Biomedical subjects

J Mulder

Publications and source records attributed to J Mulder.

At least 19 recordsLinked to original sources

PubMed2006

[Recurrent abdominal pain caused by left mesocolic hernia].

A 37-year-old man presented with symptoms of intestinal obstruction. Laparotomy revealed a congenital left mesocolic hernia. Partial removal ofthe hernial sac that largely enclosed the small intestine resulted in a speedy recovery. Thereafter the patient was able to eat without abdominal symptoms. Congenital mesocolic hernias are an infrequent cause of intestinal obstruction. In order to conduct the operation properly, surgeons must have a good understanding of the origin of the hernia and its anatomic relationships.

Abdominal Pain↗

PubMed2006

Eating behaviour and adherence to diet in patients with Type 2 diabetes mellitus.

AIM: To assess restrained, emotional and external eating behaviour in patients newly diagnosed with Type 2 diabetes compared with the general population, and to assess the relationship of eating behaviour to changes in fat and energy. METHODS: We assessed emotional, external, and restrained eating behaviour and measured fat and energy intake in a cohort of patients with newly diagnosed Type 2 diabetes. Data from a comparable sample of the general population served as reference figures. We calculated correlation coefficients of the three different types of eating behaviour at diagnosis between: (i) energy and fat intake at diagnosis and (ii) changes in energy and fat intake between diagnosis and both 8 weeks and 4 years later. In addition, we used a stepwise multiple regression model with energy and fat intake or changes in energy and fat intake as dependent variables. RESULTS: The distribution of the three types of eating behaviour was similar in patients with Type 2 diabetes and the general population. Emotional and external eating was associated with increased intake of energy and fat. Conversely, restrained eating showed an inverse correlation with energy and fat intake. External eating, but not emotional eating, showed a statistically significant relation with a decrease in energy intake in women. We found no statistically significant correlations between eating behaviour (measured at diagnosis) and changes in energy and fat intake between diagnosis and 4 years. CONCLUSIONS: Patients newly diagnosed with Type 2 diabetes have similar eating behaviour compared with the general population. At diagnosis, external eating behaviour and emotional eating behaviour are associated with high-energy intake and restrained eating behaviour with low-energy intake. Women with high scores for emotional eating behaviour seem to be less able to make initial dietary changes after being diagnosed and having received dietary advice.

Adult↗

PubMed2006

Long-term outcome of two forms of randomised benzodiazepine discontinuation.

About two-thirds of long-term users of benzodiazepines in the population are able to discontinue this drug with the aid of supervised programmes for tapering off. Little is known about the long-term outcome of such programmes, and they have never been compared with usual care. After a 15-month follow-up of a randomised controlled trial comparing such a programme with and without psychotherapy with usual care, we found significantly higher longitudinal abstinence rates in long-term benzodiazepine users who received a benzodiazepine tapering-off programme without psychotherapy (25 out of 69, 36%) compared with those who received usual care (5 out of 33,15%; P=0.03).

Anti-Anxiety Agents↗

PubMed2006

Loss to follow-up of cervical smears without endocervical columnar cells is not disturbing.

OBJECTIVE: To investigate the six-month recommended follow-up after mass screening of Pap smears because of the absence of endocervical columnar cells (ECC-) or ECC+ smears with atypical squamous or glandular cells of undetermined origin (ASCUS/AGUS) or low-grade squamous or glandular intraepithelial lesions (LSIL/LGIL) in a Dutch mass screening cervical cancer programme. METHODS: Data were extracted from computerised medical records of national representative Dutch general practices. We have studied the attendance at and the outcome of the subsequent Pap smears after a 6-month recommendation. RESULTS: The six-month follow-up was linked to 8.7% of the Pap smears (n = 1,002); 77.6% were without endocervical columnar cells (ECC-). Clear differences were found between the follow-up of ECC+ and ECC- smears; after 36 weeks of follow-up of 43.5% the women had an ECC- smear and 66.9% had other conditions. For initial ECC- Pap smears, 84.1% had no abnormalities in the subsequent Pap smear; for initial ECC+ Pap smears, in about 64% of the cases no abnormalities were found (p < 0.0001). CONCLUSIONS: Repeating ECC- smears has a low follow-up rate but also lacks evidence-based necessity. However, for the other 6-month recommended Pap smears, one in five women had still not responded within one year, so improvement is necessary.

