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Biomedical subjects

M A van't Hof

Publications and source records attributed to M A van't Hof.

At least 37 records · Page 2Linked to original sources

Effectiveness of three treatment modalities for the edentulous mandible. A five-year randomized clinical trial.

Currently, 3 treatment options are available for patients with denture complaints and an edentulous mandible with a height of at least 15 mm: meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), and construction of an implant-retained mandibular overdenture (IRO). The aim of this study was to evaluate patient satisfaction and subjective chewing ability of edentulous patients treated with one of these treatment modalities. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 mm) were randomly assigned to receive 1 of these 3 groups. Denture satisfaction and chewing ability were assessed using questionnaires focusing on denture-related complaints and problems chewing different types of food were assessed before treatment, and 1- and 5-years after treatment. At the 1-year evaluation, significantly better scores were observed in the 2 surgical groups (IRO, PPS) than in the CD group. At 5-year evaluation the "complaints of the lower denture" showed a significantly better score in the IRO group when compared to the PPS and CD groups. No significant differences were observed between the PPS and CD group. From this study it is concluded that both in the short and long term denture satisfaction appears most favourable in the IRO group when compared to the PPS and CD groups. Implant-retained overdentures are therefore a satisfactory treatment modality for edentulous patients with problems with their lower denture, even in cases of not severely resorbed mandibles.

Analysis of Variance↗

The Euro-Growth Study: why, who, and how.

BACKGROUND: Assessment of growth is important in health management of infants and children. Evaluation of growth performance requires anthropometric measurements, with proper interpretation depending on the use of appropriate references. Europe-specific growth references have not been available. The purpose of the present study was to generate such references for infants and children from birth to 3 years of age. The study was further intended to assess the influence of nutrition and lifestyle factors on growth. METHODS: The Euro-Growth Study was designed as a multicenter longitudinal cohort study. This report describes the study design, the sample (cohort), and the methods used. Quality control measures included standardized measurement techniques with ongoing cross-sectional and longitudinal consistency checks. Selectivity in participation and discontinuation and reproducibility of data over time were evaluated. RESULTS: Of 2,245 infants who were enrolled in the study at 22 study sites in 11 countries, 1,746 (78%) provided longitudinal data until 12 months of age, 1,205 (57%) until 24 months of age, and 1071 (48%) until 36 months of age. Anthropometric measurements were performed on 21,773 occasions. As a result of cross-sectional and longitudinal data checks, 209 data points (0.09% of all data points) were rejected. Comparison of participants's demographic data with those of nonparticipating local subjects indicated that the cohort was selective in maternal age (higher), maternal education level (higher), household location, and family structure. The withdrawal rate during the study was low (24%), and withdrawals occurred at random. Analysis of reproducibility over time resulted in the elimination of the data from one study site. CONCLUSION: The Euro-Growth Study provided longitudinal growth data from a large cohort of normal European children. Because of the chosen sampling method, the study cohort ws somewhat selective relative to the local background population. Internal validity was satisfactory in that the reproducibility of anthropometric measurements was high in 21 sites and the withdrawal rate was low and random.

Anthropometry↗

Euro-Growth references for length, weight, and body circumferences. Euro-Growth Study Group.

BACKGROUND: Several concerns have been raised by World Health Organization (WHO) expert groups regarding the adequacy of currently existing growth references, including those currently supported by WHO. As part of a concerted action of the European Union, new references were developed that were based on a well-defined sample of the European population and were compared with existing references. METHODS: During the longitudinal, observational multicenter study, anthropometric measurements using standardized methodology were performed in 2,245 children between 1 and 36 months of age, and sex- and age-specific growth references for recumbent length, weight, mid-upper arm, thigh, and calf circumferences were developed. RESULTS: The validity of the curve-fitting programs was demonstrated by comparing the selected sex-specific percentile distributions for all indices with the smoothed references. Comparison with the National Center for Health Statistics (NCHS)-WHO references for length and weight for age indicated that the -2 z-score value of the WHO reference as cutoff value shows that a substantial part of the children with suspected failure to thrive should be classified as normal. The references also indicate that the mid-upper arm circumference is age and sex dependent and that a single cutoff value for children less than 5 years of age should no longer be used. Mid-parental height was the best single predictor of recumbent length until 36 months of age. CONCLUSIONS: The Euro-Growth references that were developed reflect growth of a well-defined, large cohort of healthy infants and can be used for international comparisons.

