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Biomedical subjects

G Bleijenberg

Publications and source records attributed to G Bleijenberg.

At least 91 records · Page 5Linked to original sources
PubMed1995

Chronic fatigue syndrome: a clinical and laboratory study with a well matched control group.

OBJECTIVE: To investigate the relation between severity of complaints, laboratory data and psychological parameters in patients with chronic fatigue syndrome (CFS). SUBJECTS: Eighty-eight patients with CFS and 77 healthy controls matched for age, sex and geographical area. METHODS: Patients and controls visited our outpatient clinic for a detailed medical history, physical examination and psychological tests: Checklist Individual Strength (CIS). Beck Depression Inventory (BDI) and Sickness Impact Profile (SIP). Venous blood was drawn for a complete blood cell count, serum chemistry panel, C-reactive protein and serological tests on a panel of infectious agents. RESULTS: All patients fulfilled the criteria for CFS as described by Sharpe et al. (J R Soc Med 1991; 84: 118-21), only 18 patients (20.5%) fulfilled the CDC criteria. The outcome of serum chemistry tests and haematological tests were within the normal range. No significant differences were found in the outcome of serological tests. Compared to controls, significant differences were found in the results on the CIS, the BDI, and the SIP. These results varied with the number of complaints (CDC criteria). When the number of complaints was included as the covariate in the analysis, there were no significant differences on fatigue severity, depression, and functional impairment between patients who fulfilled the CDC criteria and patients who did not. CONCLUSION: It is concluded that the psychological parameters of fatigue severity, depression and functional impairment are related to the clinical severity of the illness. Because the extensive panel of laboratory tests applied in this study did not discriminate between patients and controls, it was not possible to investigate a possible relation between the outcomes of psychological and laboratory testing.

Adult↗
PubMed1994

Effect of electrostimulation on sphincter function in neurogenic fecal continence.

PURPOSE: This study was designed to examine the effects of electrostimulation on sphincter function. METHODS: Electric stimulation was performed twice a day for 30 minutes over a 12-week period on 10 patients with neurogenic fecal incontinence. Anal manometry was repeated after 6 and 12 weeks. RESULTS: Two patients experienced some improvement. Mean resting pressure was increased by 0.6 (-5.8 to +5.3) kPa and mean squeezing pressure by 0.3 (-1.6 to +2.6) kPa. All values remained below continent levels. An increase in squeezing pressure after both 6 and 12 weeks was recorded in only one patient. CONCLUSION: Electrostimulation does not improve internal or external sphincter function. There is no indication that it will do so in the long term either.

Adult↗
PubMed1994

Doctors' perception of patients' cognitions and complaints in irritable bowel syndrome at an out-patient clinic.

Functional abdominal complaints (IBS) are widespread in the general population, especially among women. Non-organic dimensions of the complaint such as complaint-related cognitions and behaviour appear to be related to the prognosis. The prognosis could possibly be improved by changing these factors during medical consultations. Therefore, doctors have to perceive patients' cognitions and behaviour. But, do they perceive them correctly? One hundred and twenty patients with functional abdominal complaints referred to an out-patient clinic for internal medicine completed a questionnaire about their complaints and their complaint-related cognitions, behaviour, and anxiety prior to the first consultation. After the first consultation, doctors completed a similar questionnaire indicating their perceptions of patients' cognitions, anxiety, behaviour, and complaints. Complaints were perceived better than cognitions, anxiety, and behaviour. Doctors underestimated patients' expectations and secondary complaints and overestimated patients' pain-related attributions, and their catastrophizing and self-efficacy cognitions.

Adult↗
PubMed1994

Dimensional assessment of chronic fatigue syndrome.

The absence of laboratory tests and clear criteria to identify homogeneous (sub)groups in patients presenting with unexplained fatigue, and to assess clinical status and disability in these patients, calls for further assessment methods. In the present study, a multi-dimensional approach to the assessment of chronic fatigue syndrome (CFS) is evaluated. Two-hundred and ninety-eight patients with CFS completed a set of postal questionnaires that assessed the behavioural, emotional, social, and cognitive aspects of CFS. By means of statistical analyses nine relatively independent dimensions of CFS were identified along which CFS-assessment and CFS-research can be directed. These dimensions were named: psychological well-being, functional impairment in daily life, sleep disturbances, avoidance of physical activity, neuropsychological impairment, causal attributions related to the complaints, social functioning, self-efficacy expectations, and subjective experience of the personal situation. A description of the study sample on these dimensions is presented.

Activities of Daily Living↗
PubMed1994

Enteroviruses and the chronic fatigue syndrome.

The possible role of enteroviral persistence in the etiology of the chronic fatigue syndrome (CFS) was investigated by serological testing, VP-1 antigen testing, and polymerase chain reaction (PCR) analysis of stool specimens as well as by viral cultures of stool--both direct and after acid treatment. No differences between 76 patients with disabling unexplained fatigue and 76 matched controls were found by serological or antigen testing. Furthermore, no enteroviruses were isolated from any stool culture. Enterovirus was detected by PCR in one stool specimen from a patient with CFS but was not detectable in a second sample obtained from the same patient 3 months later. All stool specimens from controls were PCR-negative. These results argue against the hypothesis that enteroviruses persist in patients with CFS and that their persistence plays a role in the pathogenesis of this syndrome.

