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- Getahun, H, et al.
(författare)
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Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries
- 2015
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 46:6, s. 1563-1576
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Tidskriftsartikel (refereegranskat)abstract
- Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3–4 month isoniazid plus rifampicin; or 3–4 month rifampicin alone.
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- Länne, T, et al.
(författare)
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Improved reliability of ultrasonic surveillance of abdominal aortic aneurysms
- 1997
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Ingår i: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 13:2, s. 149-153
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Small abdominal aortic aneurysms (AAA) are usually managed conservatively by serial ultrasound examinations to assess size. The development of the size of the AAA will determine whether the patient is a candidate for surgery. The precision of measurement is therefore of considerable importance. The aim of this study was to evaluate the accuracy and the reproducibility of a newly developed echo-tracking ultrasonic system in the size evaluation of AAA. DESIGN: Prospective study at a University Hospital. MATERIAL AND METHODS: An echo-tracking ultrasound system with a 3.5 MHz transducer was used in 54 patients with AAA. Thirty-six patients had repeated measurements by one technician to evaluate the intra-observer variability. In another 18 patients with aortic dilatation/AAA, the measurements were repeated by a second technician in a blinded fashion with calculation of inter-observer variability. The reproducibility was evaluated both using linear regression and plots according to the method described by Bland and Altman. RESULTS: The mean diameter of the aorta was 37 mm (range 21-51 mm). The coefficient of correlation of repetitive measurements with one observer was r = 0.99 and with two observers r = 0.99. The intra-observer variability was 0.78 mm (S.D.) and the inter-observer variability 0.93 mm (S.D.). The intra- and inter-observer coefficient of variation (CV) was 2-3%. CONCLUSIONS: The newly developed echo-tracking ultrasonography seems at present to be the most accurate and reliable method to follow the diameter of an abdominal aortic aneurysm detecting relevant changes in the diameter exceeding 2 mm (2 S.D.). Thus it fulfils the requirements both for follow-up of conservatively managed AAAs and endovascularly treated aneurysms.
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- Rahman, M. M., et al.
(författare)
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Protofibrillar and Fibrillar Amyloid-β Binding Proteins in Cerebrospinal Fluid
- 2018
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Ingår i: Journal of Alzheimer's Disease. - 1387-2877. ; 66:3, s. 1053-1064
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Tidskriftsartikel (refereegranskat)abstract
- Aggregation and deposition of misfolded amyloid-β (Aβ) peptide in the brain is central to Alzheimer's disease (AD). Oligomeric, protofibrillar, and fibrillar forms of Aβ are believed to be neurotoxic and cause neurodegeneration in AD, but the toxicity mechanisms are not well understood and may involve Aβ-interacting molecular partners. In a previous study, we identified potential Aβ 42 protofibrillar-binding proteins in serum and cerebrospinal fluid (CSF) using an engineered version of Aβ 42 (Aβ 42 CC) that forms protofibrils, but not fibrils. Here we studied binding of proteins to Aβ 42 fibrils in AD and non-AD CSF and compared these with protofibrillar Aβ 42 CC-binding partners. Aβ 42 fibrils sequestered 2.4-fold more proteins than Aβ 42 CC protofibrils. Proteins with selective binding to fibrillar aggregates with low nanomolar affinity were identified. We also found that protofibrillar and fibrillar Aβ-binding proteins represent distinct functional categories. Aβ 42 CC protofibrils triggered interactions with proteins involved in catalytic activities, like transferases and oxidoreductases, while Aβ 42 fibrils were more likely involved in binding to proteoglycans, growth factors and neuron-Associated proteins, e.g., neurexin-1,-2, and-3. Interestingly, 10 brain-enriched proteins were identified among the fibril-binding proteins, while protofibril-extracted proteins had more general expression patterns. Both types of Aβ aggregates bound several extracellular proteins. Additionally, we list a set of CSF proteins that might have potential to discriminate between AD and non-AD CSF samples. The results may be of relevance both for biomarker studies and for studies of Aβ-related toxicity mechanisms. © 2018-IOS Press and the authors. All rights reserved.
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- Skari, H, et al.
(författare)
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Congenital diaphragmatic hernia: a survey of practice in Scandinavia
- 2004
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Ingår i: Pediatric Surgery International. - : Springer Science and Business Media LLC. - 1437-9813 .- 0179-0358. ; 20:5, s. 309-313
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Tidskriftsartikel (refereegranskat)abstract
- There is no consensus on the treatment of congenital diaphragmatic hernia (CDH), and practice seems to vary between centres. The main purpose of the present study was to survey current practice in Scandinavia. Thirteen paediatric surgical centres serving a population of about 22 million were invited, and all participated. One questionnaire was completed at each centre. The questionnaire evaluated management following prenatal diagnosis, intensive care strategies, operative treatment, and long-term follow-up. Survival data (1995-1998) were available from 12 of 13 centres. Following prenatal diagnosis of CDH, vaginal delivery and maternal steroids were used at eight and six centres, respectively. All centres used high-frequency oscillation ventilation (HFOV), nitric oxide (NO), and surfactant comparatively often. Five centres had extracorporeal membrane oxygenation (ECMO) facilities, and four centres transferred ECMO candidates. The majority of centres (7/9) always tried HFOV before ECMO was instituted. Surgery was performed when the neonate was clinically stable (11/13) and when no signs of pulmonary hypertension were detected by echo-Doppler (6/13). The repair was performed by laparotomy at all centres and most commonly with nonabsorbable sutures (8/13). Thoracic drain was used routinely at seven centres. Long-term follow-up at a paediatric surgical centre was uncommon (3/13). Only three centres treated more than five CDH patients per year. Comparing survival in centres treating more than five with those treating five or fewer CDH patients per year, there was a tendency towards better survival in the higher-volume centres (72.4%) than in the centres with lower volume (58.7%), p =0.065.
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- Bruder, Carl E G, et al.
(författare)
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Phenotypically concordant and discordant monozygotic twins display different DNA copy-number-variation profiles
- 2008
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Ingår i: American Journal of Human Genetics. - : Elsevier BV. - 0002-9297 .- 1537-6605. ; 82:3, s. 763-71
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Tidskriftsartikel (refereegranskat)abstract
- The exploration of copy-number variation (CNV), notably of somatic cells, is an understudied aspect of genome biology. Any differences in the genetic makeup between twins derived from the same zygote represent an irrefutable example of somatic mosaicism. We studied 19 pairs of monozygotic twins with either concordant or discordant phenotype by using two platforms for genome-wide CNV analyses and showed that CNVs exist within pairs in both groups. These findings have an impact on our views of genotypic and phenotypic diversity in monozygotic twins and suggest that CNV analysis in phenotypically discordant monozygotic twins may provide a powerful tool for identifying disease-predisposition loci. Our results also imply that caution should be exercised when interpreting disease causality of de novo CNVs found in patients based on analysis of a single tissue in routine disease-related DNA diagnostics.
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