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Justus de Zeeuw

Publications and source records attributed to Justus de Zeeuw.

At least 19 recordsLinked to original sources
PubMed2006

[Improvement of cardiopulmonary exercise capacity in patients with obstructive sleep apnea syndrome under CPAP therapy].

BACKGROUND AND PURPOSE: Obstructive sleep apnea syndrome (OSAS) is regarded as a cardiovascular risk factor. Therefore, cardiopulmonary exercise capacity in patients with OSAS before and under treatment with continuous positive airway pressure (CPAP) was investigated. PATIENTS AND METHODS: Cardiopulmonary exercise capacity was investigated in 36 patients with untreated OSAS using spiroergometry. A follow-up after at least 6 months was performed in 17 of these patients being treated with CPAP and in eight CPAP-neglecting patients, who served as controls. RESULTS: Maximum oxygen uptake ( O(2max)) was significantly reduced in all 36 patients with untreated OSAS (17.68 +/- 6.1 ml/min/kg) compared with reference values (30.72 +/- 4.9 ml/min/kg; p < 0.001). After an average of 305.7 +/- 104.8 nights of CPAP therapy, O(2max) rose from 15.33 +/- 4.8 to 18.53 +/- 6.9 ml/min/kg, whereas O(2max) remained unchanged in controls. Further spirometric parameters of exercise capacity as well as arterial blood pressure were also significantly improved under CPAP therapy. CONCLUSION: Cardiopulmonary exercise capacity is markedly reduced in patients with OSAS. Long-term CPAP therapy leads to a significant improvement of reduced cardiopulmonary exercise capacity in these patients.

Adult↗
PubMed2006

Transbronchial biopsy guided by low-dose MDCT: a new approach for assessment of solitary pulmonary nodules.

OBJECTIVE: The objective of our study was to determine whether transbronchial bronchoscopic biopsy of solitary pulmonary nodules under CT guidance using a low-dose protocol can increase diagnostic yield in patients who had undergone unsuccessful conventional bronchoscopic biopsy. SUBJECTS AND METHODS: We included 33 consecutive patients (25 men; mean age +/- SD, 64 +/- 9.6 years) with solitary pulmonary nodules at different sites and with a lesion-to-pleura distance of at least 2 cm who previously underwent conventional bronchoscopy that did not result in histologic diagnosis. All patients were prospectively investigated with transbronchial bronchoscopic biopsy under MDCT guidance. Examinations were performed with the patient in conscious sedation using a low-dose protocol (80 kV, 20 mAs, 5-mm collimation, 10-mm slices). The position of the tip of the biopsy device was confirmed and documented before biopsies were performed. All specimens were examined by standard histopathologic techniques. The effective radiation dose was calculated for every patient. RESULTS: The diagnostic yield was 24 in 33 selected patients (overall accuracy, 72.7%): 13 (54%) had primary lung cancer and 11 (46%) had benign diagnoses. The formal operative characteristics were sensitivity, 59%; specificity, 100%; positive predictive value, 100%; and negative predictive value, 55%. The final diagnoses of the remaining nine patients in whom transbronchial bronchoscopic biopsy was not diagnostic were non-small cell lung cancer (n = 3); small cell lung cancer (n = 3); and alveolar carcinoma, carcinoid tumor, and hemorrhaged bulla (n = 1 each). All nonmalignant diagnoses were confirmed by 6 months radiographic and clinical follow-up. The mean duration of the procedure was 39 +/- 15 minutes, and the average effective dose was 0.7 mSv (range, 0.5-1.1 mSv). One case of pulmonary hemorrhage (3%) occurred after the procedure. CONCLUSION: MDCT-guided transbronchial bronchoscopic biopsy is a promising and safe tool for the diagnostic pathway of solitary pulmonary nodules in previously undiagnosed patients. Image quality was sufficient with low-dose protocols, which resulted in low radiation exposure for patients and personnel.

Biopsy, Needle↗
PubMed2005

[Early polysomnographic detection of congestive heart failure caused by aortic valve stenosis].

BACKGROUND: Obstructive sleep apnea (OSAS) is assumed to be an independent cardiovascular risk factor, whereas central sleep apnea with Cheyne-Stokes breathing occurs in congestive heart failure and has a prognostic value. CASE REPORT: The case of a 74-year-old man with long-term continuous positive airway pressure treatment due to OSAS is reported. In a routine polysomnography central apneas and Cheyne-Stokes breathing without any clinical signs of heart failure were seen. Further investigations revealed a newly diagnosed aortic valve stenosis with good left ventricular function. Clinical signs of congestive heart failure came up 2 weeks after first diagnosed Cheyne-Stokes breathing. CONCLUSION: Cheyne-Stokes breathing can be observed in acute heart failure before occurrence of any clinical signs of congestive heart failure and should always lead to further investigations. The current understanding of pathophysiological pathways in Cheyne-Stokes breathing is reviewed.

Aged↗