Adult↗

PubMed2006

Variability of centric relation position in TMD patients.

Reproducibility of the centric relation position for patients with temporomandibular disorders (TMD) is not documented in the current literature. It was the objective of this study to assess clinical variability of the centric relation position for TMD patients with a muscle-determined technique by means of an anterior deprogramming device, the leaf gauge. A sample of 60 patients with signs of TMD was selected, 8 men (Mean age 28,6, SD 5,2) and 52 women (Mean age 30,5, SD 10,1). All patients were examined with the Research Diagnostic Criteria, including pain on movement and/or function, mouth opening, joint sounds and palpation of masticatory muscles. All 60 patients were allocated to one of the following diagnostic subgroups: myofascial pain, disk displacement with reduction, disk displacement without reduction, osteoarthritis, trauma. Twelve control subjects were taken from a previous study. Three sequential centric relation records were taken; the first one was used to mount a set of casts to an articulator. Criteria of precision were formulated beforehand: 2 out of 3 centric relation records had to be identical in a split-cast procedure. Variables XL and XR represented mandibular displacement in the sagittal plane, variables YL and YR in the transversal plane, and ZL and ZR in the vertical plane, on the left and right condylar level respectively. Variables XMIN, YMIN and ZMIN represented the minimal sagittal, transversal and vertical displacement left or right respectively. Likewise, variables XMAX, YMAX and ZMAX represented the maximal sagittal, transversal and vertical displacement left or right. XDIFF, YDIFF and ZDIFF represented the difference between the minimal and maximal values of X, Y and Z. The diagnostic subgroup trauma was excluded, because there was only one patient. The null-hypothesis of no between-group differences in within-subject and total variability was tested with an analysis of variance (ANOVA). The level of significance was set at 0.05. To minimize type I errors caused by multiple testing Scheffe's test was used to maintain an overall significance of 0.05. No significant difference between patients and control subjects could be found for variables XL, XR, YL, YR, ZR and ZL. Variables XMIN, YMIN, ZMIN, XMAX, YMAX, ZMAX, XDIFF, YDIFF and ZDIFF showed no significant differences. Scheffe's testing for the variables XL, XR, YL, YR, ZL and ZR, as well as the variables XMIN, YMIN, ZMIN, XMAX, YMAX, ZMAX, XDIFF YDIFF and ZDIFF showed no significant differences. The results of this study suggest no variability in centric relation position between TMD-patients and control subjects by means of the leaf gauge.

Adult↗

PubMed2005

Predictors of discontinuation of benzodiazepine prescription after sending a letter to long-term benzodiazepine users in family practice.

BACKGROUND: Predictors of benzodiazepine discontinuation after sending a discontinuation letter by the family practitioner have not been established sufficiently. OBJECTIVE: To identify predictors of short- and long-term discontinuation of benzodiazepine use and relapse in use after a minimal intervention with a discontinuation letter followed by an offer for an evaluation consultation. METHODS: Predictors of benzodiazepine discontinuation and relapse in use were studied by logistic regression analysis and survival analysis within a family practice population of long-term benzodiazepine users (n = 1707) addressed by a discontinuation letter and followed for 21 months. RESULTS: A lower baseline prescription, a shorter duration of use, male gender and use of an agent with a half-life time <24 hours were predictive of complete discontinuation in the short (6 months) and long term (21 months). Multiple agent use at baseline, use of antidepressants at 6 months and benzodiazepine type (anxiolytic/hypnotic) at baseline predicted relapse. Attendance at an evaluation consultation 3 months after the letter was sent was not predictive of discontinuation or relapse. CONCLUSIONS: Amount of baseline use and duration of use are the main determinative characteristics of successful discontinuation. The discontinuation letter intervention is suitable for use with a broad group of long-term benzodiazepine users in family practice and can be used as a first step within a stepped care approach to decrease long-term benzodiazepine use.

Adult↗

PubMed2005

The absence of benzodiazepine craving in a general practice benzodiazepine discontinuation trial.

