PubMed Health⌕ Search

Biomedical subjects

M P Derde

Publications and source records attributed to M P Derde.

65 records · Page 4Linked to original sources

Nasal provocation with histamine: a comparison of the determination of the threshold of reactivity by three methods of rhinomanometry.

Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (P.A.R.). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from A.A.R. and P.A.R. (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For A.A.R. and A.P.R., histamine thresholds were assessed at five different pressure values as well as at five different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357).

Clinical Trials as Topic↗

Recurrent polyposis nasi. Documentation.

After a short historical review a proposal is made for the definition of nasal polyposis. The authors studied 350 CT-scans of patients with nasal complaints. In a high percentage anatomical anomalies were observed. In 57.5% of the CT-scans sinus mucosal disease was visible. In all patients with maxillary sinus disease polyps (rounded structures) could be found; in 31% these polyps were mainly of grade 2. From a retrospective study of 111 biopsies of nasal polyposis (65 patients) it became clear that different polyps from the same patient showed substantial difference in cellular content, i.e. presence of eosinophils, neutrophils, plasma cells, glands, ducti and thickening of the basal membrane. As oral acetylsalicylic acid provocation may be hazardous in ASA-sensitive patients, the authors developed a nasal aspirin provocation test. This nasal ASA test was carried out in 10 normal test subjects, 10 patients with aspecific hyperreactivity, 10 atopic patients and 16 patients with polyposis nasi. The reproducibility of the test, however, was so poor that the nasal ASA challenge test in its present form does not appear to be of any great clinical value. Finally, the authors discuss the physiopathology of nasal polyposis.

Adult↗

Area under pH 4: advantages of a new parameter in the interpretation of esophageal pH monitoring data in infants.

Twenty-four-hour continuous esophageal pH monitoring has become the preferred test to quantify acid gastroesophageal reflux. Agreement has been achieved that acid gastric content reflux into the esophagus constitutes a major cause of reflux esophagitis; we therefore calculated the "area under pH 4" (A) in 560 consecutive pH monitorings in infants 1-12 months old and related this parameter (A) to the reflux index (RI): RI less than 10%: A 185 +/- 295 (mean +/- 1 SD); RI 10-19%: A 1,046 +/- 1,206; RI 20-29%: A 1,967 +/- 2,038; RI 30-39%: A 3,307 +/- 2,955; RI greater than 40%: A 7,977 +/- 7,227. A higher RI is associated with a greater area under pH 4 (p less than 0.001); the high SD obtained in each group, however, illustrates the great variability in surface (or acidity of the reflux episodes) in all groups. Esophagoscopy and biopsy were performed in 112 infants (20%). Specificity in the prediction of (mild) esophagitis was higher for the area under pH 4 (88%) compared with the RI (50%). The sensitivity of both parameters was comparable (96 versus 93%). Our results strongly suggest that in young infants, the acidity of the reflux episodes (the area under pH 4) is a determining factor in the prediction of esophagitis. These data need to be confirmed by more studies before general application of this parameter can be advised.

Esophagus↗

[CAT-scan study of the prevalence of sinus disorders and anatomical variations in 196 children].

CT-scan was used to examine rhinosinusitis in the developing sinuses; 196 children aged from 3 to 14 years were selected on the base of their chronic rhinorrhea, nasal congestion and cough. The patient group was subdivided into six age groups (3-4, 5-6, 7-8, 9-10, 11-12 and 13-14 years). In the youngest age group, the authors noted maxillary involvement in 63%, ethmoidal involvement in 58%, and even sphenoidal sinus involvement in 29% of the children. Involvement decreased gradually with age, with 10% of ethmoidal and 0% of sphenoidal involvement in the 13-14 years age group. Maxillary sinusitis, however, persisted very frequently in the oldest age group (65%). Frontal involvement seems to become significant at the age of 7-8 years (7%) but it never exceeds 15% (11-12 age group). Septal deviations occurred in 16% of the youngest up to 72% in the oldest age group. A prevalence of bullous conchae increased with age too, although less prominently.

Adolescent↗

[Lens drain versus Donaldson drain: intermediate results of a prospective comparative study of a new versus a classical ventilation tube].

