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Biomedical subjects

J Hermans

Publications and source records attributed to J Hermans.

At least 217 records · Page 12Linked to original sources
PubMed1996

Regular physical activity and changes in risk factors for coronary heart disease: a nine months prospective study.

This study reports the non-acute effects of a long-term training programme of increasing intensity on some cardiovascular risk factors and the interrelation between these risk factors. Twenty sedentary men and 14 sedentary women were trained 3 to 4 times a week for nine months. After 36 weeks all individuals ran a half marathon run. The Wmax, weight, body mass index, systolic and diastolic blood pressure were recorded. The concentrations of fibrinogen, tissue plasminogen activator, plasminogen activator inhibitor, triacylglycerols, total cholesterol, LDL cholesterol, HDL cholesterol and lipoprotein(a) were measured. The training programme induced a median increase in Wmax of 12% in the male group (from 226 to 251.5 Watt) and of 18% in the female group (from 160 to 188.5 Watt). These increases inn Wmax did not correlate with any other property under investigation in this study. Blood pressure was not altered, but body weight and body mass index were significantly decreased in the male group (from 74.6 to 72.2 kg and from 23.1 to 22.0 kg/m2, respectively) at the end of the training programme and decreased non-significantly in the female group (from 63.0 to 60.7 kg and from 21.6 to 21.5 kg/m2, respectively). In the male group total cholesterol, low density lipoprotein cholesterol and triacylglycerols decreased significantly under the influence of the training sessions. Furthermore, in both groups, a great decrease in plasma plasminogen activator inhibitor concentrations was noticed: in men from 22.5.10(3) AU/l to 4.5.10(3) AU/l and in women from 18.7 x 10(3) AU/l to 5.1 x 10(3) AU/l. However, the changes in the lipid and fibrinolytic quantities were not correlated with each other. Initial total cholesterol, LDL cholesterol and triacylglycerol levels correlated significantly with systolic blood pressure, while diastolic pressure was correlated to tissue plasminogen activator. Since tissue plasminogen activator also was significantly related to triacylglycerols, a trias existed between primary risk factors like blood pressure, lipid levels and fibrinolysis. In contrast, the changes in these properties under the influence of physical training were not interrelated. Median serum lipoprotein(a) concentrations were significantly increased in both men and women five days before the half marathon run: from 32 mg/l to 39 mg/l in men, and from 65 mg/l to 125.5 mg/l in women. Concomitantly, median fibrinogen concentrations were significantly elevated in men (from 2.32 g/l to 3.10 g/l) and non-significantly in women (from 2.62 g/l to 2.93 g/l), although no correlation existed between the changes in these properties. In conclusion, the nine months exercise programme increased the aerobic fitness in both men and women as indicated by the Wmax increase. This improvement coincided but was not correlated with beneficial changes in several anthropometric, lipid and fibrinolytic properties. Improvement in the risk factors under investigation was more pronounced in men than in women. The changes in lipid and haemostasis properties did not correlate with each other. The increases in lipoprotein(a) and fibrinogen concentrations, both atherogenic indices, could actually present a normal physiological response to the physical strain of exercise training of increasing workload.

Blood Pressure↗
PubMed1996

Dietary fish oil in renal transplant recipients treated with cyclosporin-A: no beneficial effects shown.

This study aimed to determine whether dietary supplementation with fish oil has a beneficial effect on graft function and the incidence of rejection in renal allograft recipients treated with cyclosporin A (CsA). Renal function, blood pressure, the incidence of acute rejection episodes, graft survival, and renal histology and immunochemistry were investigated. In a randomized, placebo-controlled, double-blind trial, groups of 25 recipients of primary cadaveric renal allografts who had been treated with CsA took fish oil (30% C20:5 omega-3 and 20% C22:6 omega-3) or coconut oil (63% C8:0 and 36% C10:0) at 6 g/day for 3 months. There were no differences between the two patient groups with regard to HLA matching, panel-reactive antibody titers, or the demographic characteristics of donors or recipients. The GFR and effective RPF were determined at 1, 3, and 12 months after transplantation by simultaneous measurement of (125I-)iothalamate and (131I-)hippuran clearances. At 1 yr after transplantation, patients treated with fish oil showed better renal function than did the control patients, but this difference was not statistically significant. Blood pressure and antihypertensive drug use were similar in both groups. The number of rejection episodes was also similar, and renal histopathological and immunohistochemical studies showed no significant differences between the fish-oil group and the control patients. It is concluded that fish oil, at a dose of 6 g/day, has no beneficial effect after renal transplantation within the time scale of the study.

