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R Mertens

Publications and source records attributed to R Mertens.

At least 55 records · Page 3Linked to original sources
PubMed1995

Evaluation of Rapid ATB Staph for 5-hour antimicrobial susceptibility testing of Staphylococcus aureus. Groupement pour le Dépistage, L'Etude et la Prévention des Infections Hospitalières-Groep ter Opsporing, Studie en Preventie van Infecties in de Ziekenhuizen.

The accuracy of Rapid ATB Staph (bioMérieux, La Balme-Les Grottes, France) for detection of oxacillin resistance and for detection susceptibility to 11 other antimicrobial agents in 553 and 519 Staphylococcus aureus isolates, respectively, was evaluated by comparing results with those produced by oxacillin agar screen and agar dilution methods, respectively. Further characterization of isolates with discrepant results for oxacillin testing was done by PCR detection of the nuc and mecA genes. By oxacillin agar screening, there were 307 oxacillin-resistant and 246 oxacillin-susceptible isolates. Rapid ATB results were obtained in 5 h for 515 (93.2%) of the isolates tested. Rapid ATB showed 97.0% sensitivity for detection of oxacillin resistance, confirmed by the presence of the mecA gene. After repeat testing of isolates flagged by the ATB software as possible errors, sensitivity increased to 99% for oxacillin-resistant isolates. Essential agreement with agar dilution testing for susceptibility to amoxicillin-clavulanic acid, gentamicin, erythromycin, clindamycin, and ciprofloxacin, as estimated by Youden's J statistic, was > 0.90. Subpopulations of isolates with significantly increased MICs of amikacin, rifampin, and minocycline, indicating borderline susceptibility, were detected by Rapid ATB and categorized as resistant. Rapid ATB Staph showed adequate accuracy for detection within 5 h of the oxacillin- and multiple-drug-resistant S. aureus isolates currently prevalent in Belgium.

Colony Count, Microbial↗
PubMed1995

Childhood acute lymphoblastic leukemia (ALL): sister chromatid exchange (SCE) frequency and lymphocyte subpopulations during therapy.

Sister chromatid exchanges (SCE) and lymphocyte subsets of children with acute lymphoblastic leukemia (ALL) were investigated during chemotherapy. The treatment followed protocol ALL-BFM-90. Children with ALL at the time of diagnosis showed statistically significant higher SCE frequencies (4.9 +/- 0.77) than healthy controls (3.6 +/- 0.93; P = 0.002). The in vivo effects of cyclophosphamide (CP) resulted in a dramatic increase of the SCE frequency (20.5 +/- 3.76). This increased SCE level of lymphocytes might reflect an instability of DNA or a deficiency of DNA repair. One could suggest that lymphocytes of children with ALL might have a higher susceptibility to harmful influences; and this could be a co-factor towards the development of the malignant disease. However, immediately 1 week after the administration of CP, the SCE rate decreased. This decline of SCE frequency correlated with a severe reduction of the absolute number of T lymphocytes. The observed reduction of SCE frequency may be due to a loss of T lymphocytes, or SCE became repaired during 1 week.

Adolescent↗
PubMed1995

Effect of Viscum album L. on rapidly proliferating amniotic fluid cells. Sister chromatid exchange frequency and proliferation index.

Amniotic fluid cells (AFC) from 10 women undergoing amniocentesis were investigated. The 5-bromo-2'-deoxyuridine-induced sister chromatid exchange (SCE) frequency of AFC remained stable after the addition of a therapeutical concentration of Viscum album L. preparation Iscador P but decreased significantly after administration of high drug doses. As the proliferation index remained stable, even at extremely high drug concentrations, this effect could not be ascribed to a reduction of proliferation. No indications of cytogenetic damage or effects of mutagenicity were seen after the addition of Viscum album L. preparation P.

Amniotic Fluid↗
PubMed1995

[Hypothenar hammer syndrome].

Hypothenar hammer syndrome is an infrequently diagnosed labor disease. We report a 51 years old male who used the medial aspect of his left hand as a hammer over the past 12 years. He presented with an ipsilateral ring finger embolization. An angiogram demonstrated an ulnar artery occlusion at the hypothenar eminence. No other source of emboli was found and treatment was conservative. This disease is a consequence of repetitive trauma on the ulnar artery, that leads to vessel wall changes and promotes local thrombosis, distal embolization and eventually, occlusion in situ. Treatment options are conservative in case of occlusion or reconstruction with exclusion of the emboligeneous area.

