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Biomedical subjects

F S van Dam

Publications and source records attributed to F S van Dam.

At least 19 recordsLinked to original sources
PubMed2004

[Premature and over-simplified publication of mortality differences between hospitals in the media].

Prismant, the major institute for health-care research in the Netherlands, presented differences in mortality data from hospitals in the Netherlands. The data from the Prismant study were front-page news. However, the Prismant study was only published on their own website, and contained only raw data. The author did not consider relevant issues, e.g., the differences in case mix in the various hospitals and demographic factors. The public debate on quality of health care would benefit greatly if research institutes published only data that were peer reviewed and if journalists checked with experts before they published an article on such a specialist medical issue.

Hospital Mortality↗
PubMed2004

[The hidden treasure-chests of the regional cancer registries].

For physicians and patients, knowledge of the treatment results of individual hospitals is of great importance as it is known that hospitals with more experience perform better. Oncological characteristics of cancer patients in the Netherlands are collected by the nine Comprehensive Cancer Centres. The data are available from each affiliated hospital but remain anonymous. A plea is made for more transparency by requiring that the Comprehensive Cancer Centers place their data in the public domain.

Cancer Care Facilities↗
PubMed2004

[The measures proposed by the Dutch Healthcare Inspectorate after the death of Sylvia Millecam and her treatment by practitioners of alternative medicine].

As a result of the illness and treatment of the Dutch comedian Sylvia Millecam, who died of the consequences of an untreated mammary carcinoma following a quest for help from a series of practitioners of alternative medicine, the Dutch Healthcare Inspectorate has proposed measures designed to prevent a repetition of such a shortcoming in the delivered care. The measures include the compulsory registration of practitioners of alternative medicine, the restriction of diagnostic procedures to regular physicians, the obligation to co-operate with the best possible treatment for the patient in question, mutual exchange of information between practitioners of regular and alternative medicine, and a compulsory protocol regarding the therapeutic agreement with the patient if the regular route is not followed. How feasible these measures are remains a question. A positive aspect of the report is the attention given to the shortcomings in the care provided by the alternative circuit and the deterrent effect of the present case.

Attitude of Health Personnel↗
PubMed2004

[The opinion on care of patients with cancer undergoing palliative treatment in day care].

OBJECTIVE: To study the care utilisation and unmet care needs of patients receiving palliative treatment at the day care clinic of the Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital. DESIGN: Descriptive. METHODS: During the periods 1 April-31 July 2000 and 1 April-31 May 2001 adult cancer patients were interviewed regarding their complaints and symptoms as a result of the disease and the treatment and regarding the problems that they had with the provision of care. RESULTS: There were 155 patients who agreed to participate: 56 men and 99 women, with an average age of 57.5 years. On average, they had 3.2 'severe' complaints. According to the patients, 65% of these 'severe' complaints were known by the specialists, 38% by the general practitioners, 24% by the day care nurses and 83% by the next of kin. Again according to the patients, 17% of the reported severe complaints received insufficient attention. About 25% of patients felt that they had received insufficient information about their disease, treatment, side effects and/or complications. CONCLUSION: The day care centre did not seem to be optimally equipped to meet the needs of patients receiving chemotherapy on an outpatient basis. According to the patients, the specialists were relatively the best informed of all the care providers about their complaints and problems.

Adult↗
PubMed2003

[Less use of alternative treatments by cancer patients in 2002 than in 1999].

