| 1. |
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| 2. |
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| 3. |
- Aspevall, O, et al.
(författare)
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Performance of four chromogenic urine culture media after one or two days of incubation compared with reference media.
- 2002
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Ingår i: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 40, s. 1500-1503
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Tidskriftsartikel (refereegranskat)abstract
- Four chromogenic urine culture media were compared to culture on blood agar, MacConkey agar, and CLED (cysteine-, lactose-, and electrolyte-deficient) agar for detection of uropathogens in 1,200 urine specimens. After 2 nights of incubation, 96% of all isolates were recovered on blood agar, 96% were recovered on CLED agar, 92% were recovered on CPS ID2, 96% were recovered on CHROMagar Orientation from BBL, 95% were recovered on CHROMagar Orientation from The CHROMagar Company, and 95% were recovered on Chromogenic UTI Medium.
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| 4. |
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| 5. |
- Berzell, Martin, 1976-
(författare)
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Electronic Healthcare Ontologies : Philosophy, the real world and IT structures
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis investigates how the notion of ‘ontology’ has been used in the field of medical informatics and knowledge representation. Partly to investigate what an ‘ontology’ can be said to represent and what requirements we can have on a good ‘ontology’. The author studies the already existing medical terminologies and ‘ontologies’ to elucidate what theories they are based on. The terminological theories of Eugen Wüster and his legacy in medical informatics are studied. It is noted that terminological theories handling linguistic entities are not suited for describing and representing medical theories, since these are assumed to refer to the real world, which consists of more than linguistics entities.In order to find a metaphysical theory in accordance with the world view that medical theories describe, the author turn to the critical realism of Karl Popper, Roy Bhaskar and Ilkka Niiniluoto. These theories, taken together with the metaphysical theories regarding universals of David M Armstrong and Ingvar Johansson, are used as a basis to find out what an ‘ontology’ can be said to represent, and what criteria and requirements we can have on a good ‘ontology’. Among the requirements presented in the thesis are stability, interoperability and the requirement that a good ‘ontology’ must be in accordance with our best available theories.Finally, it is discussed how these requirements and criteria can come into conflict with one another, and how one should reason when handling these trade-offs. The author emphasises the importance of including the medical expertise in the process of creating ‘ontologies’, in order to produce as useful and relevant ‘ontologies’ as possible.
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| 6. |
- Ekdahl, Christer, et al.
(författare)
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A study of the usage of a decision-support system for infective endocarditis
- 2000
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 25:1, s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to examine a design for a World Wide Web-based decision-support system in use by clinically active physicians. A prototype implementation of the design concerned management of infective endocarditis patient cases. The design was based on an integration of hypertext and rule-based knowledge. In the study sessions, physicians in the field of internal medicine worked on managing authentic patient cases in a laboratory setting. Data was collected from interviews with the physicians using video recordings and stimulated recall technique. The qualitative data was analysed according to the constant comparative method in order to develop a model of the physicians' usage of the system. The resulting model describes perceived contributions and criteria for usefulness of the system. The ways the physicians used the system showed that it was able to provide patient-specific support for confirming clinical decisions, for higher-level patient management, and for preparing for and initiating expert consultations. Users also stated that new medical knowledge could be gained as a side effect of using the system.
