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Biomedical subjects

J M Minderhoud

Publications and source records attributed to J M Minderhoud.

At least 19 recordsLinked to original sources
PubMed1992

In vivo phosphorus magnetic resonance spectroscopy in multiple sclerosis.

Localized phosphorus magnetic resonance spectroscopy at 1.5 T was performed in 39 patients with multiple sclerosis and in 15 healthy controls. The multiple sclerosis spectra showed increased creatine phosphate levels. This increase was correlated with the severity of the handicap and was greater in patients with a progressive course of the disease than in patients with relapsing-remitting disease. No clear abnormalities were observed in the spectra of patients with multiple sclerosis regarding the phosphomonoesters, phosphodiesters, inorganic phosphate, and beta-adenosine triphosphate or with respect to pH values. There was an increased creatine phosphate level in the spectra in relation to a low metabolic state of the brain.

Adenosine Triphosphate↗
PubMed1992

Early prognostic factors for disability in multiple sclerosis, a European multicenter study.

The effects of initial clinical variables on short-term prognosis are analyzed in a cross-sectional study of 574 multiple sclerosis patients from 7 centers in 5 European countries. Patients with a primary progressive course had a 2.3 higher mean disability score (EDSS) than the primary remittent group after a mean duration of disease of 6.6 years. High age at onset was associated with a primary progressive course, and was also related to increased risk of a rapid shift to a secondary progressive course. Among the remittent patients without a secondary progressive course a high age at onset was significantly correlated to a higher disability score. In the whole remittent group the presence of pyramidal and cerebellar symptoms at onset predicted both a high disability score and a rapid shift to a secondary progression, while the effect was reverse for sensory and visual symptoms. No difference between the sexes was found.

Adult↗
PubMed1991

Residual signs in severe Guillain-Barré syndrome: analysis of 57 patients.

The residual signs in a group of seriously paralyzed Guillain-Barré patients are reported (follow-up 2-24 years) and the social effects of the illness are discussed. Thirty-five percent of the patients had recovered completely at the time of the follow-up examination, 35% had minimal residual motor signs and 30% had a moderate or severe residual paresis. The most serious residua were found distally in the legs. Muscles innervated by nerves running along an entrapment site had the most severe deficits. Sensory signs were present in 49% of the patients. More than half of the patients considered themselves to be cured. The others were more or less handicapped by their sequelae. Of the adults, 60% resumed work, 25% found a less demanding job and 15% did not return to work. Statistically significant correlations were found between the degree of residual motor deficit and the severity of the weakness in the acute phase, the duration of the plateau phase or the duration of the artificial ventilation.

Activities of Daily Living↗
PubMed1990

Long-term effect of ACTH treatment of relapse in multiple sclerosis.

A controlled, randomized study of the long-term effects of ACTH-treatment (100 units intramuscular, tapered over 12 weeks) of acute relapse in 29 MS patients was performed. Follow-up lasted one year. In some Kurtzke Functional System, the Ambulation Index and the Kurtzke Incapacity Scale a transient greater improvement in the ACTH-treated patients was observed. These superior results in the ACTH group were no longer present at 6 months. Significantly more side-effects were reported in the ACTH-group. After treatment with ACTH a higher, though not statistically significant, relapse rate in the following months was noticed.

Adult↗
PubMed1988

Prognosis of the posttraumatic vegetative state.

Of 1373 patients who, following severe brain injury had been comatose for over 6 hours, 140 (10%) were in a vegetative state one month later. Fifty-nine regained consciousness but none of those aged over 40 became independent during the first year. Of those still in a vegetative state after 3 months, none became independent irrespective of age. Of all patients comatose for over 6 hours after severe brain injury, only 1% was in a vegetative state after one year. Certain scores for features such as age, pupillary reactions, eye-opening and eye movements indicate either a favourable prognosis, a fatal outcome or irreversible coma. It is only in some 10% of all patients in coma or in a vegetative state during the first two weeks after the accident that it is possible to predict with a high degree of probability (p greater than 0.95), an unfavourable outcome (death or irreversible coma) within one year. At no time after the onset of coma is it possible to predict or distinguish, with a fair degree of probability (e.g. p greater than 0.80), those patients who will remain in a vegetative state from those who will die.

Adult↗
PubMed1988

A long-term double-blind controlled study on the effect of azathioprine in the treatment of multiple sclerosis.

The results are reported of a small double-blind controlled trial on the effect of azathioprine in multiple sclerosis. Although a trend in favour of the treated group, as regards the effect on the disability, was found, it did not reach statistical significant levels. No influence was found on the relapse rate. The influence of side-effects, which were found in the treated group in a higher percentage than in the placebo group, on the results is discussed.

Azathioprine↗
PubMed1988

Course and prognosis of chronic progressive multiple sclerosis. Results of an epidemiological study.