This study aimed to assess benzodiazepine craving longitudinally and to describe its time course by means of the Benzodiazepine Craving Questionnaire (BCQ). Subjects were long-term benzodiazepine users participating in a two-part treatment intervention aimed to reduce long-term benzodiazepine use in general practice in The Netherlands. Four repeated measurements of benzodiazepine craving were taken over a 21-month follow-up period. Results indicated that (1) benzodiazepine craving severity decreased over time, (2) patients still using benzodiazepines experienced significantly more severe craving than patients who had quit their use after one of the two interventions, and (3) the way in which patients had attempted to quit did not influence the experienced craving severity over time, however, (4) patients who had received additional tapering off, on average, reported significantly more severe craving than patients who had only received a letter as an incentive to quit. Although benzodiazepine craving is prevalent among (former) long-term benzodiazepine users during and after discontinuation, craving severity decreases over time to negligible proportions. Self-reported craving can be longitudinally monitored and quantified by means of the BCQ.

Aged↗

PubMed2005

Regional distribution of biogenic amines, amino acids and cholinergic markers in the CNS of the C57BL/6 strain.

A reliable extrapolation of neurochemical alterations from a mouse model to human metabolic brain disease requires knowledge of neurotransmitter levels and related compounds in control mouse brain. C57BL/6 is a widely used background strain for knockout and transgenic mouse models. A prerequisite for reliable extrapolation from mouse brain to the human condition is the existence of analogous distribution patterns of neurotransmitters and related compounds in control mouse and human brain. We analysed regional distribution patterns of biogenic amines, neurotransmitter and non-neurotransmitter amino acids, and cholinergic markers. Distribution patterns were compared with known neurotransmitter pathways in human brain. The present study provides a reference work for future analyses of neurotransmitters and related compounds in mouse models bred in a C57BL/6 background strain.

Amino Acids↗

PubMed2005

Psychiatric disorders in a Dutch Health Area: a repeated cross-sectional survey.

BACKGROUND: Decades of psychiatric epidemiology have shown a wide variation in prevalence rates, but a consistent relationship between psychiatric disorder and sociodemographic variables. In this repeated cross-sectional survey, the prevalence of psychiatric disorders and their distribution in the general population of the same area was assessed in 1983 and 1997. METHODS: With an interval of 14 years, 2 two-phase studies of psychiatric prevalence were carried out among the inhabitants of a Dutch Health Area (Nijmegen). In phase 1, a random sample of persons answered the General Health Questionnaire (GHQ-30). In phase 2, the respondents were interviewed using a clinical semi-structured interview. Only phase 1 data will be reported here. RESULTS: The mean overall GHQ-score changed significantly from 3.1 (+/-1.0) in 1983 to 4.6 (+/-1.8) in 1997. On a bivariate level, higher score rates were found consistently in the age categories > or = 50 years, among divorced persons, the lower educational levels, the unemployed/chronically ill and in the urban areas. On a multivariate level (second order effect), however, the variance explained by these sociodemographic variables doubled, revealing the importance of complex interactions. LIMITATIONS: Our aim to ensure identical designs in 1983 and 1997 could not completely be achieved. CONCLUSIONS: In the course of time, psychiatric prevalence increased in all sociodemographic categories, despite the improved socioeconomic conditions in the survey population as a whole. The increasing complexity of life apparently takes its toll, even of the socially best equipped.

Adolescent↗

PubMed2004

Predictors of patients' choices for breast-conserving therapy or mastectomy: a prospective study.

A study was undertaken to describe the treatment preferences and choices of patients with breast cancer, and to identify predictors of undergoing breast-conserving therapy (BCT) or mastectomy (MT). Consecutive patients with stage I/II breast cancer were eligible. Information about predictor variables, including socio-demographics, quality of life, patients' concerns, decision style, decisional conflict and perceived preference of the surgeon was collected at baseline, before decision making and surgery. Patients received standard information (n=88) or a decision aid (n=92) as a supplement to support decision making. A total of 180 patients participated in the study. In all, 72% decided to have BCT (n=123); 28% chose MT (n=49). Multivariate analysis showed that what patients perceived to be their surgeons' preference and the patients' concerns regarding breast loss and local tumour recurrence were the strongest predictors of treatment preference. Treatment preferences in itself were highly predictive of the treatment decision. The decision aid did not influence treatment choice. The results of this study demonstrate that patients' concerns and their perceptions of the treatment preferences of the physicians are important factors in patients' decision making. Adequate information and communication are essential to base treatment decisions on realistic concerns, and the treatment preferences of patients.

