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Biomedical subjects

M Afschrift

Publications and source records attributed to M Afschrift.

At least 19 recordsLinked to original sources
PubMed1995

Influence and interference of isosorbide dinitrate and food intake on superior mesenteric artery impedance in humans.

The influence of isosorbide dinitrate (ISDN) and food ingestion on superior mesenteric artery impedance was investigated in 24 healthy volunteers (age 40 +/- 2.7 years). Superior mesenteric artery circulation was assessed by duplex ultrasound. Pulsatility index (PI) was considered as a parameter of vascular resistance and was calculated as the peak-to-peak amplitude of the waveform divided by the mean amplitude. The subjects were randomly allocated to four groups (ISDN, meal, ISDN + meal, meal + ISDN). PI measurements were performed in resting and fasting conditions and serially for 1 h after sublingual 5 mg ISDN, ingestion of a 300-kcal, 300-ml mixed liquid meal; sublingual 5 mg ISDN followed 10 min later by the test meal; and ingestion of the test meal followed 5 min later by sublingual 5 mg ISDN. Five minutes after 5 mg sublingual ISDN, PI had increased from 6.8 to 12.4, while after intake of a meal PI had decreased from 7.6 to 4.9. Separate effects of 5 mg ISDN and meal intake lasted for at least 1 h. The reflex vasoconstrictive effect of 5 mg ISDN on the superior mesenteric artery circulation was counterbalanced by ingestion of a meal in healthy volunteers.

Adult↗
PubMed1995

Influence of central command and ergoreceptors on the splanchnic circulation during isometric exercise.

The splanchnic circulation can make a major contribution to blood flow changes. However, the role of the splanchnic circulation in the reflex adjustments to the blood pressure increased during isometric exercise is not well documented. The central command and the muscle chemoreflex are the two major mechanisms involved in the blood pressure response to isometric exercise. This study aimed to examine the behaviour of the superior mesenteric artery during isometric handgrip (IHG) at 30% maximal voluntary contraction (MVC). The pulsatility index (PI) of the blood velocity waveform of the superior mesenteric artery was taken as the study parameter. A total of ten healthy subjects [mean age, 21.1 (SEM 0.3) years] performed an IHG at 30% MVC for 90 s. At 5 s prior to the end of the exercise, muscle circulation was arrested for 90 s to study the effect of the muscle chemoreflex (post exercise arterial occlusion, PEAO). The IHG at 30% MVC caused a decrease in superior mesenteric artery PI, from 4.84 (SEM 1.57) at control level to 3.90 (SEM 1.07) (P = 0.015). The PI further decreased to 3.17 (SEM 0.70) (P = 0.01) during PEAO. Our results indicated that ergoreceptors may be involved in the superior mesenteric artery vasodilatation during isometric exercise.

Adult↗
PubMed1995

Acquired haemophilia in the elderly.

The occurrence of an acquired inhibitor of F VIII coagulant activity is a rare cause of a sometimes important bleeding diathesis. Antibodies against F VIII:C can spontaneously occur, mostly in elderly patients. Four elderly patients with such a typical clinical and biological syndrome are reported. No identifiable underlying disease was found and they responded favourably to an immunosuppressive treatment. In one patient plasmapheresis was successful.

Aged↗
PubMed1995

Hydrocolonic sonography: a novel screening method for the detection of colon disease?

Hydrocolonic sonography is an easy and harmless technique for the evaluation of the colon wall. In our study, 106 patients were examined by means of hydrocolonic sonography and colonoscopy. The results were compared. Polyps larger than 7 mm were detected, whereas smaller polyps were often missed. Colon cancers were found in 5 patients, and it was possible to stage them. In moderately to severely active forms of inflammatory bowel disease this technique was able to make a differentiation between ulcerative colitis and Crohn's disease. In elderly and very young patients it may well be the primary screening method for evaluating the bowel.

Adult↗
PubMed1993

Influence of isosorbide dinitrate on superior mesenteric artery impedance in humans.

