Biomedical subjects

M P Derde

Publications and source records attributed to M P Derde.

At least 37 records · Page 2Linked to original sources

PubMed1995

Study of nasal cytology in atopic patients after nasal allergen challenge.

In order to study the normal and pathological inflammatory cell population in nasal secretions, nasal microsuction has been performed in 18 atopic patients and 10 healthy volunteers after nasal allergen and/or PBS challenge. After cytospin, the samples have been stained with May-Grünwald-Giemsa solution. Three hundred inflammatory cells have been counted by light microscopy, and the percentage of each cell type has been calculated. Results show that only a significant increase (p < 0.01) in the percentage of eosinophils 1-10 h after nasal allergen challenge occurs. In general, this finding correlates well with the symptom of nasal obstruction as measured by passive anterior rhinomanometry (PAR) during the late phase, but not with the number of sneezes. In agreement with the literature, late-phase nasal obstruction is shown to be accompanied by an increase in the percentage of eosinophils in nasal secretions. The potential role of eosinophils in the pathogenesis of the late phase in the inflammatory events after nasal allergen challenge has again been confirmed by our study. This study further confirms the usefulness of nasal microsuction as a sampling technique, providing uniform and adequate nasal cytological specimen for the analysis of nasal cytology.

Adult↗

PubMed1995

Chronic nasal obstruction in children. A fiberscopic study.

In this prospective study, fiberscopies were gently performed in 375 paediatric patients. The purpose of the study was to evaluate the nasal and nasopharyngeal anatomy and aetiologies of chronic nasal obstruction using fiberoptic examination in children. The essential advantage of this examination is that it allows a more thorough inspection of these cavities. The authors demonstrated that there exists a significant relationship between the relative size of the adenoid tissue and nasal obstruction complaints in children (p < 0.001). When the presence of adenoid hypertrophy was confirmed endoscopically, surgery proved to be highly efficacious in relieving chronic nasal obstruction.

Adenoidectomy↗

PubMed1994

Abbreviated oesophageal pH monitoring in infants.

The results of 24 h oesophageal pH monitoring, performed in 129 infants aged 6-10 weeks, were compared to those in the same patients after shorter periods (3, 6, 9 and 12 h). In the investigated population there was no significant difference between the reflux index (percentage of time with a pH < 4.0) after 12 or 24 h. Moreover, the correlation coefficient between the reflux index after 12 and 24 h was excellent (r 0.95). However, the intra-individual difference in reflux index after 12 and 24 h was 5% in 19% of the infants, and even exceeded 10% in more than 5% of the infants, making the interpretation of the results unreliable. Even in this particular population of infants in whom a 24-h period could be divided into almost identical periods (including a feeding and a sleeping period), 24-h registrations provided the most reliable results. However, if for some reason the investigation had to be interrupted after a minimum of 12 h, the risk for erroneous interpretation of the data appeared to be acceptable. The results of this study must not be extrapolated to older children.

Esophagus↗

PubMed1994

Evaluation of the possibilities for preventing congenital toxoplasmosis.

Little is known about the best way to prevent congenital toxoplasmosis. Until recently, the major effort was directed at preventing the disease during pregnancy by the application of hygienic measures (primary prevention). With the advent of detecting congenital toxoplasmosis antenatally, another method for reducing the incidence of congenital toxoplasmosis becomes possible (secondary prevention). In this study, we evaluate these two methods for the prevention of congenital toxoplasmosis. For 12 consecutive years, we studied the incidence of congenital toxoplasmosis in 11,286 consecutive pregnant women. The impact of primary prevention was studied by measuring the reduction in seroconversion when hygienic measures were systematically applied. Primary prevention reduces the seroconversion rate during pregnancy by 63% (P = 0.013). The effect of secondary prevention was studied in 76 pregnant women at risk of delivering a child with congenital toxoplasmosis. Secondary prevention by means of serological screening combined with prenatal diagnosis detected congenital toxoplasmosis correctly in eight infected fetuses. Secondary prevention reduced the incidence of congenital toxoplasmosis an additional 40%. This reduction would predominantly be seen in the group of mildly to severely affected fetuses. From this study, the effectiveness of primary prevention is obvious. Health education on how to avoid toxoplasmosis during pregnancy should become standard obstetric care. Adequate serological screening and prenatal diagnosis can be helpful in reducing further the incidence of congenital toxoplasmosis. Whether or not screening for toxoplasmosis during pregnancy should be combined with primary prevention depends on the importance of congenital toxoplasmosis as a health problem in a given geographic area.

