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Biomedical subjects

K Berend

Publications and source records attributed to K Berend.

17 recordsLinked to original sources
PubMed2003

[Kidney transplant program facilitated by airlift between the Netherlands Antilles and the Netherlands; 1998-2001].

OBJECTIVE: To describe the results of a structured kidney-transplantation programme available to dialysis patients in Curaçao (Dutch Caribbean), involving transplantation in the Netherlands and follow-up in Curaçao. DESIGN: Descriptive. METHOD: In 1998, a joint venture was begun with the Academic Medical Center (AMC) in Amsterdam, the Eurotransplant Foundation, the Dutch Transplantation Working Party and the Diagnostic Division of the Sanquin Foundation in Amsterdam, the Netherlands. Its aim was to achieve a structural kidney transplantation programme for patients in the Dutch Caribbean in general and patients in Curaçao in particular. An airlift programme between Curaçao and the AMC was instituted. RESULTS: Between 1998-2001 19 patients underwent a kidney transplant, three of which failed. In most of the transplants the cold ischaemia time was less than 48 hours; the average cold ischaemia time was 32 hours. All patients returned to the Antilles within 3 months where their treatment was continued. Post-transplantation follow-up was on average 13.9 months (limits 3-36); three patients died.

Adult↗
PubMed2001

Acute aluminum encephalopathy in a dialysis center caused by a cement mortar water distribution pipe.

BACKGROUND: In Curaçao, distilled seawater from the water plant was used without further purification for hemodialysis for several decades. A new distribution pipe supplying water to a dialysis center on the island was installed in May 1996. To protect it from corrosion, this pipe was lined on the inside with a cement mortar. Because of the aggressiveness of the distilled water, calcium and aluminum (Al) leached from the cement mortar into the water used to prepare dialysate. This caused a possible hard water syndrome and definite acute Al intoxication. METHODS: We reviewed clinical details and outcome at follow-up, and arranged laboratory and toxicological studies of serum and hemodialysis water. RESULTS: Of the 27 patients who had a similar exposure ( approximately 60 hours) to the contaminated dialysate, 10 died from acute Al encephalopathy, whereas 17 patients had no or only minor symptoms and survived. The nonsurvivors were older (64 +/- 3 years vs. 52 +/- 2 years, P < 0.01) and had a lower body weight (57.5 +/- 5.9 kg vs. 86.5 +/- 4.1 kg, P < 0.01) and lower serum albumin concentrations (33 +/- 1 vs. 36 +/- 1 g/L, P < 0.01). Anuria tended to be more common in the nonsurvivors (8 out of 10 vs. 8 out of 17, P> 0.05). Serum Al concentrations, available in seven nonsurvivors, were significantly higher than in the survivors (808 +/- 127 vs. 255 +/- 25 microg/L, P < 0.01). CONCLUSIONS: The water distribution pipe was lined with a cement mortar that was probably inappropriate for transporting drinking water. Water distribution facilities as well as the dialysis community should be aware of the possibility of Al leaching from cemented water distribution pipes. Similar Al loads appear to induce a more severe intoxication in malnourished, older patients with smaller Al distribution volumes and anuria.

Acute Disease↗
PubMed2001

The relationship between diagnosis and outcome in arthroscopy of the hip.

PURPOSE: The purpose of this study was to compare the results of arthroscopy of the hip for osteonecrosis (ON) with those obtained for other diagnoses by presenting a cohort of patients with diagnosis and symptoms as dependant variables in a consecutive series of 86 cases of hip arthroscopy. TYPE OF STUDY: Retrospective review of outcomes. METHODS: There were 83 patients (86 hips) who underwent arthroscopy. Indications included ON (43%), labral injuries (20%), osteoarthritis (degenerative joint disease, DJD) (10%), Legg-Calvé-Perthes (LCP) disease (10%), and loose bodies (10%). All but 2 patients had had symptoms for at least 6 months. Symptoms were pain (100%), mechanical problems (78%), and loss of motion (56%). Arthroscopy was performed in the supine position, using a standard traction table, 30 degrees and/or 70 degrees arthroscopes, and the anterior and peritrochanteric portals. Data were collected longitudinally, retrospectively reviewed, and statistically analyzed. RESULTS: No complications were seen; 60% of the patients had significant improvement over an average follow-up of 30 months. Better results were with labral tears (91%, P <.003) or LCP disease (89%, P <.05). ON and DJD did worse with only 40% and 44% improvement, respectively. After free-vascularized fibular graft (FVFG), 34% of patients showed improvement at follow-up (P =.003). Eighteen patients (21%) underwent total hip arthroplasty at an average of 8.4 months after arthroscopy. Mechanical symptoms were a significant favorable prognostic factor (P =.0019), with 85% having a good result. Patients with ON and mechanical symptoms had a significantly lower conversion rate to total hip arthroplasty than those with only pain or pain and decreased range of motion (P =.0043). CONCLUSIONS: Arthroscopy of the hip is useful for diagnosis and therapy of loose bodies, labral injuries, focal chondral lesions, or the late sequellae of LCP disease. We conclude that the presence of mechanical symptoms is a favorable prognostic factor for any diagnosis except degenerative arthritis. Furthermore, the identification of mechanical symptoms is a specific indication for arthroscopy in ON before or after FVFG.

Arthroscopy↗
PubMed1996

Enhanced levels of soluble VCAM-1 in sickle cell patients and their specific increment during vasoocclusive crisis.

Adhesion of sickle erythrocytes to vascular endothelium plays a central role in sickle cell disease complications. Cytokines and adhesion molecules are critically involved in the regulation of these adhesive processes. To analyze their role, IL-6, GM-CSF, sVCAM-1, sICAM-1, sE-Selectin, and sP-Selectin serum levels were determined in sickle cell patients under basic conditions and during vasoocclusive crisis. In nonsymptomatic patients a high serum level of sVCAM-1 was observed compared to controls. In patients having vasoocclusive crisis sVCAM-1 levels increased even more and seemed to correlate with crisis evolution.

Adolescent↗
PubMed1994

[Little difference in quality of life of dialysis patients in Utrecht and Willemstad].

OBJECTIVE: To assess and compare the quality of life of patients treated with haemodialysis and chronic ambulatory peritoneal dialysis (CAPD) in Utrecht and Willemstad, Curaçao. DESIGN: Transverse multicentre study. METHODS: All haemodialysis and CAPD patients in Utrecht and all haemodialysis patients in Curaçao under treatment for over 6 months were studied. The objective tests applied were the 'Nottingham health profile', the 'affect balance scale', the 'index of well-being' and the 'Amsterdam complaint profile'. Possible correlations between individual patient-related and treatment-related factors and biochemical variables were also investigated. RESULTS: The objective and subjective tests revealed only slight differences in quality of life in the three groups. In a few respects, the CAPD patients rated the quality of life slightly better. In the Utrecht group a positive relationship was seen between haematocrit (higher owing to treatment with erythropoietin) and plasma bicarbonate concentration, and the quality of life.

Cross-Cultural Comparison↗