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Biomedical subjects

J T Van Dissel

Publications and source records attributed to J T Van Dissel.

9 recordsLinked to original sources
PubMed2006

Helicobacter pylori infection and typhoid fever in Jakarta, Indonesia.

We evaluated the association between typhoid fever and Helicobacter pylori infection, as the latter microorganism may influence gastric acid secretion and consequently increase susceptibility to Salmonella typhi infection. Anti-H. pylori IgG and IgA antibody titres (ELISA) and gastrin concentration (RIA) were determined in the plasma of 87 blood culture-confirmed typhoid fever cases (collected after clinical recovery) and 232 random healthy controls without a history of typhoid fever, in the Jatinegara district, Jakarta. Patients with typhoid fever more often than controls were seropositive for H. pylori IgG (67% vs. 50%, P<0.008), when antibody titres were dichotomized around median titres observed in controls. H. pylori IgA seropositivity was not associated with typhoid fever. Plasma gastrin concentrations indicative of hypochlorhydria (i.e. gastrin > or =25 or > or =100 ng/l) were not significantly elevated in typhoid fever cases compared to controls (P=0.54 and P=0.27 respectively). In a multivariate analysis, typhoid fever was independently associated with young age (<33 years, median age of the controls) [odds ratio (OR) 7.93, 95% confidence interval (CI) 3.90-16.10], and H. pylori IgG seropositivity (OR 1.93, 95% CI 1.10-3.40). Typhoid fever was independently associated with H. pylori IgG seropositivity, but not with elevated gastrin concentration. Therefore, the association suggests a common risk of environmental exposure to both bacteria, e.g. poor hygiene, rather than a causal relationship via reduced gastric acid production.

Adolescent↗
PubMed2005

Chills in 'early sepsis': good for you?

We evaluated the predictive value of chills, bacteraemia and endotoxaemia for in-hospital mortality and survival at 5-10 years long-term follow-up in a prospective cohort of 'early sepsis' patients presenting with fever resulting from community-acquired pneumonia or pyelonephritis. Febrile patients with chills had bacteraemia more often (RR 3.1, 95% CI 1.8-5.4) than those without chills. Neither chills nor bacteraemia were significantly related to in-hospital mortality, but patients with endotoxaemia had a higher in-hospital mortality rate than those without endotoxaemia. Patients with chills had a significantly higher survival rate at long-term follow-up than those without chills on admission: the estimated risk of dying was 0.644 (95% CI 0.43-0.95, P = 0.029) for an individual with chills, compared to a person without chills, adjusting for the other factors [age cohort, underlying disease and the pro-inflammatory response in the blood, i.e. tumour necrosis factor-alpha (TNF-alpha) and blood leucocyte number, as scored on hospital admission] in the Cox proportional hazards model. Chills may characterize a patient subpopulation that upon pulmonary and urinary tract infection is able to raise a more rapid and/or efficient host response.

Aged↗
PubMed2004

Cavitating pneumonia after treatment with infliximab and prednisone.

Tumor necrosis factor (TNF)-alpha antagonists constitute a novel class of immunomodulating drugs that are used for the treatment of an increasing number of inflammatory disorders. These agents are associated with an increased risk of tuberculosis, but the risk of other infections is less clear. Reported here is the case of a patient who developed cavitary pneumonia after treatment with infliximab (monoclonal TNF-alpha antibodies) and corticosteroids for rheumatoid arthritis. Cryptococcus neoformans was the only pathogen isolated from bronchoalveolar lavage fluid. The patient responded well to fluconazole. The risk of infection after treatment with TNF-alpha antagonists and the possible causative microorganisms are discussed.

Antibodies, Monoclonal↗
PubMed2003

Beneficial effects of fumarate therapy in psoriasis vulgaris patients coincide with downregulation of type 1 cytokines.

BACKGROUND: Fumarates have been shown to be effective in psoriasis vulgaris. OBJECTIVES: To find out whether successful therapy is associated with modulation of cytokines. METHODS: We determined interferon (IFN)-gamma, interleukin (IL)-4 and IL-10 secretion capacities of peripheral blood mononuclear cells (PBMC) after phytohaemagglutinin stimulation, and IL-12p70 and IL-10 secretion capacities of PBMC after endotoxin stimulation in psoriasis vulgaris patients during treatment with fumarates. In a cohort study, 12 patients (five men, median age 50 years; seven women, median age 46 years) with psoriasis vulgaris were followed during 24 months of fumarate treatment. In addition, we followed 14 healthy controls (six men, median age 31 years; eight women, median age 29 years) without skin diseases during 12 months to investigate possible changes in the cytokine secretion capacity of PBMC as a result of seasonal changes. Disease activity in patients was determined by Psoriasis Area and Severity Index (PASI) score. Blood was collected for measurement by enzyme-linked immunosorbent assay of cytokine levels after stimulation of PBMC. RESULTS: Within 6 months of fumarate treatment, the mean +/- SD PASI score had decreased to 22 +/- 9% of its initial value. These beneficial effects coincided with lymphocytopenia and a significant (P < 0.05) downregulation of IFN-gamma expression by circulating blood cells, followed by a significant downregulation of IL-4 expression. Notably, production of the cytokine synthesis inhibitor IL-10 by PBMC was unchanged. CONCLUSIONS: The beneficial effects of fumarates may be attributed to their downregulatory action on type 1 cytokines.

