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Biomedical subjects

A Maas

Publications and source records attributed to A Maas.

At least 55 records · Page 3Linked to original sources
PubMed1991

Control of nosocomial transmission of Clostridium difficile based on sporadic case surveillance.

The recognition of a cluster of antibiotic-associated nosocomial Clostridium difficile disease (NCDD) caused by serotype C in a surgical ward led to a hospital-wide NCDD surveillance and control program. The initial step included: (a) gas-liquid chromatography screening of inpatients' diarrheal stools; (b) enteric isolation precautions, cohorting and terminal room disinfection in wards with a cluster of two or more NCDD cases per month. During a 12-month period, the quarterly incidence of NCDD remained unchanged and six new clusters of serotype C, K, and H infections occurred, giving a global incidence of 1.5/1,000 admissions. C. difficile spores were recovered from 36.7% surfaces of case patient rooms versus 6.7% in control rooms. More intensive control measures were evaluated: (a) culture screening of inpatients' diarrheal stools; (b) early therapy, enteric isolation precautions, and daily meticulous room disinfection for each sporadic NCDD case. Surface disinfection reduced the contamination level four-fold (p = 0.04). In the following 12 months, no cluster occurred and the incidence of NCDD fell to 0.3/1,000 admission (protective efficacy 73%, 95% confidence interval: 46-87%). These observations suggest that early therapy, isolation precautions, and surface disinfection, focused on patients with sporadic NCDD detected by active surveillance, can prevent nosocomial transmission of C. difficile.

Adolescent↗
PubMed1991

A model for quality of life after laryngectomy.

In this paper we propose a theoretical model for quality of life after laryngectomy. By combining findings from literature, relevant factors for determining quality of life are presented. The importance of these factors is exemplified by interviews with laryngectomies. The practical purpose is to embed this model in a patient's choice process between surgery and radiotherapy, the two main treatments of laryngeal cancer. It is argued that such a decision is at best made by a cooperation of patient, physician and social worker or psychologist.

Aged↗
PubMed1991

Humoral immune response against contractile proteins (actin and myosin) during cardiovascular disease.

Sensitive and highly specific ELISA assays were developed to determine humoral immune response against actin and myosin in 122 patients suffering from various cardiovascular diseases: acute viral myocarditis (n = 10, MYO), acute myocardial infarction (n = 28, AMI), valve surgery (n = 35, VALVE), coronary bypass surgery (n = 35, CABG), and peripheral vascular surgery (n = 14, VASC). Anti-actin and anti-myosin antibodies were determined on admission and serially during a period of 90 days. Anti-actin and anti-myosin immune response (IgG, IgM) was expressed comparing absorbance of the patients' serum with a reference serum. In the different patient groups significantly (P less than 0.01) higher anti-actin and anti-myosin antibody concentrations were found on admission compared with age-matched control groups. During follow-up, all patient groups except the vascular surgery group showed a significant immune response against actin and myosin, with an immune response ratio (peak/admission) for AMA IgG and IgM respectively of 2.12 and 2.40 in the VALVE group, 1.30 and 1.99 in the CABG group, 1.42 and 1.48 in the AMI group and 1.66 and 1.25 in the MYO group; and for AAA IgG and IgM respectively of 1.57 and 3.00 in the VALVE group, 1.54 and 1.64 in the CABG group, 1.25 and 1.07 in the AMI group, and 1.42 and 1.42 in the MYO group. A significant correlation between pre-cardiac injury and peak post-cardiac injury anti-myosin and anti-actin autoantibody levels could be demonstrated suggesting that pre-injury sensitization to these antigens plays an important role in evoking post-cardiac injury immune response.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗
PubMed1989

Stress among farm women: a structural model approach.

