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Biomedical subjects

F Mortier

Publications and source records attributed to F Mortier.

At least 19 recordsLinked to original sources
PubMed2006

[Medical end-of-life decisions in neonates and infants in Flanders, Belgium; 1999/2000].

OBJECTIVE: To determine the number of medical end-of-life decisions in critically ill neonates and infants in Flanders, Belgium. DESIGN: Retrospective. METHOD: A death certificate study on all deaths of neonates and infants in the whole of Flanders was carried out over a i2-month period (August 1999-July 2000). An anonymous questionnaire was sent by mail to the attending physician of each of the 292 children who died under the age of 1 year. All physicians who had attended at least one death during the study period were included in an attitude study. RESULTS: A total of 253 (87%) of the 292 questionnaires were returned and 121 (69%) of the 175 physicians involved completed the questions on attitude. An end-of-life decision had been possible in 194 (77%; 95% CI: 70.4-82.4) of the 253 deaths for which questionnaires were returned, and such a decision was actually made in 143 cases (57%; 95% CI: 48.9-64.0). Lethal drugs were administered in 15 of 117 early neonatal deaths and in 2 of 77 later deaths (13% versus 3%; p = 0.018). The attitude study showed that 69 (58%; 95% CI: 48.1-66.5) of the 120 physicians supported a change in the law making life-termination possible in some well-defined cases. CONCLUSION: The death of neonates and infants was commonly preceded by an end-of-life decision in Flanders. The type of decision varied substantially according to the age of the child. The majority of physicians involved, favoured legalization of the use of lethal drugs in some well-defined cases.

Attitude of Health Personnel↗
PubMed2004

Drugs used for euthanasia in Flanders, Belgium.

PURPOSE: Our aim was to describe and assess the medicinal products and doses used for euthanasia in a series of cases, identified within an epidemiological death certificate study in Belgium, where euthanasia was until recently legally forbidden and where guidelines for euthanasia are not available. METHODS: In a random sample of the deaths in 1998 in Belgium, the physicians who signed the death certificates were identified and sent an anonymous mail questionnaire. The questionnaires of the deaths classified as euthanasia cases were reviewed by a multi-disciplinary panel. RESULTS: A total of 22 among 1925 questionnaires pertained to voluntary euthanasia. In 17 cases, detailed information on the euthanatics (medicinal substances used for euthanasia) used was provided. Opioids were used in 13 cases (in 7 as a single drug). Time between last dose and expiry ranged from 4 to 900 min. The panel judged that only in 4 cases effective euthanatics were used. CONCLUSIONS: In the end-of-life decision cases perceived by Belgian physicians as euthanasia, pharmacological practices were disparate, although dominated by the use of morphine, in the very late phase of dying, in doses which were unlikely to be lethal. Most physicians clandestinely engaging in euthanasia in Belgium seemed unaware of procedures for guaranteeing a quick, mild and certain death. Information on the pharmacological aspects of euthanasia should be included in the medical curriculum and continuing medical education, at least in countries with a legal framework permitting euthanasia under specified conditions.

Belgium↗
PubMed2004

Proceeding with clinical trials of animal to human organ transplantation: a way out of the dilemma.

The transplantation of porcine organs to humans could in the future be a solution to the worldwide organ shortage, but is to date still highly experimental. Further research on the potential effects of crossing the species barrier is essential before clinical application is acceptable. However, many crucial questions on efficacy and safety will ultimately only be answered by well designed and controlled solid organ xenotransplantation trials on humans. This paper is concerned with the question under which conditions, given the risks involved and the ethical issues raised, such clinical trials should be resumed. An alternative means of overcoming the safety and ethical issues is suggested: willed body donation for scientific research in the case of permanent vegetative status. This paper argues that conducting trials on such bodies with prior consent is preferable to the use of human subjects without lack of brain function.

Animals↗
PubMed2004

A classification of end-of-life decisions in neonates and infants.

AIM: Valid and reliable data are needed to gain insight into the decisions of paediatricians concerning the end of life of newborns and infants. Such data could throw light on the poorly documented aspects of medical practice regarding these end-of-life decisions (ELDs). In this article a classification of ELDs is developed. METHODS: The classification is developed from knowledge generated from large-scale epidemiological studies on ELDs. RESULTS: This classification sets out from considerations of the various possible medical end-of-life procedures for newborns and infants and from important ethical aspects of the decision-making process. From both ethical and legal viewpoints the life-shortening intention of the physician is a significant factor for the qualification of ELDs. Furthermore, the consultation of the parents is an important factor in absence of the possibility of the patient's self-determination. CONCLUSION: This classification has been devised with the aim of making reliable and valid descriptions of both the incidence and nature of ELDs in this specific population of newborns and infants.