Adult↗
PubMed1994

Biofeedback treatment of constipation: a comparison of two methods.

OBJECTIVES: Our purpose in this study was to determine whether, with balloon feedback treatment, one can obtain results similar to those achieved with electromyographic (EMG) feedback treatment, in patients with a functional outlet obstruction (spastic pelvic floor syndrome). METHODS: In a randomized controlled study, 11 patients received EMG biofeedback and nine patients received balloon feedback. Treatment outcome was assessed by standard EMG during straining, constipation score, and a standard diary with details about complaints. RESULTS: Using change scores (posttreatment score minus pretreatment score), we found significantly greater positive changes for EMG feedback at posttreatment and at follow-up. When criteria for good clinical outcome were used, eight of 11 patients treated with EMG feedback appeared to be improved, against two of nine patients treated with balloon feedback. Type of feedback was the only difference between the groups. CONCLUSIONS: Alteration of the EMG pattern leads to lessening of complaints, which means that pelvic floor contraction during straining indeed is the cause of the constipation. The results suggest that EMG feedback is more effective than balloon feedback in treating spastic pelvic floor syndrome.

Adult↗
PubMed1991

Non-surgical treatment for constipation in adults: the place of biofeedback.

The treatment of slow-transit constipation consists of dietary measures combined with a regime of laxatives and enemas. Surgery should only be considered when intractable constipation persists despite these measures. Results, however, are moderate. Functional outlet obstruction, the spastic pelvic floor syndrome, is caused by an abnormal use of a normal pelvic floor muscle. Procedures aiming at weakening pelvic floor function give no long-term good results and may lead to faecal incontinence. Biofeedback treatment, relearning normal muscle function by monitoring pelvic floor EMG and simulating defaecation, gives excellent results.

Anal Canal↗
PubMed1990

Psychologic factors in diagnosis, prognosis, and treatment of functional abdominal complaints.

Functional abdominal complaints are frequently a reason to refer a patient to an outpatients' clinic for internal medicine. According to general views, certain psychologic and anamnestic data can constitute an indication for the diagnosis 'functional'. However, in our experience patients with functional complaints cannot be distinguished from patients with organic disease on such data. These same anamnestic and psychologic data, however, do have value in predicting the outcome of the complaints. Apparently, psychologic factors play a role in the course of functional abdominal complaints. Therefore, we tested the hypothesis that prognosis of functional abdominal complaints can be improved by psychologic intervention, and we offered our patients such a psychologic intervention in the form of a cognitive-behavioural group treatment. The first, encouraging, results are presented.

Behavior↗
PubMed1990

Assessment and treatment of obstructed defecation.

Defecation may be considered as "the last taboo". The inability to defecate, or to achieve it only by digital evacuation, has never been a popular topic among patients and doctors. The extensive development of tests in laboratories studying colorectal disorders during recent years, however, has made it possible to study the different parts of the mechanism for maintaining continence. Since constipation is a disorder of this mechanism, namely a disorder of rectal evacuation, application of these tests on constipated patients is logical. Certainly surgery, either colectomy or sphincter division, is not the solution, nor is the injection of muscle weakening solutions. Biofeedback, however, seems to be a logical treatment. Development of new functional tests and strategies is needed to enable a better understanding of the problem. Collaboration between surgeon and psychologist has proved valuable and is recommended.

Constipation↗
PubMed1989

Anamnestic and psychological features in diagnosis and prognosis of functional abdominal complaints: a prospective study.

Psychological and anamnestic data from 308 patients were collected to investigate whether patients with abdominal complaints from organic causes could be distinguished psychologically or by their case histories from patients with functional abdominal complaints. Two years later the same patients took part in a follow up study. Only 9% of the patients with functional abdominal complaints became symptom free. Most variables showed no significant difference between the organic and the functional group. The most important variables with predictive value were psychological factors, factors associated with the severity and factors associated with the duration of the complaints.

Analysis of Variance↗
PubMed1987

Treatment of the spastic pelvic floor syndrome with biofeedback.

The spastic pelvic floor syndrome is a functional disorder based on contraction instead of relaxation of the pelvic floor muscle during straining, which inhibits defecation and gives rise to constipation. Until now no adequate treatment has been found for this condition. The treatment described here is aimed at teaching patients to relax their pelvic floor muscle during straining. Treatment consists of a training program with EMG feedback, followed by simulation of the defecation process, using oatmeal porridge. Patients are then given instructions to generalize the relaxation response in their daily lives. Treatment was completely successful in seven of ten patients. The three remaining patients learned to strain in the correct manner, but could not achieve generalization. Two of them underwent subtotal colectomy because of delayed colonic transit times, which subsequently resulted in normal evacuation. In the third patient, the generalization was most likely hampered by psychologic problems, for which she now receives psychotherapy.

Adult↗