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Search Results: 1 - 10 of 594313 matches for " Micha?l A Kuiper "
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Pneumopericardium should be considered with electrocardiogram changes after blunt chest trauma: a case report
Arjan JM Konijn, Peter HM Egbers, Michal A Kuiper
Journal of Medical Case Reports , 2008, DOI: 10.1186/1752-1947-2-100
Abstract: We report a rare case of pneumopericardium with extreme ECG abnormalities after blunt chest trauma in a 22-year-old male. The diagnosis was confirmed using computed tomography (CT) scanning. The case is discussed, together with its differential diagnosis and the aetiology of pneumopericardium and tension pneumopericardium.Pneumopericardium should be distinguished from other pathologies such as myocardial contusion and myocardial infarction because of the possible development of tension pneumopericardium. Early CT scanning is important in the evaluation of blunt chest trauma.When an electrocardiogram (ECG) is obtained during the diagnostic processing and evaluation of a trauma patient (as in the present case), it is important to realize that ECG findings in patients with cardiac trauma are diverse and non-specific. These findings may be non-specific ST-segment or T-wave changes, axis deviation and dysrhythmias, such as premature atrial contractions, bundle branch blocks and ventricular fibrillation [1]. Diagnostic considerations in a patient with blunt chest trauma and ECG abnormalities include, amongst others, myocardial contusion and myocardial ischaemia. Other causes involve the presence of air in thoracic structures that do not normally contain air, for example pneumothorax, pneumomediastinum and pneumopericardium. These options are discussed in a stepwise manner and related to the patient in this case report.A 22-year-old male, with no previous medical history, was admitted to the intensive care unit (ICU) at our hospital with blunt thoracic trauma and near-drowning after a high-energy trauma. The man had been driving a car when, for no apparent reason, he lost control and drove into a ditch filled with water.The patient consequently aspirated water, but managed to reach solid ground. He was transported by ambulance to the hospital emergency unit, where he was found to be in respiratory failure, probably as a result of severe lung contusion. He was subsequently
Diagnosing Sporadic Creutzfeldt-Jakob Disease in a Patient with a Suspected Status Epilepticus in the Intensive Care Unit
Harm J. van der Horn,Peter H. Egbers,Michal A. Kuiper,Wouter J. Schuiling
Case Reports in Neurological Medicine , 2013, DOI: 10.1155/2013/630141
Diagnosing Sporadic Creutzfeldt-Jakob Disease in a Patient with a Suspected Status Epilepticus in the Intensive Care Unit
Harm J. van der Horn,Peter H. Egbers,Michal A. Kuiper,Wouter J. Schuiling
Case Reports in Neurological Medicine , 2013, DOI: 10.1155/2013/630141
Abstract: Objective. Several tests are available in the diagnostics of sporadic Creutzfeldt-Jakob disease (sCJD); however, none of these is conclusive. We review the values of these tests, from an intensive care unit (ICU) perspective. Methods. Case report and review of the literature. Results. A 53-year-old woman initially presenting with psychiatric symptoms developed myoclonus and was admitted 1 month later to the ICU with a suspected nonconvulsive status epilepticus and respiratory insufficiency, probably due to extensive antiepileptic drug therapy. Typical MRI and EEG findings and a positive 14-3-3 protein led to the diagnosis of sCJD. All treatments were terminated, and autopsy confirmed sCJD. Conclusions. Clinical signs combined with MRI, EEG, and 14-3-3 and/or tau protein determination might be sufficient to diagnose or exclude sCJD and may therefore prevent the application of unnecessary diagnostic tests. 1. Introduction Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare fatal neurodegenerative disease, and key symptoms are rapidly progressive dementia, myoclonus, ataxia, and visual disturbances. Seizures, however, are an uncommon feature in this disease [1]. We report a patient with a suspected refractory status epilepticus in the intensive care unit (ICU), who was ultimately diagnosed with sCJD. The value of the available diagnostic tests will be discussed, and we raise the question whether a combination of diagnostic tests may be sufficient for diagnosing sCJD. 2. Case Presentation The case involved a 53-year-old woman. Except for a postnatal depression and a uterus extirpation, there were no previous other illnesses. About one month before admission to the ICU, she had started to exhibit aberrant emotional behavior. Seventeen days prior to ICU admission she presented with symptoms of derealization, gait abnormalities, and visual hallucinations at the neurology clinic of a local rural hospital and was admitted subsequently. Computed tomography (CT) and magnetic resonance imaging (MRI) scans were initially interpreted as normal; however, reexamination of the images at a later stage showed abnormalities similar to those found on more recent imaging. As her condition deteriorated with increasing confusion, psychosis, and a suspected catatonic state, she was transferred to the psychiatric department of our hospital 5 days later. A neurologist was consulted, and a lumbar puncture was performed. Subsequent cerebral spinal fluid (CSF) analysis showed no signs of infection and no local immunoglobulin G (IgG) production, and no neurologic diagnosis was made
Cumulative lactate and hospital mortality in ICU patients
Paul A van Beest, Lukas Brander, Sebastiaan PA Jansen, Johannes H Rommes, Micha l A Kuiper, and Peter E Spronk
Annals of Intensive Care , 2013, DOI: 10.1186/2110-5820-3-6
Abstract: Hyperlactatemia is associated with in-hospital mortality in a heterogeneous ICU population. In our patients, lactate peak values predicted in-hospital mortality equally well as lactate-time-integral of arterial blood lactate levels above the upper normal threshold.
