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Biomedical subjects

R Brand

Publications and source records attributed to R Brand.

At least 181 records · Page 10Linked to original sources
PubMed1988

Maternal and neonatal transport: results of a national collaborative survey of preterm and very low birth weight infants in The Netherlands.

In a Dutch national collaborative study on 1338 infants, born in 1983 after a pregnancy of less than 32 weeks and/or with a birth weight of less than 1500 g, a comparison was made between maternal transport to university hospital perinatal centers and delivery in local or regional general hospitals and between neonatal transport to university hospital neonatal centers and treatment in local or regional general hospitals. The risk of mortality was investigated by means of logistic regression analysis including 27 perinatal risk factors as confounding variables. The results showed that infants born after maternal transport to centers had a significantly lower mortality risk. Infants treated in centers after neonatal transport had a lower mortality risk as well, but this was not statistically significant at a .05 level. The results of the study confirm that referral by maternal transport to level III centers offers the best prospects for high-risk preterm infants.

Female↗
PubMed1988

IgA containing immune complexes and hematuria in ankylosing spondylitis. A prospective longitudinal study.

The occurrence of circulating immune complexes containing IgA (IgA-IC) was studied in groups of patients with ankylosing spondylitis (AS) selected for the presence or absence of hematuria. In studies done with 4 kinds of assays, IgA-IC were found more frequently and in higher titers in the 18 patients with AS with hematuria than in the 40 patients with AS without hematuria. Comparison of clinical indices of disease activity in these patient groups showed that the disease was more active in patients with AS with hematuria. Our findings confirm those made in a previous retrospective study on the relation between hematuria and circulating IgA-IC in AS and suggest that circulating IgA-IC play a role in the pathogenesis of hematuria in AS.

Adult↗
PubMed1988

Mortality in very preterm and very low birth weight infants according to place of birth and level of care: results of a national collaborative survey of preterm and very low birth weight infants in The Netherlands.

As part of a collaborative project in the Netherlands in 1983, for which data were collected on 1,338 newborn infants (less than 32 weeks' gestation and/or less than 1,500 g birth weight), all infants were assigned to one of three levels of care according to hospital of birth. Considerable centralization was achieved by antenatal and neonatal transport. Although the uncorrected mortality rates were similar, the mortality odds (adjusted for four and 22 potential confounding perinatal factors, respectively) were significantly higher in level 1 and level 2 hospitals compared with level 3 hospitals (tertiary perinatal care centers). By extending the facilities for full perinatal intensive care in level 3 centers and thus providing optimal care for all such infants, the overall mortality rate is expected to decrease further.

Female↗
PubMed1987

Testis-specific beta 2 tubulins are identical in Drosophila melanogaster and D. hydei but differ from the ubiquitous beta 1 tubulin.

In Drosophila as in many organisms beta tubulins are encoded by a gene family. We have determined the complete nucleotide sequences coding for the beta 1 and beta 2 tubulins of Drosophila melanogaster and the beta 2 tubulin of D. hydei, and found these insect beta tubulins to be highly conserved and like beta tubulins of other organisms. This is discussed with reference to the possible functional domains of these proteins. The beta 1 tubulin gene of Drosophila is constitutively expressed, whereas the beta 2 tubulin is expressed specifically in the testes. In D. melanogaster the amino acid sequences of these proteins are 95% homologous, differing at only 25 positions. In the testes the beta 2 tubulin participates in different microtubules as shown by genetic analysis (Kemphues et al. 1982). Interestingly, all of the amino acids characteristic of the testis-specific beta 2 tubulin are also present in the corresponding gene of D. hydei. Of special interest is the high degree of conservation of the carboxy-terminal domain in these functionally equivalent beta tubulins.

Amino Acid Sequence↗
PubMed1987

Incidence and prediction of periventricular-intraventricular hemorrhage in very preterm infants.

During a prospective national survey of mortality and morbidity in infants born before 32 weeks gestation in the Netherlands in 1983, the incidence of periventricular-intraventricular hemorrhage (PIVH) was studied with ultrasound, in 484 of those infants. Stepwise logistic regression analyses were used to examine the predictive value of several maternal, prenatal and postnatal factors for the development of neonatal PIVH. PIVH was detected in 140 infants (28.9%); of these, 36 were grade I, 39 grade II, 22 grade III and 43 grade IV. The mortality rate increased from 3 to 84% with increasing severity of PIVH. Gestational age appeared to be the strongest predictive factor for both incidence and severity of PIVH, followed by idiopathic respiratory distress syndrome (IRDS), prolonged rupture of membranes and birth weight. Of the maternal and prenatal factors studied, only prolonged rupture of membranes (greater than 24 hours) and preeclampsia appeared to influence the risk of developing PIVH. Both were associated with a 50% reduction in the incidence of PIVH. None of the intrapartum factors studied showed a significant association with subsequent development of PIVH. Development of IRDS appeared to result in a twofold increase in the incidence of PIVH.