Belgium↗

PubMed1994

Captopril treatment of chronic heart failure in the very old.

BACKGROUND: The safety and efficacy of angiotensin-converting enzyme inhibitors for very old patients with chronic heart failure have been less well documented than for younger patients. METHODS: A prospective, randomized double-blind, placebo-controlled study of captopril, 25 mg twice daily, was designed. Fifty patients (mean age 84.2 +/- 5.2) participated. The degree of chronic heart failure (according to the Boston Study Group rating), the distance walked in 6 minutes, and the occurrence of uncontrolled heart failure and adverse reactions were used as main outcome measures. RESULTS: Significantly more patients receiving placebo developed uncontrolled heart failure than patients receiving captopril (p = .022). In an intention to treat analysis, the first and last evaluations of the degree of chronic heart failure were compared. A significantly different evolution was observed between the two treatment groups (p < .001), with a significant improvement only in the captopril-treated patients (p < .001). The distance walked in 6 minutes improved significantly only in the captopril group (p = .004). The only adverse reaction was rash in two patients receiving captopril. CONCLUSIONS: The study gives further evidence that angiotensin-converting enzyme inhibitor treatment for very old patients with chronic heart failure is useful.

Aged↗

PubMed1994

'To bathe or not to bathe' during the first stage of labor.

OBJECTIVE: Does a warm tub bath relieve labor pain? How is it experienced by the parturient? METHODS DESIGN: prospective randomised trial. SETTING: labor ward of a teaching hospital with a uniform active labor management. PARTICIPANTS: one hundred and ten nulliparous low risk women, at term, in true spontaneous labor. Fifty-four women had a bath, 56 women served as controls. MEAN OUTCOME MEASURES: labor pain (assessed by means of a visual analogue scale) and post partum patients' bathing experience (by means of a self-made questionnaire). RESULTS: The study group and the control group were comparable with respect to maternal age, weight, length, duration of gestation, cervical status and labor pain sensation before randomisation. Absolute values of labor pain were not statistically different between the two groups, yet this latter progressed differently: in the bathing group the initial pain sensation (V.A.S.) was 6.8, and this remained stable during the first 25 minutes (V.A.S. = 6.7) and then rose to 8.2 after a mean of 53 minutes. In the control group, labor pain rose progressively from 6.3 to 7.3 after 25 min and to 8.7 after a mean of 52 min (p < 0.01, Student t-test). There was no difference in the use of epidural analgesia. There were no differences in labor duration nor in the frequencies of either operative deliveries or neonatal complications. Eighty percent of the bathers experienced soothing of the pain and all but one reported body relaxation. Ninety percent wanted to bathe again during a next labor. CONCLUSION: Bathing provided no objective pain relief. It had, however, a temporal pain stabilizing effect possibly mediated through the improved ability to relax in between contractions. No side effects were found. It gives great satisfaction to users. Bathing, in conjunction with other forms of analgesia, is recommended.

Adult↗

PubMed1994

Epidural analgesia in active management of labor.

OBJECTIVES: To examine the determinants of epidural analgesia in the active management of labor. To examine the association of epidural with instrumental delivery and cesarean section. STUDY DESIGN: Observational study in a teaching hospital with a uniform active labor management and availability of epidural analgesia on demand. A thousand consecutive nulliparous women at term, were assessed. RESULTS: Requests for epidural anesthesia were predominantly expressed at the time the patient was notified that spontaneous labor was going to be augmented by the administration of oxytocin, or later, when this latter treatment caused labor to be subjectively more arduous. In induced labor, the same observation applied to a greater degree, still. Operative delivery was significantly more frequent in patients with epidural. However, when the incidence of operative delivery was adjusted for the use of oxytocin, the significance between patients with epidural versus the others abated. CONCLUSION: The use of oxytocin in active management of labor results in a high demand for epidural when this is available on demand. This, however, need not be associated with an increased incidence of operative delivery.

Adult↗

PubMed1994

Concentrations of chemical mediators in nasal secretions of patients with hay fever during natural allergen exposure.

