| 1. |
- Berge, Martin, et al.
(författare)
-
Pre-treatment allergen-specific IgE analysis and outcomes of allergen immunotherapy
- 2022
-
Ingår i: European annals of allergy and clinical Immunology. - : Edizioni Edra. - 1764-1489. ; 54:5, s. 218-228
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients show varied results to allergen immunotherapy (AIT. The reason for this variability is unclear.Objective: To describe the relationship between AIT efficacy and demographic characteristics, as well as pre-treatment plasma levels of specific IgE-antibodies to grass and birch pollen.Methods: A retrospective study was performed based on medical records of 128 patients who received AIT. The patients completed a questionnaire and pre-AIT plasma levels of allergen-specific IgE to grass and birch pollen were measured using EUROLINE DPA-Dx pollen 1 method. Results. Seventy percent of patients classified their allergic symptoms as less severe after AIT. Twenty-seven percent had received AIT targeting only grass pollen, 19% targeting only birch pollen, and 55% targeting both grass and birch. A total of 35 different IgE profiles were found across our study population. On comparison of the demographic characteristics and concentration of allergen-specific IgE-antibodies, no statistically significant differences could be found.Conclusions: The majority of patients rated their allergic symptoms as less severe after AIT. No clear relationship could be demonstrated between pre-treatment allergen-specific IgE concentration, or demographic characteristics, and effect of AIT. There may be other factors underlying the different responses to AIT.
|
|
| 2. |
- Berge, M., et al.
(författare)
-
Qualitative and quantitative comparison of allergen component-specific to birch and grass analyzed by ImmunoCAP assay and Euroline immunoblot test
- 2023
-
Ingår i: European annals of allergy and clinical immunology. - : Edizioni Edra. - 1764-1489. ; 55:2, s. 68-77
-
Tidskriftsartikel (refereegranskat)abstract
- Background: In the diagnostic work up of allergy, determining allergen component-specific immunoglobulin E (IgE) is important for diagnosis, prognosis and choice of treatment.Objective: The purpose of this study was to evaluate the performance of the immunoblotting assay (Euroline) in detection of IgE antibodies against timothy grass and birch pollen allergen components compared to fluorescent enzyme assay (ImmunoCAP, Phadia 250).Methods: A total of 128 serum samples from patients allergic to timothy grass and birch pollen were analysed. The levels of IgE antibodies to timothy grass and birch pollen were measured using Euroline DPA-Dx pollen 1 and ImmunoCAP assay. The two methods were then compared on binary (positive vs negative), semi-quantitative (IgE classes) and quantitative (concentration) levels. The two methods were also compared to results from skin prick testing.Results: The Euroline method showed a positive percentage agreement of 93% and negative percentage agreement of 94% with an overall accuracy of 94% when compared to ImmunoCAP. Kappa analysis showed moderate strength of agreement between the methods in determining IgE classes for 7/11 components tested. All components showed a positive correlation when analysed using Spearman's rank correlation.Conclusions: Overall, we found that there is good correlation between the Euroline and ImmunoCAP methods in measuring IgE sensitization.
|
|
| 3. |
- Hallberg, Pär, et al.
(författare)
-
Comparison of Clinical Factors Between Patients With Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema and Cough
- 2017
-
Ingår i: The Annals of Pharmacotherapy. - Thousand Oaks, USA : Sage Publications. - 1060-0280 .- 1542-6270. ; 51:4, s. 293-300
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Angioedema is a rare and serious adverse drug reaction (ADR) to angiotensin-converting enzyme (ACE) inhibitor treatment. Dry cough is a common side effect of ACE inhibitors and has been identified as a possible risk factor for angioedema.Objective: We compared characteristics between patients with ACE inhibitor-induced angioedema and cough with the aim of identifying risk factors that differ between these adverse events.Methods: Data on patients with angioedema or cough induced by ACE inhibitors were collected from the Swedish database of spontaneously reported ADRs or from collaborating clinicians. Wilcoxon rank sum test, Fisher's exact test, and odds ratios (ORs) with 95% CIs were used to test for between-group differences. The significance threshold was set to P <0.00128 to correct for multiple comparisons.Results: Clinical characteristics were compared between 168 patients with angioedema and 121 with cough only. Smoking and concomitant selective calcium channel blocker treatment were more frequent among patients with angioedema than cough: OR = 4.3, 95% CI = 2.1-8.9, P = 2.2 × 10(-5), and OR = 3.7, 95% CI = 2.0-7.0, P = 1.7 × 10(-5) Angioedema cases were seen more often in male patients (OR = 2.2, 95% CI = 1.4-3.6, P = 1.3 × 10(-4)) and had longer time to onset and higher doses than those with cough (P = 3.2 × 10(-10) and P = 2.6 × 10(-4)). A multiple model containing the variables smoking, concurrent calcium channel blocker treatment, male sex, and time to onset accounted for 26% of the variance between the groups.Conclusion: Smoking, comedication with selective calcium channel blockers, male sex, and longer treatment time were associated with ACE inhibitor-induced angioedema rather than cough.
