| 1. |
- Askling, Helena H, et al.
(författare)
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Serologic Analysis of Returned Travelers with Fever, Sweden
- 2009
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Ingår i: Emerging Infectious Diseases. - Atlanta, GA, USA : U.S. Department of Health and Human Services * Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 15:11, s. 1805-1808
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Tidskriftsartikel (refereegranskat)abstract
- We studied 1,432 febrile travelers from Sweden who had returned from malaria-endemic areas during March 2005-March 2008. In 383 patients, paired serum samples were blindly analyzed for influenza and 7 other agents. For 21% of 115 patients with fever of unknown origin, serologic analysis showed that influenza was the major cause.
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| 2. |
- Blind, Per Jonas, et al.
(författare)
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Carboxylic ester hydrolase : a serum marker of acute pancreatitis
- 1987
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Ingår i: Pancreas. - 0885-3177 .- 1536-4828. ; 2:5, s. 597-603
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Tidskriftsartikel (refereegranskat)abstract
- By use of an enzyme-linked immunosorbent assay we established serum reference values of carboxylic ester hydrolase, a pancreatic secretory lipolytic enzyme, and explored to see if a raised serum level is indicative of acute pancreatitis. Postoperative elevation of carboxylic ester hydrolase was observed in seven out of ten patients who underwent pancreatic surgery. Serum levels of carboxylic ester hydrolase and amylase were determined in 129 patients admitted due to abdominal emergency conditions. Amylase was elevated in 27 patients, and in 20 of these raised carboxylic ester hydrolase levels affirmed the diagnosis acute pancreatitis. In five out of the seven patients with elevated amylase alone no etiologic factor of acute pancreatitis was found. Another 11 patients had raised carboxylic ester hydrolase levels without concomitant elevation of amylase. In all these patients, a likely cause of pancreatic inflammation was identifiable. Hence, a raised carboxylic ester hydrolase level, even in presence of normal amylase, could be indicative of acute pancreatic inflammation.
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| 3. |
- Blind, Per-Jonas, et al.
(författare)
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Carboxylic ester hydrolase. A sensitive serum marker and indicator of severity of acute pancreatitis.
- 1991
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Ingår i: International journal of Pancreatology. - 0169-4197. ; 8:1, s. 65-73
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Tidskriftsartikel (refereegranskat)abstract
- When using clinical criteria, both falsely positive and falsely negative diagnoses of acute pancreatitis (AP) are often made. Based on a clinical study, elevated serum levels of the pancreatic lipolytic enzyme carboxylic ester hydrolase (CEH) was recently suggested to be a highly specific marker of acute pancreatitis. To determine the sensitivity of the test for AP, a study on patients with the diagnosis set objectively was necessary. In the present study, AP was diagnosed by contrast-enhanced computed tomography in 64 patients, and histopathological examination of tissue removed at laparotomy in 18 of them. By these criteria, 42 patients suffered from acute interstitial pancreatitis (AIP), and 22 patients from necrotizing pancreatitis (NP). Based on the CEH concentrations in the first serum sample obtained in each patient, the sensitivity of CEH for pancreatitis was 98%. From the second day after admission, CEH levels in patients with NP were significantly higher than in patients with AIP. Furthermore, in patients with NP, CEH values remained at a raised level for the following 10 d, whereas a significant decrease of CEH values was noted in patients with AIP. In contrast, total serum amylase activities were higher in patients suffering of AIP than in patients suffering of NP during the observation period. We conclude, that the sensitivity of the CEH test is very high for AP. CEH concentrations remaining at a high level are suggestive of NP, whereas diminishing CEH levels are suggestive of AIP.
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| 4. |
- Bläckberg, Jonas, et al.