By using the microsuction technique, quantitative determination of the chemical mediators in nasal secretions was performed in 40 patients with seasonal allergic rhinitis during the pollen season. The aim of this study was to investigate the actual concentrations of these important mediators in nasal secretions during natural allergen exposure so as to better understand the pathophysiology of allergic rhinitis. The median concentrations of four mediators, were histamine: 51.5 ng/g (range: 4-146 ng/g); tryptase: 0 (range: 0-84 microU/g); leukotriene C4 (LTC4): 23 ng/g (range: 11-77 ng/g); and eosinophil cationic protein (ECP): 410 ng/g (range: 6-2380 ng/g). The authors compared these concentrations with those of the same mediator found in a previous study of seasonal allergic rhinitis patients after nasal challenge outside the pollen season. The present study demonstrates that during the season allergic rhinitis reflects a chronic state of allergic inflammation of the nasal mucosa involving various inflammatory mediators induced by one or more episodes of early type allergic reaction.

Adolescent↗

PubMed1994

Fiberoptic evaluation of the nasal and nasopharyngeal anatomy in children with snoring.

In this prospective study, fiberoptic examinations of the nasal cavity and nasopharynx were performed in 162 children with snoring and compared with similar examinations performed in 211 children without snoring. Our study aimed to determine a correlation between snoring and measured parameters of nasal and nasopharyngeal anatomy including the size of the adenoid tissue. Results have confirmed significant evidence that adenoid hyperplasia is the commonest etiologic factor in children with snoring (p < .001). In addition, an important statistical relevance of mouth breathing in snoring was demonstrated (p < .001). It seemed that mouth breathing is a basic condition in children's snoring. It is essential to both confirm that mouth breathing occurs, and then, to institute an appropriate treatment as a therapeutic approach for children with snoring. The introduction of the flexible fiberscope in the fields of pediatric examination of the nasal cavity and nasopharynx has proved to be of great clinical value.

Adenoids↗

PubMed1993

Sperm characteristics and outcome of human assisted fertilization by subzonal insemination and intracytoplasmic sperm injection.

OBJECTIVE: To investigate the influence of sperm characteristics on the treatment by subzonal insemination (SUZI) and intracytoplasmic sperm injection of couples with severe male infertility. DESIGN: A retrospective analysis of 300 consecutive cycles of assisted fertilization concerning 202 infertile couples was performed. One hundred fifty-three couples underwent 362 unsuccessful IVF cycles, whereas on 49 couples IVF was not performed because of poor sperm characteristics. SETTING: Procedures were performed in an institutional research environment. PATIENTS, PARTICIPANTS: Couples in which the male partner was the presumed cause of repeated failure to achieve conception by IVF or in which seminal parameters were unacceptable for IVF. INTERVENTIONS: Three hundred transvaginal oocyte retrievals were performed after superovulation by GnRH agonist and gonadotropins. MAIN OUTCOME MEASURES: After SUZI and intracytoplasmic sperm injection the following parameters were evaluated: fertilization, cleavage, pregnancy, and implantation rates in relation to the sperm parameters and the proportion of acrosome-free spermatozoa after different treatments. RESULTS: Normal fertilization occurred in 18% of the oocytes treated by SUZI and in 44% after intracytoplasmic sperm injection. Only the treatment by electroporation showed a positive correlation with the fertilization rate. Fourteen pregnancies were obtained after SUZI, 8 pregnancies after intracytoplasmic sperm injection, and 8 pregnancies after a combination of the two procedures. A score calculated from the sperm parameters after selection correlated with the fertilization obtained after SUZI, whereas a score calculated from the parameters before sperm selection correlated with the pregnancy rate. Sperm morphology influenced the implantation rate of the embryos obtained with these two procedures. CONCLUSIONS: Intracytoplasmic sperm injection and SUZI can successfully treat couples who fail IVF or who cannot benefit from IVF. Different treatments can be applied to semen samples to increase the number of acrosome-reacted spermatozoa. The few significant relations found between sperm characteristics and the outcome of assisted fertilization cannot predict the outcome.

Adult↗

PubMed1993

Higher success rate by intracytoplasmic sperm injection than by subzonal insemination. Report of a second series of 300 consecutive treatment cycles.

