vermoeidheid
• kortademigheid (vooral bij inspanning)
• opgezette benen en enkels
• koude handen en voeten
• opgeblazen gevoel en een moeilijke stoelgang
• verminderde eetlust en toch zwaarder worden
• prikkelhoest (vooral bij plat liggen)
• onrustig slapen en ’s nachts vaak plassen  
• vergeetachtigheid en gebrek aan concentratie 

16 juli 2010

Een revalidatieprogramma na hartfalen verhoogt de reactiviteit van perifere bloedvaten, verbetert fysieke prestaties en heeft een gunstig effect op de kwaliteit van leven. Dit concludeert promovenda Emeline van Craenenbroeck.

Een korte, eenmalige inspanning is al voldoende om disfunctioneren van de endotheliale progenitorcellen, een kenmerk van hartfalen, te normaliseren. Met deze bevinding kan training in de toekomst beter op individuele patiënten worden toegesneden.

 
Van Craenenbroeck onderzocht de endotheelfunctie, die een cruciale rol speelt in het functioneren van andere organen na hartfalen. Ze keek specifiek of de endotheelfunctie gemedieerd wordt door endotheliale progenitorcellen (EPC).

Bewegen

 
De promovenda van de Universiteit Antwerpen benadrukt in haar proefschrift dat regelmatig bewegen niet te vervangen is met een 'magische pil'. Vooral fysiek actieve patiënten met chronisch hartfalen profiteren van het EPC-effect, dat de vaatreactiviteit herstelt.

Bron: Universiteit Antwerpen

KOM VAN 2 TOT 9 OKTOBER 2010 NAAR ZUID PORTUGAL EN BELEEF EEN WEEK VAN GROEI EN PLEZIER!

(HER) ONTDEK JEZELF

Workshops met intensieve ademsessies, begeleid door ervaren ademcoaches, volgens de methode van Transformational Breathing.
Transformational Breathing is een krachtige techniek van bewust aangestuurde ademhaling, die je beter bij je gevoel brengt en de relatie met jezelf heelt.

Kernthema’s zijn o.a.:
Wie wil ik zijn?
Hoe krijg ik balans in mijn leven op fysiek, mentaal en emotioneel gebied?
Hoe krijg ik meer energie?
Hoe ervaar ik meer vreugde in mijn leven?

Wensen en doelen in je leven worden op deze manier duidelijk en geven meer visie.

De prachtige Algarve in Zuid Portugal biedt de gelegenheid tot rust en ontspanning.
Naast de dagelijkse workshops gaan we genieten van strand en zon en is er tijd ingepland voor creativiteit.

We verblijven in Casa Verdazul, waar je beschikt over een luxe gastenkamer met badkamer en balkon. Gelegen in een tropische tuin met zwembad.
Je investering voor deze week is €1400,- . Dit is inclusief alle workshops, verblijf met volpension en transfer van/naar vliegveld.
( Excl. Vlucht naar/van Faro).

Voor verdere informatie of aanmelding kun je ons bereiken:

 

 

Nederland: Pieterjan Elst, 0031-(0) 165 552463/ 0031-(0) 624210840
Email: pjelst@hetnet.nl
Duitsland: Dorothée Dillmann, 0049- 15775309539
Email: DillmannDorle@web.de
Portugal: Casa Verdazul, 00351 281963145
Email: info@casaverdazul.com

www.transformationalbreathing.nl
www.tag-coaching.de
www.casaverdazul.com

Ter informatie: Pieterjan Elsten werkt als logopedist en ademtherapeut in het PMC.

From WebMD Health News

Kathleen Doheny

July 1, 2010 — An immune system substance may contribute to causing the low back pain associated with herniated and degenerated discs, according to a new study.
"We have identified an immune substance that could start the inflammatory process for disc herniation and disc degeneration," says researcher William J. Richardson, MD, professor of orthopaedic surgery at Duke University Medical Center in Durham, N.C.

