Job van der Palen

Universiteit Twente, Enschede, Overijssel, Netherlands

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Publications (187)591.79 Total impact

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    ABSTRACT: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up.
    International journal of radiation oncology, biology, physics 08/2014; 89(5):1006-14. · 4.59 Impact Factor
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    Article: Response.
    Chest 08/2014; 146(2):e65-6. · 7.13 Impact Factor
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    ABSTRACT: Severe childhood obesity has become a major health problem, and effective, evidence-based interventions are needed. The relative effectiveness of inpatient compared with ambulatory treatment remains unknown.
    JAMA Pediatrics 07/2014; · 4.28 Impact Factor
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    ABSTRACT: Background Numerous instruments are available to measure HRQoL in patients with COPD, covering a wide array of domains ranging from symptoms such as dyspnea, cough and wheezing, to social and emotional functioning. Currently no information or guide is available yet to aid the selection of domains for a particular study or disease population. The aim of this paper is to identify which domains of health-related quality of life (HRQoL) are most important with respect to Chronic Obstructive Pulmonary Disease (COPD), from the patient perspective.Methods Twenty-one Dutch patients with Chronic Obstructive Pulmonary Disease (COPD) were asked to describe important domains impacted by COPD freely; second, they were presented with cues (domains from the Patient-Reported Outcomes Measurement Information System (PROMIS) framework) and were asked to select the domains that were most relevant to them. During the interview, the patients were asked to indicate in which way the selected domains impact their lives. Both the answers to the open question, and the patient statements motivating nomination of PROMIS domains were coded into themes.ResultsThe most relevant (sub)domains of HRQoL for patients with COPD were: physical health (fatigue, physical functioning), social health (instrumental support, ability to participate in social roles and activities, companionship, and emotional support), and coping with COPD.Conclusion We identified which domains of HRQoL are most important to patients with COPD. One of these (coping with COPD) is not explicitly covered by PROMIS, or by traditional questionnaires that are used to measure HRQoL in COPD.
    Health and Quality of Life Outcomes 07/2014; 12(1):106. · 2.27 Impact Factor
  • Job van der Palen
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    ABSTRACT: Inhaled corticosteroids and bronchodilators, which are pivotal to the management of respiratory diseases, are delivered by numerous devices, including pressurized metered-dose inhalers and dry-powder inhalers. However, patient adherence to these medications is suboptimal and incorrect inhaler technique is endemic, meaning that insufficient drug quantities are frequently delivered to the lungs. Genuair(®) (Almirall SA, Spain) is a novel, breath-actuated, multidose dry-powder inhaler designed to achieve reliable and effective delivery of inhaled medicines - including aclidinium bromide - to patients with chronic obstructive pulmonary disease. In addition to describing Genuair's design, which incorporates multiple feedback mechanisms in order to confirm effective medication uptake, this article discusses the performance characteristics of the inhaler, its efficiency in terms of drug deposition and the results of recent patient preference and satisfaction studies.
    Therapeutic delivery 07/2014; 5(7):795-806.
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    ABSTRACT: In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to give the best prognosis in the long term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. The aim of this retrospective study was to identify and describe these factors.
    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 06/2014;
  • Marijn A Huijing, Job van der Palen, Berend van der Lei
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    ABSTRACT: Although upper eyelid blepharoplasty is one of the most frequently performed facial plastic surgical procedures, there is no consensus of opinion about the effect of an upper eyelid blepharoplasty on the position of the eyebrows in a general population.
    Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 05/2014;
  • Expert Opinion on Drug Delivery 05/2014; 11(5):824-5. · 4.87 Impact Factor
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    ABSTRACT: To evaluate the safety and efficacy of 2 novel drug-eluting stents (DES) with biodegradable polymer-based coatings versus a durable coating DES. BIO-RESORT is an investigator-initiated, prospective, patient-blinded, randomized multicenter trial in 3540 Dutch all-comers with various clinical syndromes, requiring percutaneous coronary interventions (PCI) with DES implantation. Randomization (stratified for diabetes mellitus) is being performed in a 1:1:1 ratio between ORSIRO sirolimus-eluting stent with circumferential biodegradable coating, SYNERGY everolimus-eluting stent with abluminal biodegradable coating, and RESOLUTE INTEGRITY zotarolimus-eluting stent with durable coating. The primary endpoint is the incidence of the composite endpoint target vessel failure at 1 year, consisting of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization. Power calculation assumes a target vessel failure rate of 8.5% with a 3.5% non-inferiority margin, giving the study a power of 85% (α level .025 adjusted for multiple testing). The impact of diabetes mellitus on post-PCI outcome will be evaluated. The first patient was enrolled on December 21, 2012. BIO-RESORT is a large, prospective, randomized, multicenter trial with three arms, comparing two DES with biodegradable coatings versus a reference DES with a durable coating in 3540 all-comers. The trial will provide novel insights into the clinical outcome of modern DES and will address the impact of known and so far undetected diabetes mellitus on post-PCI outcome.
    American heart journal 04/2014; 167(4):445-51. · 4.65 Impact Factor
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    ABSTRACT: The mesenteric circulation has an extensive collateral network. Therefore, stenosis in one or more mesenteric arteries does not necessarily lead to symptoms. The objective of this study was to determine the effect of collateral flow on celiac artery (CA) and superior mesenteric artery (SMA) duplex parameters. Between 1999 and 2007, a cohort of 228 patients analyzed for suspected chronic mesenteric syndrome was studied. Stenosis of the mesenteric vessels and collateral flow patterns were identified on angiography and categorized. The effect of stenosis in one mesenteric vessel and the presence of collaterals from the other unaffected vessel was examined in both the CA and SMA. Stenosis of the CA resulted in a significantly higher peak systolic velocity (PSV) and end-diastolic velocity in the normal SMA without stenosis. This was also found for the CA without stenosis in the presence of a stenosis of the SMA. An incremental effect of the severity of the CA stenosis was found with a mean SMA PSV of 158 cm/s when normal and 259 cm/s when occluded. The presence of collaterals had a clear effect on duplex parameters of the angiographically normal SMA. In the presence of collaterals and a 70% CA stenosis, the PSV in the normal SMA was significantly higher (P = .025). This study shows that stenosis in either the CA or SMA increases flow velocities in the other unaffected mesenteric artery. This increase was correlated with the presence of collaterals. Collaterals and stenoses in one of the mesenteric arteries may lead to mimicking or overgrading of stenosis in the other mesenteric artery.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 03/2014; · 3.52 Impact Factor
  • Article: Letters.
    Spine 03/2014; 39(6):529. · 2.16 Impact Factor
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    ABSTRACT: Nitric oxide donors, such as isosorbide dinitrate ointment (ISDN), are considered as first choice agents in the treatment of chronic anal fissure. Injection with botulinum toxin A in the internal anal sphincter is often used as second-line therapy, although it may give better results and fewer side effects than nitric oxide donors. The aim of this randomized clinical trial was to investigate whether botulinum toxin A (Dysport(®) ) is more effective than ISDN in the primary treatment of chronic anal fissure. In the period April 2005 until October 2009, 60 patients (32 male) with a median age of 42 (25-82) years were randomized to receive either ISDN 10 mg/mL (1%) (n=33) or injection with 60 units Dysport(®) (n=27). The primary endpoint was the percentage complete fissure healing after 8 weeks. After a median of 9 weeks complete fissure healing was noted in 18 of 27 patients in the Dysport(®) group and in 11 of 33 patients in the ISDN group (p=0.010). Absolute improvement of pain scores after 9 weeks was similar in both groups (p=0.733). Patients treated with Dysport(®) had fewer side effects than patients treated with ISDN (p=0.028). Of the patients with a healed fissure, 28% of the Dysport(®) group and 50% of the ISDN group had a recurrence within one year (p=0.286; HR 2.08; 95% CI=0.54-7.97). Dysport(®) is more effective with fewer side effects than ISDN ointment in the primary treatment of chronic anal fissure. The recurrence rates within one year in both treatment groups is high. This article is protected by copyright. All rights reserved.