In a randomized, double-blind, placebo-controlled crossover study the acute effect of isosorbide dinitrate (ISDN) on the superior mesenteric artery velocity waveform was studied in 10 healthy subjects (mean age 48.2 years) over a 10-minute period. The superior mesenteric artery pulsatility index (PI), which quantifies the blood velocity waveform, increased from the second minute following sublingual administration of 5 mg ISDN (basal PI 4.88 +/- 0.32) and reached its upper level (8.22 +/- 1.38) from the fourth minute on. In comparison with placebo, the significant rise of PI (second minute) occurred before the significant decrease of systolic blood pressure (ninth minute) and before the significant increase in the heart rate (fourth minute). Diastolic and mean arterial blood pressures remained unchanged. These observations suggest an immediate vasoconstrictive effect of ISDN on the resistance vessels of the vascular bed of the superior mesenteric artery.

Aged↗
PubMed1993

Neurosyphilis presenting with optic neuropathy. Report of a case and review.

A patient with neurosyphilis, presenting with severe ocular impairment due to optic neuropathy, is described. In such a case, a low index of clinical suspicion and improper use of syphilitic serologic tests may delay diagnosis. However, specific tests of serum and cerebrospinal fluid are mandatory for the diagnosis. Treatment evaluation necessitates the follow-up of serology and cerebrospinal fluid cell count. Recent changes of therapy recommendations in subjects with neurosyphilis and in those syphilitic patients co-infected with HIV are mentioned.

Aged↗
PubMed1993

Bacterial surveillance cultures in a geriatric ward.

A study was carried out to examine the prevalence of oropharyngeal and urinary tract colonization and to compare the colonizing bacteria with the strains causing nosocomial infections during patients' stays in a geriatric ward. Colonization with Gram-negative rods was not uncommon. Nosocomial infections frequently occurred, although colonization seldom resulted in infection. Ampicillin and co-trimoxazole resistance was common in Gram-negative rods. There was little resistance to tobramycin, temocillin and quinolones in strains isolated in patients admitted from home or a nursing home. Isolates resistant to these antibiotics were found in patients admitted from other departments of the hospital, especially from the intensive care unit or during prolonged stay in the ward. Routine cultures for colonization were not predictive for subsequent infection. However, continuous monitoring of Gram-negative rods in colonization and infection remains an important instrument for a preventive policy and to guide antibiotic treatment.

Aged↗
PubMed1993

Results of extracorporeal shock wave lithotripsy of gall bladder stones in 693 patients: a plea for restriction to solitary radiolucent stones.

During a period of 24 months 693 consecutive patients with symptomatic gall bladder stones (526 males, 167 females; mean age 51 years, range 18-89) were treated by extracorporeal shock wave lithotripsy with a Piezolith 2300. The procedure was carried out on an out-patient basis without analgesics or sedatives. Concomitant chemolitholytic treatment (ursodeoxycholic and chenodeoxycholic acid 7.5 mg/kg/day each) was administered until three months after total fragment clearance for a maximum therapy period of 1.5 years. In 601 patients with radiolucent stones complete clearance of all fragments was obtained after three, six, 12, and 18 months in respectively 20, 41, 64, and 78%. Actuarial analysis of the subgroups according to the stone mass (size and number) selected an ideal patient population with solitary stones less than 20 mm diameter (84% stone free after one year). The results are significantly less good when the greater the number of stones or their maximal diameter increases. Treatment was interrupted in 3.6% of the patients. In 90 sludge or fragments remain present. Twenty five patients were lost to follow up for non-biliary reasons. Stone recurrence was 5.7% at one year and was observed both in patients with solitary and multiple stones. A cost effectiveness analysis suggests that laparoscopic cholecystectomy is the most effective and economic solution, although extracorporeal shock wave lithotripsy for solitary radiolucent stones less than 2 cm is cheaper than conventional cholecystectomy. Extracorporeal shock wave lithotripsy for multiple stones is the most expensive and least effective option.

Adolescent↗
PubMed1992

Leptomeningeal cyst: early diagnosis by color Doppler imaging.

A newborn with a leptomeningeal cyst over the anterior fontanelle due to birth trauma is described. Color Doppler flow sonograms were helpful to diagnose the leptomeningocele in its early stages and to differentiate it from a cephalhematoma or subgaleal haemorrhage by demonstrating cerebro-fugal flow in an arterial connection between the extracranial fluid collection and the dural space.

Arachnoid Cysts↗
PubMed1992

Noninvasive diagnosis of superior sagittal sinus thrombosis in a neonate.

