| 1. |
- Alaridah, Nader, et al.
(författare)
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Transmission dynamics study of tuberculosis isolates with whole genome sequencing in southern Sweden
- 2019
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Epidemiological contact tracing complemented with genotyping of clinical Mycobacterium tuberculosis isolates is important for understanding disease transmission. In Sweden, tuberculosis (TB) is mostly reported in migrant and homeless where epidemiologic contact tracing could pose a problem. This study compared epidemiologic linking with genotyping in a low burden country. Mycobacterium tuberculosis isolates (n = 93) collected at Scania University Hospital in Southern Sweden were analysed with the standard genotyping method mycobacterial interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) and the results were compared with whole genome sequencing (WGS). Using a maximum of twelve single nucleotide polymorphisms (SNPs) as the upper threshold of genomic relatedness noted among hosts, we identified 18 clusters with WGS comprising 52 patients with overall pairwise genetic maximum distances ranging from zero to nine SNPs. MIRU-VNTR and WGS clustered the same isolates, although the distribution differed depending on MIRU-VNTR limitations. Both genotyping techniques identified clusters where epidemiologic linking was insufficient, although WGS had higher correlation with epidemiologic data. To summarize, WGS provided better resolution of transmission than MIRU-VNTR in a setting with low TB incidence. WGS predicted epidemiologic links better which could consolidate and correct the epidemiologically linked cases, avoiding thus false clustering.
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| 2. |
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| 3. |
- Bryant, J. M., et al.
(författare)
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Emergence and spread of a human-transmissible multidrug-resistant nontuberculous mycobacterium
- 2016
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 354:6313, s. 751-757
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Tidskriftsartikel (refereegranskat)abstract
- Lung infections with Mycobacterium abscessus, a species of multidrug-resistant nontuberculous mycobacteria, are emerging as an important global threat to individuals with cystic fibrosis (CF), in whom M. abscessus accelerates inflammatory lung damage, leading to increased morbidity and mortality. Previously, M. abscessus was thought to be independently acquired by susceptible individuals from the environment. However, using whole-genome analysis of a global collection of clinical isolates, we show that the majority of M. abscessus infections are acquired through transmission, potentially via fomites and aerosols, of recently emerged dominant circulating clones that have spread globally. We demonstrate that these clones are associated with worse clinical outcomes, show increased virulence in cell-based and mouse infection models, and thus represent an urgent international infection challenge.
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| 4. |
- Fritzell, Peter, et al.
(författare)
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Bacteria : back pain, leg pain and Modic sign—a surgical multicentre comparative study
- 2019
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 28:12, s. 2981-2989
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare bacterial findings in pain-generating degenerated discs in adults operated on for lumbar disc herniation (LDH), and mostly also suffering from low back pain (LBP), with findings in adolescent patients with non-degenerated non-pain-generating discs operated on for scoliosis, and to evaluate associations with Modic signs on magnetic resonance imaging (MRI). Cutibacterium acnes (Propionibacterium acnes) has been found in painful degenerated discs, why it has been suggested treating patients with LDH/LBP with antibiotics. As multidrug-resistant bacteria are a worldwide concern, new indications for using antibiotics should be based on solid scientific evidence.Methods: Between 2015 and 2017, 40 adults with LDH/LBP (median age 43, IQR 33–49) and 20 control patients with scoliosis (median age 17, IQR 15–20) underwent surgery at seven Swedish hospitals. Samples were cultured from skin, surgical wound, discs and vertebrae. Genetic relatedness of C. acnes isolates was investigated using single-nucleotide polymorphism analysis. DNA samples collected from discs/vertebrae were analysed using 16S rRNA-based PCR sequencing. MRI findings were assessed for Modic changes.Results: No bacterial growth was found in 6/40 (15%) LDH patients, compared with 3/20 (15%) scoliosis patients. Most positive samples in both groups were isolated from the skin and then from subcutis or deep within the wound. Of the four disc and vertebral samples from each of the 60 patients, 235/240 (98%) were DNA negative by bacterial PCR. A single species, C. acnes, was found exclusively in the disc/vertebra from one patient in each group. In the LDH group, 29/40 (72%) patients had at least one sample with growth of C. acnes, compared to 14/20 (70%) in the scoliosis group. Bacterial findings and Modic changes were not associated.Conclusions: Cutibacterium acnes found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and/or low back pain, without signs of clinical discitis/spondylitis, should be seriously questioned.