Subzonal insemination (SUZI) and intracytoplasmic sperm injection (ICSI) were carried out in 300 treatment cycles in couples unable to be helped by conventional in-vitro fertilization treatment. More oocytes were damaged by ICSI (13.5%) than by SUZI (7.1%). The normal fertilization rate was substantially higher after ICSI (51.0%) than after SUZI (14.3%) and was related to the semen characteristics. The cleavage rate was similar for both procedures (77%). After 217 embryo transfers (72.3% of the treatment cycles) 66 pregnancies were established, i.e. pregnancy rates of 22.0% per started cycle and 30.4% per embryo transfer. So far, pregnancy loss has occurred in 27.3% of the pregnancies, nine healthy children have been born after eight deliveries and 41 clinical pregnancies are progressing uneventfully. Chorionic villus sampling or amniocentesis have been performed in 35 pregnancies and 39 normal fetal karyotypes have been obtained after cytogenetic analysis.

Female↗

PubMed1993

Lens tube vs Donaldson tube: results of a prospective study comparing a new with a conventional ventilation tube.

A prospective study was undertaken in 72 children comparing a new type of tympanostomy tube, the Lens tube, in one ear, and a Donaldson tube in the contra-lateral ear as a control. The average survival times of the tubes differed significantly: 17.20 months for the Lens tube, and 11.31 months for the Donaldson tube (P < 0.001). By contrast, the relapse rate (22% with the Lens tube vs 21% with the Donaldson tube) after extrusion or extraction, and the residual perforation rate (3% with the Lens tube vs 6% with the Donaldson tube) were not significantly different. Otorrhea was not significantly different either: 25% with the Lens tube vs 16% with the Donaldson tube.

Adenoidectomy↗

PubMed1993

Prevention of adjustment disorders and anticipatory nausea secondary to adjuvant chemotherapy: a double-blind, placebo-controlled study assessing the usefulness of alprazolam.

PURPOSE AND METHODS: Although a high prevalence of adjustment disorders and anticipatory nausea secondary to adjuvant chemotherapy (CT) has been reported, little has been done to develop strategies to prevent these problems. A double-blind, placebo-controlled study was therefore designed to assess the usefulness of adding low-dose alprazolam (0.5 mg to 2 mg per day) to a psychologic support program including progressive relaxation training designed to prevent the aforementioned conditions. Fifty-seven women undergoing adjuvant CT for stage II primary breast cancer agreed to participate in the assessment, which was conducted at four time points: before starting CT, 6 weeks after CT, before the fourth CT, and after the fourth CT. The Hospital Anxiety and Depression Scale (HADS), Montgomery and Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Scale (HAS), Revised Symptom Checklist (SCL-90-R), Morrow Assessment of Nausea and Emesis (MANE), and World Health Organization (WHO) grading of acute and subacute toxicities were used to compare the alprazolam (AA) and placebo (PA) arms of the study. RESULTS: At the second evaluation, the results showed a higher rate of anticipatory nausea (18% v 0%) in the PA compared with the AA arm (P = .038). These differences were no more significant at each of the further assessments. Significant differences were found for the intake of hypnotics at each assessment visit, with the rate of hypnotic users being significantly higher in the PA (19%) compared with the AA (0%) arm at the fourth assessment (P < .05). Anxiety and depression scores of self- and observer-report were similar in the two arms. A significant relationship was found between the development of anticipatory nausea and the self-report of anxiety and depression score measured by HADS at baseline. The average HADS total score at baseline was 15.33 (SD = 6.56) for patients who developed anticipatory nausea and 11.23 (SD = 6.67) for other patients. CONCLUSION: The adjunct of alprazolam to a psychologic support program delays the occurrence of anticipatory nausea and controls sleeping problems secondary to adjunct CT. Although studies are needed to improve the efficacy reported here, physicians may already consider the use of alprazolam for cancer patients undergoing CT.

Adjustment Disorders↗

PubMed1993

Laser Doppler resting fluxes, flux motion frequencies and amplitudes at the skin of the dorsum of the foot in healthy young humans.