Decision Making↗
PubMed2001

Neurophysiological effects of an extract of Eschscholzia californica Cham. (Papaveraceae).

An aqueous alcohol extract of Eschscholzia californica (Ec) has been evaluated for benzodiazepine, neuroleptic, antidepressant, antihistaminic and analgesic properties, in order to complete the study of the sedative and anxiolytic effects previously demonstrated. The plant extract did not protect mice against the convulsant effects of pentylenetetrazol, and did not cause muscle relaxant effects but appeared to possess an affinity for the benzodiazepine receptor: thus, flumazenil, an antagonist of these receptors, suppressed the sedative and anxiolytic effects of the extract. The Ec extract induced peripheral analgesic effects in mice but did not possess antidepressant, neuroleptic or antihistaminic effects.

Acetic Acid↗
PubMed2001

Repair of chronic ruptures of the anterior cruciate ligament using allograft reconstruction and a ligament augmentation device.

A prospective study was performed to determine the effect of a ligament augmentation device (LAD) on the replacement of the anterior cruciate ligament (ACL) using tendon allografts. Twenty-five patients were followed for 66 to 98 months after tendon allograft replacement with LAD reinforcement for ACL rupture. The evaluation was done using the form of the International Knee Documentation Committee (IKDC), the Lysholm score and the Tegner scale. Two patients sustained a rerupture after major injury. Three other multiply-injured patients scored poorly because of associated injuries and fractures (IKDC grade D). Four patients scored normal (grade A), 12 patients nearly normal (grade B), and 5 patients abnormal (grade C). The Lysholm score showed 14 excellent (average 96), 5 good (average 86) and 4 fair results (average 76). Three patients with excellent results were IKDC grade C, solely because the xrays showed slight narrowing of the medial joint line, which might indeed indicate future problems. On the Tegner scale, the sports level decreased by an average of 1.4 points (from 7.25 to 5.83). Only five patients showed an anteroposterior displacement of more than 3 mm, of which only one was in the grade C group.

Adult↗
PubMed2001

[Euthanasia and other medical decisions concerning the end of life in Belgium: epidemiologic studies].

BACKGROUND: The study presented here is the first replica of the Dutch death certificate study on end of life decisions (ELDs). The main objective was to assess the incidence of euthanasia (the administration of drugs with the explicit intention to shorten the patient's life at the explicit request of the patient), physician assisted suicide (PAS), and other ELDs in medical practice in Belgium (Flanders). METHODS: A 20% random sample of 3,999 deaths was selected from all death certificates between January 1 and April 30, 1998. The physicians who signed the death certificates received one mail questionnaire per death case. FINDINGS: The response rate of the physicians was 52%. The results were corrected for the non response bias, and extrapolated to estimated annual incidences after seasonal adjustment for causes of death. It was estimated that 1.3% (1.0-1.6%, CI: 95) of all deaths resulted from euthanasia or PAS. In 3.2% (2.7-3.8%, CI: 95) of all cases, the physician ended the patient's life with lethal drugs without the explicit request of the patient. Alleviation of pain and symptoms with opioids in doses with a potential life shortening effect preceded death in 18.5% (17.3-19.7%, CI: 95) of cases and nontreatment decisions in 16.4% (15.3-17.5%, CI: 95) of cases, of which 5.8% (5.1-6.5%, CI: 95) with the explicit intention of ending the patient's life. INTERPRETATION: ELDs are prominent in medical practice in Belgium (Flanders). The incidence of deaths preceded by an ELD is similar to the Netherlands, but greater than in Australia. However, in Belgium (Flanders) the incidence of ending of patient's life without the patient's explicit request (3.2%, 2.7-3.8% CI: 95) is similar to Australia (3.5%, 2.7-4.3% CI: 95), but significantly higher than in the Netherlands (0.7%, 0.5-0.9% CI: 95).

Adolescent↗
PubMed2000

End-of-life decisions in medical practice in Flanders, Belgium: a nationwide survey.