Cohort Studies↗
PubMed2002

Recurrent staphylococcal bacteraemia and subhepatic abscess associated with gallstones spilled during laparoscopic cholecystectomy two years earlier.

This is the first report of Staphylococcus aureus bacteraemia and subhepatic abscess in association with intraperitoneal gallstones spilled during laparoscopic cholecystectomy two years earlier. Spilled gallstones can lead to abscess formation in the late postoperative period by acting as foreign bodies that can become infected during bacteraemia and then become a source of recurrent bacteraemia.

Abdominal Abscess↗
PubMed1995

S. typhi vaccine strain Ty21a can cause a generalized infection in whole body-irradiated but not in hydrocortisone-treated mice.

Various mutations including galE- in the S.typhi vaccine strain Ty21a are thought to prevent proliferation of these micro-organisms in the host, and elimination of Ty21a would occur independent of the immune system of the host. To investigate this issue, we determined whether Ty21a can proliferate in immunosuppressed mice, and assessed the role of phagocytes in the eradication of Ty21a from tissues. Mice were rendered lymphocytopenic and monocytopenic by hydrocortisone s.c., or were made leucocytopenic by whole body irradiation. Bacteria were injected into a tail vene to evaluate eradication from the blood, liver and spleen, and into thigh muscle, i.e. a tissue that lacks resident macrophages. Ty21a were grown overnight in glucose [glu], or galactose and glucose [gal.glu]; only the Ty21a [gal.glu] expressed somatic O-antigens. After i.v. injection of 10(4) to 10(6) micro-organisms, Ty21a were rapidly eliminated from the liver and spleen of normal and immunosuppressed mice, i.e. within 1 day a 95% reduction of bacterial counts was observed. After i.m. injection of 10(4) to 10(6) bacteria, the number of viable Ty21a decreased in normal and hydrocortisone-treated mice, but in irradiated mice the micro-organisms proliferated and caused generalized infection. In all cases, Ty21a [glu] was eliminated more rapidly than Ty21a [gal.glu], confirming reports that killing of bacteria that lack O-antigens is more rapid than that of smooth bacteria of the same species. These results indicate that elimination of the vaccine strain against typhoid fever, Ty21a, from host tissues is not due to an intrinsic property of the micro-organisms that prevents proliferation but instead depends on the action of resident macrophages and exudate monocytes and granulocytes.

Animals↗
PubMed1992

Severe hypophosphatemia in a patient with anorexia nervosa during oral feeding.

We report a case of refeeding-associated hypophosphatemia in a 24-year-old malnourished male patient with anorexia nervosa but no history of alcoholism. He was given tube feeding with a low-calory preparation supplemented with phosphate. During refeeding, a severe hypophosphatemia developed after 5 days, i.e., serum phosphate 0.00-0.01 mmol/l for 2 days, accompanied by a reduction in red-cell ATP and 2,3-diphosphoglycerate, mild hemolytic anemia and transient changes in cardiac repolarization; there was, however, a striking lack of clinical symptomatology. Parenteral replacement with phosphate initially was complicated by an unexpected high urinary phosphate excretion due to an extremely low TmP/GFR (0.02 mmol/l) for over 2 days. Only after an increase of the TmP/GFR to supranormal values, i.e. up to 2.5 mmol/l, unrelated to changes in serum PTH or vitamin D3, the serum phosphate concentration became normal. The case report shows that severe hypophosphatemia can occur in nonalcoholic patients after oral feeding, and may induce reversible changes in renal phosphate handling that complicate replacement therapy.

Adult↗
PubMed1986

A reaction vessel for the measurement of oxygen consumption by small numbers of cells in suspension.

A reaction vessel is described that permits measurement of oxygen consumption in small numbers of cells in suspension. The assay permits accurate detection of changes in oxygen tension amounting to less than 0.016 nmol X min-1, and allows the continuous monitoring and calculation of oxygen consumption by as few as 3-6 X 10(5) blood granulocytes or mouse peritoneal macrophages. The results obtained with this assay are highly reproducible, and the values agree closely with those obtained in 10-15-fold larger samples with commercially available oxygraphs. The reaction vessel offers three basic advantages: (1) fewer cells are required per sample (at most 1/10 the number needed for conventional oxygraphs); (2) smaller volumes of test media are needed (i.e., cytokines, opsonins); and (3) the oxygen tension of the medium can be rapidly changed to any desired level at the start of or during experiments. The applications described include the oxygen consumption by human granulocytes and murine peritoneal macrophages before and after addition of both soluble and particulate stimuli. With the use of this technique it was found that the maximum oxygen consumption by human granulocytes after stimulation with phorbol myristate acetate is proportional to the oxygen tension of the medium during the addition of the triggering agent.

Animals↗