Arterial Occlusive Diseases↗
PubMed1994

National survey of methicillin-resistant Staphylococcus aureus in Belgian hospitals: detection methods, prevalence trends and infection control measures. The Groupement pour le Dépistage, l'Etude et la Prévention des Infections Hospitalières.

A questionnaire survey of Belgian acute care hospitals was conducted to determine the methods used for detection of methicillin-resistant Staphylococcus aureus (MRSA), to estimate the prevalence of this organism during the period 1989-1991 and to describe the infection control measures used locally for limiting its spread. Questionnaires were returned by 144 acute care hospitals, with a coverage of 41 to 72% of hospitals by province. Methods used for detection of MRSA included disk diffusion (91%), microdilution panels (8%) and oxacillin agar screen (9%). Only 34% of laboratories performed disk diffusion testing under optimal conditions for detection of heterogenous resistance. Among 36 hospitals reporting complete susceptibility data of Staphylococcus aureus isolates tested during the study period (n = 24,153), a mean MRSA prevalence of 14% was found (range: 0-70%). The median prevalence increased from 9.5% in 1989 to 13.7% in 1991 and showed a significant linear increase during this period in 30% of these hospitals (p < 0.01). Precautions used for controlling spread of MRSA included hand decontamination using either soap and water or antimicrobial preparations (68% of hospitals), room decontamination (62%), patient isolation (55%) and various barrier precautions (24-49%). Carrier screening was performed in 37% of hospitals, but antibiotic decolonization was attempted in only 24%. This survey identified areas for improvement in MRSA detection methods and underscored the need for multicentric surveillance of MRSA prevalence and a reappraisal of MRSA control strategies in Belgian hospitals.

Bacteriological Techniques↗
PubMed1994

A computerized nationwide network for nosocomial infection surveillance in Belgium.

OBJECTIVE: To assess the feasibility of computerized nationwide surveillance of nosocomial infections in Belgium, and to obtain preliminary national and hospital-specific incidence data. DESIGN: Prospective multicenter cohort study of surgical wound infections (SWI). SETTING: All 218 acute care hospitals in Belgium in the period October 14 to December 14, 1991. RESULTS: Eighty-five of 218 acute care hospitals (39%) succeeded in collecting the required information and in completing this pilot study, although 50% of the participating hospitals had no previous experience in nosocomial infection surveillance. Seventy percent of the small-size hospitals (< 200 beds) did not participate, mainly because of shortages of manpower. A lack of collaboration from clinicians was a problem in most participating hospitals. SWI postdischarge surveillance was most successful when based on information collected by the surgeons at the surgical outpatient clinic; by this method, postdischarge information was obtained on 43.9% of all surgical procedures. A total of 201 infections were observed among 10,537 operations, with a crude incidence rate of 1.91 per 100 operations or 1.51 per 1,000 person-days of observation. Infection rates by operation type and risk indicators are congruent with those of the literature. Survival analysis showed that the overall cumulative infection risk at 21 days postprocedure attained 81.6% of the 30-days risk. CONCLUSION: This nationwide network for nosocomial infection surveillance has introduced the practice of computerized surveillance of performance in a large number of hospitals. Still, several aspects of the surveillance demand to be improved: the collaboration of the clinicians, the quality of the data, and the postdischarge surveillance methodology.

Belgium↗
PubMed1994

International comparison of results of infection surveillance: The Netherlands versus Belgium.

OBJECTIVE: To explore the potential benefit of comparing results from two national surveillance networks. DESIGN: Two prospective multicenter cohort studies of surgical wound infections (SWI). SETTING: Thirty-five and 62 acute-care hospitals in The Netherlands (NL) and Belgium (B), respectively, from October 1, 1991, to June 30, 1992. RESULTS: The participation was equivalent in the two countries: 27% (NL) and 28% (B) of all acute-care hospitals. Marked differences emerged between the Dutch and Belgian crude infection rates and the specific rates by wound class and other risk factors. Because the case-mix in the countries is quite different, comparisons can be made only by specific surgical category. The results for inguinal hernia repair and for appendectomy are compared as an example. In herniorrhaphies, the difference in infection rate (0.4% [NL] versus 1.2% [B]) is not explained by differences in the distribution of risk factors. The shorter hospital stay in The Netherlands (4 days [NL] versus 6 days [B]), the more effective postdischarge surveillance in Belgium, and the fact that more than two thirds of the detected infections occurred after the first postoperative week probably can account for most of the difference. There was a striking difference in prophylaxis use (3.7% [NL] versus 41.9% [B]). In appendectomies, the Dutch patient population shows on average a higher risk profile, and surgery is urgent much more often in The Netherlands (78.3%) than in Belgium (49.2%). The infection rate is higher in The Netherlands, especially among the patients without prophylaxis, which again is employed less frequently there. CONCLUSION: We conclude that international comparisons yield interesting insights regarding quality of care, reaching beyond the field of nosocomial infection prevention. This is an argument in favor of more harmonization between surveillance networks.

