PubMed Health⌕ Search

Biomedical subjects

J Hellemans

Publications and source records attributed to J Hellemans.

At least 19 recordsLinked to original sources
PubMed1984

Positive 14CO2 bile acid breath test in elderly people.

The 14CO2- glycylcholate breath test (also called the bile acid breath test) was performed in a group of 42 normal young volunteers (group A), a group of 25 elderly subjects in apparently good health (group B) and a group of 22 hospitalized geriatric patients presenting with weight loss (group C). The 95 percentile value of the cumulative 14CO2 excretion at the third and the sixth hour in group A was taken as the limit for normal values for 14CO2 excretion. Using these criteria 56% of group B subjects and 50% of group C patients were considered abnormal at the third hour, whereas at the sixth hour these percentages were 56% and 54%, respectively. Repetition of the bile acid breath test after antibiotic treatment in the hospitalized group suggested that bacterial overgrowth in the small intestine was responsible for the abnormal 14CO2 breath test in the elderly persons. However, the large number of abnormal tests in healthy elderly people, not complaining of any gastro-intestinal discomfort, indicates that bacterial overgrowth may remain asymptomatic and that an abnormal test does not necessarily mean that the symptoms of a patient are to be ascribed to this finding.

Adult↗
PubMed1982

Pancreatic polypeptide is not involved in the regulation of the migrating motor complex in man.

The role of pancreatic polypeptide (PP) and motilin in the regulation of the migrating motor complex (MMC) was studied in normal subjects. Both plasma motilin and PP levels changed cyclically in the fasted state and were highest in the late phase II period preceding the activity front in the duodenum. A continental breakfast invariably disrupted the MMC and induced a fed pattern of motility. After the meal plasma motilin levels decreased whereas PP levels rose significantly. Infusion of pure porcine motilin during the fasted state induced an activity front and a rise in plasma PP levels. Infusion of bovine PP in doses producing plasma PP levels above the postprandial values neither induced an activity front nor prevented its occurrence. During PP infusion, however, plasma motilin levels were low, although the activity front was not inhibited. PP seems to have no clear role in the regulation of the motor component of the MMC of man. The role of motilin in the production of the activity front of the MMC is discussed.

Duodenum↗
PubMed1982

Antihypertensive therapy in patients above age 60 with systolic hypertension. A progress report of the European Working Party on High Blood Pressure in the Elderly (EWPHE).

1. Although systolic blood pressure elevation is responsible for increased incidence of cardiovascular accidents in old people, the preventive benefit of lowering systolic hypertension in elderly has not been confirmed. 2. A double blind study comparing the effects of a placebo and of an active regimen (hydrochlorothiazide-triamterene with or without methyldopa) in people over 60 years with isolated systolic hypertension has been undertaken by the European Working Party on High blood pressure in the Elderly (EWPHE). 3. The actively treated group shows a lowered sitting blood pressure (-15/6 mm Hg), a mild increase of serum creatine, serum uric acid and blood glucose and a mild decrease of serum potassium after two years of treatment when compared to the spontaneous changes observed in the placebo treated group. 4. The study is continuing to evaluate if the blood pressure reduction prevents or reduces the incidence of cardiovascular accidents, although some biochemical changes were provoked by the treatment.

Aged↗
PubMed1982

[Problems and future perspectives in the treatment of Parkinson's disease].

The most prominent neuropathological lesions in Parkinson's disease have been found in the substantia nigra. The neurochemical alterations are numerous; the most prominent one is the imbalance between acetylcholine and dopamine, the latter transmitter being deficient. Up to now the striato-nigral dopaminergic receptor is the best investigated and the most useful target for an effective therapy. However, a more specific modulation, stimulation or blockade of these receptors, could strongly reduce the occurrence of the side-effects and the drug resistance that are to be seen after a dopamine substitution started too early or too vigorously.

Acetylcholine↗
PubMed1982

[Specialism in geriatrics and training as a geriatrician. The development of geriatrics as a medical specialty].

Two geriatricians--Belgian and Dutch--have attempted to define their ideas and principles regarding clinical geriatrics based on their work. They strongly recommend the establishment of geriatric hospital departments which are in level and prestige equal to other hospital departments. As attending specialist the geriatrician is responsible for the overall-management of elderly patients with multiple pathology, delicate balances, specific clinical syndromes, mutual involvement of somatic and mental disorders, loss of functions, etc. The execution of this task is based on clinical expertise, knowledge of specific provisions for the elderly in the community and on teamwork with the nursing and paramedical staff of the geriatric department who know how to deal with geriatric patients. Close co-operation with other specialists is necessary to guarantee the quality of the care. Geriatricians and other specialists need to complement each other. In addition it is necessary that the geriatrician select one or more areas of special interest in the extensive professional field in order to carry out clinical research. It is important that geriatric patients are not admitted in hospital departments where they happen to be referred to, but where they have the best chance of recovery. As the geriatric department offers a specific approach, it is recommended that the very old will be admitted there in the first place unless they urgently need other specialist treatment. The elderly who are in serious distress as far as general care is concerned, but do not need hospital expertise, have to be taken care of in other ways.

