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- Berge, Andreas, et al.
(författare)
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The DENOVA score efficiently identifies patients with monomicrobial Enterococcus faecalis bacteremia where echocardiography is not necessary
- 2019
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Ingår i: Infection. - : Springer Science and Business Media LLC. - 0300-8126 .- 1439-0973. ; 47:1, s. 45-50
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Enterococcal bacteremia can be complicated by infective endocarditis (IE) and when suspected, transesophageal echocardiography (TEE) should be performed. The previously published NOVA score can identify patients with enterococcal bacteremia at risk for IE and we aimed to improve the score. Methods: Factors associated with IE were studied retrospectively in a population-based cohort of patients with monomicrobial Enterococcus faecalis bacteremia (MEFsB). Factors associated with IE in multivariable analysis were included in a new score system which was compared to the NOVA score and validated in a cohort of patients with MEFsB from another region. Results: Among 397 episodes of MEFsB, 44 episodes with IE were compared to those without IE. Long Duration of symptoms (≥ 7 days) and Embolization were associated with IE in the multivariate analysis and hence were added to the NOVA variables (Number of positive cultures, Origin of infection unknown, Valve disease, and Auscultation of murmur) to generate a novel score; DENOVA. The area under the curve in ROC analyses was higher for DENOVA (0.95) compared to NOVA (0.91) (p = 0.001). With a cutoff at ≥ 3 positive variables the DENOVA score has a sensitivity of 100% and specificity of 83% which is superior to the NOVA score (specificity 29%). The DENOVA score was applied to the validation cohort (26 IE episodes and 256 non-IE episodes) and the resulting sensitivity was 100% and the specificity was 85% compared to 35% for NOVA. Conclusions: The DENOVA score is a useful tool to identify patients with MEFsB where TEE is not needed.
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| 3. |
- Hansson, Göran, 1936-
(författare)
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Såld spannmål av kyrkotionden : Priser i Östergötland under Sveriges stormaktstid
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis presents annual price series for rye and barley in Östergötland during the period 1592-1735. Prices of wheat, oats, animal products, building materials, iron, nails, horse shoes and horse shoe nails from about the mid-17th century up to 1735 are also presented and analysed. New data has been excerpted from four hospitals and about fifty parishes in Östergötland. Prices from other provinces have also been excerpted for the study. This nes data is compared to already published prices from Sweden´s capital and from several provinces in central parts of the western national region of Sweden of that time. This area constituted Sweden´s core region. By linking the studies results to previous research, a description is made of the price developments for rye, butter and tallow up to 1775, that is, during Sweden´s period of great power and age of freedom. A principal result for the roughly 150 years primarily covered by the thesis is that it was chiefly the prices of rye and barley, the most important food at the time, that fluctuated in twelve cycles. Periodically there were large fluctuatons. The price cycles for corn (half rye, half barley) had an average amplitude of somewhat more than 100 % and a duration of 11 years on average. The prices were on average higher further north in the country. The causes of the price fluctuations are complex. During the major part of the period studied, Sweden was at war or in armistice period, which occupied a large part of the male population. Politically, increasingly great power was gradually concentrated to the king and autocracy was introduced, culminating at the end of Charles XII´s regency. The peasantry was burdened by high taxes and other onuses. After the middle of the 17th century the country was no longer self-subsistent but largely dependent on corn import. The production of foddstuffs decreased, partly through a smaller part of the country´s resources beeing used for production, and partly due to bad harvests. Recurrent epidemics reduced the population even up to the early 18th century.
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| 5. |
- Krantz, Christina, et al.