    Colorectal Disease 03/2014; · 2.08 Impact Factor
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    ABSTRACT: Aims: To investigate the prognostic value of coronary dominance for various adverse clinical events following the implantation of drug-eluting stents. Methods and results: We assessed two-year follow-up data of 1,387 patients from the randomised TWENTE trial. Based on the origin of the posterior descending coronary artery, coronary circulation was categorised into left and non-left dominance (i.e., right and balanced). Target vessel-related myocardial infarction (MI) was defined according to the updated Academic Research Consortium (ARC) definition (2x upper reference limit of creatine kinase [CK], confirmed by CK-MB elevation), and periprocedural MI (PMI) as MI ≤48 hours following PCI. One hundred and thirty-six patients (9.8%) had left and 1,251 (90.2%) non-left dominance. Target lesions were more frequently located in dominant arteries (p<0.005). Left dominance was associated with more severe calcifications (p=0.006) and more bifurcation lesions (p=0.031). Non-left dominance tended to be less frequent in men (p=0.09). Left coronary dominance was associated with more target vessel-related MI (14 [10.3%] vs. 62 [5.0%], p=0.009). Left dominance independently predicted PMI (adjusted HR 2.19, 95% CI: 1.15-4.15, p=0.017), while no difference in other clinical endpoints was observed between dominance groups. Conclusions: In the population of the TWENTE trial, we observed a higher incidence of periprocedural myocardial infarction in patients who had left coronary dominance.
    EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 02/2014; · 3.17 Impact Factor
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    ABSTRACT: Microvolt T-wave alternans (MTWA) is an electrocardiographic marker for predicting sudden cardiac death. In this study, we aimed to study the relation between MTWA and scar assessed with cardiac magnetic resonance imaging (CMR) in patients with ischemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM). Sixty-eight patients with positive or negative MTWA and analysable CMR examination were included. Using CMR and the delayed enhancement technique, left ventricular ejection fraction (LVEF), volumes, wall motion and scar characteristics were assessed. Overall, positive MTWA (n = 40) was related to male gender (p = 0.04), lower LVEF (p = 0.04) and increased left ventricular end-diastolic volume (LVEDV) (p < 0.01). After multivariate analysis, male gender (p = 0.01) and lower LVEF remained significant (p = 0.02). Scar characteristics (presence, transmurality, and scar score) were not related to MTWA (all p > 0.5). In the patients with ICM (n = 40) scar was detected in 38. Positive MTWA (n = 18) was related to higher LVEDV (p = 0.05). In patients with DCM (n = 28), scar was detected in 11. Trends were found between positive MTWA (n = 15) and male gender (p = 0.10), lower LVEF (p = 0.10), and higher LVEDV (p = 0.09). In both subgroups, the presence, transmurality or extent of scar was not related to MTWA (all p > 0.45). In this small study, neither in patients with ICM or DCM a relation was found between the occurrence of MTWA and the presence, transmurality or extent of myocardial scar. Overall there was a significant relation between heart failure remodeling parameters and positive MTWA.
    The international journal of cardiovascular imaging 02/2014; · 2.15 Impact Factor
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    ABSTRACT: Gender differences in patient-reported outcomes in patients with an implantable cardioverter defibrillator (ICD) have been researched, but findings are inconclusive and mostly based on cross-sectional study designs. To gain a better insight into potential determinants of psychological distress and health-related quality of life (HQOL), we examined the relationship between gender and patient-reported outcomes in patients with an ICD in the first year after ICD implantation. Consecutive patients (N = 300) receiving an ICD between September 2007 and February 2010 at Medisch Spectrum Twente hospital, the Netherlands, completed several questionnaires to assess psychological distress and HQOL prior to ICD implantation and at 2 months, 5 months, 8 months, and 12 months postimplantation. Correcting for clinical confounders (e.g., left ventricular ejection fraction, ICD indication, comorbidities, ICD shocks), women reported higher levels of anxiety (P = 0.021) and shock-related anxiety (P = 0.047) than men in the course of a year. On most HQOL subscales, no gender differences were found, except for subscale Physical functioning, where women reported higher levels of improvement compared to men (P = 0.008). Gender was independently associated with poorer device-related acceptance, but only on the Florida Patient Acceptance Scale domain Body image concerns (P = 0.043), with women expressing higher levels of concerns about their body image compared to men. Women report higher levels of general and shock-related anxiety, and higher levels of body image concerns than men. Women showed more improvement in physical functioning. Screening patients before and after ICD implantation for general and shock anxiety may help determine patients who could benefit from psychological counseling.