Research on the relationship between job-related stress and well-being has focused largely on organizational work contexts. Using a Dutch sample, we examined stress in a typical family business setting--the family farm--to explore how the farm wife's contribution to farm work is related to her well-being. We used LISREL to test an explanatory model based on the Michigan stress approach. In this model, farm women's farm contributions and their predictors, perceived role and financial stressors, husband support, self-esteem, and mental and physical health complaints were included. The results show that husband support is more important for farm women's well-being than the role-related or financial stressors. The implications of the findings are briefly discussed.

Adult↗
PubMed1989

Bleeding prophylaxis in autologous bone marrow transplantation for solid tumors. Comparison of cryopreserved autologous and fresh allogeneic single-donor platelets.

Bleeding prophylaxis with cryopreserved autologous thrombocytes was evaluated in 43 patients treated with high-dose chemotherapy and autologous bone marrow transplantation. Platelet transfusions were given prophylactically. Nineteen patients received only autologous, 10 only fresh allogeneic single-donor, and 14 both types of transfusions. The effects of 104 autologous versus 93 allogeneic thrombocyte transfusions were compared. The increment at 1 h was for allogeneic platelets twice that for autologous platelets (30.6 versus 15.2 x 10(9)/l), but the interval between transfusions in days (2.3) was the same. Twelve patients received alternating autologous platelet transfusion after washing out the cryoprotectant dimethyl sulfoxide (18 transfusions) and non-washed autologous platelets (24 transfusions). Platelet increments, corrected increments, and predicted recovery were not influenced by omitting the washing procedure, and no side effects of dimethyl sulfoxide occurred.

Adult↗
PubMed1988

Chemotherapy with maximally tolerable doses of VP 16-213 and cyclophosphamide followed by autologous bone marrow transplantation for the treatment of relapsed or refractory germ cell tumors.

Eleven patients with advanced nonseminomatous germ cell tumors (NSGCT), who relapsed after or were refractory to standard dose cisplatin-based remission induction chemotherapy, were treated in a phase II clinical trial with VP 16-213 2500 mg/m2 and cyclophosphamide 7 g/m2. Both drugs were given in maximally tolerable doses regarding extramedullary toxicity. Urothelial damage due to cyclophosphamide was prevented by the administration of mesnum. Autologous bone marrow was infused on day 7 to prevent long lasting medullary toxicity. Because of the disappointing results in the first three patients, a second treatment step was added. The next eight patients were treated with 2500 mg/m2 VP 16-213 divided and given on days 1-2-3 and after full bone marrow recovery with total doses of VP 16-213 2000 mg/m2 plus cyclophosphamide 7 g/m2 divided and given on days 29-30-31, followed by autologous bone marrow transplantation (ABMT) on day 35. Toxicity to high-dose VP 16-213 plus cyclophosphamide followed by ABMT consisted of mucositis, nausea, vomiting and diarrhea. No cardiac toxicity or hemorrhagic cystitis occurred. The mean duration of leukopenia and thrombopenia was 14 and 13 days respectively. The additional, preceding treatment with VP 16-213 as a single agent caused mucositis, and leukopenia and thrombopenia for a mean number of 9 and 6 days respectively. Seven responses were obtained: two complete responses of 46 and 66+ weeks respectively and five partial responses with a median response duration of 12 weeks. The median survival time was 40 weeks. This regimen of one or two courses with maximally tolerable doses of VP 16-213 plus cyclophosphamide and ABMT is not sufficient to salvage a substantial number of patients with relapsing or refractory NSGCT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

High-dose cyclophosphamide and high-dose VP 16-213 for recurrent or refractory small cell lung cancer. A phase II study.

In nine patients with recurrent or refractory small cell lung cancer a phase II study with high-dose cyclophosphamide and high-dose VP 16-213 with autologous bone marrow transplantation was performed. The regimen used was based on a previously reported phase I study. In eight of the nine evaluable patients a response was seen (six PR and two CR). One patient died of treatment related toxicity. Infection is the most important toxicity. The response duration was short. This combination is a suitable "late intensification' regimen for patients with minimal residual disease after standard dose induction chemotherapy.