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| 5. |
- Hedvall, Per-Olof, et al.
(författare)
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Att så vidare 25
- 2015
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Rapport (populärvet., debatt m.m.)abstract
- När Certec i år arrangerar ”Certec informerar” för 25:e gången firar vi det genom att i bild och text ge bort en tankebok med 25 viktiga tankar och tankesätt som vuxit fram under åren som gått.Att skapa ny kunskap tar tid. När vi till vardags håller på med att skapa användvärd teknik genom människonära design är det sällan någon quick fix. Bakom uppnådda resultat finns det en ständigt pågående teori- och metodbildning. Denna påverkar vad som faktiskt blir gjort. Och vad som inte blir gjort. Detta gäller såväl inom forskningen som i samhället i övrigt.Vi vill med denna tankesamling sammanfatta, komplettera och vidga spridningen av Certecs avhandlingar och rapporter, löpsedlar och broschyrer, föreläsningar och verksamhetsberättelser.Vår förhoppning är att du som läsare får tankar, idéer och inspiration som du kan ta med dig vidare i dina egna sammanhang.
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| 6. |
- Johansson, Stefan, 1963-
(författare)
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Design for Participation and Inclusion will Follow : Disabled People and the Digital Society
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Digitalization is rapidly taking over all aspects of society, but still there are parts of the population who have to struggle for access to, and to be able to use, the digital resources. Design processes and outcomes in the form of artefacts, that takes accessibility into account, is key to participation. This gives the designer a central role in providing for a more equal participation of all, in the digital society. The work in this thesis contributes to a better understanding of the prerequisites for participation in the digital society, and in the design processes to accomplish this, by presenting research done together with three communities: people with cognitive impairments, people with mental health issues and homeless people.The overall question has been How can participation in the digital society be understood? We have investigated the nature of difficulties or enabling factors for people with impairments, people with mental health issues and homeless people, when using the internet. We have also investigated possible digital divides within the groups, and how they can be explained.Ontologically, the work is based on an assumption that knowledge is to be found in a dialectic interplay between the material world and how we interpret what is going on in this world. The underlying epistemological assumption is that data has to be empiric, and critically interpreted in dialogue between members of the communities, which are being researched, and other stakeholders. This work draws on the idea of emancipation and that research can be liberating.The work also takes on a pragmatic stance. We have used adapted versions of Emancipatory Participatory Research, and of Participatory and Value Sensitive Design, thus making them accessible to people with cognitive impairments, people with mental health issues or homeless people. We have tested and adapted methods for sampling of rare populations, to enhance the quality of quantitative studies of how people with impairments and people with mental health issues have access to, and are using, the internet.In our research, we have found fourteen prerequisites, all of which need to be in place to provide for participation. To promote participation, we need a toolbox of methods and accessible tools. Finally, to analyse what is going on we need an analytical model which allows for analysis on multiple levels and from multiple perspectives.As a result, I here propose, define and position a framework for researching and understanding participation in the digital society, based on three parts: Guidelines, Ethics and Statistics. Guidelines can be understood as the theories, the regulations, the standards, etc. that inform our thinking. Ethics guide us in the right direction. Statistics make progress or lack of progress visible.The conclusion is: if we plan for participation - by improved statistic survey sampling methods, a participatory approach to collaborative research and in using research methods in an accessible and emancipatory way – inclusion will follow.
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| 7. |
- Jönsson, Anette, et al.
(författare)
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Long‑term follow‑up of buserelin‑induced enteric neuropathy in rats.
