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Biomedical subjects

B H Stricker

Publications and source records attributed to B H Stricker.

At least 109 records · Page 6Linked to original sources

Bromocriptine and suppression of postpartum lactation. The incidence of adverse cardiovascular effects in women of child-bearing age.

The use of bromocriptine for the suppression of postpartum lactation drew widespread attention to a potentially increased risk for cardiovascular and cerebrovascular adverse effects. To estimate the incidence of these events a follow-up study was performed among 2,130 women of 15-44 years of age who were treated with a course of bromocriptine in 1990-1992. None of these women were admitted to the hospital for cardiovascular or cerebrovascular events. However, the incidence of pregnancy hypertension and the use of cardiovascular drugs increased considerably in the last 2 months before delivery. Therefore, cardiovascular or cerebrovascular events can probably be explained by pre-existing morbidity rather than by the use of bromocriptine. We estimated, using a 'worst-case' analysis, that fewer than 2 Dutch women each year would develop serious cardiovascular or cerebrovascular events.

Adolescent↗

Hypoglycaemia associated with use of inhibitors of angiotensin converting enzyme.

The use of angiotensin-converting-enzyme (ACE) inhibitors has been associated with increased insulin sensitivity in diabetic patients. Although such an effect could be beneficial in the treatment of hypertension or congestive heart failure in diabetic patients, it might also precipitate severe hypoglycaemia. To test this hypothesis we carried out a nested case-control study, using data in the Dutch PHARMO system (1986-92), among diabetic patients treated with insulin or with oral antidiabetic drugs, who were admitted to hospital with hypoglycaemia. We identified 94 patients who had been admitted with hypoglycaemia and selected 654 controls from the same cohort. With adjustment for a wide range of potential confounding factors, hypoglycaemia was significantly associated with current use of ACE inhibitors (odds ratio 2.8 [95% CI 1.4-5.7]). Both among users of insulin and among users of oral antidiabetic drugs, use of ACE inhibitors was significantly associated with an increased risk of hospital admission for hypoglycaemia (2.8 [1.2-6.4] and 4.1 [1.4-12.2], respectively). Although ACE inhibitors have several advantages over other antihypertensive drugs in diabetes, the risk of hypoglycaemia should be taken into account. Further investigation of the mechanism is needed since as many as 13.8% of all hospital admissions for hypoglycaemia might be attributable to use of ACE inhibitors.

Adult↗

[Acute kidney insufficiency following administration of tiaprofenic acid].

A 62-year-old woman was admitted with acute renal failure, 3 weeks after starting intake of the nonsteroidal anti-inflammatory drug tiaprofenic acid (Surgam). A renal biopsy revealed tubulointerstitial nephritis. After discontinuation of the drug and correction of electrolyte disturbances, renal function recovered almost completely within 6 months.

Acute Kidney Injury↗

A rapid method to estimate the incidence rate and prevalence of insulin-dependent diabetes mellitus in children 0-19 years of age.

OBJECTIVE: To trace new cases of insulin-dependent diabetes mellitus (IDDM) on an ongoing basis and to estimate the incidence rate and prevalence of IDDM in children 0-19 years of age. RESEARCH DESIGN AND METHODS: The estimation of the prevalence and incidence rate of IDDM was based on, respectively, the prevalence and the rate of new users of insulin. The data were obtained from pharmacy, patient-based, drug dispensing histories in a well-defined population encompassing 257,113 individuals in the Netherlands. RESULTS: The IDDM incidence rate was estimated at 11.5 (CI95 6.6-17.8) per 100,000 person years in 1989-1990 in children 0-19 years of age. The prevalence was estimated at 11.0 (CI95 8.6-13.4) per 10,000 children 0-19 years of age. DISCUSSION: The incidence rate is comparable to that found in a large, national survey among all paediatricians and internists in the Netherlands. The method offers ongoing monitoring of the incidence and prevalence of IDDM in children, 0-19 years of age, against low costs. The method is suitable for rapid and cost-efficient recruitment of cohorts of incident IDDM patients, which fosters research to identify and quantify the attribution of different types of aetiologic and prognostic factors of IDDM.