The complex microvascular geometry and the spatially heterogeneous perfusion of the skin seem to limit the application of Laser Doppler flowmetry (LDF) in resting conditions because of the large spatial variations that these microvascular measurements can show in even very adjacent areas of the dermal mantle. In this study cutaneous LDF was carried out at three spatially different areas of the dorsum of the foot in 22 young (mean age 25.5 years) and healthy human subjects: microvascular resting flux, flux frequency and flux amplitude as well as the distal tissue perfusion pressure as a macrovascular parameter and the skin temperature were measured. Intraindividually marked variations of the microvascular variables often existed between the three areas, but the variability was significantly different (p < 0.001): the resting flux yielded a variation coefficient (VC) of 36.2%, the amplitude of flux waves a VC of 20.2%, while the frequency of flux waves was a very precise individual parameter (VC 7.4%). Interindividually the variation of all three flux parameters was still significantly greater than intraindividually, but the mean value of all the subjects was the same in all three areas: mean resting flux was resp. 2.32, 2.23 and 2.44 arbitrary units (AU); mean frequency of flux waves 5.15, 4.96 and 4.90 cycles min-1; mean amplitude of flux waves 0.34, 0.36 and 0.36 AU. At last, no correlation existed between any of the microvascular flux variables on the one hand and the distal tissue perfusion pressure and skin temperature on the other hand.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Immune changes induced by electroconvulsive therapy (ECT).

There is a significant increase in the percentage and absolute number of activated lymphocytes (OKT10+, IL2R1+) after ECT treatment of major depressive disorder. There is an acute decrease in the absolute number of total lymphocytes, T8+ and Leu11+ cells one hour after a single ECT.

Adult↗

PubMed1992

Fiberoptic examination of the nasal cavity and nasopharynx in children.

In this prospective study, a flexible fiberoptic nasolaryngoscope with color video camera was used to examine the nasal cavity and nasopharynx in 180 pediatric patients. The relative size of the adenoid tissue was judged by endoscopy, which lead to a classification into 3 types according to the distance from the vomer to the adenoid tissue. The condition of the nasopharyngeal orifice of the Eustachian tube was also described and differentiated into 3 types relating to the condition of adenoid tissue. Assessment was performed by correlating these measurements with the tympanogram, lateral X-ray and clinical complaints. The authors conclude that: (1) fiberoptic examination allows direct visualization of the size and condition of the adenoid tissue, as well as of the condition of the nasopharyngeal orifice of the Eustachian tube. (2) The size of the adenoid tissue correlates very well with the nasal obstruction complaints as well as with the type of tympanogram. (3) The condition of the nasopharyngeal orifice of the Eustachian tube significantly corresponds with the type of tympanogram. (4) For the indication of adenoidectomy, fiberscopy gives more accurate information than standard X-ray. (5) With a correct choice of premedication and local anesthesia, it is a minor invasive technique which is very well tolerated by children. It is possible in all cases, provided it is performed by a skilled endoscopist and preceded by careful explanation to the child. (6) Finally, thanks to the possibility of direct visualization of the fiberscopic image via a monitor, it allows a better explanation of the indication for adenoidectomy to the child's parents.

Acoustic Impedance Tests↗

PubMed1992

The value of dynamic color duplex scanning in the diagnosis of venogenic impotence.

To determine the value of color duplex scanning in the diagnosis of venogenic impotence we examined 53 patients. The control population consisted of 26 psychogenically impotent men and 8 normal potent men who all had a firm erection after pharmacological stimulation. There was no significant difference in the values of duplex parameters between these 2 groups. The venous leak population was characterized by a bad erectile response to pharmacological stimulation despite a good arterial compliance and by a persistent diastolic flow as shown by duplex scanning. There was a significant difference with the control population for the parameters of resistance index after 10 minutes (p = 0.001), minimal resistance index (p = 0.016) and corporeal volume increase (p = 0.010). There was a good correlation between the results of duplex scanning and those of pharmacocavernosography-pharmacocavernosometry (93%). We conclude that dynamic color duplex scanning can be used as a screening procedure to diagnose significant venous leakage in an objective manner with the resistance index.

Aged↗

PubMed1992

Evaluation of reflux episodes during simultaneous esophageal pH monitoring and gastroesophageal reflux scintigraphy in children.

Gastroesophageal pH monitoring and reflux scintigraphy were simultaneously performed in 65 children, who were being investigated for suspected gastroesophageal reflux disease. The aim of the study was to compare, peak per peak, the information provided by the two techniques during a 1-h simultaneous-recording period. During this period, 123 reflux episodes were recorded with both techniques, but only six occurred simultaneously. Significantly more reflux episodes were recorded on scintigraphy (n = 88; p less than 0.05), particularly during the first half-hour period (n = 62), if compared with the number of pH drops greater than 1 unit, even at pH levels higher than 4 (n = 41; p less than 0.05). It is concluded that the two techniques explore differently the reflux phenomenon.

Child↗