(författare)
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Flera svenska fall av infektion med rävens dvärgbandmask [Echinococcus multilocularis infection - six cases during two years in Sweden]
- 2020
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 117
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Forskningsöversikt (refereegranskat)abstract
- Alveolar echinococcosis (AE) caused by the fox tapeworm Echinococcus multilocularis is a zoonosis presenting with focal liver lesions and has a poor prognosis without treatment. The disease is common in Central and Eastern Europe but has been highly unusual in Sweden. A suspicion of AE usually arises through radiology and the diagnosis may be confirmed by histology and/or serological antibody detection. AE is treated with radical surgery in combination with anti-helminthic drug therapy. During the last two years six cases of AE have been diagnosed in Sweden. In no case was AE suspected clinically before biopsy. A heightened awareness of AE is needed among Swedish physicians, including radiologists, surgeons and pathologists.
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| 5. |
- Bläckberg, Jonas, et al.
(författare)
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Genotypic differences in the hepatitis B virus core promoter and precore sequences during seroconversion from HBeAg to anti-HBe
- 2000
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Ingår i: Journal of Medical Virology. - 1096-9071. ; 60:2, s. 107-112
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Tidskriftsartikel (refereegranskat)abstract
- Hepatitis B virus (HBV) strains from anti-HBe positive patients often show specific mutations in the precore gene, the core promoter region, or both. The dynamics of seroconversion in relation to the appearance of these mutations has not been studied and compared between defined HBV genotypes. Samples from patients followed during seroconversion from HBeAg to anti-HBe were amplified by polymerase chain reaction (PCR), sequenced and genotyped. Among 16 sets of samples, 6 belonged to genotype A, 6 to genotype D, 2 to genotype B, 1 to genotype C, and 1 to genotype E. Whereas strains from genotypes B, C and E showed changes in the core promoter, precore codon 28 or both, genotype A and D strains displayed a different pattern. In 4 of 6 anti-HBe positive samples from genotype A, the precore had a wild-type sequence while the core promoter sequence showed a specific TGA mutation. In another genotype A strain a precore stop mutation was preceded by a mutation in codon 15, thus conserving base-pairing at the pregenomic RNA level in this region. In contrast, all genotype D strains showed wild-type sequences in both the core promoter and precore codon 28 in pre- and post-seroconversion samples. Thus, in 8 patients with a mean follow-up time of 17 months, wild-type sequences in both the core promoter and precore codon 28 were found after seroconversion to anti-HBe. This study also confirmed, for genotype D, that HBeAg seroconversion often occurs earlier than genomic conversion.
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| 6. |
- Bläckberg, Jonas
(författare)
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Hepatitis B virus infection and genomic changes from a long-term perspective
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hepatitis B virus is a non-cytopathic virus with a small, circular, partially double-stranded DNA of 3.2 kb. It causes acute and chronic inflammatory liver disease and hepatocellular carcinoma (HCC). Retesting of stored sera from an outbreak of acute hepatitis in 1969-72 allowed identification of 126 cases of acute hepatitis B. No chronic carriers expressing hepatitis B surface antigen (HBsAg) could be found among 100 patients at follow-up 25-30 years later. Sixteen patients with documented self-limited acute hepatitis were evaluated further. HBV DNA could not be detected by PCR in serum or PBMCs. However, HBV DNA could be detected in the liver specimens of two patients 30 years after having an acute hepatitis B infection. Both patients had histological signs of minor liver inflammation. When selected genomic sequences of the strains detected in the liver were compared with the primary infecting strains in serum collected 30 years earlier, they were identical. Mutations in the precore and core promoter (cp) regions of the HBV genome have been associated with a lack of detectable hepatitis B e antigen (HBeAg). The precore and cp regions of viral strains from 83 chronic HBV carriers, including 16 carriers sampled during HBeAg seroconversion, were sequenced. The development of precore and cp mutations appeared to be a separate event from the HBeAg seroconversion. Mutations in strains from 16 patients with HBV infection and HCC were analyzed. Sequencing of the preS, S, X, and precore regions showed a high prevalence (50%) of mutations affecting part of the preS2 region which codes for B and T cells epitopes.
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| 7. |
- Bläckberg, Jonas, et al.