Aged↗

PubMed2004

Silent myocardial infarction and its prognosis in a community-based cohort of Type 2 diabetic patients: the Fremantle Diabetes Study.

AIMS/HYPOTHESIS: Our study investigated the prognosis of Type 2 diabetic patients with silent myocardial infarction in a community-based cohort. METHODS: We analysed data from 1269 patients with Type 2 diabetes mellitus from a community-based observational study of diabetes care, control and complications. Silent myocardial infarction was defined as Q waves (Minnesota codes 1.1, 1.2) on a baseline electrocardiogram in the absence of a history or symptoms of CHD. RESULTS: Silent myocardial infarction was present in 3.9% of patients, or 44% of all Q-wave myocardial infarctions. The patients were subdivided into those with (i). no clinical or Q-wave evidence of myocardial infarction (Group 1), (ii). silent myocardial infarction (Group 2), (iii). self-reported CHD but no Q waves (Group 3), and (iv) self-reported CHD and Q waves (Group 4). Compared to Groups 3 and 4, Group 2 patients were more likely to be women, less likely to have smoked, and had higher serum HDL-cholesterol concentrations and higher blood pressure. Over an average of seven years, and after adjusting for other independent predictors of death, all-cause and CHD mortality were similar in Groups 1 and 2 and greater (twofold for all-cause and fourfold for CHD mortality) in Groups 3 and 4. CONCLUSIONS/INTERPRETATION: Silent myocardial infarction is common in Type 2 diabetes and has a prognosis similar to that in patients without a history of CHD or Q waves.

Aged↗

PubMed2004

[Dental caries and dental erosion among 5- and 6-year old and 11- and 12-year old school children in the Hague, the Netherlands. Changing prevalences?].

In 2002 a dental survey amongst 6- and 12-year-old schoolchildren in The Hague had been carried out. The 2002 survey suggested that in the period 1996-2002 the caries prevalence (% of cariesfree children) and the caries experience (mean dmfs/dmft scores) among 6-year-old children did not have changed significantly. Children of low socio-economic status in 2002 had an average higher dmfs/dmft count compared to 6-year-olds of medium and high SES. However, the survey suggested in the period 1996-2002 a significant increase of cariesfree 12-year-old children in low SES. Among 12-year-olds socio-economic differences in caries experience of the permanent dentition have diminished in 2002. In 1998 and 2002 respectively 3 and 23% of the 12-year-olds showed the prevalence of any dental erosion. This increase of the prevalence of dental erosion is in agreement with data from other European countries.

Child↗

PubMed2004

Reliability of a measuring-procedure to locate a muscle-determined centric relation position.

Although reproducibility of centric relation position, determined with an anterior deprogramming device, a leaf gauge, is widely accepted among clinicians, data confirming statistical evidence are lacking in the current literature. The objective of this study was to prove clinical reliability of a measuring-procedure to locate the centric relation position, determined with the leaf gauge. A sample of 15 subjects (6 men, 9 women, age 22 to 46), assessed with the Research Diagnostic Criteria to rule out any TMD-signs, was selected. Three observers each took three sequential interocclusal records with the leaf gauge, to mount a set of casts into the centric relation position in an articulator. Out of 15 subjects, 12 (5 men, 7 women) fitted criteria of precision--three out of three interocclusal records for each of the three observers--in a split-cast procedure. The applied statistical method is an analysis of variance model (ANOVA) with two factors for 3 observers and 12 subjects. The variance components estimation procedure is MIVQUE (0). The a was set at 0.05. No significant difference between observers for the measured variables sagittally (XL, XR), transversally (YL, YR), and vertically (ZL, ZR) could be found. MIVQUE variance components estimates for observers is < 0, varies for subjects from 0.04 to 0.20 and varies for error from 0.12 to 0.25 mm. Reliability of a measuring-procedure to locate a muscle-determined centric relation position could be established satisfactory.

Adult↗

PubMed2003

[Methicillin resistant Staphylococcus aureus (MRSA) infection in a dog in the Netherlands].

