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Biomedical subjects

J F Fennis

Publications and source records attributed to J F Fennis.

At least 37 records · Page 2Linked to original sources
PubMed1995

Chronic fatigue syndrome: a clinical and laboratory study with a well matched control group.

OBJECTIVE: To investigate the relation between severity of complaints, laboratory data and psychological parameters in patients with chronic fatigue syndrome (CFS). SUBJECTS: Eighty-eight patients with CFS and 77 healthy controls matched for age, sex and geographical area. METHODS: Patients and controls visited our outpatient clinic for a detailed medical history, physical examination and psychological tests: Checklist Individual Strength (CIS). Beck Depression Inventory (BDI) and Sickness Impact Profile (SIP). Venous blood was drawn for a complete blood cell count, serum chemistry panel, C-reactive protein and serological tests on a panel of infectious agents. RESULTS: All patients fulfilled the criteria for CFS as described by Sharpe et al. (J R Soc Med 1991; 84: 118-21), only 18 patients (20.5%) fulfilled the CDC criteria. The outcome of serum chemistry tests and haematological tests were within the normal range. No significant differences were found in the outcome of serological tests. Compared to controls, significant differences were found in the results on the CIS, the BDI, and the SIP. These results varied with the number of complaints (CDC criteria). When the number of complaints was included as the covariate in the analysis, there were no significant differences on fatigue severity, depression, and functional impairment between patients who fulfilled the CDC criteria and patients who did not. CONCLUSION: It is concluded that the psychological parameters of fatigue severity, depression and functional impairment are related to the clinical severity of the illness. Because the extensive panel of laboratory tests applied in this study did not discriminate between patients and controls, it was not possible to investigate a possible relation between the outcomes of psychological and laboratory testing.

Adult↗
PubMed1995

Undefined malabsorption syndrome with villous atrophy successfully reversed by treatment with cyclosporine.

A 47-year-old man with a flat jejunal mucosa complicated by malabsorption, diarrhoea and lymphocytic colitis is presented. There was no response to gluten withdrawal alone, combination of a gluten-free diet and prednisone therapy, or total parenteral nutrition. Complete clinical remission was only achieved after simultaneous treatment with cyclosporine and a gluten-free diet. Rechallenge with a gluten-containing diet while cyclosporine treatment continued resulted in a relapse of diarrhoea and malabsorption. We conclude that cyclosporine may be an effective agent for the treatment of undefined, refractory forms of malabsorption.

Atrophy↗
PubMed1994

Doctors' perception of patients' cognitions and complaints in irritable bowel syndrome at an out-patient clinic.

Functional abdominal complaints (IBS) are widespread in the general population, especially among women. Non-organic dimensions of the complaint such as complaint-related cognitions and behaviour appear to be related to the prognosis. The prognosis could possibly be improved by changing these factors during medical consultations. Therefore, doctors have to perceive patients' cognitions and behaviour. But, do they perceive them correctly? One hundred and twenty patients with functional abdominal complaints referred to an out-patient clinic for internal medicine completed a questionnaire about their complaints and their complaint-related cognitions, behaviour, and anxiety prior to the first consultation. After the first consultation, doctors completed a similar questionnaire indicating their perceptions of patients' cognitions, anxiety, behaviour, and complaints. Complaints were perceived better than cognitions, anxiety, and behaviour. Doctors underestimated patients' expectations and secondary complaints and overestimated patients' pain-related attributions, and their catastrophizing and self-efficacy cognitions.

Adult↗
PubMed1994

Dimensional assessment of chronic fatigue syndrome.

The absence of laboratory tests and clear criteria to identify homogeneous (sub)groups in patients presenting with unexplained fatigue, and to assess clinical status and disability in these patients, calls for further assessment methods. In the present study, a multi-dimensional approach to the assessment of chronic fatigue syndrome (CFS) is evaluated. Two-hundred and ninety-eight patients with CFS completed a set of postal questionnaires that assessed the behavioural, emotional, social, and cognitive aspects of CFS. By means of statistical analyses nine relatively independent dimensions of CFS were identified along which CFS-assessment and CFS-research can be directed. These dimensions were named: psychological well-being, functional impairment in daily life, sleep disturbances, avoidance of physical activity, neuropsychological impairment, causal attributions related to the complaints, social functioning, self-efficacy expectations, and subjective experience of the personal situation. A description of the study sample on these dimensions is presented.

Activities of Daily Living↗
PubMed1994

Enteroviruses and the chronic fatigue syndrome.

The possible role of enteroviral persistence in the etiology of the chronic fatigue syndrome (CFS) was investigated by serological testing, VP-1 antigen testing, and polymerase chain reaction (PCR) analysis of stool specimens as well as by viral cultures of stool--both direct and after acid treatment. No differences between 76 patients with disabling unexplained fatigue and 76 matched controls were found by serological or antigen testing. Furthermore, no enteroviruses were isolated from any stool culture. Enterovirus was detected by PCR in one stool specimen from a patient with CFS but was not detectable in a second sample obtained from the same patient 3 months later. All stool specimens from controls were PCR-negative. These results argue against the hypothesis that enteroviruses persist in patients with CFS and that their persistence plays a role in the pathogenesis of this syndrome.

Adult↗
PubMed1990

Psychologic factors in diagnosis, prognosis, and treatment of functional abdominal complaints.

