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Biomedical subjects

H Bobbaers

Publications and source records attributed to H Bobbaers.

At least 37 records · Page 2Linked to original sources
PubMed1998

Clinical spectrum associated with positive ANCA titres in 94 consecutive patients: is there a relation with PR-3 negative c-ANCA and hypergammaglobulinaemia?

OBJECTIVE: To calculate the positive predictive value (ppv) of cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCAs) and anti-proteinase 3 (PR 3) antibodies for Wegener's granulomatosis (WG) and to evaluate their association with other diseases. METHODS: The clinical files of all 94 patients who had a positive c- or perinuclear (p)-ANCA test, or both, in the laboratory of the University Hospital, Leuven between April 1995 and March 1996 and who attended the Internal Medicine Department of the hospital were retrospectively studied. RESULTS: Of the 94 patients with ANCAs (fluorescence titre > or = 1/40), 57 were c-ANCA positive and 45 p-ANCA positive (eight were simultaneously c- and p-ANCA positive). Of the 57 c-ANCA positive patients, 23 had WG. The ppv for WG thus was 40%. This value did not increase by defining a higher threshold for a positive ANCA. There was not a good relation between ANCA titres and disease activity in the WG patients, nor was there a relation between anti-PR 3 antibody levels and WG disease activity. The ppv of anti-PR 3 antibodies for WG however was very high (85%). There was a positive correlation between the level of (hyper) gammaglobulinaemia and c-ANCA titres in those patients with final diagnoses not known to be associated with c-ANCA. Forty five patients had positive p-ANCAs. The largest group were those with inflammatory bowel disease (n = 20, of whom the majority had colitis ulcerosa or primary sclerosing cholangitis, or both); the great majority of these patients had no anti-myeloperoxidase antibodies. Vasculitis was present in eight patients, of whom two had WG (both were also c-ANCA positive). CONCLUSION: There is a low ppv of c-ANCAs for WG, caused by a high percentage of PR 3 negative, positive c-ANCA determinations, possibly related to hypergammaglobulinaemia. Anti-PR 3 antibodies have a high ppv for WG. However, neither c-ANCA titre, nor the level of anti-PR 3 antibodies correlated with the activity of the disease.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1997

Intravascular catheter related bloodstream infection: epidemiology, pathogenesis and prevention.

Intravascular catheters are increasingly used in modern medicine. Unfortunately, infectious complications of catheter use are not rare. Clinical infection, however, is largely preventable. Over the past decade more knowledge has been gathered about the pathogenesis and epidemiology of these infections. Controlled clinical trials have allowed to formulate practice guidelines for prevention. Some controversies remain, however, and need to be resolved by further study.

Bandages↗
PubMed1997

Relief of sleep apnoea after treatment of acromegaly: report of three cases and review of the literature.

Sleep apnoea syndrome (SAS) is common in acromegalic patients. Occasionally, the relief of apnoeas after treatment of the acromegaly has been documented. We report the cases of three patients with acromegaly and severe obstructive sleep apnoea, who demonstrated a manifest improvement (respiratory disturbance index (RDI) <20) after treatment with octreotide, indicating that this drug may be effective in this disturbance. In one case, SAS disappeared although the growth hormone level was not fully normalized. This raises the intriguing hypothesis that octreotide has an effect on respiratory control or on the upper airway, that is not directly related to its action on production of growth hormone.

Acromegaly↗
PubMed1995

Linear IgA dermatosis: a new cause of fever of unknown origin.

We describe a 60-year-old patient who presented with prolonged fever, weight loss, adenopathies and malaise. Two months later, an aphthous stomatitis and pharyngitis developed, together with ulcerations bilaterally in the groin. Two separate skin biopsies revealed the diagnosis of linear IgA dermatosis. This entity, which is well known to dermatologists but not to internists, should be added to the extensive list of disorders than can provoke the syndrome of fever of unknown origin.

Autoimmune Diseases↗
PubMed1995

Case report: pseudotumoral pelvic retroperitoneal fibrosis associated with orbital fibrosis.

We report the case of a man with bilateral orbital fibrous pseudotumours and a large pelvic mass which was initially thought to be malignant. Sonographically guided transrectal core biopsies showed it to be a fibrotic retroperitoneal pseudotumour. The mass decreased after steroid therapy. The computed tomography and magnetic resonance imaging features of this unusual form of pelvic fibrosis as well as the association with heterotopic fibrosis are discussed.

Fibrosis↗
PubMed1994

Kaposi's sarcoma presenting as generalized lymphedema.

We present a HIV-1 seropositive patient with generalized lymphedema, due to a rare lymphangiomatous variant of Kaposi's sarcoma, successfully treated with interferon-alpha. The clinical presentation and treatment possibilities of Kaposi's sarcoma are reviewed.

Blotting, Western↗
PubMed1994

Is BCG vaccination against tuberculosis still indicated?

