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Biomedical subjects

T Stijnen

Publications and source records attributed to T Stijnen.

198 records · Page 11Linked to original sources
PubMed1986

Overweight and chronic illness--a retrospective cohort study, with a follow-up of 6-17 years, in men and women of initially 20-50 years of age.

A retrospective cohort-study with a follow-up of 6-17 years was carried out in four general practices in the Netherlands in the period 1967-1983. In total 317 overweight men and 565 overweight women were followed in a continuous morbidity registration, starting in the year they were diagnosed as overweight (at age 20-50 years). Incidence of illnesses in this group was compared to that in a control group (444 men and 627 women not registered overweight), matched on sex, age and calendar-year at start of follow-up. The incidence of registered morbidity in the overweight group was higher for diabetes, gout, arteriosclerotic disease, arthrosis for men and women, and also for varicose veins for women. Increasing BMI at start of follow-up was associated with increased risk for most illnesses under study. For gout and arteriosclerotic disease in men, overweight appeared to be a risk factor at lower levels of BMI than in women.

Adult↗
PubMed1986

Decreased cerebrovascular resistance in small for gestational age infants.

Using a transcutaneous Doppler technique we found a significantly lower cerebrovascular resistance and higher cerebral blood flow velocity indicating vasodilatation and increase of cerebral blood flow in small for gestational age infants compared with appropriate for gestational age infants during the first days of life. We speculate that these findings are due to a continuation of the fetal situation in which chronic hypoxia, mostly caused by pregnancy-induced hypertension, possibly causes a prostacyclin-induced vasodilatation.

Blood Flow Velocity↗
PubMed1986

Serum immune complexes containing IgA appear to predict erosive arthritis in a longitudinal study in rheumatoid arthritis.

Fifty seven patients with rheumatoid arthritis (RA) were studied longitudinally, and the presence of rheumatoid factor (RF) and various types of immune complexes (IC) was correlated with joint activity and the presence of extra-articular features (EAF). In a cross sectional study it was found that the levels of circulating IC and RF correlated significantly with joint disease activity and the presence of EAF. Longitudinally, levels of IC measured by the C1q binding activity and IC containing IgG and IgM correlated significantly with fluctuations in joint disease activity, whereas IC containing IgG and IgA correlated with the occurrence of EAF. RF and IC levels, however, did not predict the clinical course of the disease. IC containing C3 and C4 were found infrequently and were only present in patients with active rheumatoid vasculitis (RV). The continuous presence of these IC appeared to be linked to the recurrence of vasculitis, irrespective of treatment. Significantly more erosions of hands and feet were found after one year follow up in those RA patients who presented early (disease duration less than one year) who initially had a raised serum IgA IC level (r = 0.72; p less than 0.005).

Antigen-Antibody Complex↗
PubMed1986

Cytomegalovirus immunity and T lymphocytes in bone marrow donors and acute graft-versus-host disease.

T lymphocyte subset numbers in bone marrow grafts were correlated with the cytomegalovirus (CMV) antibody status of the donors and with the occurrence of acute graft-versus-host disease (GVHD) in their recipients. We studied whether or not the (previously reported) association between donor CMV antibodies and GVHD could be explained by CMV-related changes in T cell subsets in the marrow grafts. There were no significant correlations between any of the T cell subsets in the marrow grafts and the occurrence of grades II-IV GVHD. A particular subset of CD8+ T cells carrying the HNK1 marker was significantly increased in the marrow grafts of CMV-seropositive donors. Although recipients of marrow from CMV-seropositive donors received an average of five times more CD8+ HNK1+ T cells than those with CMV-seronegative donors, that situation was not associated significantly with the development of GVHD.

Acute Disease↗
PubMed1986

Evaluation of antileukoprotease in surgical lung specimens.

To evaluate the presence of antileukoprotease in the lung and its possible contribution to parenchymal protection, surgically removed lungs or lobes of 41 patients were studied. Tissue slices were stained immunohistochemically for antileukoprotease. Site and number of antileukoprotease-containing cells were recorded. To measure emphysema, the mean linear intercept of each slice was determined. Antileukoprotease was observed in bronchial epithelium and glands and in at least two types of nonciliated cells and in a few basal cells of bronchiolar epithelium. No relationship existed between the frequency of antileukoprotease positive cells in membranous bronchioles and the mean linear intercept, the smoking history or lung function except for total lung capacity. These results do not support a protective activity of antileukoprotease against emphysema, but neither do they provide evidence against it.

Female↗
PubMed1985

Rheumatoid factors in rheumatoid arthritis and vasculitis.

