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Biomedical subjects

B Hofman

Publications and source records attributed to B Hofman.

17 recordsLinked to original sources

Tuberculosis in children: a 13-year follow up of 1714 patients in a Belgian home care centre.

From May 1970 to September 1983, 1714 children with different forms of primary tuberculosis were referred to the paediatric home care centre (Enfants soignés au Foyer, E.S.F.) of the Brussels University Hospital St.-Pierre. They were subdivided in five groups: asymptomatic (33%), symptomatic (28%), dubious tuberculous infections (35%), high-risk contacts (3%) and unestablished diagnosis (1%). They were aged from 10 days to 19 years, and 82% of them were migrants of low socio-economic level. Fifty percent of the symptomatic infections, mainly pulmonary, appeared in children under 3 years of age. An adult source of contamination was identified in 33% of the cases (48% of the symptomatic children). Diagnosis was based on tuberculin screening with a 2IU intradermal test. Gastric aspirates yielded Mycobacterium tuberculosis in 15% of our patients, 11% of them showing resistance to one or more tuberculostatic drugs. Treatment was given to 1359 patients with excellent results. Therapy was shortened during the last 2 years of the study from 12 to 6 months for the asymptomatic patients and from 12 to 9 months for the symptomatic infections. Few complications were observed. Tuberculosis remains a serious cause of morbidity particularly in migrant children. Correct diagnosis and treatment of the disease is very important.

Adolescent

Acute hemodynamic and antiischemic properties of intravenous bepridil in coronary artery disease.

The acute hemodynamic and antiischemic effects of intravenous bepridil (3 mg/kg/5 minutes followed by 1 mg/kg/hour) were studied in 19 patients with coronary artery disease under basal conditions and during 2 identical pacing stress tests 30 minutes before (pace test I) and 15 minutes after (pace test II) onset of infusion. Bepridil immediately decreased coronary and systemic vascular resistance (26 and 17%, respectively). This resulted in a 19 and 21% reduction in left ventricular systolic and mean aortic pressures and a 15% increase in coronary flow and stroke index (p less than 0.05 vs control for each). These vasodilating effects were short lasting, persisting for 5 minutes after the bolus infusion, followed by significant reductions in heart rate (15%) and contractility (10%) and a temporary 46% increase in left ventricular filling pressure. During both pace tests heart rate, contractility, coronary flow and myocardial O2 consumption were comparable. In contrast, bepridil prevented the significant increase in systemic resistance and mean aortic pressure observed during pace test I (11 and 15%, respectively). Subsequently, myocardial O2 demand was significantly less during pacing after bepridil, due to an 11% reduction in left ventricular systolic pressure (p less than 0.05 vs control and pacing test II vs I). This resulted in marked antiischemic effects: normalization of lactate extraction and reduction in ST-segment depression (-14 +/- 7 vs 3 +/- 6% and 0.2 +/- 0.02 vs 0.13 +/- 0.02 mV, respectively, pace test I vs II, p less than 0.05), and in less or no angina in 18 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Poliomyelitis in the Netherlands 1958-69: the influence of a vaccination programme with inactivated poliovaccine.

The Netherlands is one of the few countries where poliomyelitis vaccination is practised with inactivated vaccine. Vaccinations started in 1957 and since 1962 have been carried out with a diphtheria-tetanus-pertussis-poliomyelitis vaccine according to a fixed schedule. The overall acceptance rate has been over 90%.Since 1957 the poliomyelitis morbidity has decreased by more than 99% in fully vaccinated persons and by 60-80% among nonvaccinated persons. The latter reduction probably resulted from a decrease in the amount of virus circulating after the vaccination campaign had started. The rather unequal distribution of acceptance rates allowed for a more detailed examination, which showed a relation between acceptance rates and morbidity figures. The morbidity pattern is now characterized by a few local outbreaks among nonvaccinated subjects in areas with low vaccination rates, and by the virtual disappearance of the disease in the rest of the country.

Adolescent

[Intubation lesions of the oropharynx, larynx and trachea].

The authors examined and followed 104 patients who had undergone surgery under endotracheal anesthesia in order to recognize the lesions of the oropharynx and the larynx resulting from intubation and other manipulations within the oral cavity and the pharynx. Laryngoscopic examination disclosed: a hematoma of true vocal cords in 5 patients, hematoma of the aditus ad laryngem and soft palate in 1 patient, edema in 4 patients, and in 8 patients hematoma of the oropharyngeal mucosa. The patients reported the following post-extubation discomforts: sore throat, hoarseness, dysphagia, a feeling of burning, clenching or foreign body in the throat, rough throat, irritation to hacking cough, and pains in the cervical musculature. Laryngitis was singled out as a disorder found in an increased percentage in the study group, as compared to the literature data, for which an explanation is given.

Adolescent

The "H-graft" in portacaval shunt in dogs.

When working experimentally on dogs we have investigated the possibility of using an autogenous vein graft and polytetrafluoroethylene (Gore-Tex) prosthesis in the construction of the portacaval shunt. The portacaval shunt flow has been examined under similar hemodynamic conditions by experimenting on surviving dogs with the internal jugular vein and the above prosthesis. This study presents methods of research, hemodynamic measurements and the technique of portacaval shunt construction. After performance of the arteriovenous mesenteric-renal fistula we have succeeded in raising partially the portal vein pressure with the increase in the venous blood flow markedly higher. The portacaval shunt flow and the mesenteric-renal fistula have been verified by aortography and on autopsy. The jugular vein employed in the construction of the portacaval shunt remained unobstructed in 6 dogs (75 per cent) and the Gore-Tex prosthesis in 4 (50 per cent).

Animals