Age Factors↗

Euro-Growth references on increments in length, weight, and head and arm circumferences during the first 3 years of life. Euro-Growth Study Group.

BACKGROUND: Reliable assessment of growth performance of infants and young children requires reference data increments. Available increment references are based on data fitted to mathematical models, a process that diminishes variation in increment values. METHODS: Fully longitudinal data from the multicenter Euro-Growth Study (21 study sites: n = 2145 children) were used to develop sex-specific percentiles for increments in length, weight, and head and mid-upper arm circumferences for selected intervals during the first 36 months of life. Increments (per unit of time) were calculated for 2-, 3- and 6-month intervals from birth to 12 months of age and for 6-month intervals from 12 to 36 months of age. Weight increments were also calculated for 1-month intervals from birth to 6 months of age. The influence of sex, mid-parental height, and study site was determined using analysis of covariance. Comparison with other references was accomplished using percentile values. RESULTS: Mean and standard deviation values as well as selected percentiles (P; P3, P5, P10, P25, P50, P75, P90, P95, and P97) of increments are presented. Length increments of boys were higher than those of girls until 5 months of age but tended to be lower thereafter. Weight increments of boys were higher until 9 months of age. Sex, mid-parental height, and study site explained only between 2% and 13% of the variances of increments. Mean increments were comparable but P10 and P90 substantially differed from published data. CONCLUSIONS: The new Euro-Growth references for increments in length, weight, and head and mid-upper arm circumferences provide tools for health workers that should be useful in screening for adequacy of growth during the first 3 years of life.

Age Factors↗

Euro-Growth references for body mass index and weight for length. Euro-Growth Study Group.

BACKGROUND: Fully longitudinal data from the multicenter Euro-Growth study (21 study sites; n = 2145 children) were used to develop sex-specific percentiles and Z-scores for body mass index (BMI) and weight for length (WfL) during the first 36 months of life. METHODS: Smoothed percentile curves for BMI against age were constructed and checked against raw percentiles. Smoothed percentile curves for WfL were constructed according to established procedures and were checked against raw percentiles. The relation of BMI with length and of WfL with age was examined. The relation between BMI and WfL was tested using z-scores of each. The influence of gender, geographic location (study site), and genetic factors on BMI and WfL was examined. Finally, the new references for BMI and WfL were compared with other published references. RESULTS: Selected percentiles (P; P3, P5, P10, P25, P50, P75, P90, P95, and P97) for BMI showed a sharp increase from 1 to 6 months of age and a gradual decline between 12 and 36 months. Smoothed percentiles for WfL showed only small deviations from raw percentiles. BMI was found to be essentially independent of length, whereas WfL showed some degree of dependence on age. Values for BMI and WfL showed very good agreement, except at the extremes of the age range. A modest degree of influence of geographic location on BMI and WfL was found. Correlations with parental BMI and WfL were very weak, however. Comparison with the National Center for Health Statistics (NCHS) references showed the latter to have a narrower range of values. CONCLUSIONS: The new Euro-Growth references for BMI and WfL provide improved tools for health workers and researchers dealing with childhood obesity.

Age Factors↗

Euro-Growth references for breast-fed boys and girls: influence of breast-feeding and solids on growth until 36 months of age. Euro-Growth Study Group.