Birth Weight↗
PubMed1986

Neonatal mortality risk in relation to gestational age and birthweight. Results of a national survey of preterm and very-low-birthweight infants in the Netherlands.

In a cohort of 1338 very preterm and/or very-low-birthweight infants, representing 94% of all infants born alive after less than 32 weeks' gestation or weighing less than 1500 g in the Netherlands in 1983, the neonatal mortality rate was 233 per 1000. In these infants, the best obstetric estimate of gestational age was a better predictor of neonatal mortality than birthweight. In such pregnancies, careful obstetric assessment of gestational age seems to be a more accurate basis for clinical decisions and management than the expected birthweight.

Birth Weight↗
PubMed1983

The immunocytochemical demonstration of human placental lactogenic hormone (hPL): a parameter for the functional capacity of the trophoblast.

Forty-two placentae from pregnancies of 36 to 42 weeks' gestation were examined: the maternal serum human placental lactogen (hPL) values of the mothers during the last week of gestation ranged between 3 and 12 micrograms/ml. hPL was demonstrated by the indirect immunofluorescence technique and was present in all placentae. A significant regional difference in hPL concentration was not found, but within individual sections focal differences in intensity were apparent. Of intensity group I (weakly positive) 92 per cent correlated with maternal serum hPL values of 3 to 6 micrograms/ml; 78 per cent of group II/III (very strongly positive) with values above 6 micrograms/ml. In the four-field Chi-square test the probability of error was at 5%. In 32 cases trophoblast islands (Islands of Ortmann) were present, of which 20 were hPL positive. Their degree of intensity corresponded to group I of the syncytiotrophoblast. Of the placentae showing hPL-positive Islands of Ortmann, 95 per cent correlated with maternal serum hPL values below 6 micrograms/ml whilst 70 per cent of the hPL-negative trophoblast islands correlated with serum values above 8 micrograms/ml. It is suggested that maternal serum hPL values are determined by the rate of synthesis of hPL by the placenta and not by the rate of secretion. The focal differences in intensity indicates that the serum level does not only depend on the absolute surface area of the trophoblast, but that there also exist qualitative and functional differences between different areas of the syncytiotrophoblast. Heterotopic hPL synthesis in the Islands of Ortmann is considered to be independent of hPL synthesis by the syncytiotrophoblast.

Female↗
PubMed1982

Morphometric characterization of diffuse large-cell (histiocytic) lymphomas.

From 28 large-cell lymphomas, defined by marker studies, enzyme histochemistry, and electron microscopy as large noncleaved follicle center cell tumors (lnc FCC), B-immunoblastic or true histiocytic lymphomas, morphometric cell parameters, including nuclear size and shape, cytoplasmic area, and cytoplasm-to-nucleus ratio, were measured. Moreover, size, number, and location of nucleoli in the nuclei of the characteristic cells of lnc FCC and B-immunoblastic lymphoma were determined. Statistical evaluation of the data showed the nuclear shape to be the most sensitive parameter in the differentiation of true histiocytic lymphoma from lnc FCC and B-immunoblastic lymphomas. With nucleolar parameters lnc FCC could be differentiated from B-immunoblastic lymphoma: lnc FCC had a higher mean number of nucleoli per cross-section of nucleus and more eccentrically located nucleoli. Moreover, the measurements show that the differences in number and location of nucleoli between large noncleaved follicle center cells and B-immunoblasts are smaller than generally described in the literature. Our results show that it is possible to differentiate by morphometry between lnc FCC, B-immunoblastic, and true histiocytic lymphomas.

Analysis of Variance↗
PubMed1979

Use of treadmill score to quantify ischemic response and predict extent of coronary disease.

In this study we assessed whether various responses to exercise testing could be quantified in order to derive the probabilities of presence of coronary disease, and if present, to assess its severity. A treadmill score based on the exercise response was determined in 405 patients who had both treadmill tests and coronary angiograms. The score was derived using discriminant function analysis, by weighting and combining depth and configuration of ST depression (downsloping, horizontal or slowly upsloping), timing onset and duration of ischemia, grading ventricular arrhythmias, heart rate and blood pressure change, coexistence of exercise-induced chest pain and sex. The treadmill score was effective in detecting coronary disease (lesions with an greater than or equal to 50% narrowing), with a predictive accuracy (PA) (probability that a subject manifesting a positive test has disease) of 87%, a true negative rate (TNR) (probability of a subject with a negative test having no disease) of 80%, and sensitivity of 94%. The treadmill score also detected severe disease (triple-vessel, main left and/or greater than 90% proximal occlusion of the left anterior descending artery), with a PA of 73%, TNR of 79% and sensitivity of 82%. We conclude that the exercise response, expressed numerically as a treadmill score, permits analysis of most of the relevant data from exercise testing, increases test accuracy by 10-15% compared with standard criteria for treatmill test interpretation, and enables the derivation of probability statements for presence and severity of coronary disease. The validity of any prediction on the basis of exercise performance may thus be quantitatively judged.

