Biomedical subjects

D J Heersema

Publications and source records attributed to D J Heersema.

8 recordsLinked to original sources

PubMed2005

A randomized crossover study of bee sting therapy for multiple sclerosis.

BACKGROUND: Bee sting therapy is increasingly used to treat patients with multiple sclerosis (MS) in the belief that it can stabilize or ameliorate the disease. However, there are no clinical studies to justify its use. METHODS: In a randomized, crossover study, we assigned 26 patients with relapsing-remitting or relapsing secondary progressive MS to 24 weeks of medically supervised bee sting therapy or 24 weeks of no treatment. Live bees (up to a maximum of 20) were used to administer bee venom three times per week. The primary outcome was the cumulative number of new gadolinium-enhancing lesions on T1-weighted MRI of the brain. Secondary outcomes were lesion load on T2*-weighted MRI, relapse rate, disability (Expanded Disability Status Scale, Multiple Sclerosis Functional Composite, Guy's Neurologic Disability Scale), fatigue (Abbreviated Fatigue Questionnaire, Fatigue Impact Scale), and health-related quality of life (Medical Outcomes Study 36-Item Short Form General Health Survey). RESULTS: During bee sting therapy, there was no significant reduction in the cumulative number of new gadolinium-enhancing lesions. The T2*-weighted lesion load further progressed, and there was no significant reduction in relapse rate. There was no improvement of disability, fatigue, and quality of life. Bee sting therapy was well tolerated, and there were no serious adverse events. CONCLUSIONS: In this trial, treatment with bee venom in patients with relapsing multiple sclerosis did not reduce disease activity, disability, or fatigue and did not improve quality of life.

Adult↗

PubMed2005

Serum uric acid, dehydroepiandrosterone sulphate, and apolipoprotein E genotype in benign vs. progressive multiple sclerosis.

The majority of patients with multiple sclerosis (MS) experience gradual progression of disability, either as secondary progressive MS (SPMS) or primary progressive MS (PPMS). A subgroup with relapsing-remitting MS shows a benign course with little or no disease progression and minimal disability decades after the first manifestations, so called benign MS (BMS). In our search to identify factors that are associated with progression of MS, we investigated serum levels of uric acid and dehydroepiandrostenedione sulphate (DHEAS), and apolipoprotein (apo)E genotype in 28 patients with BMS, 33 with SPMS, 21 with PPMS, and 29 healthy individuals. We found no significant changes in uric acid levels and apoE genotype between the four groups. Mean DHEAS levels were lower in MS patients compared with healthy controls (P = 0.049), but there were no significant differences between the clinical subgroups of MS. In patients with SPMS and PPMS there was no correlation between progression rate and serum levels of either uric acid or DHEAS. Our results suggest that serum levels of uric acid and DHEAS, and apoE genotype do not differ between patients with a benign and progressive course of MS.

Adult↗

PubMed1995

Strabismus in very low birth weight and/or very preterm children: discrepancy between age of onset and start of treatment.

Very low birth weight (VLBW; less than 1500 g) and/or very preterm children are at risk for strabismus. However, the age of onset of strabismus is still unknown. The present study reports on the frequency of strabismus in 450 5-year-old children born with a birth weight of less than 1500 g and/or with a gestational age below 32 weeks. The age at which strabismus was initially diagnosed was determined retrospectively. At 5 years of age 65 of the at-risk children (14.4%) presented with strabismus. Fifteen of them (3%) had at that age not been referred to or treated by an ophthalmologist. At 3 years of age only 28 strabismic children were being treated; 7 at-risk children (2%) had been treated for strabismus before the end of the 1st year. These results were compared to those from a second study in which eye alignment was longitudinally examined in 194 VLBW children from 6 weeks until 12 months of (corrected) age and additionally in 65 of these children at the age of 2.5 years. At a first glance, the frequency of strabismus in the longitudinal study seemed rather stable during the first 2.5 years of life, with values varying between 14% and 18%. However, only a small percentage of misalignments which were noted at 6 weeks of age persisted until 2.5 years. On the other hand, if children had a misalignment at 9 months, strabismus was still present when they were reexamined at 1 and at 2.5 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Age of Onset↗

PubMed1993

Visual functions in relation with neonatal cerebral ultrasound, neurology and cognitive development in very-low-birthweight children.