Acute Disease↗
PubMed1996

The cytological screening history of 469 patients with squamous cell carcinoma of the cervix uteri; does interval carcinoma exist?

BACKGROUND: To determine whether interval carcinomas occurred and to determine the level of screening-participation by women who developed a cervical carcinoma. METHODS: A retrospective study of the cytological history of 469 patients diagnosed between January 1980 and December 1989 with cervical squamous cell carcinoma in 12 hospitals in the western part of The Netherlands. Clinical data, and cervical smear histories in 3.5 years preceding the diagnoses were obtained. Cervical smears diagnosed as Pap I, II or IIIA were traced for review. RESULTS: 306 patients' data were completed. Two hundred and twenty-three patients (72.9%) had never been screened and 83 patients (27.1%) had had at least one smear, of which 39 were normal. The percentage of women over 54 was higher in patients who had never been screened (58%) than in those screened (46%). Women over 54 were in higher Figo stage. Interval carcinoma was proven in six of 306 (2%) patients. Of the normal smears 53% were false negative. CONCLUSION: The high number of non-participants still forms the main reason for the failure of cervical cancer screening. Secondly, the assumed existence of frequent interval carcinoma could not be demonstrated. There are grounds for changing the age limits of the current Dutch screening program without changing the screening interval.

Adult↗
PubMed1996

Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis.

OBJECTIVE: To evaluate nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis in general practice. DESIGN: Nasal smear eosinophilia was assessed and compared with 'consensus diagnoses' made by three experts in a modified Delphi method. SETTING: Nineteen general practices in The Netherlands. SUBJECTS: 363 consecutive patients aged 12 years or over who visited their general practitioner because of chronic or recurrent nasal symptoms between 1 March 1990 and 1 March 1991. MAIN OUTCOME MEASURES: The predictive value of nasal smear eosinophilia for allergic rhinitis; the prevalence of eosinophilic non-allergic rhinitis. RESULTS: The positive predictive value of nasal smear eosinophilia (> or = 10% eosinophils) for allergic rhinitis was 30/37 = 81% (95% confidence interval (CI): 65-92%), the negative predictive value 172/312 = 55% (95% CI: 50-61%). Addition of the result of nasal smear eosinophilia to the information that was already obtained from the medical history resulted in a significant but very small improvement in the discrimination between patients with and without allergic rhinitis. The prevalence of eosinophilic non-allergic rhinitis was 7/349 = 2.0% (95% CI: 0.8-4.1%). CONCLUSION: Nasal smear eosinophilia contributes significantly to the diagnosis of allergic rhinitis; however, this contribution is very small and considered clinically irrelevant. Eosinophilic non-allergic rhinitis has a low prevalence; identifying this disorder is of minor importance. In conclusion, nasal smear eosinophilia is not recommended for use in general practice.

Adolescent↗
PubMed1996

Prevalence of depression and clues to focus diagnosis. A study among Dutch general practice patients 65+ years of age.