(författare)
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Nasal nitric oxide is associated with exhaled NO, bronchial responsiveness and poor asthma control
- 2014
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Ingår i: Journal of Breath Research. - : IOP Publishing. - 1752-7155 .- 1752-7163. ; 8:2, s. 026002-
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Tidskriftsartikel (refereegranskat)abstract
- The fraction of exhaled nitric oxide (FeNO) is an established marker of airway inflammation in asthma. Nasal nitric oxide (nNO) has initially been regarded as a promising marker of inflammation of nasal mucosa. However, due to its dual origins, paranasal sinuses and nasal mucosa, the clinical use of nNO is controversial. There is an inflammatory link between inflammation in the upper and lower airways within the united airways' paradigm, but the study of the clinical value of nNO in asthma has been limited. The objective of this study is to analyse nNO in asthmatics and its relationship to FeNO, bronchial hyperresponsiveness, allergic sensitization and asthma control. A total of 371 children and young adults from an asthma cohort were included in this study, which performed measurements of nNO (through aspiration at 5 mL s(-1)), FeNO, bronchial responsiveness to methacholine, blood eosinophil count (B-Eos) and IgE sensitization. The asthma control test (ACT) and a questionnaire regarding medical treatment, symptoms of asthma, rhinitis and chronic rhinosinusitis were completed by all subjects. An association was found between higher nNO levels and increased bronchial responsiveness (p < 0.001), FeNO (p < 0.001) and B-Eos (p = 0.002). Sensitization to furry animals related to higher levels of nNO (p < 0.001). Subjects with poorly controlled asthma (ACT < 15) had lower levels of nNO than subjects with a higher ACT score (619 +/- 278 ppb, versus 807 +/- 274 ppb, p = 0.002). Loss of smell showed the strongest association with lower nNO levels among the upper airway symptoms recorded. In patients with asthma, nNO was positively correlated with exhaled NO, bronchial responsiveness and asthma control. This study suggests clinical utility of nNO in subjects with asthma, but in order to get better understanding of the nNO determinants, simultaneous mapping of upper airway comorbidities by clinical examination is appropriate.
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| 6. |
- Kullberg-Lindh, Carola, 1959, et al.
(författare)
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Quantitative analysis of CMV DNA in children the first year after liver transplantation.
- 2003
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Ingår i: Pediatric transplantation. - 1397-3142. ; 7:4, s. 296-301
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Tidskriftsartikel (refereegranskat)abstract
- CMV infection is a major problem after solid organ transplantation especially in children where primary infection is more common than in adults. Early diagnosis is critical and might be facilitated by quantitative analysis of CMV DNA in blood. In this retrospective study of 18 children who had a liver transplantation 1995-2000, serum samples were analysed by Cobas Amplicor Monitor (Roche). Four patients developed symptomatic CMV infection at a mean time of 4 wk after transplantation. They showed maximum CMV DNA levels in serum of 26 400, 1900, 1300 and 970 copies/mL, respectively. In comparison, CA Monitor was positive, at a low level (415 copies/mL), in one of 11 patients with asymptomatic (4) or latent (7) infection. CMV IgM was detected at significant levels (> or =1/80) in all four patients with symptomatic, and in one with asymptomatic CMV infection. Eight patients were given one or several courses of ganciclovir. Five of these lacked symptoms of CMV disease, and had low (415 copies/mL) or undetectable CMV DNA in serum. The data suggest that quantitative analysis of CMV DNA may be of value in early identification of CMV disease and for avoiding unnecessary antiviral treatment.
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| 10. |
- Söderström, Ann, 1961, et al.
(författare)
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Predictive factors and virological response to interferon treatment in children with chronic hepatitis B.
- 2005
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Ingår i: Scandinavian journal of infectious diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 37:1, s. 40-7
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Tidskriftsartikel (refereegranskat)abstract
- Further knowledge about factors predicting response to interferon treatment for chronic hepatitis B in children is required, in particular as the benefits of therapy are uncertain. In the present study, baseline characteristics were related to virological and histological responses in 27 children given interferon-alpha for 24 weeks after steroid priming. HBe seroconversion was seen in 8 of 27 HBeAg positive patients and was accompanied by a sustained virological response (SR), with a median 4.1 log HBV DNA reduction. Pretreatment viraemia level was the only baseline parameter associated with SR. After 12 weeks of IFN (mid-treatment), viraemia was significantly reduced in all patients, with a median of 3.0 (range 0.6-5.2) log decline in SR compared with 0.6 (range -0.5-3.6) log decline in non-sustained responders (NSR). HBV DNA levels below 1 million copies/ml at week 12 predicted sustained response with a positive predictive value of 75% and a negative predictive value of 89%. During the latter half of the IFN treatment HBV DNA tended to increase by a mean of 0.4-0.5 log for all patient groups. Flares during IFN treatment were rare or mild as measured by ALT. Pretreatment anti-HBc IgM was associated with liver damage but not with response. Histological inflammation scores were improved in SR. Thus, pretreatment HBV DNA levels were associated with IFN response, and the virological response at week 12 predicts SR and may be useful in the decision to continue or modify therapy.
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