Publications by authors named "Court J"

Microbiology is a difficult topic to teach given that the objects of study are mostly invisible to the learner. The majority of university students beginning their training in biology are more interested in natural objects that can be seen with the naked eye. Nonetheless, micro-organisms are key components of the biosphere and a good microbiological background is required for a thorough training in natural sciences.

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Background: In neutropenic patients, bloodstream infections (BSI) significantly contribute to morbidity and mortality. Appropriate empirical antibiotic therapy (EAT) of BSI is essential, at the same time overconsumption of very broad-spectrum antibiotics should be avoided. We investigated: (1) whether surveillance cultures can predict BSI with third-generation cephalosporin -resistant Enterobacterales and Pseudomonas aeruginosa (3GC-R), (2) the effect of inappropriate empirical antimicrobial therapy (IEAT) on clinical outcome and (3) the potential reduction of carbapenem use when using surveillance cultures to guide therapy.

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Objectives: Among patients with haematological malignancy, bacteraemia is a common complication during chemotherapy-induced neutropenia. Resistance of gram-negative bacteria (GNB) to third-generation cephalosporins (3GC) is increasing. In order to explore the value of using surveillance cultures to guide empirical treatment e.

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Article Synopsis
  • The guideline was developed by a multidisciplinary committee from various Dutch medical societies to provide recommendations for managing febrile neutropenia in both adults and children.
  • The recommendations are based on a review of clinical guidelines and recent literature from 2010 to 2020, addressing nine critical questions regarding the condition.
  • It differentiates between high- and standard-risk neutropenia in adults by the duration of neutropenia, recommending specific antibiotics like ceftazidime and cefepime for high-risk cases and suggesting the use of the MASCC score for evaluating infection risk in standard-risk cases.
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Objectives: Evaluation of the appropriateness of the duration of antimicrobial treatment is a cornerstone of antibiotic stewardship programs, but it is time-consuming. Furthermore, it is often restricted to antibiotics prescribed during hospital admission. This study aimed to determine whether mandatory prescription-indication registration at the moment of prescribing antibiotics enables reliable automated assessment of the duration of antibiotic therapy, including post-discharge duration, limiting the need for manual chart review to data validation.

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Purpose: Different bacteria lead to divers diabetic foot infections (DFIs), and some bacteria probably lead to higher amputation and mortality risks. We assessed mortality and amputation risk in relation to bacterial profiles in people DFI and investigated the role of sampling method.

Methods: We included people (> 18 years) with DFI in this retrospective study (2011-2020) at a Dutch tertiary care hospital.

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serotype 3 (SPN3) is a cause of invasive pneumococcal disease and associated with low carriage rates. Following the introduction of pediatric 13-valent pneumococcal conjugate vaccine (PCV13) programs, SPN3 declines are less than other vaccine serotypes and incidence has increased in some populations coincident with a shift in predominant circulating SPN3 clade, from I to II. A human challenge model provides an effective means for assessing the impact of PCV13 on SPN3 in the upper airway.

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Background In the Netherlands, home treatment with intravenous antimicrobial therapy is a relatively new concept. Although several studies have shown that outpatient parenteral antimicrobial therapy (OPAT) can be administered safely, people receiving antimicrobials at home remain at risk for adverse events, including readmission. Aim The aim of our retrospective study was to identify risk factors for readmission in patients discharged with OPAT.

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Educational escape rooms (EERs) are live-action, team-based games used to teach content-related and generic knowledge and skills. Instead of students just playing the EER, we believed that giving them the opportunity to create their own EERs would augment the learning effects of this teaching method. We report on the feasibility, evaluation, and lessons learned of our assignment on an opioid epidemic-based EER.

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In our efforts to identify novel small molecule inhibitors for the treatment of adrenoleukodystrophy (ALD), we conducted a high-throughput radiometric screen for inhibitors of elongation of very long chain fatty acid 1 (ELOVL1) enzyme. We developed a series of highly potent, central nervous system (CNS)-penetrant pyrimidine ether-based compounds with favorable pharmacokinetics culminating in compound . Compound is a selective inhibitor of ELOVL1, reducing C26:0 VLCFA synthesis in ALD patient fibroblasts and lymphocytes in vitro.

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Accumulation of very long chain fatty acids (VLCFAs) due to defects in ATP binding cassette protein D1 (ABCD1) is thought to underlie the pathologies observed in adrenoleukodystrophy (ALD). Pursuing a substrate reduction approach based on the inhibition of elongation of very long chain fatty acid 1 enzyme (ELOVL1), we explored a series of thiazole amides that evolved into compound ─a highly potent, central nervous system (CNS)-penetrant compound with favorable pharmacokinetics. Compound selectively inhibits ELOVL1, reducing C26:0 VLCFA synthesis in ALD patient fibroblasts, lymphocytes, and microglia.

