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Biomedical subjects

M Peeters

Publications and source records attributed to M Peeters.

At least 127 records · Page 7Linked to original sources

Short-term ventilatory effects in workers exposed to fumes containing zinc oxide: comparison of forced oscillation technique with spirometry.

Following the occurrence of metal fume fever in some subjects after the installation of an electric furnace in a steel plant, a survey was undertaken to examine whether subjects exposed to fumes containing zinc oxide would exhibit a detectable impairment in ventilatory function, and whether a forced oscillation technique (FOT) was more suited for this detection than conventional spirometry. Pulmonary function measurements were made in 57 exposed workers (production or maintenance) and 55 nonexposed workers (maintenance or strandcasting department) at the beginning and near the end of a work shift (day or night). Maximal expiratory volumes and flows were measured by means of a pneumotachograph, and respiratory resistance (Rrs) and reactance at various frequencies by means of a FOT. These measurements were repeated 1 day later. During the day shift, there were no significant differences in pulmonary function between exposed and control workers. However, during the night shift, an influence of exposure on pulmonary function was revealed both by spirometry and by FOT: workers exposed at night showed a slight decrease in vital capacity (VC) and in forced expiratory volume in one second (FEV1), and a decline in respiratory resistance (Rrs) with oscillation frequency, that were more marked than in unexposed subjects. In contrast to the frequency dependence of Rrs, the changes of lung volumes and expiratory flows were related to differences in initial values between exposed and nonexposed workers. The decrease in FEV1 was maintained the day after exposure. The forced oscillation technique proved at least as sensitive as spirometry to detect small across-shift changes in ventilatory function. Although the effects on pulmonary function were small, it is likely that they represent a subclinical response to the inhalation of small quantities of zinc oxide.

Adult↗

Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study.

OBJECTIVES: It is generally believed that the mucosal inflammation in ulcerative colitis is characterized by a diffuse, continuous involvement starting from the rectum without "skip areas." It was the aim of this study to examine 20 patients with established "left-sided ulcerative colitis" prospectively by ileocolonoscopy with biopsies to determine the extent and the continuity of the mucosal inflammation and the incidence of skip lesions in ulcerative colitis. METHODS: Twenty patients with left-sided ulcerative colitis underwent a complete ileocolonoscopy with biopsies of the terminal ileum and all colonic segments. The patients remained in clinical follow-up for at least 8 yr after the initial examination. RESULTS: The upper margin of inflammation was sharply demarcated in 6 patients and gradual in 14. Segmental inflammation, separated from the distal inflamed segment by apparently uninvolved mucosa, was found in 15 patients (75%) and always included the area around the appendiceal orifice. The correlation between endoscopic abnormalities and histological changes was excellent. CONCLUSION: In so-called "left-sided" ulcerative colitis distal involvement may be accompanied by more proximal areas of inflammation, particularly in the periappendiceal area of the cecum.

Adolescent↗

Breath tests in Helicobacter pylori infection: methodological aspects.

The urea breath test (*C-UBT) is generally considered as a simple, non-invasive and accurate test to demonstrate Helicobacter pylori (Hp) infection. Sensitivity and specificity vary between 95-100%. Some authors even claim that this test should be considered 'gold standard' for the detection of active Hp infection. Although today many centres already use this test in clinical praxis, there exists no uniformity in test protocol. Most modifications recently published in literature, had only minor impact on the accuracy of the test. More important than 'inventing' the n'th *C-UBT, there is a need for a consensus on features such as: which isotope, is a test meal necessary and which one should be used, what is the appropriate urea dose, how many breath samples should be taken and at what time interval, is there a difference between children and adults, what is the most appropriate method to differentiate between buccal and stomach urease activity. Even the expression of the cut-off value has to be defined. Ideally, the answers should result in one *C-UBT which can be used in research and clinical practice. In conclusion, *C-UBT is a simple, non-invasive and accurate test to demonstrate H. pylori infection. To make results comparable there is an absolute need for standardisation in methodology.

Adult↗

Prevalence of the human immunodeficiency virus among patients with tuberculosis in Sierra Leone, established from dried blood spots on filter paper.