Education, Medical, Graduate↗
PubMed1981

[Advice on scientific research on the aged person].

A few years ago, the Ministry of Culture, Recreation and Social Welfare inaugurated a Planning group to establish a scientific program for research on ageing. This contribution gives comment on this advice just published. In general the program will only be used to a certain extent. The planning group advises to inaugurate another steering committee, that should control the research itself and its evaluation. The commentators hope that this steering committee will be enabled to apply the program in a fairly independent way. Why: because the advice lacks a strong structure. It is clear that the gerontological field is such a vast area, that it is impossible to do research on all topics. Therefore, we need some more clear alternatives to choose between. The commentators stress three different alternatives: 1. the fundamental research in bio-medical as well as in behavioural sciences; 2. the major practical problems of ageing people and their support; 3. accent on development of methods and measures. The comment emphasizes also the conditions for research-education at university level and the stimulation of grants for developing new research projects. In addition, some remarks are made about the composition of the planning group. Unfortunately, in that group the medical practitioner and the psychologist were missing.

Aged↗
PubMed1979

Motilin and the interdigestive migrating motor complex in man.

In order to assess the possible role of the new candidate gut hormone, motilin, in controlling the interdigestive migrating motor complex (MMC) in man, 14 normal subjects were studied after an overnight fast by means of three pressure-recording catheters with orifices 25 cm apart in the upper small intestine. The typical aboral progressing bursts of pressure waves occurred at a mean interval of 137 minutes and were preceded by a peak motilin level 25 pmol/liter higher than the lowest level in the postactivity-front quiescent period. To study the effect of exogenous motilin, an infusion of pure porcine motilin at various dose levels was given to 16 normal volunteers shortly after the onset of the phase I quiescent period. Motilin infusion induced an activity front in 12 of the 16 subjects. The mean activity front interval was reduced to 46 min (P less than 0.001). This effect could be obtained even at the low dose level of 0.4 pmol/kg/min, which produced an increase in plasma motilin level of only 57 pmol/liter. These data suggest that a cyclic rise in plasma motilin levels is one of the factors involved in the production of the activity front of the migrating motor complex in man.

Adolescent↗
PubMed1979

Achalasia, diffuse esophageal spasm, and related motility disorders.

From 1972 to 1977, the authors observed 156 patients with primary esophageal motility disorders which caused such a severe degree of dysphagia that treatment by pneumatic dilatation was deemed necessary. Before dilatation, 24% of the patients presented with motility disorders that did not fit well into the two classical disease entities, diffuse esophageal spasm and achalasia (absence of peristalsis with presence of lower esophageal sphincter (LES) relaxations or presence of peristalsis with absence of LES relaxations). After treatment with pneumatic dilatation, these "intermediate" forms constituted 45% of the motor disorders. This was due mainly to the reappearance, on manometric tracings, of peristaltic contractions and of LES relaxations. Radiologic and manometric observations suggest that in many patients, this "return of peristalsis" may be an apparent change in pressure pattern rather than a real change in motility. In 6 of the 156 patients, a deterioration of the esophageal motility disorder was observed, which was characterized by the loss of peristalsis and of LES relaxations over a period of a few months or years. The frequent occurrence of intermediate types of motility disorders and the transition from diffuse spasm to achalasia suggest that achalasia and diffuse esophageal spasm are part of a spectrum of related motor disorders.

Adolescent↗
PubMed1978

Glucose intolerance during diuretic therapy. Results of trial by the European Working Party on Hypertension in the Elderly.

119 elderly, hypertensive patients were followed-up for 1 year and 48 for 2 years in a double-blind, randomised, controlled trial in which they received either placebo or 25-50 mg hydrochlorothiazide and 50-100 mg of triamterene daily. Half of the active treatment group also received 250 mg to 2 g methyldopa daily. After 2 years the active treatment group had an average increase in fasting blood-sugar of 9.6 mg/dl compared with an average fall of 3.1 mg in the placebo group (p less than 0.001). Blood-glucose rose by an average of 26.6 mg/dl in the active group when determined 1 hour after 50 g oral glucose and decreased by an average of 5.3 mg/dl in patients who had been on placebo for two years (p less than 0.05). The hyperglycaemic effect of diuretics appeared to be related to potassium loss since, in both groups, impairment of glucose tolerance was most marked in those in whom the serum-potassium decreased over the 2 years.

Aged↗