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J Bouma

Publications and source records attributed to J Bouma.

At least 37 records · Page 2Linked to original sources
PubMed1997

An exploration of the relation between hostility and disease.

Hostility has been studied mainly in relation to coronary heart disease (CHD). However, given the pathways linking hostility to CHD, it might be expected that hostility also relates to non-CHD. Therefore, the relation between the expression and the experience of hostility and various health outcomes was examined in a cross-sectional design. The data were collected among male patients with a myocardial infarction in the age range of 30-70 years (N = 279) and a population sample of men in the same age group (N = 2663). Based on checklist of the most frequent disorders, the subjects from the latter group were divided into subsamples according to their disease status. Three components of hostility, i.e., resentment, suspicion, and aggression, were measured by the Buss Durkee Hostility Inventory (Buss & Durkee, 1957). The overall finding was that all components of hostility were related to non-CHD disease but not to CHD.

Adult↗
PubMed1997

Effect of intrathecal baclofen delivered by an implanted programmable pump on health related quality of life in patients with severe spasticity.

OBJECTIVES: To compare clinical effectiveness and health related quality of life in patients with severe spasticity who received intrathecal baclofen or a placebo. METHODS: In a double blind, randomised, multicentre trial 22 patients were followed up during 13 weeks and subsequently included in a 52 week observational longitudinal study. Patients were those with chronic, disabling spasticity who did not respond to maximum doses of oral baclofen, dantrolene, and tizanidine. After implantation of a programmable pump patients were randomly assigned to placebo or baclofen infusion for 13 weeks. After 13 weeks all patients received baclofen. Clinical efficacy was assessed by the Ashworth scale, spasm score, and self reported pain, and health related quality of life by the sickness impact profile (SIP) and the Hopkins symptom checklist (HSCL). RESULTS: At three months the scores of the placebo and baclofen group differed slightly for the spasm score (effect size=0.20) and substantially for the Ashworth scale (effect size=1.40) and pain score (effect size=0.94); health related quality of life showed no significant differences. Three months after implantation the baclofen group showed a significant, substantial improvement on the SIP "physical health", "mental health", "mobility", and "sleep and rest" subscales and on the HSCL mental health scale; patients receiving placebo showed no change. After one year of baclofen treatment significant (P<0.05) improvement was found on the SIP dimensions "mobility" and "body care and movement" with moderate effect sizes. Improvement on the SIP subscale "physical health" (P<0.05; effect size 0.86), the SIP overall score (without "ambulation"), and the "physical health" and overall scale of the HSCL was also significant, with effect sizes >0.80. Changes in health related behaviour were noted for "sleep and rest" and "recreation and pastimes" (P<0.01, P<0.05; effect size 0.95 and 0.63, respectively). Psychosocial behaviour showed no improvement. CONCLUSIONS: Intrathecal baclofen delivered by an implanted, programmable pump resulted in improved self reported quality of life as assessed by the SIP, and HSCL physical health dimensions also suggest improvement.

Adult↗
PubMed1996

[Cost-effectiveness analysis of dental implants].

In this article the cost-effectiveness of dental implants (rootform and transmandibular) is compared with making complete dentures combined with vestibuloplasty and just a set of new dentures. The cost components of labour and technique are analysed at the individual patient level. Effectiveness was measured using a ratio scale. Several assumptions for the long run effectiveness of the treatment options are necessary due to lack of information about this in the literature. Assumptions were made regarding: survival rate, life span of dental implants and complete dentures, costs of aftercare and development of oral health in the long run. The main conclusion is that overdentures on rootform implants are superior to complete dentures combined with preprosthetic surgery or overdentures on a transmandibular implant. The choice between treatment with rootform implants or just a new set of dentures is a more difficult matter.

Cost-Benefit Analysis↗
PubMed1995

The importance of the groin node status for the survival of T1 and T2 vulval carcinoma patients.

