PubMed Health⌕ Search

Biomedical subjects

L de Groot

Publications and source records attributed to L de Groot.

At least 19 recordsLinked to original sources
PubMed2005

Predictive value of neonatal MRI with respect to late MRI findings and clinical outcome. A study in infants with periventricular densities on neonatal ultrasound.

PURPOSE: The aim of this study was to correlate hypoxic-ischemic white matter damage on neonatal MRI with MRI appearance and neurological outcome at the age of 1 1/2 years. PATIENTS AND METHODS: A sequential cohort of infants with periventricular densities on neonatal ultrasound was studied with neonatal MRI. Images of 46 infants with a mean gestational age of 31 weeks were obtained at a mean age of 20 days after birth and at 1 1/2 years. To establish agreement between the neonatal and follow-up MRI (general, motor, and visual scores), the weighted Cohen's kappa test was used. To establish the predictive power of neonatal MRI with respect to the neurologic indices at the age of 1 1/2 years, the sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: There was a moderately good to good agreement between the general, motor, and visual neonatal and follow-up MRI scores: weighted kappa = 0.59 (95% CI: 0.44 - 0.74), 0.82 (95% CI: 0.72 - 0.93), and 0.70 (95% CI: 0.56 - 0.84), respectively. Neonatal MRI scores provided a good prediction of the three neurological outcome measures (developmental delay, cerebral palsy, and cerebral visual impairment): sensitivity, specificity, and predictive values were high, with little difference between the three MRI scores. The 32 patients with (nearly) normal neonatal MRI scores were neurologically (nearly) normal at 1 1/2 years on all three outcome measures, whereas 8 patients with seriously abnormal neonatal MRI scores were neurologically abnormal at 1 1/2 years on all three outcome measures. CONCLUSION: Neonatal MRI is able to predict the precise localization and size of perinatal leukomalacia on follow-up MRI and provides a good prediction of neurological outcome at 1 1/2 years.

Age Factors↗
PubMed2003

Peri- and intraventricular cerebral sonography in second- and third-trimester high-risk fetuses: a comparison with neonatal ultrasound and relation to neurological development.

OBJECTIVES: To determine whether periventricular leukomalacia (PVL) and peri- and intraventricular hemorrhages can be detected in fetuses at risk for preterm birth and to establish the clinical significance of this finding. METHODS: Prenatal cerebral sonography was performed in 26 fetuses at risk for uteroplacental insufficiency on the day of inclusion into the study and weekly until delivery. Neonatal cerebral ultrasound examination was performed within 24 h of birth and biweekly until discharge. The infants underwent standardized neurological examinations. RESULTS: During 30 observations, 21/26 fetuses presented in a cephalic position. Successful visualization in the coronal and sagittal planes was significantly correlated with that of a control population (r = 0.615; 95% CI, 0.390-0.771). In 20/21 fetuses at least one observation was adequate for analysis. Eleven cerebral abnormalities were found in nine fetuses, periventricular echodensities in four, intraventricular hemorrhage in two, and localized thalamic densities in five. In six of these infants ultrasound abnormalities persisted after birth. Neurological follow-up at 24 months demonstrated abnormalities in three infants, two infants were normal and one was lost to follow-up. The three infants with normal ultrasound results after birth had a normal follow-up. Five infants with normal antenatal ultrasound results showed ultrasound abnormalities during the neonatal period; four of them developed PVL Grade 1 and one developed PVL Grade 2. The follow-up of two of these infants was normal, two died and one developed spastic tetraplegia. Abnormal antenatal brain sonography was significantly correlated with gestational age at birth (r = 0.487; P = 0.029). CONCLUSION: Peri- and intraventricular echodensities can be detected reliably before birth in fetuses at high risk for uteroplacental insufficiency. When abnormalities persist, there is a high risk for an adverse outcome.

Cerebral Hemorrhage↗
PubMed2003

The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people.

