PubMed Health⌕ Search

Biomedical subjects

J Mulder

Publications and source records attributed to J Mulder.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Trends in dental caries prevalence amongst schoolchildren in the Hague. A comparison with the results from a survey in 1996 and previous years].

Starting in 1969, periodic cross-sectional examinations of schoolchildren have been carried out in the city of The Hague (the Netherlands). The results of 1996 show that no further change in caries prevalence has taken place in 5- and 7-year-old Dutch children of low, medium and high SES. In 11-year-old children of medium and high SES a further decrease in caries prevalence could be observed in 1996. Between 1989 and 1996 a significant caries decrease in the deciduous dentition was found amongst 5-year-old children from Turkey and Morocco. No improvement of dental health in 7-year-olds was found. Since 1989 an increase in percentages of caries-free 11-year-olds from Turkey took place whereas this percentage in children from Morocco tended to stabilize (26 and 29% respectively in 1989 and 1996).

Child↗
PubMed1996

Dental health in Dutch drug addicts.

The aim of this study was to describe to dental health status of a group of Dutch 20-40-yr-old drug addicts (n = 121) and to compare the results if DMFS with data of an age-comparable sample of the general adult population in the Netherlands (n = 1532). Mean DMFT of the addicted group was 16.9. ANOVA showed that the mean DMFS of the addicted group differed statistically significantly from the DMFS of the general population of the same age (= 52.1 versus 38.9) Statistically significant differences in DMFS were also found between the various age groups. The percentage of addicted subjects with more than cervical plaque on one or more teeth was 76.5%m 82.4% and 88.2% in the three youngest age groups. In almost all addicted subjects, bleeding of the gingiva was present Only 36% had visited the dentist less than a year ago and 18% brushed their teeth less than once a day. It is concluded that there is a large gap in dental health status and behavior between drug addicts and the general population. Dental care as an integral part of the care for drug addicts is advocated.

Adult↗
PubMed1996

Purine enzyme activities in recent onset rheumatoid arthritis: are there differences between patients and healthy controls?

OBJECTIVE: Purine enzyme activities may predict the effectiveness of azathioprine treatment and be associated with increased deaths from infectious diseases. In rheumatoid arthritis, patients show variable responses to azathioprine and a higher percentage of death is caused by infections. The aim of the study was to investigate possible rheumatoid arthritis associated abnormalities of purine enzyme activities by measuring several of these enzymes in patients with recent onset rheumatoid arthritis before treatment with disease modifying antirheumatic drugs or prednisone. METHODS: 23 patients with recent onset rheumatoid arthritis and 28 healthy controls were studied. Activities of the enzymes 5'-nucleotidase, purine nucleoside phosphorylase (PNP), hypoxanthine guanine phosphoribosyltransferase (HGPRT), and thiopurine methyltransferase (TPMT) were measured. Assessment of disease activity and blood sampling for routine measurements and HLA typing were done simultaneously. RESULTS: Purine enzyme activities did not differ between patients and healthy controls. Enzyme activities had no significant relations with indices of disease activity or rheumatoid factor titre or with the rheumatoid arthritis associated HLA types. Activity of 5'nucleotidase decreased with age (P < or = 0.05) and was lower by about 27% (P = 0.007) in males than in females. CONCLUSIONS: In rheumatoid arthritis patients, neither the variability in azathioprine effectiveness nor the increased death rate from infections can be explained by pre-existing abnormalities in the activities of the purine enzymes 5'-nucleotidase, PNP, HGPRT, or TPMT at an early stage of the disease, before disease modifying antirheumatic drugs or prednisone treatment. Besides adjustment for age, results of studies involving purine 5' nucleotidase activity should also be adjusted for sex.

Adult↗
PubMed1996

Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis.