In order to determine the relationship between visual functions and neonatal cerebral ultrasound, neurological examinations and cognitive development, a prospective longitudinal study was conducted in 69 high-risk very-low-birthweight children. Visual development was studied at 1 and 2.6 years of corrected age by assessment of visual acuity, binocular visual fields, optokinetic nystagmus and strabismus. Visual impairments were found in 33% at age 1 and in 28% at age 2.6. Visual impairments were related to intraparenchymal damage, as detected by neonatal cerebral ultrasound, as well as to abnormal neurological examinations and lower mean developmental indices. A stepwise multiple regression analysis with neonatal cerebral ultrasound as the dependent variable and visual functions at ages 1 and 2.6 and neurological examinations at ages 1 and 2 as independent variables, however, demonstrated that standardized neurological examinations were better markers of neonatal cerebral damage than visual functions. In cognitive development at ages 1 and 2, the neurological examination at age 1 was the most important variable. In cognitive development at age 3.6, visual functions at age 2.6 were more important. Early visual impairments might thus influence later cognitive development. The effectiveness of appropriate early intervention strategies to stimulate visual and cognitive development in infants with less severe visual impairments should be subject to further study.

Brain↗

PubMed1993

Blind, deaf and mute after a status epilepticus caused by hyperpyrexia from shigellosis--a case report with a four-year follow-up.

A nearly four-year-old boy awoke blind, deaf and mute from a coma of five days duration after a status epilepticus caused by hyperpyrexia from shigellosis. The authors give a detailed report of the recovery. Visual and auditory functions recovered within six months after the onset but expressive language difficulties remained. Following a discussion of the underlying mechanisms producing the cerebral damage, the hypothesis of a type of "disconnection syndrome" is put forward to explain the persisting language deficit.

Age of Onset↗

PubMed1992

Visual field and grating acuity development in low-risk preterm infants during the first 2 1/2 years after term.

The effect of early visual experience on visual field size and grating acuity development was studied longitudinally in 36 appropriate for gestational age (AGA) and 26 small for gestational age (SGA) low-risk preterm infants. These were selected out of 194 very low birth weight (VLBW) infants (birthweight less than 1500 g) born in 1985 and 1986. Criteria for inclusion as low-risk were the absence of neurological, respiratory, circulatory and alimentary problems in the neonatal period; no retinopathy of prematurity and no evidence of abnormality on the neonatal cranial ultrasound scans. Binocular field sizes were assessed using kinetic arc perimetry. Binocular grating acuity was tested by means of the prototype version of the acuity card procedure. Results were compared with norms obtained in control fullterms in earlier studies. Infants were tested at 6 weeks, 6, 6, 9 and 12 months of age from the expected term date. Twenty-two of these infants were retested at 2 1/2 years of corrected age. Visual field size and visual acuity estimates of (both AGA and SGA) low-risk, VLBW preterms and control fullterms overlapped at all test ages, except for a slight but significantly faster development of the upper and the lower visual field at 6 weeks corrected age in the preterm group. These results indicate that for clinical purposes visual experience before the expected term date has not only no measurable effect on the normal development of behavioural acuity, but also no accelerating effect on the development of peripheral vision.

Child, Preschool↗

PubMed1992

Visual acuity and visual field development after cryocoagulation in infants with retinopathy of prematurity.

Visual development was studied in 10 very-low-birth-weight infants (less than 1500 g) with retinopathy of prematurity (ROP) stage 3+ who had been treated with cryocoagulation in both eyes. Binocular visual acuity (acuity cards method) and binocular visual fields (kinetic perimetry) were assessed repeatedly in the first year of life. At 12 months corrected age, visual acuity was normal in seven and impaired in three infants, who appeared to be severely myopic. Normal visual fields were found in eight infants at this age. The results indicate that cryotherapy in cases of ROP stage 3+ does not interfere with visual acuity development. The effect on visual field development needs further investigation.

Cryosurgery↗

PubMed1989

[Behavioral determination of visual acuity in 1-to-4-year-old children].

Visual acuity was assessed in 210 children aged 1 to 4 years using the Acuity card method. Visual acuity is expressed in minutes of arc, indicating the minimal angle for separate perception of two lines. Binocular visual acuity showed a gradual growth from 1.8 to 0.9 min, arc and monocular visual acuity from 1.7 to 1 min. arc during this age period. Adult values of 0.65 min. arc(binocular) and 0.70 (monocular) were not yet reached at 4 years of age. Age norms for visual acuity in children from 1 to 4 years of age were determined. The success rate for binocular visual acuity assessment was 99.5% at all ages and increased for monocular acuity assessment from 50% in the 1 to 2 year old to 100% in the 4 year olds. Acuity assessment was fast (test time 3.3 and 2.0 minutes for assessment of binocular and monocular acuity respectively). The inter-observer reliability of the binocular assessment in the same child was high.

Child Behavior↗