The purpose of this study was to analyze (1) the prognostic factors for survival of T1 and T2 carcinoma patients and (2) the impact of the initial groin node status for the time to recurrence and site of recurrence. We performed a follow-up study on 190 women with a T1 or T2 squamous cell carcinoma of the vulva. Data were obtained on age and general medical condition, the clinical and histological characteristics of the primary tumor and the inguinofemoral lymph nodes, treatment, recurrences, and survival. The standard treatment was radical vulvectomy with bilateral inguinofemoral lymphadenectomy supplemented with postoperative radiotherapy to the primary site, groin, and pelvic side walls if groin metastases were present. Compared to patients without lymph node metastases in the groin, the relative risk of dying within a given time period was estimated to be 2.47 (limits of the 95% confidence interval: 1.24, 4.93) and 9.69 (3.90, 24.03) for patients with unilateral and bilateral node metastases, respectively. The number of metastatic lymph nodes or their intra- or extranodal growth was not associated with survival. The relative risk of dying within a given time period was 2.71 (1.36, 5.40) for patients with a T2 tumor compared to those with a T1 tumor and 2.37 (1.31, 4.31) for patients with vasoinvasive growth compared to those without capillary-lymphatic tumor infiltration. Tumor thickness, differentiation grade, and multifocal growth did not determine survival. In the multivariate Cox regression analysis, the presence of inguinofemoral lymph node metastases proved to be the most important prognostic factor for patients' survival. Of the 119 patients who underwent lymphadenectomy but in whom no groin node metastases were found, 6 (5%) patients manifested an early recurrence (i.e., residual cancer or a recurrence within 2 years after the diagnosis). In contrast, of the 51 patients with histologically documented groin node metastases, 15 (29.4%) manifested an early recurrence and these recurrences appeared equally distributed over the primary site and other sites.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1995

Patient satisfaction with implant-retained mandibular overdentures. A comparison with new complete dentures not retained by implants--a multicentre randomized clinical trial.

OBJECTIVES: The aim of this study was to establish the treatment outcome of full denture treatment with or without implant support, in which the outcome assessment focuses on the patient's subjective evaluation ('denture-satisfaction'). DESIGN: A multicenter randomized clinical trial. SUBJECTS: Thirty-two men and 118 women (mean age 56 +/- 9, range 35-84 years) participated in the study. The mean height of the mandible was 13 +/- 2 mm, measured on a lateral cephalometric radiograph. The patients were randomly assigned to either a group treated with implant-retained mandibular overdentures and a new maxillary denture, or to a control group treated with a new set of complete dentures. MAIN OUTCOME MEASURES: Denture satisfaction was assessed using questionnaires focusing on denture-related complaints and 'a general satisfaction rate'. RESULTS: Based on the baseline data, from the 'denture complaints' questionnaire six interpretable factors could be extracted. One factor did not vary following treatment and was excluded from the outcome analysis. At the 1-year evaluation three out of five factors showed significantly better scores for the group treated with implants than for the control-group. The same was found for the general satisfaction rate. CONCLUSION: For patients with a severely resorbed mandible, overdentures retained by dental implants appear to provide a more satisfactory solution to their denture-related problems.

Adult↗
PubMed1995

[Dental implants: cost-effectiveness analysis].

The efficacy and effectiveness of dental implants have been proven during the last years. An economic evaluation must be integrated within the clinical evaluations to determine economic (allocative) efficiency. According to the literature dental implants will show better results. The treatment is, however, more expensive. Assessment of costs and benefits can lead to more efficiency in dental care. The possibilities to evaluate the outcome of treatment are discussed and essential aspects of the economic evaluation are described.

Consumer Behavior↗
PubMed1993

Zeniplatin in patients with advanced ovarian cancer, a phase II study with a third generation platinum complex.

25 patients with residual or recurrent ovarian cancer were treated with the new platinum complex zeniplatin (CL 286,558) and 23 patients were evaluable for response. Responses were achieved in 4 patients, 1 complete and 3 partial remissions (16%). 7 patients had stable disease and 12 patients had tumour progression. At a median follow-up of 12 months, the median progression-free survival in responding patients was 11 months and overall survival 81%. The median overall survival of progressive patients amounted to 9 months, indicating the advanced stage of disease in most patients. Renal function was monitored by isotope clearance studies. There was no significant change in effective renal plasma flow (ERPF) or glomerular filtration rate (GFR) in 10 patients who completed six cycles of treatment. 1 patient with a marginal creatinine clearance at baseline suffered from sudden and severe renal failure during the first cycle. Zeniplatin may be active in relapsing, platinum-pretreated patients, and has no direct effects on renal function as measured by isotope clearance. Despite these findings, occasional nephrotoxicity may occur in patients with compromised kidney function, even with prophylactic hydration, and thus limit the application of this new analogue.

Adult↗
PubMed1992

Effects of interleukin-3 after chemotherapy for advanced ovarian cancer.

