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Paddenberg E, Dees A, Proff P, Kirschneck C. Individual dental and skeletal age assessment according to Demirjian and Baccetti: Updated norm values for Central-European patients. J Orofac Orthop 2024; 85:199-212. [PMID: 36239773 PMCID: PMC11035409 DOI: 10.1007/s00056-022-00431-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/16/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Chronological age often differs from dental and skeletal age. With orthopantomograms and lateral cephalograms, dental and skeletal development can be determined according to the methods published by Demirjian et al. and Baccetti et al. However, gender and skeletal class as possible confounders were frequently not considered and available norm values are not up-to-date. This retrospective cross-sectional study thus aimed to evaluate effects of skeletal class and gender on dental and skeletal age of growing patients and to generate updated norm values for contemporary Central-European patients. METHODS A total of 551 patients were included in the dental and 733 in the skeletal age assessment, respectively. Dental analysis was based on tooth mineralisation stages in orthopantomograms (Demirjian) and skeletal age was defined by cervical vertebrae maturation stages (CVMS) in lateral cephalograms (Baccetti). Skeletal class was determined by the individualised ANB angle of Panagiotidis/Witt. With nonlinear regression analysis a formula for determining dental age was established. Effects of gender and skeletal class were evaluated and updated norm values generated. RESULTS Inter- and intrarater reliability tests revealed at least substantial measurement concordance for tooth mineralisation and CVMS. Demirjian stages and CVMS significantly depended on gender with girls developing earlier. Skeletal class significantly affected skeletal age only, but without clinical relevance. Updated norm values for dental age differed significantly from the original values of Demirjian and the values for skeletal age differed from those published by Baccetti. CONCLUSION Optimised norms, separated by gender, increase precision in determining individual dental and skeletal age during orthodontic treatment planning. Further studies analysing the effect of skeletal class on dental and skeletal development are needed.
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Affiliation(s)
- Eva Paddenberg
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Adrian Dees
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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2
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Alam N, Oskam E, Stassen PM, Exter PV, van de Ven PM, Haak HR, Holleman F, Zanten AV, Leeuwen-Nguyen HV, Bon V, Duineveld BAM, Nannan Panday RS, Kramer MHH, Nanayakkara PWB, Alam N, Nanayakkara P, Oskam E, Stassen P, Haak H, Holleman F, Nannan Panday R, Duineveld B, van Exter P, van de Ven P, Bon V, Goselink J, De Kreek A, van Grunsven P, Biekart M, Deddens G, Weijschede F, Rijntjes N, Franschman G, Janssen J, Frenken J, Versluis J, Boomars R, de Vries G, den Boer E, van Gent A, Willeboer M, Buunk G, Timmers G, Snijders F, Posthuma N, Stoffelen S, Claassens S, Ammerlaan H, Sankatsing S, Frenken J, Alsma J, van Zanten A, Slobbe L, de Melo M, Dees A, Carels G, Wabbijn M, van Leeuwen-Nguyen T, Assink J, van der Honing A, Luik P, Poortvliet W, Schouten W, Veenstra J, Holkenborg J, Cheung T, van Bokhorst J, Kors B, Louis- Wattel G, Roeleveld T, Toorians A, Jellema W, Govers A, Kaasjager H, Dekker D, Verhoeven M, Kramer M, Flietstra T, Roest L, Peters E, Hekker T, Ang W, van der Wekken W, Ghaem Maghami P, Kanen B, Wesselius H, Heesterman L, Zwietering A, Stoffers J. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. The Lancet Respiratory Medicine 2018; 6:40-50. [DOI: 10.1016/s2213-2600(17)30469-1] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/22/2017] [Accepted: 10/25/2017] [Indexed: 11/29/2022]
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3
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Roncarati A, Vicenzi R, Melotti P, Dees A. Largemouth bass (Micropterus salmoidesLacépède): reproduction management and larval rearing in Italy. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2005.2s.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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4
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Huang L, Luiken GPM, van Riemsdijk IC, Petrij F, Zandbergen AAM, Dees A. Nephrocalcinosis as adult presentation of Bartter syndrome type II. Neth J Med 2014; 72:91-93. [PMID: 24659592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Bartter syndrome consists a group of rare autosomal-recessive renal tubulopathies characterised by renal salt wasting, hypokalaemic metabolic alkalosis, hypercalciuria and hyperreninaemic hyperaldosteronism. It is classified into five types. Mutations in the KCNJ1 gene (classified as type II) usually cause the neonatal form of Bartter syndrome. We describe an adult patient with a homozygous KCNJ1 mutation resulting in a remarkably mild phenotype of neonatal type Bartter syndrome.
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Affiliation(s)
- L Huang
- Department of Internal Medicine, Ikazia Hospital Rotterdam, Rotterdam, the Netherlands
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5
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Mathot BJ, Dees A. A patient with a tumour in the breast and extensive haematomas. Scurvy. Neth J Med 2013; 71:369-373. [PMID: 24038563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- B J Mathot
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, the Netherlands
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6
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Verweij KE, Engelkens HJH, Bertheux CA, Dees A. Multiple lesions in upper jaw. Multiple buccal exostoses. Neth J Med 2011; 69:347-350. [PMID: 21934183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- K E Verweij
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, the Netherlands.
