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Biomedical subjects

P Desmet

Publications and source records attributed to P Desmet.

At least 19 recordsLinked to original sources
PubMed2004

Detection of bacterial DNA in synovial fluid from horses with infectious synovitis.

Standard culturing techniques are often unrewarding in confirming diagnosis of synovial infection in the equine patient. Several human studies report the use of sensitive polymerase chain reaction (PCR) techniques for the detection of bacterial involvement in acute synovitis. However, successful extraction of bacterial DNA directly from clinical samples from horses without prior culture has not been reported yet. The goal of this study was to develop a sensitive and reliable method for molecular detection and identification of bacterial species in synovial fluid from horses with infectious synovitis. Synovial fluid samples from 6 horses with culture confirmed synovial infection were used for broad range 16S rRNA gene PCR. Synovial aspirates of 2 healthy horses were used as negative controls. Following extraction and purification of synovial fluid DNA, all samples were processed by touchdown PCR. Amplicons were detected by reverse line blot hybridisation and visualised with chemiluminescence. Pathogen-specific detection of 16S rRNA gene sequences was successful in all 6 synovial fluid samples. No bacterial DNA was detected in the aspirates from the negative control horses using touchdown PCR followed by 25 additional cycles of amplification. The identity of the pathogens was confirmed by DNA sequencing of the amplicons. It can be concluded that broad range 16S rRNA gene PCR followed by reverse line blot hybridisation is a promising technique for detection of bacterial DNA in synovial fluid samples. Further research should aim at the detection of bacterial DNA in synovial fluid samples suspected of infection but having negative culture results. When the 16S PCR proves to be reliable and more sensitive than standard culturing techniques, it may become a powerful tool in the diagnosis of synovial infection.

Animals↗
PubMed2004

Five-year immunological outcome of highly active antiretroviral treatment in a clinical setting: results from a single HIV treatment centre.

Our objective was to study the evolution of CD4 cell count five years after starting highly active antiretroviral treatment (HAART) in a clinical setting. The study was performed at the HIV outpatient clinic, Institute of Tropical Medicine, Antwerp. All patients (n = 225) who started HAART in 1997, who had a CD4 cell count within six months prior to starting HAART and who were subsequently followed for at least two years were included. Change in CD4 cell count after start of HAART and the influence of patient and clinical factors were investigated using graphical exploration, endpoint analysis and mixed-effects linear regression. The mean CD4 cell count at start of HAART was 280 cells/mm(3). At the five-year endpoint of the study the mean increase in CD4 cell count was 333 cells/mm(3), while 79% of the patients had a viral load less than 400 copies/mL. There was a significant negative correlation between increase in CD4 cell count at five years and time since first positive HIV test at start of HAART (P = 0.021). Patients who ever had a HAART interruption of more than seven days had a significantly lower increase in CD4 cell count than those who did not (225 cells/mm(3) compared with 438 cells/mm(3); P < 0.001). A mixed-effects linear regression model additionally suggested a significant impact of exposure to antiretrovirals prior to HAART (P = 0.03). Overall, the recovery of CD4 cell count after five years of HAART is good, although therapy interruptions have an important negative impact.

Adult↗
PubMed2001

Ritonavir/saquinavir plus one nucleoside reverse transcriptase inhibitor (NRTI) versus indinavir plus two NRTIs in protease inhibitor-naive HIV-1-infected adults (IRIS study).

OBJECTIVES: To compare the efficacy, tolerability and safety of a ritonavir 400 mg/saquinavir hard gel fomulation 400 mg twice daily versus an indinavir 800 mg once every 8 h containing first-line protease inhibitor (PI) treatment regimen. METHODS: Open, randomized, multicentre clinical trial. PI-naive patients received either ritonavir/saquinavir and one nucleoside reverse transcriptase inhibitor (NRTI) or indinavir and two NRTIs. Intention-to-treat (ITT) and on-treatment (OT) analyses were performed. RESULTS: The baseline characteristics of the study participants were similar in both arms, 67 patients (37%) were naive to antiretroviral treatment. The proportion of patients who achieved a plasma viral load below the level of detection of 400 copies/ml at week 48 was 43% (39/90) in the ritonavir/saquinavir arm and 63% (57/90) in the indinavir arm (P=0.005, I

Acquired Immunodeficiency Syndrome↗
PubMed2000

Partial tibial neurectomy in 113 Belgian blue calves with spastic paresis.