OBJECTIVE: To determine the use of alternative diets and other alternative treatments in 2002 compared to 1999. DESIGN: Descriptive, questionnaire. METHOD: During the period 13-26 May 2002 a survey was held among all patients visiting the outpatient clinic of the Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital, Amsterdam, the Netherlands. Patients were asked about their current and past use of alternative therapies, their reasons for using these therapies, the way they were informed about these therapies and the expenses involved. The data were compared with the results of a similar study during the period 15-19 March 1999. RESULTS: Of the 729 patients who fulfilled the inclusion criteria, 66 (9%) declined to participate in the study. Of the remaining 663 patients (average age 58.5 years; 28% male), 131 (20%) used an alternative therapy. Of these, 43 patients (7%) used an alternative diet, mainly the Houtsmuller diet, and 88 patients (13%) used a mixture of alternative therapies such as homeopathy, vitamins and herbs. In 1999, 131 patients (30%) used an alternative form of treatment, 51 (13%) of whom used a diet. Of the 43 users of diets in 2002, 11 (26%) believed that the diet would slow down the disease process; in 1999 this was 53% (27/51). Of the 131 users of alternative therapies in 2002, 55% had been made aware of the possibilities of alternative treatments via family and friends. Internet and TV played a minor role as a source of information. 33 (79%) of the diet users informed their physician or nurse about the use. The diet users spent an average of 170 euro per month on their diets. CONCLUSION: Both the percentage of cancer patients who used an alternative diet and the percentage of diet users who believed that a diet could affect the course of the disease were reduced by half compared to three years earlier.

Complementary Therapies↗
PubMed2001

[Definition of 'quack' in the public debate on alternative medicine].

In May 1999 the Amsterdam Court of Justice decided that a retired internist and propagandist of his own alternative cancer therapy, could rightfully be called a quack by his critics. Recently this judgment was reversed on appeal. The first court used the medical definition of quackery: a treatment of which the supposed benefits are unsubstantiated. The court of appeal, however, took into consideration that to the general public calling someone a quack is an indication that this person is a swindler and practises medicine unlawfully. This definition is supported by the most authoritative Dutch dictionary. Apparently a different semantic interpretation of the term quack has led to these strongly diverging verdicts. The terms quack and quackery are indispensable in the public debate on alternative medicine.

Complementary Therapies↗
PubMed2001

Neurophysiological evaluation of late effects of adjuvant high-dose chemotherapy on cognitive function.

OBJECTIVES: To evaluate late neurotoxicity of adjuvant high-dose (HD) chemotherapy versus standard-dose (SD) chemotherapy by event-related potentials (ERP) and quantitative electroencephalography (qEEG). PATIENTS AND METHODS: From a randomized study in high-risk breast cancer patients on the efficacy of high-dose versus standard-dose adjuvant chemotherapy, late effects on cognitive functioning were analyzed by neuropsychological tests. Cognitive impairment was found in 32% of the HD group, 17% of the SD group and in 9% of a control group of stage I breast cancer patients not treated with chemotherapy. In 17 consecutive patients in the HD group and 16 consecutive patients in the SD group neurophysiological tests were performed, consisting of P300 and qEEG. Results of patients treated with chemotherapy were compared with results of 14 control patients not treated with chemotherapy. All patients were tested two years after treatment. RESULTS: Asymmetry of the alpha rhythm of > or =0.5 Hz was found in 7 HD patients, 2 SD patients and in none of the control patients (p = 0.01). No differences were found between the groups with regard to frequency of alpha rhythm, alpha blocking and latency of P300. No correlation was found between neurophysiological parameters and neuropsychological performance, except for an overall relation between the P300 latencies and the total number of deviant test scores. CONCLUSION: Although the neurophysiological differences are subtle and the relation with the cognitive functioning in individual patients as measured by the neuropsychological examination is equivocal, the results suggest that there is neurophysiological support for cognitive dysfunction as a late complication of high-dose systemic chemotherapy in breast cancer.

Alpha Rhythm↗
PubMed2000

[Complementary therapies in the hospital:'if you can't beat them, join them'?].

Some major cancer hospitals in the United States have established a department for complementary medicine as a service to their patients. Surveys in the Netherlands have shown that notably nursing staff and consumers consider the availability of complementary therapy in health care to be very important. Nevertheless, this appears to be an undesirable development as the effectiveness of these therapies has not been demonstrated and the therapists involved might interfere with regular patient therapy.

Complementary Therapies↗
PubMed2000

[Information needs of men with prostate cancer and their partners].