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7
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Abstract
A 51-year-old African male presented to the emergency department with a sore throat, a productive cough and a striking pinched voice. Investigation revealed severe hypocalcaemia (0.97 mmol/l) with a prolonged QT interval on ECG. The authors administered intravenous calcium in the emergency department, which instantly improved the quality of the patient's voice. He was eventually diagnosed with primary hypoparathyroidism and an upper airway infection. Severe hypocalcaemia is a life-threatening condition. Identifying laryngospasm as an atypical presentation in the presence of a concomitant airway infection and prompt treatment in the emergency department are critical.
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Affiliation(s)
- M J van Veelen
- Department of Emergency Medicine, Ikazia Ziekenhuis, Rotterdam, The Netherlands.
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8
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de Weerd A, van Rijn M, Baggen R, Dees A. Severe non-type-1 Legionella pneumophila infection without pneumonia. Neth J Med 2010; 68:84-86. [PMID: 20167960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We present a patient with myalgia and ongoing fever without respiratory symptoms caused by a Legionella pneumophilia infection. We conclude that in patients with fever of unknown origin legionellosis should be considered, even in the absence of pulmonary symptoms. When considering legionellosis, diagnostic tests should include the urinary antigen test.
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Affiliation(s)
- A de Weerd
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, the Netherlands.
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9
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Drooger JC, Dees A, Swaak AJG. ANCA-Positive Patients: The Influence of PR3 and MPO Antibodies on Survival Rate and The Association with Clinical and Laboratory Characteristics. Open Rheumatol J 2009; 3:14-7. [PMID: 19461938 PMCID: PMC2684710 DOI: 10.2174/1874312900903010014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 02/16/2009] [Accepted: 02/19/2009] [Indexed: 12/02/2022] Open
Abstract
Objectives: To compare the survival rate, and the clinical and laboratory characteristics in patients, characterized by the presence of certain anti-neutrophil cytoplasmic auto-antibodies (ANCAs). Methods: In a retrospective observational study, we analyzed the data of all patients with a positive ANCA test between 1995 and 2005 at our hospital. Based on serology patients were divided in three subgroups (ANCA-Proteinase 3 (PR3), ANCA-Myeloperoxidase (MPO) and atypical ANCA), irrespective of the diagnosis. Patient survival was compared by Kaplan Meier survival analysis. Differences in clinical and laboratory characteristics between the groups of specific ANCAs were determined. Results: Fifty-four ANCA-positive patients were analyzed. Eighteen of these patients were ANCA-PR3-positive, 17 were ANCA-MPO-positive and 19 had a atypical ANCA. A random control group was created of matched ANCA negative patients. Average follow-up time was 52 months. The calculated five year survival rate in respectively the ANCA-PR3- positive group, the ANCA-MPO-positive group, the atypical ANCA group and the ANCA-negative group was 45%, 81%, 90% and 100%. (P = 0.012, Wilcoxon test). A higher mean leukocyte count, a higher mean erythrocyte sedimentation rate and more fever was observed in the ANCA-PR3-positive group compared to the ANCA-MPO-positive group. Conclusions: A remarkable lower survival rate was observed in ANCA-PR3-positive patients compared to ANCA-MPO-positive patients. We also demonstrated that patients characterized by the presence of a defined ANCA differ in clinical and laboratory characteristics.
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Affiliation(s)
- J C Drooger
- Departments of Internal Medicine and Rheumatology, Ikazia Hospital, Postbus 5009, 3008 AA, Rotterdam, The Netherlands
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10
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Bakashvili N, Swaak AJG, Tervaert JWC, Dees A. [ANCA(antineutrophil cytoplasmic antibodies)-associated vasculitis in a man with extreme fatigue, fever and progressive renal dysfunction]. Ned Tijdschr Geneeskd 2008; 152:1009-1014. [PMID: 18549177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A 55-year-old man, with no previous history, presented with extreme fatigue and fever and was admitted to hospital. He had progressive renal dysfunction and his serum anti-neutrophil cytoplasmic antibodies (ANCA) were markedly elevated. Renal histology was consistent with ANCA-associated vasculitis. The patient was successfully treated with cyclophosphamide and prednisolone. The classification and management of the ANCA-associated vasculitides are described. The classification was guided by the clinical presentation, serology and results of tissue biopsies. The ANCA inflammation had affected the middle sized and small vessels of especially the upper and lower airways, and the kidneys. The antibodies were directed at proteinase-3 (PR3) or myeloperoxidase (MPO). PR3-ANCA is predominantly found in Wegener's granulomatosis, while MPO-ANCA is related to microscopic polyangiitis. Tissue studies showed granulomatous inflammation of the airways which is typical of Wegener's disease. This type of inflammation is absent in microscopic polyangiitis. The initial treatment schedule consists of prednisone 1 mg/kg daily and oral cyclophosphamide 2 mg/kg daily. In the remission phase, the cyclophosphamide is replaced by azathioprine. It is not yet known how long maintenance treatment should be continued and which parameters have prognostic value.