PSR B1929+10 Revisited in X-Rays
A. Wozna,L. Kuiper,W. Hermsen
Physics , 2003, DOI: 10.1051/0004-6361:20040368
Abstract: This article has been withdrawn because it was submitted twice unintentionally.
Clinical review: use of venous oxygen saturations as a goal - a yet unfinished puzzle
Paul van Beest, G?tz Wietasch, Thomas Scheeren, Peter Spronk, Michal Kuiper
Critical Care , 2011, DOI: 10.1186/cc10351
Abstract: Shock is defined as global tissue hypoxia secondary to an imbalance between systemic oxygen delivery (DO2) and systemic oxygen demand (VO2). Unrecognised and untreated global tissue hypoxia increases morbidity and mortality. Accurate detection of global tissue hypoxia is therefore of vital importance. Physical findings, vital signs, measuring central venous pressure and urinary output are important but insufficient for accurate detection of global tissue hypoxia [1-3]. Measurement of mixed venous oxygen saturation (SvO2) from the pulmonary artery has been advocated as an indirect index of tissue oxygenation [4]. As a result of an extensive debate in the literature [5-7], however, use of the pulmonary artery catheter has become somewhat unpopular. In contrast, insertion of a central venous catheter in the superior vena cava via the jugular of the subclavian vein is considered standard care in critically ill patients. Just like SvO2, the measurement of central venous oxygen saturation (ScvO2) has been advocated in order to detect global tissue hypoxia.Venous oxygen saturations have been the subject of research for over 50 years, but especially over the past decade the amount of literature describing changes in ScvO2 and SvO2 in critically ill patients, including high-risk surgical patients, increased substantially. This led to high expectations with respect to the use of venous oxygen saturation as a therapeutic goal. The aim of the present review is to summarise the evidence and to discuss the clinical utility of both SvO2 and ScvO2 in the treatment of critically ill patients, including high-risk surgical patients.We performed a search of the PUBMED database from 1980 to 2010 using combinations of the following terms: SvO2, ScvO2, venous oxygen saturation, venous saturation, critically ill, shock, septic shock, high risk surgery, surgery, operation. The articles published in English were included when published in a peer-reviewed journal. The clinical investigations
Phosphate and Nitrate Release from Mucky Mineral Soils  [PDF]
Michal A. Leblanc, Léon E. Parent, Gilles Gagné
Open Journal of Soil Science (OJSS) , 2013, DOI: 10.4236/ojss.2013.32012

High-organic (mucky) mineral soils make a small proportion of the Canadian agricultural land but are highly productive, especially for organic farming. Although these high-quality soils may release large amounts of nitrate and phosphate to the environment, there is yet no reliable agro-environmental indicator for managing N and P compared to the adjacent mineral and organic soils. Our objective was to quantify the N mineralization and P environmental risks of mucky mineral soils. Nine Canadian soil series (eight Orthic Humic Gleysols and one Terric Humisol with three variants) were analyzed for texture, pH(CaCl2), total C and N, oxalate and Mehlich-III (M-III) extractable P, Al and Fe, and water extractable P (Pw). Soil texture varied from loamy sand to heavy clay, organic carbon (OC) content ranged from 14 to 392 g·OC·kg-1, total N from 1.21 to 16.38 g·N·kg-1, and degree of P saturation (DPSM-III) as molar (P/[Al + γFe])M-III percentage between 0.3% and 11.3%. After 100 d of incubation, soils released 31 to 340 mg·N·kg-1. The N mineralization rate was closely correlated to organic matter content (r = 0.91, p < 0.01). Sandy to loamy soils released 1.2 - 1.8 kg·N·ha-1·d-1 compared to 1.6 - 2.4 kg·N·ha-1·d-1 for clayey soils, 2.0

High-Energy Observations of the Binary Millisecond Pulsar PSR J0218+4232
L. Kuiper,W. Hermsen,F. Verbunt,T. Belloni,A. Lyne
Physics , 1998,