BACKGROUND: The World Health Organization (WHO) recommends exclusive breast-feeding during the first 4 to 6 months of life, but limited information is available regarding the growth performance of infants fed according to the recommendation. The present study used data from the Euro-Growth study to determine the growth of breast-fed European infants who did or did not receive solids from an early age, in comparison with growth of infants who were fed by other modes. METHODS: There were 319 infants who were exclusively breast-fed according to the WHO recommendations for at least 4 to 5 months, and 185 infants who were breast fed but received solids (but no formula) from an early age. There were 1,509 infants who were fed in a variety of ways, which included breast-feeding during the early months of life in the majority (65%) of infants. Anthropometric data were available from birth to 36 months of age. Growth of the two groups of breast-fed infants was assessed by comparing z-scores of length, weight, and body mass index with those of the group fed by other means. Furthermore, multiple regression analysis was used to assess the influence on increment in length and weight of the duration of breast-feeding and the age at which solids were introduced. Euro-Growth references for breast-fed boys and girls were developed and compared with the National Center for Health Statistics (NCHS)-WHO and Euro-Growth references. RESULTS: The pattern of growth of children who were fed according to the WHO recommendations showed higher weight during the first 2 to 3 months of life and lower weight and length from 6 to 12 months. Between 12 and 36 months of age, differences between groups were small and clinically nonrelevant. Duration of breast-feeding was negatively correlated with increment in length and weight until 12 and 24 months but not until 36 months of age. The influence of duration of breast-feeding was much weaker than that of mid-parental height. The mean and standard deviation z-scores of the Euro-Growth references for weight of breast-fed infants deviate substantially from the NCHS-WHO references during the first 6 months of life in particular. The mean and standard deviation z-scores for length and weight of breast-fed children were close to the Euro-Growth references. CONCLUSION: The Euro-Growth references may be used to monitor length, weight, body mass index, and body circumferences of children who are fed according to WHO recommendations. The additional references, which were developed for breast-fed boys and girls, will be useful in view of the commitment of WHO to the collection of data for the development of a new international growth reference.

Age Factors↗

Iodine supply in children from different european areas: the Euro-growth study. Committee for the Study of Iodine Supply in European Children.

BACKGROUND: In many areas of Europe iodine deficiency disorders still exist. Urinary iodine excretion is a valuable tool in characterizing the iodine supply of a population. However, there is a continuing discussion on the most appropriate parameter to measure urinary iodine excretion. METHODS: In 247 children (ages 3-5 years) from six European centers, spot urine samples were analyzed for urinary iodine concentration and urinary iodine-creatinine ratio. RESULTS: The median values of urinary iodine concentration from the six centers were very similar (90-106 microg/l) corresponding to a normal or marginal iodine supply according to the criteria of the World Health Organization. However, the median values of the urinary iodine-creatinine ratio from the six centers differed significantly (143-445 microg/g, P < 0.001). The different results of the two urinary parameters to assess urinary iodine supply were due to large significant differences in the urinary creatinine concentration reported by the various centers, which probably reflect marked differences in water intake. CONCLUSIONS: Iodine deficiency is still a significant health problem in many European countries. In comparable and homogeneous population subgroups (even from different countries), the urinary iodine-creatinine ratio appears to be a much better parameter for assessing iodine supply than urinary iodine concentration.

Child Nutritional Physiological Phenomena↗

A 4-year clinical study on amalgam, resin composite and resin-modified glass ionomer cement restorations in overdenture abutments.

OBJECTIVE: To assess the performance of three different filling materials in overdenture abutment teeth. METHODS: In 49 patients amalgam, resin composite and resin-modified glass ionomer cement were used to seal the root canal orifices of 155 overdenture abutment teeth. After initial preparation of the cavities, the three restorative materials were randomly assigned to the abutment teeth using a number of balancing criteria. All patients were reviewed every six months and received the same preventive regimen. Survival was assessed at two levels: Sorig (survival of the restoration independent from eventual maintenance treatments) and Scomp (restorations survived even without maintenance treatments). RESULTS: The calculated overall survival percentage of the original restorations (Sorig) after four years was 63 +/- 6% (mean +/- SE). Calculation for the overall complete survival (Scomp) revealed a percentage survival of 57 +/- 6%. At both levels, the differences between the survivals of the investigated materials were not statistically significant (p-values > 0.05). Two abutments were lost, severe caries was the reason for one extraction and another abutment tooth was extracted for periodontal reasons. CONCLUSIONS: The results of this study did not point out a superior restorative material for the seal of root canal orifices of overdenture abutments. The distribution of failures over the patients indicates a certain patient dependency.