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Affiliation(s)
- N Bakashvili
- Ikazia Ziekenhuis, Rotterdam. Afd. Inwendige Geneeskunde
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11
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Sprangers JM, Nienhuis JE, Dees A. [Sigmoid carcinoma as a long-term complication following ureterosigmoidostomy]. Ned Tijdschr Geneeskd 2008; 152:970-971. [PMID: 18564445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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12
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Mordenti O, Roncarati A, Dees A, Melotti P. Reproduction and larval rearing of chub ( Leuciscus cephalus L.): comparison between different broodstocks origin. Italian Journal of Animal Science 2007. [DOI: 10.4081/ijas.2007.1s.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- O. Mordenti
- Dipartimento di Morfofisiologia Veterinaria e Produzioni Animali. UUniversità di Bologna, Italy
| | - A. Roncarati
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
| | - A. Dees
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
| | - P. Melotti
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
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13
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Felici A, Melotti P, Roncarati A, Bianchi C, Forlini L, Dees A. Natural and synthetic pigments used in the pink-red coloration of salmon flesh: methodology of quali-quantitative assessments and sampling results. Italian Journal of Animal Science 2007. [DOI: 10.4081/ijas.2007.1s.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- A. Felici
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
| | - P. Melotti
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
| | - A. Roncarati
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
| | - C. Bianchi
- COOP Italia S.C.aR.L.. Casalecchio di Reno (BO), Italy
| | - L. Forlini
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
| | - A. Dees
- Dipartimento di Scienze Veterinarie. Università di Camerino, Italy
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14
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de Geus HRH, Dees A. Sporadic porphyria cutanea tarda due to haemochromatosis. Neth J Med 2006; 64:307-9. [PMID: 16990695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Haemochromatosis is a hereditary iron-overload syndrome caused by increased intestinal iron absorption and characterised by accumulation of potentially toxic iron in the tissues. Sometimes this disease presents as a cutanea porphyria. We describe a patient with joint complaints and blistering skin lesions on sun-exposed skin. After identifying the porphyria cutanea tarda by urine analysis we found that the serum activity of uroporphyrinogen decarboxylase (UROD) was normal, meaning a partial inactivation of UROD in liver tissue due to external factors. Further investigation showed the homozygous Cys282Tyr missense mutation and high levels of serum ferritin. It is important to recognise the symptoms of iron overloading at an early stage because hereditary haemochromatosis needs to be treated immediately. We therefore advocate routine sampling of ferritin levels in patients with unexplained joint complaints.
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Affiliation(s)
- H R H de Geus
- Department of Intensive Care, Erasmus Medical Centre, Rotterdam, the Netherlands.
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15
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Kappers MHW, Swaak AJG, Zuidgeest DMH, Dees A. [Progressive multifocal leukoencephalopathy in a patient following long-term immunosuppressive therapy for systemic lupus erythematosus]. Ned Tijdschr Geneeskd 2006; 150:387-92. [PMID: 16523804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A 41-year-old woman who had suffered from systemic lupus erythematosus (SLE) for 22 years presented with signs of neurological deficits. CT-scanning of the brain revealed hypodense lesions that suggested cerebral infarction due to vasculitis in SLE. However, in spite of intensified immunosuppressive therapy, she showed rapid neurological deterioration. After extensive, additional examinations and tests, the diagnosis was finally changed to progressive multifocal leukoencephalopathy, caused by an opportunistic infection by the JC polyomavirus. Neurological and psychiatric symptoms frequently occur in patients with SLE. The differential diagnosis of these symptoms in SLE is extensive and includes, on the one hand, primary neurological and psychiatric diseases related to direct involvement of the nervous system by SLE, and on the other hand, secondary syndromes arising as a result of complications of the SLE or the immunosuppressive treatment. Opportunistic infections are often an important secondary cause of neurological and psychiatric syndromes in patients with SLE. The clinical symptoms and radiological cerebral signs are non-specific and usually do not suffice to differentiate between the various syndromes. Since each syndrome requires its own specific clinical approach and treatment, extensive diagnostics are mandatory before the diagnosis 'cerebral lupus' can be made and immunosuppressive therapy can be started or intensified.
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Affiliation(s)
- M H W Kappers
- Erasmus MC-Dijkzigt, afd. Interne Geneeskunde, Postbus 2040, 3000 CA Rotterdam.
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16
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de Geus HRH, Giard RWM, Jacobs FAH, Lonnee ER, Dees A. [Abnormalities in tattooed skin: sometimes sarcoidosis]. Ned Tijdschr Geneeskd 2005; 149:1113-7. [PMID: 15932139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A 43-year-old man presented with a nodular tattoo lesion on his right upperarm. Histologically it resembled the granulomatous reaction seen in systemic sarcoidosis. Further evaluation revealed asymmetrical hilar lymphadenopathy with no interstitial lung disease. Since the patient was a heavy smoker, bronchus carcinoma could not be excluded and cervical mediastinoscopy was performed in order to obtain a lymph-node biopsy. This confirmed the diagnosis of systemic sarcoidosis. The patient was treated by local application of corticosteroids, but with little result. Skin lesions in scars or tattoos may be the first symptom of systemic sarcoidosis. Skin biopsy for histological confirmation of the diagnosis is recommended, as is further investigation to evaluate other organ systems which may be affected.
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Affiliation(s)
- H R H de Geus
- Afd. Interne Geneeskunde, Ikazia Ziekenhuis, Montessoriweg 1, 3083 AN Rotterdam.
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17
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van den Bosch AE, van der Klooster JM, Zuidgeest DMH, Ouwendijk RJT, Dees A. Severe hypokalaemic paralysis and rhabdomyolysis due to ingestion of liquorice. Neth J Med 2005; 63:146-8. [PMID: 15869043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Chronic ingestion of liquorice induces a syndrome with findings similar to those in primary hyperaldosteronism. We describe a patient who, with a plasma K+ of 1.8 mmol/l, showed a paralysis and severe rhabdomyolysis after the habitual consumption of natural liquorice. Liquorice has become widely available as a flavouring agent in foods and drugs. It is important for physicians to keep liquorice consumption in mind as a cause for hypokalaemic paralysis and rhabdomyolysis.