Adult↗
PubMed1985

The effect of high-dose fentanyl anaesthesia on P50 in man.

The effect of high dosage fentanyl anaesthesia on P50 was studied in patients undergoing coronary bypass surgery. After induction of fentanyl anaesthesia 100 micrograms X kg-1 with pancuronium muscle relaxation P50 changed significantly (P less than 0.005) from 3.40 +/- 0.12 to 3.33 +/- 0.13 kPa. This anaesthesia technique decreases P50 in vivo, but this has more theoretical than practical importance.

Aged↗
PubMed1985

Inefficacy of plasma exchange in cold agglutinin hemolytic anemia--a case study.

A therapeutic trial of plasma exchange was conducted in an 82-year-old woman with severe cold agglutinin hemolytic anemia, who was unresponsive to conventional treatment. In spite of considerable improvement of pertinent parameters (total IgM, cold agglutinin titer and thermal amplitude) this treatment failed to induce a clinical remission. This failure may be the result of the ability of the cold agglutinin to fix complement to the red cell membrane at temperatures much higher than the thermal amplitude. A simple laboratory test to detect this dissociation between complement fixing ability and agglutination activity is described.

Aged↗
PubMed1984

Heparin small pool high yield purified factor VIII: in vivo recovery and half-life of routinely produced freeze-dried concentrate.

New approaches and techniques for improving source material collection and Factor VIII production at Blood Bank level have been reported recently. Heparin has been shown to be of importance in increasing yields and stability of FVIII in the purification and concentration process. Work has been done to develop on a routine scale the heparin double cold precipitation technique for the production of a freeze-dried high yield purified FVIII concentrate. The product has been tested clinically in 4 severe hemophilia A patients for recovery, half-life and acute side-effects, using two dosages over 8 infusions. There was no significant difference between the two dosages. Mean recovery 99.1% and mean half-life 8 hr, ranging from 6.5 to 10.3 hr. No side-effects justify further exploration of the potential of heparin for high yield purified FVIII production.

Adult↗
PubMed1982

[Health education and group work during in-patient rehabilitation following myocardial infarction (author's transl)].

Starting from the usual in-patient rehabilitation measures for myocardial infarction patients and based on the authors' clinical experiences, a working model is presented concerning the health educational care of patients undergoing rehabilitation procedures immediately following infarction or bypass operation. The new concept is based on a psychosomatic view of the cardiovascular diseases, and uses group-dynamic elements in its methodological approach. The rehabilitational tasks of health education are understood as therapeutic strategies and are aimed at achieving changes on the attitudinal and behavioural level.

Aftercare↗
PubMed1977

Severe head injuries in three countries.

Methods for assessing early characteristics and late outcome after severe head injury have been devised and applied to 700 cases in three countries (Scotland, Netherlands, and USA). There was a close similarity between the initial features of patients in the three series; in spite of differences on organisation of care and in details of management , the mortality was exactly the same in each country. This data bank of cases (which is still being enlarged) can be used for predicting outcome in new cases, and for setting up trials of management.

Adolescent↗
PubMed1975

Telemetered epidural pressure.

An implantable transducer capable of telemetering epidural brain pressure during long periods of time is described. The transducer is constructed from conventionally available materials, and routine workshop techniques are used. The coplanarity principle has been applied while the described mounting clamp allows discrete positioning of the transducer relative to the brain. Basically, the transducer consists of a coil-capacitor circuit in which alterations of epidural pressure induce changes in capacity and, thus, the transducer's resonance frequency. An external electromagnetically coupled impedance-measuring device converts the resonance frequency to a pressure analogous voltage. In vitro tests showed that the transducer had good accuracy and reliability for a period of more than 1 month. An in vivo experiment with a cat showed that the measured epidural pressure was linearly related to ventricular fluid pressure.

Animals↗