The verification procedure appeared to be feasible in the three institutions and enabled a significant reduction of mean 3D setup deviations. The computer simulation of the procedure proved to be a useful tool, because it enabled an accurate prediction of the setup accuracy and the required number of corrections.

No abstract

No abstract

The present study shows that health status consists of conceptually distinct sub-domains. Integral assessment of health status thus entails measuring all sub-domains. Existing instruments measure only few sub-domains. Integral assessment of health status thus requires the combination of different instruments. The present framework of health status can help in composing such a battery of instruments. Patient profiles obtained by the framework are essential in individualizing treatment.

The quality of sleep is significantly compromised in many patients with chronic obstructive pulmonary disease (COPD) and may be further diminished when certain comorbidities are present. A reduced sleep quality is associated with daytime consequences like fatigue, psychiatric problems and an impaired quality of life. Sleep induces physiologic alterations in respiratory function, which can become pathologic and may provoke or worsen hypoxemia and hypercapnia in COPD. Dyspnea, cough and excessive mucus production should be optimised to minimise causes for sleep disturbance. Pharmacological therapy may be helpful; sedatives like benzodiazepines and non-benzodiazepine benzodiazepine-receptor agonists (NBBRAs) are (equally) effective in improving sleep quality. Whether or not these hypnotics produce serious adverse respiratory effects during sleep, remains unclear due to opposing studies. Therefore, their use should be as short as possible.

In many women, the diagnosis of breast cancer leads to psychosocial adjustment problems. Biodemographic variables, coping, and social support are factors that influence psychosocial adjustment. The main objective of the present study was to identify and estimate the associations between psychosocial adjustment and biodemographic variables, coping, and social support by using Structural Equation Modeling (SEM). Eighty-seven women with newly diagnosed early stage breast cancer completed several questionnaires covering these areas. It appeared that in the period shortly after surgery, coping style, especially illness-specific coping, is of high relevance for psychosocial adjustment. In our study, we could not confirm the positive role of social support found in other studies on psychosocial adjustment. Biodemographic variables had both direct and indirect associations with psychosocial adjustment: older women and women who had had breast-conserving treatment used a more optimistic coping style; the latter group also reported higher body image; and finally, women with a more advanced stage of disease reported a reduction in recreational activities.

P Pr re ed di ic ct to or rs s f fo or r n no oc ct tu ur rn na al l h hy yp po ox xa ae em mi ia a ( (m me ea an n S Sa aO O 2 2 < <9 90 0% %) ) i in n n no or rm mo ox xi ic c a an nd d m mi il ld dl ly y h hy yp po ox xi ic c p pa at ti ie en nt ts s w wi it th h C CO OP PD D In 10 patients, enough desaturations occurred to qualify as nocturnal hypoxaemia. They had a significantly lower daytime PaO 2 value, and a lower steady-state hypercapnic ventilatory response. They also smoked more often, and complained about daytime sleepiness. Multiple linear regression analysis demonstrated that daytime PaO 2 (32%) was the best independent predictor. Sleepiness (12%), and number of cigarettes smoked (5%) also contributed independently, but in a minor way. Patients with a high daytime PaO 2 (>11 kPa) did not develop nocturnal hypoxaemia.The hypercapnic ventilatory response was used to distinguish nocturnal hypoxaemic from normoxaemic patients. Only patients with a low response (<3.5 l·min -1 ·kPa -1 ) appeared to run a risk of developing nocturnal hypoxaemia. The sensitivity of this test was 80%, and the specificity 70%.It is concluded that daytime PaO 2 , hypercapnic ventilatory response and sleepiness are helpful in predicting nocturnal hypoxaemia.

No abstract