(författare)
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Long-term outcome of acute hepatitis B and C in an outbreak of hepatitis in 1969-72
- 2000
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Ingår i: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 1435-4373 .- 0934-9723. ; 19:1, s. 21-26
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate the epidemiology, etiology, and long-term outcome of an extended outbreak of acute hepatitis that occurred in an area of Sweden between 1969 and 1972. The outbreak was analyzed retrospectively by retesting stored frozen serum samples for the presence of hepatitis A, B and C markers. The results were compared with the diagnoses that had been determined during the outbreak. Of 180 patients, 29 (16%) had acute hepatitis A, 126 (70%) had acute hepatitis B, and eight (4.4%) had acute hepatitis C. The Australia antigen test used during the outbreak had failed to identify 21 patients with acute hepatitis B virus infection. Genotyping of the hepatitis B virus strains showed that genotype D was the most prevalent, irrespective of the transmission route. An attempt was made to follow up patients with unresolved hepatitis B virus infection, 25-27 years after the acute infection. None of the 100 patients with acute hepatitis B infection who were traced had become chronic carriers. In ten patients with hepatitis C virus infection, the follow-up showed considerable variation in the outcome, ranging from spontaneous resolution to death through liver cirrhosis. Intravenous drug users had a high prevalence of hepatitis C virus infection, with 52% testing positive for hepatitis C antibodies.
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| 8. |
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| 9. |
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| 10. |
- Bläckberg, Jonas, et al.
(författare)
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Occult hepatitis B virus after acute self-limited infection persisting for 30 years without sequence variation
- 2000
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Ingår i: Journal of Hepatology. - 0168-8278. ; 33:6, s. 992-997
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: After acute self-limited hepatitis B virus (HBV) infection, serological loss of viral antigens and appearance of anti-HBs is generally believed to signify viral clearance. Latent and occult HBV infection appearing decades after self-limited hepatitis B has not been reported, nor has the evolutionary rate of HBV DNA over the same observation period. METHODS: DNA from serum and leukocytes from 16 patients with acute self-limited hepatitis B 30 years earlier was tested by polymerase chain reaction and positive samples were sequenced. Liver tissue from four patients was also tested. Additionally, another 10 HBV strains isolated from acute HBV cases in 1969-72 were compared to 11 strains isolated from acute cases in 1998-99 in the same community. RESULTS: HBV DNA was detected in liver from two patients, but not in serum or leukocytes. The HBV strains detected in liver showed complete homology, in the sequences analyzed, to the strains originally infecting these patients. Ten strains from 1998-99 were identical in pre-S and core promoter/precore regions to strains from the same community isolated 30 years earlier. CONCLUSIONS: HBV can persist as an occult infection three decades after acute, apparently self-limited hepatitis B, and both the mutation and evolutionary rates of HBV DNA are low.
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| 11. |
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| 12. |
- Engelsberg, Karl, et al.
(författare)
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Dirofilaria repens infection of the eye
- 2022
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Ingår i: Journal of Ophthalmic Inflammation and Infection. - : Springer Science and Business Media LLC. - 1869-5760. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- A 43-year-old woman was referred to the Eye clinic at Skåne University Hospital complaining of redness and a foreign body sensation in the left eye for 2 to 3 days. Vision was unaffected, and she was otherwise completely well. In particular, there was no itching or swelling elsewhere.
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| 13. |
- Glimaker, M., et al.
(författare)
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Early lumbar puncture in adult bacterial meningitis-rationale for revised guidelines
- 2013
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 45:9, s. 657-663
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Tidskriftsartikel (refereegranskat)abstract
- Current international guidelines recommend cerebral computerized tomography (CT) before lumbar puncture (LP) in many adults with suspected acute bacterial meningitis (ABM), due to concern about LP-induced cerebral herniation. Despite guideline emphasis on early treatment based on symptoms, performing CT prior to LP implies a risk of delayed ABM treatment, which may be associated with a fatal outcome. Firm evidence for LP-induced herniation in adult ABM is absent and brain CT cannot discard herniation. Thus, the recommendation to perform CT before LP may contribute to an avoidable delay of LP and ABM treatment. The inappropriate use of the diagnostic treatment sequence of brain CT scan, followed by LP, followed by antibiotics and corticosteroids should be avoided in adults with suspected ABM by omitting needless contraindications for LP, thus eliminating an unnecessary fear of immediate LP. Revised Swedish guidelines regarding early LP are presented, and the background documentation and reasons for omitting impaired consciousness, new onset seizures, and immunocompromised state as contraindications to LP are discussed.