Composite Resins↗

Cross-sectional and longitudinal analyses of nutrition guidance by primary care physicians.

OBJECTIVE: To investigate in primary care physicians (PCPs) the determinants of a nutrition guidance practice ('noticing patients' overweight and guidance of treatment'), as well as their mechanism of action, in a cross-sectional and a longitudinal approach. DESIGN: Mixed longitudinal design. Five years follow up study of a previous cross-sectional study in October 1992. SUBJECTS: A representative sample of 675 Dutch PCPs, in practice for 5 up to 20y. INTERVENTIONS: A shortened version of the Wageningen PCPs Nutritional Practices Questionnaire was mailed to the subjects in August 1997. MAIN OUTCOME MEASURE: To obtain with the LISREL-program a model of the mechanism of action of determinants of the dependent variable 'noticing patients' overweight and guidance of treatment' with an adequate fit of the empirical data, both in the cross-sectional and in the longitudinal approach. RESULTS: The same set of predisposing factors and intermediary factors explains the dependent variable both in two different representative cross-sectional study populations of PCPs, and in a cohort cross-sectional study at two points in time. Two dynamic LISREL-models were developed (the 'determinant-longitudinal approach' and the 'early behaviour longitudinal approach') which explain the dependent variable. The latter model has, as added value, a gain in explained variance. In 5 y time, the dependent variable decreased significantly (P < 0.001). CONCLUSIONS: This study reconfirms that PCPs' nutritional guidance practices are determined partly directly by predisposing factors, and indirectly via driving forces and barriers. However this study also reveals that an important nutrition guidance practice of PCPs, 'noticing patients' overweight and guidance of treatment', shows a significant decrease over the last 5 y. At the same time, two of the four predisposing factors and two of the three driving factors also decreased significantly. As research findings indicate that the role of diet in health and disease becomes of greater influence PCPs need to be activated to apply their responsibility in this field within a multi-faceted approach.

Attitude of Health Personnel↗

The NECTAR-study: development of nutrition modules for general practice vocational training; determinants of nutrition guidance practices of GP-trainees. Nutrition Education by Computerized Training And Research.

OBJECTIVE: To identify determinants of nutrition guidance practices of general practitioner-trainees (GP-trainees), to investigate whether these determinants differ from those found by experienced general practitioners; to reveal educational directions towards the development of computer-based instruction on nutrition. DESIGN: Cross-sectional study by means of validated questionnaires. SUBJECTS: All GP-trainees in training at the eight university departments for vocational training in the Netherlands in September, 1998 (n = 985). MAIN OUTCOME MEASURES: Reliability of determinants of nutrition guidance practices was calculated by means of Crohnbach's alpha. The mechanism of action of determinants was identified by means of linear structural relationship analysis (LISREL) using a model developed for GPs. RESULTS: Crohnbach's alphas for factors ranged from 0.58-0.90. The empirical GP-trainee-data fitted with the corresponding GP-model on the mechanism of action. CONCLUSIONS: The same predisposing factors, driving forces and barriers as found with GPs were identified with GP-trainees. Comparing the GP-and GP-trainee-models, only minor differences were found in the path coefficients between factors. Lack of nutrition training and education proved to be of great influence on the extent of nutrition information given. The GP-trainee-model will be of use in developing computer-based instruction on nutrition. It is expected that GPs may also benefit from this instruction.

Algorithms↗

Influence of sulphasalazine, methotrexate, and the combination of both on plasma homocysteine concentrations in patients with rheumatoid arthritis.