AIMS: To assess the prevalence of depression in elderly patients presenting in general practice, and to assess which patient characteristics and presenting symptoms are useful clues for predicting depression. DESIGN: Cross-sectional survey based on data collected at the presenting consultation and at a subsequent domiciliary interview. SUBJECTS AND SETTING: 580 of 706 consecutive patients aged 65+ years consulting 13 general practitioners in the Netherlands. METHOD: GPs entered data on presenting symptoms and their assessment of psychological state during the consultation. Formal psychiatric assessment was subsequently done at home using the Diagnostic Interview Schedule (plus additional questions to assess minor depression according to ICHPPC-2-Defined). Major depression and dysthymia were assessed with the Diagnostic Interview Schedule. RESULTS: The estimated prevalence of depression (both major and minor plus dysthymia) was 7.9%, and was very similar whether based on GP assessment or formal validated interview schedule, but the GPs did not identify the same patients as the formal psychiatric assessment. GPs identified only 26% (95% CI 4-71%) of patients with major depression. Clinical clues which could help the GP to suspect underlying depression were female gender, the presentation of vague symptoms, and gastrointestinal symptoms. CONCLUSIONS: Although presentation of symptoms does provide some clues about the likelihood of underlying depression, the sensitivity of GP diagnosis remains low and needs to be improved.

Aged↗
PubMed1996

The highest leukaemia-free survival after allogeneic bone marrow transplantation is seen in patients with grade I acute graft-versus-host disease. Acute and Chronic Leukaemia Working Parties of the European Group for Blood and Marrow Transplantation (EBMT).

The purpose of the present study was to evaluate the relation between the grade of acute graft-versus-host disease (GVHD) and several outcome parameters. Special attention was given to leukaemia-free survival (LFS). The study included 2,122 patients with acute leukaemia in first remission and 780 patients with chronic myeloid leukaemia (CML) in the first chronic phase, who were receiving first transplants from HLA-identical donors. Transplant-related mortality (TRM) was the same in patients with or without grade I acute GVHD, but was increased in patients with grades II, III and IV acute GVHD. In patients with grades 0, I, II, III and IV acute GVHD, the five-year probability of TRM (+/-SE) overall was 20 +/- 1%, 19 +/- 2%, 30 +/- 2%, 61 +/- 4% and 90 +/- 3%, respectively. The incidence of relapse in patients with grades I-IV was lower than in patients without acute GVHD. The five-year relapse probability according to GVHD grade (0-IV), was 28 +/- 2%, 22 +/- 2%, 22 +/- 2%, 17 +/- 5% and 20 +/- 2%. The five-year LFS in all patients with leukaemia, according to grade of acute GVHD, was 57 +/- 2%, 63 +/- 2%, 55 +/- 3%, 32 +/- 4% and 8 +/- 3%. In multivariate analysis, adjustments for age, sex, diagnosis, interval from diagnosis to transplantation, T-cell depletion and year of transplantation were considered. Patients with grade I acute GVHD had the highest LFS (relative risk 0.84, p = 0.04 compared with those without acute GVHD).

Acute Disease↗
PubMed1996

Hematopoietic precursor cell transplants in Europe: activity in 1994. Report from the European Group for Blood and Marrow Transplantation (EBMT).

This report, the fifth of a series, summarizes indications and donor source of hematopoietic precursor cell transplants performed in Europe in 1994 and illustrates the evolution since 1990. 306 teams in 30 participating countries performed a total of 10 066 transplants, 3502 allogeneic and 6564 autologous transplants. In 1990, there were only 143 teams and a total of 4234 transplants, 2137 allogeneic and 2097 autologous transplants. Main indications in 1994 were leukemias with 3881 transplants (39%), 2635 allogeneic (75%) and 1246 autologous (19%) transplants; lymphomas with 3760 transplants (37%), 245 allogeneic (7%) and 3515 autologous (54%) transplants; severe aplastic anemia with 250 transplants (2%), 248 allogeneic (7%) and 2 autologous transplants; solid tumors with 1800 transplants (18%), 13 allogeneic and 1787 autologous (27%) transplants and congenital disorders with 375 (4%) transplants, 361 allogeneic (11%) and 14 autologous transplants. The relative proportion of the main indication has stayed unchanged for allogeneic transplants. There was, in contrast, a marked increase in lymphomas and solid tumors, ie mainly for breast carcinoma, as an indication for autologous transplants since 1990. For the 3502 allogeneic transplants, the donor was an HLA-identical sibling in 2677 cases (76%), an HLA non-identical family member in 195 cases (6%), a syngeneic twin in 45 cases (1%) and an unrelated donor in 585 cases (17%). Donor source was bone marrow for 3322 allogeneic (95%) and 1869 autologous (29%) transplants, peripheral blood for 180 allogeneic (5%) and 4289 autologous (65%) transplants and a combination of bone marrow and peripheral blood for a few allogeneic and 406 autologous (6%) transplants. The relative proportion of peripheral blood as a source for autologous transplants has changed since 1991 from 15 to 72.1% in 1994. A similar trend for allogeneic transplants is just emerging.