OBJECTIVE: To evaluate nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis in general practice. DESIGN: Nasal smear eosinophilia was assessed and compared with 'consensus diagnoses' made by three experts in a modified Delphi method. SETTING: Nineteen general practices in The Netherlands. SUBJECTS: 363 consecutive patients aged 12 years or over who visited their general practitioner because of chronic or recurrent nasal symptoms between 1 March 1990 and 1 March 1991. MAIN OUTCOME MEASURES: The predictive value of nasal smear eosinophilia for allergic rhinitis; the prevalence of eosinophilic non-allergic rhinitis. RESULTS: The positive predictive value of nasal smear eosinophilia (> or = 10% eosinophils) for allergic rhinitis was 30/37 = 81% (95% confidence interval (CI): 65-92%), the negative predictive value 172/312 = 55% (95% CI: 50-61%). Addition of the result of nasal smear eosinophilia to the information that was already obtained from the medical history resulted in a significant but very small improvement in the discrimination between patients with and without allergic rhinitis. The prevalence of eosinophilic non-allergic rhinitis was 7/349 = 2.0% (95% CI: 0.8-4.1%). CONCLUSION: Nasal smear eosinophilia contributes significantly to the diagnosis of allergic rhinitis; however, this contribution is very small and considered clinically irrelevant. Eosinophilic non-allergic rhinitis has a low prevalence; identifying this disorder is of minor importance. In conclusion, nasal smear eosinophilia is not recommended for use in general practice.

Adolescent↗
PubMed1996

[Adjustment of complete dentures. Have oral stereognosis and denture quality a predictable value?].

The denture complaints of 397 complete denture wearing participants were assessed. The quality of the dentures and denture bearing surfaces were professionally scored as well. Combination of these scores gave a specific denture quality, the so-called 'prosthetic condition'. The oral stereognostic capability was recorded with an Oral Stereognosis Test. There was no correlation between denture complaints and the results of the Oral Stereognosis Test, nor between denture complaints and prosthetic condition.

Adult↗
PubMed1995

Substitution of didanosine sachets by chewable tablets: a pharmacokinetic study in patients with AIDS.

We have conducted a pharmacokinetic study of didanosine (ddI), formulated in sachets and in tablets, in patients with acquired immune deficiency syndrome (AIDS). Fifteen subjects received 250 or 167 mg of ddI twice daily as the sachet formulation and used this for at least 1 month. Subsequently, the patients were converted to receive ddI chewable/dispersible tablets (250-mg sachets to 200-mg tablets; 167-mg sachets to 125-mg tablets). Four subjects withdrew because of clinical deterioration or adverse effects. Serial blood samples were collected for pharmacokinetic monitoring during the use of the sachets and after 1 month of use of the tablets. No statistically significant differences were found in the maximum plasma concentration (Cmax), the time to reach Cmax (tmax), the area under the plasma concentration-time curve (AUC), or the terminal elimination half-life (t1/2) between the two formulations. Patients who received low-dose ddI (sachets, 167 mg; tablets, 125 mg) displayed lower plasma concentrations than did the patients receiving high-dose ddI (sachets, 250 mg; tablets, 200 mg), despite an equal weight-normalized dose of ddI in these two groups.

Absorption↗
PubMed1995

Treatment times for three different types of veneer restorations.

In a longitudinal clinical trial the treatment times needed for the fabrication of veneer restorations (VRs) were recorded and analysed. Treatment times were determined for: (1) direct resin composite (DC), (2) indirect resin composite (IC) and (3) porcelain (P) veneer restorations and for two preparation designs, with and without incisal coverage. Significant effects on the treatment times were found for the factors: (1) type of VR, (2) operator, (3) number of VRs and (4) 'problems' in try-in phase for indirect VRs (IC- and P-VRs). The mean total time needed to perform one DC-VR was 46 min with a 95% confidence interval (c.i.) of 40-54 min, for one IC-VR 70 min (c.i. 60-82 min) and for one P-VR 62 min (c.i. 53-71 min). In the cases where more than one VRs were placed in one patient the times per VR were respectively: DC, 38 min (c.i. 34-44 min); IC, 59 min (c.i. 52-67 min); P, 49 min (c.i. 44-55 min). The results of this study are considered to be useful in further cost-benefit analyses.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1995

Infections during low-dose methotrexate treatment in rheumatoid arthritis.

We studied the infection rate in patients with rheumatoid arthritis (RA) treated with low-dose methotrexate (MTX) in a 6-year open prospective study and in a 12-month randomized double blind trial comparing MTX with azathioprine (AZA) that was followed by a 3-year open prospective study. The literature on infections during low dose MTX in RA was reviewed. We also did a search for therapy-related opportunistic infections in RA and in MTX-treated psoriasis and psoriatic arthropathy patients. In our studies the infection rate during MTX treatment was higher in severe RA than in moderate RA. In severe RA there were often 2 infections simultaneously. The majority of the infections occurred in the first 1.5 years of treatment. There was no difference in the infection rate of MTX and AZA in the comparative trial. In the literature the infection rate was highest in short-term double-blind studies. Opportunistic infections are increasingly reported in RA treated with MTX and rarely with AZA, cyclosporine A, and cyclophosphamide or in MTX treated psoriasis and psoriatic arthropathy. In RA it appears that the initial period of treatment with MTX is the most vulnerable phase for infections, with the exception of opportunistic infections, which are not limited to a certain treatment period. Probably there are more MTX-associated infections in severe RA than in moderate RA.