 
The substance, interleukin-17 or IL-17, was found in more than 70% of surgical tissue samples taken from patients with degenerated or herniated disc disease, but rarely in healthy disc tissue samples, the researchers found.
The discovery is believed to be a first, Richardson tells WebMD. ''This is the first paper to identify IL-17 in patients with disc herniation and disc degeneration. It suggests that IL-17 may be a mediator for disc herniation and the inflammatory pain associated with that, and also with disc degeneration."

 
While there is no immediate benefit for those suffering from low back pain due to disc problems, "it opens up new avenues to deal with the problem down the road," he says. One possibility: a drug that blocks IL-17. Such drugs are in development for rheumatoid arthritis, Richardson says, but he has not begun a study for disc patients.
The study is published in the July issue of Arthritis & Rheumatism.

 
Your Immune System and Your Discs

Low back pain is among the most frequent reasons people seek medical care, the researchers note, with the economic burden of acute low back pain estimated at $200 billion a year in the U.S.
Disc problems are a common cause of that low back pain.

Discs act as cushions between vertebrae, the shock absorbers for your spine. When a disc becomes herniated, sometimes called a slipped or ruptured disc, part of its soft inner layer pushes out through a tear in the tough outer layer. The result is often back pain that shoots down your leg, called sciatica.
"There appear to be two components to sciatica; one is mechanical compression [when the disc pushes out through the tear], the other is inflammatory," Richardson says.

"What wasn't clearly understood was what substances were involved in the inflammatory component."
His team obtained tissue samples from patients, looking at 25 samples of degenerated disc tissue and 12 samples of herniated disc tissue, and compared them with eight samples of healthy tissues.
In looking for specific inflammatory substances, they found IL-17 was found in more than 70% of the diseased tissues but rarely or modestly in healthy tissues.

 
Disc Degeneration, Herniation: Second Opinion

The research adds valuable new information to what is known about disc problems, says Theodore Oegema, PhD, a professor of biochemistry and orthopaedic surgery at Rush University Medical Center in Chicago, who wrote an editorial to accompany the study.
He calls it ''a new twist to an old story."
It's already known that IL-17 contributes to the chronic inflammation seen in psoriasis vulgaris, the bone resorption problem in rheumatoid arthritis and gum disease, and in the intestinal disorder Crohn's disease, Oegema writes in the editorial.
The new research, he tells WebMD, supplies evidence of IL-17 cell involvement in early disc degeneration, not simply in herniation. In time, he says, researchers may develop methods, possibly with targeted drugs, to stall the degeneration of discs that can occur with age by blocking IL-17 in that area.

 
SOURCES:

William J. Richardson, MD, professor of orthopaedic surgery, Duke University Medical Center, Durham, N.C.
Theodore Oegema, PhD, professor of biochemistry and orthopaedic surgery, Rush University Medical Center, Chicago.
Shamji, M. Arthritis & Rheumatism, July 2010, vol 62: pp 1974-1982.
Oegema, T. Arthritis & Rheumatism, July 2010, vol 62: pp 1840-1841.
Kathleen Doheny is a freelance writer for WebMD.

From Medscape Medical News

Laurie Barclay, MD

June 30, 2010 — Advice to stay active vs bed rest may offer small benefits in pain and function for patients with acute low back pain (LBP), but both approaches are comparable for patients with sciatica, according to the results of a review reported online June 16 in the Cochrane Database of Systematic Reviews.

 
"Acute...LBP is a common reason to consult a general practitioner," write Kristin Thuve Dahm, from the Norwegian Knowledge Centre for the Health Services in Oslo, Norway, and colleagues. "Debate continues on the comparative effectiveness of advice on bed rest and staying active as part of the primary care management."

 
To evaluate the outcomes of advice to rest in bed or to stay active for patients with acute LBP or sciatica, the reviewers searched the Cochrane Back Review Group Trials Register, CENTRAL, MEDLINE, EMBASE, Sport, and SCISEARCH to May 2009. They also searched bibliographies of pertinent articles and contacted study authors.

 
Criteria for inclusion in the review were randomized controlled trials of the efficacy of advice to stay active or rest in bed for patients with acute LBP or sciatica, with primary study endpoints of pain, functional status, recovery, and return to work. Two reviewers independently extracted data and determined the risk for bias for selected studies, which were combined qualitatively or statistically, as appropriate on the basis of data availability and presentation.