BACKGROUND & AIMS: The elderly are at an increased risk of poor nutritional status which is mutually interacting with functional status. We evaluated the effects of a liquid nutrition supplement on anthropometric and functional indices in elderly people. METHODS: Subjects (n=68; mean age=82+/-7 years) with body mass index <or=25 kg/m(2) received either a supplement or a placebo for 6 months. Anthropometric (body weight, bioelectrical impedance, calf circumference), biochemical (albumin, prealbumin), functional parameters (handgrip strength, timed 'up and go' test) and dietary intake were measured. Activities of daily living and Nottingham Health Profile (NHP) were assessed. RESULTS: No compensation of energy intake occurred. After 6 months, the supplement group had gained more weight (+1.6 kg) than the placebo group (+0.3 kg) (P=0.03). No other significant changes in anthropometric, functional or blood parameters were seen. There was a significant improvement on the section 'sleep' of the NHP (mean change+/-SE=-0.38+/-0.19 for supplement vs 0.24+/-0.19 for placebo, P=0.03). CONCLUSION: Dietary supplementation led to an increase in body weight and had a positive influence on sleep in elderly persons. Supplementation did not affect energy intake from regular meals and thus resulted in additional energy intake.

Activities of Daily Living↗
PubMed2001

Muscle power in "high-risk" preterm infants at 12 and 24 weeks corrected age: a measure for early detection.

UNLABELLED: A group of 72 "high-risk" preterm infants was studied at the corrected ages of 12 and 24 wk. Only infants with a high risk for developmental deviance with gestational ages below 32 wk and/or birthweights of less than 1500 g were included in the study. In addition, the infants were categorized according to their medical history, as confirmed by the "Neonatal Medical Index" (NMI I to V), with category I describing infants with few medical problems and V characterizing those with the most serious complications. In this study we included only "high-risk" infants as categorized in NMI III to V, since infants with a "low risk" have been described earlier. Apart from the standard paediatric follow-up, an age-adequate neurological assessment was made, with special emphasis on the relationship between active and passive muscle power. When development is optimal, these two components of muscle power should be in balance in order to create a stable posture and fluent motility. We compared muscle power at the corrected ages of 12 and 24 wk to determine whether the method employed to assess muscle power could enhance early detection of deviant development. At 12 wk of age, only 5 infants showed overall optimal muscle power, while at 24 wk this figure had increased to 27. Significantly more infants in NMI III had optimal outcomes at 24 wk of age. When muscle power in the different parts of the body was studied separately at 24 wk, outcomes in shoulders and trunk still showed significant discrepancies in all NMI groups. At this age, fewer asymmetries were found compared to outcomes at 12 wk. CONCLUSION: Our method of assessing muscle power is useful in detecting preterm infants at risk for pathological development.

Age Factors↗
PubMed2001

Study of a group of extremely preterm infants (25-27 weeks): how do they function at 1 year of age?

The functional outcome of 49 extremely preterm infants (gestational age: 25-27 weeks) was studied at the corrected age of 12 months. Apart from pediatric follow-up, a full neurologic assessment and the Bayley Motor and Mental Scales of Infant Development was done. Emphasis was placed on postural control, spontaneous motility, hand function, and elicited infantile reactions. Special attention was given to symmetric development. The infants were then categorized as having optimal or nonoptimal or asymmetric outcome. Overall, an optimal outcome was found in 19 infants (39%) and nonoptimal outcome in 30 infants (61%), 7 of whom failed on all domains of function. Postural control had a significant influence on the different domains of development such as motility (P < or = .001) and persistent infantile reactions (P < or = .001) and slightly less on hand function (P = .08) and asymmetry (P = .06). The outcome on spontaneous motility was significantly related to the results on infantile reactions (P < or = 005) and hand function (P = .05). Also, the score on the motor scale of the Bayley Developmental test was clearly related to outcome on spontaneous motility (P < or = .001) and reactions (P< or = .02). Abnormal brain ultrasonograms were related to the asymmetry of the infantile reactions (P < or = .05). Poor coordination of gross motor function will have consequences for appropriate visuomotor and sensorimotor integration, thereby hampering motor learning and later cognitive function, as is often described in preterm infants. It is suggested that the poor postural control found in many infants born preterm is the result of both myogenic and neurogenic deviations caused by the preterm birth and its nursing consequences.

Child Development↗
PubMed2001

Appraisal of 4 months' consumption of nutrient-dense foods within the daily feeding pattern of frail elderly.

