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Biomedical subjects

J M Minderhoud

Publications and source records attributed to J M Minderhoud.

At least 55 records · Page 3Linked to original sources
PubMed1987

Acquired brain damage and driving: a review.

Five issues in evaluating driving ability after brain damage were addressed through a review of the literature. Some preliminary conclusions were reached: (1) about half of all subjects studied still hold a valid driver's license; (2) brain-damaged drivers could not, in general, be seen as risky drivers, although some individuals show decreased driving skill and risky behavior in traffic; and (3) statistics show no increase in traffic violations or accidents in groups of neurologic patients with acquired brain lesions or diseases. Frequently noted problems of brain-damaged drivers include poor judgment of traffic situations, impulsivity, and visuospatial impairments. Traditional psychologic tests have insufficient predictive value regarding fitness to drive. It is suggested that new techniques be developed to enable more valid statements about the skills needed for safe traffic participation. These assessment techniques should emphasize the higher cognitive levels in driving, ie, the tactical and strategic levels. At the moment, driver training programs in rehabilitation focus mainly on the operational level, with emphasis on handling the car, use of controls and mirrors, and technical adaptation of the vehicle.

Activities of Daily Living↗
PubMed1986

T-lymphocyte subpopulations in peripheral blood of patients with multiple sclerosis, patients with other neurological diseases and healthy controls.

We report our results in profiling peripheral blood lymphocyte subpopulations with monoclonal antibodies in 17 multiple sclerosis (MS) patients, 22 patients with other neurological diseases (OND), and 11 healthy controls, using a blind experiment. Untreated patients with a chronic progressive MS have higher T-helper cell (OKT4+) counts and a higher ratio OKT4+/OKT8+ than other MS patients, OND or healthy controls. Two weeks after the onset of a relapse of MS there is a decreased T-helper and an increased T-suppressor cell percentage. Treatment with ACTH results in a significant increase of helper cells after 4 weeks of therapy. Patients with the lowest helper cell counts and the lowest helper/suppressor ratio show the best clinical improvement by ACTH. High OKT4+ cell percentages make a chronic progressive course of MS more probable.

Adrenocorticotropic Hormone↗
PubMed1986

Epidemiological aspects of multiple sclerosis: a comparative study of four centres in Europe.

Epidemiological data of 931 patients with definite and probable multiple sclerosis in four areas in Europe (Groningen, Göttingen, Darmstadt and Baranya) were collected and compared. The same criteria and scoring methods were used. Clear differences between the areas appeared: a high percentage of severely disabled patients were encountered in the northern part (Groningen) and a high percentage of signs and symptoms related to supraspinal lesions in brainstem, cerebellum and hemispheres were found in the south east (Hungary). In Göttingen, in the central part of the total area, a relatively higher percentage of younger MS patients with minimal disability were found. However, it still has to be determined to which extent these differences are real or caused by information bias.

Female↗
PubMed1985

Two cases of schistosomiasis.

Two patients with neuroschistosomiasis are reported. In both patients diagnostic problems were encountered. The first case began with an aspecific allergic reaction of facial oedema and abnormal behaviour. The symptoms were followed by generalized convulsive seizures, dysphasia and hemiparesis. The disease characteristics, paraclinical findings and remarkable improvement on antischistosomal drug therapy strongly suggested cerebral schistosomiasis. The second case history starts with a cauda syndrome while in the end the diagnosis of transverse myelitis was confirmed.

Adolescent↗
PubMed1984

The 'flight of colours' test in multiple sclerosis, retrobulbar neuritis and healthy controls.

The results of the test for afterimages ('flight of colours'; FOC) in healthy controls, MS patients and persons with a history of retrobulbar neuritis are presented. The FOC proved to be a reliable test of involvement of the visual system in these diseases. This concerns the duration of the afterimages as well as the palette of colours. The results were in accordance with those of the VEP, provided patients with a retrobulbar neuritis more than three years ago were omitted. In these persons the FOC proved to be more sensitive than the flash-VEP in detecting old lesions. It was concluded that these methods measure different aspects of the visual system.

Adult↗
PubMed1984

Saccadic oscillations associated with the quick phases of caloric nystagmus in severe diffuse brain damage.

Caloric nystagmus patterns associated with ocular dysmetria, ocular flutter or flutter dysmetria were studied in ten patients being in a vegetative state, among whom were 9 patients with head injury and 1 with complications caused by a grand mal status. Brain damage was complicated by hypoxemia and especially by brain stem herniation. It was more often observed in very young children and appears to be associated with a poor clinical course. Physostigmine seems to have an activating and provocating effect on these saccadic oscillations. In view of Zee and Robinson's hypothesis on the pathophysiology of saccadic oscillations, it is suggested that these nystagmus patterns may reflect a disturbance of brain stem midline structures (pausing neurons) or an abnormal supranuclear (cerebellum) control.