OBJECTIVE: To study the influence of sulphasalazine (SSZ), methotrexate (MTX), and the combination (COMBI) of both on plasma homocysteine and to study the relation between plasma homocysteine and their clinical effects. METHODS: 105 patients with early rheumatoid arthritis (RA) were randomised between SSZ (2-3 g/day), MTX (7.5-15 mg/week), and the COMBI (same dose range) and evaluated double blindly during 52 weeks. Plasma homocysteine, serum folate concentrations, and vitamin B12 were measured. The influence of the C677T mutation of the enzyme methyl-enetetrahydrofolatereductase (MTHFR) gene was analysed. RESULTS: A slight trend towards increased efficacy and an increased occurrence of minor gastrointestinal toxicity was present in the COMBI group, no differences existed clinically between SSZ and MTX. Only a slight and temporary increase in plasma homocysteine was found in the SSZ group, in contrast with the persistent rise in the MTX group and the even greater increase in the COMBI patients. Patients homozygous for the mutation in the MTHFR gene had significantly higher baseline homocysteine, heterozygous MTHFR genotype induced a significantly higher plasma homoeysteine at week 52 compared with no mutation. No correlation was found between clinical efficacy variables and homocysteine. Patients with gastrointestinal toxicity had a significantly greater increase in homocysteine. CONCLUSION: A persistent increase in plasma homocysteine concentrations was observed in patients treated with MTX alone and more pronounced in combination with SSZ, in contrast with SSZ alone. An increase in plasma homocysteine is related to the C677T mutation in MTHFR. A relation in the change in homocysteine concentrations with (gastrointestinal) toxicity was found, no relation with clinical efficacy existed.

Antirheumatic Agents↗

Psychologic implications of surgical-orthodontic treatment in patients with anterior open bite.

Two hundred eighty-two patients who received surgical-orthodontic treatment to correct anterior open bite were retrospectively evaluated by interview and questionnaires to determine the motivation and expectations before treatment, experience during treatment, psychosocial impact, functional and esthetic results, and satisfaction. All patients underwent a Le Fort I osteotomy, and 126 patients also received a bilateral sagittal split advancement osteotomy. The mean follow-up was 6 years. The most important reasons for treatment, as cited by the patients, were biting and chewing problems (28%), dissatisfaction with facial appearance (26%), and symptoms of temporomandibular joint (TMJ) dysfunction (21%). Patients with anterior open bite had a critical attitude toward facial appearance; therefore, esthetic aspects should be taken seriously. The expectations on chewing ability, phonetics, nasal passage, and facial appearance were met by the treatment; however, expectations on TMJ function, interincisal relationship, and biting ability were not completely fulfilled. There was a subjective improvement of TMJ sounds in 27% and a worsening in 14% of the patients. Dysesthesia of the infraorbital nerve was noticed in 4% of patients and of the mental or inferior alveolar nerve in 23% of the patients. Chewing and biting abilities improved in 53% and 73%, respectively. Facial appearance, self-confidence, and social interaction had improved. Patients had expected more information before and psychologic support after treatment. Despite the relapse of open bite in 20% of the patients, 75% were satisfied with the dental and 85% with the facial appearance.

Adolescent↗

Effects of pancreatic enzyme preparations on erythrocyte glutathione peroxidase activities and plasma selenium concentrations in cystic fibrosis.

