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Biomedical subjects

F Jacobs

Publications and source records attributed to F Jacobs.

At least 19 recordsLinked to original sources
PubMed2006

Successful treatment of septic shock due to pan-resistant Acinetobacter baumannii using combined antimicrobial therapy including tigecycline.

Reported here is the case of a patient with septic shock due to multidrug-resistant Acinetobacter baumannii, which developed after complicated acute pancreatitis with intra-abdominal abscess. Treatment with colistin methanesulphonate and high doses of meropenem were initiated, but since shock persisted, tigecycline was added to the regimen, resulting in successful resolution of the infection.

Acinetobacter Infections↗
PubMed2004

Optimised tracer-dependent dosage cards to obtain weight-independent effective doses.

PURPOSE: The aim of this study was twofold: firstly, to determine whether the European Association of Nuclear Medicine (EANM) dosage card results in weight-independent effective doses or weight-independent count rates; secondly, to determine whether one dosage card is sufficient for 95 different radiopharmaceuticals, and, if not, how many cards we reasonably need to take into account inter-tracer variability. METHODS: Normalisation factors for count rate and effective dose were calculated as a function of body weight, with 70 kg as standard. Calculations were performed, using whole-body absorption fractions and MIRDOSE 3 software, for seven anthropomorphic phantoms and ten radionuclides. An analytic function for both relations was proposed. Normalisation factors for effective dose for 95 radiopharmaceuticals were investigated using cluster analysis. RESULTS: Normalisation factors for count rate and effective dose can be estimated accurately as a function of body weight W by (W/70)a holding only one parameter, called the a value. The a values for 95 radiopharmaceuticals were classified into three clusters (nA=7, nB=76, nC=12). Cluster A contains tracers for renal studies. Cluster B contains all remaining tracers, except iodine-labelled tracers for thyroid studies and 89Sr for therapy, which belong to cluster C. CONCLUSION: Correction factors proposed by the EANM task group mainly correct for effective dose. They are very similar to the factors obtained for cluster A. Using the EANM factors for tracers belonging to clusters B and C results in significantly higher effective doses to children. We suggest using three tracer-dependent dosage cards for which the correction factors have been calculated to obtain weight-independent effective doses.

Adult↗
PubMed2004

Bacillus cereus pneumonia in a patient with acute lymphoblastic leukemia.

Reported here is a case of Bacillus cereus pneumonia that occurred in a patient with acute lymphoblastic leukemia. The presentation was severe, essentially marked by respiratory distress and pleuritic chest pain. Classic empirical treatment initiated for febrile neutropenia did not cover this rare pathogen and appropriate therapy was therefore delayed. B. cereus is most often a culture contaminant, but it can also be responsible for self-limited gastrointestinal intoxication and, more rarely, severe systemic diseases. Virulence in the case of systemic disease is attributed to tissue necrosis mediated by toxin release. B. cereus pneumonia, as described in the English-language literature, mainly affects immunocompromised patients and most often has a fatal outcome. Thus, the identification of B. cereus in clinical specimens of severely ill immunocompromised patients should lead physicians to question its clinical significance.

Adult↗
PubMed2004

Registration accuracy of 153Gd transmission images of the brain.

PURPOSE: The aim of the study was to determine the accuracy of non-rigid nine-parameter image registrations based on 153Gd transmission computed tomography (TCT) images as compared with those based on 99mTc-ethyl cysteinate dimer (ECD) images and to assess whether normalised mutual information (NMI) or count difference (CD) should be used. METHODS: TCT and ECD data were acquired in 25 randomly selected patients. Emission images were registered to an ECD template with a CD cost function. The same registration parameters were applied to the transmission images to create a TCT template. All TCT images were registered to the TCT template and the same registration parameters were applied to the ECD images. The procedure was repeated with NMI as cost function. Accuracy of both ECD-based and TCT-based registrations was assessed by comparing the normalisation parameter values and regional activities in the spatially normalised ECD images, using a mixed-model analysis of variance (ANOVA). Scheffe post hoc tests were performed. RESULTS: No significant differences were found between ECD/CD, ECD/NMI and TCT/CD, suggesting that ECD registration can be done with either CD or NMI, and that TCT registration using CD is equally as accurate as ECD registration. The accuracy of TCT registration with NMI was lower, with discrepancies occurring in the frontal inferior region and the cerebellum. The analysis of normalisation parameters indicated that z-scaling is underestimated and yz-rotation overestimated with TCT/NMI registration. CONCLUSION: We conclude that ECD registrations with CD or NMI are as accurate as TCT registrations with CD and that TCT registrations with NMI should be avoided.

