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Biomedical subjects

L Hermans

Publications and source records attributed to L Hermans.

At least 19 recordsLinked to original sources
PubMed1998

Thrombotic thrombocytopenic purpura: a rare but potential life-threatening complication following ticlopidine administration.

Thrombotic thrombocytopenic purpura (TTP) is a known, although rare, complication of ticlopidine treatment. It typically appears within the first days or weeks after initiation of therapy. We describe a case of TTP in a 75-year-old patient, due to ticlopidine, occurring three weeks after coronary stent implantation. The patient responded favourably to fresh frozen plasma exchanges. We are reporting this case to emphasize that prognosis depends on prompt diagnosis and early treatment, implying careful biochemical monitoring.

Aged↗
PubMed1997

Classification of normal and abnormal electrogastrograms using multilayer feedforward neural networks.

A neural network approach is proposed for the automated classification of the normal and abnormal EGG. Two learning algorithms, the quasi-Newton and the scaled conjugate gradient method for the multilayer feedforward neural networks (MFNN), are introduced and compared with the error backpropagation algorithm. The configurations of the MFNN are determined by experiment. The raw EGG data, its power spectral data, and its autoregressive moving average (ARMA) modelling parameters are used as the input to the MFNN and compared with each other. Three indexes (the percent correct, sum-squared error and complexity per iteration) are used to evaluate the performance of each learning algorithm. The results show that the scaled conjugate gradient algorithm performs best, in that it is robust and provides a super-linear convergence rate. The power spectral representation and the ARMA modelling parameters of the EGG are found to be better types of the input to the network for this specific application, both yielding a percent correctness of 95% on the test set. Although the results are focused on the classification of the EGG, this paper should provide useful information for the classification of other biomedical signals.

Algorithms↗
PubMed1997

Renal responses to exercise in heart and kidney transplant patients.

There is a lack of information about renal responses in heart and kidney transplant patients after intense physical exercise. Eleven heart and ten kidney transplant recipients, as well as two control groups of healthy subjects, were given a maximum exercise test on a bicycle ergometer. One control group was also given a moderate load corresponding to the peak load of the kidney transplant group. Blood and urine samples were collected before and after exercise and assayed for lactate, creatinine, total protein, and albumin. The glomerular filtration rate remained stable at the end of exercise in the transplant patients, while there was a slight (17%) decrease in the control group. Albumin excretion rates after maximum exercise attained a mean of 237 micrograms.min-1 in the control group and a mean of 45 and 16 micrograms.min-1, respectively, in the heart and kidney groups. Postexercise proteinuria seemed to be related to the absolute intensity of the event, but kidney transplant patients showed a reduced effect as compared to heart transplant patients. We conclude that short-term, maximum exercise in heart and kidney transplant recipients is not detrimental to kidney function.

Adult↗
PubMed1997

Randomized coronary patency trial of double-bolus recombinant staphylokinase versus front-loaded alteplase in acute myocardial infarction.

One hundred two patients with evolving myocardial infarction of 6 hours' duration were given aspirin and intravenous heparin and randomly allocated to intravenous front-loaded, weight-adjusted rTPA administration over a 90-minute period (52 patients) or to two 15 mg doses of recombinant staphylokinase, 30 minutes apart (50 patients). Thrombolysis in Myocardial infarction (TIMI) perfusion grade 3 at 90 minutes was achieved in 68% (95% confidence interval, 55% to 81%) of patients treated with staphylokinase versus 57% (95% confidence interval, 43% to 72%) of patients treated with rTPA (p = not significant). Double-bolus staphylokinase was significantly more fibrin-specific than accelerated rTPA with residual fibrinogen at 90 minutes of 105% +/- 4.1% and 68% +/- 7.5%, respectively (p < 0.0001). Thirteen patients in each study group underwent angioplasty of the culprit coronary artery within the first 24 hours because of suboptimal recanalization (TIMI < 3). In the patients without prior coronary intervention, TIMI 3 at 24 hours was 100% after staphylokinase administration (n = 35) versus 79% after rTPA (n = 34) (p = 0.005). The distribution of inhospital events did not significantly differ between both groups. One patient receiving rTPA died in the hospital from ischemic stroke. Staphylokinase administration did not induce allergic reactions, but significant staphylokinase-neutralizing activity (> 5 micrograms/ml) and specific anti-staphylokinase IgG developed in 73% of patients after 2 weeks. Thus two 15 mg doses of staphylokinase induce early, complete, and sustained coronary artery patency at least as frequently as accelerated rTPA without associated fibrinogen degradation but with subsequent induction of circulating neutralizing antibodies.

