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Biomedical subjects

S van der Geest

Publications and source records attributed to S van der Geest.

At least 55 records · Page 3Linked to original sources
PubMed1989

Incidence and effects of herpes simplex virus infection after autologous bone marrow transplantation for solid tumours.

In a prospective study of 44 patients, who underwent autologous bone marrow transplantation (ABMT) for solid tumours, the results of serial viral cultures and determination of complement-fixing antibodies to herpes simplex virus (HSV) were analysed. No primary infections with HSV occurred. Of 31 initially HSV-seropositive ABMT patients, 61% developed positive HSV cultures. Half of these patients showed a significant antibody rise. Active HSV infection did not influence the recovery of the bone marrow after ABMT, but coincided with a significantly increased number of febrile days.

Adult↗
PubMed1988

Impairment of organ function after oral ingestion of refined petrol.

After oral ingestion of 600 ml of refined petrol a 23-year-old male developed multiple organ failure. Acute renal insufficiency due to nephrotoxic tubular necrosis requiring hemodialysis was a major manifestation. Moreover, respiratory failure, seizures, hemolysis, disseminated intravascular coagulation, liver damage and erosions of mucous membranes occurred. The patient subsequently recovered completely. In spite of the poor absorption from the gastrointestinal tract and the high first-pass effect in the liver, massive petrol intoxication may lead to reversible multisystemic lesions.

Acute Kidney Injury↗
PubMed1988

Chemotherapy with maximally tolerable doses of VP 16-213 and cyclophosphamide followed by autologous bone marrow transplantation for the treatment of relapsed or refractory germ cell tumors.

Eleven patients with advanced nonseminomatous germ cell tumors (NSGCT), who relapsed after or were refractory to standard dose cisplatin-based remission induction chemotherapy, were treated in a phase II clinical trial with VP 16-213 2500 mg/m2 and cyclophosphamide 7 g/m2. Both drugs were given in maximally tolerable doses regarding extramedullary toxicity. Urothelial damage due to cyclophosphamide was prevented by the administration of mesnum. Autologous bone marrow was infused on day 7 to prevent long lasting medullary toxicity. Because of the disappointing results in the first three patients, a second treatment step was added. The next eight patients were treated with 2500 mg/m2 VP 16-213 divided and given on days 1-2-3 and after full bone marrow recovery with total doses of VP 16-213 2000 mg/m2 plus cyclophosphamide 7 g/m2 divided and given on days 29-30-31, followed by autologous bone marrow transplantation (ABMT) on day 35. Toxicity to high-dose VP 16-213 plus cyclophosphamide followed by ABMT consisted of mucositis, nausea, vomiting and diarrhea. No cardiac toxicity or hemorrhagic cystitis occurred. The mean duration of leukopenia and thrombopenia was 14 and 13 days respectively. The additional, preceding treatment with VP 16-213 as a single agent caused mucositis, and leukopenia and thrombopenia for a mean number of 9 and 6 days respectively. Seven responses were obtained: two complete responses of 46 and 66+ weeks respectively and five partial responses with a median response duration of 12 weeks. The median survival time was 40 weeks. This regimen of one or two courses with maximally tolerable doses of VP 16-213 plus cyclophosphamide and ABMT is not sufficient to salvage a substantial number of patients with relapsing or refractory NSGCT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Pharmaceuticals in the Third World: the local perspective.

This introduction is a plea in favour of social field research into the local context of the distribution and use of pharmaceuticals in developing countries. This local perspective is conspicuously absent in studies and policy recommendations concerning drug use in the Third World.

Developing Countries↗
PubMed1987

Self-care and the informal sale of drugs in south Cameroon.

Self-care, though the most common of all forms of therapeutic action, has been little studied. This paper describes the context of self-medication with western pharmaceuticals in an area of South Cameroon (in 1980). The identity and appropriateness of these pharmaceuticals are briefly discussed. The paradoxical character of self-medication is emphasised: improvement in the quality of self-medication implies both growth and loss of self reliance, increase and decrease of medicalisation. People in Cameroon, or indeed anywhere in the Third World, find themselves in a 'double-bind'.

Cameroon↗
PubMed1986

Renal hemodynamics during separate and combined infusion of amino acids and dopamine.