BACKGROUND: Our study is a repeat of the Dutch death-certificate study on end-of-life decisions (ELDs). The main objective was to estimate the frequency of euthanasia (the administration of lethal drugs with the explicit intention of shortening the patient's life at the patient's explicit request), physician-assisted suicide (PAS), and other ELDs in medical practice in Flanders, Belgium. METHODS: A 20% random sample of 3999 deaths was selected from all deaths recorded between Jan 1 and April 30, 1998. The physicians who signed the corresponding death certificates received one questionnaire by post per death. FINDINGS: The physicians' response rate was 1355 (52%). 1925 deaths were described. The results were corrected for non-response bias, and extrapolated to estimated annual rates after seasonal adjustment for death causes, and we estimate that 705 (1.3%, 95% CI 1.0-1.6) deaths resulted from euthanasia or PAS. In 1796 (3.2%, 2.7-3.8) cases, lethal drugs were given without the explicit request of the patient. Alleviation of pain and symptoms with opioids in doses with a potential life-shortening effect preceded death in 10,416 (18.5%, 17.3-19.7) cases and non-treatment decisions in 9218 (16.4%, 15.3-17.5) cases, of which 3261 (5.8%, 5.1-6.5) with the explicit intention of ending the patient's life. INTERPRETATION: ELDs are prominent in medical practice in Flanders. The frequency of deaths preceded by an ELD is similar to that in the Netherlands, but lower than that in Australia. However, in Flanders the rate of administration of lethal drugs to patients without their explicit request is similar to Australia, and significantly higher than that in the Netherlands.

Australia↗
PubMed2000

The role of osteoporosis in distal radius fractures.

Our study was designed to establish whether the degree of osteoporosis of the distal forearm affects the outcome of distal radius fractures in elderly women. We assessed the Gartland and Werley score, wrist mobility, grip strength, ulnar variance, radial inclination and palmar tilt of both wrists in 27 postmenopausal women who had sustained a unilateral distal radius fracture following a simple fall. Bone mineral density of the contralateral uninjured wrist and mid-tibial ultrasound velocity were measured. The Gartland and Werley score, wrist mobility, loss of grip strength and the radiological results of the fractured wrist did not correlate with bone mineral density of the uninjured distal radius or with mid-tibial ultrasound velocity. These results may indicate that the influence of osteoporosis on the radiological and clinical outcome in distal radius fractures is not very important.

Aged↗
PubMed1999

Effect of extracts of Orthosiphon stamineus Benth, Hieracium pilosella L., Sambucus nigra L. and Arctostaphylos uva-ursi (L.) Spreng. in rats.

Aqueous extracts of Sambucus nigra and Arctostaphylos uva-ursi and hydroalcohol extracts of Orthosiphon stamineus and Hieracium pilosella were tested for their diuretic activities in rats; pharmacological evaluation revealed that they led to an increase in urine flow. Urinary sodium excretion in rats was increased with O. stamineus and S. nigra.

Animals↗
PubMed1997

Behavioural effects of Passiflora incarnata L. and its indole alkaloid and flavonoid derivatives and maltol in the mouse.

Lyophilised hydroalcoholic and aqueous extracts of the aerial parts of Passiflora incarnata L. (Passifloraceae) (Passion-flower), as well as chemical constituents of the plant, indole alkaloids (harman, harmin, harmalin, harmol, and harmalol) maltol and flavonoids (orientin, isoorientin, vitexin and isovitexin) were assessed for behavioral effects in mice. The accordance with the traditional use of P. incarnata, psychotropic properties were confirmed by some behavioral tests in mice. The anxiolytic properties of hydroalcoholic extract were confirmed at 400 mg/kg by the increase of rears and steps climbed in the staircase test (non-familiar environmental test), and the increase in locomotion and time spent in light side in the light/dark box choice test (non-familiar environmental test). The sedative properties of aqueous extract were confirmed at 400 g/kg by decrease of rears and steps climbed in the staircase test and the decrease of rears and locomotion in the free exploratory test. Moreover, the aqueous extract induced sleep in mice after treatment with a sub-hypnotic dose of pentobarbital.

Alkaloids↗
PubMed1997

An analytical study, anti-inflammatory and analgesic effects of Harpagophytum procumbens and Harpagophytum zeyheri.

The iridoids of Harpagophytum procumbens and Harpagophytum zeyheri were studied by CLHP. Harpagoside is the main iridoid for both drugs whereas 8-p-coumaroylharpagide is a representative iridoid of Harpagophytum zeyheri only. The ratio harpagoside/8-p-coumaroylharpagide can be used to distinguish chemically both species. For commercial dried aqueous extracts this ratio is intermediate because they are probably prepared from a mixture of H. procumbens and H. zeyheri drugs. The aqueous extracts of both drugs show similar analgesic and anti-inflammatory properties. Harpagophytum procumbens and Harpagophytum zeyheri should be accepted as sources for the drug Harpagophyti radix.

Analgesics↗
PubMed1994

The role of stomachal digestion on the pharmacological activity of plant extracts, using as an example extracts of Harpagophytum procumbens.

