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Biomedical subjects

R J Odink

Publications and source records attributed to R J Odink.

At least 19 recordsLinked to original sources
PubMed2002

A lower prevalence of atopy symptoms in children with type 1 diabetes mellitus.

BACKGROUND: The Th1/Th 2 concept is a model to understand the pathophysiology of certain diseases. Atopic diseases (asthma, eczema and hayfever) are characterized by a chronic inflammatory reaction that is dominated by Th 2 cells, and type 1 diabetes mellitus (DM) is Th1 cell dominated. Because it is known that Th1 and Th 2 cells reciprocally counteract each other, it can be speculated that the prevalence of Th 2-mediated disease is lower in patients with Th1-mediated disease. OBJECTIVE: To compare the prevalence of atopic diseases between children with DM and age-matched controls. METHODS: Parents of children with DM were requested by Dutch paediatricians to complete the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire on the prevalence of atopic diseases. A control group was derived from a Dutch cross-sectional survey (the ISAAC2 study). RESULTS: We received 555 completed questionnaires, which is estimated to be 25% of the total number of Dutch children with DM. The control group consisted of 777 children. After age-matching, the questionnaires of 188 DM patients were used. Symptoms of asthma, hayfever and eczema were reported less in the group of children with DM compared with the control group (wheeze last year, OR 0.796, 95% CI 0.408-1.554; hayfever symptoms last year, OR 0.642, 95% CI 0.369-1.118; eczema symptoms last year, OR 0.693, 95% CI 0.430-1.115). CONCLUSION: The lower prevalence of astma, hayfever and eczema symptoms in DM patients compared with age-matched controls, although not statistically significant, is consistent with the Th1/Th 2 concept.

Asthma↗
PubMed2001

Postprandial chylomicron clearance rate in late teenagers with diabetes mellitus type 1.

A delayed chylomicron (CM) clearance rate, a known risk factor for atherosclerosis, has been described in adults with diabetes type 1 (DM1). We determined the CM clearance rate in late teenagers with DM1, and the relationship between CM clearance rate and elevated plasma lipid concentrations in DM1 teenagers in poor metabolic control (as characterized by HbA(1c) percentage). Plasma lipids and CM clearance were determined in nine patients with DM1 (mean age +/- SD: 17.5 +/- 0.6 y) and four healthy controls (mean age +/- SD: 20.1 +/- 0.8 y), by measuring breath (13)CO(2), plasma triglyceride, retinyl palmitate, and (13)C-labeled oleic acid concentrations, after oral administration of a fat-rich meal together with vitamin A and (13)C-oleic acid. In patients with DM1, fasting triglyceride and cholesterol concentrations were positively correlated with HbA(1c) percentage (p < 0.05). Neither in DM1 patients, nor in controls, was an elevated triglyceride concentration (above 1.7 mmol/L) found. Yet, in 22% of DM1 patients, cholesterol concentration was above 5.2 mmol/L, but not in any of the controls. CM clearance rate in DM1 patients was similar to that in controls and did not significantly correlate with HbA(1c) percentage. Fasting lipid concentrations in DM1 patients were not significantly correlated with CM clearance rate. Present data indicate that elevated lipid concentrations in late teenagers with DM1 are not attributable to a delay in CM clearance rate. A delayed CM clearance rate at late teenager age is not a risk factor contributing to the increased risk for atherosclerosis in DM1.

Adolescent↗
PubMed2000

Growth until puberty after in utero exposure to coumarins.

Anticoagulation with coumarins is an effective therapy during pregnancy. Fetal exposure to coumarin derivatives during the first trimester, however, is associated with skeletal anomalies (warfarin or coumarin embryopathy). Information about long-term effects of prenatal coumarin exposure on the skeletal development is not available. We investigated growth and body proportions at school age of children exposed to coumarins in utero. A blind population-based cohort study was conducted on 307 exposed children and 267 non-exposed controls ages 8-15 years. The exposed cohort was based on a prospective registry of coumarin-treated pregnant women. Anthropometric data included height, weight, head circumference, and measurements to evaluate body proportions. The mean height of exposed children did not differ from that of the non-exposed children (mean difference 0.01 SD). In addition, no differences were found for the proportional measures. As a group, children exposed in the first trimester showed no evidence of growth impairment. Two children in this group, however, were born with signs of coumarin embryopathy and one of these displayed a deficit in height at school age. Long-term growth was not affected by a high cumulative dosage or exposure after the first trimester. We conclude that, when exposure during the first trimester is avoided, coumarin therapy during pregnancy has no demonstrable risk for the child's skeletal development.