SETTING: Sierra Leone National Tuberculosis Programme. OBJECTIVE: To evaluate serological testing in field conditions of dried blood spots (DBS) on filter paper for unlinked surveillance of human immunodeficiency virus (HIV) associated tuberculosis. DESIGN: DBS were first evaluated against sera in 359 consenting patients on the capital city's District Tuberculosis Register (DTR). DBS eluates were tested with repeated ELISA using different antigens. Serum samples were tested with ELISA and confirmed with LIA. The cost was compared with that of rapid/simple tests on whole blood. In a second phase, DBS were applied to an unlinked countrywide serosurvey of 582 patients from the DTRs. RESULTS: The specificity of DBS for HIV-1 and HIV-2 was 100% and sensitivity was 100% and 87.5%, respectively. The cost of the strategy was half that of rapid/simple tests on whole blood. In 1995, HIV-1 associated tuberculosis seroprevalence was 2.41%. CONCLUSION: The proposed method for the surveillance of HIV-1 associated tuberculosis in Africa is simple, cheap and accurate. Further investigations are necessary to evaluate its sensitivity for HIV-2, and to study the epidemiology of HIV-2 in Sierra Leone.

AIDS Serodiagnosis↗

Sequence analysis of a highly divergent HIV-1-related lentivirus isolated from a wild captured chimpanzee.

Two strains of simian immunodeficiency viruses (SIV) isolated from chimpanzees (SIVCPZ-GAB and SIVCPZ-GAB2) originating from Gabon have previously been genetically characterized and shown to belong phylogenetically to the same lineage as the human immunodeficiency virus type 1 (HIV-1). We describe the sequence analysis of a third HIV-1-related virus, SIVCPZ-ANT, isolated from a wild captured chimpanzee originating from Zaire. This virus displayed the same genetic organization as HIV-1 and was found to fall on the same lineage as HIV-1 and SIVCPZ-GAB. Protein sequence identity with SIVCPZ-GAB ranged from 72% (Pol) to 48% (Env) for the structural proteins, while a particularly divergent Vpu was found (only 25% identity to SIVCPZ-GAB). The V3 regions of the SIVCPZ isolates were exceptionally conserved in contrast to the high divergence of V3 among HIV-1 isolates. However, SIVCPZ-ANT did not show a greater degree of sequence similarity with SIVCPZ-GAB than with HIV-1 isolates and represents a quite divergent outgroup of the HIV-1 lineage. Our data suggest multiple introductions of HIV-1 in the human population and shed new light on the origin of the HIV-1 pandemic.

Amino Acid Sequence↗

Mother-to-child transmission of human T-cell lymphotropic virus types I and II (HTLV-I/II) in Gabon: a prospective follow-up of 4 years.

SUMMARY: For 4 years. we determined the mode and risk of mother-to-child transmission of HTLV-I in a prospective cohort of 34 children born to seropositive mothers in Franceville, Gabon. We also determined the prevalence of antibodies to HTLV-I/II in siblings born to seropositive mothers. Antibodies to HTLV-I/II were detected by Western blot, and the proviral DNA was detected by the polymerase chain reaction (PCR). The risk of seroconversion to anti-HTLV-I for the 4 years of follow-up was 17.5 percent. Anti-HTLV-I/II and proviral DNA were only detected after age 18 months. We observed a seroprevalence rate of 15 percent among the siblings born to HTLV-I/II seropositive mothers. Furthermore, we report a case of mother-to-child transmission of HTLV-II infection in a population of HTLV-II-infected pregnant women that is emerging in Gabon. The lack of detection of HTLV-I/II proviral DNA in cord blood and amniotic fluid and, furthermore, the late seroconversion observed in the children indirectly indicate that mother-to-child transmission occurred postnatally, probably through breast milk.

Amniotic Fluid↗

Comparative evaluation of three assays for the quantitation of human immunodeficiency virus type 1 RNA in plasma.