To substitute for exocrine pancreatic insufficiency, patients with cystic fibrosis (CF) take pancreatic enzymes (PE) originating from porcine pancreas. Five different pancreatic enzyme preparations used by our patients contained 0.5-1.4 microg selenium per g tablet. In patients taking PE in doses that were gradually increased to improve fat absorption during a 48-month period, the effects of PE dose on erythrocyte selenium-dependent glutathione peroxidase (SeGSH-Px) activities and plasma selenium concentrations were studied. At baseline, erythrocyte SeGSH-Px activities were significantly lower in patients (p=.01), while plasma selenium concentrations did not differ between patients and healthy subjects. When PE dose and, consequently, selenium intake from PE was increased, erythrocyte SeGSH-Px activities (p < .001) and plasma selenium concentrations (p=.02) increased. Changes in SeGSH-Px activities during the initial 8 months correlated with those in selenium intake from PE (r=0.67, p < .001). Plasma selenium concentrations plateaued at 12 months and erythrocyte SeGSH-Px activities did so at 36 months, when patients had reached SeGSH-Px activities similar to those of healthy subjects. At 48 months, patients took an average lipase dose of 17400 U x kg(-1) x d(-1) and selenium dose from PE of 0.53 microg x kg(-1) x d(-1). We conclude that selenium content of PE preparations has a significant effect on SeGSH-Px activity in patients with CF. This form of selenium supply needs to be taken into account when selenium supplements are given to patients with CF.

Administration, Oral↗

Radiographic evaluation of apical root resorption with 2 different types of edgewise appliances. Results of a randomized clinical trial.

The purpose of this paper was to compare radiographically the prevalence and degree of apical root resorption after treatment with a fully programmed edgewise appliance (FPA) and a partly programmed edgewise appliance (PPA) in a randomized multipractice clinical trial. Two groups of patients with Class II malocclusions were treated orthodontically. The type of treatment was randomly assigned by a computer program. During fixed appliance therapy, one group was treated according to the precepts of the straight wire concept (FPA; n = 32) while the other was treated with conventional full edgewise mechanics (PPA; n = 29). Treatment times were recorded. Radiographs of the maxillary incisors were made before and after active treatment with fixed appliances using the bisecting angle technique. To correct for different projecting angles the pairs of radiographs were digitally reconstructed. The prevalence and degree of root resorption were assessed. The mean treatment time was 1.8 years and 1.6 years for treatment with FPA and PPA, respectively. The mean amount of loss of tooth length was 8.2% for the patients treated with FPA and 7.5% for the patients treated with PPA. No statistically significant differences could be assessed between both groups at the end of active treatment. The mean prevalence of apical root resorption was 75% for the patients treated with FPA and 55% for the patients treated with PPA. Statistical evaluation showed no significant differences. We concluded that the prevalence and degree of root resorption is independent of the appliances as used in this study.

Adolescent↗

Condylar remodelling and resorption after Le Fort I and bimaxillary osteotomies in patients with anterior open bite. A clinical and radiological study.

A sample of 259 patients with vertical maxillary hyperplasia, mandibular hypoplasia and anterior vertical open bite, collected from three different institutions, was analysed regarding temporomandibular joint (TMJ) sounds, condylar remodelling, and condylar resorption. All patients underwent Le Fort I osteotomies, and bilateral sagittal split advancement osteotomies were performed in 117 patients. Intraosseous wire fixation was used in 149 and rigid internal fixation in 110 patients. Cephalometric and orthopantomographic radiographs were available before surgery, immediately after surgery, one year postoperatively and at the latest follow up. The mean follow up was 69 months (range 20-210 months). The number of patients with TMJ sounds decreased from 38% to 31%. At the latest follow up 23.6% of the patients showed condylar remodelling, 7.7% unilateral condylar resorption and 7.7% bilateral condylar resorption. Condylar contours, as assessed on orthopantomographic radiographs, were classified as five different types. Condyles with preexisting radiological signs of osteoarthrosis or having a posterior inclination were at high risk for progressive resorption. Female patients with severe anterior open bite, high mandibular plane angle and a low posterior-to-anterior facial height ratio, who underwent a bimaxillary osteotomy, were prone to condylar resorption. Bone loss was predominantly found at the anterior site of the condyle. The incidence of condylar resorption was significantly higher after bimaxillary osteotomies (23%) than after only Le Fort I intrusion osteotomies (9%). Avoidance of intermaxillary fixation by using rigid internal fixation tended to reduce condylar changes, in particular in patients who underwent only a Le Fort I osteotomy. Rigid internal fixation in bimaxillary osteotomies resulted in condylar remodelling in 30% and progressive condylar resorption in 19% of the patients. Condylar changes were not significantly different after using either miniplate osteosynthesis or positional screws in bilateral sagittal split osteotomy procedures.