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Affiliation(s)
- A E van den Bosch
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands
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18
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Melotti P, Roncarati A, Dees A, Vicenzi R. Largemouth bass ( Micropterus salmoidesLacépède): results of farming trials. Italian Journal of Animal Science 2005. [DOI: 10.4081/ijas.2005.2s.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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19
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van Leerdam ME, Dingemans-Dumas AM, Boldewijn JK, Dees A. [A man from Surinam with haemorrhagic diarrhoea after long-standing schistosomiasis]. Ned Tijdschr Geneeskd 2004; 148:1928-30. [PMID: 15495993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A 35-year-old man presented with a brief history of haemorrhagic diarrhoea. He had moved to The Netherlands 24 years before and had been in Surinam 12 years ago for the last time. Physical examination and routine laboratory tests revealed no abnormalities. Colonoscopy showed a striking congestion of the small blood vessels; histological examination of a sigmoid biopsy revealed Schistosoma eggs and microbiological investigation of the feces revealed ova of Schistosoma mansoni. The schistosomiasis was thus diagnosed more than 10 years after the last possible exposure to schistosomal cercariae. The patient was treated with a single dose of praziquantel.
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Affiliation(s)
- M E van Leerdam
- Afd. Interne Geneeskunde, Ikazia Ziekenhuis, Montessoriweg 1, 3083 AN Rotterdam.
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20
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van 't Hof S, Dees A, van Vliet ACM. [Spontaneous rupture of the bladder]. Ned Tijdschr Geneeskd 2004; 148:1610. [PMID: 15382564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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22
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Abstract
Chronic obstructive pulmonary disease (COPD) often leads to massive oedema and the development of what is usually called cor pulmonale. The mechanisms by which patients with COPD retain salt and water are not completely understood. Several abnormalities have been found including reduced renal blood flow with relatively preserved glomerular filtration rate and elevated levels of renin, aldosterone, arginine vasopressin and atrial natriuretic peptide. Generally, these abnormalities worsen with the severity of COPD and are most marked during the oedematous phases. Cardiac output is remarkably normal, suggesting that "cor pulmonale" is not primarily a cardiac disorder but rather a condition of volume overload due to activation of sodium-retaining mechanisms. The stimulus for this activation could be underfilling of the arterial system (reduced effective circulating volume) secondary to a fall in total peripheral vascular resistance. The latter is caused by hypercapnia-induced dilation of the precapillary sphincters. Apparently, the massive sodium retention by the kidney is not able to restore the circulating volume and a vicious cycle ensues ultimately leading to a clinical picture which resembles right-sided heart failure. Predictably, only blockade of the effects of carbon dioxide at the level of the precapillary sphincters would be able to halt this process.
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Affiliation(s)
- P W de Leeuw
- Dept of Medicine, University Hospital Maastricht, Maastricht, The Netherlands.
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23
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Theunissen CCW, Engelkens HJH, Mulder LJMM, Dees A. [Diagnostic image (107). A man with weight loss and skin nodes]. Ned Tijdschr Geneeskd 2002; 146:1832. [PMID: 12382368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A 63-year-old man who presented with loss of weight and skin nodes on head and hands was diagnosed with pulmonary carcinoma.
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Affiliation(s)
- C C W Theunissen
- Afd. Inwendige Geneeskunde, Ikazia Ziekenhuis, Montessoriweg 1, 3083 AN Rotterdam.
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24
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Van Bekkum JW, Bac DJ, Nienhuis IE, De Leeuw PW, Dees A. Life-threatening hypokalaemia and quadriparesis in a patient with ureterosigmoidostomy. Neth J Med 2002; 60:26-8. [PMID: 12074040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We report quadriparesis as a result of severe hypokalaemia and acidosis in a 50-year-old man who had undergone ureterosigmoidostomy for bladder extrophy 48 years earlier. Aggressive suppletion with intravenous potassium and bicarbonate combined with potassium-sparing diuretics and ACE inhibitors resulted in complete restoration of the serum potassium and resolution of the neurological symptoms. The underlying mechanism as well as the treatment of hypokalaemia and hyperchloraemic metabolic acidosis after ureterosigmoidostomy are briefly discussed.
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Affiliation(s)
- J W Van Bekkum
- Ikazia Hospital, Department of Internal Medicine, Rotterdam, The Netherlands.
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Abstract
A patient with a palpable mass in the breast suggestive of carcinoma underwent radical modified mastectomy. Surprisingly, histology of the tumor revealed an extramedullary plasmacytoma. Further diagnostic work up showed no evidence of underlying multiple myeloma. Among neoplastic lesions of the breast, although rare, malignancy of mesenchymal or lymphoproliferative origin should always be considered.
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Affiliation(s)
- C van Nieuwkoop
- Department of Internal Medicine, Ikazia Hospital, Montessoriweg 1, 3083 AN, Rotterdam, The Netherlands.
