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Biomedical subjects

J Minderhoud

Publications and source records attributed to J Minderhoud.

8 recordsLinked to original sources
PubMed1988

[Effect of international legislation on veterinary medicine in The Netherlands].

The development of legislation in the veterinary field in the Netherlands under the influence of agreements with separate countries or that resulting from EEC directives is reviewed. The effects of international legislation on veterinary practice are elucidated with disease control in animals, equalization of certificates, animal welfare and the problem of residues. Effects on the authorities occur by way of EEC directives in the field of commercial traffic in fresh meat, fresh poultry meat and manufactured meats, bilateral agreements with third countries, international transport of animals and veterinary education. Attention is paid to the advisory role of the Federation of Veterinarians of the EEC (FVE) in EEC legislation in the veterinary field. In discussing future developments in legislation in the veterinary sphere, the Veterinary Medicinal Products Act, the Veterinary Surgeons' Act, the Animal Health and Welfare Act and the Integrated Surveillance System of the Animal and Meat Production Chain are referred to.

Animals↗
PubMed1980

Treatment for severe head injury.

Difficulties in establishing the value of certain treatments for head injury are reviewed. An analysis of 1000 severely head injured patients, managed by varying methods in three different countries, showed that certain treatments were more often used in the most severely injured patients. Even when the severity of injury was taken account of, it appeared that the use of steroids and tracheostomy did not affect outcome; but that patients undergoing mechanical ventilation had outcomes which were worse than expected. The value of treatments proposed for severe head injury needs rigorous scrutiny.

Brain Injuries↗
PubMed1979

Prognosis of patients with severe head injury.

The relationship between clinical features of brain dysfunction in the first week after severe head injury and outcome 6 months later has been analyzed for 1000 patients. Depth of coma, pupil reaction, eye movements, and motor response pattern, and patient age prove to be the most reliable predictors. The degree of brain dysfunction changes markedly soon after injury, and more reliable predictions of outcome result when assessment is based on the best level of functioning recorded in each early epoch. Predictions based on very early assessment are, therefore, often unduly pessimistic. Individual predictions of outcome, based on a large data bank, provide a powerful tool for assessing the relative efficacy of alternative treatments.

Adolescent↗
PubMed1977

Severe head injuries in three countries.

Methods for assessing early characteristics and late outcome after severe head injury have been devised and applied to 700 cases in three countries (Scotland, Netherlands, and USA). There was a close similarity between the initial features of patients in the three series; in spite of differences on organisation of care and in details of management , the mortality was exactly the same in each country. This data bank of cases (which is still being enlarged) can be used for predicting outcome in new cases, and for setting up trials of management.

Adolescent↗
PubMed1976

Predicting outcome in individual patients after severe head injury.

Clinical data available in the first few days after severe head injury have been collected prospectively on 600 patients from Glasgow and the Netherlands and stored on computer; the patients in the two countries were similar in initial severity and in their outcome on a defined scale at 6 months. Calculated predictions of outcome were made in 200 randomly selected cases, using Bayesian statistics to compare the data from each patient with those from the 400 remaining cases whose outcome was known. Confident predictions (greater than 0-97 probability) were made in 44% of cases within the first 24 hours of coma, and in 52-61% when data up to 3 days were available. The higher confidence-rate occurred when prediction was limited to two outcomes (death or survival). Comparison of predicted with actual outcomes showed that 96-98% of confident predictions were correct. More logical clinical decisions should be possible when these predictions are available.

Adult↗