Adolescent↗

Immunohistochemical analysis of intratumoral heterogeneity of [131I]cG250 antibody uptake in primary renal cell carcinomas.

In previous studies, highly heterogeneous uptake of 131I-labelled chimeric monoclonal antibody G250 ([131I]cG250) in primary renal cell carcinomas has been observed (intratumoral differences > factor 100). In this study, we investigated a possible correlation between intratumoral antibody uptake and four immunohistochemically determined parameters: G250 antigen expression, blood vessel density, neovascularization and percentage of viable tumour cells. Whole tumour slices of four different tumours were cut into 1-cm3 cubes, and in each cube the [131I]cG250 uptake was determined. The correlation between [131I]cG250 uptake and each individual parameter was determined in a multiple regression analysis. Additionally, the data were reanalysed after introducing arbitrary cut-off values for each parameter. If a sample showed expression of a parameter above the introduced threshold value, this sample fulfilled one condition. Subsequently, the Pearson correlation coefficients were calculated from [131I]cG250 uptake and the number of fulfilled conditions (0-3). All tumour samples with high [131I]cG250 uptake [> 0.1% of the injected dose per gram (ID g(-1))] showed high antigen expression (> 50%). However, not all samples with high antigen expression displayed high uptake. A statistically significant correlation between [131I]cG250 uptake and antigen expression was found (beta = 0.44, 0.69 and 0.74) in three out of four tumours analysed. Of the other determined parameters, no consistent correlation with [131I]cG250 uptake was found; only the percentage of viable tumour cells correlated significantly in two out of four tumours (beta = 0.80 and 0.26). Calculation of the Pearson correlation coefficients showed a statistically significant correlation between [131I]cG250 uptake and an increased number of fulfilled conditions in all tumours, indicating that each of the individual parameters contribute to the uptake of [131I]cG250. These observations indicate that high antigen expression is a prerequisite for high antibody uptake. However, regional differences in antibody uptake within a tumour cannot be explained by antigen expression alone.

Antibodies, Monoclonal↗

Effects of naso-gastric tube feeding on the nutritional status of children with cancer.

OBJECTIVE: To study the effect of sufficient energy intake, by means of the protocolized administration of naso-gastric tube feeding, on the nutritional status of a child with cancer. DESIGN: A comparative experimental study. SETTING: Tertiary care at the Centre for Pediatric Oncology, South East Netherlands, University Hospital, Nijmegen. SUBJECTS: Seven children, newly diagnosed with cancer, were included in the experimental study and all completed the trial period. Fourteen patients were included in the retrospective study. They were randomly chosen from a group of patients previously treated for a malignancy at our department and who had received naso-gastric tube feeding for at least 16 weeks. INTERVENTION: Protocolized (experimental group) vs non-protocolized (retrospective group) administration of naso-gastric tube feeding over a period of 16 weeks. The main difference was the amount of tube feeding administered. In addition to energy from other foods, children in the experimental group received 106+/-13% of their total daily energy requirements (TDER) by means of tube feeding, whereas children in the retrospective group had received 75+/-24%. MAIN OUTCOME MEASURES: Weight as a percentage of weight for height according to the 50th percentile of a healthy reference population=ideal weight. RESULTS: Weight, expressed as a percentage of the ideal weight, increased significantly in the experimental group (18.2 8.4; P=0.01) and the retrospective study group (5.2 7.3; P=0.001). However, the increase was statistically significant in favour of the experimental group (P=0.003), in which all the children reached their ideal weight, compared to 21% in the retrospective group. CONCLUSION: Aggressive protocolized nutritional intervention during the intensive phase of anti-cancer treatment, in the form of naso-gastric tube feeding that provides the child's total daily energy requirements, results in considerable improvement in the nutritional status.

Adolescent↗