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| 7. |
- Ekdahl, Christer, 1962-
(författare)
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Infective Endocarditis : aspects of pathophysiology, epidemiology, management and prognosis
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Infective endocarditis (IE) is a rare but complex disease that is fatal if untreated. With a modern combination of antimicrobial therapy and heart valve surgery, mortality is still 10-20 %. The structure of the endocarditis vegetation impedes the penetration of phagocytic cells such as monocytes and granulocytes. This leads to high bacterial counts inside the vegetation and the need for long treatment courses with a combination of intravenously administered bactericidal antibiotics.The aim of this thesis was to study the changes in epidemiology, management, and mortality at our hospital between 1980 and 2001, and to identify prognostic factors associated with mortality. To assess the issue of referral bias, differences between referred episodes and episodes from our local community were studied. Additional aims were to study the occurrence of the pro-chemotactic cytokines IL-8 and TNF-α in heart valves and vegetations during the active phase of IE, and to study the effect of the glycopeptide antibiotic vancomycin in dense staphylococcal cultures in vitro. As it is a rare and complex disease, management of IE is usually complicated for non-specialists. For this reason a computerised decision support system for IE was developed and evaluated.Between 1980 and 2001, the occurrence of Staphylococcus aureus IE and the use of early heart valve surgery increased significantly, regardless of whether the episodes were referred or of local origin. Glycopeptide antibiotics, mainly vancomycin, were used more frequently, especially among referred patients. Referred patients were younger, predominantly male, had more complications, and received surgical treatment more often than patients from our local community. The reason for the lower frequency of female patients in the referral cohort cannot be explained by more comorbidity or fewer complications. The differences between referred and local episodes seen in our study highlight the need for assessment and adjustment for referral bias in IE studies (Paper I).In six patients who needed early heart valve surgery, the largest numbers of IL-8-containing cells, and the greatest amount of inflammation, were seen in patients with short preoperative antimicrobial treatment courses. No such relationships were seen with respect to TNF-α-containing cells. The IL-8-containing cells and the inflammatory cells were predominantly scattered in the heart valve stroma or in the margin of the vegetation (Paper II). The primary effect of IL-8 is to stimulate chemotaxis of polymorphonuclear neutrophil granulocytes. This indicates that there is no deficiency of IL-8 in the area close to the vegetation as a cause of the localised agranulocytosis often present inside the vegetation.Our study revealed a need for computerised decision support systems (DSSs) in the field of IE, but to be used in clinical practice these DSSs need be part of knowledge bases covering larger domains (Paper IV). Some of our initial ideas described in Paper III, especially the use of Internet technology and the combination of rule-based advice and explanatory hypertext, will probably be included in these knowledge bases.In vitro, there is a rapid reduction of free vancomycin in broth containing dense staphylococcal cultures. Consequently, there is a simultaneous increase in broth MICs, particularly in high inocula, which is not caused by a development of resistance (Paper V). These findings need further evaluation in vivo, but indicate that the dosing regimen of vancomycin is of particular importance in staphylococcal infections with dense inocula, e.g. infective endocarditis.Diabetes mellitus and moderate to severe heart failure were independent risk factors for 6-month mortality in left-sided, Duke definite IE episodes, regardless of referral or local origin of the episodes. Early heart valve surgery had a positive impact on the 6-month mortality in the referral cohort of episodes, which may be due to referral bias (Paper VI).
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| 8. |
- Ekerfelt, Christina, 1957-, et al.
(författare)
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Lyme borreliosis in Sweden - Diagnostic performance of five commercial Borrelia serology kits using sera from well-defined patient groups
- 2004
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley. - 0903-4641 .- 1600-0463. ; 112:1, s. 74-78
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Tidskriftsartikel (refereegranskat)abstract
- Five commercial Borrelia serology kits available in Sweden were evaluated and compared for their diagnostic performance in sera from clinically well-characterized patient groups. With the clinically defined groups as the gold standard, i.e. without knowledge of antibody status in serum and cerebrospinal fluid, the diagnostic performance of the kits was compared and important differences in diagnostic usefulness were found. The kits from Abbot and DAKO, that often predict clinically relevant Borrelia infection and do not detect antibodies in sera from patients without strong suspicion of Borrelia infection, were considered the most useful in the population studied. This kind of validation study is an important part of good laboratory practice and should be performed by laboratories serving patient populations with varying endemicity of Borrelia.
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| 9. |
- Eriksson, Katarina, et al.