Functional abdominal complaints are frequently a reason to refer a patient to an outpatients' clinic for internal medicine. According to general views, certain psychologic and anamnestic data can constitute an indication for the diagnosis 'functional'. However, in our experience patients with functional complaints cannot be distinguished from patients with organic disease on such data. These same anamnestic and psychologic data, however, do have value in predicting the outcome of the complaints. Apparently, psychologic factors play a role in the course of functional abdominal complaints. Therefore, we tested the hypothesis that prognosis of functional abdominal complaints can be improved by psychologic intervention, and we offered our patients such a psychologic intervention in the form of a cognitive-behavioural group treatment. The first, encouraging, results are presented.

Behavior↗
PubMed1989

Anamnestic and psychological features in diagnosis and prognosis of functional abdominal complaints: a prospective study.

Psychological and anamnestic data from 308 patients were collected to investigate whether patients with abdominal complaints from organic causes could be distinguished psychologically or by their case histories from patients with functional abdominal complaints. Two years later the same patients took part in a follow up study. Only 9% of the patients with functional abdominal complaints became symptom free. Most variables showed no significant difference between the organic and the functional group. The most important variables with predictive value were psychological factors, factors associated with the severity and factors associated with the duration of the complaints.

Analysis of Variance↗
PubMed1985

Alpha and beta-blockade and beta-stimulation in Raynaud's syndrome: a double-blind, placebo controlled, single dose study.

We examined in a double blind fashion and placebo controlled the effects of some alpha and beta adrenergic receptor agonists and antagonists on the recovery of finger skin temperature 12 min after finger cooling (5 min waterbath for both hands) in twelve patients with Raynaud's syndrome. A favourable effect was established on phenoxybenzamine 20 mg as compared to placebo. A significant but rather small effect on orciprenaline 10 mg. The beta-agonists prenalterol (10 mg) and terbutaline (5 mg) did not influence the recovery of finger skin temperature. The beneficial effect of phenoxybenzamine 20 mg was not influenced by the addition of beta-agonists (prenalterol 10 mg or terbutaline 5 mg) or a beta-blocker (propranolol 40 mg). The beta-agonists terbutaline and orciprenaline caused a fall in diastolic pressure and an increase in heart rate. These effects presumably were connected with one collapse and three near-collapses. On alpha- and beta-blocker (phenoxybenzamine and propranolol) a decrease in systolic pressure appeared, whereas diastolic pressure did not significantly differ from the placebo value. While physical exercise is considered to exacerbate the hypotensive effect of alpha-blockers, a fall in blood pressure during physical exercise could not be established in our experiments after the addition of propranolol to the alpha-blocker phenoxybenzamine. Our results suggest that an alpha-blocker is a good choice in Raynaud's syndrome, whereas the addition of a beta-blocker may have some advantages.

Adrenergic Agonists↗
PubMed1984

Treatment of Raynaud's syndrome with adrenergic alpha-blockade with or without beta-blockade.

In a double blind placebo-controlled cross-over trial of 24 weeks 31 patients with Raynaud's syndrome were treated with the alpha-blocker phenoxybenzamine (10-20 mg daily) and with the combination of the alpha-blocker phenoxybenzamine (10-20 mg daily) and the beta-blocker sotalol (40-80 mg daily). A favourable effect on recovery of finger temperature after finger cooling was demonstrated after alpha-blockade as compared to the before treatment situation. This favourable effect was not different when the group received the combined alpha- and beta-blockade. The blood pressure was not influenced by either of the 2 medications. Fluid retention appeared with alpha-blockade and was absent with combined alpha- and beta-blockade. Decrease of heart rate occurred with alpha- plus beta-blockade and was absent with alpha-blockade alone. Clinical symptoms of Raynaud's syndrome equally were alleviated by the two medications. Common, and equally frequent side effects of the two medications were nasal congestion, disturbed ejaculation and potency, dry mouth, exercise-induced and orthostatic dizziness. We conclude that alpha-blockade is beneficial in Raynaud's syndrome and that additional beta-blockade counteracts the alpha-blocker side-effect fluid retention, reduces the heart rate and thus may prevent alpha-blocker induced tachycardia, and that it does not cause hypotension.

Adrenergic alpha-Antagonists↗
PubMed1984

Therapeutic efficacy of alpha-adrenoceptor blockade in primary and secondary Raynaud's syndrome.

Twenty patients with primary and 11 with secondary Raynaud's syndrome were treated with the alpha-adrenoceptor blocker phenoxybenzamine (10-20 mg daily). In the secondary group mean age and mean duration of symptoms as well as presence of positive ANA and positive Clq binding test were significantly higher than in the primary group. In both groups a beneficial effect of the medication on finger temperature 12 min after finger cooling and on clinical symptoms was established. Secondary Raynaud's syndrome reacted at least as well as primary syndrome.

Adrenergic alpha-Antagonists↗
PubMed1982

Finger temperature after a finger-cooling test: influence of air temperature and smoking.

Skin temperature of one finger was measured before and after immersion of the gloved fingers of both hands in 16 degrees C water for 5 min [room temperature (Ta) 24 or 20 degrees C]. At Ta 24 degrees C, 23 of 25 normal nonsmokers (92%) had finger rewarming to above 24 degrees C in 12 min after cold immersion, at Ta 20 degrees C, only 1 of 12 (8%) had similar rewarming. Among 12 habitual smokers only 4 (33%) rewarmed above 24 degrees C (Ta 24 degrees C) following a 1-h abstinence from smoking, but 8 (67%) did so after a 24-h abstinence. Only 2 of these 8, however, did so in a retest 10 min after smoking a cigarette. The smokers were not tested at Ta 20 degrees C. We conclude that air temperature and cigarette smoking are important determinants of finger rewarming following a finger-cooling test.

Adult↗