Anemia, Aplastic↗
PubMed1996

Granulocytic sarcoma after allogeneic bone marrow transplantation: a retrospective European multicenter survey. Acute and Chronic Leukemia Working Parties of the European Group for Blood and Marrow Transplantation.

In a retrospective analysis we assessed occurrence, contributing factors and outcome of patients experiencing granulocytic sarcoma as a localized extramedullary relapse after allogeneic BMT. EBMT members were asked to report the number of patients transplanted for leukemia between January 1981 and December 1992 and the number of patients with granulocytic sarcoma. Of a total of 5824 patients transplanted for AML, CML or MDS by 86 teams, granulocytic sarcoma was observed in 26 patients (0.45% occurring 4-56 months after BMT. Granulocytic sarcoma occurred after allogeneic BMT in 20 out of 3071 patients grafted for AML (0.65%), and in the CML/MDS subgroup in six out of 2753 grafted patients (0.22%). Granulocytic sarcoma can involve any site of the body, presenting as a soft tissue mass; it occurred in body cavities (eg pleural cavity, abdominal cavity, spinal canal, stomach and bladder), the head and neck region (orbit, ear, skull base, peripheral nerves), the trunk and limbs, and mammary and sex glands. Granulocytic sarcoma predicts an additional hazard to outcome after BMT. Nine of 26 patients (33%) were alive 15-151 months after the onset of granulocytic sarcoma. Advanced disease stage at grafting adversely affected survival and all patients died. The best treatment option still needs to be defined.

Adolescent↗
PubMed1996

Allogeneic bone marrow transplantation for chronic myeloid leukemia. Working Party Chronic Leukemia of the European Group for Blood and Marrow Transplantation (EBMT).

Results of 3000 patients transplanted for chronic myeloid leukemia in Europeere used to assess outcome and main risk factors for survival (SURV), leukemia free survival (LFS), relapse incidence (RI) and transplant related mortality (TRM). More than one third (39%) of all patients are alive at + 10 years. SURV at 10 years is better for patients transplanted in first chronic phase (49%) than in accelerated phase (19%) or blast crisis (0%) due to both decreased TRM (41% versus 67% versus -) and RI (35% versus 51% versus -). For those patients transplanted in first chronic phase from an HLA-identical sibling donor with non-T-cell depleted bone marrow, modern conditioning and GVHD prevention method, median SURV has not been reached at +10 years and exceeds 55%. Other risk factors are discussed.

Acute Disease↗
PubMed1996

Risk factors for developing EBV-related B cell lymphoproliferative disorders (BLPD) after non-HLA-identical BMT in children.

B cell lymphoproliferative disorders (BLPD) are relatively frequent after genotypically non-HLA-identical BMT. We performed univariate analysis to study which BMT-related variables were associated with an increased risk of developing BLPD. Sixty-five recipients of other than genotypically HLA-identical BM grafts were included in the study. Seventy-seven recipients of genotypically HLA-identical BM grafts served as a comparison group. BLPD occurred in nine of 65 children after non-HLA-identical BMT (14%) and in none of the 77 children after HLA-identical BMT (0%). In all cases, BLPD was proven to be EBV-related. Our data suggest that the combined use of Campath 1G and anti-LFA1 was associated with an increased risk of developing BLPD, particularly children who had received a T cell-depleted BM graft, using albumen density gradient sedimentation followed by E-rosetting, and who were conditioned with Ara-C, CY and TBL. In addition, T cell numbers below 50/microliters at 1 month and below 100/microliters at 2 months after BMT, respectively, were associated with an increased risk of developing BLPD. Longitudinal determination of T cell numbers after non-HLA-identical BMT is a simple method for identifying patients at risk of developing BLPD. In addition to monitoring levels of circulating EBV-infected lymphocytes, monitoring T cell numbers may allow early intervention to prevent progression of BLPD.