Reverse transcriptase-coupled polymerase chain reaction (Amplicor HIV-1 Monitor), the branched DNA (bDNA) method (Quantiplex HIV-1 RNA) and the nucleic acid sequence-based assay (NASBA HIV-1 RNA QT) were comparatively evaluated for the quantitation of human immunodeficiency virus type 1 (HIV-1) RNA in plasma. Among 60 plasma specimens from HIV-1 infected patients, HIV-1 RNA was detected in 56 by Amplicor (sensitivity, 93.3%), in 41 by bDNA (sensitivity, 68.3%), and in 60 by NASBA (sensitivity, 100%). HIV-1 RNA was not detected by any of these methods in 34/34 plasma specimens from HIV-1-seronegative blood donors (specificity, 100%). The HIV-1 RNA levels as determined by the different methods were correlated significantly. The frequency of concordant results (log difference < 0.50) was 80.4% between Amplicor and NASBA, 77.5% between Amplicor and bDNA, and 58.6% between bDNA and NASBA. After initiation of antiviral therapy, HIV-1 RNA level variations observed with the three methods were similar. HIV-1 RNA levels were inversely correlated with the CD4+ T cell counts, whereas no correlation was found with HIV-1 p24-antigen levels. When the methods were evaluated for reproducibility, coefficients of variation ranged from 11% to 40% for Amplicor, from 6% to 35% for bDNA, and from 13% to 62% for NASBA. Quantitation of HIV-1 RNA in culture supernatants from HIV-1 subtype A to H strains showed that bDNA can be used to quantitate RNA from all HIV-1 subtypes, whereas Amplicor failed to detect RNA from subtype A strains and NASBA subtype G strains.

CD4 Lymphocyte Count↗

Familial aggregation in Crohn's disease: increased age-adjusted risk and concordance in clinical characteristics.

BACKGROUND & AIMS: Because the mode of Crohn's disease inheritance is unknown, age-adjusted risk estimates and knowledge of disease characteristics will aid genetic counseling and modeling. The aim of this study is to determine the prevalence of familial occurrence of inflammatory bowel disease in first-degree relatives of patients with Crohn's disease and estimate their age-adjusted risks. It also evaluates agreement in disease characteristics between generations within families with a history of Crohn's disease. METHODS: Six hundred forty patients with Crohn's disease and 800 control subjects were questioned about the occurrence of inflammatory bowel disease in their first-degree relatives. Agreement for age at diagnosis, initial disease location, disease behavior, and number of bowel resections was determined in 68 families with two or more members affected and compared with data in 100 unrelated patients with Crohn's disease. RESULTS: Probands with Crohn's disease had a more frequent positive family history than controls. The age at diagnosis between probands with and without a positive family history was insignificant. Crude and age-adjusted risk elements were higher in relatives of patients, especially daughters, compared with those of controls. The age at diagnosis was older for parents than offspring but similar between siblings. Initial disease location was especially striking between siblings. CONCLUSIONS: This study confirms familial aggregation and a high degree of disease concordance in Crohn's disease. The age at diagnosis and initial disease location was especially strong within generations.

Adolescent↗

A clinical validation of Bordetella pertussis and Bordetella parapertussis polymerase chain reaction: comparison with culture and serology using samples from patients with suspected whooping cough from a highly immunized population.

The aim of this study was to validate the performance of the polymerase chain reaction (PCR) assay for Bordetella pertussis and Bordetella parapertussis in comparison with both culture and serology. The number of samples positive in PCR was 2.4-fold higher than the number of samples positive in culture. In serologically confirmed cases, the sensitivity of PCR and culture depended on the duration of disease and the age of the patient, being less sensitive in older age and later in disease. The sensitivity of the PCR in patients with < 10 days of symptoms was 70%, 50%, and 10% in the age groups < 1 year, 1-4 years, and > or = 5 years, respectively. Evidence suggested that the effect of age on sensitivity may be due to differences in immune responses. The low IgA response in the < 1 year age group may be related to the high number of samples positive in PCR and culture, even late in disease.

Bacterial Typing Techniques↗

Virological and immunological analysis of a triple combination pilot study with loviride, lamivudine and zidovudine in HIV-1-infected patients.

