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Siep Thomas

Publications and source records attributed to Siep Thomas.

24 records · Page 2Linked to original sources
PubMed2002

Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial.

OBJECTIVE: To test the hypothesis that fusidic acid would not increase the treatment effect of disinfecting with povidone-iodine alone in children with impetigo. DESIGN: Randomised placebo controlled trial. SETTING: General practices in Greater Rotterdam. PARTICIPANTS: 184 children aged 0-12 years with impetigo. MAIN OUTCOME MEASURES: Clinical cure and bacterial cure after one week. RESULTS: After one week of treatment 55% of the patients in the fusidic acid group were clinically cured compared with 13% in the placebo group (odds ratio 12.6, 95% confidence interval 5.0 to 31.5, number needed to treat 2.3). After two weeks and four weeks the differences in cure rates between the two groups had become smaller. More children in the placebo group were non-compliant (12 v 5) and received extra antibiotic treatment (11 v 3), and more children in the placebo group reported adverse effects (19 v 7). Staphylococcus aureus was found in 96% of the positive cultures; no strains were resistant to fusidic acid. CONCLUSIONS: Fusidic acid is much more effective than placebo (when both are given in combination with povidone-iodine shampoo) in the treatment of impetigo. Because of the low rate of cure and high rate of adverse events in the placebo group, the value of povidone-iodine in impetigo can be questioned.

Anti-Bacterial Agents↗
PubMed2002

Normal values and determinants of circadian urine production in older men: a population based study.

PURPOSE: We evaluated circadian urine production and its determinants in a large population based sample of older men. MATERIALS AND METHODS: We collected data on 1,688 men 50 to 78 years old, without radical prostatectomy, prostate or bladder cancer, neurogenic bladder disease or negative advice from their general practitioner, recruited from the population of Krimpen, the Netherlands. Measurements consisted of self-administered questionnaires, including the International Prostate Symptom Score, a 3-day frequency-volume chart, transrectal prostatic ultrasound, uroflowmetry and post-void residual volume. Hourly urine production was determined and urine production day-to-night ratio was calculated from the frequency-volume chart. RESULTS: Men younger than 65 years showed a clear circadian urine production pattern, whereas in older men this pattern was less clear. Smoking, use of diuretic drugs, post-void residual and 24-hour polyuria reinforced the circadian pattern, in favor of daytime urine production. The urine production day-to-night ratio was not associated with prostate enlargement, reduced urinary flow rate, body weight, hypertension, cardiac symptoms, diabetes mellitus, use of antidepressants, cardiac or hypnotic drugs. CONCLUSIONS: Urine production in men younger than 65 years showed a clear circadian pattern in contrast to men older than 65 years. These data can be used as a reference when describing urine production patterns in select populations. In daily practice frequency-volume charts can be used to determine urine production. This method is inexpensive, easy to use and provides valid information on urine production in a natural environment.

Aged↗
PubMed2002

Relation between nocturnal voiding frequency and nocturnal urine production in older men:a population-based study.

OBJECTIVES: To describe the normal values for nocturnal urine production and its determinants, as well as the relation between nocturnal urine production and voiding frequency. METHODS: Data were collected from 1688 men aged 50 to 78 years without bladder or prostate cancer, radical prostatectomy, neurogenic bladder dysfunction, or negative advice from their general practitioner. Measurements included self-administered questionnaires, a 3-day frequency-volume chart, transrectal ultrasonography of the prostate, uroflowmetry, and postvoid residual urine volume measurement. The mean nocturnal urine production was computed from the frequency-volume charts. Linear regression analyses were performed to determine associated factors for nocturnal urine production. Areas under the receiver operating characteristic curves were used to describe the discriminative value of nocturnal urine production on nocturnal voiding frequency. A cutoff value for "increased" nocturnal urine production was defined using logistic regression analysis. RESULTS: The nocturnal urine production was 60.6 mL/hr for the total study population; it increased with age and was significantly higher in men with 24-hour polyuria. Nocturnal urine production was on average higher in men with increased nocturnal voiding frequency, but had only a reasonable discriminative value on nocturnal voiding frequency (areas under receiver operating characteristic curve of 0.71 and 0.76). Nocturnal urine production exceeding 90 mL/hr is suggested as abnormal. CONCLUSIONS: On average, nocturnal voiding frequency is indicative of nocturnal urine production. However, nocturnal urine production is only a modest discriminator for increased nocturnal voiding frequency. Therefore, the use of nocturnal urine production as an explanatory variable for nocturnal voiding frequency in daily practice is of little value.

Age Factors↗
PubMed2002

Health status and its correlates among Dutch community-dwelling older men with and without lower urogenital tract dysfunction.

OBJECTIVE: To study health status and its correlates in older men with and without lower urogenital tract dysfunction. METHODS: Cross-sectional population-based study on 1688 men aged 50-78 years without bladder or prostate cancer, radical prostatectomy, neurogenic bladder dysfunction or a negative advice from their general practitioner. Data were collected through self-administered questionnaires, including Sickness Impact Profile (SIP, three domains), Inventory of Subjective Health (ISH), International Prostate Symptom Score (IPSS) and International Continence Society (ICS) Male Sex questionnaire, medication use, socio-economic and lifestyle factors. Additional information was collected by measurement of blood pressure, transrectal ultrasonography of the prostate and uroflowmetry. Four health status domains were analyzed using the ISH and three domains of the SIP. Lower urinary tract symptoms (LUTS) were categorised using IPSS, erectile and ejaculatory dysfunction were defined using the ICS questionnaire. RESULTS: All urogenital characteristics and parameters were related to at least two of the health status domains. Multivariate regression analyses yielded that LUTS and cardiac symptoms were associated with suboptimal scores of all four domains. Chronic obstructive pulmonary disease and drugs for abdominal symptoms were related to three domains; erectile and ejaculatory dysfunction, muskuloskeletal or psycho(ana)leptic drugs and marital status to two domains. CONCLUSIONS: The impact of LUTS on health status was equally important as the impact of cardiac symptoms. The impact of sexual dysfunction was smaller than expected. Longitudinal studies are needed to determine how health status and illnesses interact.

Aged↗
PubMedDate not supplied

Incidence of influenza and associated illness in children aged 0-19 years: a systematic review.

A systematic review was conducted to estimate the incidence of influenza and concomitant morbidity and mortality in children from 0 to 19 years (0-19 years). Medline was searched for observational studies and placebo or non-treated arms of experimental studies providing occurrence rates of laboratory-proven influenza illness. From the 2758 titles identified, 356 full papers were reviewed based on the abstract or title; after searching their reference lists an additional 16 papers were found. Finally 28 studies met our inclusion criteria, reporting a varying seasonal incidence of influenza of up to 46%. However, when analysing two long-term observational studies and averaging seasonal fluctuations, the overall incidence of influenza was found to range from 5% to 9.5% per year. Serious morbidity was seldom reported and no cases of mortality were found. Our review shows influenza as an infection with a moderate average incidence and a self-limiting character that is associated with mild morbidity and rare cases of mortality in children. This systematic review may be subject to two contrasting biases. First, the limited number of children reported in the literature with proven influenza infections would tend to under-represent the incidence of uncommon but serious complications such as death. Second, the preferential reporting of influenza outbreak seasons may over-estimate the importance of influenza. Future population based studies should focus on consecutive influenza seasons and capture indirect benefits of vaccinations such as interruption of transmission in the community so that preventive strategies for children can be reconsidered with special attention to their cost effectiveness.

Adolescent↗