Adolescent↗
PubMed1996

The influence of the oncogenes NRAS and MYC on the radiation sensitivity of cells of a human melanoma cell line.

Activation of certain oncogenes may alter the sensitivity of cells to ionizing radiation. We studied the effect of oncogene activation on the radiation sensitivity of cells of a human melanoma cell line. The cell line IGR39D was transfected with the MYC oncogene, the proto-oncogene NRAS, NRAS activated by a point mutation (61-arginine) or a combination of mutated NRAS and MYC. Single-dose experiments showed a decreased survival after transfection with MYC, wild-type NRAS or mutated NRAS. Co-transfection with MYC and mutated NRAS decreased survival up to 4 Gy, whereas at higher doses no shift in radiosensitivity was seen. Flow cytometry data indicated that differences in radiosensitivity could be explained at least in part by a difference in the distribution of cells in the phases of the cell cycle. After transfection of cells with either NRAS or MYC, the number of cells in G1 phase decreased with a concomitant increase of cells in the G2/M phase. When the cell line transfected with activated NRAS was manipulated so that the distribution of the cells in the phases of the cell cycle resembled th at of the parental line at the time of irradiation, the survival of the cells was improved. Similar experiments with the cell line containing MYC did not result in an alteration of the distribution of the cells in the cycle, or the survival after single-dose fractions, suggesting the presence of a distinct mechanism for influencing radiation sensitivity. Both NRAS and MYC transfection decrease the radiation sensitivity of human melanoma cells, but the underlying mechanisms seem different. In conclusion, transfection with NRAS or MYC alone increases radiation sensitivity while transfection of cells containing NRAS with MYC restores resistance at higher doses.

Cell Cycle↗
PubMed1995

Thermodynamic parameters for the helix-coil transition of oligopeptides: molecular dynamics simulation with the peptide growth method.

The helix-coil transition equilibrium of polypeptides in aqueous solution was studied by molecular dynamics simulation. The peptide growth simulation method was introduced to generate dynamic models of polypeptide chains in a statistical (random) coil or an alpha-helical conformation. The key element of this method is to build up a polypeptide chain during the course of a molecular transformation simulation, successively adding whole amino acid residues to the chain in a predefined conformation state (e.g., alpha-helical or statistical coil). Thus, oligopeptides of the same length and composition, but having different conformations, can be incrementally grown from a common precursor, and their relative conformational free energies can be calculated as the difference between the free energies for growing the individual peptides. This affords a straightforward calculation of the Zimm-Bragg sigma and s parameters for helix initiation and helix growth. The calculated sigma and s parameters for the polyalanine alpha-helix are in reasonable agreement with the experimental measurements. The peptide growth simulation method is an effective way to study quantitatively the thermodynamics of local protein folding.

Alanine↗
PubMed1995

[Symptoms of disease and food allergy in children with Down syndrome].