To define the maximum tolerated dose and to study whether recombinant human interleukin-3 (rhIL-3) reduced chemotherapy-induced neutropenia and thrombocytopenia, 20 chemotherapy-naive patients with advanced ovarian cancer eligible for treatment with 6 cycles of carboplatin-cyclophosphamide every 4 weeks (day 1) were entered in a phase I/II open, single-center trial. Cohorts of five patients received during 7 days 1, 5, 10, or 15 micrograms/kg/d rhIL-3 (days 5 through 11) in cycles 1, 3, and 5 by continuous intravenous (IV) infusion or once daily subcutaneous (SC) administration. In control cycles 2, 4, and 6, no rhIL-3 was administered. rhIL-3 significantly increased the recovery of leukocyte, neutrophil, and platelet counts, especially at 5, 10, and 15 micrograms/kg rhIL-3. rhIL-3 also increased basophil, eosinophil, monocyte, and lymphocyte counts at this dose steps. Effects on reticulocytes were limited. No difference in efficacy between SC and IV rhIL-3 treatment was found. Chemotherapy postponement for insufficient bone marrow recovery was necessary in 22 of 45 control cycles versus 2 of 49 rhIL-3 cycles (P less than .001). Platelet transfusions were required in 7 of 45 control cycles versus 3 of 50 rhIL-3 cycles (P less than .5). rhIL-3 up to 10 micrograms/kg/d could be administered without severe side effects. At 15 micrograms/kg/d, rhIL-3 headache was dose-limiting. Other side effects were fever, flu-like symptoms, nausea, skin rash, flushing, facial erythema, and urticaria. Liver toxicity occurred in rhIL-3 and control cycles. rhIL-3 slightly increased tumor necrosis factor alpha, C-reactive protein, and serum amyloid A plasma levels, whereas no effect on IL-6 plasma levels was observed. rhIL-3 administered SC appears to be an interesting hematopoietic growth factor for reduction of chemotherapy-induced myelotoxicity.

Adolescent↗
PubMed1992

A survey of prevention and treatment regimens for oral sequelae resulting from head and neck radiotherapy used in Dutch radiotherapy institutes.

Radiation treatment plays an important role in the management of head and neck cancer. Unfortunately several radiation-induced side effects may occur including mucositis, hyposalivation, radiation caries, trismus and osteoradionecrosis. It is generally accepted that most side effects can be prevented or reduced in severity. The purpose of this investigation was to make a survey of the prevention and treatment regimens for oral sequelae resulting from head and neck radiotherapy applied in all radiotherapy institutes in the Netherlands, and to evaluate the differences in these regimens. In all Dutch centers (n = 20) in which irradiation of head and neck cancer patients is performed, members of the staff responsible for prevention and treatment of oral side effects were interviewed. Questions referred to composition of the dental team, screening and care pre-irradiation, care during irradiation, and care post-irradiation. There appeared to be a great diversity in the preventive approach of the head and neck cancer patient in Dutch radiotherapy institutes. The most comprehensive counseling was performed by those centers in which a dental team was active, particularly when an oral hygienist was a member of such a team. The diversity is among others based on lack of well-defined guidelines in many centers, the spread of a relatively small patient group over a rather large number of centers, absence of a dental team in some centers, absence of an oral hygienist in some dental teams, and the observation that a rather large number of patients were not referred, or not timely referred to the dental team. There seems to be a need for the development of a general protocol for the prevention of oral complications applicable in all centers.

Dental Caries↗
PubMed1992

A phase I-II study with intraperitoneal cisplatin plus systemic etoposide in patients with minimal residual ovarian cancer.

In patients with residual ovarian cancer after standard platinum-based induction, dose intensification was achieved by intraperitoneal administration of cisplatin 90 mg/m2 with intravenous Na thiosulphate and increasing dosages of etoposide. 40 patients entered the study, 4 on 200 mg/m2, 6 on 400 mg/m2, 22 on 600 mg/m2 and 8 on 800 mg/m2 etoposide. The optimal dose for etoposide was 600 mg/m2. 29 patients on the two highest dose steps were evaluable for response. 14 patients reached a complete remission, which was surgically confirmed in 6. All these patients initially had tumour residuals smaller than 1 cm. 3 patients had a partial response, 4 had stable disease and 8 progressed. At a maximal follow-up of 2 years (median 12 months), median time to progression was 12 months and median overall survival was 14 months. Of the 14 patients with complete remission, 2 relapsed at 9 and 11 months. Apart from a rash, in 4 of 22 patients at 600 mg/m2 and in 5 of 8 at 800 mg/m2 etoposide, the main toxicity was leukopenia grade 3-4 in 58% of cycles on 600 and in 76% at 800 mg/m2 etoposide. Leukopenic fever, however, occurred only three times; thrombocytopenia was rare. Cycles had to be delayed sporadically and the etoposide dose was reduced in 9% of all cycles at 600 and in 11% at 800 mg/m2. Intraperitoneal instillation of cisplatin gave no peritoneal symptoms. Intraperitoneal cisplatin with intravenous etoposide was tolerable and effective for patients with small tumour residuals after induction for stage III ovarian cancer.