(författare)
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A double-blind treatment study of bacterial vaginosis with normal vaginal lactobacilli after an open treatment with vaginal clindamycin ovules
- 2005
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 85:1, s. 42-46
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Tidskriftsartikel (refereegranskat)abstract
- The expected 4-week cure rate after conventional treatment of bacterial vaginosis are only 65-70%. In an attempt to improve the cure rate by adding probiotic lactobacilli we performed a double-blind placebo-controlled study of adjuvant lactobacilli treatment after an open treatment with vaginal clindamycin ovules. Women with bacterial vaginosis as defined by Amsel's criteria were treated with clindamycin ovules. Vaginal smears were collected and analysed according to Nugent's criteria. During the following menstruation period the women used, as an adjuvant treatment, either lactobacilli-prepared tampons or placebo tampons. The lactobacilli tampons were loaded with a mixture of freeze-dried L. fermentum, L. casei var. rhamnosus and L. gasseri. The cure rate was recorded after the second menstruation period. There was no improvement in the cure rate after treatment with lactobacilli-containing tampons compared to placebo tampons, the cure rates as defined by Amsel's criteria were 56% and 62%, respectively, and 55% and 63%, as defined by Nugent's criteria. This is the first study to report cure rates for women with 'intermediate' wet smear ratings according to Nugent's classification and this group had an overall cure rate of 44%. The cure rate of treatment of bacterial vaginosis was not improved by using lactobacilli-prepared tampons for one menstruation.
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| 10. |
- Eriksson, Katarina
(författare)
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Bacterial Vaginosis : Diagnosis, Prevalence, and Treatment
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bacterial Vaginosis (BV) is a disorder of unknown etiology, characterized by a foul smelling vaginal discharge, loss or reduction of the normal vaginal Lactobacilli, and overgrowth of other anaerobic bacteria. Thus, it presents a formidable problem for clinicians as well as microbiologists researching its etiology, clinical course, treatment, and epidemiology. The present work focuses on the unresolved issues of the epidemiology and treatment of BV in order to provide valid methods for treatment studies of this condition and to describe the prevalence of BV in defined populations.The first study validates the use of PAP-stained smears in the diagnosis of BV. The study assesses the methods of Amsel’s clinical criteria and Nugent criteria on Gram-stain smears, against Pap-stained smears and also validates different observers. The result shows that the PAP-staining of vaginal smears is a good method in BV diagnosis; the kappa value is 0.86 (interobserver weighted kappa index) compared to 0.81 for Gram-stained smears, and 0.70 for rehydrated air-dried smears using the mean Nugent score as the criterion standard. This enables population based studies on archived PAP-stained smears from the screening of cervical cancer.In the second study, we use the knowledge gained from study one to investigate the prevalence of BV in a cohort from the population of Åland. The prevalences of BV on the Åland Islands were: 15.6 %, 11.9 %, 8.7 %, and 8.6% in 1993, 1998, 2003, and 2008, respectively. This means that the prevalence of BV decreased between1993-2008 from 15.6% to 8.6%. The confidence intervals are not overlapping, thus indicating a significant decrease in prevalence from 1993 to 2008.The third study is a prospective, double-blind placebo controlled treatment study of BV. After conventional treatment with clindamycin, the patients were treated with adjuvant treatment of Lactobacilli-loaded tampons or placebo. The study showed no differences between the treatment and the placebo group, indicating that the tampon does not work at all. There are a variety of possible explanations for the result, which are analyzed in this thesis.The fourth study aimed to evaluate whether clindamycin is retained for a long time in the vaginal mucosa, thus disturbing the Lactobacilli in an attempt to reimplant Lactobacilli in the probiotic treatment studies. In conventional treatment, it is also useful to know whether clindamycin is retained, especially when considering the pressure from antibiotics on the antimicrobial sensitivity pattern. In the study, we found that the clindamycin disappears rapidly.Conclusion: BV research requires effort from many different scientific disciplines and the riddle of this condition and its treatment can only be resolved by concerted actions in research and treatment. The vision for the future includes, among other factors, better molecular biology based diagnostic tools, and knowledge of population based bacterial floras.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Eriksson, Katarina, et al.