Adult↗
PubMed1995

Rapid changes in human immunodeficiency virus type 1 RNA load and appearance of drug-resistant virus populations in persons treated with lamivudine (3TC).

The effect of the appearance of drug-resistant human immunodeficiency virus type 1 (HIV-1) on viral RNA load was studied in patients treated with the reverse transcriptase inhibitor lamivudine. During the first 12 weeks of treatment, HIV-1 RNA concentrations and amino acid changes in codon 184, causing high-level resistance to lamivudine, were determined in longitudinal serum samples from HIV-1 p24 antigen-positive and -negative patients. A marked decline in the amount of HIV-1 RNA (approximately 95% below baseline) and HIV-1 p24 antigen was observed within 2 weeks, followed by a rise that coincided with the appearance of lamivudine-resistant viruses in serum (isoleucine mutants initially, which were subsequently replaced by valine variants). After 12 weeks, a partial antiviral effect was observed despite the presence of a complete codon 184 mutant virus population in serum. This study shows that the rapid appearance of drug-resistant virus in serum is followed by an increase in viral RNA load.

CD4 Lymphocyte Count↗
PubMed1995

Changes in dental attitude and behavior among Dutch adults wearing complete dentures.

In 1992 a follow-up on the Dutch National Dental Survey of 1986 (DNDS) was performed. The main objective was to detect and analyze changes in oral self care, dental attendance, and oral health status. This paper will focus on the DNDS adults wearing complete dentures. Changes over a 6-yr period will be presented of: dental attendance, denture satisfaction and wearing of the complete dentures, and denture treatments. A postal questionnaire was used: 232 persons (64%) participated in the study. Analysis of Variance (ANOVA) was used to study the effect of dental and social variables on observed changes since 1986. Risk ratios (RR) were computed to clarify the actual effects of these variables. With respect to dental attendance, a shift towards visits for denture check-ups was found, thought to reflect the respondents' concern for their complete dentures (RR = 1.6). A small shift towards more visits because of denture problems was found. This was attributed to denture treatments that had taken place between 1986 and 1992 (RR = 2.8). With respect to changes in denture satisfaction, no influence of denture treatments could be noted, but a relation was found with a variable indicating the imperfection of the complete dentures as felt by the respondents (RR = 2.8). In 31% of the respondents some denture treatment had been performed since 1986. No objective dental criteria of complete dentures and denture bearing areas had influenced these denture treatment decisions, but only respondents' subjective criteria (RR = 1.9-2.9).

Adult↗
PubMed1995

Acute bronchitis: course of symptoms and restrictions in patients' daily activities.

OBJECTIVE: To obtain information on the course of complaints and restrictions in daily activities of patients with acute bronchitis. DESIGN: Prospective study. SETTING: General practice. SUBJECTS: Otherwise healthy persons over 16, who visited their GP with an acute cough with purulent sputum and/or auscultatory abnormalities. MAIN OUTCOME MEASUREMENTS: Recordings by patients on reasons for encounter, symptoms and restrictions in daily activities at entry, and one and two weeks after entry. RESULTS: 99 Patients were included, of whom 79 were suitable for further analysis. Discomfort caused by coughing and concern in the patient and his/her social environment were the main reasons why patients visited their general practitioner. Counting from the onset of the disease it took three to four weeks before most patients were well and able to perform all their usual daily activities again. CONCLUSION: In most cases acute bronchitis has considerable impact on patients' well-being and daily activities for some weeks.

Activities of Daily Living↗
PubMed1995

["Prosthetic condition" and satisfaction with dentures].