Brain↗
PubMed2004

Management of long-term catheter-related Brevibacterium bacteraemia.

Brevibacterium has been reported as a rare cause of implanted-device infection. In two cases of recurrent Brevibacterium casei bacteraemia associated with infection of surgically implanted intravascular devices, relapse occurred 2 and 5 months, respectively, after completion of therapy with vancomycin via the infected catheter. A second intravenous antibiotic therapy course by the antibiotic-lock technique led to bacteriological cure in one patient. Molecular typing results demonstrated that the recurrent bacteraemia was caused by the same strain. Implanted-device removal may be necessary, in addition to appropriate antibiotics, for successful management of such infections.

Actinomycetales Infections↗
PubMed2004

Carotid artery occlusion due to fulminant rhinocerebral mucormycosis.

Mucormycosis is a rare disorder with a potentially lethal course caused by an opportunistic fungus of the Phycomycetes family. Rhinocerebral mucormycosis (RCM) is an acute fulminant form of invasive fungal sinusitis occurring principally in individuals who are immunologically or metabolically compromised. This form originates from one of the paranasal sinuses and may spread to the orbit or the intracranial space either by direct extension or using the unique capability of spreading along vascular walls, leaving the bony structure intact. Carotid artery occlusion is a complication of RCM. Because of the rapidity with which this disease progresses, prompt and aggressive therapy is essential. The morbidity and mortality of this disease are directly related to the length of time before diagnosis and treatment. The diagnosis is difficult because invasive mucormycosis may be present with no mucosal changes and a normal sinus CT scan. It is a histological diagnosis. Treatment of RCM includes early diagnosis, correction of underlying conditions, early and radical surgical debridement, and lipid formulation of amphotericin B. Multiple surgeries are often necessary for adequate debridement. We report a case of carotid artery occlusion due to RCM and discuss the literature on its early signs and symptoms, pathophysiology, and treatment options.

Acute Disease↗
PubMed2003

Haemophilus parainfluenzae: an underdiagnosed pathogen of biliary tract infections?

Presented here is a case of monobacterial peritonitis complicating cholecystitis and caused by an uncommon agent of gastrointestinal infections, Haemophilus parainfluenzae. The pathogenic role of this organism in digestive infections, particularly in those of the biliary tract, has been reported increasingly though sporadically. Indeed, it has been shown to be a coloniser of the gastrointestinal tract, and a recent hypothesis of an ascending route of infection to the biliary tract has been postulated to partly explain its pathogenicity. More frequent identification of Haemophilus parainfluenzae as a causal agent of biliary tract infection would probably be obtained through the use of specific culture media, since its potential implication has been demonstrated.

Anti-Bacterial Agents↗
PubMed2003

Clinical impact of a PCR assay for identification of Staphylococcus aureus and determination of methicillin resistance directly from blood cultures.

We evaluated the clinical usefulness of a PCR assay that discriminates Staphylococcus aureus from coagulase-negative staphylococci and detects methicillin resistance on blood cultures by measuring the adaptation of antimicrobial therapy based on the PCR results. Only 7 of 28 patients (25%) benefited from a modification of antibiotic therapy based on the PCR results, since empirical therapy was appropriate in a majority of cases.

Blood↗
PubMed2002

Biodistribution and displacement studies of the selective 5-HT2A receptor antagonist 123I-5-I-R91150 in the normal dog.

There is increasing interest in mapping receptors in vivo by using functional imaging modalities such as single photon emission tomography (SPET) and positron emission tomography (PET). Since SPET is a more accessible functional imaging modality than PET and, overall, it is more economical, radioligands suitable for this technique are in greater demand. Recently, 123I-5-I-R91150, a radioligand with high selectivity and affinity for 5-HT(2A) receptors in the brain, was introduced for SPET. This study reports on the whole-body distribution and brain uptake of the selective 123I-5-I-R91150 ligand in four normal dogs. The frontal to cerebellar ratio of uptake in time was determined in three dogs. Time-activity curve of venous blood was determined in one dog. Maximal global brain uptake was found at 10-60 min post-injection. Higher brain uptake was noted in the frontal cortical areas compared to the cerebellum. The frontal-cerebellar ratio reached the highest values at 90-180 min. Reversibility and pharmacological selectivity of ligand binding was demonstrated through displacement and blocking studies with the 5-HT(2A) receptor antagonist ketanserin. This study demonstrates that the specific 5-HT(2A) iodinated ligand can be used for imaging and semi-quantification of the 5-HT(2A) receptors in the canine brain in vivo by using SPET.