Female↗
PubMed1995

A randomized trial of recombinant staphylokinase versus alteplase for coronary artery patency in acute myocardial infarction. The STAR Trial Group.

BACKGROUND: Recombinant staphylokinase (STAR) was shown recently to offer promise for coronary arterial thrombolysis in patients with evolving myocardial infarction. The present multicenter randomized open trial was designed to assess the thrombolytic efficacy, safety, and fibrin specificity of STAR relative to accelerated alteplase (recombinant tissue-type plasminogen activator [RTPA]). METHODS AND RESULTS: One hundred patients with evolving myocardial infarction of < 6 hours' duration and with ST-segment elevation were allocated to accelerated and weight-adjusted RTPA over 90 minutes (52 patients) or to STAR (the first 25 patients to 10 mg and the next 23 patients to 20 mg given intravenously over 30 minutes). All patients received aspirin and intravenous heparin. The main end points were coronary artery patency and plasma fibrinogen levels at 90 minutes. Thrombolysis in Myocardial Infarction (TIMI) perfusion grade 3 at 90 minutes was achieved in 62% of STAR patients versus 58% of RTPA patients (risk ratio, 1.1; 95% CI, 0.76 to 1.5). With 10 mg STAR, TIMI grade 3 patency was 50% (risk ratio, 0.86; 95% CI, 0.54 to 1.4 versus RTPA); with 20 mg STAR, it was 74% (risk ratio, 1.3; 95% CI, 0.90 to 1.8 versus RTPA). Residual fibrinogen levels at 90 minutes were 118 +/- 47% (mean +/- SD) of baseline with STAR and 68 +/- 42% with RTPA (P < .0005). STAR therapy was not associated with an excess mortality or electric, hemorrhagic, mechanical, or allergic complications. However, patients developed antibody-mediated STAR-neutralizing activity from the second week after STAR treatment. As an addendum to the randomized study, 5 patients were given 40 mg STAR over 30 minutes, resulting in TIMI perfusion grade 3 at 90 minutes in 4 patients without fibrinogen breakdown (residual levels at 90 minutes of 105 +/- 8% of baseline). CONCLUSIONS: STAR appears to be at least as effective for early coronary recanalization as and significantly more fibrin-specific than accelerated RTPA in patients with evolving myocardial infarction.

Angioplasty, Balloon, Coronary↗
PubMed1994

At equipotent doses, isradipine is better tolerated than amlodipine in patients with mild-to-moderate hypertension: a double-blind, randomized, parallel-group study.

1. The objective of this double-blind parallel-group study was to compare the tolerability of isradipine and amlodipine, specifically, the side-effects known to be related to the use of dihydropyridine calcium antagonists. 2. A total of 205 patients with mild-to-moderate essential hypertension were randomized to receive either the sustained-release (SRO) formulation of isradipine (n = 103) or amlodipine (n = 102), both at dosages of 5 mg once daily. Blood pressure measurements were taken at the end of the dosing interval to assess the antihypertensive efficacy of the two drugs. 3. Adverse reactions were assessed in two ways: a) spontaneously reported adverse events were recorded and investigated in depth for severity, duration, relation to the study drug, and outcome; b) a questionnaire was used to elicit specific adverse reactions known to be related to the use of dihydropyridine calcium antagonists which were evaluated for severity, duration, relation to the study drug, and outcome. 4. After 6 weeks of active treatment, both isradipine and amlodipine reduced mean sitting systolic/diastolic blood pressure: from 165.1/100.1 to 145.2/89.7 mm Hg with isradipine; and from 164.1/100.6 to 145.7/90.5 mm Hg with amlodipine. There was no difference in antihypertensive effect between isradipine and amlodipine (95% CI: -3.73 to 4.73 and -1.89 to 3.49 for differences in systolic and diastolic blood pressure, respectively). 5. The number of patients spontaneously reporting adverse events was significantly higher (P = 0.02; 95% CI: 3.1 to 26.7%) with amlodipine (33.3%) than with isradipine (18.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Tolerability of isradipine in the treatment of mild-to-moderate hypertension in general practice: a large-scale surveillance study.