This study introduces the concept of 'prosthetic condition', combining the professionally assessed complete denture quality and quality of the residual alveolar ridge. In a group of 397 complete maxillary and mandibular denture wearers the prosthetic condition was assessed and the denture satisfaction recorded. The total prosthetic condition (maxillary and mandibular combined) was good in 225 (57%), moderate in 81 (20%), and poor in 91 (23%) subjects; the mandibular prosthetic condition was good in 155 (39%), moderate in 148 (38%), and poor in 94 (23%) subjects; 297 (75%) subjects were satisfied with their dentures. None of the criteria used for the prosthetic condition could explain the denture satisfaction. Furthermore, there was no significant correlation between prosthetic condition and denture satisfaction.

Adult↗
PubMed1995

[Dental health in drug and alcohol addicts].

The aim of this study was to describe the dental health status of a group of Dutch twenty- to forty-year-old drug addicts (n = 121) and to compare the results on DMFS with data of an in age comparable sample of the general non-addicted adult population in the Netherlands (n = 1532). The average DMFT of the addicted group was 16.9. The average DMFS of this group differed statistically significantly from the DMFS of the general non-addicted population of the same age (52.1 versus 38.9). Statistically significant differences in DMFS were also found between the various age groups. In the youngest three age groups the percentage of addicted subjects with cervical plaque on one or more teeth was 76.5%, 82.4% and 88.2%. Bleeding of the gingiva occurred in almost all addicted subjects. Only 36% of the addicts had visited their dentist less than a year ago and 18% of them brushed their teeth less than once a day. It is concluded that a large gap exists in dental health status and behaviour between drug addicts and the general non-addicted population. Dental care as an integral part of the care for drug addicts is advocated.

Adult↗
PubMed1995

Porosity in resin composite core restorations: the effect of manipulative techniques.

Forty acrylic resin duplicates of an endodontically treated and extracted human molar were restored with two resin composite materials for core restorations. Two different manipulation techniques, bulk insertion and syringe application, were used. In a simulated clinical setup, the core buildups produced by the different manipulation techniques were investigated for voids. In 20 duplicates, a post was placed to simulate a metal post and resin composite core buildup. The syringe technique produced significantly fewer incorporated voids for both resin composite core materials than did the bulk insertion technique. It was not possible to demonstrate a relationship between the presence of voids and the presence of a metal post.

Analysis of Variance↗
PubMed1994

Methotrexate revisited: effects of long-term treatment in psoriasis.

In the past 22 years, 113 patients with severe psoriasis have been treated with low-dose methotrexate (MTX) in our department. The maximum weekly dosage was 15 mg (Weinstein schedule), the estimated mean cumulative dose was 4803 mg, and the estimated mean duration of therapy was 8 years and 11 months. In 81% of the patients, prolonged clearance or near clearance was achieved, indicating the potent and sustained potential of MTX in the treatment of both the pustular and erythematosquamous variants of psoriasis. Eighty-three patients (73%) had side-effects, most frequently abnormal liver function tests, nausea and gastric complaints. Apart from hair loss in seven patients, there were no mucocutaneous side-effects, probably because of the low-dose treatment schedule. In 71 patients MTX therapy was discontinued; in 33 patients because of side-effects. In 55 patients one or more liver biopsies were performed. Fibrosis was seen in seven of these patients (13%) and cirrhosis in two (4%). There was no relation between liver biopsy classification and cumulative dosage or duration of MTX therapy, nor was there any relation between liver histology and abnormal liver function tests. During this 22-year period, there were no deaths or life-threatening side-effects attributable to MTX treatment. We conclude that low-dose MTX (< or = 15 mg/week) is a relatively safe therapy for severe psoriasis, if patients are carefully selected beforehand, and regular monitoring for side-effects and drug interactions is performed during therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Survival and retreatment need of abutment teeth in patients with overdentures: a retrospective study.

The retreatment need was assessed in 148 patients wearing 125 overdentures in the mandible and 56 in the maxilla. The total number of abutment teeth was 512. During the evaluation period 44 abutments were extracted. The endpoints of the survival analysis after 6 yr were 89%, taking the loss of all abutments as the failure criterion for overdentures. During the clinical examination it was found that 31% of the abutments needed treatment while the retrospective part showed a mean yearly restoration need of 17.5%. Caries was the most important reason for retreatment. These data demonstrated that patients with overdentures should be regarded as high risk patients for retreatment of abutments. Therefore a stringent maintenance program, including regular recall appointments and the application of a preventive regimen, is desirable.

Adult↗