Adult↗
PubMed1992

Psychosexual functioning after treatment for gynecological cancer: an integrative model, review of determinant factors and clinical guidelines.

This review summarizes investigations dealing with the sexual functioning of women with gynecological cancer. A critical review of methods of investigation and results is presented and an outline for future research. The literature review is preceded by a short theoretical introduction on cancer and sexual behavior relevant to the conceptualization and assessment of sexual functioning under these circumstances. The review is concluded by some guidelines to help patients and partners cope with sexual problems after treatment of gynecological cancer.

Journal Article↗
PubMed1992

Inhibin as a marker for granulosa cell tumor.

In order to determine whether serum-immunoreactive inhibin could constitute a biochemical marker for the presence and progression of ovarian granulosa cell tumors and their metastases, we measured immunoreactive inhibin concentrations in series of serum samples obtained from 8 patients with granulosa cell tumor. Six series were tested in retrospect. From these, three came from patients who had been treated with an abdominal hysterectomy and bilateral salpingo-oophorectomy. In the 2 patients with residual or recurrent disease, inhibin was elevated, 4 and 20 months respectively before clinical manifestations of recurrence became evident; it reflected the effects of secondary therapy. Inhibin remained undetectable in one patient who was free of disease during 11 years of follow-up. Inhibin concentrations were also inappropriately increased in 2 of 3 women with amenorrhea and infertility resulting from small granulosa cell tumors. After removal, inhibin concentrations became normal and fertility resumed. Fertility also returned in the third patient. There was a significant negative correlation between the serum inhibin and FSH concentrations, consistent with autonomous production of inhibin by granulosa cell tumors. It is concluded that granulosa cell tumors have the capacity to produce inhibin. In retrospect, inhibin proved to be a marker for both primary and also recurrent and residual disease.

Adult↗
PubMed1991

Endodermal sinus tumor of the ovary during pregnancy: a case report.

Serum alpha-fetoprotein screening led to the detection of an endodermal sinus tumor of the ovary in a 24-year-old female in week 17 of pregnancy. After surgery, chemotherapy was postponed. In week 28 levels of serum alpha-fetoprotein increased, but delivery was delayed until 33 weeks' gestation. After delivery, the patient received four chemotherapy courses (cisplatin, etoposide, and bleomycin). Mother (24 months after last chemotherapy) and child are doing well.

Adult↗
PubMed1990

Psychosexual functioning after the treatment of cancer of the vulva. A longitudinal study.

Ten couples, the women beginning treatment for carcinoma of the vulva, participated in a 2-year longitudinal study on sexual functioning before and after treatment. Sexual functioning was measured on admission and at 6, 12, and 24 months posttreatment. Sexual functioning was made operational in terms of current sexual behavior, sexual motivation, sexual (dis)satisfaction, and the perception of genital sensations of sexual arousal. An age-matched nonpatient control group was added to the study and the impact of physical variables was also evaluated. Within 1 year, all women who were sexually active before the treatment had resumed their sexual activities. At the 6-month assessment an increase in relational sexual dissatisfaction could be detected. Over the remaining observation period the women's satisfaction with sexual interaction with the partner was not found to be different from their pretreatment satisfaction and not different from the satisfaction in the control group, in spite of the physical damage and persisting poor perception of genital symptoms of sexual arousal during lovemaking. Satisfaction with sexual interaction with the partner under these circumstances appears to be more an expression of satisfaction with the intimate aspects of the sexual relationship than of satisfaction with the physiologic arousal aspects of the sexual relationship. It is argued that psychological and social variables are more crucial for sexual rehabilitation than physical variables. Therefore, psychosocial issues constitute the most promising focus for intervention.

Adult↗