The tolerability of isradipine was evaluated in an open trial of patients with mild-to-moderate essential hypertension as treated in general practice. The primary objective was to identify all adverse reactions, especially those that were newly occurring (greater than or equal to 6 reports), with a frequency greater than 1/1,000. Over 1,100 general practitioners and 5,526 patients participated in this trial. After a 2-week washout period, and a 3-week placebo run-in, patients with diastolic blood pressure (DBP) greater than or equal to 95 mm Hg were initially given isradipine at 1.25 mg twice daily. After 4 weeks, doses were doubled if DBP was greater than 90 mm Hg. If, after a further 4 weeks with doubled dosages, the DBP was still greater than 90 mm Hg, a second (nonspecified free-choice) antihypertensive agent was added to the treatment. Adverse events were recorded by open questioning. The incidence of adverse events was found to be similar to that with placebo; adverse events were generally mild or moderate in intensity and disappeared over time. No newly occurring adverse events were found. In conclusion, isradipine is safe and well tolerated at effective antihypertensive doses in patients with mild-to-moderate hypertension as treated in general practice.

Calcium Channel Blockers↗
PubMed1992

Long-term (2-year) isradipine data in the treatment of mild-to-moderate hypertension.

At the end of a short-term (3-month) study of antihypertensive treatment of mild-to-moderate hypertension, 141 of the 200 study patients continued into a 2-year follow-up of isradipine as monotherapy or in combination with other antihypertensive agents. Although all 141 patients completed the first year, only 102 completed the study. Twenty-four patients dropped out: 2 with flushing; 1 each with arrhythmia, edema, angina, and headache; 12 who were noncompliant; 2 with disease unrelated to the study drug; and 4 for reasons unknown. Before the follow-up, 70% of the 141 patients were taking isradipine; after 2 years, 63% were still taking isradipine as monotherapy. During the follow-up study, the blood pressure remained stable (142.9/86.8 mm Hg after 3 months, and 142.9/86.2 mm Hg after 2 years), whereas the normalization rate was only slightly changed (73 vs. 75.2%). The incidence of reported adverse events decreased with time. At the end of the short-term study, 44.7% of patients had reported one or more adverse events; after 2 years of treatment, only 14.4% reported adverse events. Two patients had ECG signs of left ventricular hypertrophy: one showed no relevant changes while the other presented clear signs of regression. No clinically relevant laboratory abnormalities were noted during the study. In conclusion, isradipine is effective, well tolerated and safe in the long-term treatment of mild-to-moderate hypertension.

Calcium Channel Blockers↗
PubMed1991

Helminth and protozoan parasites in dogs and cats in Belgium.

This study investigates the level of helminthic and protozoal infestation over the last 10 years in strays, well-cared-for dogs and cats. Determination of the prevalence of infections was based either on faecal examination or on worm counts at necropsy. Of 2324 faecal flotations (NaCl sp.gr. 1.20) of stray dogs, 34.2% had eggs or proglottids of one or more worm species consisting of Toxocara canis (17.4%), Toxascaris leonina (10.1%), Uncinaria stenocephala (11.4%), Trichuris vulpis (7.0%) and cestodes (2.1%). Isospora oocysts were observed in 5.2% of the dogs. The data on the distribution of the various worm species in the positive dogs indicate that T. canis eggs were by far the most common (50.9%). Necropsy data from 212 infected dogs indicate that 38.9% were infected with T. canis and 33.7% with T. leonina. The overall prevalence of worm infestation of 246 well-cared-for kennel dogs, based on worm egg counts by the McMaster technique, was 36.1%. Of 30 feline faecal samples examined by flotation, 83.3% were positive for parasites, including Toxocara cati (60%), Ancylostoma tubaeformae (36.6%), Taenia (Hydatigera) taeniaeformis (20%) and coccidia (30%). Toxocara cati was the most frequently found worm species at the necropsy of 25 cats (52%). Toxoplasma was not observed.