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| 14. |
- Holm, Alexander, et al.
(författare)
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Patients' perspective on prostatic artery embolization : A qualitative study
- 2021
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Ingår i: SAGE Open Medicine. - : SAGE Open. - 2050-3121. ; 9, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe the patients' experience of undergoing prostatic artery embolization.Methods: A retrospective qualitative interview study was undertaken with 15 patients of mean age 73 years who had undergone prostatic artery embolization with a median duration of 210 min at two medium sized hospitals in Sweden. The reasons for conducting prostatic artery embolization were clean intermittent catheterization (n = 4), lower urinary tract symptoms (n = 10) or haematuria (n = 1). Data were collected through individual, semi-structured telephone interviews 1-12 months after treatment and analysed using qualitative content analysis.Results: Four categories with sub-categories were formulated to describe the results: a diverse experience; ability to control the situation; resumption of everyday activities and range of opinions regarding efficacy of outcomes. Overall, the patients described the procedure as painless, easy and interesting and reported that while the procedure can be stressful, a calm atmosphere contributed to achieving a good experience. Limitations on access to reliable information before, during and after the procedure were highlighted as a major issue. Practical ideas for improving patient comfort during the procedure were suggested. Improved communications between treatment staff and patients were also highlighted. Most patients could resume everyday activities, some felt tired and bruising caused unnecessary worry for a few. Regarding functional outcome, some patients described substantial improvement in urine flow while others were satisfied with regaining undisturbed night sleep. Those with less effect were considering transurethral resection of the prostate as a future option. Self-enrolment to the treatment and long median operation time may have influenced the results.Conclusions: From the patients' perspective, prostatic artery embolization is a well-tolerated method for treating benign prostate hyperplacia.
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| 15. |
- Kahn, Fredrik, et al.
(författare)
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Heparin-Binding Protein As A Prognostic Biomarker of Sepsis and Disease Severity at The Emergency Department
- 2019
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Ingår i: Shock. - 1540-0514. ; 52:6, s. 135-135
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Rapid and early detection of patients at risk to develop sepsis remains demanding. Heparin-binding protein (HBP) has previously demonstrated good prognostic properties in detecting organ dysfunction among patients with suspected infections. This study aimed to evaluate the plasma-levels of HBP as a prognostic biomarker for infection-induced organ dysfunction among patients seeking medical attention at the emergency department.DESIGN: Prospective, international multicenter, convenience sample study SETTING:: Four general emergency departments at academic centers in Sweden, Switzerland and Canada.PATIENTS: All emergency encounters among adults where one of the following criteria were fulfilled: a) respiratory rate >25 breaths per minute; b) heart rate >120 beats per minute; c) altered mental status; d) systolic blood pressure <100 mm Hg; e) oxygen saturation <90% without oxygen; f) oxygen saturation <93% with oxygen; g) reported oxygen saturation <90%.INTERVENTION: None MEASUREMENTS AND MAIN RESULTS:: A total of 524 ED patients were prospectively enrolled, of these 236 (45%) were eventually adjudicated to have a non-infectious disease. Three hundred forty-seven patients (66%) had or developed organ dysfunction within 72 hours, 54 patients (10%) were admitted to an intensive care unit (ICU), and 23 patients (4%) died within 72 hours. For the primary outcome, detection of infected-related organ dysfunction within 72 hours, the AUC for HBP was 0.73 (95% C.I. 0.68-0.78) among all patients and 0.82 (95% C.I. 0.76-0.87) among patients confidently adjudicated to either infection or no infection. Against the secondary outcome, infection leading to admittance to the ICU, death or a persistent high SOFA-score due to an infection (SOFA-score ≥5 at 12-24 hours) HBP had an AUC of 0.87 (95% C.I. 0.79-0.95) among all patients and 0.88 (95% C.I. 0.77-0.99) among patients confidently adjudicated to either infection or non-infection.CONCLUSIONS: Among patients at the emergency department, HBP demonstrated good prognostic and discriminatory properties in detecting the most severely ill patients with infection.