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Article Synopsis
  • The study investigated how often patients with COVID-19 also had bacterial lung infections, focusing on those with positive SARS-CoV-2 tests or high CO-RADS scores.
  • Conducted from March to June 2020, the research involved a retrospective analysis of COVID-19 patients, categorizing them as unlikely, possible, or probable for bacterial co-infection based on clinical and laboratory data.
  • Findings revealed that 82.9% of patients were unlikely to have bacterial co-infections, suggesting that antibiotics should be used sparingly in COVID-19 cases, as 81% of all patients received them within 72 hours despite low co-infection rates.
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Childhood vaccine refusal is a globally contentious topic, with some jurisdictions addressing it with punitive policies. Media discourse influences how solutions are framed by implying blame - a process known as framing. We examined Australian media discourse on vaccine rejection over a period in which mandatory childhood vaccination policies were discussed and introduced, focusing on the common Australian pejorative term 'anti-vaxxer'.

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Introduction: Junior doctors are working in an increasingly overstretched National Health Service. In 2018, Kettering General Hospital (KGH) was awarded £60 800 of government funds to create high-quality rest facilities and improve junior doctor well-being.

Methods: An audit and survey in KGH identified the structural and functional improvements needed.

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Rho kinase (ROCK) inhibitors are of therapeutic value for the treatment of disorders such as hypertension and glaucoma, and potentially of wider use against diseases such as cancer and multiple sclerosis. We previously reported a series of potent and selective ROCK inhibitors based on a substituted 7-azaindole scaffold. Here we extend the SAR exploration of the 7-azaindole series to identify leads for further evaluation.

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Prior to Darwin's masterworks, a university professor of medicine's purview generally included the professorship of botany and direction of the botanical gardens. Yet from the landmark 1876 Johns Hopkins model and especially after the 1910 Flexner Report, botany was limited at certain medical schools to (exaggerating somewhat) "decorating their lobbies!" Darwinian-era scientific paradigms spread from continental Europe through promulgators such as Huxley and Osler, transforming laboratory research, disease aetiology, biochemical therapeutics, and clinical "bedside" teaching. Unintended consequences at universities with medical schools might include altered loyalties and resources among competing disciplines.

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Chronic subdural hematomas (cSDH) are one of the most frequent reasons for consultation in neurosurgery. Multiple authors have proposed middle meningeal artery embolization (MMAE) as an option in cSDH patients to manage recurrence or avoid surgery altogether. Although many articles have been published on the matter, the current body of evidence still has to be evaluated before MMAE is integrated into clinical practice.

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The demographics and comorbidities of patients with community acquired pneumonia (CAP) vary enormously but stratified treatment is difficult because aetiological studies have failed to comprehensively identify the pathogens. Our aim was to describe the bacterial microbiota of CAP and relate these to clinical characteristics in order to inform future trials of treatment stratified by co-morbidity. CAP patients were prospectively recruited at two UK hospitals.

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Importance: Open-globe injuries (OGI) are a leading cause of monocular blindness world-wide with considerable cost to the individual and society.

Background: To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand.

Design: Retrospective study.

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Rho kinase (ROCK) inhibitors are potential therapeutic agents for the treatment of a variety of disorders including hypertension, glaucoma and erectile dysfunction. Here we disclose a series of potent and selective ROCK inhibitors based on a substituted 7-azaindole scaffold. Substitution of the 3-position of 7-azaindole led to compounds such as 37, which possess excellent ROCK inhibitory potency and high selectivity against the closely related kinase PKA.

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Our aims were to address three fundamental questions relating to the symptoms of community-acquired pneumonia (CAP): Do patients completely recover from pneumonia symptoms? How long does this recovery take? Which factors influence symptomatic recovery?We prospectively recruited patients at two hospitals in Liverpool, UK, into a longitudinal, observational cohort study and modelled symptom recovery from CAP. We excluded patients with cancer, immunosuppression or advanced dementia, and those who were intubated or palliated from admission. We derived a statistical model to describe symptom patterns.

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Lomibuvir () is a non-nucleoside, allosteric inhibitor of the hepatitis C virus NS5B polymerase with demonstrated clinical efficacy. Further development efforts within this class of inhibitor focused on improving the antiviral activity and physicochemical and pharmacokinetic properties. Recently, we reported the development of this series, leading to compound , a molecule with comparable potency and an improved physicochemical profile relative to .

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Anecdotal reports suggest that Sherpa highlanders demonstrate extraordinary tolerance to hypoxia at high altitude, despite exhibiting lower arterial oxygen content than acclimatized lowlanders. This study tested the hypothesis that Sherpas exposed to hypobaric hypoxia on ascent to 5,300 m develop increased microcirculatory blood flow as a means of maintaining tissue oxygen delivery. Incident dark-field imaging was used to obtain images of the sublingual microcirculation from 64 Sherpas and 69 lowlanders.

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