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Biomedical subjects

H A Oomen

Publications and source records attributed to H A Oomen.

At least 19 recordsLinked to original sources
PubMed1996

The prevalence of affective disorder and in particular of a rapid cycling of bipolar disorder in patients with abnormal thyroid function tests.

OBJECTIVE: Cognitive and affective functioning is sensitive to changes in thyroid hormones. We have sought to determine: (1) the prevalence of thyroid function abnormalities in a psychiatric population on admission (as compared to the prevalence in a normal population), and (2) whether such thyroid function abnormalities are associated with the occurrence or development of cognitive and affective disorders. DESIGN: Serum was collected 2-3 weeks after hospitalization in 3 major clinics from 3756 psychiatric patients in 1987-1990, stored, and assayed in 1993 for the presence of antibodies against the TSH-receptor and thyroperoxidase (TPO-Ab) and for TSH levels. The psychiatric cohort was matched with a control population of healthy individuals living in the same area (n = 1877). The prevalence study was followed by a case-control study involving patients from one clinic that had routinely assigned a DSM-IIIR classification to its patients. Cases were those admissions with thyroid abnormalities and three subgroups of cases were randomly formed demonstrating either TSH less than 0.4 mU/l (n = 44) or over 4.0 mU/l (n = 44), or TPO-Ab positivity (n = 50). Cases were compared to random controls from the same psychiatric population, viz patients without thyroid abnormalities (n = 83). Comparison was with respect to their psychiatric follow-up diagnosis (the investigator was blinded to the thyroid test results). RESULTS: Prevalence study. The percentage of patients positive for TSH-receptor-Ab was 0.26 (9/3504), for TPO-Ab was 10.0 (331/3316) and outside the TSH range of 0.4-4.0 mU/l was 10.0 ((332/3316): 5.9% (198/3316) > 4.0 mU/l and 4.1% (134/3316) < 0.4 mU/l). Abnormal total thyroxine levels were found in only 9.8% of subjects with abnormal TSH, indicating the predominantly subclinical character of the thyroid alteration. In comparison, the healthy area controls over 55 years of age showed the same prevalence of positive TPO-antibodies and TSH under 0.4 mU/l, but a higher prevalence of TSH over 4.0 mU/l. CASE-CONTROL STUDY: In the case control analysis differences could not be noticed with regard to prevalences of dementia, schizophrenia or other psychiatric illnesses apart from the prevalence of affective disorders which were more prevalent in TPO-Ab positive patients and patients with a low serum TSH. Since prior use of lithium, carbamezapine, carbimazole and/or thyroxine could be a factor of importance in this association, analyses were also carried out excluding patients with such prior drug use. In these analyses affective disorders were still more prevalent in patients with a low serum TSH (particularly in males, 40% in cases vs 9% in controls, P < 0.05). The most significant association was however between TPO-antibody positivity (and in particular with high titre and/or with TSH > 4.0 mU/l) and a subgroup of the affective disorders, viz with a rapid cycling of bipolar disorder (18% in cases vs 0% in controls, P < 0.001). CONCLUSION: Though causal relations cannot be determined from this cross-sectional study, this admission survey found early forms of autoimmune thyroid disease, sometimes characterized only by TPO-Abs, highly significantly associated with rapid cycles of a bipolar disorder. It also found a weak association between subclinical hyperthyroidism (low serum TSH without TPO-Ab positivity) and affective disorder.

Adult↗
PubMed1995

Screening psychiatric admissions for anticardiolipin antibody.

Anticardiolipin antibody (aCL) may provide an instrument for screening in neuropsychiatric syndromes due to cerebral ischemia. Thirty-five psychiatric patients, aCL-positive on admission, were matched against aCL-negative patients. Their clinical records on admission and after 2-years of follow-up were analyzed without knowledge of aCL results. An inventory was made of cerebrovascular and systemic vascular symptoms. In 13 out of 35 aCL-positive cases, vascular morbidity, suggesting ischemic causes of central nervous system pathology, could be demonstrated during follow-up and none in the comparison group. No correlation was found, however, between Hachinski ischemic scores on admission and aCL-positivity. Yet, if only on the basis of increased incidence of subsequent ischemia, the aCL-IgG/M isotype appears to be a valuable predictor of vascular neuropsychiatric symptoms.

Aged↗
PubMed1994

Psychiatric symptoms before systemic lupus erythematosus is diagnosed.