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| 16. |
- Kidd-Ljunggren, Karin, et al.
(författare)
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Clinical and serological variation between patients infected with different Hepatitis B virus genotypes.
- 2004
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Ingår i: Journal of Clinical Microbiology. - 1098-660X. ; 42:12, s. 5837-5841
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Tidskriftsartikel (refereegranskat)abstract
- Hepatitis B virus (HBV) has eight genotypes which have distinct geographical distributions. Studies comparing differences in the clinical outcomes of infections caused by strains with genotype-related variations in the HBV genome have largely compared genotypes B and C and genotypes A and D but not all four genotypes. The present study included 196 HBV-infected patients attending an infectious diseases outpatient clinic in Sweden. The age and geographic origin, liver function, HBeAg and anti-HBe status, and the presence or absence of HBV DNA were analyzed for each patient. HBV DNA was detected in 144 patients, and the HBV genotype and the core promoter and precore sequences were determined for the isolates from 101 of these patients. Among the patients who might be considered most likely to be nonviremic, namely, anti-HBe-positive HBV carriers with normal alanine aminotransferase (ALT) levels, 65% had detectable HBV DNA and were thus viremic. Among the viremic patients, HBeAg-positive patients were more likely to have elevated ALT levels than anti-HBe-positive patients. HBV genotypes A to F were represented in the study, and their distributions coincided accurately with the origin of the patient. A significantly higher number of genotype D-infected patients were anti-HBe positive and had elevated ALT levels (42% of genotype D-infected patients but 0% of patients infected with genotypes B and C). Genotype D strains with mutations in the core promoter and precore regions were significantly correlated with elevated ALT levels in the patients. The differences were not age related. Therefore, in this large-scale cross-sectional study, genotype D appears to be associated with more active disease.
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| 17. |
- Kidd-Ljunggren, Karin, et al.
(författare)
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High levels of hepatitis B virus DNA in body fluids from chronic carriers.
- 2006
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Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701. ; 64:4, s. 352-357
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Tidskriftsartikel (refereegranskat)abstract
- infection with hepatitis B virus (HBV) is a major global health problem. Transmission is mainly blood-borne, although the route of infection during horizontal transmission in childhood is unclear. Nosocomial outbreaks of HBV have been widely reported, but have mainly focused on blood-borne transmission. There is Limited knowledge of the viral Load Levels in other body fluids. In the present study, chronic HBV carriers were tested for the presence of HBV DNA in serum, saliva, nasopharyngeal fluid, urine and tears by means of qualitative and quantitative polymerase chain reaction (PCR) methods. Twenty-five patients who were positive for HBV DNA with both PCRs were included. Low titres in real-time PCR corresponded with weak bands in the qualitative assay. HBV DNA was found in two urine samples, 10 saliva samples, five nasopharyngeal, swabs and in tear fluid from four patients. One highly viraemic HBeAg-positive carrier with serum HBV DNA Levels of 7 x 10(9) genome copies had high copy numbers detected in both saliva and nasopharyngeal fluid. These results demonstrate that highly viraemic HBV carriers may have high titres of HBV DNA in other body fluids. This has particular importance for infection control programmes and regulations, underlining the importance of aiming towards regular HBV DNA testing and thus infectivity assessment of chronic carriers in order to prevent transmission. (c) 2006 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
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| 18. |
- Lindberg, Helena, et al.