Adult↗
PubMed1993

Effect of human and recombinant IFN-alpha and IFN-beta on the sister-chromatid exchange (SCE) frequency in amniotic fluid cells in vitro.

Sister-chromatid exchange (SCE) and rates of proliferation in human amniotic fluid cells from healthy donors exposed to human IFN-alpha and IFN-beta and recombinant IFN-alpha and -beta were investigated. Amniotic fluid cells were obtained from pregnant women undergoing genetic amniocentesis. For 46 h, cells were treated with IFNs at concentrations of 10(3)-10(5) U/l. A dose-depending decrease of SCE rate with IFN-alpha and IFN-beta was observed. Our studies in amniotic fluid cells show that the mean SCE frequencies are reduced after incubation with IFN-alpha as well as with IFN-alpha. In contrast to IFN-gamma, the type I IFNs IFN-alpha and IFN-beta cause a genetic effect on DNA repair or a protection from DNA damage. Previously we had shown that a significant dose-depending increase of SCE rates was found in amniotic fluid cultures after addition of IFN-gamma. Therefore, IFN-alpha and IFN-beta (both human IFNs) and also recombinant IFN-alpha and IFN-beta, also in high doses, are neither genotoxic/clastogenic nor embryotoxic. Amniotic cells are vulnerable human cells, which may be well suited for examining the effects of agents like interferon.

Amniotic Fluid↗
PubMed1993

Cytogenetics of Askin's tumour. Case report and review of the literature.

The eleventh cytogenetically analyzed Askin's tumour, diagnosed in a two-year-old girl, is reported. Chromosomal analysis revealed a pseudodiploid karyotype of tumour cells with translocations of t(11;22)(q24;q12) and der(4)t(2;4)(q24;q35). The observed t(11;22)(q24;q12) is not only a unique characteristic of all cytogenetically analyzed Askin's tumours but it also occurs in 92-100% of peripheral neuroepithelioma and of Ewing's sarcoma, irrespective of its osseous or extraosseous localization. This genetical similarity further supports a nosological concept according to which Askin's tumour, Ewing's sarcoma and peripheral neuroepithelioma represent phenotypic variations of the same tumour, namely the peripheral primitive neuroectodermal tumour.

Child, Preschool↗
PubMed1992

[Early renal dysfunction after elective surgery of the infrarenal aorta: incidence and predictive factors].

Renal dysfunction was investigated in the early postoperative period in 223 patients subjected to surgery of the infrarenal aorta. Dysfunction was diagnosed as an elevation of creatinine plasma levels above 2 mg/dl in patients with normal preoperative renal function, or a 50% increase over abnormal preoperative levels, within the first 5 postoperative days. The overall incidence was 5.68% (13 patients), and 2 patients required hemodialysis. Predictive variables were chronic hypertension and preoperative creatinine levels above 1.5 mg/dl. Two patients died from causes other than renal failure. No hemodynamic renal failure could be identified in 7 patients. The possibility of atheromatous renal embolization cannot be excluded in these patients. In patients with elevated risk for renal failure, delaying surgery after angiography, careful hemodynamic monitoring and surgical techniques may help decrease the incidence of this complication.

Aged↗
PubMed1991

[Popliteal aneurysm: results of the management of 33 lesions].