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26
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van der Kamp R, Nienhuis JE, Rosekrans PA, Dees A. [Two patients with emphysematous pyelonephritis]. Ned Tijdschr Geneeskd 2000; 144:713-6. [PMID: 10778721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
A 55-year-old man with diabetes mellitus was sick with shivering, abdominal pain and Escherichia coli in blood and urine cultures; a 40-year-old woman with asthmatic bronchitis had abdominal pain and anaemia. Both had renal dysfunction and the CT scan showed hydronephrosis with a perirenal inflammatory infiltrate and gas in the right and left renal pelvis, respectively. The man had a difficult recovery after treatment with antibiotics and percutaneous drainage. In the woman, a calculus obstructed the pyelo-ureteral passage; the resected kidney contained a squamous cell carcinoma. She was operated, received chemotherapy and recovered. Emphysematous pyelonephritis is a rare, severe disease. Percutaneous drainage and, if necessary, nephrectomy are paramount in the treatment. The condition is observed mostly in patients with diabetes mellitus or obstruction of the urinary tract.
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27
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van Jaarsveld BC, Krijnen P, Pieterman H, Derkx FH, Deinum J, Postma CT, Dees A, Woittiez AJ, Bartelink AK, Man in 't Veld AJ, Schalekamp MA. The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group. N Engl J Med 2000; 342:1007-14. [PMID: 10749962 DOI: 10.1056/nejm200004063421403] [Citation(s) in RCA: 540] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Patients with hypertension and renal-artery stenosis are often treated with percutaneous transluminal renal angioplasty. However, the long-term effects of this procedure on blood pressure are not well understood. METHODS We randomly assigned 106 patients with hypertension who had atherosclerotic renal-artery stenosis (defined as a decrease in luminal diameter of 50 percent or more) and a serum creatinine concentration of 2.3 mg per deciliter (200 micromol per liter) or less to undergo percutaneous transluminal renal angioplasty or to receive drug therapy. To be included, patients also had to have a diastolic blood pressure of 95 mm Hg or higher despite treatment with two antihypertensive drugs or an increase of at least 0.2 mg per deciliter (20 micromol per liter) in the serum creatinine concentration during treatment with an angiotensin-converting-enzyme inhibitor. Blood pressure, doses of antihypertensive drugs, and renal function were assessed at 3 and 12 months, and patency of the renal artery was assessed at 12 months. RESULTS At base line, the mean (+/-SD) systolic and diastolic blood pressures were 179+/-25 and 104+/-10 mm Hg, respectively, in the angioplasty group and 180+/-23 and 103+/-8 mm Hg, respectively, in the drug-therapy group. At three months, the blood pressures were similar in the two groups (169+/-28 and 99+/-12 mm Hg, respectively, in the 56 patients in the angioplasty group and 176+/-31 and 101+/-14 mm Hg, respectively, in the 50 patients in the drug-therapy group; P=0.25 for the comparison of systolic pressure and P=0.36 for the comparison of diastolic pressure between the two groups); at the time, patients in the angioplasty group were taking 2.1+/-1.3 defined daily doses of medication and those in the drug-therapy group were taking 3.2+/-1.5 daily doses (P<0.001). In the drug-therapy group, 22 patients underwent balloon angioplasty after three months because of persistent hypertension despite treatment with three or more drugs or because of a deterioration in renal function. According to intention-to-treat analysis, at 12 months, there were no significant differences between the angioplasty and drug-therapy groups in systolic and diastolic blood pressures, daily drug doses, or renal function. CONCLUSIONS In the treatment of patients with hypertension and renal-artery stenosis, angioplasty has little advantage over antihypertensive-drug therapy.
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Affiliation(s)
- B C van Jaarsveld
- Department of Internal Medicine, Erasmus University Hospital, Rotterdam, The Netherlands.
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28
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van den Meiracker AH, Dees A. [Hypertensive crisis: definition, pathophysiology and treatment]. Ned Tijdschr Geneeskd 1999; 143:2185-90. [PMID: 10578410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Hypertensive crises are currently subdivided into hypertensive emergencies and urgencies depending on the acuteness with which the elevated blood pressure has to be lowered. Malignant hypertension, defined as severe hypertension and a hypertensive fundus grade III or IV, can present itself as an emergency or an urgency. For a hypertensive emergency intravenously acting blood pressure lowering agents are almost always required, whereas an urgency can usually be treated with oral agents. In view of the danger of cerebral hypoperfusion, blood pressure reduction during the initial treatment phase of a hypertensive crisis should not be more than 20 to 25%. Agents that exert a controllable blood pressure lowering action are preferred. Controllable blood pressure lowering cannot be achieved with nifedipine capsules. The practice of biting and swallowing a nifedipine capsule for the treatment of a hypertensive crisis therefore is to be discouraged.
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29
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Abstract
A large pedunculated, polypoid mass in the duodenum of a patient with asymptomatic anaemia, with mucosal biopsies indicating a villous adenoma, turned out to be a liposarcoma during laparotomy. The patient had had a completely resected retroperitoneal liposarcoma 8 years before. Liposarcoma recurrence should be highly suspected even in case of atypical presentation and long disease free interval.
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Affiliation(s)
- F H Wolfhagen
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands.