Abnormalities, Drug-Induced↗
PubMed1999

Hypertensive encephalopathy in a patient with neonatal thyrotoxicosis.

UNLABELLED: Neonatal hyperthyroidism may give rise to serious cardiovascular complications. A girl with severe thyrotoxicosis in whom hypertensive encephalopathy developed is described. CONCLUSION: Neonatal thyrotoxicosis can give rise to hypertension and may lead to hypertensive encephalopathy.

Female↗
PubMed1998

[Plantar fibromatosis in infants].

In 2 girls aged 5 months swellings were noted shortly after birth, on the plantar surface of the anteromedial parts of both heels and the left heel, respectively. On an expectative management, the swellings grew with the feet, without causing symptoms. The clinical picture and characteristic location led to the diagnosis of plantar fibromatosis. In infants it is a rare disorder which frequently shows spontaneous regression and does not behave aggressively. To avoid unnecessary investigations or even surgery and to reassure the parents, it is important to recognize this condition in infants.

Fascia↗
PubMed1998

Predictive value of serum follicle-stimulating hormone levels in the differentiation between hypogonadotropic hypogonadism and constitutional delay of puberty.

OBJECTIVE: Gonadotropin secretion was evaluated to predict hypogonadotropic hypogonadism (HH) in 36 children suspected of having HH. METHODS: LH was measured for 24 h at 10-min intervals, and FSH and estradiol or testosterone at 1-hour intervals. Twenty boys (age 15.7, range 13.2-19.3 years) and 16 girls (age 16.1, range 13.0-20.6 years) were studied. RESULTS: LH pulses were detected in 9 boys and 5 girls. HH was confirmed in all 11 LH apulsatile boys and in 8 of 11 LH apulsatile girls. Random FSH values of < or =1.11 and < or =2.86 IU/l in boys and girls, respectively, discriminated patients with LH pulses from patients without (sensitivity for lack of LH pulses 97 and 100%, respectively). In boys testicular volume was not discriminatory. In 1 girl LH pulses were observed without estradiol production, suggesting LH neurosecretory dysfunction. CONCLUSIONS: Low FSH levels in adolescence are strongly related to a lack of LH pulses. Lack of LH pulses is highly suspect for HH. FSH may be a tool in the differentiation between HH and delayed puberty.

Adolescent↗
PubMed1998

Short-term growth in asthmatic children using fluticasone propionate.

BACKGROUND: Inhaled corticosteroids may reduce short-term growth velocity in asthmatic children and knemometry is the most sensitive tool to detect this short-term growth suppression. STUDY OBJECTIVE: To compare lower leg growth velocity, as measured by knemometry, in asthmatic children during and after treatment with inhaled fluticasone propionate (FP), 100 microg twice daily. DESIGN: Nonrandomized open trial. SETTING: University hospital, outpatient clinic for pediatric pulmonology. PATIENTS: Twenty-one asthmatic children (13 boys), aged 6 to 10 years. INTERVENTIONS: Inhalation of FP from a dry powder inhaler, 100 microg, twice daily for 6 weeks, followed by 2 weeks during which only an inhaled beta2-agonist was used on demand (washout). During treatment and washout periods, patients were seen every 2 weeks at the same time of day. MEASUREMENTS AND RESULTS: Lower leg growth velocity measured by knemometry during FP treatment was not significantly different from that during washout (p=0.33, one-way analysis of variance). CONCLUSIONS: No significant suppression of lower leg growth velocity was found in prepubertal asthmatic children using FP, 100 microg, by dry powder inhaler twice daily for 6 weeks.

Administration, Inhalation↗
PubMed1997

Bilateral epiphysiodesis around the knee as treatment for excessive height in boys.