(författare)
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The prevalence of BV in the population on the Åland Islands during a 15-year period
- 2010
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - Malden, USA : John Wiley & Sons. - 0903-4641 .- 1600-0463. ; 118:11, s. 903-908
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe the prevalence and age distribution of bacterial vaginosis (BV) during an observation period of 15 years in a population study with cross-sectional samples of adult women living on the Åland Islands. The Åland Islands form an archipelago in the Baltic Sea and are a province of Finland. Every fifth year, specific age groups in the adult female population are invited to participate in a screening program for early diagnosis of cervical cancer using a papanicolaou (PAP)-stained vaginal smear. Women in the age groups of 20, 25, 30, 35, 40, 45, 50, 55, and 60 years are called each year. BV diagnosis of the PAP-stained smears uses the classification according to Nugent. The PAP-stained smears from the screening program of cervical cancer 1993, 1998, 2003, and 2008 were used in this study. A total of 3456 slides were investigated and 271 women could be followed for the 15-year observation period. The prevalence of BV declined from 15.6% in 1993 to 8.6% in 2008. The highest prevalence occurred among the age groups of 35 and 50 years. Among the 271 women who could be followed for the 15-year observation period, two-third showed normal/intermediate flora and one-third were infected with BV at least once. As this is a cross-sectional population study spanning 15 years, the prevalence of BV in the female adult population of the Åland Islands can be estimated. The prevalence has declined between 1993 and 2008 from 15.6% to 8.6%.
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| 15. |
- Eriksson, Katarina, et al.
(författare)
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Vaginal retention of locally administered clindamycin
- 2011
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : John Wiley & Sons. - 0903-4641 .- 1600-0463. ; 119:6, s. 373-376
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Tidskriftsartikel (refereegranskat)abstract
- Since bacterial vaginosis (BV) is characterized by a lack of, or very few, lactobacilli and high numbers of small, mostly anaerobic bacteria, an obvious treatment modality would be eradication of the BV-associated bacterial flora followed by reintroduction of lactobacilli vaginally. As probiotic treatment with lactobacilli is one tool for improving the cure rate when treating BV, it is necessary to know the length of time after treatment that clindamycin can be found in the vagina and if this could interfere with the growth of the probiotic lactobacilli. We evaluated the vaginal concentration of clindamycin in 12 women for 8 days to obtain data on the concentration of clindamycin in the vagina after intravaginal treatment with the drug. The participants were examined five times between two menstrual periods: before treatment, the day after treatment was finished, and 3, 5 and 8 days post-treatment. The first day post-treatment clindamycin 0.46 x 10-3 to 8.4 x 10-3 g/g vaginal fluid (median 2.87 x 10-3) was found. Thereafter, the concentration of clindamycin decreased rapidly. In 10 patients clindamycin was found after 3 days. A very low concentration was still present 5 days after treatment in four patients. After 8 days no clindamycin was found. Clindamycin is rapidly eliminated from the vagina, within 3-8 days, after local administration. Our results indicate that treatment with probiotic lactobacilli could be problematic if carried out within 5 days after cessation of clindamycin treatment.
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| 16. |
- Eriksson, K., et al.