OBJECTIVE: To determine the need for information of men with prostate cancer and their spouses. DESIGN: Descriptive. METHOD: In February and March 1998 three questionnaires, especially developed for this study, were administered to 40 men treated for prostate cancer and 24 spouses in the Antoni van Leeuwenhoek hospital, Amsterdam, the Netherlands. The questionnaires concerned need for information and knowledge of prostate cancer. RESULTS: In general, patients and spouses indicated to want as much information as possible about prostate cancer and its treatment. Such needs decreased with increasing age. The need for medical-technical information was found to be higher than the need for psychosocial information. Spouses had significantly more need for information than patients, especially psychosocial information. This difference was partly related to age. The patients' needs for information were largely satisfied, while spouses indicated that their needs were often not met. General knowledge of prostate cancer of both patients and spouses was sufficient. CONCLUSION: Men with prostate cancer and their spouses had a substantial need for especially medical-technical information. Their needs decreased with increasing age. The need of spouses was higher than that of patients. Patients' needs were largely satisfied, whereas those of spouses were not always met. Psychosocial information in particular was inadequate.

Aged↗
PubMed2000

Rehabilitation of olfaction after laryngectomy by means of a nasal airflow-inducing maneuver: the "polite yawning" technique.

OBJECTIVE: To develop a nasal airflow-inducing maneuver and apply it in the olfactory rehabilitation of patients who have undergone laryngectomy. DESIGN: Intervention study; before-and-after trial. SETTING: National cancer center. PATIENTS: Forty-four patients who underwent laryngectomy; 34 men and 10 women; mean age, 64 years (range, 42-80 years); mean time since surgery, 6 years (range, 8 months to 18 years). INTERVENTION: In a prospective clinical intervention study, we assessed the effectiveness of a nasal airflow-inducing maneuver ("polite yawning," ie, yawning with closed lips). Speech therapists trained the patients in the maneuver, and its effectiveness in inducing nasal airflow was checked with digital and water manometers. MAIN OUTCOME MEASURES: Olfactory acuity was assessed before and after the intervention by means of an odor detection test and a structured questionnaire concerning olfaction, taste, and appetite. Patients were categorized as "smellers" and "nonsmellers" on the basis of the results of the odor detection test and the present odor perception scale derived from the questionnaire. RESULTS: The nasal airflow-inducing maneuver could be taught to all patients, mostly in only one 30-minute therapy session. Fifteen of the 33 patients in the pretreatment nonsmeller category converted to smellers, for a success rate of 46% (P<.001). CONCLUSION: The nasal airflow-inducing maneuver (the "polite yawning" technique) allowed almost half of the patients to recover their sense of smell.

Adult↗
PubMed2000

A pain monitoring program for nurses: effects on nurses' pain knowledge and attitude.

One of the reasons for inadequate pain treatment in hospitalized patients is that nurses have insufficient knowledge about pain and pain management. To address this problem, a Pain Monitoring Program (PMP) for nurses was developed, implemented, and evaluated. The PMP consisted of two components: educating nurses about pain, pain assessment, and pain management, and implementing daily pain assessment by means of a numeric rating scale. The effects of the PMP were measured in a one-group pretest-post-test design. The results show that nurses have knowledge deficits and prejudices with regard to pain and pain management. Age and additional pain courses in pain partly predict nurses' pain knowledge. After nurses were educated, the average score on the Pain Knowledge Questionnaire increased from 69.1% (SD = 13.2) at pretest to 75.8% (SD = 11.5) at post-test (P < 0.001). Nurses' attitudes changed with regard to their level of knowledge and skills in relieving pain, willingness to assess pain on a daily basis, and attention to patients' pain complaints. It can be concluded that the PMP is effective in improving nurses' knowledge of pain management and focusing nurses' attention to patients' pain complaints.

Adult↗
PubMed2000

A pain monitoring program for nurses: effects on communication, assessment and documentation of patients' pain.