A newborn boy presented within the first day of life with moaning, anemia, and thrombocytopenia. The clinical syndrome resulted from thrombosis of the posterior part of the superior sagittal sinus due to impression at birth of the tip of the occipital squama. Both computed tomography and ultrasound scans were valuable noninvasive tools for documentation of the thrombus itself and the cerebral sequelae. Color Doppler ultrasound scan confirmed the absence and reappearance of flow in the superior sagittal sinus.

Birth Injuries↗
PubMed1992

Arcuate ligament syndrome mimicking celiac occlusion.

In a patient with weight loss and a systolic epigastric murmur, aortography demonstrated positional celiac axis occlusion. Color Doppler imaging of the celiac axis showed occlusion in the supine position, but patency was documented during deep inspiration and with the patient in the upright position. This report documents a rare example of extreme celiac axis compression with position-dependent celiac patency.

Adult↗
PubMed1991

Floating thrombi: diagnosis and follow-up by duplex ultrasound.

The clinical features and evolution of floating thrombi (FT) diagnosed by duplex ultrasound were examined. In 76 consecutively diagnosed above-knee deep venous thromboses the prevalence of FT was 18%. Of 44 FT diagnosed in 39 patients, 18 (39%) were located in the common femoral, 12 (26%) in the popliteal and seven (15%) in the external iliac veins. Serial duplex examinations revealed that 31% of FT in the iliofemoral segment disappeared 33% remained unchanged and 36% adhered to the vein wall within 2 weeks following diagnosis. After 3 months, 87% of the floating segments had disappeared, irrespective of the localization or therapeutic regimen. Thirteen patients experienced pulmonary embolism before (12/13) or following (4/13) diagnosis of floating thrombosis; three of four superficial femoral vein FT embolized. Fifteen per cent of the patients with FT died during the study period and 28% of the thrombi were associated with a malignant neoplasm; the incidence of malignancy was 60% in superficial and 39% in common femoral vein FT.

Adult↗
PubMed1990

[Thyroid diseases in the elderly].

Thyroid dysfunction in the elderly differs from that in the young, because most symptoms at presentation are absent, or non specific or atypical. Hypothyroid patients generally present with cardiovascular or central nervous system symptoms. A serious complication, occurring more easily in elderly is hypothyroid coma. The diagnosis of hypothyroidism is confirmed by a high serum TSH and low values of FT4 and T4. Elderly patients should be started on low doses of thyroid-hormone replacement that are increased slowly. Particular caution must be used in patients with underlying cardiovascular disease. Hyperthyroid patients are more likely to show cardiovascular symptoms, central nervous system symptoms or gastrointestinal symptoms. The diagnosis is confirmed by a low serum TSH value and elevated values for the serum FT4 and/or T3. Radioiodine (131I) therapy is the most efficient treatment in this age group. A diffusely enlarged thyroid gland in the elderly is most often caused by a multinodular goiter. Solitary thyroid nodules which appear cold on isotope scan may represent a carcinoma. The diagnosis of malignancy can be made after fine needle-aspiration of the nodule.

Aged↗
PubMed1989

Ultrasound measurement of the subarachnoid space in infants.

An original non-invasive method for easy and reproducible measurement of the subarachnoid space width in infants is described. Preliminary results of normal values during the neonatal period are presented as well as of the validity of the ultrasound method for abnormal values obtained by available computed tomography scanning.

Brain↗
PubMed1988

Sonographic demonstration of portal venous gas in necrotizing enterocolitis.

Portal vein gas embolism was demonstrated by ultrasound in a preterm infant with necrotizing enterocolitis. This sign could not be detected radiographically. It is speculated that portal venous gas occurs more frequently than hitherto inferred from radiological studies. This observation points to the value of ultrasonography in providing early objective evidence in support of the diagnosis of NEC. The favourable outcome for the patient proves that portal venous gas embolism is not necessarily associated with a fulminant course of enterocolitis.

Embolism, Air↗
PubMed1988

Ultrasonic evaluation of gastric clearing in young infants.

Gastric emptying was determined using ultrasound in young infants. Gastric volume was calculated from anteroposterior, craniocaudal and laterolateral antral diameters. There was a linear decline of the logarithm of a gastric filling index over time in normal subjects. The mean clearing angle in normal subjects was 52 degrees (range 45-59). Examples of significantly different clearing rates could be demonstrated in a variety of clinical conditions. In several subjects gastric emptying rate was not exponential. Ultrasound seems very promising for the study of gastric emptying, especially in young children.

Evaluation Studies as Topic↗