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30
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van Jaarsveld B, Krijnen P, Bartelink A, Dees A, Derkx F, Man in't Veld A, Schalekamp M. The Dutch Renal Artery Stenosis Intervention Cooperative (DRASTIC) Study: rationale, design and inclusion data. J Hypertens Suppl 1998; 16:S21-7. [PMID: 9856380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
RATIONALE Renal artery stenosis may lead to renovascular hypertension, risking multiple organ damage including damage to the contralateral kidney. Progression of stenosis may impair the function of the affected kidney. It is important to identify individuals with this disease among hypertensive patients. The first aim of the Dutch Renal Artery Stenosis Intervention Cooperative (DRASTIC) study is to assess the prevalence of renal artery stenosis in patients with well-defined forms of drug-resistant hypertension, and to determine the predictive value of clinical characteristics and diagnostic tests in these pre-selected patients. With regard to treatment, the effect of renal angioplasty on hypertension is disappointing in atherosclerotic stenosis and technical failure frequently occurs. Therefore, the second aim is to compare the effects of balloon angioplasty and antihypertensive medication on blood pressure in patients with atherosclerotic renal artery stenosis. DESIGN HYPERTENSIVE patients receiving standard antihypertensive medication in whom diastolic blood pressure remained > or =95 mmHg during three consecutive visits to the outpatient clinic underwent full diagnostic work-up, including renal arteriography. The prevalence of renal artery stenosis in this well-defined patient group was then established, and the predictive value of the various diagnostic tests was assessed. Patients with an atherosclerotic renal artery stenosis of > or =50% were then randomly assigned to balloon angioplasty or to treatment with antihypertensive drugs. After 1 year of intensive follow-up of blood pressure and renal function, re-arteriography was performed. CONCLUSION In total, 1205 patients have been included in the study, about 500 have received diagnostic work-up, and it is expected that 100 patients will be randomly assigned for renal angioplasty or medical treatment.
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Affiliation(s)
- B van Jaarsveld
- Department of Internal Medicine I, University Hospital Dijkzigt, Rotterdam, The Netherlands
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31
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Bonapart IE, Nienhuis JE, Gravendijk RE, Jonkman JG, Dees A. [Hypertension with neurologic manifestations caused by an enlarged prostate]. Ned Tijdschr Geneeskd 1998; 142:1156-8. [PMID: 9623239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A 74-year-old man suffering from hypertension had transient loss of strength in his left arm and leg. His severe hypertensive spells were caused by high-pressure chronic bladder retention. The patient had benign hyperplasia of the prostate for which transvesical enucleation was performed. The blood pressure then returned to normal. The transient neurological deficits had probably been caused by the abrupt blood pressure changes. In older male patients the possibility of this reversible cause of hypertension should be kept in mind.
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Affiliation(s)
- I E Bonapart
- Afd. Inwendige Geneeskunde, Ikazia Ziekenhuis, Rotterdam
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32
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Abstract
A 69-year-old man developed cholestatic liver enzyme disturbances three and a half weeks after starting treatment with acenocoumarol because of a deep venous thrombosis in his leg. Serological testing showed no signs of recent viral infections. A presumptive diagnosis of hepatotoxicity caused by the use of acenocoumarol was made and the anticoagulant was replaced by low molecular weight heparin. Three weeks after withdrawal of the acenocoumarol, the enzymes had improved. The patient made a full recovery within two months. This case suggests a causal relationship between acenocoumarol exposure and liver damage.
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Affiliation(s)
- E L de Bruyne
- Ikazia Hospital, Department of Internal Medicine, Rotterdam, Netherlands
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33
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34
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Dees A, Kremer Hovinga T, Breed JG, Verstappen VM, Puister SM, Meems L. Calcium antagonists, a useful additional therapy in treatment resistant hypertension: comparison of felodipine ER and nifedipine Retard by 24-h ambulatory blood pressure monitoring. Neth J Med 1997; 50:2-12. [PMID: 9038037 DOI: 10.1016/s0300-2977(96)00077-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare the efficacy and tolerability of felodipine extended release (ER) 2.5 mg (F2.5) and 5 mg (F5) once daily with nifedipine Retard 10 mg (N20) and 20 mg (N40) twice daily as additional therapy in patients who remained hypertensive despite treatment with an ACE-inhibitor, beta-blocker or diuretic. DESIGN AND METHODS In a multicentre, double-blind parallel study, 61 men and 54 women, aged 35-75, with a supine diastolic blood pressure between 95 and 115 mmHg were randomised to treatment with F2.5, F5, N20 or N40 for 8 weeks, with optional doubling of the dose after 4 weeks. Blood pressure was measured at the office after 0, 4 and 8 weeks and by 24-h ambulatory monitoring (ABPM) after 0 and 4 weeks. Spontaneously reported adverse events and a subjective symptom assessment questionnaire were used for side-effect profiling. RESULTS Mean office systolic/diastolic blood pressure was clinically relevantly reduced in all treatment groups after 4 weeks by 8/7, 12/9, 11/9 and 18/11 mmHg for F2.5, F5, N20 and N40, respectively, and after 8 weeks (F2.5-5: 17/11 mmHg: F5-10: 18/14 mmHg; N20-40: 19/14 mmHg; N40-80: 25/14 mmHg) with no statistically significant differences between these groups. The lowest dose of felodipine (F2.5) was the least effective. After 4 weeks the ABPM showed consistent 24-h reductions in blood pressure (4/2; 8/5; 7/5; 10/6 mmHg, respectively) over 24 h for the felodipine ER 5 mg group only and for both nifedipine groups. No statistically significant difference between these groups was found. An office responder does not appear to be identical to an ambulatory one and vice versa. The adverse events, mostly oedema, flushing and headache, were dose-related. CONCLUSIONS Both felodipine ER and nifedipine Retard are effective "add-on' drugs in patients with monotherapy-resistant hypertension. The blood-pressure-lowering effect is dose-dependent and tolerability is inversely related to efficacy. The results emphasize the benefits of combining two agents with low doses.