|
|
| 4. |
- Hugosson, Svante, 1956-
(författare)
-
Invasive haemophilus influenzae infection. Clinical, immunologic and pathogenic aspects
- 1998
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Invasive Haemophilus influenzae (Hi) infection, predominantly manifested as acute meningitis and epiglottitis, is a serious disease with associated mortality and residual handicap. Prevention of the disease is possible by vaccination against Hi serotype b (Hib). In a prospective study in a Swedish population before large scale Hib vaccination of infants was introduced, the incidence of invasive Hi infection, in children 0-4 years of age, was 55/100.000/year. Hib caused 98 % of the cases. In a study on laboratory reports, the incidence in Sweden was reduced by 90 % two years after the initiation of the vaccination programme. The pre vaccination incidence in adults was high; 2.8/100.000/year and 51% of the cases were caused by Hib. No significant impact on the incidence in children older than 4 years and adults was found by the vaccination programme during the first two years. Acute epiglottitis during the pre vaccination era was studied retrospectively, and the incidence was higher than previously reported. Blood cultures confirmed Hi as the most prevalent etiologic pathogen in children, but in adult epiglottitis, the aetiology was often unknown. Cultures from nasopharynx had a low diagnostic value. The case fatality rate of invasive Hi infection was 2.9 % and residual sequelae were diagnosed in 5.8 %. These cases were all caused by Hib. The most prevalent sequelae was sensorineural hearing loss after meningitis. Adults who had recovered from Hi meningitis in childhood were investigated and the prevalence of a late progression of pure tone audiometric abnormality was documented. In these cases, hearing loss was peripheral, with cochlea as the suspected site of the lesion, and subclinical vestibular pathology was over-represented. However, brain dysfunction and central auditory disturbance, unpredictable by conventional audiometry was also found. The functional capacity of Hib vaccination induced antibodies was studied with three assays. The induced serum bactericidal and opsonophagocytic activity usually correlated to the serum concentration of antibodies against the Hib capsular polysaccharide (PRP). However, the prevalence of non-functional antibodies indicates that a functional evaluation is desirable in addition to serum concentrations of antibodies in bacterial vaccine trials. A chemiluminescence (CL)-index assay proved more useful than phagocytic killing in measuring serum opsonic action, and the ELISA and CL-index showed that PRP conjugated to diphtheria toxoid was more immunogenic than PRP conjugated to outer membrane protein complex of meningococcus serogroup B. In an overlay assay of radiolabeled bacteria by thin-layer chromatography, Hi recognised three glycosphingolipid (GSL) specificities; lactosylceramide, gangliotri-/gangliotetraosylceramide and neolactotetraosylceramide. Target tissues for Hi were investigated for relevant GSLs and Hi bound to neolactotetraosylceramide of polymorphonuclear leukocytes and oropharyngeal epithelium. The epithelial expression of neolactotetraosylceramide, although as a minor compound, serve as a relevant carbohydrate receptor for Hi in the upper respiratory tract.
|
|
| 5. |
- Hussain, Rashida, 1976-, et al.
(författare)
-
Isolation and culture of primary human nasal epithelial cells from anesthetized nasal epithelia
- 2014
-
Ingår i: Acta Oto-Laryngologica. - London, United Kingdom : Informa Healthcare. - 0001-6489 .- 1651-2251. ; 134:3, s. 296-299
-
Tidskriftsartikel (refereegranskat)abstract
- Conclusion: Using a local anesthetic agent before obtaining nasal biopsies by nasal brushing makes the sampling procedure smooth, avoids lacrimation, nasal itching/irritation, and/or sneezing and provides enough viable cells to establish primary cultures.Objectives: To examine the use of local anesthesia to avoid the irritation experienced by the subject when nasal biopsies are obtained by nasal brushing in order to culture viable nasal epithelial cells.Methods: Nasal epithelial cells were collected from the mid-part of the inferior turbinate of healthy volunteers by brushing with interdental brushes, after spraying a topical anesthetic on the nasal mucosa. Immunocytochemistry was performed to assess the purity of epithelial cells.Results: Cell samples ranging from 1.16 x 10(5) to 3.06 x 10(5) cells/per sample were obtained. Of 11 samples, 7 formed confluent cultures, while the remaining 4 samples showed only patches of epithelial cells. Neither fungal nor bacterial contamination posed a problem. Immunocytochemistry of the cytospin slides confirmed the presence of epithelial cells in the cultures. No adverse effects were experienced by the volunteers.
