Biomedical subjects
Publications and source records attributed to P Moons.
Accurate differentiation of retro- or intraperitoneal localization of a primary abdominal tumor by US and CT is often difficult. In our case an abdominal mass was incidentally discovered and identified as a typical benign schwannoma, but with a very atypical location in the mesentery. We found that MRI was a valuable adjunct to CT for exact tumor localization.
BACKGROUND: Although noncompliance with immunosuppressive medication is recognized as a critical behavioral risk factor for late acute rejection episodes and graft loss after transplantation, little is known about the degree of subclinical cyclosporine noncompliance, its associated risk for acute late rejection episodes (>1 year after transplantation), and its determinants in heart transplant recipients. METHODS: The convenience sample of this longitudinal study included 101 European heart transplant recipients (87 men and 14 women), with a median age of 56 (Q1 = 50, Q3 = 61) and a median posttransplantation status of 3 (range 1 to 6) years. Subclinical cyclosporine noncompliance was measured during a 3-month period with electronic event monitoring. Selected sociodemographic, behavioral, cognitive, emotional, health, and treatment-related determinants of medication noncompliance were measured by using instruments with established psychometric properties or by patient interviews. With the use of iterative partitioning methods of cluster analysis, including nonstandardized electronic event monitoring compliance parameters, patients were categorized by degree of subclinical cyclosporine noncompliance into a 3-cluster solution. RESULTS: Overall compliance was high, with a median medication taking compliance of 99.4%. The 3 derived clusters, that is, excellent compliers (84%), minor subclinical noncompliers (7%), and moderate subclinical noncompliers (9%), differed significantly by degree of subclinical noncompliance (p < .0001) and showed a 1.19%, 14.28%, and 22.22% incidence of late acute rejections (p = .01), respectively. The 3 groups also differed in terms of former medication noncompliance (p = .02), appointment noncompliance (p = .03), and perceived self-efficacy with medication taking (p = .04). CONCLUSIONS: Although in absolute numbers cyclosporine compliance in this sample was high, minor deviations from dosing schedule were associated with an increased risk for acute late rejection episodes. This suggests a pivotal role of patient compliance in successful long-term outcome after transplantation.
A case of symptomatic adrenal pseudocyst due to recurrent hemorrhage is presented. Because of the hemorrhages, the cyst-like lesion had unusual appearances at US, CT and MRI, resembling a malignant cystic tumor.
Sports camps for children with cardiac anomalies have existed for many years. However, no formal evaluation of the benefits of attending such camps has been undertaken heretofore. We assessed potential changes in the self-perceived health of children with congenital heart disease who attended a special sports camp. Thirty-one children with cardiac anomalies attended a 3-day multisports camp. Sixteen children, all of whom were 10 years or older, literate, and Dutch- or French-speaking, completed the Child Health Questionnaire (CHQ-CF87) before and after attending the camp. The scores of the children were compared with those of healthy peers by calculating mean standardized differences. After attendance at the sports camp, the children achieved significant improvements in the self-perception of their physical functioning, role functioning due to emotional problems, role functioning due to behavioral problems, mental health, and general behavior. The children's self-esteem and general behavior after the camp were significantly better than that of their healthy counterparts. We conclude that children with congenital heart disease who participate in activities at special sports camps may reap benefits in terms of their subjective health status. Although further research is needed, we recommend the participation in sport activities by children with heart defects, and more specifically their participation in sports camps.
OBJECTIVE: To evaluate symptom experience related to side effects of immunosuppressive therapy in heart transplant recipients. METHODS: This descriptive, cross-sectional study included 105 heart transplant recipients (90 men; 15 women) with a median age of 56 years. Maintenance immunosuppression consisted of triple therapy (cyclosporine, corticosteroids, azathioprine). Symptom frequency and symptom distress were assessed by an adapted version of the Transplant Symptom Frequency and Symptom Distress Scale, which includes 27 symptoms associated with side effects of immunosuppressive therapy. RESULTS: The most frequent symptom for both sexes was increased hair growth. Impotence and painful menstruation were experienced as the most distressing symptoms for men and women, respectively. Women reported a significantly higher level of symptom experience. The majority of the most frequent and most distressing symptoms were corticosteroid associated. CONCLUSIONS: Patients' perception of side effects completes the symptomatologic profile of immunosuppressive therapy. A gender-specific evaluation is indicated because symptom experience differs between the sexes.
Rupture of an aneurysm of the sinus of Valsalva is an uncommon heart defect. A continuous murmur may be the first clinical sign of this rupture. Additional imaging techniques, and in the first place echocardiography, can be used to confirm the diagnosis. We present a case where, at the age 53 years, the diagnosis was made of a ruptured sinus of Valsalva into the right atrium, with a typical windsock image on echocardiogram. Although several cases of a ruptured sinus of Valsalva are reported in the literature, it is still an underdiagnosed condition because it is frequently missed during physical examination.