 
The 10 selected randomized controlled trials had varying risk for bias. Findings from 2 trials enrolling a total of 401 patients with acute LBP suggested that advice to stay active was associated with small improvements in pain relief (SMD, 0.22; 95% confidence interval [CI], 0.02 - 0.41) and in functional status (SMD, 0.29; 95% CI, 0.09 - 0.49). There was moderate-quality evidence that patients with sciatica who were given advice to rest in bed or to stay active had little or no difference in pain relief (standardized mean difference [SMD], –0.03; 95% CI, –0.24 to 0.18) or in functional status (SMD, 0.19; 95% CI, –0.02 to 0.41).
For patients with acute LBP, low-quality evidence from 3 randomized controlled trials enrolling a total of 931 patients suggested little or no difference among exercises, advice to rest in bed, or to stay active. For patients with sciatica, low-quality evidence from 1 randomized controlled trial enrolling a total of 250 patients suggested little or no difference among physiotherapy, advice to rest in bed, or to stay active.

 
Various strategies for advising patients were not compared in any of the identified trials.
Limitations of this review include those inherent in the included studies, with varying quality of evidence and risk for bias.
"Moderate quality evidence shows that patients with acute LBP may experience small benefits in pain relief and functional improvement from advice to stay active compared to advice to rest in bed; patients with sciatica experience little or no difference between the two approaches," the study authors write. "Low quality evidence suggests little or no difference between those who received advice to stay active, exercises or physiotherapy. Further research is very likely to have an important impact on the estimate of effect and is likely to change our confidence in it."

 
Cochrane Database Syst Rev. Published online June 16, 2010. Abstract

 

From : Arthritis Care Research News Alerts

Athan Baillet; Nadine Zeboulon; Laure Gossec; Christophe Combescure; Louis-Antoine Bodin; Robert Juvin; Maxime Dougados; Philippe Gaudin

07/15/2010

 

 

Researchers from the University of Grenoble Medical School in France determined that cardio-respiratory aerobic exercise is safe for patients with stable rheumatoid arthritis (RA). The team found that RA patients who exercised regularly had improved function, less joint pain, and greater quality of life. Full findings of the study are now available online and will publish in the July print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

 
RA, a chronic inflammatory disease characterized by swollen joints, pain, stiffness, fatigue, and general malaise affects up to 1% of the global population, according to the World Health Organization (WHO). The Centers for Disease Control and Prevention (CDC) citing health-related quality of life (HRQL) studies found that RA patients were 40% more likely to report fair or poor general health and twice as likely to have a health-related activity limitation compared with those without arthritis.

The current study led by Athan Baillet, M.D., conducted an abstract search of relative medical journals for studies that researched RA patients and impact of aerobic exercise. The team analyzed 14 studies and meta-analysis included 510 patients in the intervention group and 530 in the control group. Participants in these studies had a mean age of 44–68 years and their RA disease duration was 1–16 years. Researchers compared HRQL, the Health Assessment Questionnaire (HAQ), joint count, and pain using a visual analog scale (VAS) among patients in the studies.

"Our results show that patients with stable RA would benefit from regular aerobic exercise," said Dr. Baillet. "Cardio-respiratory conditioning appears safe and its effects, while small, help to reduce joint pain and improve function." Researchers assessed the efficacy of exercise on RA symptoms using standardized mean differences (SMDs) which is the difference (between groups) of mean outcome variation from baseline/SD at baseline of aerobic exercises versus non-aerobic rehabilitation. Meta analysis of the research showed that exercise improved the post-intervention quality of life (SMD=0.39), HAQ score (SMD=0.24), and pain VAS (SMD=0.31). The difference in scores between those who exercised and those who had not are considered clinically meaningful by both patients and doctors noted the researchers.

 
The American College of Rheumatology states that exercise is beneficially for everyone, including those with RA, and currently recommends 150 minutes of moderate intensity aerobic activity each week. Safe forms of aerobic exercise, such as walking, aerobic dance, and aquatic exercise, help arthritis patients to control weight, and improve sleep, mood, and overall health.
"While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group. Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA," concluded Dr. Baillet.