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Biomedical subjects

J Clement

Publications and source records attributed to J Clement.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Hantavirus infections in Belgium].

Hantavirus disease is a recently recognised zoonosis. The main vectors are infected but healthy wild rodents or laboratory rats. Transmission to man occurs via contact with, or inhalation of aerosolised excretions. The target organs in man are the kidney (Old World) or the lung (New World), probably via a local hyperproduction of pro-inflammatory cytokines. To date, more than 33 different hantaviruses have been characterised, at least 14 of them being of clinical importance. Each serotype has its own rodent vector and its own geographical spread. In Europe, the red bank vole (Clethrionomys glareolus) is the main rodent vector, carrying the Puumala (PUU) serotype, which is the etiologic agent of a viral affection known as Nephropathia epidemica (NE). PUU infection has been recognised for the first time in Belgium in 1983. From this date on, approximately 500 cases have been diagnosed. In our regions, a diagnosis of hantavirus disease is mandatory when a febrile patient presents with lumbaches, headache, and an acute renal failure with proteinuria, and particularly with thrombocytopenia.

Animals↗
PubMed1997

Advanced practice psychiatric nursing: a national profile.

The results of a national survey of Advanced Practice Psychiatric Nurses (APPN) are presented. Results are based on the Society for Education and Research in Psychiatric/Mental Health Nursing's (SERPN) Primary Mental Health and Advanced Practice Psychiatric Nursing monograph. Characteristics of the nurses, the clients they serve, and their practice patterns are described. Documenting the cost-effectiveness of these practitioners and increasing the number of younger APPNs is recommended.

Educational Status↗
PubMed1997

A comparative analysis of revenue and cost-management strategies of not-for-profit and for-profit hospitals.

Not-for-profit (NFP) and for-profit (FP) hospitals were compared on several performance indicators including revenues, costs, productivity/efficiency, and profitability. The indicators were adjusted, where appropriate, for outpatient activity and a case-mix index for all patients. FP hospitals had higher profit margins as well as higher gross and net revenues per case-mix adjusted admission. On the other hand, NFP hospitals had lower total cost per case-mix adjusted admission even after subtracting taxes from FP hospital costs. There were no significant differences between the two groups on efficiency and productivity indicators--paid hours per case-mix adjusted admissions, occupancy levels, and case-mix adjusted ALOS. The higher profits of FP hospitals were attributed to revenue management rather than cost and efficiency management.

Analysis of Variance↗
PubMed1996

Correlation between ELISA, hemagglutination inhibition, and neutralization tests after vaccination against tick-borne encephalitis.

The significance of IgG antibody levels determined by a binding assay (ELISA) was investigated as a surrogate marker for the presence of neutralizing and hemagglutination inhibiting antibodies in sera from individuals vaccinated against tick-borne encephalitis (TBE). To assess the extent of interference by flavivirus cross-reactive antibodies, sera from persons with a proven or suspected history of other flavivirus infections and/or vaccinations were also examined. An excellent and highly significant correlation was found between ELISA IgG units and the antibody titers obtained by the hemagglutination inhibition (HI) as well as by the neutralization test (NT), provided that there was no other exposure to flavivirus antigens except TBE vaccination. Yellow fever vaccination and/or dengue virus infections induced significant levels of antibodies reactive in the TBE ELISA and HI test, which did not exhibit, however, neutralizing activity against TBE virus. The phenomenon and problem of "original antigenic sin" was demonstrated in a TBE vaccinee with a history of previous flavivirus infections. TBE vaccination first induced a booster reaction resulting in a rise in the level of cross-reactive antibodies only, whereas TBE virus-neutralizing antibodies became detectable only after the third vaccination. It is concluded that the level of IgG antibodies determined by ELISA is a good marker for predicting the presence of neutralizing antibodies after TBE vaccination, but only in the absence of flavivirus cross-reactive antibodies. Otherwise, a neutralization assay is necessary for assessing immunity.

Animals↗
PubMed1996

Kill kinetics of antimicrobial agents against Helicobacter pylori.

