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Biomedical subjects

P L van Daele

Publications and source records attributed to P L van Daele.

15 recordsLinked to original sources
PubMed2001

[Stomach ache and fever after consumption of watercress in Turkey: fascioliasis].

A 52-year-old woman presented several months after returning from a visit to Turkey with stomach-ache and fever. Laboratory results showed leucocytosis with marked eosinophilia. Furthermore, serum liver enzyme activities were slightly elevated. A CT scan of the abdomen showed several spots which, on a later scan, had migrated. Serologic tests confirmed the clinical diagnosis of fascioliasis. The patient was successfully treated with triclabendazole. Infection presumably occurred after eating watercress which the patient had bought on a market in Turkey.

Abdominal Pain↗
PubMed2000

[Disorders of bone metabolism in gastrointestinal and hepatic diseases].

Gastrointestinal and hepatic diseases are frequently associated with metabolic bone disorders, especially osteoporosis and osteomalacia. Malabsorption of vitamin D and calcium are important aetiological factors, although other factors may contribute, like the use of glucocorticosteroids in the treatment of inflammatory bowel disease. Treatment is first of all focused on correction of calcium and vitamin D deficiency. In severe osteoporosis additional treatment with bisfosfonates needs serious consideration.

Adrenal Cortex Hormones↗
PubMed1998

[Hyperammonemia in hydronephrosis].

A man aged 81 with bilateral hydronephrosis presented with lethargy deepening into coma caused by hyperammonaemia. The hyperammonaemia was most likely caused by excessive absorption of ammonia produced by Proteus mirabilis in the obstructed and dilated urinary tract. The patient died within a few hours.

Aged↗
PubMed1998

Risk factors for increased bone loss in an elderly population: the Rotterdam Study.

The association of bone loss with age, sex, and several prevalent and modifiable potential risk factors for osteoporosis was studied in 1,856 men and 2,452 women aged 55 years and over from the Rotterdam Study, a population-based cohort study in the Netherlands. The rate of change in femoral neck bone mineral density was estimated longitudinally between 1990 and 1995, after 2 years of follow-up on average. These rates, adjusted for age and body mass index, were -0.0025 (95% confidence interval -0.0038 to -0.0012) in men and -0.0045 (95% confidence interval -0.0056 to -0.0034) g/cm2/year in women (p=0.03). Bone loss accelerated with age, as seen more clearly in men than in women. Lower body mass index and cigarette smoking were associated with increased bone loss in both men and women. In men, higher calcium intake was associated with lower rates, and disability was associated with borderline significantly higher rates of bone loss (p=0.07). In women, a nonsignificant relation was observed with disability, but not with dietary calcium intake. Alcohol intake was not consistently related to the rate of bone loss in either sex. It is concluded that in elderly people the rate of bone loss is higher in women, progresses with age, and is further determined by several modifiable risk factors, particularly in men.

Absorptiometry, Photon↗
PubMed1997

Longitudinal changes in ultrasound parameters of the calcaneus.

We examined with a median follow-up of 1.4 years (range 1.0-2.0 years) the rates of change per year in ultrasound parameters of the calcaneus. Speed of sound (SOS), Broadband ultrasound attenuation (BUA) and Stiffness were measured twice in 543 subjects (224 men) participating in the Rotterdam Study. SOS fell by -2.5 m/s per year in both sexes (95% CI -4.0 to -1.1 m/s per year in men and -3.6 to -1.4 m/s per year in women). Stiffness decreased by -0.62 (-1.33 to 0.09) per year in men and -0.66 (-1.24 to -0.08) per year in women. In men the rate of change in SOS and Stiffness tended to increase with age. BUA did not change significantly during follow-up in either sex. The prospectively assessed rates of loss differed considerably from those observed cross-sectionally, especially for SOS in men (cross-sectional -0.7 m/s per year, longitudinal -2.5 m/s per year). There was substantial variation between individuals both in changes per year in SOS and in changes per year in BUA. With a median follow-up time of 1.4 years, approximately 27% of the variation in the rate of change for SOS could be explained by measurement error while for BUA this was approximately 9% and for Stiffness 11%. Only a small percentage of subjects had changes larger than could be accounted for by measurement error (SOS: men 26.8%, women 21.6%; BUA: men 28.5%, women: 38.8%; Stiffness: men 32.6%, women 35.1%). The latter may limit the use of ultrasound measurements as a follow-up tool in individuals rather than in populations.

Age Factors↗
PubMed1996

[Ultrasound assessment of the calcaneus: for the time being a conservative approach in clinical use; the ERGO study (Erasmus Rotterdam Health and the Elderly)].