Between 1987 and 1993, six boys who had been predicted to grown to an excessive height were treated with bilateral Phemister epiphysiodesis around the knee. Median predicted adult height was 210.4c (range: 207.4-213.4 c), the median observed adult height was 201.5 c (range: 195.5-206.7 c). Median height reduction was 9.3 c (range: 4.1-15.3 c). Median length of follow-up was 44 months (range: 21-84 months). At final follow-up, all patients had full range of motion, no infections, no pain, no angular deformities, equal leg lengths, and radiographic evidence of physeal closure. Bilateral Phemister epiphysiodesis around the knee is a good alternative to pharmacological treatment for boys with excessive height.

Adolescent↗
PubMed1994

[Growth, development and prediction of body height in children with central precocious puberty after 3 years of therapy with Decapeptyl-Depot, a slow-releasing GnRH agonist].

More than 100 patients with central precocious puberty are participating in this international multicenter study using monthly i.m. injections of the slow-release GnRH agonist Decapeptyl-Depot. In 15 patients, Decapeptyl-Depot treatment could be discontinued after 2 years of therapy. Gonadal suppression was promptly reversible in all of them, as shown by prepubertal low gonadotrophin and sex steroid levels. Of the remaining 90 patients, 40 have been treated for more than 3 years, including 33 girls and 7 boys. Plasma levels of LH, FSH, estradiol and testosterone dropped to the prepubertal range after one month of Decapeptyl-Depot and remained there for the whole period of therapy. At start of therapy, mean chronologic age of these 40 children was 6.6 +/- 1.4 (SD) years, mean bone age 10.2 +/- 1.9 years. Mean predicted adult height increased in the boys from 173.6 +/- 13.8 (SD) cm at start of therapy to 184.6 +/- 17.0 cm after 3 years. Predicted adult height increased in girls from 158.0 +/- 12.2 to 161.0 +/- 7.5 cm. Undue side effects were not seen, long term tolerance was good. It is concluded that Decapeptyl-Depot injected i.m. every 4 weeks suppresses the pituitary gonadal axis in children with central precocious puberty without clinical or biochemical escapes, and leads to an increase in predicted adult height by more than 3 cm in all boys and in 53% of the girls after three years of treatment.

Body Height↗
PubMed1993

[Microalbuminuria as risk factor for nephropathy in children with insulin-dependent diabetes mellitus].

OBJECTIVE: To assess the prevalence of microalbuminuria (> or = 30 mg/24 h) in children with insulin dependent diabetes mellitus (IDDM). DESIGN: Retrospective. SETTING: Department of Pediatrics, University Hospital, Free University of Amsterdam. METHODS: Albumin excretion rate was assessed in 24-hour voiding volumes in 71 children, mean age 11.8 yrs (range 3.5-17.9; 27 boys and 43 girls). Mean duration of IDDM was 5.4 yrs (1.0-5.0). Patients with albuminuria were compared with patients without microalbuminuria. Results of angiotensin-converting enzyme inhibition (n = 4) are presented. RESULTS: The prevalence of microalbuminuria was 16% (n = 11). In 7% (n = 5) the microalbuminuria was persistent; in 9% (n = 6) it was intermittent. The mean age of the children with microalbuminuria (14.0 years; 8.9-17.4) was significantly higher than the age of the children without this disorder (11.7 years; 3.5-17.9). Two prepubertal children had developed microalbuminuria. The group with microalbuminuria had a significantly higher age at onset of the disease (8.1 years; 1.9-13.0) than the group without microalbuminuria (5.8 jaar; 0.9-14.5). The daily dose of insulin in the group with microalbuminuria was significantly higher (1.15 U/kg; 0.6-1.56) than in the group without microalbuminuria (0.97 U/kg; 0.20-1.87). There was no correlation between microalbuminuria and the duration of the disease. CONCLUSION: Microalbuminuria may exist as early as the prepuberal period, but is found more frequently in children with IDDM who have entered puberty. There is a correlation between microalbuminuria and the age which it develops, the age at onset of the IDDM and the daily dose of insulin. Secondary prevention of diabetic nephropathy with ACE inhibition appears to be possible.

Adolescent↗
PubMed1993

Pulsatile GnRH treatment in boys and girls with idiopathic hypogonadotrophic hypogonadism.