OBJECTIVE: To obtain an impression of how often parents of children with Down's syndrome suspect their children of having a food allergy and what action results from this suspicion. DESIGN: Inventorizing controlled descriptive study. 'Zuid-Holland' in the Netherlands. METHODS: An anonymous questionnaire was sent to 110 parents of children with Down's syndrome and 223 control parents. RESULTS: The parents of children with Down's syndrome reported symptoms of their child which might relate to food allergy more frequently than control parents. They reported more respiratory disease symptoms (62% and 53% respectively; pneumonia: 22% and 3%), more gastrointestinal disease symptoms (28% and 17%; constipation or diarrhoea: 28% and 13%), but fewer skin disease symptoms (12% and 26%). 34% of the parents of Down's syndrome children and 22% of the control parents suspected their child of having an allergy and 13% in both groups suspected food to be the allergenic responsible. Medical and laboratory investigations were performed in 37% and 31% and food allergy was diagnosed in 7% and 31% respectively. No elimination-reïntroduction diet was reported as used for diagnosing. Parents of children with Down's syndrome were less satisfied with their consultation of health workers. All parents in both groups who suspected their children of having a food allergy started an elimination diet, 66% found it had a beneficial effect. CONCLUSION: Compared with control parents, parents of children with Down's syndrome reported symptoms relating to food allergy more frequently, suspected their children of having a food allergy equally often, but had it diagnosed less frequently. However, neither group of parents mentioned that an elimination-provocation test was used for the diagnosis.

Animals↗
PubMed1995

International Prognostic Index for aggressive non-Hodgkin's lymphoma is valid for all malignancy grades.

An International Prognostic Index (IPI) for patients with aggressive non-Hodgkin's lymphoma (NHL) has recently been published. The IPI is based on pretreatment clinical characteristics and developed on clinical trial patients, classified as intermediate grade according to the Working Formulation (WF). We applied this IPI in a population-based registry of NHL patients. This registry does not have the restrictions that usually hold for patients in clinical trials, eg, with respect to age and performance status. Moreover, it covers all the three WF classes (low, intermediate, and high). The IPI turned out to be of prognostic value for response rate and survival in our unselected cohort of 744 patients, as well. In each of the three WF classes separately, the four IPI classes showed going from low to high substantially decreasing response rates and survival percentages. For our cohort of WF intermediate grade patients 5-year survival levels were lower in all four IPI classes (59%, 34%, 14%, and 10%, respectively), probably reflecting the selection of clinical trial patients in the original study (73%, 51%, 43%, and 26%).

Aged↗
PubMed1995

Acute graft-versus-host disease: grade and outcome in patients with chronic myelogenous leukemia. Working Party Chronic Leukemia of the European Group for Blood and Marrow Transplantation.

Acute graft-versus-host disease (aGVHD) has been classified according to the Seattle criteria as grades 0, I, II, III, and IV for 20 years. The predictive value of such detailed grading is a matter of debate; publications usually report GVHD as present or absent or as absent, moderate, or severe. The Working Party Chronic Leukemia of the European Group for Bone Marrow Transplantation analyzed data of 1,294 patients transplanted from an allogeneic donor for chronic myelogenous leukemia (CML) in first chronic phase and tested the predictive value of aGVHD grading for the following end-points: day 100 mortality (D100M), transplant-related mortality (TRM), relapse incidence (RI), leukemia-free survival (LFS), and survival (SURV). aGVHD was absent in 462 patients (35.7%), grade I occurred in 335 (25.8%), grade II in 264 (20.5%), grade III in 110 (8.5%), and grade IV in 123 patients (9.5%). A total of 297 patients (23%) died within 100 days, 495 patients (38%) died of any TRM, and 100 patients (8%) died of relapse. D100M according to grades 0, I, II, III, and IV was 17%, 13%, 19%, 38%, and 70%, respectively, with significant difference between 0-II versus III-IV. TRM was 28%, 27%, 43%, 68%, and 92%, respectively, with a distinct separation between 0-I versus II-IV. RI showed a continuous decrease of 37%, 30%, 23%, 18%, and 8%, respectively, with increasing aGVHD. LFS was 45%, 51%, 44%, 26%, and 7%, respectively, and was best for patients with grade I aGVHD. This finding was also reflected in a better overall survival (60%, 64%, 53%, 30%, and 8%, respectively). The better LFS for grade I aGVHD patients compared with patients with grade 0 or II aGVHD was confirmed (P = .05) in a multivariate analysis. These data document the value of the present 5-point grading of aGVHD, ie, different outcome is observed depending on endpoint analyzed. Restricting information about aGVHD to presence or absence is not warranted.

Acute Disease↗