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Biomedical subjects

J Troost

Publications and source records attributed to J Troost.

At least 55 records · Page 3Linked to original sources

Epilepsy in a Dutch working population: are employees diagnosed with epilepsy disadvantaged?

The present study was designed to determine whether employees diagnosed with epilepsy, in contrast to comparable colleagues, encounter disadvantages in their professional careers. Attention was focused on education, job training, number of jobs performed, sickness absenteeism, accidents at work and wages. A group of 34 employees diagnosed with epilepsy was selected and compared with matched, non-epileptic colleagues. Slight differences between both groups were found for all items except for education. Only for wages was a statistically significant difference found. It is concluded that workers diagnosed with epilepsy and comparable colleagues both received the same educational and vocational training in order to reach their position. The data did not substantiate the proposition that employees diagnosed with epilepsy have poor attendance records, higher number of accidents in the workplace or that they are at a disadvantage in securing a job. However their salaries appear to be lower than the earnings of colleagues who hold comparable jobs.

Absenteeism↗

Radiofrequency lesions of the dorsal root ganglion in the treatment of hip flexor spasm: a report of two cases.

The current popular model of spasticity is that the abnormalities are primarily due to increased sensitivity of the reflex are at the segmental level of the spinal cord. Neurosurgical procedures, such as open selective dorsal rhizotomy for the reduction of spasticity, have been based on this assumption. We describe two patients with hip flexor spasm of different origin treated with radiofrequency lesions of the dorsal root ganglion.

Adolescent↗

[Value of treatment of low-grade glioma still controversial].

There is debate in the literature on the treatment of low-grade glioma, especially regarding the role of radiotherapy. Several retrospective analyses have demonstrated longer survival and delayed tumour recurrence in patients treated with radiotherapy. However, radiotherapy may bring about adverse events, especially in long-term survivors. In four patients, a women of 54 and three men of 51, 31 and 16 years old, a low-grade glioma was diagnosed. In three, expectative therapy, combined with antiepileptic drugs, or with radiotherapy and partial tumour resection (n = 1) led to a period of many years without symptoms. In the fourth, total tumour resection followed by radiotherapy did not prevent recurrence of the tumour and death of the patient.

Adolescent↗

[Cervical myelopathy as complication of manual therapy in a patient with a narrow cervical canal].

A 31-year-old man had manipulative therapy because of pain in the neck, the left shoulder and the left arm. Immediately after cervical traction he developed neurological symptoms. Clinical investigation led to the diagnosis of cervical myelopathy. The patient had a rather narrow cervical canal. Six weeks after treatment with external fixation and corticosteroids the situation had improved markedly, with remaining hypesthesia in both hands and the right leg.

Adult↗

Vigabatrin in the treatment of infantile spasms.

The anti-epileptic effect of vigabatrin as a first choice therapy was investigated in 6 children suffering from infantile spasms (IS). All 6 children showed a reduction in seizure frequency. Three children became seizure-free within a period of 2 weeks. Because our results suggest "an all or nothing phenomenon", a period of 2 weeks may be sufficient to evaluate the efficacy of vigabatrin in untreated infants suffering from IS. We suggest to use vigabatrin as a first choice anti-epileptic drug in infants with IS.

Aminocaproates↗

Gammahydroxybutyrate and narcolepsy: a double-blind placebo-controlled study.

We treated 24 patients with narcolepsy for 4 weeks with gammahydroxybutyrate (GHB), 60 mg/kg/night, in a randomized double-blind placebo-controlled cross-over trial. Both clinical and polysomnographic criteria were used to assess the results. Compared to placebo, GHB reduced the daily number of hypnagogic hallucinations (from 0.87 to 0.28; p = 0.008), daytime sleep attacks (from 2.27 to 1.40; p = 0.001) and the severity of subjective daytime sleepiness (from 1.57 to 1.24 on a 0-4 scale; p = 0.028). The number of daily cataplexy attacks was reduced from 1.26 at baseline to 0.56 after 4 weeks of GHB intake. This reduction, however, was not statistically significantly different from the difference between baseline and placebo. GHB stabilized nocturnal rapid eye movement (REM) sleep, i.e. it reduced the percentage of wakefulness during REM sleep (p = 0.007) and the number of awakenings out of REM sleep (p = 0.016), and tended to increase slow wave sleep (p = 0.053). Adverse events were few and mild. We conclude that GHB is an effective and well-tolerated treatment for narcolepsy.

Adolescent↗

Generalized mastocytosis and neurological complications in a 71-year-old patient.

A woman born in 1917 presented with recurrent urticaria since childhood. In the course of her life she developed urticaria pigmentosa, followed by generalized mastocytosis involving the bones, gastro-intestinal tract, and liver. At the age of 71 years neurological symptoms of cranial nerves necessitated hospital admission. Within a month a concomitant conus medullaris syndrome caused sphincter dysfunction and sacral sensory disturbances. No cause or secondary abnormalities were found on myelography, CT and MRI of the brain and the spinal cord, and in the CSF.

Aged↗

Ritanserin, a 5-HT2 receptor blocker, as add-on treatment in narcolepsy.

In a double-blind placebo-controlled trial, ritanserin (a 5-HT2 receptor blocker) 5 mg/day or placebo was added to the usual medication in 28 patients with narcolepsy during 4 wk. The effect was assessed by means of polysomnography, daily and weekly subjective evaluations, and Multiple sleep latency tests (MSLT). During the night ritanserin increased the amount of nonrapid eye movement slow wave sleep and reduced wakefulness after sleep onset. It improved the feeling of being refreshed in the morning after awakening and reduced subjective daytime sleepiness. The drug did not significantly influence sleep latency in the MSLT.

Adolescent↗

EEG signs of cerebrovascular disorder, using physical exercise as a provocative method.

A group of patients suffering from cerebrovascular insufficiency was submitted to a pilot EEG investigation using physical exercise as a provocative method. Two control groups, one of young (20--30 years) and another of older (more than 50 years) subjects, were also investigated. Quantitative EEG spectral data, determined at rest and during a period after physical exercise, showed that deviations of the frequency distribution of the alpha band were related to cerebrovascular insufficiency.

Adult↗

[Fucosidosis].

Explore the source record for details and available documents.

Fabry Disease↗

Fucosidosis. II. Ultrastructure.

The ultrastructural changes of a sural nerve biopsy, liver biopsy and the autopsy of a case (I) of fucosidosis are described. Light microscopy revealed the presence of foam cells in various organs. The contents of the vacuoles stained positive with P.A.S. and Sudan. Electron microscopical examination showed inclusions in hepatocytes, Schwann cells and neurons. These inclusions had a single limiting membrane and contained heterogeneous structures, vesicular, multivesicular and membrane like structures, forming concentric lamellae. In another patient (case III) with a different clinical presentation and a different enzyme pattern (a reduced alpha-L-fucosidase activity, in combination with a reduced arylsulfatase A activity) similar abnormalities as in case I were found in a sural nerve and liver biopsy. It is suggested that the combined reduction of enzyme activity is responsible for the disease.

Autopsy↗