OBJECTIVE: To examine whether ultrasound measurements of the calcaneus can help to identify subjects with a risk for non-vertebral fractures. DESIGN: Cross-sectional survey. SETTING: The suburb of Ommoord in Rotterdam, the Netherlands. METHODS: 1421 subjects (631 men, 790 women) underwent both ultrasound measurements of the calcaneus and bone mineral density measurement of the femoral neck by dual energy X-ray absorptiometry (DXA). At the calcaneus speed of sound (SOS in m/s) and broadband ultrasound attenuation (BUA in dB/MHz) were measured. In addition, all subjects were asked about fractures in the preceding 5 years. The frequency of non-vertebral fractures was examined per tertile of SOS and BUA. In addition, we examined whether there was a trend in the number of fractures per tertile of SOS or BUA, within tertiles of femoral neck bone mineral density. RESULTS: The measures of SOS, BUA and bone mineral density (DXA-measured) are comparable as predictors of fractures. Subjects with values of SOS, BUA or bone mineral density in the lowest tertiles were all found to report two to three times as many fractures as subjects with values for these variables in the highest tertiles. Within tertiles of bone mineral density, subjects with a low SOS reported more fractures than subjects with a high SOS. For BUA a similar but less pronounced pattern was visible. Nevertheless, the area under the receiver operating characteristic (ROC) curve was 0.63 for SOS and 0.64 for BUA, comparable to 0.62 for bone mineral density of the proximal femur. Combining ultrasound and bone mineral density measurements had limited effect on the area under the ROC curve (0.65). CONCLUSIONS: Subjects with lower values of ultrasound parameters are at increasing risk of fracture, especially if low ultrasound values are accompanied by a lower bone mineral density. It remains to be seen whether ultrasound parameters are useful for screening.

Absorptiometry, Photon↗
PubMed1996

Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam Study.

OBJECTIVE: To investigate the relationship of osteoarthritis (OA) to bone mineral density (BMD) and rate of bone loss. METHODS: The study group consisted of 2,745 persons (1,624 women) from the general elderly population. Disability was assessed by the Health Assessment Questionnaire. Femoral neck BMD was measured at baseline and, in 1,723 subjects, after 2 years of followup. Knee and hip radiographic OA was assessed on anteroposterior radiographs. RESULTS: With the exception of knee radiographic OA in men, radiographic OA was associated with significantly increased BMD (3-8%). BMD increased significantly according to the number of affected sites and the Kellgren score. Radiographic OA was also associated with significantly elevated bone loss with age (in men, only for radiographic OA of the hip). A significant increase in relation to the number of affected sites and the Kellgren score (except with regard to knee OA in men) was found, independent of disability. CONCLUSION: Radiographic OA is associated with high BMD and increased rate of bone loss. This suggests a more pronounced difference in BMD earlier in life.

Age Factors↗
PubMed1995

[Vertebral deformities and bone density in the elderly; the ERGO Study (Erasmus Rotterdam Health and the Elderly). ERGO Study Group].

OBJECTIVE: To assess the prevalence of vertebral deformities in men and women aged 55 years and over. DESIGN: Cross-sectional study. SETTING: A quarter in Rotterdam, The Netherlands. METHODS: As part of the 'Rotterdam elderly study', 750 responding men and 750 women underwent lateral radiography of the spine and subsequent morphometry of the vertebrae to detect presence of vertebral deformities. Grade 1 and grade 2 deformities were scored on the basis of the results of the morphometry. The entire vertebral column was classified as normal (no deformities), moderate spinal deformity (grade 1 deformities) or severe spinal deformity (grade 2 deformities). Dual Energy X-ray Absorptiometry (DXA) was used to assess the bone mineral density (BMD) at the femoral neck. RESULTS: The prevalence of moderate or severe spinal deformity was estimated to be 18% in men (12% moderate and 6% severe) and 22% in women (11% moderate and 11% severe) after adjustment for the present age distribution of the Dutch population. The prevalence of deformities increased with age, in particular for severe deformities in women aged 70 years and over. A decreasing BMD was observed with increasing severity of vertebral deformities. Men with severe spinal deformity had a 4% lower BMD whereas women with severe spinal deformity had a 6% lower BMD. CONCLUSION: Vertebral deformities are frequently present in the general population, mostly in the higher age groups. There was an association with decreased BMD. In view of the ongoing aging of the population, a future increase in the prevalence of vertebral deformities is to be expected.

Absorptiometry, Photon↗
PubMed1995

Bone density in non-insulin-dependent diabetes mellitus. The Rotterdam Study.