(författare)
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Validation of the use of Pap-stained vaginal smears for diagnosis of bacterial vaginosis
- 2007
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Ingår i: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. - : Wiley. - 1600-0463 .- 0903-4641. ; 115:7, s. 809-813
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Tidskriftsartikel (refereegranskat)abstract
- Papanicolaou-stained cervicovaginal smears (Pap smears) are used to screen for cervical cancer. Since there is a lack of consensus in published reports respecting the efficacy of Pap-stained smears in BV diagnostics, there is a need to validate their use for diagnosis of BV. Slides from the international BV00 workshop were Pap stained and independently analyzed by four investigators under a phase-contrast microscope. All workshop slides-whether Pap-stained, Gram-stained or rehydrated air-dried smears-were scored according to the same Nugent classification. The diagnostic accuracy of Pap smears for diagnosis of BV had a sensitivity of 0.85 and a specificity of 0.92, with a positive and negative predictive value of 0.84 and 0.93, respectively. The interobserver weighted kappa index was 0.86 for Pap-stained smears compared to 0.81 for Gram-stained smears, and 0.70 for rehydrated air-dried smears using the mean Nugent score as the criterion standard. Provided that the samples are taken from equivalent locations (the vaginal fornix) and analyzed according to the same scoring criteria, there is no discernable difference in the diagnostic accuracy of the three smear-staining methods. The Pap-stained vaginal smears can be used as a wholly adequate alternative to Gram-stained smears for BV diagnosis.
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| 17. |
- Forsum, Urban, et al.
(författare)
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An international study of the inter-observer variation between the interpretations of vaginal smear criteria of Bacterial Vaginosis
- 2002
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Ingår i: APMIS. - : Wiley. - 1600-0463 .- 0903-4641. ; 110:11, s. 811-818
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Tidskriftsartikel (refereegranskat)abstract
- An international workshop on vaginal smear-based diagnosis of bacterial vaginosis was organized where 13 investigators scoring 258 slides with smears from vaginal fluid. Interobserver reproducibility of interpretations of Nugent scores, Hay/Ison scores and wet smear scores for the diagnosis of bacterial vaginosis was shown to be high. Detailed analysis of individual scoring results however indicated that basic standards of quality control to ensure robust individual readings of slides must be adhered to.
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| 18. |
- Forsum, Urban, et al.
(författare)
-
Anna-Karin Hatt hade visst rätt
- 2010
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Ingår i: Svenska Dagbladet. - 1101-2412.
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 19. |
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| 20. |
- Forsum, Urban, et al.
(författare)
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Bacterial vaginosis - A laboratory and clinical diagnostics enigma : Review article II
- 2005
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley. - 0903-4641 .- 1600-0463. ; 113:3, s. 153-161
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Forskningsöversikt (refereegranskat)abstract
- Diagnosing bacterial vaginosis (BV) has long been based on the clinical criteria of Amsel et al., whereby three of four defined criteria must be satisfied. Though there are other criteria and scoring methods which function well in comparison (i.e. Nugent scoring), it is not certain that they will always identify the same category of patients. Point-of-care methods based on various combinations of microbial products, presence of RNA, or more complex laboratory instrumentations such as sensor arrays, have also been introduced for the diagnosis of BV No method for diagnosing BV can at present be regarded as the best. It could be that - based partly on tacit knowledge on the part of the clinical investigators scoring in the clinic - various scoring systems have been chosen to fit a particular BV-related problem in a particular population. In this review we critically examine these pertinent issues influencing clinical scoring and laboratory diagnostics of BV. Copyright © APMIS 2005.
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| 21. |
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| 22. |
- Forsum, Urban, 1946-, et al.
(författare)
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Bacterial vaginosis--a microbiological and immunological enigma.
- 2005
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Ingår i: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. - : Wiley. - 0903-4641 .- 1600-0463. ; 113:2, s. 81-90
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Tidskriftsartikel (refereegranskat)abstract
- The development of bacterial vaginosis (BV) among women of childbearing age and the resulting quantitative and qualitative shift from normally occurring lactobacilli in the vagina to a mixture of mainly anaerobic bacteria is a microbiological and immunological enigma that so far has precluded the formulation of a unifying generally accepted theory on the aetiology and clinical course of BV. This critical review highlights some of the more important aspects of BV research that could help in formulating new basic ideas respecting the biology of BV, not least the importance of the interleukin mediators of local inflammatory responses and the bacterial shift from the normally occurring lactobacilli species: L. crispatus, L. gasseri, L. jensenii, and L. iners to a mixed flora dominated by anaerobic bacteria.