|
|
| 6. |
- Ryman, Charlotte, et al.
(författare)
-
Health literacy in cancer care : A systematic review
- 2024
-
Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 70
-
Forskningsöversikt (refereegranskat)abstract
- PURPOSE: Health literacy (HL) is a set of knowledge and skills that enables individuals to interpret and act upon health information, which is essential for health equity. There is a growing body of evidence in the field of HL in cancer care but there is, to our knowledge, no systematic review that explores the association between sociodemographic factors and HL among patients with cancer. The aim of this study was therefore to conduct a systematic review of the existing literature that assesses HL levels and the relationship between HL and sociodemographic factors in an adult cancer population.METHODS: This is a systematic review and its protocol was registered in PROSPERO (ID: CRD42021164071). The study was conducted in accordance with the PRISMA statement. The literature search, from December 2009 to September 2023, was made in six databases, AMED, CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science Core Collection.RESULTS: Fifteen studies were included in the review. The included studies used nine different measurement tools for assessing HL. In the included studies between 11.9 % and 86 % had limited HL. We identified a relationship between limited HL and annual income, education level, ethnicity, living in rural areas and multiple comorbidities.CONCLUSION: The results indicate that limited HL is prevalent in the cancer population and should be acknowledge in everyday practice to meet health equity. Our awareness about sociodemographic factors and its association with HL, may enhance adherence to cancer treatment and quality of life, and lower physical and emotional distress.
|
|
| 7. |
- Thunberg, Ulrica, 1967-, et al.
(författare)
-
Anterior rhinoscopy and middle meatal culture in acute rhinosinusitis
- 2013
-
Ingår i: Journal of Laryngology and Otology. - : Cambridge University Press. - 0022-2151 .- 1748-5460. ; 127:11, s. 1088-1092
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the use of bacterial culture findings for middle meatal samples obtained via anterior rhinoscopy, in the diagnosis of adults with acute rhinosinusitis.Materials and methods: Microbial cultures were prepared for 30 adult patients with acute rhinosinusitis and suspected bacterial involvement, using samples from the nasopharynx, and from the nasal middle meatus obtained via anterior rhinoscopy. Findings for the ipsilateral maxillary antrum were used as a reference.Results: Seventeen patients had a bacterial infection as verified by a positive culture from the maxillary antrum. Middle meatal samples had a similar sensitivity but a better specificity, positive predictive value and negative predictive value, compared with nasopharyngeal samples, although predictive values were not statistically significant at a 95 per cent confidence level.Conclusion: Anterior rhinoscopy with culture of middle meatal samples can be recommended as a diagnostic procedure for acute rhinosinusitis. The results can also guide the decision on antibiotic treatment.
|
|
| 8. |
- Thunberg, Ulrica, 1967-, et al.
(författare)
-
Anti-Staphylococcal humoral immune response in patients with chronic rhinosinusitis
- 2019
-
Ingår i: Rhinology Online. - : European Rhinologic Society. - 2589-5613. ; 2, s. 50-58
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Staphylococcus aureus (S. aureus) can behave both as a harmless commensal and as a pathogen. Its significance in the pathogenesis of chronic rhinosinusitis (CRS) is not yet fully understood. This study aimed to determine serum antibody re-sponses to specific staphylococcal antigens in patients with CRS and healthy controls, and to investigate the correlation between specific antibody response and severity of symptoms.Methodology: Serum samples from 39 patients with CRS and 56 healthy controls were analysed using a protein microarray to investigate the antibody response to S. aureus specific antigens, with a focus on immunoglobulin G (IgG) directed toward stap-hylococcal components accessible to the immune system. Holm-Bonferroni corrections were applied in all analyses. Information about growth of S. aureus in nares and maxillary sinus was taken from a previous study based on the same individuals. Clinical symptoms were assessed using a scoring system.Results: IgG antibody levels toward staphylococcal TSST-1 and LukF-PV were significantly higher in the CRS patient group com-pared to healthy controls, and levels of anti-TSST-1 antibodies were significantly higher in the CRS patient group with S. aureus in maxillary sinus than in controls. There were no correlations between the severity of symptoms and levels of serum anti-staphylo-coccal IgG antibody levels for LukF-PV and TSST-1.Conclusions: TSST-1 and LukF-PV could be interesting markers for future studies of the pathogenesis of CRS.
