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J Vandenbroucke

Publications and source records attributed to J Vandenbroucke.

At least 19 recordsLinked to original sources

Factor V Leiden: the venous thrombotic risk in thrombophilic families.

Factor V Leiden (FVL) leads to a sevenfold increased risk of venous thrombosis and is present in 50% of individuals from families referred because of unexplained familial thrombophilia. We assessed the association of FVL with venous thromboembolism (VTE) in 12 thrombophilic families of symptomatic probands with FVL in a retrospective follow-up study. We screened 182 first- and second-degree relatives of the 12 unrelated propositi for the FVL mutation and the occurrence of VTE. The incidence rate of VTE in carriers of FVL (0.56%/year) was about six times the incidence for the Dutch population (0.1%/year). The incidence rate in non-carriers also appeared to be higher (0.15% per year). At the age of 50 years, the probability of not being affected by VTE was reduced to 75% for carriers and to 93% for non-carriers (P = 0.009). Identification of carriers of FV Leiden may be worthwhile in young symptomatic individuals and their relatives with a strong positive family history of venous thromboembolism or a history of recurrent venous thrombosis who may be at risk (e.g. pregnancy, use of oral contraceptives). After adjustment for prothrombin G20210A (present in two families), even higher thrombotic incidence rates were found in carriers and non-carriers of FVL. This makes the presence of other unknown prothrombotic risk factors more probable in these families.

Adult↗

Clinical and pathological changes in the knee after accidental chlorhexidine irrigation during arthroscopy. Case reports and review of the literature.

We describe six knees in five patients, referred to us after accidental irrigation with chlorhexidine 1% in aqueous solution during arthroscopy. All six knees developed persisting pain, swelling and crepitus with loss of range of movement. Radiographs showed loss of joint space in all three compartments due to extensive chondrolysis, with many loose bodies and synovitis. Histological examination showed partial necrosis of the cartilage, with slight non-specific inflammation and fibrosis of synovial specimens. Care is needed in checking irrigation fluids, and these should have a distinctive colour.

Adult↗

Dystrophic kyphoscoliosis in neurofibromatosis type I: a report of two cases and review of the literature.

We report two cases of dystrophic scoliosis in neurofibromatosis, each of particular interest. In the first, kyphosis was present with vertebral rotatory subluxation but no neurologic impairment, while the second patient showed manifest paraplegia due to rapidly progressive kyphoscoliosis. The importance of early surgical stabilisation, both front and back if possible, is stressed. Very sharp curves with progressive myelopathy should not be treated with halo-femoral traction because of the potential danger of evoking permanent paraplegia.

Adolescent↗

Simple trapezectomy for treatment of trapeziometacarpal osteoarthritis of the thumb.

This is a review of 20 patients (22 operations) with symptomatic osteoarthritis of the first carpometacarpal joint who were treated by simple trapezectomy without interposition material. They were all women with a mean age of 60 years (46-77). The average follow-up was 2 years, ranging from 8 months to 3 years. Pain relief is the main contributor to the good clinical results of this procedure. Sixteen patients professed to be very satisfied, two had a fair result and four cases claimed to be unsatisfied. Range of motion (opposition and counter opposition) and first web space were very well preserved. Mean values of grip strength showed reduction of grip power on the operated side though not statistically. However, we did find a statistically significant difference in pinch strength between operated and non-operated side. In general, simple trapezectomy is our preferred surgical therapy in the treatment of carpometacarpal osteoarthritis in the elderly population.

Aged↗

Ultraviolet exposure and the development of banal and atypical naevi--a cross-sectional study on Curaçao and in The Netherlands.

The atypical naevus is both a risk factor for and a precursor lesion of melanoma. Sunlight is known to be an important aetiological factor for melanoma. Whether solar exposure is also involved in the initiation of (atypical) naevi is an issue of current interest. We performed a cross-sectional study among 270 inhabitants in the cloudy Netherlands and 282 white Dutch immigrants of the tropical island Curaçao to investigate whether solar exposure plays a role in the development of atypical naevi. All participants were interviewed and underwent total skin examination; banal melanocytic naevi and atypical naevi were counted. There was no significant difference in the mean number of melanocytic naevi > or = 2 mm or > or = 5 mm between Curaçao and the Netherlands. Furthermore, there was no significant difference in the mean crude and age standardized prevalence of atypical naevi between the Netherlands and Curaçao. In both groups individuals with atypical naevi had significantly more total naevi. Concerning the role of sun exposure in the development of naevi in the Netherlands, we found that the total naevus count had a significant association with cumulative sun exposure before the age of 12 as well as with two or more painful sunburns before the age of 12. In Curaçao these relationships were not observed. In contrast, however, on Curaçao the presence of atypical naevi showed an association (odds ratio = 2.6, 95% confidence interval 1.1-6.0) with the highest level of cumulative sun exposure and with painful sunburns before the age of 12 (odds ratio = 2.6, 95% confidence interval 1.2-5.5). In the Dutch group these associations were not significant. We hypothesize that in the development of banal naevi there is an association between the total number of naevi and sun exposure only at low exposure levels; however, after overstepping a critical threshold a further association between melanocytic naevi and sun exposure is lacking. Sunlight exposure before the age of 12 plays a complex role: only very high exposure levels seem to contribute to the development of atypical naevi.

Adolescent↗

Changing pattern of drug use in relation to disease duration of rheumatoid arthritis.

The prevalent use of antirheumatic drugs in a cohort of 311 middle aged female patients with seropositive and seronegative rheumatoid arthritis (RA) was investigated. Seropositive patients used a greater amount and more aggressive drugs during each decade of disease duration. The overall use of drugs decreased with disease duration, except for a subgroup of seropositive patients with RA who, with increased disease duration, used more aggressive drugs.

Anti-Inflammatory Agents, Non-Steroidal↗

Treatment of achalasia with pneumatic dilatations.

During the last 13 years 264 unselected patients with achalasia have been treated solely by the technique of pneumatic dilatation. The principle of the method was to continue the series of consecutive dilatations until the result was satisfactory. This paper reports the late results in 138 patients who were treated more than three years ago (3-13 years; mean 6.6 years). The results were evaluated by somebody who had not before been involved in the treatment of achalasia. The evaluation was based on a personal interview, a standardized radiological examination, and intraluminal pressure measurements. These late results were classified as excellent in 45%, good in 32%, moderate in 17%, and poor in 6%. The best results were obtained in patients with a history of five to twenty years and a moderately dilated oesophagus (50-80 mm.). Comparison of the clinical results with the manometric data obtained before, immediately after, and late after treatment indicates that intraluminal pressure measurements may be a useful guide for the treatment of achalasia by pneumatic dilatations.

Adolescent↗