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| 23. |
- Forsum, Urban, 1946-, et al.
(författare)
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Bakteriell vaginos
- 2004
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Bok (övrigt vetenskapligt/konstnärligt)
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| 24. |
- Forsum, Urban, 1946-, et al.
(författare)
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Begrepp och termer inom hälso- och sjukvård
- 1999
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Ingår i: Socialmedicinsk tidskrift. - Stockholm : Socialmedicinsk tidskrift. - 0037-833X. ; :6, s. 540-547
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Tidskriftsartikel (refereegranskat)
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| 25. |
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| 26. |
- Forsum, Urban, et al.
(författare)
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Clinical microbiology informatics - Developments in Sweden
- 2007
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley-Blackwell Publishing Inc.. - 0903-4641 .- 1600-0463. ; 115:5, s. 415-421
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 27. |
- Forsum, Urban, 1946-, et al.
(författare)
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Developments in the recent past - Immunology
- 2007
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley-Blackwell Publishing Inc.. - 0903-4641 .- 1600-0463. ; 115:5, s. 406-408
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 28. |
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| 29. |
- Forsum, Urban, 1946-
(författare)
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Ett område där värderingarna går isär
- 2008
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:43, s. 3058-3058
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Tidskriftsartikel (refereegranskat)
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Forsum, Urban
(författare)
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Letter: En intressant fotnot
- 2009
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 106:44, s. 2866-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 34. |
- Forsum, Urban, 1946-, et al.
(författare)
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Literary fiction in the medical programme
- 2006
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Ingår i: Celebrating the past by expanding the future.. - : Lecture Notes in Computer Science. - 9185643076 ; , s. 38-40
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- During the fall of 2006, the Faculty of Health Sciences (FHS) celebrates its 20th birthday. Linköping has a long tradition of health education; our nursing programme started already in 1895 and occupational therapy began in 1965. From the late 1960’s, medical students from Uppsala spent their last seven semesters in Linköping, mainly for clinical studies. After some years, academic and teachers from the young faculty, together with the county council, realized the enormous potential benefits of a complete undergraduate medical programme at Linköping University. Inspired by apparent innovations from McMaster University in Canada, Maastricht in Holland, Ben Gurion in Israel and Tromsø in Norway, these ideas and ideals were gradually turned into reality. In a complicated process, concerning the life or death of the medical faculty, a close co-operation between the University and the County Council of Östergötland was extremely fruitful. A proposal regarding a complete medical programme, and study periods integrated between the other health education programmes, was forwarded to the Swedish government in December 1982 and approved in 1984.
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| 35. |
- Forsum, Urban, 1946-, et al.
(författare)
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Methods in molecular biology
- 2004
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- An accessible introduction to how genomics has and will provide novel methods for bacterial investigation and advance our understanding and knowledge of bacterial pathogenicity. The authors critically evaluate the applications of genomics to diagnostic bacteriology, highlighting both current and likely future uses, describing real-time PCR methods, and outlining the promise of microarrays in clinical bacteriology. Their discussion examines in detail genomic approaches to antibacterial discovery, the nature of pathogenicity, the discovery of new pathogens, the exploration of the concept of clonality in bacteria, and bacterial taxonomics.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
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| 40. |
- Forsum, Urban, 1946-, et al.
(författare)
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Special edition : Dendritic cells.