Animals↗
PubMed1991

Effects of isradipine on peripheral hemodynamic reflex responses in mild-to-moderate essential hypertension.

In a randomized double-blind, placebo-controlled, crossover study of isradipine (5 mg twice daily), effects on peripheral hemodynamic reflex responses were studied in nine patients (mean age 48 years) at baseline and after six weeks of active treatment. Assessments included vital signs, resting blood flow in the calf and finger (using an electrocardiograph-triggered venous occlusion plethysmograph), reflex responses during isometric exercise and cold pressor resistance, and venous capacitance in the forearm and calf. Isradipine lowered systolic and diastolic blood pressure as well as mean arterial pressure in patients with mild-to-moderate essential hypertension without reflex tachycardia or venoconstriction. All of the reflex responses studied were attenuated. It is concluded that vasodilatation of the peripheral circulation induced by isradipine contributes partially to the blood pressure-lowering effect.

Adult↗
PubMed1991

Exercise and heart transplantation. A review.

Results of heart transplantation as therapy for end-stage cardiac diseases are encouraging not only because of actuarial survival curves but also because of the recovered quality of life for the heart transplant recipient. Although heart transplantation drastically improves the physical capacity of the patients, heart recipients still have a reduced maximal aerobic capacity compared to healthy people. Altered resting and exercise haemodynamics, due to cardiac denervation, are a common finding after orthotopic heart transplantation: increases in heart rate and stroke volume at exercise are first linked with the augmented venous return and later with the increased plasmatic nor-adrenaline level. Maximal heart rate and stroke volume are both reduced when compared to innervated heart. Reduced cardiac output response to exercise therefore results in early anaerobic metabolism, acidosis, hyperventilation and diminished physical capacity. In spite of an altered ventilatory adaptation to exercise, characterised by hyperpnoea in most transplant patients, ventilation is not the limiting factor for exercise in heart recipients without associated obstructive pulmonary disease. Endurance training restores lean tissue, decreases submaximal minute ventilation, increases peak work output, maximal ventilation and peak heart rate. Guidelines for prescribing exercise are not yet standardised due to the limited number of studies on a sufficient cohort of heart recipients. Nevertheless, recommendations similar to those used for persons with coronary heart disease, with modifications due to the denervated heart, seem to be used. The cardiocirculatory and pulmonary capacity of heart transplant recipients allow them to undertake endurance sports activities such as walking, jogging, cycling and swimming, and these should be encouraged.

Energy Metabolism↗
PubMed1990

Anticoccidial efficacy of diclazuril in pheasants.

Diclazuril, a new anticoccidial drug, was tested in young pheasants artificially infected with the three most common pathogenic species of Eimeria, E colchici, E duodenalis and E phasiani. In two replicate experiments each with 40 birds the mortalities in the infected controls were 50 and 25 per cent. Diclazuril was administered in the feed at dose levels of 1, 2 and 4 ppm from the day before the inoculation of coccidia until the end of the test on day 6 after infection. The 1 ppm dose failed to inhibit the development of the parasite completely, as was shown by a reduction of the weight gain of the birds and the output of a small number of oocysts. Diclazuril at 2 or 4 ppm adequately controlled the infection, with weight gains similar to those of the uninfected controls. At all dose levels, mortality, intestinal lesions and diarrhoea were prevented.

Animals↗
PubMed1990

Diclazuril, a new broad-spectrum anticoccidial for chickens. 3. Floor-pen trials.