In the Netherlands, methicillin resistant Staphylococcus aureus (MRSA) are regularly isolated from humans. We present the first isolation of MRSA from animal origin in the Netherlands. A coagulase positive staphylococcus was cultured from an infected wound in a Dutch dog that recently underwent surgery abroad. The staphylococcus was resistant to methicillin, ampicillin, amoxycillin + clavulanic acid, cephalexin, erythromycin, lincomycin, tetracycline, gentamicin and enrofloxacin. It was identified as S. aureus by fermentation of mannitol and Martineau-PCR. The presence of mecA was confirmed by PCR.

Animals↗

PubMed2003

Chronic excess of corticosterone increases serotonergic fibre degeneration in aged rats.

Evidence is presented for the potentiating role of corticosterone on axonal degeneration of serotonergic neurones during ageing. Aged rats, 24 months old, were implanted subcutaneously with 2 x 100 mg pellets of corticosterone. Serotonergic and cholinergic (ChAT- and NADPHd-positive) fibre degenerations in the anteroventral thalamic nucleus (AVT) were measured 2 months after corticosterone implantation. Numbers of immunoreactive serotonergic raphe and mesolimbic cholinergic neurones were also quantified. Basal plasma corticosterone and adrenocorticotropin (ACTH) concentrations were assayed at 2, 4, 6, and 8 weeks after implantation in the plasma and at 1, 2, 4 and 6 weeks in urine. The degree of serotonergic fibre aberrations in the AVT increased significantly after corticosterone exposure, while that of ChAT-positive and NADPHd-stained axon aberrations showed a modest but nonsignificant increase. A positive correlation between the magnitudes of serotonergic and cholinergic fibre aberrations appeared in the AVT, but only in the corticosterone-treated rats. The number of serotonin immunopositive neurones in the raphe nuclei after corticosterone decreased marginally, while that of mesopontine ChAT-positive neurones was not influenced. Measurements of basal plasma corticosterone and ACTH, as well as urine corticosterone, revealed that the steroid implantation increased the plasma corticosterone level for at least 4 weeks and decreased ACTH level for at least 6 weeks. By the week 8, the pituitary-adrenal function was apparently restored. However, at sacrifice, both the weight of adrenal glands and that of thymus remained reduced, indicating the long-lasting effects of corticosterone on target tissues. It is concluded that the raphe serotonergic neurones and their projecting fibres are sensitive to corticosterone excess in aged rats and become more vulnerable to degeneration processes than under normal ageing conditions. Cholinergic neurones of brainstem origin, which also express massive NADPHd activity, are more resistant against corticosterone, but their axon degeneration correlates to serotonergic fibre degeneration.

Adrenal Glands↗

PubMed2003

Platelet loss across the hemofilter during continuous hemofiltration.

BACKGROUND: Thrombocytopenia is a common finding in patients in the intensive care unit receiving continuous renal replacement therapy (CRRT). It is unknown if the hemofilter itself contributes to the platelet loss. OBJECTIVE: To measure the direct effect of the hemofilter on platelet counts during CRRT. DESIGN: Prospective, observational study. SETTING: Intensive care unit of a University hospital. PATIENTS: Critically ill patients with acute renal failure receiving CRRT. METHODS: Two samples of blood were drawn simultaneously, pre-filter and post-filter, and analyzed for platelet count. A correction factor was applied to the post-filter platelet count to adjust for the hemoconcentrating effect of net ultrafiltration. RESULTS: Forty-eight sets of paired data from 22 patients were studied. There was a small but significant decrease in mean platelet count across the hemofilter. The mean platelet count drop was 2.32 x 10(9)/L (s.e. 1.06, p = 0.0487, 95% CI (0.01, 4.62)). Blood flow was strongly related to degree of platelet loss, with a decreased loss of 0.07 x 10(9)/L for every ml/min increase in blood flow (p = 0.015). There was no overall decrease in concurrently measured red cell counts across the hemofilter. However, there was a machine-specific affect on red cell loss (p < 0.0001). The total calculated daily platelet loss across the filter was 625 x 10(9) cells. CONCLUSION: The hemofilter may contribute to the thrombocytopenia seen during CRRT, by means of either destruction or retention of platelets during passage. This affect appears attenuated by higher blood flows. This information is useful in the assessment of a low platelet count in patients receiving CRRT.