(författare)
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Performance of the 2023 Duke-ISCVID diagnostic criteria for infective endocarditis in relation to the modified Duke criteria and to clinical management- reanalysis of retrospective bacteremia cohorts
- 2024
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Ingår i: Clinical Infectious Diseases. - 1537-6591. ; 78:4, s. 956-963
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundRevised diagnostic criteria for infective endocarditis (IE), the 2023 Duke-ISCVID criteria, were recently presented and need validation. Here, we compare the 2000 modified Duke criteria for IE with Duke-ISCVID among patients with bacteremia and relate the diagnostic classification to IE-treatment.MethodsWe reanalyzed patient cohorts with Stapylococcus aureus, Staphylococcus lugdunensis, non-beta-hemolytic streptococci, Streptococcus-like bacteria, Streptococcus dysgalactiae, Enterococcus faecalis and HACEK bacteremia. Episodes were classified as definite, possible or rejected IE with the modified Duke and Duke-ISCVID criteria. Reclassification included the microbiology criteria, PET-CT and cardiac implanted elect-ronical devices. To calculate sensitivity, patients treated as IE were considered as having IE.ResultsIn 4050 episodes of bacteremia, the modified Duke criteria criteria assigned 307episodes (7.6%) as definite IE, 1190 episodes (29%) as possible IE and 2553 episodes (63%) as rejected IE. Using the Duke-ISCVID criteria, 13 episodes (0.3%) were reclassified from possible to definite IE and 475 episodes (12%) were reclassified from rejected to possible IE. With the modified Duke criteria, 79 episodes that were treated as IE were classified as possible IE and eleven of these episodes were reclassified to definite IE with Duke-ISCVID. Applying the decision to treat for IE as reference standard, the sensitivity of the Duke-ISCVID criteria was 80%. None of the 475 episodes reclassified to possible IE were treated as IE.ConclusionsThe Duke-ISCVID criteria reclassified a small proportion of episodes to definite IE at the expense of more episodes of possible IE. Future criteria should minimize the possible group while keeping or improving sensitivity.
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| 19. |
- Lindh, Magnus, 1960, et al.
(författare)
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Treatment of chronic hepatitis B infection : an update of Swedish recommendations
- 2008
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Ingår i: Scandinavian Journal of Infectious Diseases. - London : Taylor & Francis. - 0036-5548 .- 1651-1980. ; 40:6-7, s. 436-450
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Forskningsöversikt (refereegranskat)abstract
- The main goal for treatment of chronic hepatitis B is to prevent complications such as liver cirrhosis or hepatocellular carcinoma. Knowledge from population studies of the long-term risk of chronic HBV infection, as well as the recent introduction of pegylated interferon and additional nucleoside analogues has changed the therapeutic situation. Recently, a Swedish expert panel convened to update the national recommendations for treatment. The panel recommends treatment for patients with active HBV infection causing protracted liver inflammation or significant liver fibrosis, verified by liver histology. In general, pegylated interferon alpha-2a is recommended as first-line treatment, in particular for HBeAg-positive patients with HBV genotypes A or B. Among nucleoside analogues, entecavir is the first choice and adefovir or tenofovir can be used as alternatives. Lamivudine monotherapy is not recommended due to the high risk of resistance development. Combinations of nucleoside analogues such as tenofovir and lamivudine or emtricitabine are alternatives for patients with non-response or infection with resistant variants, or as first choice for patients with advanced liver disease. Nucleoside analogue treatment should be monitored to detect primary non-response and virological breakthrough. Special recommendations are given for HBV/HIV coinfected patients, immunosuppressed patients, children, and for treatment before and after liver transplantation. The present guideline is translated from Swedish, where it is published on the MPA and RAV websites (www.mpa.se and www.rav.nu.se) including 7 separate papers based on thorough literature search. The complete reference list can be received from the Medical Products Agency upon request.
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| 20. |
- Ljungquist, Oskar, et al.
