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- Almroth, Gabriel, 1953-, et al.
(författare)
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Acute glomerulonephritis associated with streptococcus pyogenes with concomitant spread of streptococcus constellatus in four rural families
- 2005
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Ingår i: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 110:3, s. 217-231
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Tidskriftsartikel (refereegranskat)abstract
- We studied history, renal histopathology and microbiology of an epidemic of acute glomerulonephritis associated with throat infections and uncommon culture results in four neighbour families. A 40-year-old man (index patient) was referred to a university hospital for dialysis and kidney biopsy due to a suspected acute glomerulonephritis. An acute tonsillitis had preceded the condition. Penicillin treatment had been started four days before the discovery of renal failure. Throat swabs were positive for β-hemolytic streptococci, group C (GCS). GCS were also found in throat cultures from his wife and two of their children. The bacteria were typed as Streptococcus constellatus. A third child had S. constellatus expressing Lancefield antigen group G. A neighbour and two of his children fell ill the following week with renal involvement. Throat swabs from both these children were positive for S. constellatus. His third child had erythema multiforme and S. constellatus in the throat while a fourth child had β-hemolytic streptococci group A, Streptococcus pyogenes. Kidney biopsies on the index patient and his neighbour showed an acute diffuse prolipherative glomerulonephritis compatible with acute post-streptococcal nephritis and microbiological analysis of renal tissue revealed in both cases S. pyogenes and S. constellatus. The families had had much contact and had consumed unpasteurized milk from our index patient's farm. In four of seven persons in two additional neighbouring families S. constellatus was found in throat swabs during the same month while two persons carried Streptococcus anginosus expressing the Lancefield C antigen. In conclusion spread of S. constellatus coincided with the occurrence of four cases of acute glomerulonephritis. The two biopsied patients had both S. pyogenes and S. constellatus present in renal tissue. The epidemic either suggested that the outbreak of glomerulonephritis was due to S. pyogenes but coincided with the transmission and colonization of S. constellatus or that the S. constellatus strains were highly pathogenic or nephritogenic and that this organism can be transmitted in such cases.
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| 2. |
- Janerot-Sjöberg, Birgitta, 1958-, et al.
(författare)
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Effect of contrast on systolic myocardial ultrasound color-Doppler velocity.
- 2001
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Ingår i: Proceedings to IEEE Engineering Med & Biol(CD skiva),2001. - : IEEE. - 0780372115 ; , s. 3289-3291
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Konferensbidrag (refereegranskat)abstract
- Intravenously distributed ultrasound contrast increases echoes from the normally low echogenic bloodpool and myocardial perfusion imaging is developing. However the microspheres used are potential endothelial stimulators as well as nonlinear scatterers. Tissue Doppler is developed to detect velocities of myocardial motion, which are in the same range as perfusion flow velocities. The effect of contrast is not evaluated. We performed echocardiography in 12 patients with ischemic heart disease before and immediately after a slow intravenous infusion of 27 ml Optison® using color myocardial Doppler imaging (GE Vingmed systemV). Longitudinal basal systolic velocities and their integrals were analyzed in digitally stored cineloops. Peak mean velocity increased 10% by contrast from mean 5.2 ± 1.8 (SD) to 5.7 ± 2.3 cm/s (p=0.02, confidence interval 2-16%) but integral did not change (0.8 ± 0.4 cm). Contrast has no effect on blood pressure or heart rate in used dose. It is therefore of interest to further evaluate if this increase in velocity; a) is a methodological effect that may be used to detect contrast within myocardium (and thereby perfusion/blood volume), or b) is secondary to increased flow and motion caused by endothelial and vascular effects from the contrast microspheres. Either have important methodological, physiological and clinical impact.
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