Analysis of Variance↗
PubMed1976

St.Agnes--the first year as the team sees it.

The St. Agnes Community Health Centre was established in October 1974, in the rapidly growing area of Tea Tree Gully, South Australia. It was built to provide additional facilities to an already existing comprehensive medical centre. The embryo centre is described during the first year of operation through the eyes of the health team.

Australia↗
PubMedDate not supplied

Acute renal insufficiency and renal replacement therapy after pediatric cardiopulmonary bypass surgery.

The aim of the study was to investigate renal function and renal replacement therapy after cardiopulmonary bypass surgery in children. Patient characteristics (sex, age, diagnosis), operation type, and death were listed. The study was performed retrospectively using serum creatinine level before, and peak values after, cardiopulmonary bypass surgery for assessment of renal function. Of the children on renal replacement therapy, indication, efficacy, and complications were recorded. In a 5-year period, 1075 children had cardiopulmonary bypass surgery at the Department of Cardiothoracic Surgery at Leiden University Medical Center and Academic Medical Center of Amsterdam. One-hundred eighty (17%) patients developed acute renal insufficiency. Twenty-five (2.3%) patients required renal replacement therapy. Peritoneal dialysis is a safe and effective treatment for children after cardiopulmonary bypass surgery. However, 15 (60%) of 25 children on renal replacement therapy died of nonrenal causes. In 9 out of 10 surviving children, renal function was normal at time of discharge from hospital. Acute renal insufficiency is a frequent complication after open-heart surgery, although renal replacement therapy was infrequently necessary. Peritoneal dialysis is a safe and effective therapeutic measure for children after cardiac bypass surgery.

Acute Kidney Injury↗
PubMedDate not supplied

Breast-feeding and acute otitis media.

INTRODUCTION: The risk of acute otitis media (AOM) is estimated as a function of a number of covariates, with special emphasis on changes to this risk after breast-feeding is discontinued. MATERIALS AND METHODS: Two hundred eighty-nine children born between July 1987, and October 1988, were studied up to the age of 24 months. The enrollment of the children took place during their regular check-up visits at three different child health care centers. RESULTS: The risk of AOM was significantly decreased until 4 months after breast-feeding was discontinued; then, without the protective effect of breast-feeding, and with increasing months, the children approached the risk level estimated in the group of children who were never breast-fed. Approximately 12 months after breast-feeding was discontinued, the risk was virtually the same as if the child had never been breast-fed. The risk of AOM was also significantly dependent on the infant's number of siblings and socioeconomic status. CONCLUSION: The risk of AOM depends on the number of months an infant is breast-fed and the number of months that pass after breast-feeding is discontinued.

Acoustic Impedance Tests↗
PubMedDate not supplied

Glenohumeral osteoarthrosis after Putti-Platt repair.

The Putti-Platt capsulorraphy for recurrent anterior dislocation of the glenohumeral joint was performed in 139 shoulders between 1955 and 1985. Sixty-six (46%) operated shoulders were studied with a mean follow-up period of 22 years (range 10 to 40 years). There were 52 shoulders of men and 14 shoulders of women; 45% of the shoulders were on the dominant side. Two patients underwent surgery on both shoulders. The average age of the patients was 49.3 years (range 33 to 74 years). Evaluation was based on patient history and the results of physical examination and radiography. The redislocation rate was low (only 3%), and 71% of the patients did not have pain, strength loss, stiffness, or instability in the operated shoulder. Radiographs were made of all shoulders, including the nonoperated shoulders. Osteoarthrotic changes of the glenohumeral joint were found in 40 (61%) shoulders. Arthrosis was mild in 23 (35%) shoulders, moderate in 13 (20%) shoulders, and severe in 4 (6%) shoulders. The rate of glenohumeral arthrosis is increased in patients who have undergone a Putti-Platt procedure and is positively correlated with the length of time since surgery. No correlation was found in this study between external rotation at 6 months after operation and the development of glenohumeral arthrosis. The number of dislocations before operation was correlated with the severity of arthrosis but not with its incidence.

Adolescent↗