A prospective study was undertaken in which in 72 children a new type of tympanostomy tube, the Lens drain, was inserted in one ear, and a Donaldson drain was inserted in the contralateral ear as a control. The average survival times of both tubes especially seemed to differ significantly: 15.25 months for the new tube, and 10.53 months for the conventional tube (p less than 0.05). By contrast, the relapse rate (20% with the Lens tube versus 27% with the Donaldson tube) after extrusion or extraction, and the residual perforation rate (8% with the Lens tube versus 5% with the Donaldson tube) were not significantly different. Otorrhea was apparently present equally frequently with either tube: 19% with the Lens tube versus 15% with the Donaldson tube.

Child↗

Reference values for fructosamine concentrations in children's sera: influence of protein concentration, age, and sex.

Fructosamine and protein (total and fractionated) were measured in the serum of 170 normal children, ages two weeks to 15 years. The mean fructosamine concentration was 2.12 mmol/L, 5% lower than the mean value observed for adults. We observed no sex-related difference in fructosamine values, but saw a pronounced age dependency of reference values. For children younger than three years, the mean concentration of fructosamine was 15% lower than in adults, but glycated protein concentrations increased with age, reaching essentially adult values by age six years. Expressing fructosamine concentrations per gram of serum total protein or of albumin weakened the influence of age, but did not eliminate it completely. We report reference intervals for fructosamine concentrations in children's sera.

Adolescent↗

[Nasal provocation using histamine. A comparison of threshold determination using 3 methods of rhinomanometry].

Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (AAR), the active posterior rhinomanometry (APR) and the passive anterior rhinomanometry (PAR). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from AAR and PAR (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For AAR and APR, histamine thresholds were assessed at 5 different pressure values as well as at 5 different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357).

Adult↗

Feasibility study concerning the use of expert systems for the development of procedures in pharmaceutical analysis.

The feasibility of using expert systems for the development of analytical procedures is investigated. A system for the computer generation of procedures to determine active drug substances in commercial formulations is proposed. It is shown that in nearly 85% of the cases investigated the present system immediately yields a correct procedure or conclusion. It is concluded that selecting methods and developing procedures with the use of expert systems is difficult but feasible.

Journal Article↗

[The effect of swimming on nasal patency and tubal function in children. Prospective 24-week cross-over study in 154 children].

This prospective cross-over study involving 154 healthy school children over a time span of 24 weeks revealed a favorable influence of swimming on nasal patency and tubal function in children. The positive influence of bathing on middle ear ventilation seems to be of shorter duration than that on nasal resistance. Tympanogram distribution and nasal resistance are most favorable in girls, older children and in the spring-summer period. A good nasal patency is often associated with a good middle ear ventilation. Advising children against swimming because of sinusitis and otitis is probably not justified.

Acoustic Impedance Tests↗

Use of a microcomputer for the definition of multivariate confidence regions in medical diagnosis based on clinical laboratory profiles.

The use of multivariate confidence regions is proposed for the classification of clinical laboratory profiles into diagnostic classes. For this purpose, a multivariate confidence region is developed for each diagnostic class. Three methods (UNEQ, EQ, and SIMCA) are evaluated and compared with classical linear discriminant analysis. As an example, a small data set concerning the differentiation of the thyroid functional states on the basis of five laboratory tests is used. It is shown that related procedures can produce results of very different quality and that the multivariate region approach is attractive for the clinician's daily practice since the methods are easily implemented on a microcomputer.

Computers↗

Quantification of eosinophil cationic protein and eosinophils in nasal secretions of allergen-induced nasal inflammation.

By using the microsuction technique, a quantitative determination of eosinophil cationic protein (ECP) in nasal secretions was performed in 18 atopic patients and 10 healthy volunteers. The percentage of the eosinophils was counted by simple microscopic examination. In the control group, results showed that the percentage of the eosinophils was almost 0 (range: 0-0.7%), and the median baseline ECP concentration was measured at 105 ng/g (range: 2-281 ng/g). No significant changes in either eosinophils or ECP were observed in this group. In the patient group, there existed a significantly higher baseline percentage of eosinophils (median: 2.7%, range: 0-45%) than in the control group but not for baseline ECP concentration (median: 160 ng/g, range: 6-1475 ng/g). One hour after nasal allergen challenge (NAC), a significant (P < 0.01) increase was seen in the percentage of eosinophils of the nasal secretions and this was remained for 10 hours (median: 5.5-13.3%). However, the difference that occurred was that ECP reached its highest concentration (median: 401 ng/g, range: 32-2298 ng/g) only 24 hours after NAC, while the percentage of the eosinophils decreased. Our findings again support a role of migration and activation of eosinophils in the pathogenesis of nasal allergic reaction, especially during the late phase.

Adolescent↗