Popliteal aneurysm is a rather infrequent lesion which may cause severe ischemia and loss of the extremity. Between 1975 and 1990, 21 patients, all male with a mean age of 73 years, presented with popliteal aneurysm which was associated to aneurysm in other arteries in 62% and other medical problems in 95% of patients. 61% of patients had severe ischemia due to thrombosis or embolism. Surgery was performed for 29 lesions (10 as an emergency). Exclusion and bypass was performed in 26 (20 with saphenous vein and 6 with a prosthesis). Amputation due to irreversible ischemia was required in 3 patients. There was no mortality in this series and only 1 patient required later amputation. Permeability was estimated at 85% at 5 years of follow up, including all bypasses. We conclude that popliteal aneurysm should be diagnosed and electively operated with saphenous vein grafting.

Aged↗
PubMed1991

[Gastrointestinal symptoms in disseminated Langerhans cell histiocytosis. Case report and review of the literature].

Symptoms of gastrointestinal disease are variable in Langerhans' cell histiocytosis (LCH). The incidence of gastrointestinal involvement is estimated to be approximately 5% in disseminated LCH. This report focuses on a 10.5 months old female infant who suffered from relapsing diarrhea and intermittent anal blood loss since the second week of life and from weight loss later in the course of disease. Definite diagnosis of LCH was not established before the patient developed additional characteristic symptoms. Analysis of large series of patients and a retrospective histopathological study reveals that an involvement of the gastrointestinal tract must be anticipated in about 50% of all cases with disseminated LCH.

Biopsy↗
PubMed1990

Unusually long survival time after resection and irradiation of a brain metastasis from osteosarcoma.

Cerebral metastases of osteosarcomas are rare. The cases published up to now have manifested only a short relapse-free period of survival. Intracranial filia generation must be anticipated if metastasis formation takes place in the lung. We report here on a young patient who underwent operation for an intraparenchymal cerebral metastasis 76 months after amputation of the left leg due to an osteosarcoma chondroblasticum, and who is, at present, healthy, 13 months after resection. This unusually long survival time is attributed to the good neurological status before craniotomy, early diagnosis, and the improvement of the cytostatic therapy (COSS-80-scheme).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Flavimonas oryzihabitans septicaemia in a T-cell leukaemic child: a case report and review of the literature.

We describe the first case of septicaemia with Flavimonas oryzihabitans reported from Germany and possibly associated with colonisation of a venous port system. The patient, an 8-year-old T-cell leukaemic girl, was receiving a third course of chemotherapy before bone marrow transplantation. The cardinal symptom, fever, subsided when the venous port system for administration of drugs was no more used. The organism was tested extensively for characteristic biochemical features and antimicrobial susceptibility. We discuss the relevant literature and suggest the means of making a definitive microbiological diagnosis.

Anti-Bacterial Agents↗
PubMed1990

[The medical treatment of intestinal obstruction due to adhesions and adherences].

Adhesions are the most common cause of intestinal obstruction. Medical treatment for those patients with no signs of vascular involvement has been successful in many cases. We reviewed the clinical records of 87 patients with intestinal obstruction due to adhesions, having a total of 122 episodes. Satisfactory follow up was obtained in 76% of patients for a mean of 29.6 months. 47% of episodes resolved without need for surgical intervention. Volume entrapment during the first hours was correlated with need for surgical treatment (p < 0.01). Recurrences were not different between medical and surgical patients (p = 0.28). Thus, medical treatment of this type of intestinal obstruction may be attempted in most patients, not only those who are poor surgical risks.

Adult↗
PubMed1989

National study on the utilization of prophylactic antibiotics in surgery, Belgium, 1986.

During the last week of May 1986, a 1-week prospective study on antibiotic utilization in surgical patients was held in 104 (42%) of the 247 Belgian acute care hospitals. All surgical patients with a post-operative stay of at least 3 days were studied, involving 3112 patients. Each patient was observed for 7 days, starting from the day before surgery. Antibiotics were administered to 71.9% of all patients; 21.9% received therapeutic antibiotics and 52.9% prophylactic antibiotics; 2.9% received both. Of the 1285 patients undergoing a surgical procedure with no indication for antimicrobial prophylaxis, 50.7% nevertheless received prophylaxis; 92.8% of patients with a generally recognized indication for prophylaxis received antibiotic prophylaxis. Less than one fifth (17.1%) of all prophylactic courses were stopped on the day of the intervention whilst 26.3% were continued up to the fifth post-operative day or beyond. The most frequently prescribed drugs for this indication included first and second generation cephalosporins and nitroimidazoles. The number of different generic drugs utilized per hospital ranged from 1 to 18 (mean: 7.7).

Aged↗