To study the occurrence of rheumatoid factors (RF) in relation to the activity of rheumatoid arthritis and the occurrence of vasculitis, RF of IgM, IgA, and IgG classes were measured in sera from 35 patients with definite or classic rheumatoid arthritis (RA) using ELISA. For 26 patients, the RF levels were studied longitudinally and compared with changes in the articular index. Although IgM RF was occasionally found in patients without RA, IgA and/or IgG RF were almost exclusively associated with RA. The titers of IgM, IgA, and IgG RF were significantly higher in sera from patients with clinically diagnosed rheumatoid vasculitis than in sera from patients without vasculitis. No significant correlation between changes in the articular index and changes in titer of any class-specific RF could be found for the group of RA patients as a whole. However, in individual patients, increases or decreases in IgM and IgG RF titer were significantly correlated with an increase or decrease in the articular index.

Adolescent↗
PubMed1985

Midazolam versus fentanyl/droperidol and placebo as intramuscular premedicant.

Midazolam, a new short-acting benzodiazepine with promising premedicant effects, was investigated in a double-blind, randomized clinical trial in 203 patients versus fentanyl/droperidol and placebo. Subjective effects, side-effects, amnesia and overall satisfaction were recorded. Midazolam caused the greatest decrease in anxiety level, and while causing more confusion and somnolence than placebo, caused less confusion and somnolence than fentanyl/droperidol. Half the patients who received midazolam reported anterograde amnesia. No serious side-effects were reported. Patient satisfaction was greater in the midazolam group than in the other groups.

Adolescent↗
PubMed1984

On the efficacy of low dose prednisolone and heparin sodium in the prevention of infusion thrombophlebitis. A double-blind trial.

A prospective, double-blind investigation into the effectiveness of the addition to infusion fluids of an injectable containing 0.3 mg prednisolone and 10 units heparin per ml in a phosphate buffer pH = 7.5 versus the phosphate buffer alone is described. 196 Patients were allocated alternately to each group. On a total number of 593 cannulation days, 16 cases of thrombophlebitis were diagnosed. Statistical evaluation revealed a significant difference between the two groups (p less than 0.01) in favour of prednisolone + heparin sodium.

Catheterization↗
PubMed1983

Dose-response relationship in isotretinoin therapy for conglobate acne.

58 male patients with therapy-resistant conglobate acne were randomly selected for treatment with isotretinoin 1.0 or 0.5 mg/kg bodyweight. 27 patients received the high-dose regimen and 31 patients the lower dosage. The efficacy of the drug was highly satisfactory in both therapy groups and no differences could be observed between them. Side-effects (dry lips, dry nose, scaling of the skin) were generally well tolerated in both groups, they were more serious in the 1.0-mg/kg group. It is concluded that isotretinoin therapy is very effective in male patients with conglobate acne and that a dosage of 0.5 mg/kg is preferable to higher dosage regimens.

Acne Vulgaris↗
PubMedDate not supplied

Spelling errors made by children with mild epilepsy: writing-to-dictation.

Errors and corrections made by 64 mildly epileptic children of at least average intelligence who were attending ordinary elementary schools when writing in response to dictation (writing-to-dictation) were assigned to one of 28 descriptive error categories. Numbers and types of errors were compared with those obtained in 630 form-matched, healthy control subjects (Wilcoxon's two-sample test, less than or equal to 0.01). Epileptic children made significantly more errors than control subjects. Separate error categories had no diagnostic power. The groups could not be distinguished on the basis of skill-related errors. However, performance errors (erroneous deviations from the intended product), were found to be made more frequently by epileptic children. Epileptic children made more corrections and also left more errors uncorrected than control children. No relationship could be established with illness variables. Deficient problem-solving strategies, probably resulting from emotional concomitants of epilepsy, may explain the results.

Adolescent↗
PubMedDate not supplied

Carbamazepine (CBZ) controlled release compared with conventional CBZ: a controlled study of attention and vigilance in children with epilepsy.

To compare the effects on attention and vigilance of conventional carbamazepine (CBZ) and CBZ controlled release (CBZ-CR), 15 schoolchildren with epilepsy and normal intelligence receiving CBZ were switched to CBZ-CR. Psychological examination was performed on the day before (day A) and 1 month after substitution (day B). Measurements of attention and vigilance were repeated throughout the day at 2-h intervals. Both on days A and B, CBZ plasma levels were monitored during a 12-h period. Fifteen matched healthy controls were submitted to identical test programs, allowing comparisons within subjects as well as between patients and control children. Variability of performance over sessions was neither increased nor decreased with CBZ-CR. Consistent differences over sessions did not exist between patients and controls with either drug. No relation was noted between reaction time and CBZ plasma level. The pharmacologic data confirm results of earlier studies in children. We noted a reduction in intradose fluctuations of CBZ level with CBZ-CR as compared with conventional CBZ. The neuropsychological results do not show a difference between the drugs. Neither were differences noted with respect to antiepileptic efficacy and side effects. At the end of the study, all but one of the children (and their parents) opted to receive CBZ-CR for ease of dosage administration and overall satisfaction.