In order to induce pubertal development, low-dose, pulsatile gonadotrophin-releasing hormone (GnRH) was administered i.v. in adolescent boys and girls with an isolated hypogonadotrophic hypogonadism. The first study included GnRH treatment in 21 male patients with the goal of initiating testicular growth and spermatogenesis; in the second study, GnRH was administered in three adolescent boys and two girls in an increasing pulse frequency as well as pulse dose in order to imitate the 'physiological' pubertal changes. In the first study gonadotrophin and testosterone levels increased in all patients, and testicular growth also occurred. When GnRH treatment was discontinued spermatogenesis was present in 14 out of the 17 patients examined, and was observed in another patient during subsequent human chorionic gonadotrophin (HCG) treatment. Ultimately, 15 out of the 19 patients developed spermatozoa. In the second study, small increases in luteinizing hormone (LH) and follicle stimulating hormone (FSH) were observed during a low-frequency GnRH schedule, followed by a further rise during the 'physiological' schedule with a 90-min pulse interval; testosterone and oestradiol also increased. An increased secretion of growth hormone occurred only in boys during GnRH treatment, after their testosterone levels had increased. In girls, none of the GnRH treatment schedules was associated with an increase in growth hormone. Pulsatile GnRH treatment is thus feasible as a method of inducing testicular growth and spermatogenesis. A GnRH treatment schedule with an increasing pulse frequency and pulse dose can imitate the 'physiological' pubertal changing pattern of gonadotrophins just as well as the use of sex steroid. However, with respect to growth hormone secretion, GnRH will induce an increase in boys only.

Adolescent↗
PubMed1993

Comparison of complete and incomplete suppression of pituitary-gonadal activity in girls with central precocious puberty: influence on growth and predicted final height. The German-Dutch Precocious Puberty Study Group.

The question as to whether treatment with short-acting or with slow-release gonadotropin-releasing hormone (GnRH) agonists has different effects on growth and bone maturation when treating girls with central precocious puberty has not yet been studied. In a meta-analysis, we compared 21 naive girls with central precocious puberty who were treated with buserelin with 22 naive girls with central precocious puberty who received Decapeptyl in depot form. Treatment lasted for at least 18 months. At the start of therapy, chronological age, bone age, growth velocity and pubertal stage in the two groups were very similar. During the first 6 months of treatment, significantly more phases of incomplete suppression of pituitary-gonadal activity occurred in the buserelin group. As a result, growth velocity and bone maturation (delta bone age/delta chronological age) remained significantly higher than in the Decapeptyl Depot group (p < 0.0001 and p < 0.01, respectively). In contrast to the Decapeptyl Depot group, the height standard deviation score (SDS) for bone age in the buserelin group did not change significantly in the first 6 months of treatment, and the predicted adult height decreased. Between the 6th and 18th months of therapy, the development of growth rate, delta bone age/delta chronological age, height SDS for bone age and predicted adult height in both groups became almost identical. However, the rate of growth and bone maturation in the buserelin group remained faster than in the Decapeptyl group, though not significantly so. The mean predicted adult height had risen significantly after 18 months in the Decapeptyl Depot group but not in the group treated with buserelin.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Height↗
PubMed1993

Cushing's disease in a child caused by a corticotropin-releasing hormone-secreting intrasellar gangliocytoma associated with an adrenocorticotropic hormone-secreting pituitary adenoma.

Cushing's disease resulting from intrasellar corticotropin-releasing hormone (CRH)-secreting gangliocytomas is very rare, and only two such cases have been reported in the literature to date. The authors present a third case in which an adrenocorticotropic hormone-secreting pituitary adenoma was found in addition to a gangliocytoma in a 10-year-old girl with clinical and endocrinological symptoms of Cushing's disease. Computed tomographic and magnetic resonance imaging scans showed a suprasellar and parasellar tumor. A green-colored, heterogeneous tumor and a small adenoma were removed transsphenoidally. Histological examination revealed a large gangliocytoma immunoreactive for CRH and a small, mucoid cell pituitary adenoma immunoreactive for ACTH. This is the first case of such a tumor causing Cushing's disease in a child. It might exemplify induction of an ACTH-secreting pituitary adenoma by means of chronic overstimulation of CRH.

