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373 results on '"Terpstra, O T"'

1. Knowing 'and' Acting in the Clinical Workplace: Trainees' Perspectives on Modelling and Feedback

Author

Stegeman, J. H., Schoten, E. J., and Terpstra, O. T.

Abstract

In this article we discuss clinical workplace learning using a dual approach: a theoretical one and an empirical one. Drawing on the philosophical work of Aristotle, Polanyi and Schön we posit that the "knowing 'and' acting" underpinning day-to-day medical practice is personal and embraces by nature a tacit dimension. Consequently, imparting and acquiring this knowledge type necessitates personal interaction between trainer and trainee. The tacit dimension particularly influences modelling and feedback. In our empirical exploration we explore these educational routes in two disparate disciplines: surgery and paediatrics. We use a longitudinal design with in-depth interviewing. Our conclusion on modelling is: modelling is a dynamic and fragmented process reflecting discipline bound characteristics and working styles. On feedback it is: "feedback" serves as vehicle for three distinctive forms of commenting on performance, each holding a specific power of expression for learning. We propose to view clinical workplace learning as: "an interactive master-apprenticeship model encompassing modelling and feedback as natural educational routes". We conceptualise modelling and feedback as "function" of interaction (developing grounded theory). "Modelling function" and "feedback function" may serve to study these routes as didactical components of ongoing interaction between trainer and trainee rather than an educator-driven series of unrelated events.

Published
2013
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18. Gallstone disease. Surgical aspects

Author

Gouma, D. J., Terpstra, O. T., van Lanschot, J. J. B., Tytgat, G. N. J., Jansen, P. L. M., Jones, E. A., Pinedo, H. M., Schouten, W. R., and Surgery

Published
2005

19. The effect of aprotinin on renal function in orthotopic liver transplantation

Author

Molenaar, I. Q., Begliomini, B., Gian Luca GRAZI, Ringers, J., Terpstra, O. T., and Porte, R. J.

Subjects
Male, Time Factors, APROTININ, RENAL FUNCTION, LIVER TRANSPLANTATION, Middle Aged, Kidney, Liver Transplantation, Electrolytes, Aprotinin, Creatinine, Humans, Female
Abstract

In the European Multicenter Study on the Use of Aprotinin in Liver Transplantation (EMSALT), a randomized, double-blind, placebo-controlled, prospective study, we demonstrated that aprotinin significantly reduces intraoperative blood loss during orthotopic liver transplantation (OLT). Aprotinin is metabolized in the kidney and potentially nephrotoxic at high concentrations. Renal insufficiency is a common and serious complication after OLT. It is unknown whether aprotinin increases the risk of renal failure after OLT.We analyzed intraoperative urine output, need for postoperative dialysis, perioperative serum creatinine levels, and creatinine clearance in 93 patients enrolled in EMSALT, receiving a high dose of aprotinin, a regular dose, or placebo.Peak increase in serum creatinine exceeding 0.5 mg/dl during one of the postoperative days occurred in 11 (35%) patients in the placebo group, in 11 (34%) patients in the high-dose group, but only in 1 (3%) patient in the regular-dose group (P=0.007). Furthermore, a perioperative decrease in creatinine clearance was seen in the placebo group (-23.9+/-10.1 ml/min) but not in both high-dose (-1.6+/-13.3 ml/min) and regular-dose (9.7+/-10.3 ml/min) groups (P0.02 comparing regular-dose and placebo group).Despite its potential nephrotoxicity, the use of aprotinin for reducing blood loss during OLT does not lead to a higher incidence of postoperative renal insufficiency. In combination with the observed reduction in blood loss, these findings support the prophylactic use of regular-dose aprotinin during OLT.

Published
2001

46. Reduced Porcine Islet Isolation Yield in the Presence of Hyperemic Islets.

Author

Hilling, D. E., Rijkelijkhuizen, J. K. R. A., Töns, H. A. M., Marang-van de Mheen, P. J., Merks, J. W. M., Terpstra, O. T., and Bouwman, E.

Subjects
SWINE diseases, LABORATORY swine, EXOCRINE glands, ALDEHYDES, ENDOCRINE glands
Abstract

When studying histological characters of porcine pancreata in relation to islet isolation, a remarkably high number of hyperemic islets (HIs) was encountered. The abnormalities observed in these HIs ranged from a single dilated vessel to hemorrhages extending into the surrounding exocrine tissue. The aim of the present study was to compare pancreata with and without HI on islet isolation outcomes. This study involved a histological examination of 143 purebred (74 juvenile and 69 adult) and 47 crossbred (only juvenile) porcine pancreata. Islet isolation was performed in 48 purebred adult pigs and in 25 crossbred pigs. Tissue samples were stained with Aldehyde Fuchsine. The presence of HIs was scored semi-quantitatively (HI-, HI +). We observed HIs in 48 % of the purebred and in 68 % of the crossbred pigs. However, only 3.3 ± 3.1 % and 3.1 ± 4.7 % of all assessed islets was hyperemic in HI + pancreata in purebred and crossbred pigs, respectively. In both groups, significantly higher endocrine cell mass was found in the HI + pancreata (p < 0.01). When the higher endocrine cell mass was taken into account, we found significantly lower yields in the HI + pancreata in both purebred and crossbred pigs (p = 0.03 in both groups). The presence of HIs occurs frequently in porcine donor-pancreata and is associated with reduced isolation outcomes. [ABSTRACT FROM AUTHOR]

Published
2011
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50. Integrin signaling via RGD peptides and anti-beta1 antibodies confers resistance to apoptosis in islets of Langerhans.

Author

Pinkse GGM, Bouwman WP, Jiawan-Lalai R, Terpstra OT, Bruijn JA, de Heer E, Pinkse, Gabrielle G M, Bouwman, Wendy P, Jiawan-Lalai, Reshma, Terpstra, O T, Bruijn, Jan A, and de Heer, Emile

Abstract

Islet transplantation is associated with a high rate of early graft failure caused by early immune attack and poor functionality of islets. Apoptosis of islet cells appears soon after islet isolation and primarily involves the beta-cell. The purpose of this study was to determine the effect of ligation to extracellular matrix (ECM) proteins on survival of the islets of Langerhans following islet isolation. Islets that had been cultured for 24 h on collagen type I showed an islet survival of 59.7 +/- 8.7%, while islets that had been cultured on collagen type IV and laminin showed an islet survival of 88.6 +/- 10.3 and 94.3 +/- 5.6%, respectively. Islets that had been pretreated with anti-beta1 antibodies and argenin-glycin-aspartic acid (RGD) peptides showed a decrease in the level of apoptosis by a factor of 2.5 and 3.1, respectively, and an increase of phospho-Akt Ser 473 activity by a factor of 3.1 and 2.9, respectively, compared with untreated islets. When detached from their natural ECM surrounding in the pancreas, islet cells undergo apoptosis, unless islets are cultured on collagen IV or laminin or treated with anti-beta1 integrin antibodies or RGD peptides to mimic ECM ligation. These results indicate that inhibition of anoikis may offer opportunities to improve function and viability of islet cells. [ABSTRACT FROM AUTHOR]

Published
2006
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