|
|
| 9. |
- Thunberg, Ulrica, 1967-
(författare)
-
Aspects of Staphylococcus aureus in Chronic Rhinosinusitis
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic rhinosinusitis (CRS) affects about 10% of the European population, and is considered a great scourge. Its cause is not clear. Findings of Staphylococcus aureus in the maxillary sinus are common in CRS patients, but are usually regarded as insignificant due to the bacterium’s attribute as a commensal elsewhere. S. aureus has the ability to cause both mild disease and serious conditions, due to its wide armoury of secreted components such as staphylococcal enterotoxins and cell-surface-associated virulence components. This thesis focuses on the clinical features and importance of S. aureus in CRS, including a long-term perspective on the disease, through studying a cohort of CRS patients. S. aureus was found to be highly prevalent in the maxillary sinus and nares of CRS patients, which might indicate an impact on the disease. A sheltered sampling technique for maxillary sinus culture reduced the contamination rate but did not significantly improve the diagnostic reliability. Whole genome sequencing showed that 95% of paired S. aureus isolates collected simultaneously from the nares and maxillary sinus were from identical lineages, indicating colonization of the maxillary sinus from the nares as one joint milieu. A decade-long persistence of S. aureus in the nares and maxillary sinus was established in 20% of CRS patients. The vast majority of S. aureus isolates were susceptible to all tested antibiotics, including the strains that had persisted for a decade. No significant differences in the prevalence of gene determinants were seen for selected virulence factors and MSCRAMMs in S. aureus isolates sampled from CRS patients and healthy controls. The overall alterations of anti-staphylococcal antibodies over time showed great variability and minor support for an impact of S. aureus on CRS. At the long-term follow-up, symptoms were generally reduced and VAS quality of life in terms of fatigue was improved. The subgroup of CRS patients without nasal polyposis had a greater chance of symptom relief than their counterparts with nasal polyposis in this longterm perspective. There was no correlation between severity of symptoms for CRS patients and S. aureus growth in the maxillary sinus to support a role for S. aureus in CRS.
|
|
| 10. |
- Thunberg, Ulrica, 1967-, et al.
(författare)
-
Bacterial findings in optimised sampling and characterisation of S. aureus in chronic rhinosinusitis
- 2017
-
Ingår i: European Archives of Oto-Rhino-Laryngology. - Heidelberg, Germany : Springer. - 0937-4477 .- 1434-4726. ; 274:1, s. 311-319
-
Tidskriftsartikel (refereegranskat)abstract
- The bacterial spectrum in chronic rhinosinusitis (CRS) is clinically relevant. This study aimed to compare two sampling techniques and to characterise Staphylococcus aureus isolated from CRS patients. Bacterial specimens were collected from the nares and maxillary sinus in 42 CRS patients and from the nares in 57 healthy controls. Maxillary sinus sampling was performed in two ways in each patient: with a cotton-tipped aluminium swab through the enlarged sinus ostium, and with a protected brush. S. aureus was characterised by DNA-sequencing of the repeat region of the S. aureus protein A gene, spa typing. The protected brush technique was superior to the cotton-tipped aluminium swab in reducing contamination rate. However, the two sampling methods were consistent in terms of clinically relevant bacterial findings, and the easy-to-handle cotton-tipped swab can still be recommended when culturing the maxillary sinus. Patients showed a significantly higher presence of S. aureus in the nares compared with healthy controls, and healthy controls showed a significantly higher presence of coagulase-negative staphylococci in the nares compared with patients. The spa types were identical for the nares and maxillary sinus in all patients except one. The sampling techniques showed equivalent results, indicating a low risk of unnecessary antibiotic treatment when using the easy-to-handle cotton-tipped aluminium swab. The high rate of identical spa types of S. aureus isolated from the nares and maxillary sinus of CRS patients might indicate colonisation of the maxillary sinus from the nares.
|
|