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Affiliation(s)
- A Dees
- Department of Internal Medicine, Ikazia Ziekenhuis, Rotterdam, Netherlands
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35
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Abstract
Abdominal actinomycosis is a rare disorder. The diagnosis is frequently missed preoperatively. We describe a patient who had had an intrauterine contraceptive device in situ for 5 years. She presented with a painful pelvicoabdominal mass, located between the uterus and rectum, and a colitis-like disease of the distal colon. Culture of the removed IUD demonstrated Actinomyces. She was intensively treated with intravenously penicillin for six weeks. Following this conservative treatment the abdominal tumor and the colitis-like symptoms totally disappeared. During two years follow-up she is free of symptoms and no signs of recurrence of the disease have been noticed. The case described here strongly underlines that Actinomyces infection should be born in mind in the differential diagnosis of a young female with an IUD, presenting with colitis, fever and an abdominal mass. Prolonged intravenously administered penicillin is warranted before surgery should be considered.
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Affiliation(s)
- S K Nugteren
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands
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36
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Leebeek FW, Ouwendijk RJ, Kolk AH, Dees A, Meek JC, Nienhuis JE, Dingemans-Dumas AM. Granulomatous hepatitis caused by Bacillus Calmette-Guerin (BCG) infection after BCG bladder instillation. Gut 1996; 38:616-8. [PMID: 8707098 PMCID: PMC1383125 DOI: 10.1136/gut.38.4.616] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Bladder instillations with Bacillus Calmette-Guerin (BCG) are commonly used as immunotherapy for bladder carcinoma. Sometimes patients experience serious systemic side effects, such as sepsis or pneumonitis. Granulomatous hepatitis is a rare serious side effect, which has been considered a hypersensitivity reaction to BCG. PATIENT The first case of granulomatous hepatitis after BCG bladder instillation in which mycobacteria were identified by staining techniques and mycobacterial DNA was detected in liver tissue using the polymerase chain reaction is reported. CONCLUSION The granulomatous hepatitis was caused by BCG infection of the liver after haematogenous dissemination of BCG, rather than hypersensitivity.
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Affiliation(s)
- F W Leebeek
- Department of Internal Medicine, Ikazia Hospital Rotterdam, the Netherlands
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37
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Dees A, Weening RS, de Boer M, Baggen MG. Unexplained recurrent pneumonia: a post-childhood case of chronic granulomatous disease. Neth J Med 1995; 46:193-6. [PMID: 7760970 DOI: 10.1016/0300-2977(94)00088-q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A 31-year-old patient was recurrently admitted because of pneumonia. Specialised leukocyte function tests revealed the diagnosis of an X-linked type of chronic granulomatous disease. Treatment with interferon-gamma successfully prevented new infections.
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Affiliation(s)
- A Dees
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, Netherlands
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38
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Abstract
Two cases of acute left ventricular failure associated with severe essential hypertension are presented. On admission echocardiography indicated severe dyskinaesia of all wall segments of the heart. Anti-hypertensive treatment resulted in significant improvement in clinical and echocardiographic findings.
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Affiliation(s)
- C Veen
- Department of Medicine, Zuiderziekenhuis, Rotterdam, The Netherlands
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39
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Benner PM, Dees A, Ouwendijk RJ. [Dyspepsia... or something more?]. Ned Tijdschr Geneeskd 1992; 136:1889-91. [PMID: 1328902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- P M Benner
- Ikazia Ziekenhuis, afd. Interne Geneeskunde, Rotterdam
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40
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Abstract
A 63 year old woman had been intensively treated for recurrent carcinoma of the neck. Following acute vascular surgery of the carotid artery, she developed the vasodilatory type of the carotid sinus syndrome. The presentation of this type of the syndrome was remarkable, since it is usually associated with primary or metastatic carcinoma in the neck region. Previous cancer treatment may have modified the course of disease in this patient, which ultimately had a lethal outcome.
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Affiliation(s)
- A Dees
- Department of Medical Oncology, Rotterdam Cancer Institute, The Netherlands
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41
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Bontenbal M, Planting AS, Rodenburg CJ, Dees A, Verweij J, Bartels CC, Alexieva-Figusch J, van Putten WL, Klijn JG. Weekly low-dose mitoxantrone plus doxorubicin as second-line chemotherapy for advanced breast cancer. Breast Cancer Res Treat 1992; 21:133-8. [PMID: 1627816 DOI: 10.1007/bf01836959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Weekly low dose mitoxantrone (3 mg/m2) plus doxorubicin (8 mg/m2) was administered as second-line chemotherapy to 33 patients with advanced breast cancer. Four out of 28 evaluable patients (14%) obtained a partial response with a median duration of 34 weeks (range 18-67+ weeks), while 8 patients (29%) showed stable disease with a median duration of 28 weeks (range 11+-60 weeks). Gastrointestinal toxicity and alopecia were mild. Grade II and III leukopenia occurred in 63% of the courses without serious infectious disease. Four patients experienced an asymptomatic drop of 16-20% in the left ventricular ejection fraction (LVEF) after relatively low cumulative doses of each drug, and one patient with a history of pericarditis carcinomatosa and mediastinal irradiation developed a heart failure. In conclusion, this second-line combination treatment had moderate activity in breast cancer and caused only few subjective side effects, especially with respect to gastrointestinal symptoms.
