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Biomedical subjects

F G Versteegh

Publications and source records attributed to F G Versteegh.

At least 19 recordsLinked to original sources
PubMed2001

Comparison of handling and acceptability of two spacer devices in young children with asthma.

UNLABELLED: This study compared parents' preference for two spacer devices, NebuChamber and Babyhaler for the treatment of young children with asthma. In this open, cross-over study 141 patients (aged 5-57 mo) who used inhaled steroids via a spacer device were randomized to budesonide via NebuChamber or beclomethasone dipropionate via Babyhaler. Both treatments were given by the parents twice daily for 2 wk. At the final visit parents completed a questionnaire on preference in general and for a given set of features. Acceptability and handling were scored in a diary. Diary scores on acceptability by the child and handling of both spacer devices were comparable. In the preference questionnaire, 68% of parents preferred NebuChamber [95% confidence interval (CI) 60-76] and 25% Babyhaler (95% CI 18-33). The preference was independent of the type of spacer used before the study and was also apparent in the different features: acceptability by child, carrying around, cleaning, close fitting of face mask, assembling and disassembling, damage resistance and size. These differences were statistically significant for all features, except for acceptability by the child. CONCLUSION: Two-thirds of parents prefer NebuChamber over Babyhaler for the treatment of their young asthmatic children.

Aerosols↗
PubMed2000

Specificity and sensitivity of high levels of immunoglobulin G antibodies against pertussis toxin in a single serum sample for diagnosis of infection with Bordetella pertussis.

Laboratory confirmation of pertussis by culture, PCR, or detection of antibody increase in paired sera is hampered by low sensitivity in the later stages of the disease. Therefore, we investigated whether, and at which level, concentrations of immunoglobulin G (IgG) antibodies against pertussis toxin (PT), IgG-PT, in a single serum sample are indicative of active or recent pertussis. IgG-PT, measured by enzyme-linked immunosorbent assay in units per milliliter, was analyzed in 7,756 sera collected in a population-based study in The Netherlands, in the sera of 3,491 patients with at least a fourfold increase of IgG-PT, in paired sera of 89 patients with positive cultures and/or PCR results, and in the sera of 57 patients with clinically documented pertussis with a median follow-up of 1.4 years. We conclude that, independently of age, IgG-PT levels of at least 100 U/ml are diagnostic of recent or active infection with Bordetella pertussis. Such levels are present in less than 1% of the population and are reached in most pertussis patients within 4 weeks after disease onset and persist only temporarily.

Adolescent↗
PubMed1999

Efficacy and safety of high-dose inhaled steroids in children with asthma: a comparison of fluticasone propionate with budesonide.

OBJECTIVE: To compare the efficacy and adverse effects of inhaled fluticasone propionate (FP), 400 microgram/d, with those of budesonide (BUD), 800 microgram/d, in children with moderate to severe asthma. METHODS: Three hundred thirty-three children, ages 4 to 12 years, receiving inhaled corticosteroids were enrolled in a double-blind, double-dummy, randomized, parallel-group study. After a 2-week run-in phase, 166 children received FP and 167 received BUD for 20 weeks. The primary outcome variable was mean morning peak expiratory flow; the 2 treatments were to be regarded as equivalent if the 90% CI for the treatment difference was within +/- 15 L/min. Pulmonary function, height, and diary cards were assessed at each visit; and morning serum cortisol levels were determined before and after treatment. RESULTS: Baseline peak expiratory flow was similar, FP 236 +/- 72 (SD) L/min and BUD 229 +/- 74, increasing after treatment to 277 +/- 41 and 257 +/- 28, a difference between treatments of 12 L/min (90% CI 6-19 L/min; P =.002). Symptom control and use of rescue medication were the same. Cortisol levels after treatment were 199 nmol/L (FP) and 183 nmol/L (BUD) (treatment ratio = 1.09; 90% CI 0.98-1.21; P =.172). Linear growth was less in those receiving BUD (mean difference, 6.2 mm; 95% CI 2.9-9.6; P =.0003). CONCLUSION: FP at half the dose was superior to BUD in improving peak expiratory flow and comparable in controlling symptoms. Growth was reduced with BUD compared with FP, but there was no difference in serum cortisol suppression or hepatic or renal function.

Androstadienes↗
PubMed1998

Ciprofloxacin in preterm neonates: case report and review of the literature.