Adolescent↗
PubMed1984

Delayed deterioration following mild head injury in children.

A series of 42 children is described who, following a seemingly minor or trivial head injury, developed neurological signs after a lucid or symptom-free period. This group constitutes 4.34 per cent of 967 consecutive patients aged 2 months to 17 years who were seen by members of the neurological staff during the years 1978-1981. Only one patient had an intracranial haematoma. The majority of patients showed a benign transient syndrome consisting of either convulsive or nonconvulsive signs with a spontaneous and full recovery. There were, however, 3 deaths in this series, apparently due to severe and uncontrollable unilateral or diffuse brain swelling, demonstrating the malignant counterpart of this benign syndrome. The theories seeking to explain these phenomena are reviewed. Special reference is made to the hypotheses of Bruce and his associates regarding brain swelling as a causative factor. It is considered that an adequate theory to explain the pathogenesis is still lacking. It is concluded that the juvenile brain responds to cranial trauma in a manner different from the adult brain. This implies a different approach in policy to hospital admission.

Adolescent↗
PubMed1984

Sexual disturbances arising from multiple sclerosis.

Multiple sclerosis patients under the age of 50 with only a slight handicap were very often found to have disturbances of sexual functions (among male patients 71.4%; among female patients 73.9%; control group 18.7%). In 19.6% of the cases, the disturbances were of a serious nature. These disturbances, as well as disturbances of function of bladder and colon, were found to be mainly brought about by separate damage in the lumbosacral region of the spinal cord. The incidence of these disturbances bore no relationship to the degree of motor disturbances, age of the patient or duration of the disease.

Adult↗
PubMed1984

Proposal for summing the incapacity status or environmental status scores.

Factor analysis was performed on the scores of variables of the Incapacity Status (ISS) and the Environmental Status Scale (ESS) in 184 MS patients. The aim of the study was to examine the relation between these variables and to examine the possibilities of using a summation process on scores. It proved that summing scores of the ISS conceals important information on communication disorders and on bladder, bowel and sexual dysfunctions. It was suggested to use three, composed variables of the ISS and the five variables of the ESS in the summation to produce a figure which reflects the handicaps of the patients.

Activities of Daily Living↗
PubMed1983

Agreement between physicians on assessment of outcome following severe head injury.

This study describes inter-observer agreement between physicians and consistency of one observer on repeated scoring in the assessment of outcome 6 to 12 months after severe head injury. Observer agreement is expressed by Kappa, taking chance agreement into account. The study was conducted in "live" and "non-live" situations, using five- and eight-category outcome scales. Kappa values were considerably higher when the five-category scale was used. However, even with the five-category scale, disagreement was considerable, and the results indicate that accurate predictions of the quality of survival will be difficult to attain. Observer agreement should be taken into account in prognosis studies, and when different therapeutic regimens are evaluated on the basis of outcome.

Brain Injuries↗
PubMed1983

Megadose steroids in severe head injury. Results of a prospective double-blind clinical trial.

A prospective double-blind clinical trial was performed on 161 patients to determine the effectiveness of high-dose steroid therapy in patients admitted comatose after a non-missile-related head injury. Patients were randomized into a high-dose dexamethasone phosphate group and a placebo group. The initial dose of 100 mg of dexamethasone was administered within 6 hours of the accident. For statistical analysis, a sequential test was chosen, using survival at 1 month as a basic criterion of effectiveness. No significant difference was found in the 1-month survival rate or in the distribution of outcome after 6 months, either within the group as a whole, or in subgroups with varying severity of brain damage on admission. The authors conclude that dexamethasone in high doses has no statistically significant effect on morbidity or mortality in head-injured patients who are comatose on admission.

Brain Injuries↗
PubMed1982

The pattern of recovery after severe head injury.

The pattern of recovery after head injury was studied on the basis of clinical data on 200 patients. An unmistakable pattern was found in which it was possible to distinguish between symptoms of only short duration (due to the unfavourable prognosis, among other things), symptoms which showed a fairly quick recovery such as the E score and the oculovestibular response, and symptoms characterized by a longer interval between the accident and their recovery. A clear difference was found between the pattern recovery of E scores and oculovestibular response on the one hand, and recovery of M and V scores on the other. The implications of the pattern of recovery thus established, are discussed.

Craniocerebral Trauma↗