In studies on the natural course of multiple sclerosis (MS), several forms of the disease are distinguished. The most important are the relapsing remitting and the chronic progressive forms. The relationship between these remains unclear. In a prospective epidemiological survey we studied the course of MS using the year in which the chronic-progressive phase started as a landmark. The reliability of this "year of progression" was examined in an observer agreement study. Data were acquired from 342 patients. Progression of the handicap was most rapid in case of a secondary progressive course, female sex, high relapse rate in the preceding remitting phase and "year of progression" at a higher age. Survival after the "year of progression" was lowest in the secondary progressive group. Determining the "year of progression" seems to be significant for the prognosis.

Adolescent↗
PubMed1988

Tizanidine versus baclofen in the treatment of spasticity in multiple sclerosis patients.

Sixteen patients suffering from spasticity due to multiple sclerosis were treated with baclofen and tizanidine in a partially blind cross-over study. No significant difference in efficacy was found. The most striking difference was seen in the side-effects: baclofen frequently caused more or less severe muscle weakness and even falling during walking and standing. Treatment with tizanidine produced an apparent improvement of mobility in some patients suffering from moderate or marked paresis associated with a marked spasticity of their legs. Isometric muscle strength did not show any significant changes during either treatment. The different impact of baclofen and tizanidine on mobility and weight support seems to be related to their different site of action in spasticity.

Adult↗
PubMed1987

Cognitive impairment in patients with multiple sclerosis and mild physical disability.

Forty mildly disabled and clinically stable patients with multiple sclerosis (MS), representative of the corresponding population in Northern Holland, with disability Status Scale scores evenly distributed within the 1 to 4 range, were compared with 40 age-, sex-, and education-matched normal controls on a battery of neuropsychological tests. Apart from impairments in perceptual-motor functioning, generally mild deficiencies in intelligence and, specifically, in memory were displayed in the MS group. Attentional processes appeared uncompromised. Increasing fatigue during testing could not account for poor performance. The memory deficits could be attributed to poor initial learning, although there was also evidence suggesting that accelerated forgetting of what had been learned may appear with the progression of MS. Seven patients (17.5%), as compared with none of the controls, were classified by blind clinical judgement of test performance as definitely impaired.

Adult↗
PubMed1987

Bed rest and ACTH in the treatment of exacerbations in multiple sclerosis patients.

The effect of treatment with bed rest only and bed rest combined with ACTH was studied retrospectively in 55 multiple sclerosis (MS) patients suffering from 99 relapses. No convincing arguments in favour of the combination with ATCH over bed rest alone were found. A review of the literature on the treatment of exacerbations in multiple sclerosis patients with bed rest and ATCH is given.

Adrenocorticotropic Hormone↗
PubMed1987

Acquired brain damage and driving: a review.

Five issues in evaluating driving ability after brain damage were addressed through a review of the literature. Some preliminary conclusions were reached: (1) about half of all subjects studied still hold a valid driver's license; (2) brain-damaged drivers could not, in general, be seen as risky drivers, although some individuals show decreased driving skill and risky behavior in traffic; and (3) statistics show no increase in traffic violations or accidents in groups of neurologic patients with acquired brain lesions or diseases. Frequently noted problems of brain-damaged drivers include poor judgment of traffic situations, impulsivity, and visuospatial impairments. Traditional psychologic tests have insufficient predictive value regarding fitness to drive. It is suggested that new techniques be developed to enable more valid statements about the skills needed for safe traffic participation. These assessment techniques should emphasize the higher cognitive levels in driving, ie, the tactical and strategic levels. At the moment, driver training programs in rehabilitation focus mainly on the operational level, with emphasis on handling the car, use of controls and mirrors, and technical adaptation of the vehicle.

Activities of Daily Living↗
PubMed1986

T-lymphocyte subpopulations in peripheral blood of patients with multiple sclerosis, patients with other neurological diseases and healthy controls.

We report our results in profiling peripheral blood lymphocyte subpopulations with monoclonal antibodies in 17 multiple sclerosis (MS) patients, 22 patients with other neurological diseases (OND), and 11 healthy controls, using a blind experiment. Untreated patients with a chronic progressive MS have higher T-helper cell (OKT4+) counts and a higher ratio OKT4+/OKT8+ than other MS patients, OND or healthy controls. Two weeks after the onset of a relapse of MS there is a decreased T-helper and an increased T-suppressor cell percentage. Treatment with ACTH results in a significant increase of helper cells after 4 weeks of therapy. Patients with the lowest helper cell counts and the lowest helper/suppressor ratio show the best clinical improvement by ACTH. High OKT4+ cell percentages make a chronic progressive course of MS more probable.

Adrenocorticotropic Hormone↗