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Biomedical subjects

R Peeters

Publications and source records attributed to R Peeters.

At least 55 records · Page 3Linked to original sources

[Late sequellae of a splenectomy (author's transl)].

This is the case of a patient who underwent splenectomy after traumatic rupture of the spleen. After the operation, while on parenteral feeding, the patient presented with fever and septicemia during approximately 2 months; no origin to this could be found. Two months after the accident the patient died of perforation of a subdiaphragmatic abscess into the stomach and the lung. The authors discuss the possibilities of coming to an earlier diagnosis. They recognize the necessity of a more aggressive attitude to establish the diagnosis.

Adult↗

[The case for more active prevention of deep-vein thrombosis after major surgery (author's transl)].

The frequency of deep-vein thrombosis (DVT) determined by the 125I-fibrinogen test and confirmed by phlebographic studies, is 20 to 30 % in high-risk patients over the age of forty undergoing major surgery. Comparison of this figure with the incidence of clinically detected thrombosis (5 to 10 %) shows that physical signs are unreliable in the detection of this disease. The ultimate fate of these thrombi is unknown. The majority will probably disappear spontaneously; some will be responsible for the development of a "post-phlebitic syndrome" in the extremities and some will propagate and may produce a fatal pulmonary embolus. Besides the currently used physical methods of prophylaxis, some new pharmalogical techniques for the prevention of postoperative deep-vein thrombosis have been tested and advocated in neighbouring countries. Oral anticoagulants have been used routinely for many years by most Dutch surgeons but have never become very popular in other countries. They need extensive laboratory control and, in spite of this, up to 20 % overdosage bleedings have been recorded. As both the administration of low-dose subcutaneous heparin and IV dextran have been reported to provide effective prophylaxis against deep venous thrombosis, we decided to study and compare their efficacy in a randomized clinical trial in order to assess their practical value in daily surgical practice. 119 adult patients undergoing abdominal surgery have been investigated. They have been devided at random in three groups : a dextran 40 group (n=39), a heparin group (n=39) and a control group (n=41 patients). DVT was diagnosed by the fibrinogen uptake test in 21,9 % patients in the control group in 12,8 % patients in the dextran group, and in 10,2 % patients in the heparin group. For the highrisk patients over the age of 70, the administration of low dose SC heparin, as well as the administration of IV low molecular weight dextran significantly reduced the incidence of postoperative DVT in the lower extremities (p less than 0.05). The dextran 40 and heparin groups were not significantly different. The techniques are simple and do not need laboratory control. No deleterious side effects have been noted. A large-scale multicentre international, clinical trial (4121 patients) recently showed that low-dose heparin prophylaxis not only lowered the incidence of postoperative deep-vein trombosis without severely augmenting the risk of bleeding, but also significantly reduced the frequency of fatal pulmonary embolism in the postoperative period. It is suggested that the administration of low-dose subcutaneous heparin should become a routine prophylactic measure in daily surgical practice.

Adult↗

Determination of benzalkonium chloride in drug formulations by capillary electrophoresis (CE).

A Capillary Electrophoresis method was developed and applied successfully to test the quality of different drug formulations for release and stability studies. In the method an uncoated fused-silica capillary was employed containing a phosphoric acid buffer electrolyte which was brought to pH by triethylamine. The benzalkonium chlorides (BAC-C12 and BAC-C14) present in the standard were completely separated from each other and from the peaks of the main compound. Performance results of the method in terms of system repeatability, precision and accuracy are discussed.

Benzalkonium Compounds↗

Intragastric intussusception--a curiosity.

A case of a 53-year-old man with an intragastric intussuscepted small bowel segment is presented. The patient had previously been operated on for recurrent bleeding gastric ulcers. A discussion is presented on the unusual aspects of the intussusception.

Humans↗

Perinatal mortality and morbidity in rural West-Java, Indonesia. Part II: The results of a longitudinal survey on pregnant women.

The main objective of this prospective survey is to obtain more information on the natural history of pregnancy and its outcome, including low birth weights, and of the factors closely associated with it. During the survey period the birth rate was 40 per thousand and the perinatal death rate 48 per thousand. The main causes of neonatal deaths are infections (predominantly tetanus) and hypoxia/birth asphyxia. Perinatal mortality is significantly associated with the following risk factors: age of mother less than 20 years; birth interval shorter than 18 months, twins, and breech presentation. The incidence of low birth weight is 14.7%. Statistically significant associations have been found between low birth weight and several risk factors.

Birth Weight↗

The value of short-term peripheral parenteral nutrition after colorectal surgery: a comparative study with conventional postoperative intravenous fluid.

The potential beneficial effect of postoperative peripheral parenteral nutrition (PPN) was assessed in ten patients undergoing colorectal surgery and compared with the conventional use of intravenous fluids in ten controls. Clinical and biological parameters were checked. A significant improvement in the nitrogen-balance, which was not positive during the first postoperative days was observed. All other daily measured parameters (lipid metabolism, electrolytes, glucose levels and plasma pH) remained within normal ranges. In our opinion, short-term postoperative PPN may lessen protein losses and is indicated in those patients who may have a prolonged paralytic ileus without risking complications of central venous access. However, peripheral solutions may cause phlebitis and PPN is by no means an alternative to central TPN.

Aged↗

Perinatal mortality and morbidity in rural West-Java, Indonesia. Part I: Vital statistics based on cross-sectional surveys.

The first part of this article gives the summary result of 4 cross-sectional surveys conducted in 3 rural villages in West Java. It is expected that these surveys provide the researchers with more precise data on perinatal mortality and its associated causes in order to plan and implement the Tanjungsari Intervention Study (1986-1990). This comprises a mapping and numbering survey, and a census survey. Based on a sampling frame of 7964 houses, a systematic sample (one in eleven) was drawn for the Household and for the Married Women Surveys. The survey results yield some basic demographic indicators, occupational information and data on education. Also data on environmental health and vital statistics are presented. It is shown that the crude birth rate is 40 per thousand and that the estimated infant mortality rate reaches a figure of 120%. Furthermore, during individual interviews data was collected on characteristics, attitudes habits as well as on reproductive behaviour, of all married women under 50 years of age.

Adolescent↗

[Enteral nutrition in gastrointestinal fistulas. Review of the literature].

The use of enteral feeding systems in patients with enterocutaneous fistulae is reviewed. The following problems are discussed: methods of administration, effects of enteral nutrition on patients with a gastro-intestinal fistula, clinical results (nutritional schemes, timing of nutritional support and caloric input). It is concluded that an enteral feeding system is the first choice in cases of distal GIT-fistulae, and in low-output fistulae. In other cases, it may be used in combination with TPN. The need for fistula-registration is thought to be of importance in view of prospective studies in this field.

Energy Intake↗

The use of muscle flaps in leg soft tissue defects.

The use of muscle transpositions following the technique of Ger is discussed in fifteen cases where important soft tissue defects in the leg, some of them combined with complicated fractures, made spontaneous healing or coverage with split skin grafts impossible.

Adolescent↗

[Indications for total parenteral nutrition in surgery (author's transl)].

The indications for total parenteral nutrition are compared with those for enteral alimentation. The indications for parenteral nutrition (nutrition support and hyperalimentation) in gastro-intestinal surgery, traumatology and burn care are discussed. Prophylactic TPN, supplemental TPN and therapeutic TPN are covered as well as their merit in the treatment of surgical complications.

Acute Kidney Injury↗