Psychiatric symptoms are rarely reported as an initial feature of systemic lupus erythematosus (SLE). Nevertheless, many patients have the feeling that psychiatric symptoms occurred before they were diagnosed as having SLE. This feeling was confirmed by an enquiry among members of the Dutch Lupus Patients Society: half of them had experienced psychiatric complaints before SLE was diagnosed. Two-thirds of these patients searched for professional help for these complaints. This motivated us to study whether SLE patients were admitted into psychiatric hospitals without being diagnosed as having SLE. Sera from 2121 patients admitted to a psychiatric hospital and from 500 controls matched for sex and age were tested for the presence of antinuclear antibodies (ANA) and antibodies to DNA. ANA were found in 3% of patients, as well as controls. Anti-DNA antibodies were found in 1% of both patients and controls. Two out of 114 patients psychiatric patients with ANA and/or anti-DNA antibodies had SLE and/or Sjögren's syndrome. We concluded that SLE is not an important cause of admission to psychiatric hospitals. Routine tests for the determination of antinuclear and anti-DNA antibodies on admissions in these hospitals thus would not seem useful. To study whether patients with another chronic disease also had psychiatric complaints before being diagnosed, we performed the same enquiry among members of the Dutch Sarcoidosis Patients Society. The results were almost equal to those of the enquiry of the members of the Dutch Lupus Patients Society. Why members of both societies so often report psychiatric symptoms before their disease is diagnosed should be a subject of further studies.

Adult↗
PubMed1991

Psychiatric symptoms as features of systemic lupus erythematosus.

An enquiry of the Dutch Lupus Patients Society revealed that 49% of the members had experienced psychiatric symptoms before systemic lupus erythematosus (SLE) was diagnosed and 33% had sought professional psychiatric help at that stage. To determine the frequency of SLE on psychiatric admission 2,121 patients were tested for the presence of SLE-specific antinuclear and anti-DNA autoantibodies. The results suggest that SLE is a cause of admission in psychiatric hospitals at the rate of 0.1-0.2% and routine screening of antinuclear and anti-DNA antibodies on admission is not an effective diagnostic approach.

Adult↗
PubMed1990

[Medical history. Risk factors and prevention in dental practice].

The need for the taking of a medical history when dealing with dental patients, is discussed from two different points of view. The medically compromised patient, according to article 9 part 3 of the regulation 'Special dentistry' in The Netherlands must be recognized by a medical history so adequate preventive treatment will avoid unnecessary medical intervention. As part of the EC proposals on the education of dental practitioners, the prevention of medical emergencies in the dental practice is important as well. A structured medical history based on risk classification and preventive measures meets both options.

Dental Care for Persons with Disabilities↗
PubMed1989

[Do dentists agree on dental anaesthesia?].

Hundred-and-ten dentists, both practitioners and teachers, attending a postgraduate course in medical emergencies, were unanimous in their choice of anaesthetics and medical anamnesis, the importance of avoiding toxicity and also in the unpredictability and infrequency of allergic reactions. There was no consensus on the importance of the aspiration test to avoid intravascular injection.

Anesthesia, Dental↗
PubMed1981

Parasitic duodenitis.

Sixty-two patients presenting with upper abdominal pain of the non-ulcer dyspepsia type, and radiological signs of duodenitis, were investigated for parasites; biopsies of the duodenum were performed, both by capsule and by endoscopy. The findings were compared with a group of 18 healthy controls with and without parasites. The group of 36 patients with parasites showed a significant degree of inflammatory infiltrate compared to the non-parasitized patients and to the control group.

Duodenitis↗
PubMed1979

Machakos Project Studies: Agents affecting health of mother and child in a rural area of Kenya. XIV. Growth pattern or rural Akamba pre-school children.

Between June 1974 and February 1977, in one eighth sample of the Machakos Project area, weight and height were determined in all 1-60 months-olds. This resulted in 568 subjects producing averagely 9.3 monthly growth data over an average period of 22.2 months. Only subjects examined five times or over were considered. Weighing and measuring were done by home visiting fieldworkers. Growth in the first six months closely followed the Harvard Standards of weight-for-age (W/A) and height-for-age (H/A). In the course of the next six months this dropped until about 83% for W/A and 92% for H/A, to stay at these levels until the sixth year. In the group which persistently grew over 88% for W/A these values were 91.5% for W/A and 94.8% for H/A. This group is thought to represent the local standard for optimum growth. In the group which persisted at levels below 75% of W/A a distinction was made between normal slow growers and PEM cases. In both W/A was more compromitted than H/A. Children persistently or episodically under W/A 70% were considered malnourished; their incidence in the 1-5 year group was between 4.5 and 6.5%. There was no reason to put the PEM level above 70% of W/A; This should be used as a cut-off level for screening PEM cases. A diagram is presented to visualize the successive age cohorts simultaneously for W/A, H/A and W/H as regards their position to the respective Harvard Standards, indicating percentages of positive and negative deviators.

Body Height↗
PubMed1979

Sicklers surviving childhood in Tanzania.

Sixty two cases of sickling haemoglobinopathy have been admitted and specially studied between 1973 and 1977 in the Bugando Hospital, Mwanza, Tanzania. Presenting symptoms are described. The problems of recognition in the medical diaspora and of management are considered. It is expected that with improving regional health facilities more cases will survive childhood but also will cause special difficulties in adequate care. It is pleaded that because of the ubiquity of the HbS gene in Tanzania sufficient priority is given to the affected in planning health services in Tanzania.

Adolescent↗