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Biomedical subjects

W van Steenbergen

Publications and source records attributed to W van Steenbergen.

8 recordsLinked to original sources
PubMed1995

Aging and hepatotoxicity of isoniazid and rifampin in pulmonary tuberculosis.

We evaluated whether elderly patients with pulmonary tuberculosis and without apparent preexisting liver disease are at an increased risk to develop hepatotoxicity from an isoniazid-rifampin regimen and require regular liver function tests in comparison with younger patients. We analyzed the data of 131 patients treated in the period 1980-1985 of whom 64 (49%) were at least 60 yr of age. Subsequent increases of transaminases (measured weekly for as long as 4 wk after the start of treatment and later on when symptoms suggestive of hepatotoxicity occurred) above baseline values were found more frequently in the elderly (38 versus 18%, p < 0.05) and were also more pronounced in them (p < 0.01). The ratio of the highest transaminase value over the baseline value was called the transaminase index (TI). A TI of at least 5 was found in 22% of elderly and 8% of younger patients (p = NS), but ratios as high as 10 were mostly asymptomatic and always normalized progressively without treatment adjustment. Only symptomatic patients with a TI > or = 10 (five elderly and three younger) required temporary or definitive treatment adjustment. We conclude that repeated liver function test evaluations are generally unnecessary, except for symptomatic elderly and younger patients alike, in order to detect those with a TI > or = 10, thus requiring drug adjustment.

Adolescent↗
PubMed1994

Suppression of gonadotropin secretion in the hospitalized postmenopausal female as an effect of acute critical illness.

Plasma gonadotropins were measured in 126 postmenopausal women (age range 69-90 years) admitted to a geriatric ward. After clinical examination, patients were classified as 'acutely or severely ill' or as 'not ill'. Plasma gonadotropins were compared between both groups. Logistic regression was used to select clinical and/or biochemical parameters which differentiated patients with abnormal, low gonadotropins from patients with high gonadotropin concentrations. Plasma gonadotropins were significantly lower in the 'acutely or severely ill' than in the 'healthy' patient group. By logistic regression, blood sedimentation rate, total protein concentration, and serum thyrotropin concentration were significantly correlated with low gonadotropins. Linear regression analysis showed a significant linear relationship between plasma gonadotropins and age (at least for ages over 80 years), blood sedimentation rate (at values more than 65 mm) and total protein concentration. Marked suppression of plasma gonadotropins was frequently found to occur in acutely ill postmenopausal women, in relation to biochemical parameters of acute illness such as blood sedimentation rate, total protein concentration, and serum thyrotropin. In addition, ageing per se seems characterized by a progressive attenuation of the high postmenopausal gonadotropin levels.

Acute Disease↗
PubMed1992

Acute pancreatitis complicating the insertion of a self-expandable biliary metal stent.

A patient is reported who developed acute pancreatitis complicated by pseudocyst formation immediately after the insertion of a self-expanding metallic biliary stent via the percutaneous route. The distal end of the stent was positioned into the duodenum. Endoscopists should be aware of this potential complication of metallic biliary stents.

Acute Disease↗
PubMed1987

Postoperative biliocutaneous fistula: successful treatment by insertion of an endoprosthesis.

An elderly patient with a postoperative biliocutaneous fistula, the persistence of which was due to an unrecognized fibro-malignant stricture of the distal common bile duct, was treated by the insertion of an endoscopic biliary endoprosthesis. Immediately after the procedure, bile discharge through the fistula ceased completely, and the fistula closed in three days. Endoscopic treatment methods are worth trying before surgical revision of a biliocutaneous fistula is performed.

Aged↗
PubMed1985

Traditional infant feeding practices: right or wrong?

Infant feeding practices, breastmilk and food intake and post-natal growth in Madura, East Java, Indonesia and Machakos, Kenya are described. Breastfeeding is commonly practised. Additional foods are introduced the first week post-partum in Madura and at age 2-3 months in Machakos. Growth started to falter at 2-3 months in Madura but was acceptable during the first 6 months in Machakos. It was felt that apart from breastfeeding and morbidity, other factors pertaining to mother's perceptions about what infants should eat and her possibility to make suitable weaning foods, should be considered to understand the background of growth faltering.

Breast Feeding↗
PubMed1983

Prognostic significance of piecemeal necrosis in acute viral hepatitis.

The predictive value of piecemeal necrosis (PMN) in acute hepatitis was investigated in 62 patients (39 hepatitis B virus infection, 9 hepatitis A virus infection and 14 possible hepatitis NANB virus infection). The 62 initial biopsies were blindly recoded and classified into three groups: 1. Acute hepatitis with signs of possible transition to chronicity (AHTC) (n = 35) (i.e. a picture of acute hepatitis associated with PMN). 2. AHTC-borderline group (BL) (n = 15) (i.e. a picture of acute hepatitis with minimal PMN). 3. Uncomplicated acute hepatitis (AH) (n = 12) (i.e. a picture of acute hepatitis without PMN). Follow-up of the patients revealed an evolution to chronicity in a very high percentage of the AHTC-cases of hepatitis B (95%) and NANB (89%) etiology. Also 67% of the BL-cases of hepatitis B etiology developed chronic liver disease. In hepatitis B the immunohistochemical pattern of HBsAg is of additional help. In hepatitis A, PMN is often present (5/9) but no evolution to chronicity was observed. This study shows that PMN in acute hepatitis appears to be a useful prognostic feature for chronicity in hepatitis B and NANB.

Acute Disease↗
PubMedDate not supplied

Multimedia E-mail systems for computer-assisted radiological communication.

In the film-based organization of communicating radiological results to the referring physician, the different media (text, images, graphics, voice) are separated. When using computer technology, multimedia reports containing links between these different media can be used. This changes the way radiological reports are generated, accessed, and possibly discussed. We performed experiments in a clinical setting using two different metaphors for communicating multimedia information. In the 'paper metaphor', labels in the report text are linked to annotations in selected images. In the 'slide presentation metaphor', annotated images are presented synchronously to a spoken report. With both systems additional interaction between radiologist and referring physician is supported using multimedia 'electronic mail'. The experiments indicate that multimedia does not only significantly increase the efficiency of information transfer, but also has the potential to make reporting itself more efficient. Given that the amount of image-related information keeps growing, multimedia links are a promising method to give efficient access to the most relevant information.

Computer Graphics↗