Nurses need to be informed about the patient's pain to be able to take appropriate measures to alleviate pain. However, communication, assessment, and documentation of pain by nurses is often a problemfor hospitalized patients. In this study we aimed to overcome the main barriers by developing, implementing, and evaluating a Pain Monitoring Program (PMP) for nurses. The PMP consists of two components: educating nurses about pain, pain assessment and pain management; and implementing daily pain assessment by means of a numeric rating scale. We describe the effects of the PMP on communication about pain between nurses and patients and between physicians and patients, agreement between patients 'pain intensity and nurses estimations of patients'pain intensity, and documentation about pain in the nursing records. Factors that might influence communication, assessment, and documentation are also discussed. The effects of the PMP were measured in a quasi-experimental design with a nonequivalent control group. In total, 703 patients participated: 358 patients in the control group and 345 in the intervention group. Results of the control group showed that communication about pain between nurses and patients, agreement between patients' and nurses pain ratings, and documentation about pain in nursing records, remain inadequate. Patients'pain intensity and age were related to communication, assessment, and documentation. Communication and documentation is better in patients with moderate to severe pain than in patients with mild pain, and assessment is better in patients with mild pain. Older patients communicate less with nurses and physicians about pain, and nurses document less about pain in nursing recordsfor older patients compared with younger patients. The PMPproved to be effective in improving nurses'assessment of patients 'pain and documentation about pain in nursing records. Patients' pain intensity and care setting were related to the efficacy of the PMP Communication about pain between patients and nurses, and between patients and physicians did not improve as a result of the PAIP Based on this study it can be concluded that in using a simple method such as the numeric rating scale, together with an education program, attention is focused in a systematic way on patients'pain complaints and creates a common language between patients and nurses. Because the PMP proved effective in a heterogenous population in multiple care settings, it is recommended to implement the PMP in nursing practice.

Aged↗
PubMed2000

High-dose chemotherapy with peripheral blood progenitor cell transplantation in the adjuvant treatment of breast cancer.

High-dose chemotherapy as adjuvant treatment for high-risk breast cancer has been and is being investigated in a series of randomized trials. The preliminary information from 5 studies is difficult to interpret. The data are consistent with a modest benefit of high-dose therapy, but strong evidence for this is lacking. Additional follow-up and the results of several large trials outside the United States are awaited. Hitherto unrecognized pharmacologic interactions between high-dose agents and long-term toxicities such as cognitive function impairment complicate the issue considerably.

Antineoplastic Agents, Alkylating↗
PubMed1999

[The national cancer fund (Koningin Wilhelmina Fonds) and the Houtsmuller-therapy for cancer].

Dr. Houtsmuller, a retired internist, introduced an anticancer diet ten years ago. He claimed to have cured himself from metastatic melanoma by following a diet consisting of healthy nutrients, large amounts of vitamins, minerals, antioxidants and shark cartilage powder in combination with psychological support. The efficacy of the therapy was never described in a scientific article. Currently about 63% of all cancer patients in the Netherlands using a diet use the Houtsmuller diet. The national cancer fund (Koningin Wilhelmina Fonds) invited him to speak at their 50-year commemorative symposium. Shortly before he admitted that his medical history did not mention metastatic melanoma. Dr. Houtsmuller has seriously damaged the position of physicians in the Netherlands by addressing patients directly without first seeking support from his scientific medical peers. Cancer organizations such as Koningin Wilhelmina Fonds are urged to properly inform the public about the real value or lack of value of alternative treatments in general and of alternative diets in particular.

Aged↗
PubMed1999

Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma.

BACKGROUND: A number of patients who have undergone adjuvant (CMF) chemotherapy for operative primary breast carcinoma have reported impaired cognitive function, sometimes even years after completion of therapy. The possible role of cytostatic treatment as a causative factor has scarcely been investigated. The objective of the current study was to examine the late effects on neuropsychologic functioning of CMF adjuvant chemotherapy given to patients with breast carcinoma. METHODS: Thirty-nine breast carcinoma patients who had been treated with adjuvant CMF (6 courses) followed (n = 20) by 3 years of tamoxifen 20 mg daily or not (n = 19) were examined with neuropsychologic tests and interviews. The control group consisted of 34 age-matched axillary lymph node negative breast carcinoma patients who received the same surgical and radiation therapy but no systemic adjuvant treatment. The CMF patients were examined a median of 1.9 years after the sixth CMF course, and the controls a median of 2.4 years after surgery of the primary tumor. RESULTS: Patients treated with CMF reported significantly more problems with concentration (31% vs. 6%, P = 0.007) and with memory (21% vs. 3%, P = 0.022) than the control patients. No relation was found between reported complaints and results on the neuropsychologic tests. Impairment in cognitive function was found in 28% of the patients treated with chemotherapy compared with 12% of the patients in the control group (odds ratio 6.4 [95% confidence interval 1.5-27.6] P = 0.013). Hormonal therapy had no influence on patients' self-reports of symptoms or cognitive function. Cognitive impairment following chemotherapy was noticed in a broad domain of functioning, including attention, mental flexibility, speed of information processing, visual memory, and motor function. CONCLUSIONS: Breast carcinoma patients treated with adjuvant CMF chemotherapy have a significantly higher risk of late cognitive impairment than breast carcinoma patients not treated with chemotherapy (OR 6.4). This cognitive impairment is unaffected by anxiety, depression, fatigue, and time since treatment, and not related to the self-reported complaints of cognitive dysfunction.