We evaluated the activity of clarithromycin, 14-OH clarithromycin, amoxycillin, bismuth, metronidazole and ciprofloxacin against six strains of Helicobacter pylori to determine if there were differences in response to these antimicrobial agents during growth in vitro. Clarithromycin and its 14-hydroxy-metabolite exhibited an early bactericidal activity with at least a 3 log10 reduction after 2-8 incubation. Exposure to bismuth, ciprofloxacin and metronidazole resulted in a > 3 log reduction by 24 h with the greatest decrease in viability occurring between 8 and 24 h. The viable count of three strains was reduced by a 1-2 log10 after 24 h exposure to amoxycillin and by a > 3 log10 after 48 h.

Amoxicillin↗
PubMed1995

Canine Lyme disease in Belgium.

Lyme borreliosis is a multisystem disease caused by the tick-borne spirochaete Borrelia burgdorferi. In addition to causing human illness, borreliosis has been recorded in many species of mammals, including domestic animals which come into contact with the infected tick vector. This paper describes the first two cases to the authors' knowledge of Lyme borreliosis in dogs in Belgium. Both animals suffered recurrent lameness and general prostration. In addition, one of the dogs had recurrent paralysis of nerves V, VII, IX and X, leading to dysphagia and total bilateral paralysis of the mandibular muscles. This complication of Lyme borreliosis has been well documented in human pathology, but has not previously been recorded in the veterinary literature.

Animals↗
PubMed1995

Efficacy of AZT therapy in reducing p24 antigen burden in a modified SCID mouse model of HIV infection.

A modified severe combined immunodeficient (SCID) mouse model of HIV infection which utilized multiple reconstitutions with human lymphocytes and a large inoculum of HIV was investigated. This mouse model yielded splenic HIV p24 antigen concentrations detectable by standard clinical means. The concentration of p24 exceeded 600 pg/g of spleen through 4 weeks postinfection. A 1-week course of AZT therapy initiated after infection produced a dose responsive reduction in p24 antigen burden. Up to a 95% reduction in p24 antigen burden was observed following AZT therapy at 50 mg/kg/day, while AZT therapy at 5 and 0.5 mg/kg/day produced 52 and 18% reductions. In vitro and pharmacokinetic evaluations correlated potency and tissue concentrations of AZT with treatment efficacy. Active HIV replication in the SCID mice was suggested by both the recovery of viable virus from SCID spleens, and by the efficacy of a brief course of AZT therapy. This SCID mouse model of HIV infection was more quantitative than previous mouse models that utilize PCR-based techniques for detection of HIV. The high HIV burden in this SCID mouse model allowed reductions in p24 concentration to be monitored in response to AZT therapy. A dose response to AZT therapy was demonstrated, even when the first dose was administered after infection. This result suggests greater sensitivity than in previous models in which pretreatment with AZT was required to produce a protective response. This SCID mouse model may be useful for determining efficacy of experimental HIV therapeutics prior to clinical use. An effective animal model could result in a reduction in cost and more rapid development of effective HIV therapeutics.

Animals↗
PubMed1995

Epidemiology and laboratory diagnosis of hantavirus (HTV) infections.

Hantavirus (HTV) is recently discovered "hemorrhagic fever virus" belonging to the Bunyaviridae family, which is spread throughout the world by wild rodents and/or laboratory rats. During an epidemic in the Belgian-French Ardennes in 1993, more than 200 acute cases were recorded of the milder European form of HTV-illness, otherwise known as Nephropathia epidemica (NE). This variant may be recognized by the sudden onset of fever, acute renal failure, thrombocytopenia and sometimes by ophthalmologic complications. The symptomatology is rather aspecific and diagnosis can only be confirmed by serologic tests, of which the best option nowadays seems to be: screening by IgG EIA, followed by IgM confirmation with a mu-capture EIA test. Some of the tests described allow an evaluation of the causative serotype or even the moment of infection. Next to the "classic" serologic assays for detection of specific viral antibodies, we describe briefly our own experience with newer tests such as "high density particle agglutination" and "line immuno assay". Polymerase chain reaction for viral RNA genome typing and immunohistochemical colouring of the viral antigen in tissues seem to offer promising alternatives for the immediate future.