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Affiliation(s)
- M Bontenbal
- Department of Medical Oncology, Rotterdam Cancer Institute (Dr Daniel den Hoed Cancer Center), The Netherlands
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42
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Dees A, Heysteeg M, de Leeuw PW. [Pulmonary hypertension and cor pulmonale caused by chronic obstructive lung disease; pathogenesis and treatment]. Ned Tijdschr Geneeskd 1991; 135:1120-4. [PMID: 1857437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- A Dees
- Afd. Interne Geneeskunde, Zuiderziekenuis, Rotterdam
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43
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Dees A, Kluchert SA, van Vliet AC. Pseudo-renal failure associated with internal leakage of urine. Neth J Med 1990; 37:197-201. [PMID: 2074911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Three patients with internal leakage of urine are described. As a result of urine resorption into the blood a condition developed resembling acute renal failure. Internal loss of urine is divided into intraperitoneal and extraperitoneal leakage and usually gives rise to oliguria and microscopic haematuria. In the intraperitoneal type increasing abdominal complaints and ascites will develop whereas in the extraperitoneal type regional oedema will become present without, in the case of sterile urine, abdominal complaints of importance. Important clues as to the diagnosis are the concentrations in serum and urine of urea, creatinine and sodium, and the demonstration of the leak by means of imaging techniques. Treatment of choice is a drainage procedure, for instance by a bladder catheter. In acute renal failure this pseudo form should be distinguished from the real thing.
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Affiliation(s)
- A Dees
- Department of Internal Medicine, Diakonessenhuis Refaja, Dordrecht
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44
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Abstract
Infection with the helminthic parasite, Strongyloides stercoralis, is usually acquired by skin invasion (or occasionally via ingestion of larvae). After transformation to the adult form, the parasite preferentially localises in the small intestine, especially in the duodenal and jejunal part. A remarkable feature of Strongyloides is its property of endogenous reinfection. In the case of an immunocompromised host a massive infection, called hyperinfections Strongyloides, may occur. Numerous gastrointestinal complications of strongyloides infections, sometimes with a lethal outcome, have been reported. The intestinal manifestations are usually limited to the small bowel, and rarely involve the stomach. We report a patient with complicated strongyloides infection of the stomach.
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Affiliation(s)
- A Dees
- Department of Medical Oncology, Rotterdam Cancer Institute/Daniel den Hoed Kliniek, The Netherlands
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45
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Dees A, Ligthart JL, van Putten WL, Planting AS, Stoter G. Mechanical ventilation in cancer patients. Analysis of clinical data and outcome. Neth J Med 1990; 37:183-8. [PMID: 2074909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Between 1984 and 1988, 49 medically treated cancer patients were ventilated in the intensive care unit (ICU) of our hospitals. The charts of these patients were analyzed retrospectively. Sixty-seven percent of patients died during ventilation; 24% were able to leave hospital. The remaining 9% were transferred from the ICU to the ward, but died shortly thereafter in hospital. Assessment of the severity of acute disease prior to intubation by means of the organ failure score or the APACHE-II score was strongly associated with outcome after ventilation.
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Affiliation(s)
- A Dees
- Department of Intensive Care, Rotterdam Cancer Institute
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46
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Dees A, Hoff AM, Mali SP, Hordijk ML. [When latex disintegrates, or a mechanical pyloric ulcer]. Ned Tijdschr Geneeskd 1990; 134:2011-3. [PMID: 2234165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Complications of Celestin oesophageal tube disintegration are discussed with reference to the case of a patient with a tube inserted because of extrinsic stenosis presenting with upper abdominal complaints.
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Affiliation(s)
- A Dees
- Afd. Interne Oncologie. Dr. Daniel den Hoed Kliniek, Rotterdam
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47
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Dees A, Schönfeld DH, Rodenburg CJ, Vecht CJ. Cerebral emboli in chronic intravascular coagulation detected by single photon emission computer tomography (SPECT). Ann Oncol 1990; 1:304-5. [PMID: 2265142 DOI: 10.1093/oxfordjournals.annonc.a057756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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48
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Dees A, Blok WL, de Leeuw PW. [Lowering of blood pressure, an easy job?]. Ned Tijdschr Geneeskd 1989; 133:1625-6. [PMID: 2797270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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49
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Dees A, Verweij J, van Putten WL, Stoter G. Mitomycin C is an inactive drug in the third-line treatment of hormone and chemotherapy refractory breast cancer. Eur J Cancer Clin Oncol 1987; 23:1343-7. [PMID: 3119346 DOI: 10.1016/0277-5379(87)90118-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Mitomycin C (MMC) is rarely used in first-line chemotherapy for advanced breast cancer, although the drug is reported to be active. Treatment with MMC is usually reserved for second- or third-line treatment. We have given MMC as second- or third-line treatment to 59 patients. Fifty-six patients were evaluable for response. No complete and only 3 partial responses were observed for an overall response rate of 5%. The median time to progression was 2 months and median survival time was 6 months. In this retrospective study MMC is demonstrated to be inactive in third-line chemotherapy.
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Affiliation(s)
- A Dees
- Department of Medical Oncology, Rotterdam Cancer Institute, The Netherlands
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