Various researchers have described anti-inflammatory activity of aqueous extracts of devil's-claw (Harpagophytum procumbens DC.). In this study the extent of the anti-inflammatory activity of an aqueous extract prepared from cryoground fresh plant and administered intraperitoneally, per os (by gavage), and intraduodenally was determined in rats. The anti-inflammatory properties were assessed by applying the carrageenan-induced edema test. The results obtained indicated that intraperitoneal pretreatment with an aqueous extract of H. procumbens significantly reduced the carrageenan-induced edema at 400 and 800 mg/kg 4 h after carrageenan injection (45 and 65% inhibition, respectively). When administered orally (by gavage), the extracts were inefficient. This result could be attributed to the time in transition in the stomach, where the pH is acidic, causing a decrease of the activity of the extract. This inference is consistent with the results obtained by other authors, showing the absence of extract activity when it was treated in an environment of pH 1 and 37 degrees C (similar to the physicochemical conditions found in the stomach) and then administered intraperitoneally. Intraduodenal pretreatment with the aqueous extract significantly reduced the carrageenan-induced edema at 200, 400, and 1600 mg/kg 6-9 h after carrageenan injection (43, 60, and 41% inhibition, respectively). The presence of extract activity after intraduodenal administration supports the assumption that transition of the extract through the stomach leads to loss of activity.

Administration, Oral↗
PubMed1992

Anti-inflammatory and analgesic effects of an aqueous extract of Harpagophytum procumbens.

The dried aqueous extract of Harpagophytum procumbens (Pedaliaceae) and its main iridoid glycoside, harpagoside, have been evaluated for anti-inflammatory and analgesic effects in mice and rats, in order to validate or invalidate the involvement of this compound in such properties. This extract exerted significant and dose-dependent anti-inflammatory and analgesic effects, from the dose 100 mg of dried secondary roots/kg, the first being obtained on an acute inflammatory process (carrageenan-induced edema test in rats) and the second being obtained against a chemical stimulus (writhing test in mice). Harpagoside does not appear to be involved in anti-inflammatory properties, since this iridoid glycoside did not protect against carrageenan inflammatory effects when it was used at 5 and 10 mg/kg; 5 mg corresponding to the quantity contained in 400 mg of dried secondary roots. The main iridoid glycoside of H. procumbens appears to be implicated in the peripheral analgesic properties of this species, but other compounds have to be involved, since the dose of 10 mg/kg exerted a significant protective effect. The absence of the activity of H. procumbens after an acid treatment (0.1 N hydrochloric acid), stomach, suggests the use of a suitable galenic preparation in order to protect the active principles from the action of the acid released in the stomach.

Analgesics↗
PubMed1991

Neurotropic action of the hydroalcoholic extract of Melissa officinalis in the mouse.

A lyophilised hydroalcoholic extract of Melissa officinalis L. (Lamiaceae) has been evaluated for behavioral effects in mice. According to the traditional use of M. officinalis, sedative properties have been confirmed for low doses by the decrease of behavioral parameters measured in a non-familiar environment test (staircase test) and in a familiar environment test (two compartment test). With high doses, a peripheral analgesic activity was obtained by reducing the acetic acid-induced pain (writhing test); moreover, the plant extract induced the sleep in mice after treatment with an infrahypnotic dose of pentobarbital and potentialised the sleep induced by a hypnotic dose of pentobarbital.

Analgesics↗
PubMed1991

Hepatoprotective and anti-inflammatory effects of a traditional medicinal plant of Chile, Peumus boldus.

Dried hydro-alcoholic extract of Peumus boldus (Monimiaceae) has been evaluated for hepatoprotective, choleretic and anti-inflammatory effects in mice and rats, in order to validate or to invalidate traditional therapeutic indications. This extract exerted a significant hepatoprotection of tert-butyl hydroperoxide-induced hepatotoxicity in isolated rat hepatocytes (in vitro technique) by reducing the lipid peroxidation and the enzymatic leakage of LDH; this in vitro efficacy was reinforced by a significant hepatoprotection on CCl4-induced hepatotoxicity in mice (in vivo technique), the plant extract reducing the enzymatic leakage of ALAT. Boldine, the main alkaloid of P. boldus appears to be implicated in this hepatoprotective activity. Choleretic effects, often mentioned in traditional indications, have not been confirmed in rats. Finally, significant and dose-dependent anti-inflammatory effects were obtained on an acute inflammatory process (carrageenan-induced edema test in rats). Boldine does not appear to be involved in such properties.

Animals↗