Abstract: We report the detection of pulsed X-ray emission ($4.9\sigma$) from the binary millisecond pulsar PSR J0218+4232 in a 100 ks ROSAT HRI observation. The pulse profile shows a sharp main pulse and an indication for a second weaker pulse at $\sim$ 0.47 phase separation. The pulsed fraction is 37 \pm 13%. PSR J0218+4232 was several times in the field of view of the high-energy $\gamma$-ray telescope EGRET and a source positionally consistent with the pulsar was detected above 100 MeV. Spatial and timing analyses of EGRET data indicate that the source is probably multiple: Between 0.1 GeV and 1 GeV PSR J0218+4232 is the most likely counterpart, while the BL Lac 3C66A is the best candidate above 1 GeV. If part of the EGRET signal truly belongs to the pulsar, then this would be the first millisecond $\gamma$-ray pulsar.
Deformed diffusion and generalized Laplacian for directed networks
Michal Fanuel,Johan A. K. Suykens
Physics , 2015,
Abstract: A diffusion equation on a complex network is usually implemented with the help of the combinatorial Laplacian which incorporates information about the network structure. In this paper, a deformed diffusion equation on directed networks, governed by a generalized Laplacian, is introduced within a framework of discrete differential forms, closely related to combinatorial Hodge theory. Edge directions are incorporated with the help of an edge flow $1$-form, whose deforming impact is controlled by a coupling constant. Hence, information about the community structure is encoded in the dominant modes in the long time limit. On the one hand, for a small deformation of the combinatorial Laplacian, the dominant modes of the deformed diffusion allow to uncover community structures which are only encoded in the edge directions. We show that the dynamics distinguishes two categories of nodes, i.e. the nodes with a majority of outgoing links from the nodes with a majority of incoming links. Furthermore, the categorization naturally implements the connectivity of nodes and hence, goes beyond a simple degree counting. On the other hand, in the case of maximal deformation, the dominant modes of the dynamics characterize important nodes of the directed network that we name Bi-directional Outer Cores (BOC's) and Bi-directional Inner Cores (BIC's) which are the analogue of connected components of undirected networks. These BIC's and BOC's are shown to support stationary distributions. The relevance of these aspects is illustrated on a series of artificial and real-life directed networks such as a food web and a neuronal network.
Acute posthypoxic myoclonus after cardiopulmonary resuscitation
Bouwes Aline,van Poppelen Dani?l,Koelman Johannes HTM,Kuiper Michael A
BMC Neurology , 2012, DOI: 10.1186/1471-2377-12-63
Abstract: Background Acute posthypoxic myoclonus (PHM) can occur in patients admitted after cardiopulmonary resuscitation (CPR) and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP) and electroencephalogram (EEG). Methods Patients with acute PHM (focal myoclonus or status myoclonus) within 72 hours after CPR were retrospectively selected from a multicenter cohort study. All patients were treated with hypothermia. Criteria for cortical origin of the myoclonus were: giant SEP potentials; or epileptic activity, status epilepticus, or generalized periodic discharges on the EEG (no back-averaging was used). Good outcome was defined as good recovery or moderate disability after 6 months. Results Acute PHM was reported in 79/391 patients (20%). SEPs were available in 51/79 patients and in 27 of them (53%) N20 potentials were present. Giant potentials were seen in 3 patients. EEGs were available in 36/79 patients with 23/36 (64%) patients fulfilling criteria for a cortical origin. Nine patients (12%) had a good outcome. A broad variety of drugs was used for treatment. Conclusions The results of this study show that acute PHM originates from subcortical, as well as cortical structures. Outcome of patients admitted after CPR who develop acute PHM in this cohort was better than previously reported in literature. The broad variety of drugs used for treatment shows the existing uncertainty about optimal treatment.
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