More than 70 years after the introduction of BCG vaccination into clinical practice many questions remain to be answered. Major trials produced conflicting results regarding the degree of protection of this vaccine against tuberculosis. Several factors which may contribute to the inconsistent results of these trials, are discussed. In developing countries continuation of routine BCG vaccination of infants is highly recommended considering the ease of administration, low cost, wide availability and safety on the one hand and the protection provided particularly against haematogenous spread of tuberculosis on the other hand. In developed countries the vaccine is reserved for high risk groups since the prevalence of tuberculosis in the general population declined dramatically during the past decades. However, as the incidence of tuberculosis in the Western world no longer decreases steeply and indeed increases again in some countries, and because (para-) medical personnel risks to be among the prime victims of this re-emergence of tuberculosis, rigorously sustained preventive measures to protect this professional category deserve renewed interest. Among those, BCG vaccination can be considered, especially in case of a high prevalence of multidrug-resistant tuberculosis, but also for the Belgian situation with a high degree of non-immune health care workers. Therefore, we believe that BCG vaccination still has a future.

Adolescent↗
PubMed1993

Nailfold capillaroscopy in connective tissue disorders and in Raynaud's phenomenon.

This article focuses on the value and the limitations of nailfold capillaroscopy in the differential diagnosis of certain connective tissue diseases and in the early recognition of secondary Raynaud's phenomenon. The finding of a "scleroderma-pattern" (apical enlargement and drop-out of capillaries) points almost certainly to an underlying progressive systemic sclerosis, mixed connective tissue disease or dermatomyositis.

Arthritis, Rheumatoid↗
PubMed1993

Recurrent meningococcal infections in a patient with congenital C5 deficiency.

A congenital C5 deficiency was the cause of recurrent meningococcal disease in a 27-year-old man. The lack of serum bactericidal activity accounts for the higher incidence and the different course of Neisseria infections in patients with a deficiency of the late complement components. Early antibiotic treatment and vaccination with a capsular polysaccharide meningococcal vaccine (A,C,Y,W-135) should be considered.

Adult↗
PubMed1993

Fluconazole-resistant Cryptococcus neoformans var gattii in an AIDS patient.

We describe a case of meningitis due to Cryptococcus neoformans var gattii in an AIDS patient. The reasons for the observed predominance of C. neoformans var neoformans infections in AIDS patients living in areas endemic for the gattii variety are not understood thus far. Treatment with fluconazole resulted in poor clinical and mycological response. In vitro sensitivity testing of the fungus revealed high minimal inhibitory concentrations, suggesting fluconazole resistance. Treatment with amphotericin B was successful.

AIDS-Related Opportunistic Infections↗
PubMed1991

Immunophenotypic analysis of histiocytes involved in AIDS-associated Mycobacterium scrofulaceum infection: similarities with lepromatous lepra.

The present study reports a rare case of systemic M. scrofulaceum infection in an AIDS patient and analyses the inflammatory infiltrate in a lymph node by immunohistochemistry. Special emphasis is put on the histiocytes. The diffuse infiltrate consists mainly of large histiocytes that contain numerous bacilli. These cells display the phenotype of mature histiocytes and in addition coexpress the antigens recognized by RFD7 and RFD9, both markers of different subsets of histiocytes which have been reported to be co-expressed by the infected histiocytes in the infiltrate of lepromatous lepra. Interdigitating reticulum cells are rare as well as T cells which are mainly of the suppressor/cytotoxic type. These findings are similar to those reported for lepromatous lepra and might indicate common deficiencies in T cell-macrophage interactions in both conditions. Superimposed on the diffuse infiltrate of large histiocytes we observed 'monocytic granulomas', the presence of which might be related to a reactional state comparable to erythema nodosum leprosum, a reactional state of lepromatous lepra.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Frequency dependence of pulmonary compliance and resistance in patients with obstructive lung disease.

The frequency dependence of pulmonary compliance and resistance was investigated in 27 patients with obstructive lung disease. Compliance and resistance were determined either by the conventional zero crossing (Cdyn) and isovolume (RL) technique or by a modified Fourier analysis following a smoothing procedure (auto- and cross-correlation function) yielding an effective compliance and resistance, CL and RL. The latter technique was used to calculate CL and RL from the fundamental and third and fourth harmonics present in the flow and transpulmonary pressure signals. Three breathing frequencies were investigated: 0.5, 1, and 2 Hz. Both Cdyn and CL, calculated from the fundamental component, decreased progressively with frequency. However, Cdyn showed less frequency dependence than CL. CL calculated from the harmonics was significantly smaller than CL from the fundamental at the same breathing frequency. RL, as well as RL calculated from the fundamental, tended to increase with frequency. A decline of resistance with frequency became apparent, however, when RL from the fundamental was compared with RL obtained from the corresponding higher order harmonics. These results suggest that the frequency dependence of resistance can be masked by the usual procedure of breathing at several frequencies. Instead the measurements should be performed at a single frequency, for instance spontaneous breathing, by computing resistance from the higher order harmonics present in the breathing signals.

Adolescent↗
PubMed1984

Pulmonary resistance and compliance by auto- and cross-correlation functions of transpulmonary pressure and flow.

A technique is described on how to calculate the pulmonary resistance and compliance from the higher order harmonics present in mouth flow and transpulmonary pressure signals during spontaneous breathing. The estimates of resistance and compliance (or rather reactance) obtained from these harmonics following a conventional Fourier transform are not reliable because of a lack of reproducibility. This is obviated by a preliminary smoothing of the signals by means of auto- and cross-correlation functions. Both the conventional and the modified technique yield identical results for the fundamental component of breathing.

Adolescent↗