Adult↗
PubMed1999

Deterioration of olfaction and gustation as a consequence of total laryngectomy.

INTRODUCTION: After total laryngectomy the absence of a nasal airflow results in a decrease in olfaction and perception of flavors. MATERIALS AND METHODS: Odor perception was assessed in 63 laryngectomized patients with two different olfactory tests. The methods used by patients to smell were observed during olfactory testing. Patients' judgment about their olfaction and gustation was assessed by means of a structured questionnaire, semistructured interview, and self-rating. RESULTS: Based on the results of the olfactory tests, patients were categorized as "smellers" and "nonsmellers." Approximately one third of the patients were able to smell the odorous substances used in the olfactory tests. The smellers more often used a variety of methods to smell than the nonsmellers (P < .002); in most patients the method consisted of active use of facial muscles. Patients appeared well able to judge their own odor perception. Compared with the smellers, the nonsmellers judged their odor perception as worse (P < .003) and reported a more severe decrease in gustation after the operation (P < .033). The results of this study in laryngectomized patients confirm the interrelation between olfaction and gustation: the nonsmellers reported a poorer gustation and a more severe decrease in gustation and appetite than both the smellers and a reference group of elderly persons (P < .05). Patients who reported a deterioration of olfaction and gustation tended to experience negative consequences such as the inability to smell smoke, leaking gas, or agreeable odors. CONCLUSION: Olfaction and odor-related flavor sensation are seriously deteriorated after total laryngectomy.

Aged↗
PubMed1998

Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy.

BACKGROUND: Although high-dose chemotherapy is rapidly gaining acceptance as a treatment option for a number of cancers, the long-term toxic effects of such therapy are a concern. Cognitive deficits (e.g., problems with memory and concentration) are not uncommon after chemotherapy, but they have not been documented systematically. In this study, we assessed the prevalence of cognitive deficits in a group of patients with high-risk breast cancer who were randomly assigned to receive either high-dose or standard-dose adjuvant chemotherapy plus tamoxifen, and we investigated whether high-dose chemotherapy impaired cognitive functioning more than standard-dose chemotherapy. METHODS: Cognitive functioning was evaluated by use of a battery of neuropsychologic tests. In addition, patients were interviewed with regard to cognitive problems, health-related quality of life, anxiety, and depression. Results from patients who received adjuvant systemic therapy were compared with results from patients who had early stage breast cancer not treated with such therapy (control patients). RESULTS: The study population consisted of 34 patients treated with high-dose chemotherapy plus tamoxifen, 36 patients treated with standard-dose chemotherapy plus tamoxifen, and 34 control patients. For all patients, the average time since the completion of last nonhormonal therapy was 2 years. Cognitive impairment was found in 32% of the patients treated with high-dose chemotherapy, in 17% of the patients treated with standard-dose chemotherapy, and in 9% of the control patients. In comparison with the control patients, patients treated with high-dose chemotherapy appeared to have an 8.2-times higher risk of cognitive impairment (odds ratio; 95% confidence interval [CI] = 1.8-37.7); in comparison with the patients who received standard-dose chemotherapy, this risk of impairment was 3.5-times higher (95% CI = 1.0-12.8). CONCLUSION: High-dose chemotherapy appears to impair cognitive functioning more than standard-dose chemotherapy. Central nervous system toxicity may be a dose-limiting factor in high-dose chemotherapy regimens.

Adult↗