One hundred and thirteen double-muscled Belgian blue calves (69 males and 44 females) with spastic paresis (52 unilateral and 61 bilateral) were treated surgically by partial tibial neurectomy under caudal epidural anaesthesia. Telephone inquiries made at least three-and-a-half months later established that good results were obtained in 83.2 per cent of the calves; a considerable improvement was reported in 4.4 per cent which still had intermittent spastic contractions; severe hyperflexion of the hock necessitating early slaughtering was recorded in 4.4 per cent of the calves; and in 8 per cent there was little or no improvement.

Anesthesia, Epidural↗
PubMed2000

Calmodulin increases the sensitivity of type 3 inositol-1,4, 5-trisphosphate receptors to Ca(2+) inhibition in human bronchial mucosal cells.

Inositol-1,4,5-trisphosphate (IP(3)) releases Ca(2+) from intracellular stores by binding to its receptor (IP(3)R), a multigene family of Ca(2+)-release channels consisting of IP(3)R1, IP(3)R2, and IP(3)R3. IP(3)R1 is stimulated by low cytoplasmic Ca(2+) concentrations and inhibited by high concentrations. Discrepant reports appeared about the effect of cytoplasmic Ca(2+) on IP(3)R3, showing either a bell-shaped dependence or only a stimulatory phase with no negative feedback by high Ca(2+) concentrations. We investigated how calmodulin interfered with the feedback of cytosolic Ca(2+) on the unidirectional IP(3)-induced Ca(2+) release in permeabilized 16HBE14o- bronchial mucosal cells, where IP(3)R3 represents 93% of the receptors at the mRNA level and 81% at the protein level. Calmodulin inhibited the Ca(2+) release induced by 1.5 microM IP(3) with an IC(50) value of 9 microM. This inhibition was absolutely dependent on the presence of cytosolic Ca(2+). Ca(2+) inhibited the IP(3)R with an IC(50) value of 0.92 microM Ca(2+) in the absence of calmodulin and with an IC(50) value of 0.15 microM Ca(2+) in its presence. It is concluded that: 1) IP(3)R3 can be inhibited by calmodulin, 2) IP(3)R3 is inhibited by high Ca(2+) concentrations, and 3) calmodulin shifts the inhibitory part of the Ca(2+)-response curve toward lower Ca(2+) concentrations.

Animals↗
PubMed1999

Comparative evaluation of Fungitest-, Neo-Sensitabs- and M27T-NCCLS broth microdilution methods for antifungal drug susceptibility testing of Candida species and Cryptococcus neoformans.

Two commercial antifungal susceptibility testing systems (Fungitest and Neo-Sensitabs) were compared with the M27T-NCCLS reference broth microdilution method using one hundred isolates of Candida sp. and Crptococcus neoformans. Six different antifungal drugs were tested: amphotericin B, 5-fluorocytosine, fluconazole, itraconazole, ketoconazole and miconazole. The overall agreement between the Fungitest and the reference methods was much better than between the Neo-Sensitabs and the reference methods: the agreement for the Fungitest ranged from 100% for amphotericin B to 76.7% for itraconazole whereas for the Neo-Sensitabs, it ranged from 90.4% for amphotericin B to 36% for ketoconazole. For the total number of tests performed with Neo-Sensitabs, there were 37.8% of discrepancies with the reference method whereas for the tests performed with Fungitest, there was only 16.5% of discrepancies. Major discrepancies, defined as results that classified an isolate as susceptible by one method and resistant by another, occurred in 21 cases for the Neo-Sensitabs test and only in four cases with the Fungitest, namely 0.6% of the cases. We conclude that the Fungitest method constitutes a simple and reliable procedure for antifungal drug susceptibility testing.

Amphotericin B↗
PubMed1998

Histological study of the innervation of the suspensory ligament of the forelimb of the horse.

The innervation pattern of the interosseus muscle of the forelimb was studied in two ponies and two horses. The nerves of the suspensory ligament were studied histologically after neurectomy of the ulnar and median nerve branches proximal to the carpal joint. The results demonstrated that the interosseus muscle is innervated by the deep branch of the lateral palmar nerve which emerges at the level of the midcarpal region and contains fibres from the ulnar and the median nerve. These findings provide evidence that an ulnar nerve block proximal to the accessory bone would fail to anaesthetise the entire suspensory ligament.

Anesthesia↗
PubMed1995

Community survey of diarrhoea in children under 5 years in Kinshasa, Zaire.