OBJECTIVES: The appraisal and acceptance of micronutrient-dense versus identical regular foods among frail elderly are described. METHODS: Four types of dairy and four types of fruit products, either enriched with multiple micronutrients or not, were consumed by 150 frail elders for 4 months. In the first 2 and last 2 weeks of the intervention, hedonic aspects were assessed. Afterward, evaluation forms were completed. RESULTS: At the start, small but consistent differences existed between the enriched and the regular foods concerning the scores on pleasantness, desire to eat the product, and attitude toward the product. At the end, those ratings dropped slightly or stayed equal. Significant differences between groups emerged from the overall evaluation score: 6.4 plus or minus 1.6 and 7.7 plus or minus 1.7 respectively (p <.001). DISCUSSION: Optimization of the hedonic parameters of nutrient-dense foods and major long-term attention for application in the daily elderly feeding pattern is of essential importance.

Aged↗
PubMed2000

The influence of postural control on motility and hand function in a group of 'high risk' preterm infants at 1 year of age.

The functional outcome of a group of 75 'high-risk' preterm infants was studied at the corrected age of 12 months. Only infants with high-risk for developmental deviance with gestational ages below 32 weeks and/or birthweights less than 1500 g were included in the study. Additionally the infants were categorised according to their medical history conforming with the 'Neonatal Medical Index' (NMI I to V), with category I describing infants with few medical problems and V characterizing those with the most serious complications. In this study we included only infants with 'high-risk' as categorised in NMI III to V, since infants with 'low-risk' have been described earlier. Infants with cerebral ultrasonographic abnormalities were incorporated into the NMI categories, but also analysed separately to compare outcomes. At 12 months (corrected age) apart from pediatric follow-up, a full neurological assessment was done with emphasis on postural control, spontaneous motility and hand function. Special attention was given to symmetrical development. The infants were then categorised as having optimal, non-optimal or asymmetrical outcomes. An overall optimal outcome on postural control was found in 64% of all infants (67% in NMI III, 60% in NMI IV and 62.5% in NMI V). Too much extension interfering with postural control was found significantly more often in infants in NMI V (15%), compared to infants in NMI IV (8%) and NMI III (4.5%). Poor postural control had a significant influence on other domains of development such as motility (P=0.00), asymmetry (P=0.00) and hand function (P=0.00). Cerebral ultrasonographic abnormalities seemed to have an influence on motility (P=0.03), while no direct relationship was found with postural control, hand function or asymmetry. It is unclear whether this poor coordination of gross motor function will have consequences for appropriate visual-motor and sensorimotor integration therewith hampering later cognitive function, as often described in preterm infants. It is suggested that the poor postural control found in many infants is the result of both myogenic and/or neurogenic deviations and associated with cerebral pathology, but is also caused by the preterm birth and its nursing consequences.

Echoencephalography↗
PubMed2000

The stepping response in early infancy.

Postnatally, the stepping response can be elicited right after birth, but soon diminishes and disappears by about 2-3 months of age. It is still not clear if the disappearance of the response is caused by gradual maturation of the central nervous system, environmental factors, or biomechanical factors such as added body weight and/or increased muscle mass of the legs. This clinical study assessed the stepping response in a group of healthy infants (n = 58) at the age of 6 weeks: 37 born preterm and corrected for gestational age. Quantitative measures of stepping response were obtained together with the qualitative measures of behavioural state and the distribution of active and passive muscle power of the legs. Mechanical factors were studied by dividing the infants according to their birth weight status, and calculating the ponderal index (PI), leg volume (LV), and weight gain of each group. Preterm infants show more stepping responses, more muscle power discrepancies, and different leg volumes than their full-term counterparts. In addition, our results reported significant relationship between gestational age and relative birth weight on the manifestation of stepping response. Within the preterm group the responses lingered longer in infants with shorter gestational ages and in those with lower birth weight status. Consequently, this study suggests that environmental experience and the time of birth of the infants play a more significant role than maturation and mechanical factors in the manifestation of the infantile stepping response.

Body Mass Index↗
PubMed1999

Meal patterns in the SENECA study of nutrition and the elderly in Europe: assessment method and preliminary results on the role of the midday meal.