    Pacing and Clinical Electrophysiology 02/2014; · 1.75 Impact Factor
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    ABSTRACT: A phantom shock-the sensation of an implantable cardioverter defibrillator (ICD) discharge in the absence of an actual discharge-is a phenomenon that can occur in ICD patients. Little is known about the influence of psychological factors on the incidence of phantom shocks. We evaluated psychological correlates of phantom shocks 2 years post-ICD implant in a cohort of Dutch ICD recipients. Consecutive patients (N = 300; 87.5% men; mean age = 62.3) willing to participate in a prospective study (Twente ICD Cohort Study) on psychological factors in ICD recipients received an ICD between September 2007 and February 2010. At baseline, patients complete the 36-item Short Form Health Survey, Hospital Anxiety and Depression Scale, and the Type D Scale. Lifetime presence of anxiety and depression was assessed with the MINI structural interview. During a follow-up of 24 months, 16 patients (5.4%) experienced a phantom shock. Median time to (first) phantom shock was 13 weeks (range 0-48 weeks). In univariable analysis, no significant relationships were found between clinical or psychological indices and the occurrence of phantom shocks, nor was there an association between phantom shocks and type D personality, symptoms of anxiety, or a history of anxiety and depression. Neither symptoms of anxiety and depression nor psychiatric history were associated with the occurrence of phantom shocks. Further studies using more explorative, qualitative research techniques are warranted to examine the correlates of phantom shocks.
    Pacing and Clinical Electrophysiology 01/2014; · 1.75 Impact Factor
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    ABSTRACT: Self-management interventions in patients with chronic conditions have received increasing attention over the past few years, yet the meta-analyses encountered considerable heterogeneity in results. This suggests that the effectiveness of self-management interventions must be assessed in the context of which components are responsible for eliciting the effect and in which subgroups of patients the intervention works best. The aim of the present study is to identify condition-transcending determinants of success of self-management interventions in two parallel individual patient data meta-analyses of self-management trials in patients with congestive heart failure (CHF) and in patients with chronic obstructive pulmonary disease (COPD).
    BMJ Open 01/2014; 4(5):e005220. · 1.58 Impact Factor
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    ABSTRACT: Background Although upper eyelid blepharoplasty is one of the most frequently performed facial plastic surgical procedures, there is no consensus of opinion about the effect of an upper eyelid blepharoplasty on the position of the eyebrows in a general population. Objectives This study was undertaken to determine this effect and to investigate whether preoperative compensatory rhytidosis of the forehead may cause a significantly greater postoperative lowering of the eyebrows. Methods An evaluation of 140 consecutive patients with complaints of visual impairment was performed, who underwent an upper eyelid blepharoplasty. The position of the eyebrows was measured pre- and postoperatively at three positions for each eye. In addition, the role of compensatory rhytidosis on eyebrow position was determined by classifying horizontal forehead lines. Results The mean drop in eyebrow position for all patients ranged from 0.35% to 1.23%. In females (n= 126) there was no significant postoperative drop in eyebrow position. In males (n=14) however, one out of six measured distances (centre of pupil, lateral iris, lateral canthus) displayed a significant lowering of the eyebrow (p=0.005). Conclusions Our results show that the position of the eyebrow is not lowered significantly after an upper eyelid blepharoplasty performed among women with dermatochalasis and functional complaints of visual impairment. Male patients showed a slight trend of lowering of the eyebrows post-operatively. Preoperative lifting of the eyebrows by means of frontalis muscle activity did not influence the position of the eyebrows postoperatively, although forehead lines did seem to diminish significantly.
