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Biomedical subjects

J T M van der Meer

Publications and source records attributed to J T M van der Meer.

8 recordsLinked to original sources
PubMed2006

[Central catheters should be removed immediately if bacteraemia occurs].

No randomised controlled study has been conducted into the correct treatment of catheter-related bacteraemia infections. This is due to the fact that true bacteraemia is difficult to differentiate from catheter contamination. Experience in the treatment of patients who do not have bacteraemia is therefore often incorrectly extrapolated to patients who do have bacteraemia with a central catheter in situ. Removing the central catheter can reduce the risk of complications of bacteraemia.

Bacteremia↗
PubMed2006

Antimicrobial treatment of infective endocarditis caused by viridans streptococci highly susceptible to penicillin: historic overview and future considerations.

In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to penicillin. Early treatment trials indicate that some patients with subacute endocarditis can be cured with shorter treatment duration than currently advised by international guidelines. Also, high-dose antibiotics, as recommended today, have a predominantly pharmacokinetic and pharmacodynamic rationale that is based mostly on experimental animal studies. Shortening antimicrobial treatment in select patients with endocarditis would be of great benefit. As yet there are no predictors of cure that can be used to individualize treatment duration in patients with bacterial endocarditis.

Anti-Bacterial Agents↗
PubMed2004

[Sexual transmission of hepatitis C in homosexual men].

An acute hepatitis C infection was diagnosed in three HIV-positive gay men, aged 43, 48 and 30 years, respectively. In all three, unprotected sexual intercourse and fisting was a universal risk factor for the infection. They all denied having used drugs intravenously, which is the most common risk factor. The third man had a documented proctitis (lymphogranuloma venereum) at the time when the HCV transmission must have taken place. No serious complications occurred during the acute HCV infection. Because the infection did not resolve spontaneously after a few months, all three men were treated with pegylated interferon and ribavirin. Recently, the number of cases of acute HCV infection has been seen to increase in The Netherlands. This may be due primarily to an increase in unprotected sexual intercourse and fisting. This hypothesis is supported by a documented increased prevalence of sexually transmissible diseases among gay men in The Netherlands. As acute infections may turn into chronic infections, treatment of an acute infection should be considered in order to prevent the chronic disease.

Acute Disease↗
PubMed2003

Optimisation of the antibiotic guidelines in The Netherlands. VII. SWAB guidelines for antimicrobial therapy in adult patients with infectious endocarditis.

The Working Party on Antibiotic Policy (Dutch acronym is SWAB) is a Dutch organisation that develops guidelines for in-hospital antimicrobial therapy of bacterial infectious diseases. This present guideline describes the antimicrobial treatment for adult patients with infective endocarditis. The choice and duration of antimicrobial therapy is determined by the infecting micro-organism, sensitivity of this micro-organism for antimicrobial therapy, location of the endocarditis, left-sided or right-sided, and presence of intracardial prosthetic material. In this guideline, the empirical therapy for endocarditis is discussed as well as the therapy for the most frequent causative organisms: streptococci, enterococci, staphylococci and HACEK micro-organisms.

Adult↗
PubMed2002

A space-occupying lesion of the skull base, masked by nasopharyngeal lymphatic tissue hypertrophy and causing cranial nerve dysfunction in an HIV-infected patient.

Patients infected with HIV are at increased risk of developing lymphoma. The lymphomas often involve extranodal sites and +/-90% are of B-cell phenotype. We describe an HIV-infected patient with unilateral multiple cranial nerve dysfunction, most likely as a result of a nasopharyngeal B-cell non-Hodgkin's lymphoma in which early histologic confirmation of the diagnosis was delayed by the simultaneous presence of nasopharyngeal lymphatic tissue hypertrophy. It is of practical importance to recognize non-Hodgkin's lymphoma as a cause of cranial nerve dysfunction and to be aware of the possibility and the implications of the simultaneous presence of nasopharyngeal lymphatic tissue hypertrophy in HIV-infected patients.

Cranial Nerve Diseases↗
PubMed2002

[Guidelines for endocarditis prevention revised by the Netherlands Heart Foundation].

The risk of endocarditis developing as the consequence of a bacteremia caused by a health care procedure in a patient with a predisposing heart disease is small. The administration of antibiotics before such a procedure is thought to reduce this risk still further. However, the protective effect of this preventive measure has never been demonstrated in a prospective randomized study. With certainty it can be said though, that it is not 100% efficacious and reports on prophylaxis failure have appeared ever since the introduction of this preventive measure. The revised guidelines are as far as possible based on published data. Where data are lacking, experts opinion was followed. The guidelines are not exhaustive and do not cover each and every circumstance in which prophylaxis could be warrantable. The purpose of the guidelines is to give the clinician something to go by in the most frequently occurring health care procedures. Not everyone will agree with the choices made by the commission in areas where data are lacking. In these areas, local directives may differ from the published directives. For a made to order advice on prophylaxis one should turn to an expert on endocarditis.

Anti-Bacterial Agents↗
PubMed2002

Prophylaxis of endocarditis.

For a long time it has been known that bacteraemias caused by medical or dental procedures may cause endocarditis in patients with specific types of congenital or acquired heart disease. In the 1940s it was thought that the administration of antibiotics before such procedures would prevent endocarditis. However, the beneficial effect of this preventive measure on the incidence of endocarditis did not live up to its expectations. Quite soon it became obvious that prophylaxis was not 100% efficacious in man, although it did prevent endocarditis in animals. A controlled study into the protective effect of prophylaxis in humans has never been carried out. In the last decade it has become dear from case-control studies that endocarditis prophylaxis is not a very effective preventive measure but that it reduces an already small risk even further. In this article the theoretical background of endocarditis prophylaxis and possible explanations for its lack of effect are discussed.

Animals↗