The paper discusses the assessment method for meal patterns in the course of the SENECA follow-up survey in 1993 in eight study towns across Europe and relates the percentage of energy intake at the midday meal to geographical latitude, total energy intake, energy intake as snacks, number of cooked meals, time spent at the main meal and intake of milk products, fat and leafy vegetables. A questionnaire for the assessment of meal patterns in western Europe has to include the possibility to assess more than three meals per day as well as a variety of meals at any time of the day. Meal structures vary between cooked meals, bread- or soup-based meals, but may also consist of spoon food, salads or fruit. Positive correlations were found between the percentage of energy intake at the midday meal and the number of cooked meals consumed per day, negative relations were found between the percentage of energy intake at the midday meal and the geographical latitude as well as total energy intake, energy intake in form of snacks and consumption of milk products.

Aged↗
PubMed1999

Predictive value of neonatal MRI as compared to ultrasound in premature infants with mild periventricular white matter changes.

A follow-up study was performed in 42 premature infants in whom serial neonatal ultrasound and a single neonatal MRI of the brain was normal, or showed mild periventricular white matter changes. The aim of the study was to evaluate the clinical significance of periventricular signal intensity changes on MRI and to compare the predictive value of neonatal MRI with that of ultrasound. The infants underwent repeated standardised motor assessments and developmental tests. MRI was repeated at the corrected age of 12 months. Pronounced periventricular signal intensity changes on neonatal MRI and periventricular echodensities (flaring) on ultrasound were associated with a high incidence of transient motor problems during infancy. The degree of echogenicity carried the highest predictive value, as compared to duration of flaring on ultrasound and degree of periventricular signal intensity change on MRI. It is concluded that signal intensity changes on neonatal MRI represent the same ischaemic change of the periventricular white matter as flaring on ultrasound and that routine neonatal MRI screening is not warranted in premature infants without clinical evidence of neurological problems and with normal or mildly abnormal ultrasound scans. Recording of the degree of echogenicity should become a routine procedure in neonatal cerebral ultrasonography.

Cerebral Ventricles↗
PubMed1999

Unilateral thalamic lesions in premature infants: risk factors and short-term prognosis.

The aim of the study was to assess incidence, risk factors, clinical symptomatology and short-term outcome of unilateral thalamic lesions in preterm infants, as detected by ultrasound. Sixteen preterm infants, born after a gestational age of less than 35 weeks, with a unilateral thalamic lesion, but without additional significant cerebral lesions, were included. Their follow-up data were compared to those of a selected control group consisting of healthy premature infants. In addition, the neonatal clinical data of the patients with a thalamic lesion were compared to data of the healthy control group and of a general control group, consisting of a non-selected year-cohort of preterm infants. During the study period, the incidence of unilateral thalamic lesions was 5.3% among preterm infants. Ultrasound was not able to distinguish between hemorrhagic and ischemic lesions. The infants with a unilateral thalamic lesion had a more complicated respiratory course and were ventilated significantly longer than infants without such a lesion. The infants with a thalamic lesion had disturbances in tone, persisting throughout infancy, while the healthy control group showed only transient disturbances in tone.

Case-Control Studies↗
PubMed1998

Lateral biases in head turning and the Moro response in the human newborn: are they both vestibular in origin?

Head turning after release from the midline and the Moro response to a full-body drop in 15 full-term newborns lying supine on a custom-built platform was studied. While the lateral bias for head turning was not as pronounced as for the Moro response, it was still assumed in the ratio of 2 (right):1 (left) as predicted by Previc (1991). Onset latency and time-to-peak acceleration were both significantly shorter in the right arm during the initial phase of the Moro response. For both measures, this right arm bias persisted over four consecutive elicitations in most infants. Vaginally delivered infants and those born by Caesarean section did not differ in terms of head preference and the two measures of arm advantage. Our main finding was that infants with a right-sided head preference had a consistently shorter onset latency for the right arm. We interpret this association as stemming from a common labyrinthine asymmetry that involves different vestibulospinal pathways for the neck and arm muscles. In general, our findings are discussed in the context of Previc's (1991) left-otolithic dominance hypothesis and Grattan, De Vos, Levy, and McClintock's (1992) model of newborn functional asymmetries.