Diclazuril is a benzeneacetonitrile showing great promise as a broad-spectrum anticoccidial agent for chickens, turkeys, and rabbits. The high anticoccidial activity of diclazuril in chickens, as first reported in dose-titration studies and battery trials, was confirmed in three floor-pen trials. The efficacy was demonstrated against six major pathogenic species of Eimeria after artificial infection with one or more species. The experimental data indicated that diclazuril, at dose levels of .5, .75, 1, and 2 ppm, had a high anticoccidial activity in terms of preventing mortality, suppressing or reducing lesion scores, and allowing for normal weight gains as well as productivity. The performances obtained with diclazuril was generally comparable with that of salinomycin at 60 ppm and that of lasalocid at 90 ppm.

Animals↗
PubMed1989

Efficacy of diclazuril in the prevention and cure of intestinal and hepatic coccidiosis in rabbits.

The efficacy of diclazuril against intestinal and hepatic coccidiosis was studied in artificially infected rabbits. Prophylaxis against intestinal coccidiosis was evaluated using a mixed infection of Eimeria intestinalis, Eimeria magna and Eimeria perforans. Continuous medication in the feed at 1 p.p.m. was 100% effective in reducing oocyst output and faecal scores, and weight gain and feed efficiency were normal. Hepatic coccidiosis induced by Eimeria stiedai was prevented at 0.5 and 1 p.p.m. as shown by negative oocyst counts, normal liver weight, absence of liver lesions, and normal body-weight gain and feed efficiency. Medication at 1 p.p.m. for 7 consecutive days during the prepatent phase of hepatic coccidiosis resulted in large reductions in oocyst counts and lesion scores with a normal liver weight and growth performance. Diclazuril at 1 p.p.m. in the feed prevented both intestinal and hepatic coccidiosis in rabbits and can be advocated for safe mass medication.

Animals↗
PubMed1989

Diclazuril, a new broad spectrum anticoccidial drug in chickens. 2. Battery trials.

Battery trials have confirmed the broad spectrum anticoccidial activity of diclazuril as previously reported in dose titration studies. The advocated dose level of 1 ppm in the diet demonstrated excellent activity against the economically most important Eimeria species. At this dose level, body weight gains were comparable to those of uninfected, unmedicated controls and the oocyst production was negative in most species. Lesion scores and dropping scores were nil or highly reduced. An E. maxima-147 strain, less sensitive to ionophores, also responded well to diclazuril. It was concluded that diclazuril is a promising anticoccidial for the control of all species of coccidia that cause losses to the poultry industry.

Animals↗
PubMed1988

Efficacy of flubendazole against gastrointestinal and lung nematodes in pigs.

Three trials were carried out on landrace pigs of various ages to assess the anthelmintic efficacy of flubendazole. The pigs were either artificially infected with Metastrongylus apri or naturally or artificially infected with the gastrointestinal nematodes Ascaris suum, Oesophagostomum dentatum or Hyostrongylus rubidus. For mass medication of young pigs and fatteners a dose regimen of 30 ppm flubendazole in the feed for 10 consecutive days was 100 per cent effective against the four nematode species. For individual medication a single dose of 5 mg/kg bodyweight administered in a small amount of feed was also 100 per cent effective. No side effects were observed.

Animals↗
PubMed1988

[Clazuril: a new anticoccidial agent for pigeons].

The effectiveness of clazuril (Appertex), a new anticoccidial agent for the treatment of pigeons is described in the present study. Clazuril, a benzene-acetonitrile derivative, is administered in a single dose. In laboratory studies, 121 carrier pigeons infected with E. labbeana and E. columbarum were treated once with clazuril in gelatin capsules at dose levels of 10 mg, 5 mg, 2.5 mg, 1.25 mg, 0.63 mg or with a placebo. When a single dose of 2.5 mg and higher was administered, all faecal samples became negative for oocysts within seven days after treatment. In the field studies, 1531 young and full-grown carrier pigeons, from 116 infected dove-cotes, were treated with 1 tablet of 2.5 mg clazuril. Seven days after treatment, the faecal samples of 105 dove-cotes were negative for oocysts of E. Labbeana and E. columbarum; in six dove-cotes, infection was also virtually reduced to zero. Performance in racing was not affected by treatment and side-effects were not observed.

Acetonitriles↗