(författare)
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16S rRNA is a valuable tool in finding bacterial aetiology of community-acquired pleural empyema-a population-based observational study in South Sweden
- 2022
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 2374-4235 .- 2374-4243. ; 54:3, s. 163-169
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe incidence of community-acquired pleural empyema is increasing. Knowledge of the bacterial aetiology is important in order to base recommendations on empirical antimicrobial treatment. The primary aim of the present study was to describe the bacterial aetiology of adult patients with culture proven and/or 16S rRNA-positive community-acquired pleural infection.MethodsWe performed a retrospective, population-based observational cohort study in Skåne County, south of Sweden. We included all patients with pleural samples obtained between 1st of January 2011 to 31st of December 2017 in Skåne, south of Sweden, with a positive culture and/or 16S rRNA result. Exclusion criteria were patients with culture-negative and/or 16S rRNA-negative pleural samples, age < 18 years, pleural empyema caused by trauma or iatrogenesis, pleural infection caused by tuberculosis or fungi, simultaneous lung- or abscess of the abdomen and bacterial species considered to be contaminants.ResultsA total of 291 patients were included in the study, of which 63% were men and the median age was 69 years. The dominating bacterial aetiology was viridans streptococci (36%), followed by Streptococcus pneumoniae (14%) and anaerobic bacteria (12%). 16S rRNA added information of bacterial aetiology in addition to standard culturing methods in 63% of the patients.ConclusionWe found that the aetiology of adult patients with culture proven and/or 16S rRNA-positive community-acquired pleural empyema is dominated by viridans streptococci, S. pneumoniae and anaerobic bacteria. Our study shows that 16S rRNA is a valuable tool in finding the bacterial aetiology of community-acquired pleural empyema.
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| 21. |
- Selander, Bo, et al.
(författare)
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No evidence of intrauterine transmission of hepatitis A virus from a mother to a premature infant.
- 2009
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 98, s. 1603-1606
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To determine whether or not an intrauterine transmission of hepatitis A virus (HAV) occurred from an infected mother to her premature infant delivered by caesarean section. Methods: The mother and her child were tested for HAV by serology and reverse transcription PCR. Results: An outbreak of HAV infection was seen among children and a 33-year-old day-care teacher, pregnant in third trimester, at a day-care centre in southern Sweden. Due to premature labour and diminished foetal movements a caesarean section was performed and a premature girl in gestational weeks 33 +1 was born. During the 3-week postnatal hospitalization period the child presented no clinical symptoms of HAV infection and anti-HAV IgM antibodies remained undetectable at day 14 and 109 after birth. Furthermore HAV RNA remained undetectable by reverse transcription PCR in the child's blood at birth and in throat and faeces for the first 3 and 4 weeks of life respectively. HAV RNA in the mother's blood was detected at 6 days prior to and at 17 days after delivery. HAV RNA was undetectable in breast milk when tested on day 3 after delivery. Conclusion: The study shows that it is not possible to obtain reliable BFI data, which reflect changes in CBF after acetazolamide infusion, using the CW-NIRS and ICG method.
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| 22. |
- Svensson, Joel, et al.
(författare)
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Babesia-infektion kan vara vanligare i Sverige än vi tidigare trott - Parasiten kan spridas via fästingar och blodtransfusion
- 2019
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Ingår i: Läkartidningen. - 0023-7205. ; 116
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Babesia is a malaria-like, intraerythrocytic parasite with more than 100 different species. It is a zoonosis and some of the species are transmitted to humans by ticks and also as a possible transfusion-transmitted infection. In Sweden the disease has been well known in veterinary medicine for a long time, but only a few but severe cases have been published in humans during the last decades. Common symptoms from human Babesia infections (babesiosis) are fever, chills and myalgia and they vary from subclinical to potentially fatal among those with risk factors such as immunosuppression and splenectomy. In the U.S. more than 2,000 cases of babesiosis are found yearly and it is one of the most frequent fatal infections following blood transfusion. A study from southern Sweden has recently revealed a seroprevalence of 16% of Babesia antibodies among Borrelia-infected persons. These results indicate that there is a need to broaden awareness of Babesia in Sweden.
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