Belgium↗
PubMed1995

[Epidemic of hantavirus disease in Entre-Sambre-et-Meuse: year 1992-1993. Clinical and biological aspects].

A multihospital study allowed us to follow a total of 62 serologically proven cases of Nephropathia epidemica (NE) in the Belgian region between Sambre and Meuse during the 1992-1993 period. The clinical picture consisted of sudden high fever (100% of the cases), headache (71%), abdominal or lumbar pains (80%) and, as a less frequent but very specific sign, acute myopia (24%). Non-specific respiratory symptoms such as a non-productive cough and an abnormal lung auscultation were found in 1 case out of 4. Frequent laboratory anomalies were thrombocytopenia (69%), left-shift leucocytosis (77%), abnormal LDH (69%) and an inflammatory syndrome (86%) with levels of C-reactive protein (CRP) elevated up to a mean of 102 mg/L, often accompanied by a marked fall of total serum cholesterol and a rise of triglycerides. Impaired kidney function is the rule (84%), nevertheless serum creatinine levels remain inferior to 150 mumol/L (1.7 mg%) in 25% of the patients. As for neurological signs, 1 case of encephalitis and 1 syndrome of Guillain-Barré were observed. Relative bradycardia (< 90 bpm) was noted in 50% of the cases with fever, whereas Doppler-echocardiography detected pericarditis in 1 case, and transient impairment of the left ventricle function in 3 cases. Frequent elevation of liver enzymes (46%) confirms the observation that from now on, Hantavirus infections should be considered in the differential diagnosis of viral hepatitis. One severe case was observed with shock, diffuse intravascular coagulation and adult respiratory distress syndrome (ARDS), followed by 5 other patients presenting with marked degrees of hypoxemia and hypocapnia. We conclude that not only the causative Hantaviral serotype, but also the degree of "systemic inflammatory response syndrome" (SIRS) seems to determine the clinical picture in Hantavirus infections.

Adolescent↗
PubMed1995

Efficacies of ABT-719 and related 2-pyridones, members of a new class of antibacterial agents, against experimental bacterial infections.

The 2-pyridones are a new class of broad-spectrum orally bioavailable antibacterial agents. These compounds are potent bacterial DNA gyrase inhibitors which differ from fluoroquinolones by placement of the nitrogen atom in the ring juncture. ABT-719 is an S isomer and a representative 2-pyridone. ABT-719 administered orally or subcutaneously was 4- to 10-fold more effective than ciprofloxacin against Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes infections in normal mice. ABT-719 was equivalent in efficacy to ciprofloxacin for treatment of gram-negative bacterial infections caused by Pseudomonas aeruginosa or Escherichia coli. The racemate and R forms of ABT-719 produced similar results against gram-positive and gram-negative bacterial infections. The 50% effective doses of ABT-719 were at least threefold lower than those of ciprofloxacin for therapy of intracellular infections caused by Salmonella typhimurium or Listeria monocytogenes. In immunosuppressed mice, ABT-719 was more effective than ciprofloxacin against quinolone-sensitive S. aureus, Enterococcus faecalis, and Enterococcus faecium. The pharmacokinetic properties of ABT-719 were consistent with its relative efficacy. The 2-pyridones are potent, orally available antibacterial agents with efficacy against gram-positive and gram-negative bacterial infections in mice.

Animals↗
PubMed1995

Increased production of nitric oxide in patients infected with the European variant of hantavirus.

Serum nitrate levels, a measure of nitric oxide (NO) production in vivo, were very high (95 +/- 14 microM) in 13 patients infected with Puumala virus, the European variant of Hantavirus (HTV), as compared to those in healthy subjects (33 +/- 3 microM). Serum nitrate levels showed a high and significant correlation with scores on the Acute Physiological And Chronic Health Evaluation (APACHE II) scale and with serum creatinine, and an inverse correlation with platelet counts. Serial serum measurements of nitrate in 2 severe cases showed very high levels at the onset of arterial hypotension and acute renal failure. We conclude that excessive amounts of NO are produced in patients infected with Puumala virus and that this reactive nitrogen intermediate could play an important role in the pathogenesis of the disease.

Acute Disease↗