Animals↗
PubMed2002

[The infective diseases clinic].

The Clinic of Infectious Diseases was created at Erasme Hospital in 1980. Its main activity consists in taking care of patients with infectious complications in various hospital departments. Its main scientific contributions concern the evaluation of new treatments, pharmacokinetics of antimicrobial agents and physiopathology of sepsis. The evaluation of the impact of infectious diseases on the appropriateness of antimicrobial therapy and the control of infection is a major contribution of the clinic. Several works concern the study of the immune response in case of infection due to an intracellular pathogen and in response to vaccination.

Belgium↗
PubMed2001

Association of MUC-1 and SPGL-1 with low-density microdomain in T-lymphocytes: a preliminary note.

Two mucin-type glycoproteins, MUC-1 and P-selectin glycoprotein ligand-1 (PSGL-1), and glycosphingolipids (GSLs), expressed in human T-cell line HUT78, were highly enriched in low-density buoyant fraction (termed "GEM"), together with CD45, Yes, Fyn, and lck(56). Enrichment of MUC-1, PSGL-1 and GSLs, together with these signal transducer molecules in low-density membrane fraction was observable when fraction was prepared from cells either in nonionic detergent Brij 58 or in hypertonic alkaline conditions (500 mM Na(2)CO(3)). On pretreatment of cells with cholesterol-binding reagent methyl beta-cyclodextrin, levels of MUC-1 and PSGL-1 together with the above signal transducers in GEM was greatly reduced, and they were translocated into high-density membrane fraction. Similar association of lck(56), Yes, Fyn, and cSrc together with MUC-1 was also found in GEM fraction of mouse T-cell lymphoma EL4 cells expressing MUC-1 through transfection of its gene. These findings indicate the presence of another glycosyl cluster ("glycocluster"), in addition to the previously well-established GSL cluster organized with signal transducer molecules in GEM fraction, and its possible functional role in T-cells.

Animals↗
PubMed2001

Fatal primary infection due to human herpesvirus 6 variant A in a renal transplant recipient.

We describe a fatal primary human herpesvirus 6 (HHV-6) variant A infection in a kidney transplanted adult woman. On day 20 post transplantation (TX), after rejection therapy, the patient presented an acute hemophagocytic syndrome with hepatitis and central nervous system involvement. HHV-6 IgG and IgM antibodies seroconversion was demonstrated. HHV-6 variant A was the sole pathogen detected by nested PCR and/or culture in blood, bone marrow aspiration, liver biopsy, cerebrospinal fluid and bronchoalveolar lavage. The graft was HHV-6 seropositive and the patient was not transfused before day 28 post TX, suggesting that the virus was transmitted by the graft. Despite immunoglobulins, ganciclovir and foscarnet therapy, the HHV-6 infection progressed and led to severe aplasia. The patient developed Aspergillus fumigatus pneumonia and died from fulminant candidemia. This case demonstrated for the first time that HHV-6 variant A primary infection can cause life-threatening disseminated infection in immunosuppressed patients.

Adult↗
PubMed2001

Ceftazidime- and imipenem-induced endotoxin release during treatment of gram-negative infections.

To determine whether ceftazidime and imipenem, which target two different penicillin-binding proteins, result in different amounts of endotoxin and cytokine release in patients with gram-negative infection, plasma endotoxin, interleukin-6, and tumor necrosis factor alpha were measured during the first 24 h of antibiotic therapy in 27 patients with gram-negative infection who had been randomized to receive either ceftazidime 2 g t.i.d. (n=12) or imipenem/cilastatin 1 g t.i.d. (n=15). The source of infection was the digestive tract (n=13), the urinary tract (n=5), the respiratory tract (n=2), soft tissue (n=2), i.v. line (n=2), or other (n=3). After the first antibiotic injection, a significant increase in the median concentration of plasma interleukin-6 and plasma tumor necrosis factor alpha was noted, without significant differences related to the antibiotic administered. Antibiotic-induced endotoxemia was detectable in nine patients (including 7 with bacteremia). In conclusion, ceftazidime and imipenem had similar effects on endotoxin and cytokine release during the treatment of gram-negative infections.

Bacteremia↗