Adolescent↗

Angiotensin converting enzyme inhibitor associated cough: a population-based case-control study.

The objectives of this study were to determine the risk for coughing as an adverse reaction to angiotensin converting enzyme (ACE) inhibitors under everyday circumstances in a large population and to study whether this adverse effect is more common in women. A population-based case-control study was used. The study was set in the practices of 161 Dutch general practitioners (GPs), in which all consultations, morbidity, mortality, medical interventions and prescriptions were registered during 4 consecutive 3-month periods in 4 consecutive groups of 40-41 GPs. The subjects were 2436 patients with incident coughing and up to 3 controls per case were obtained (total group: 7348 controls), matched for GP and a contemporary consultation in the same 3 months. All cases and controls were 20 years or older and had no notification of respiratory infections, influenza, tuberculosis, asthma, chronic bronchitis, emphysema, congestive heart failure, sinusitis, laryngitis, haemoptysis or respiratory neoplasms during the 3-month period. The results showed that cases were 3.6 times as likely as controls to have been exposed to ACE inhibitors (95% CI: 2.4-5.5) but after adjustment for potential confounders the odds ratio was 2.5 (95% CI: 1.6-3.9). The crude odds ratio for males was 2.7 (95% CI: 1.4-5.1) and for females 4.2 (95% CI: 2.4-7.5). The adjusted odds ratio for males was 1.8 (95% CI: 0.9-3.5) and for females 2.7 (95% CI: 1.5-4.8).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Vulvo-vaginal candidiasis associated with acitretin.

The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was estimated in a cohort of acitretin users by using prescription sequence analysis. Study subjects were 196 women between 15 and 45 years of age, exposed to acitretin in 1990. Prescriptions of drugs for treatment of vulvo-vaginal candidiasis were used as proxy for the occurrence of vulvo-vaginal candidiasis. Validation of the proxy drug was performed by record linkage of pharmacy and medical records. In addition to the risk estimation by incidence rate ratios a case-crossover study with patient-stratified logistic regression analysis was performed to control for distortion due to individual differences in contribution of exposure time. The positive predictive value of the proxy drug for vulvo-vaginal candidiasis ranged between 57 and 100%, the sensitivity was 87% and the specificity estimated 99%. The crude incidence rate ratio for vulvo-vaginal candidiasis following acitretin exposure was 2.8 (CI95%: 1.1-7.1). The pooled Mantel-Haenszel incidence rate ratio was 3.3 (CI95%: 1.1-9.6) after stratification for accumulated level of exposure. Patient-stratified analysis on the subgroup of cases (n = 15) revealed an odds ratio of 6.5 (CI95%: 2.3-18.2). This study strongly suggests that the higher occurrence of vulvo-vaginal candidiasis during acitretin exposure is attributable to the drug.

Acitretin↗

Acute myocardial infarction while using the nicotine patch.

A 39-year-old man developed an acute myocardial infarction 20 days after starting treatment with nicotine patches. He had not smoked while using the patches. He recovered without complications. Coronary angiography did not reveal coronary stenoses. He had no history of myocardial infarction, hypertension, or diabetes mellitus. Although coincidence cannot be excluded, it is recommended that all patients should be strongly advised not to smoke while using the nicotine patch and to consult a physician if chest pain develops.

Administration, Cutaneous↗

[Pulmonary hypertension following use of fenfluramine for obesity].

Pulmonary hypertension was diagnosed in a 41-year-old woman after 16 months' use of fenfluramine as a treatment for obesity. Despite discontinuation, pulmonary pressure remained elevated. Drug-induced pulmonary hypertension is rare but has been reported relatively often after use of the sympathicomimetic agent aminorexfumarate, but also, although more rarely, of fenfluramine.

Adult↗

[Skin reactions attributed to the use of bromhexine].

Since 1972, the Netherlands Centre for Monitoring of Adverse Reactions to Drugs has received 22 reports of skin reactions attributed to use of bromhexine. The reports concerned II men and II women. The ages ranged between 5 months and 88 years. The skin reactions occurred within one to 30 days after starting the use of bromhexine. Most skin reactions consisted of generalised urticaria. Other reports concerned once an angioedema and once an anaphylactic reaction. Most patients recovered completely after cessation of bromhexine without further treatment.