Adolescent↗
PubMedDate not supplied

Application of treatment thresholds to diagnostic-test evaluation: an alternative to the comparison of areas under receiver operating characteristic curves.

Diagnostic tests are often evaluated by comparison of the areas under receiver operating characteristic (ROC) curves. In this study the authors compared this approach with a more direct method that takes into account consequences of a diagnosis. Data from a prospective study of diagnosis of pulmonary embolism were used for a motivating example. Using multivariable logistic regression analysis, three diagnostic models were built and compared based on their ROC curves. Although model 1 (0.706) and model 2 (0.702) had the same ROC-curve area, they performed differently when risks and benefits of subsequent decisions were considered by applying the treatment probability threshold. Models 1 and 3 (0.611) had substantially different ROC-curve areas but performed similarly taking into account the therapeutic consequences. This demonstrates that comparison of diagnostic tests using the areas under the ROC curves may lead to erroneous conclusions about therapeutic usefulness. To correspond to daily practice, it would be more appropriate to also consider the clinical implications in evaluating diagnostic tests. This is made feasible by explicit definition and application of a treatment threshold.

Decision Support Techniques↗
PubMedDate not supplied

Flumazenil therapy for hepatic encephalopathy. A double-blind cross over study.

OBJECTIVES AND METHODS: Thirty-one patients with acute or chronic liver disease were included in the study to investigate the effect of flumazenil on hepatic encephalopathy. After screening for recent benzodiazepine use or non-hepatic causes of encephalopathy, 18 patients entered a double-blind cross-over study. The 13 remaining patients, most of them with renal failure or recent use of benzodiazepines, were given flumazenil in an open study. In the controlled study, flumazenil (1.0 mg) or placebo was given in a single injection on two separate days to study the immediate effect; half the patients received a continuous infusion of flumazenil (0.25 mg/h) or placebo for two 3-day periods to study a potential steady state effect. In the open study, a single bolus of flumazenil (1.0 mg) was given. RESULTS: In the controlled study, fifteen minutes after bolus injection, the clinical grade of hepatic encephalopathy decreased in 6 patients after injection of flumazenil, whereas a decrease was found in 2 after the placebo (P = 0.06). However, the EEG grade did not change in any of the patients, and the changes in the mean dominant frequency as measured by spectral analysis did not differ between flumazenil and the placebo. Furthermore, patients on flumazenil did not differ significantly from those on placebo during the infusion period. Subgroup analysis of underlying liver disease and the causes of encephalopathy revealed a trend for clinical improvement only in the patients with chronic liver disease, but without significant changes in the mean dominant frequency. In the open study, the clinical grade of encephalopathy decreased in 3 patients and, in contrast to the controlled study, the EEG also improved in 2 patients and the mean dominant frequency increased significantly. Responders had previously used benzodiazepines. CONCLUSION: Our study does not support a major therapeutic effect of flumazenil on hepatic encephalopathy.

Adolescent↗
PubMedDate not supplied

Cortical somatosensory evoked potentials from lumbosacral dermatomes: airpuff versus electrical stimulation.

Cortical potentials were elicited by airpuff stimulation of the L5 and S1 dermatome in a group of 24 healthy volunteers. The results were compared with the SEPs obtained by conventional electrical stimulation. Both stimulus modalities produce stable and good reproducible cortical responses of similar waveform. The most stable second negative peak, labeled N2, was used in this study. Mean latencies (in msec) were: N2 L5 air = 67.1 +/- 3.3, N2 L5 electr. = 55.7 +/- 3.7 N2 S1 air = 67.2 +/- 3.9, and N2 S1 electr. = 55.1 +/- 2.9 The maximum R/L difference (mean + 3 SD) was 5.7 msec, 5.9 msec, 7.2 msec and 7.2 msec for respectively N2 L5 air, N2 L5 electrical, N2 S1 air and N2 S1 electrical. Single regression analysis showed a significant influence of height, but not age upon all latencies. Multiple regression analysis with height and age as independent variables showed a significant influence of height and age together upon the latencies of the electrical SEP (both L5 and S1). For the airpuff SEP only height was significant. Gender had no effect on the cortical components. The amplitude of peak N2 after electrical stimulation of the S1 dermatome was significant higher than after airpuff stimulation, 2.9 and 1.7 microvolt respectively. For the L5 dermatome both types of stimuli produced responses of nearly equal amplitude, 2.5 and 2.1 microvolt for electrical and airpuff stimulation respectively. Airpuff SEPs may provide a good alternative for electrical stimulation.

Adult↗