This community based survey was undertaken to assess the prevalence, characteristics and risk factors of diarrhoea in children < 5 years of age in an urban zone, at Kinshasa, Zaire. 155 community cases selected by cluster sampling, 155 age-matched controls, and 18 children with diarrhoea seen at a health centre (HC) were examined. The diarrhoea prevalence rate was 6.5%. The highest risk of persistent diarrhoea was in children of 2 to 3 years, non breast-fed, with more than one enteric agent in their stools and living in households without electricity. The rates of detection of Strongyloides stercoralis, Entamoeba histolytica and Salmonella, and heavy infections of Trichuris trichiura and Trichomonas hominis were significantly higher in cases (p < 0.05). The rate of detection of Cryptosporidium was rather high, specially in HC cases (22.2%). It was also found in both diarrhoeal (14.8%) and non-diarrhoeal specimens (12.9%). There was a lack of association between the presence of faecal white blood cells and enteric bacteria, and also between the presence of faecal red blood cells and E. histolytica, which might be due to the frequent practice of rectal injections and suppositories. A mother's perception of fever and stool aspect was fairly in agreement (respectively 70% and 53%) with that of the investigators. The high rate of dehydrated children (50.9%) may be due to the dehydration definition applied at the HC. The survey's results were used to improve the local case management flow chart and to adjust educational activities directed at mothers.

Animals↗
PubMed1994

[Viable meniscus transplantation].

The integrity of the semilunar cartilages has proved to be the best safeguard against mechanical degenerative changes. One can postulate that restoring normal congruency between the femur and tibia with intact menisci would be the ideal solution to many mechanical knee problems. Several semilunar cartilages have been transplanted with good functional results in medial and lateral compartmental meniscal disease. However, this form of chondroprotection in the load-bearing area of the femur and tibia can only be properly evaluated after 10 to 20 years of follow-up. In order to obtain functional results, meniscal allografts have to be incorporated in the knee joint by intimate meniscofemoral synovial bonding. The synovial fibroblasts must grow into the collagen meshwork of the meniscal allograft. Such ingrowth has been shown in freeze-dried and deep-frozen meniscal allografts. However, in a small number of transplants shrinking has been observed on repeat arthroscopy at 6 months. Satisfactory incorporation of meniscal allografts has been obtained with fresh allografts, but availability remains a problem when this method is used for meniscal substitution. For this reason viable meniscal allograft implantation was initiated in a series of 25 patients and the value of this method studied. The meniscal allograft can be kept in an adequate semisynthetic nutrient medium for approximately 2-3 weeks without apparent loss of viability, during which period the appropriate recipient can be selected and prepared, a thorough laboratory screening can be conducted, and the culture results and disease transmission factors can be evaluated. In this way, live transplant hazards can be avoided, resulting in a higher success rate.

Adult↗
PubMed1991

Laminitis in the pony: conservative treatment vs dorsal hoof wall resection.

The clinical and radiographic findings in 21 ponies with laminitis and its treatment and results are described. All ponies received non-steroidal anti-inflammatory drugs. All were fed hay and no concentrates. They were box rested for varying periods depending on clinical improvement. Dorsal hoof wall resection was performed in 11 ponies and all regained complete soundness. To shorten the period of non-activity, working ponies were shod and the hoof wall defect was packed with technovit or a combination of glue with cotton cuttings. Ten were treated conservatively; two recovered completely, four remained lame and four were killed because of recurrent laminitis.

Animals↗
PubMed1989

The value of cryptococcal serum antigen screening among HIV-positive/AIDS patients in Kinshasa, Zaire.

Cryptococcal meningitis is a frequently observed opportunistic infection in AIDS patients in Zaire and other countries in Central Africa. The prognosis in those patients is very poor because of the advanced stage of their cryptococcal disease at presentation. To improve the prognosis of cryptococcal meningitis in HIV-infected patients through earlier diagnosis, a routine serum cryptococcal antigen screening was performed on 450 HIV-positive/AIDS patients seen at the Cliniques Universitaires de Kinshasa between 1 January 1988 and 31 August 1988. Cryptococcal antigen was detected in the sera of 55 (12.2%) of them. Cerebrospinal fluid was obtained from 44 of these 55 patients and the presence of Cryptococcus neoformans was demonstrated by direct microscopy and culture in 29 (66%) of them.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Radiographic measurement from the lateromedial projection of the equine foot with navicular disease.

Radiographic measurements from the lateromedial projection of the equine foot were compared in three groups of horses. Group 1 consisted of 143 normal horses, group 2 were 60 horses with clinical navicular disease and group 3 were 161 horses with clinical and radiographic navicular disease. Several measurements tended to be larger in group 3 than group 1. An enlargement of the navicular bone was observed in proximodistal and dorsopalmar directions. Partial enlargement of the pedal bone was observed in groups 2 and 3. Few differences were observed between age classes. All horses aged four years and over had an increased length of the hoof in the dorosopalmar direction and a decrease of the cranial angle of the hoof. Enlargement of the navicular bone fits well into the concept of osteoarthrosis. The pedal bone was partly engaged. These findings may be an expression of a regional acceleratory phenomenon.

Animals↗