    Journal of Plastic Reconstructive & Aesthetic Surgery 01/2014; · 1.44 Impact Factor
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    ABSTRACT: Introduction It is still unknown how best to maintain effects of exercise programmes in COPD in the long-term. We present the long-term effects of a community-based exercise programme incorporated in a self-management programme, compared to a self-management programme only in patients with COPD. Methods All included patients participated in four self-management sessions. Additionally, patients in the intervention group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained three times/week for five months and two times/week during the subsequent six months. To encourage a behavioural change towards exercise, one of these weekly training sessions was home-based (unsupervised). No formal training was offered to intervention patients in the second year. Results The intervention was assigned to 80 patients, and the control condition to 79 patients. 82.5% and 78.5% of the intervention and control group, respectively, completed 24 months follow-up. Modified intention-to-treat analyses were performed. Although statistically significant after 12 months (35.1 meters (95%CI: 8.4 to 61.8)), the between-group difference on maximal exercise capacity was not statistically significant after 24 months (12.2 meters (95%CI: -16.6 to 41.0). Nevertheless, the between-group difference in daily physical activity was maintained after 24 months (1193 steps/day (95%CI: 203 to 2182)). A beneficial effect was also found on CRQ dyspnoea score but not on other CRQ domains, CCQ and HADS. Conclusions Our intervention was effective in achieving a behavioural change reflected by a sustained increase in daily physical activity, not accompanied by a sustained increase in maximal exercise capacity after two years of follow-up (ISRCTN81447311).
    Respiratory Medicine. 01/2014;
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    ABSTRACT: Previous research on substance use disorders (SUD) has yielded conflicting results concerning whether alexithymia is a state or trait, raising the question of how alexithymia should be addressed in the treatment of SUD-patients. The absolute and relative stabilities of alexithymia were assessed using the Toronto Alexithymia Scale (TAS-20) and its subscales. In total, 101 patients with SUD were assessed twice during a 3-week inpatient detoxification period while controlling for withdrawal symptoms and personality disorder traits. The relative stability of the total TAS-20 and subscales was moderate to high but showed remarkable differences between baseline low, moderate, and high alexithymic patients. A small reduction in the mean levels of the total TAS-20 scores and those of one subscale revealed the absence of absolute stability. The levels of alexithymia were unrelated to changes in withdrawal symptoms, including anxiety- and depression-like symptoms. The differences between low, moderate, and high alexithymic patients in terms of the change in alexithymia scores between baseline and follow-up indicated a strong regression to the mean. The findings suggest that alexithymia in SUDpatients as measured using the TAS-20 is both a state and trait phenomenon and does not appear to be related to changes in anxiety- and depression-like symptoms.
    Psychiatry Research. 01/2014;

Publication Stats

2k Citations
591.79 Total Impact Points


  • 2007–2014
    • Universiteit Twente
      • • Department of Research Methodology, Measurement and Data Analysis (OMD)
      • • Department of Psychology, Health and Technology (PHT)
      • • Faculty of Behavioral Sciences (BS)
      Enschede, Overijssel, Netherlands
  • 1994–2014
    • Medisch Spectrum Twente
      • • Cardiothoracic Surgery
      • • Pulmonary Medicine
      • • Hospital Medical Spectrum Twente
      Enschede, Overijssel, Netherlands
  • 2013
    • Tactus Addiction Institute
      Deventer, Overijssel, Netherlands
    • Poliklinika Glavić
      Ragusa, Dubrovačko-Neretvanska, Croatia
    • Bernhoven Hospital
      Os, North Brabant, Netherlands
  • 2012
    • Repatriation General Hospital
      Tarndarnya, South Australia, Australia
  • 2009
    • Stichting Epilepsie Instellingen Nederland
      Heemstede, North Holland, Netherlands
  • 2005
    • University of Washington Seattle
      • Cardiovascular Health Research Unit (CHRU)
      Seattle, WA, United States