Acute Kidney Injury↗

PubMed2002

Diffusional water permeability (PDW) of adult and neonatal rabbit renal brush border membrane vesicles.

We have shown that there is a maturational increase in osmotic water permeability (Pf) of rabbit renal brush border membrane vesicles (BBMV). The purpose of the present study was to further investigate the changes in proximal tubule water transport that occur during postnatal development. Diffusional water permeability (PDW) has not been measured directly in adult or neonatal BBMV. We validated the method described by Ye and Verkman (Simultaneous optical measurement of osmotic and diffusional water permeability in cells and liposomes. Biochemistry 28:824-829, 1989) to measure PDW in red cell ghosts and liposomes, to examine the maturational changes in PDW in BBMV. This method utilizes the sensitivity of 8-aminonaphtalene-1,3,6-trisulfonic acid (ANTS) fluorescence to the D2O-H2O content of the solvent. ANTS-loaded neonatal (11 days old) and adult BBMV were rapidly mixed with two volumes of isoosmotic D2O solution using a stopped-flow apparatus at 5 degrees -37 degrees C. PDW was lower in neonatal than adult BBMV at 5 degrees (3.77 +/- 0.34 vs. 5.35 +/- 0.43 mm/sec, respectively, p<0.05) and 20 degrees C (7.03 +/- 0.40 vs. 9.04 +/- 0.25 mm/sec, respectively, p<0.001), but was not different at 30 degrees and 37 degrees C. The activation energy (Ea) was higher in neonatal than in adult BBMV (9.29 +/- 0.56 kcal/mol vs. 6.46 +/- 0.56 kcal/mol, p<0.001). In adult BBMV, PDW was inhibited by 0.5 mM HgCl2 by 46.6 +/- 3.6%, while it was not affected in neonatal BBMV (p<0.001). The results indicate that PDW can be measured in rabbit renal BBMV. There are significant changes in water transport across the apical membrane during postnatal development, consistent with a maturational increase in channel-mediated water transport.

Aging↗

PubMed2002

17beta-estradiol enhances cortical cholinergic innervation and preserves synaptic density following excitotoxic lesions to the rat nucleus basalis magnocellularis.

Estradiol exerts beneficial effects on neurodegenerative disorders associated with the decline of cognitive performance. The present study was designed to further investigate the effect of 17beta-estradiol on learning and memory, and to evaluate its neuroprotective action on cholinergic cells of the nucleus basalis magnocellularis, a neural substrate of cognitive performance. Female rats were ovariectomized at an age of 6 months. Three weeks later they received injections of either a mid-physiological dose of 17beta-estradiol or vehicle (oil), every other day for 2 weeks. The effect of estradiol on cognitive performance was tested in two associative learning paradigms. In the two-way active shock avoidance task estradiol-replaced animals learned significantly faster, while in the passive shock avoidance test no differences were observed between the experimental groups. Subsequent unilateral infusion of N-methyl-D-aspartate in the nucleus basalis magnocellularis resulted in a significant loss of cholinergic neurons concomitant with the loss of their fibers invading the somatosensory cortex. Estradiol treatment did not affect the total number of choline-acetyltransferase-immunoreactive neurons and their coexpression of the p75 low-affinity neurotrophin receptor either contralateral or ipsilateral to the lesion. In contrast, cholinergic fiber densities in estradiol-treated animals were greater both in the contralateral and ipsilateral somatosensory cortices as was detected by quantitative choline-acetyltransferase and vesicular acetylcholine transporter immunocytochemistry. However, estradiol treatment did not affect the lesion-induced relative percentage loss of cholinergic fibers. A significant decline of synaptophysin immunoreactivity paralleled the cholinergic damage in the somatosensory cortex of oil-treated animals, whereas an almost complete preservation of synaptic density was determined in estradiol-treated rats. Our results indicate that estradiol treatment enhances the cortical cholinergic innervation but has no rescuing effect on cholinergic nerve cells in the basal forebrain against excitotoxic damage. Nevertheless, estradiol may restore or maintain synaptic density in the cerebral cortex following cholinergic fiber loss. This estradiol effect may outweigh the lack of cellular protection on cholinergic cells at the functional level.

Acetylcholinesterase↗