OBJECTIVE: To investigate the relation between non-insulin-dependent diabetes mellitus and bone mineral density at the lumbar spine and hip. DESIGN: Population-based study with a cross-sectional survey. SETTING: A district of Rotterdam, the Netherlands. PARTICIPANTS: 5931 residents (2481 men, 3450 women) of the district aged 55 years or more. MEASUREMENTS: Participants were classified as having non-insulin-dependent diabetes mellitus if they were receiving antidiabetic medication or if they had a serum glucose level of 11.1 mmol/L or more after a nonfasting oral glucose tolerance test. Bone mineral density, measured at the lumbar spine and proximal femur using dual-energy x-ray absorptiometry and the frequency of nonvertebral fractures during the preceding 5 years were compared between persons with and without non-insulin-dependent diabetes mellitus. RESULTS: 243 men and 335 women had non-insulin-dependent diabetes mellitus. Both men and women with this condition had substantially higher mean bone mineral density values at all four sites measured than those with normal glucose tolerance. The increase could not be explained by age; obesity; use of estrogens, thiazides, or loop diuretics; impairment in abilities of daily living; smoking; or osteoarthritis. Women with non-insulin-dependent diabetes mellitus reported having had fewer fractures in the 5 preceding years than women without this condition (adjusted odds ratio, 0.63; 95% CI, 0.44 to 0.90). The frequency of fractures in men was similar for those with and without non-insulin-dependent diabetes mellitus (adjusted odds ratio, 0.96; CI, 0.60 to 1.52). CONCLUSIONS: Men and women with non-insulin-dependent diabetes mellitus have increased bone mineral density. Non-insulin-dependent diabetes mellitus in women is associated with a lower frequency of nonvertebral fractures.

Aged↗
PubMed1994

Age-associated changes in ultrasound measurements of the calcaneus in men and women: the Rotterdam Study.

Broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the os calcis were measured in a sample of 1405 persons (628 men), aged 55-93 years, from the cohort of the Rotterdam Study, a population-based study of diseases in the elderly. We studied the effect of age, body mass index, age at menopause, current use of thiazides, loop diuretics, and estrogens, smoking, and disability on SOS and BUA. Comparisons were made between ultrasound measurements and bone mineral density (BMD) measurements of the lumbar spine and proximal femur using DXA. We found a significant decline with age in SOS and BUA in men (-0.4 and -0.1 %/year, respectively) and women (-1.3 and -0.4%/year, respectively), which persisted after adjustment for body mass index. Age at menopause was not associated with SOS or BUA. Pack-years of smoking was negatively related to SOS in both sexes and to BUA in men. Severe disability was associated with lower SOS and BUA in men, but not in women. Despite the small number of exposed persons, current corticosteroid use was associated with lower BUA in men. The other risk factors examined did not affect the ultrasound measurements. We observed modest correlations between SOS or BUA, on the one hand, and BMD of the lumbar spine, on the other hand (r = 0.32-0.42). Similar correlations were found between ultrasound measurements and BMD measurements of the proximal femur. We conclude that in persons 55 years or over (1) there is a significant age-related decline of BUA and SOS, which is about three times higher in women compared with men, and (2) ultrasound measurements are not able to predict low BMD in hip or spine.

Absorptiometry, Photon↗
PubMed1994

The association between age and bone mineral density in men and women aged 55 years and over: the Rotterdam Study.

In this cross-sectional study, bone mineral density (BMD) measurements were performed in 1762 ambulatory subjects (678 men and 1084 women) aged 55 years and over from the Rotterdam Study, a population based study of diseases in the elderly. BMD measurements of the proximal femur and lumbar spine were performed using dual energy X-ray absorptiometry. No age-related decline in BMD could be observed in the lumbar spine. Yearly percentage BMD reduction in women and men was -0.6% and -0.3% in the femoral neck, -0.8% and -0.5% in the Ward's triangle, and -0.4% and -0.3% in the trochanter, respectively. Late menopause was associated with high BMD in Ward's triangle and lumbar spine. We conclude that: (1) accurate assessment of age-related bone reduction in the spine is impossible from cross-sectional studies since BMD measurements in the elderly may be influenced by spinal osteoarthritis; and (2) the rate of age-related bone reduction in the femoral neck appears to be approximately two times higher in women than in men.

Absorptiometry, Photon↗
PubMed1994

Biochemical markers of bone turnover: an update.

Currently, biomarkers are available which have considerably increased the possibility of monitoring changes in bone turnover. Assays for carboxy-terminal procollagen I fragments, osteocalcin and the bone-specific isoenzyme of alkaline phosphatase allow a more precise assessment of the complex osteoblastic functions in health and disease; osteocalcin appears at present to be the most satisfactory one. With respect to bone resorption, the measurement of urinary pyridinoline cross-links seems to be the most reliable assay. It has to be emphasized, however, that a single biomarker may be of value in some metabolic bone diseases but not in others.

Acid Phosphatase↗