Cesarean Section↗
PubMed1998

Muscle power and medical history in high risk preterm infants at 3 months of corrected age.

A group of 73 "high risk" preterm infants was studied at the corrected age of 12 weeks. The infants were categorized according to their medical history in 5 classes conform with the "Neonatal Medical Index" (NMI). Only infants with high-risk for developmental discrepancies with a score of NMI > or = III were included in the study. Apart from pediatric follow-up and an age-adequate neurological examination, special emphasis was put on measuring a specific feature in the development of preterm infants: the relationship between active muscle power and passive tone. These two components of muscle power should be in balance with each other to create stable posture and fluent motility and later co-ordination. Discrepancy between active and passive muscle tone was found in all NMI groups studied and was most outspoken in the legs. Infants in NMI IV and V showed a significantly higher incidence of increased passive tone than the infants in NMI III. When the different regions of the body were studied separately, the infants in NMI IV and V showed significantly increased passive tone in the trunk and shoulders (p 0.009) compared to infants in NMI III, which may constitute an alarm signal of deviant development. The main aim of the study was to provide a clinical method for early detection, subtle enough to select infants most at risk for later functional and neurological problems.

Chi-Square Distribution↗
PubMed1998

Living alone does not adversely affect nutrient intake and nutritional status of 70- to 75-year-old men and women in small towns across Europe.

This study determined the relationships between living alone and a variety of sociodemographic variables and dietary intake and nutritional status of 70- to 75-year-old men and women across Europe. Data from nine centers, collected as part of the SENECA study, were selected for analysis. Respondents were categorized as either living alone, living with a spouse/partner only, or living with a spouse/partner and/or other person(s). Analyses included chi-square statistics, t-tests, and analysis of variance, measures of relationships and differences between residential-status groups. The sample included 512 subjects who lived alone, 1017 who lived with a spouse/partner only, and 380 who lived with a spouse/partner and/or other person(s). Variables which differed significantly by living arrangement included higher vitamin A, calcium, riboflavin and water intake by both males and females living alone as compared to either those living with a spouse, those living with others, or both groups. Females who lived alone had lower energy intake than those who lived with other than a spouse/partner, and women who lived alone or as couples versus those who lived with others had lower protein and carbohydrate intakes. Males who lived alone had significantly lower intakes of vitamin C than those who lived with person(s) other than a spouse, but still they were considerably above recommended levels. Respondents who lived with a spouse/partner only were less likely to have an unfavorable BMI status than people in the other two groups. Thus, nutrient intakes of 70- to 75-year-olds across Europe are generally not adversely impacted by living alone, and relative to some nutrients, namely vitamin A, calcium, and riboflavin, their diets are better than those living in one or both of the other residential categories.

Aged↗
PubMed1998

Medicine use and vitamin status in elderly Europeans.

The relationship between medicine use and plasma levels of beta-carotene, retinol, alpha-tocopherol, cobalamin, folate and pyridoxal-5'-phosphate was investigated in 676 men and 759 women, aged 74 to 79 years, from 13 towns in 11 European countries. Information on medicine use was obtained by questionnaire. Vitamin concentrations were determined in fasting blood samples. The percentage of subjects using drugs was 83%. Antihypertensive drugs, analgesics, diuretics, sleeping tablets and psychotropics were most frequently used. Plasma retinol concentration, plasma beta-carotene concentration in smokers and plasma alpha-tocopherol concentration in ex-smokers were significantly different between subjects using drugs and those taking no medication. As expected the plasma level of beta-carotene was lower in medicine users (relative adjusted difference: -0.26 micromol/l, 95% CI[-0.45;0.01]). However, plasma levels of retinol and alpha-tocopherol were higher (absolute adjusted difference: 0.07 micromol/l, 95% CI[0.00;0.14] and 2.29 micromol/l, 95% CI[0.56;4.02] respectively). Folate and cobalamin were only significantly different with use of specific drug groups. The results of this study suggest that in rather healthy elderly people medicine use affects plasma levels of beta-carotene and cobalamin in a negative way, and has a positive effect on plasma levels of retinol, alpha-tocopherol and folate.

Aged↗