Adolescent↗

[Adrenal cortex suppression attributed to the use of budesonide].

The Netherlands Centre for Monitoring of Adverse Reactions to Drugs received two reports of adrenal suppression, attributed to inhaled budesonide. In the first patient, a 7-year-old girl, there were growth retardation, centripetal weight gain and a Cushingoid moonface with unmeasurable serum levels of cortisol after long-term treatment with 600, and later 1000 micrograms daily. In the second patient, an 8-year-old boy, there was malaise with onset a few months after start of treatment with 400 micrograms budesonide daily. There was a lowered serum level of cortisol which returned to normal after discontinuation of budesonide. Although inhaled corticosteroids cause systemic adverse effects less frequently than orally administered corticosteroids, such effects may occur occasionally.

Administration, Topical↗

[Registration of suspected adverse effects by the Bureau Adverse Effects Drugs; research activities in 1993].

In 1993, the Netherlands Centre for Monitoring of Adverse Reactions to Drugs received 1585 reports of suspected adverse reactions. The most important reports concerned myocardial infarction due to sumatriptan, cholestatic hepatitis due to itraconazole, agranulocytosis due to trazodone and bleeding due to fluoxetine and fluvoxamine. Other published reports concerned cholestatic hepatitis due to amoxicillin/clavulanic acid, hair loss due to beta-blockers, muscle necrosis due to diclofenac, bronchospasm, apnoea and cardiac arrest due to dipyridamole perfusion scintigraphy, interaction of fluvoxamine/fluoxetine and coumarins, liver enzyme elevations due to heparin, skin reactions due to Imedeen, deafness due to neomycin, addiction to nicotine chewing gum, atrial fibrillation and skin reactions due to nicotine patches, interaction between oral contraceptives and terbinafine, neonatal problems caused by psychopharmacological agents, parapemphigus caused by sulfasalazine, taste loss due to terbinafine en intracranial bleeding after use of tranylcypromine and beer. Pharmacoepidemiological studies were performed concerning methods for record linkage, the communication process with respect to the acitretin alert and the adverse events due to sumatriptan.

Drug-Related Side Effects and Adverse Reactions↗

[Local and generalized skin reactions in the use of nicotine patches].

Nicotine-containing patches are prescribed to facilitate tobacco withdrawal by mitigating abstinence symptoms and diminishing craving. In clinical trials local skin reactions were often recorded as a reaction to the patches. Systemic skin reactions were described, but only rarely. The Netherlands Centre for Monitoring of Adverse Reactions to Drugs received II reports of local and 5 reports of systemic skin reactions to nicotine patches during the period January 1993 until April 1994. Skin reactions usually occur after about 15 days' use and local reactions tend to become worse when treatment is continued. The mechanism of the reaction and the part of the patch to which the skin reacts are still unclear.

Administration, Cutaneous↗

[Psychotic reactions during administration of quinolones].

A 86-year-old woman became psychotic one day after starting treatment with 800 mg norfloxacin daily. Discontinuation and short-term treatment with haloperidol were followed by rapid disappearance of symptoms within two days. Since 1984, the Netherlands Centre for Monitoring of Adverse Reactions to Drugs received 19 similar reports of which 12 were attributed to norfloxacin, 3 to ofloxacin and 4 to pipemidic acid. The risk appears to be relatively high in the elderly, especially if they have fever, renal dysfunction and a psychiatric history. Lowering the doses may solve this problem provided the bacterial susceptibility is taken into account.

Adolescent↗

[Anaphylaxis caused by chlorhexidine following cystoscopy or urethral catheterization].

Since 1983 the Netherlands Centre for Monitoring of Adverse Reactions to Drugs received 6 reports of anaphylaxis due to a chlorhexidine-containing lubricant used during cystoscopy or urinary catheterization. One case was described earlier. An accidental rechallenge in two patients was positive. In 5 cases, the causal relationship with chlorhexidine was confirmed by a positive reaction to intracutaneous testing. Although this adverse reaction is probably rare, medical practitioners should be aware of the possibility that a severe anaphylactic reaction may occur during use of these products.

Adrenal Cortex Hormones↗