OBJECTIVE: To compare two antiretroviral regiments, loviride plus lamivudine (3TC) plus zidovudine (ZDV) (triple combination) and loviride plus ZDV (double combination) in terms of pharmacokinetic interactions, tolerability, safety, and immunological and virological efficacy. STUDY DESIGN: An open, case-controlled, pharmacokinetic and 24-week continuous treatment pilot study. PATIENTS: Twenty p24 antigen-positive patients, 10 per treatment group, were matched according to p24 antigenaemia less or more than 100 pg, CD4 count less or more than 150 x 10-(6)/l, and gender. Eight out of 10 cases and seven out of 10 controls had received previous antiretroviral therapy. RESULTS: No clinically relevant pharmacokinetic interactions were observed. Both treatment combinations were well tolerated. Median absolute and percentage CD4 count increases above baseline were more pronounced in the triple combination arm than in the double combination arm. Median p24-antigen and plasma viraemia level decreases below baseline were more pronounced in the triple combination arm. The M(184)I/V mutation was detected in all plasma samples of triple combination patients examined at week 12. Mutations conferring resistance to loviride and ZDV were found in a significant subset of patients in both treatment arms. CONCLUSIONS: Both combination regimens have an excellent safety/tolerability profile, but a higher level of in vivo efficacy is achieved by the triple combination, despite genotypic changes conferring resistance to one or all of these agents. The conclusions drawn are limited by small population size and the heterogenous pretreatment history. However, they support the validity of and strongly encourage a rationally designed multidrug combination approach to HIV therapy.

Acetamides↗

Epidemiological and molecular characteristics of HIV infection in Gabon, 1986-1994.

OBJECTIVE: To describe trends in the prevalence of HIV-1 infection in different populations in Gabon, and the molecular characteristics of circulating HIV strains. METHODS: Data were collected on HIV prevalence through sentinel surveillance surveys in different populations in Libreville (the capital) and in Franceville. In Libreville, a total of 7082 individuals (hospitalized patients, tuberculosis patients, pregnant women, asymptomatic adults, prisoners) were recruited between 1986 and 1994. In Franceville, we tested 771 pregnant women and 886 healthy asymptomatic adults (1986-1988). Sera were screened for HIV antibodies by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot or line immunoassay (LIA). Reactive samples in ELISA were tested for the presence of antibodies to HIV-1 group O viruses by ELISA using V3 peptides from HIV-1 ANT-70 and HIV-1 MVP-5180 followed by confirmation by LIA and a specific Western blot. Seventeen HIV-1 strains were isolated (1988-1993) and a 900 base-pair fragment encoding the env region containing V3, V4, V5 and beginning of gp41 was sequenced and a phylogenetic tree was constructed. RESULTS: HIV prevalence was relatively low and remained stable (0.7-1.6% in pregnant women, 2.1-2.2% in the general population). The prevalence was also stable among prisoners (2.1-2.6%). Among hospitalized and tuberculosis patients prevalence was higher and increased (1.8-12.7% and 1.5-16.2%, respectively). Only three sera had antibodies to HIV-1 group O. The 17 HIV-1 strains represent six different genetic subtypes including type O. CONCLUSION: Our data from 1986 to 1994 show a stable and low HIV prevalence in Gabon, and a high genetic diversity of HIV-1 strains. This, also observed in Cameroon, is in contrast to that found elsewhere in Africa. Differences in rate of spread of HIV infection are probably explained by interplay between numerous factors. The role of different HIV subtypes in the dynamics of the HIV epidemic should be examined further.

Adult↗

The differentiation of Bordetella parapertussis and Bordetella bronchiseptica from humans and animals as determined by DNA polymorphism mediated by two different insertion sequence elements suggests their phylogenetic relationship.