UNLABELLED: We report the use of ciprofloxacin in a preterm boy suffering from an invasive multiple resistant Enterobacter cloacae infection. The treatment was effective, after other antibiotics failed, and no adverse effects were observed during 3 years of follow up. The literature on compassionate ciprofloxacin use in 28 preterm or low birth weight infants is reviewed. Ciprofloxacin has been used to treat neonatal pneumonia, meningitis and septicaemia and was effective in all cases. Side-effects were limited to dental dyschromia and one observation on the emergence of resistance. Pharmacokinetics of ciprofloxacin were studied in seven preterm infants; iv doses ranging from 4 to 40 mg/kg per day revealed adequate serum peak concentrations (0.98-5.7 mg/l) but trough-peak ratios were high (median ratio: 32%), suggesting slower elimination in preterm infants as compared to older children. CSF concentrations were 0.10-1.45 mg/l. CONCLUSION: Ciprofloxacin treatment of preterm or low birth weight infants may be effective and without severe side effects in infections with bacteria resistant to other antibiotics

Anti-Infective Agents↗
PubMed1997

[Activated charcoal as first-choice therapy in poisoning].

In gastrointestinal detoxication, three methods are possible: ipecac induced emesis, gastric lavage and administration of activated charcoal. The method of treatment predominantly used in the Netherlands is gastric lavage in combination with activated charcoal. Published evidence suggests that activated charcoal not preceded by gastric emptying is preferred. Additional advantages of using activated charcoal alone as the method of choice for gastrointestinal decontamination are patient friendliness, low cost and time saving because quick intervention by general practitioners is possible.

Adult↗
PubMed1991

[Magnesium poisoning in an infant].

We present the case of a girl aged 3 weeks with extreme hypermagnesaemia (7.94 mmol/l) due to an overdose of magnesium oxide, prescribed as a laxative. We treated her successfully with a combination of hyperhydration, forced diuresis and natriuresis, and additional intravenous calcium and insulin. We also performed an exchange transfusion which, however, had a questionable effect on the final outcome.

Combined Modality Therapy↗
PubMed1991

Spontaneous pneumomediastinum in children.

Spontaneous pneumomediastinum is defined as a non-traumatic mediastinal air leak in patients without underlying lung disease. In children it is rarely diagnosed but is likely to be often missed. We have made a comprehensive review of the literature on spontaneous pneumomediastinum in children. The aetiopathogenesis, incidence, clinical features, diagnosis and treatment are discussed. We suggest that spontaneous pneumomediastinum in children is underdiagnosed.

Child↗
PubMed1990

Relationship between airway obstruction, desaturation during exercise and nocturnal hypoxaemia in cystic fibrosis patients.

We measured pulmonary function, responses to exercise and oxygen saturation (So2) at rest, and also before and during sleep in 24 patients with cystic fibrosis in a varying degree of severity. The pulmonary function indices analysed were forced expiratory volume in one second (FEV1), total lung capacity (TLC), measured by body plethysmography (TLC box) and Helium dilution (TLC He), residual volume measured by body plethysmography (RV) and the amount of trapped air (TA = TLC box-TLC He). The exercise variables included symptom limited maximal oxygen uptake (Vo2max), maximum minute ventilation (VEmax) and So2, at rest in sitting position and during maximal exercise. So2 was measured by ear oximetry. The lowest mean So2 obtained in two consecutive nights over a period of 1 hour was taken as the indicator of nocturnal oxygen saturation. A high correlation existed between resting supine and sitting So2, and the degree of nocturnal hypoxaemia (0.84 and 0.76, respectively). Highly significant correlations existed also for the indices of airway obstruction, Vo2 max and lowest So2 at exercise versus the nocturnal lowest hourly mean So2. From all variables a resting So2 in the sitting position lower than 94% appeared to be most predictive of nocturnal desaturation and indicates a risk of nocturnal hypoxaemia in patients with cystic fibrosis.

Adolescent↗
PubMed1985

Acute tubular dysfunction in infants with obstructive uropathy.

Eleven patients are described with severe hyponatraemia, hyperkalaemia and metabolic acidosis associated with a urinary tract infection and obstructive uropathy. This clinical entity resembles adrenocortical disorders. Urine culture investigation in combination with abdominal ultrasound examination will reveal urinary tract obstruction. Differential diagnosis, pathogenesis and treatment are discussed. In most patients correction of the metabolic disturbance can be achieved with antibiotic treatment, occasionally in combination with surgical therapy. Some degree of polyuria will generally persist.

Acidosis↗
PubMed1984

[An epidemic of hand, foot and mouth disease].

Five patients with hand-, foot- and mouth disease, caused by infection with Coxsackievirus type A16, are described in an epidemic outbreak of this disease. Hand-, foot- and mouth disease, is characterized by a most distinctive enanthem-exanthemcomplex. In 65% of the cases a vesiculopapular exanthem is noted. Most cases are described in epidemic outbreaks. Although the vast majority of occurrences of the disease have been due to Coxsackie A16 viral infections, occasionally Coxsackie A5, A10 and enterovirus 71, seldom Coxsackievirus B1 or B3, have been etiologically incriminated. In this article attention is paid to the clinical characteristics, the epidemiology and the differential diagnostic aspects of hand-, foot- and mouth disease.

Child, Preschool↗