- 2003
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - 0903-4641 .- 1600-0463. ; 111, s. 673-674
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Tidskriftsartikel (refereegranskat)
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| 41. |
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| 42. |
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| 43. |
- Forsum, Urban
(författare)
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The biology of Mobiluncus
- 2001
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Ingår i: Venerelogy. - 1032-1012. ; 14:4, s. 169-173
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Forskningsöversikt (refereegranskat)abstract
- Mobiluncus, a member of the anaerobic vaginal flora typical for bacterial vaginosis, is a strikingly mobile, curved, rod-shaped bacterium forming a bacterial genus that has thus far not been assigned with certainty to higher bacterial taxa. Two species, M curtisii and M mulieris, are well recognised, but atypical strains do occur. A normal residence for Mobluncus in the indigenous human bacterial flora might be the rectum or large intestine. Investigations during the last 20 years have not come up with a definite individual role for Mobiluncus in the pathogenesis of bacterial vaginosis. Its possible role in obstetric and gynaecological infections that are strongly suspected to be linked to bacterial vaginosis, and its role in extragenital infections, remain elusive. Mobiluncus is thus a conspicuous member of the mixed anaerobic flora that is so characteristic of bacterial vaginosis. The role of Mobiluncus in the pathogenesis of bacterial vaginosis will probably be resolved only when new insight is attained into the complex interrelationships of mixed anaerobic infections.
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| 44. |
- Forsum, Urban, 1946-, et al.
(författare)
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The impact of qualitative analysis in laboratory medicine
- 2005
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Ingår i: TrAC. Trends in analytical chemistry. - : Elsevier BV. - 0165-9936 .- 1879-3142. ; 24:6, s. 546-555
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Tidskriftsartikel (refereegranskat)abstract
- Laboratory medicine is a challenge for the metrologically and terminologically inclined scientist. One main reason is the need for a sound theory that can be applied in a systematic way to cover all aspects of examinations, i.e., those procedures whose results are reported on an ordinal scale and those reported on more primitive scales (e.g., classifications and narratives). Validation of procedures for examinations involving properties on a nominal scale is especially difficult to achieve because it is hard to find gold standards, in the conventional sense, against which to validate and which combine performance characteristics and clinically relevant specificity and sensitivity. We present a systematic, unambiguously defined terminology (the C-NPU coding scheme) for metrologically derived terms for expressing properties, and present some examples of how to attain diagnostic goals. If the analytic process in the laboratory can be subsumed into medical contexts in a systematic way, many pitfalls in reporting results can be avoided. © 2005 Elsevier Ltd. All rights reserved.
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| 45. |
- Forsum, Urban, 1946-
(författare)
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Varning för Ellen!
- 2004
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 101:17, s. 1544-1544
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 46. |
- Jakobsson, Tell, 1951-, et al.
(författare)
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Changes in the predominant human Lactobacillus flora during in vitro fertilisation
- 2008
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Ingår i: Annals of Clinical Microbiology and Antimicrobials. - : BioMed Central (BMC). - 1476-0711. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Signature matching of nucleotide sequences in the V1 and V3 regions 16S rRNA genes using pyrosequencing technology is a powerful tool for typing vaginal Lactobacilli to the species level and has been used for investigating the vaginal microbial niche. Methods: This study has characterized the normal cultivable vaginal Lactobacillus flora at varying estradiol levels in plasma, the study comprised 17 patients undergoing ovarian stimulation for In Vitro Fertilization (IVF) treatment. The vaginal status of each participant was initially assessed as normal according to Amsel and Nugent criteria. Results: L. crispatus, L. gasseri and/or L. jensenii were present in 10of the patients throughout the study period, and little variation among these three species was encountered in individual patients. The flora of three women was dominated by L. delbrüeckii, L. rhamnosus or L. vaginalis. One woman exhibited a dominance of L. iners. The flora of the remaining three women were initially dominated by L. rhamnosus or L. reuteri, but as their estrogen levels rose, their flora composition altered, to become dominated by one of the three species most common in a normal, healthy vagina. Conclusion: Signature matching of nucleotide sequences in the V1 and V3 regions of 16S rRNA genes is a discriminative tool for the study of vaginal Lactobacilli and can be used to track the Lactobacillus flora under a variety of physiological conditions. © 2008 Jakobsson and Forsum, licensee BioMed Central Ltd.