Healthy volunteers (N = 9) and patients with varying degrees of renal insufficiency (N = 36) were given a low dose of dopamine and/or amino acids intravenously during a simultaneous measurement of the glomerular filtration rate and the effective renal plasma flow. Dopamine infusion led to a rise in the glomerular filtration rate and a fall in the filtration fraction. Infusion of amino acids was accompanied by an increase in the glomerular filtration rate while the filtration fraction remained unchanged or increased slightly. The highest values for the glomerular filtration were obtained during the combined infusion of amino acids and dopamine. A reserve in filtration capacity was not or hardly present in patients with moderate (GFR 30 to 90 mliter/min/1.73 M2) to severe (GFR less than 30 mliter/min/1.73 M2) renal insufficiency. We conclude that dopamine decreases total renal vascular resistance while amino acids mainly reduce the tone of afferent arterioles. As amino acids and dopamine seem to be additive in their effects on the glomerular filtration rate, we recommend the combined infusion of these two stimuli to measure renal reserve filtration capacity.

Amino Acids↗
PubMed1985

Clonidine withdrawal syndrome in a patient with heart failure.

Clonidine withdrawal syndrome is described in a patient with heart failure and suspected cardiogenic shock. Hemodynamic monitoring disclosed hypertension and a very high systemic vascular resistance. Treatment consisted of nitroprusside followed by captopril.

Aged↗
PubMed1985

Testing renal reserve filtration capacity with an amino acid solution.

In healthy individuals and in patients with varying degrees of impaired renal function, glomerular filtration rate (GFR) and effective renal plasma flow were measured before and during infusion of an amino acid solution (Vamin N). GFR increased during amino acid infusion in healthy individuals while the filtration fraction (FF) remained constant. However, in patients with impaired renal function no significant changes in GFR were observed. The FF increased slightly. We conclude that amino acid infusion can increase GFR, possibly by utilization of 'dormant cortical nephrons' together with a rise in net ultrafiltration pressure of other filtrating glomeruli, both due to afferent vasodilatation. Thus, amino acid administration can be used to test the presence of reserve filtration capacity.

Adult↗
PubMed1982

The secondary importance of primary health care in South Cameroon.

Primary health care in Cameroon meets with serious obstacles. The state gives it a low priority in its budget and over-all policy. The health institutions are rarely active in this field. Institutions which do practice some primary health care are usually foreign. The villagers, finally, are little interested. They insist only on improvement of curative services and material life conditions. The conclusion is that primary health care is regarded as something of secondary importance. First comes a better life. The research for this paper was conducted in 1980 in the South of Cameroon.

Cameroon↗
PubMedDate not supplied

Successful aging in the oldest old: Who can be characterized as successfully aged?

BACKGROUND: Successful aging is a worldwide aim, but it is less clear which indicators characterize elderly persons as successfully aged. We explored the meaning of successful aging from 2 perspectives. METHODS: Analysis of data from the first cross-sectional part of the longitudinal Leiden 85-plus Study, conducted in Leiden, the Netherlands. All inhabitants of Leiden aged 85 years were eligible. Data were obtained from 599 participants (response rate, 87%). Successful aging from a public health perspective was defined as a state of being. All participants were classified as successful or not successful based on optimal scores for physical, social, and psychocognitive functioning and on feelings of well-being, using validated quantitative instruments. Qualitative indepth interviews on the perspectives of elderly persons were held with a representative group of 27 participants. RESULTS: Although 45% (267/599) of the participants had optimal scores for well-being, only 13% (79/599) had optimal scores for overall functioning. In total, 10% (58/599) of the participants satisfied all the criteria and could be classified as successfully aged. The qualitative interviews showed that most elderly persons viewed success as a process of adaptation rather than a state of being. They recognized the various domains of successful aging, but valued well-being and social functioning more than physical and psychocognitive functioning. CONCLUSIONS: If successful aging is defined as an optimal state of overall functioning and well-being, only a happy few meet the criteria. However, elderly persons view successful aging as a process of adaptation. Using this perspective, many more persons could be considered to be successfully aged.

Activities of Daily Living↗
PubMedDate not supplied

Topical antimicrobial prophylaxis of nosocomial pneumonia in mechanically ventilated patients. Microbiological observations.

Generally, reduction of colonization and infection with potentially pathogenic microorganisms in intensive care units (ICU) is attempted by a combination of antimicrobial agents administered topically in the digestive tract and systematically. We tested the efficacy of topical antimicrobial prophylaxis of the oropharynx and stomach administered in combination with sucralfate without systemic prophylaxis in 25 mechanically ventilated ICU patients. The regimen successfully reduced colonization with potentially pathogenic microorganisms in the oropharynx and trachea without modifying the intestinal flora. However, colonization and infections with gram-positive cocci and gram-negative rods other than Enterobacteriaceae and Pseudomonadaceae and resistant to one or both the antimicrobial agents used were observed.

Administration, Intranasal↗