We describe a novel insertion sequence (IS) element, IS1002, which was found to be closely related to IS481, which is found only in Bordetella pertussis; we found that these two IS elements have a level of sequence identity of 61.5% and also have almost identical terminal inverted repeats. IS1002 was present in both B. pertussis and Bordetella parapertussis strains isolated from humans. In contrast, IS1002 was absent from B. parapertussis strains isolated from sheep. A DNA fingerprint analysis performed with another IS element, IS1001, which is present in B. parapertussis and Bordetella bronchiseptica, revealed that B. parapertussis isolates obtained from sheep are distinct from human isolates. Thus, human and ovine B. parapertussis strains comprise two distinct populations, indicating that little or no transmission occurs between sheep and humans. An IS-associated restriction fragment length polymorphism analysis revealed by B. parapertussis strains isolated from sheep are genetically more polymorphic than the human B. parapertussis population, which is genetically very homogeneous. This suggests that human B. parapertussis strains diverged from a single clone only recently. IS1001 is present in a subset of B. bronchiseptica strains that were derived mainly from pigs and rabbits, suggesting that these strains had a common ancestry. On the basis of the results of a comparison of IS1001 band patterns and IS1001 sequences, ovine and human B. parapertussis strains appear to have evolved independently from B. bronchiseptica strains and to have adapted to different hosts (sheep and humans). Once in the human host, B. Parapertussis probably acquired IS1002 from B. pertussis. In contrast to human B. parapertussis isolates, B. pertussis strains produced polymorphic IS1002-related DNA fingerprint patterns.

Amino Acid Sequence↗

Dynamics of the population structure of Bordetella pertussis as measured by IS1002-associated RFLP: comparison of pre- and post-vaccination strains and global distribution.

The effect of temporal and geographic factors on the population structure of Bordetella pertussis was studied using IS1002-based RFLP analysis. Among the 106 strains analysed, 36 different RFLP types were observed. For the Dutch strains, there was evidence for a shift in the population structure in time since the majority of strains were found in different families of related strains in successive periods. Most pronounced were the differences observed between 1950-1954 and later periods. This difference may have been caused by the introduction of the whole-cell vaccine in 1953, resulting in the expansion of strains which are less affected by vaccine-induced immunity. Strains with RFLP types identical to the vaccine strains were observed in the period 1950-1954, but not later, suggesting a decreased frequency of such strains due to vaccination. Analysis of strains from the 1994 Dutch pertussis epidemic revealed that 71% of the strains belonged to two RFLP types, indicating that pertussis epidemics are caused by clonal expansion. IS1002-based RFLP analysis of strains from different countries suggested a partial geographic isolation of B. pertussis populations. One RFLP type was found to have a wide distribution in time and in space.

Base Sequence↗

Virologic and serologic characteristics of a natural chimpanzee lentivirus infection.

This study set out to characterize the unique features of natural lentivirus infection in chimpanzees over time. The virologic and serologic characteristics of this infection were followed longitudinally in a naturally infected chimpanzee together with a small cohort of experimentally HIV-1-infected chimpanzees. The subsequent isolates from the naturally infected chimpanzee were all non-syncytium forming (NSI) versus syncytium forming in the experimentally infected animals. In contrast to HIV-1-infected chimpanzees virus load was higher and plasma viremia occurred but in a cyclic pattern. Serologic follow-up suggested the development of neutralizing antibodies with subsequent escape of new isolates. Interestingly, the sequence of the principal neutralizing (V3 loop) domain (of HIV-1) remained constant over time. Antibodies to peptides from the V3 loop were type specific. The occurrence of persistent, fluctuating plasma viremia and NSI-type virus variants of this natural lentivirus infection are unique characteristics not previously reported in experimentally infected chimpanzees.

Acquired Immunodeficiency Syndrome↗

Infectious virus titer, replicative and syncytium-inducing capacity of human immunodeficiency virus type 1.

The relationship was investigated between a viral infectious titer in peripheral blood mononuclear cells (PBMC) and plasma on the replicative and syncytium-inducing capacity of human immunodeficiency virus type 1 (HIV-1) isolates. The replicative capacity was defined as the minimum time required for p24 antigen to become positive in PBMCs or plasma of HIV-1 infected individuals, cocultured with PBMCs of healthy donors. Syncytium induction was determined by the MT-2 cell assay and defined as the presence of giant multinucleated cells. The replicative capacity of HIV-1 in PBMCs of healthy donors correlated with the infectious viral titer in PBMCs, but not in the plasma of HIV-1 positive patients. Syncytia formation in MT-2 cells was not related to the infectious viral titer in PBMCs or plasma of HIV-1 positive patients. These findings suggest that syncytium formation, not replicative capacity, is an intrinsic HIV-1 phenotype.

Giant Cells↗