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| 47. |
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| 48. |
- Jakobsson, Tell, 1951-
(författare)
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Lactobacillus iners and the normal vaginal flora
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The ecological niche of the vagina contains a large number of different microbes that are constantly interacting with each other and the host. Culture methods have not been sufficient in order to resolve the complexity of the normal vaginal flora. Further, the methods for delineating normal flora from not normal flora are not easily handled and are traditionally not based on culture but on microscopy of elements of the vaginal fluid. In the work presented in this thesis, an international collaboration was established that pin-pointed some of the difficulties in classifying vaginal floras, including staining, sampling, and discordance when lactobacilli are few in number, and that emphasized the importance of the size of the vision field in microscopes. As lactobacilli are prominent members of the normal vaginal flora they need to be carefully classified if further work towards more robust scoring tools is to be achieved.Phenotypic methods have not been able to separate the closely related Lactobacillus species of the vagina. Progress in molecular biology has provided possibilities to characterize these lactobacilli, which are mainly from the Lactobacillus acidophilus group. In this work a large number of strains collected by true random sampling were subjected to RAPD-PCR, TTGE and multiplex PCR for species identification. The major species found were L. crispatus, L. gasseri and L. jensenii and the recently described L. iners. The presence of L. iners has not been detected in previous studies due to its special nutrient requirements. Development of pyrosequencing technology also made it possible to match signatures of the two variable regions V1 and V3 of the 16S rRNA gene of the vaginal lactobacilli and identify them to the species level in a high throughput manner. The study confirmed that the dominating flora in women with normal vaginal flora comprises the four species mentioned previously. Repetitive sampling during IVF-treatment with highly varying oestrogen levels demonstrates changes that possibly occur during changes in the natural life cycle. Furthermore, L. iners was found to be the first species to be established after spontaneously resolved or treated Bacterial Vaginosis.These findings can be of help in developing new strategies for regaining and retaining the normal vaginal flora.
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| 49. |
- Jakobsson, Tell, et al.
(författare)
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The predominant Human vaginal Lactobacillus flora during IVF treatment
- 2008
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Ingår i: Annals of Clinical Microbiology and Antimicrobials. - : American Society for Microbiology. - 1476-0711. ; 7:14, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Signature matching of nucleotide sequences in the V1 and V3 regions 16S rRNA genes using pyrosequencing technology is a powerful tool for typing vaginal Lactobacilli to the species level and has been used for investigating the vaginal microbial niche.Methods: This study has characterized the normal cultivable vaginal Lactobacillus flora at varying estradiol levels in plasma; the study comprised 17 patients undergoing ovarian stimulation for In Vitro Fertilization (IVF) treatment. The vaginal status of each participant was initially assessed as normal according to Amsel and Nugent criteria.Results: L. crispatus, L. gasseri and/or L. jensenii were present in 10 of the patients throughout the study period, and little variation among these three species was encountered in individual patients. The flora of three women was dominated by L. delbrüeckii, L. rhamnosus or L. vaginalis. One woman exhibited a dominance of L. iners. The flora of the remaining three women were initially dominated by L. rhamnosus or L. reuteri, but as their estrogen levels rose, their flora composition altered, to become dominated by one of the three species most common in a normal, healthy vagina.Conclusion: Signature matching of nucleotide sequences in the V1 and V3 regions of 16S rRNA genes is a discriminative tool for the study of vaginal Lactobacilli and can be used to track the Lactobacillus flora under a variety of physiological conditions.
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| 50. |
- Jakobsson, Tell, 1951-, et al.
(författare)
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Vaginala laktobaciller som normalflora
- 2004
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Ingår i: Bakteriell Vaginos. - Växjö : Grafiska Punkten. - 9163148005 ; , s. 31-35
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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