Adenoma↗
PubMed1993

[Comparison between complete and incomplete suppression of the hypophyseal-gonadal axis in girls with central precocious puberty: effect on growth and prospective final height].

BACKGROUND: Whether short-acting or slow-release gonadotropin-releasing hormone agonists have different effects on growth and bone maturation in children with central precocious puberty is still unknown. METHODS: In a meta-analysis, we studied 21 previously untreated girls with central precocious puberty treated with Buserelin and 22 previously untreated girls with central precocious puberty treated with Decapeptyl Depot. Duration of treatment was at least 18 months in both groups. RESULTS: At start of therapy, chronological age, bone age, height velocity and pubertal stage were well comparable between the groups. During the first 6 months of treatment, clinical and biochemical escapes from suppression were more frequent in the Buserelin group; height velocity and bone maturation (delta bone age/delta chronological age) remained significantly higher (p < 0.0001 and p < 0.01, resp.) in Buserelin than in Decapeptyl Depot patients. In contrast to the Decapeptyl Depot group, in the Buserelin patients height standard deviation score for bone age did not change and predicted adult height decreased. From 6 to 18 months of therapy, the development of height velocity, delta bone age/delta chronological age, standard deviation score for bone age and predicted adult height showed an almost parallel course in both groups. Height velocity and bone maturation tended to be faster in the Buserelin group. Mean predicted adult height rose significantly in the Decapeptyl Depot group, but not in the Buserelin-treated girls. CONCLUSIONS: A slow-release gonadotropin-releasing hormone agonist appears to be superior to short-acting drugs not only in terms of long-term tolerance but also for achieving the auxological objectives in central precocious puberty therapy. This is mainly due to their faster and more complete suppression of gonadotropins during the first 6 months of treatment.

Age Determination by Skeleton↗
PubMed1992

Growth, bone maturation and height prediction after three years of therapy with the slow release GnRH-agonist Decapeptyl-Depot in children with central precocious puberty.

More than 100 patients with central precocious puberty are participating in this international multicenter study using monthly i.m. injections of the slow-release GnRH agonist Decapeptyl-Depot. In 15 patients, Decapeptyl-Depot treatment could be discontinued after 2 years of therapy. Gonadal suppression was promptly reversible in all of them, as shown by prepubertal low gonadotrophin- and sex steroid levels. Of the remaining 90 patients, 40 have been treated for more than 3 years, including 33 girls and 7 boys. Plasma levels of LH, FSH, estradiol and testosterone dropped to the prepubertal range after one month of Decapeptyl-Depot and remained there for the whole period of therapy. At start of therapy, mean chronologic age of these 40 children was 6.6 +/- 1.4 (SD) years, mean bone age 10.2 +/- 1.9 years. Mean predicted adult height increased in the boys from 173.6 +/- 13.8 (SD) cm at start of therapy to 184.6 +/- 17.0 cm after 3 years. Predicted adult height increased in girls from 158.0 +/- 12.2 to 161.0 +/- 7.5 cm. Undue side effects were not seen, long term tolerance was good. It is concluded that Decapeptyl-Depot injected i.m. every 4 weeks suppresses the pituitary-gonadal axis in children with central precocious puberty without clinical or biochemical escapes, and leads to an increase in predicted adult height by more than 3 cm in all boys and in 53% of the girls after three years of treatment.

Adolescent↗
PubMed1992

True hermaphroditism in 45,X/46,XY mosaicism.

This report discusses the clinical findings on two patients with 45,X/46,XY mosaicism, two boys presented with penile hypospadias and cryptorchidism. A dysgenetic ovary and a testis were found in one boy, and a dysgenetic ovary in the other. Both patients can be considered to be true hermaphrodites on the basis of histology and clinical and hormonal observations. 45,X/46,XY mosaics have a wide range of phenotypic appearances and their gonadal morphology can also show great differences. However, the incidence of true hermaphroditism in individuals with 45,X/46,XY mosaicism is low and the reports in the literature rare. It is likely that males with 45,X/46,XY who suffer only mild maldevelopment of the external genitalia will not be recognized. In all patients with penoscrotal hypospadias and cryptorchidism with 45,X/46,XY mosaicism, the possibility of true hermaphroditism should be considered.

Child↗