- 2016
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Ingår i: Molecular Medicine Reports. - : Spandidos Publications. - 1791-3004 .- 1791-2997. ; 13:4, s. 3507-3513
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Tidskriftsartikel (refereegranskat)abstract
- A few patients have been shown to develop severe abdominal pain and gastrointestinal dysmotility during treatment with gonadotropin‑releasing hormone (GnRH) analogs. A rat model of enteric neuropathy has been developed by administration of the GnRH analog buserelin to rats. Loss of enteric neurons and ganglioneuritis throughout the gastrointestinal tract has been described, without other histopathological changes. The aim of the present study was to investigate the long‑term effects of this rat model on body weight, and on morphology and inflammatory changes in the gastrointestinal tract. Rats were administered subcutaneous injections of buserelin or saline once daily for 5 days and allowed to recover for 3 weeks. This regimen was repeated four times. The rats were weighed weekly and were sacrificed 16 weeks after the fourth treatment. The bowel wall was measured by morphometry, and the presence of enteric neurons, mast cells, eosinophils and T‑lymphocytes was evaluated. Buserelin‑treated rats were shown to have a lower body weight at sacrifice, as compared with the controls (P<0.05). Compared with controls, buserelin treatment caused loss of myenteric neurons in the ileum and colon (P<0.01), a thinner circular muscle layer in ileum (P<0.05) and longitudinal muscle layer in colon (P<0.05), increased number of eosinophils in the submucosa of the ileum (P<0.05), and an increased number of T‑lymphocytes in the submucosa and circular muscle layer of the fundus (P<0.01 and P<0.05, respectively) and circular muscle layer of the colon (P<0.05). Mast cells were equally distributed in the two groups. Thus, long‑term follow‑up of buserelin‑induced enteric neuropathy reveals reduced body weight, loss of myenteric neurons, thinning of muscle layers, and increased numbers of eosinophils and T‑lymphocytes in the gastrointestinal tract.
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| 8. |
- Jönsson, Bodil, 1959, et al.
(författare)
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Evaluation of the Cobas TaqMan MTB test for detection of Mycobacterium tuberculosis complex.
- 2015
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Ingår i: Infectious diseases (London, England). - : Informa UK Limited. - 2374-4243 .- 2374-4235. ; 47:4, s. 231-6
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Tidskriftsartikel (refereegranskat)abstract
- The Cobas TaqMan MTB assay is used for rapid detection of the Mycobacterium tuberculosis complex (MTC) in clinical samples. It is only validated for respiratory samples, but is often requested by physicians for non-respiratory specimens. The aim of this study was therefore to evaluate the performance of this assay in clinical praxis in a country with low prevalence of tuberculosis (TB).
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| 9. |
- Jönsson, Bodil, 1959, et al.
(författare)
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TB can be detected with PCR – but only in smearpositive respiratory samples : Tbc kan påvisas med PCR – men bara i direktpositiva luftvägsprov
- 2018
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Ingår i: Lakartidningen. - 0023-7205. ; 115:1-2
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Forskningsöversikt (refereegranskat)abstract
- Unnecessary and inappropriate clinical requests represent a great waste of time and money and may also result in false diagnoses. PCR techniques, such as Cobas TaqMan MTB, are used for rapid detection of tuberculosis (TB). These assays are only validated for respiratory specimens, but they are commonly requested also for non-respiratory specimens. These assays perform well in smear-positive respiratory samples, while the sensitivities are quite unsatisfactory for both respiratory and non-respiratory smearnegatives samples. The specificity is high and it is possible to rapidly distinguish between TB and infections caused by environmental mycobacteria. The analyses demonstrate, furthermore, that PCR assays cannot be used to evaluate treatment, detect relapses or exclude TB. Nor can these assays be used to evaluate contagiousness or to screen for TB. © 2017, Swedish Medical Association. All rights reserved.
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| 10. |
- Larsson, Lars-Olof, et al.
(författare)
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Nontuberculous Mycobacterial Diseases in Humans
- 2019
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Ingår i: Nontuberculous Mycobacteria (NTM) - Microbiolocical, Clinical and Geografical distribution) / Editors: Ali Akbar and Parissa Farnia. - : Academic Press. - 9780128146927 ; , s. 101-119
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Bokkapitel (refereegranskat)abstract
- The number of patients infected with nontuberculous mycobacteria (NTM) is increasing and presents severe health problems. NTM infections in children are not uncommon and differ in several aspects from NTM infections in adults. In children, lymph nodes are most often infected, while lung infections dominate among adults. Thus, this chapter on NTM infections will focus on infections in children and pulmonary infections in adults. The reason why NTM diseases have been more commonly recognized is partly due to increased awareness and improved diagnostic methods. In addition, the number of patients with impaired resistance to infections has increased and such conditions are important risk factors for developing NTM disease. However, many NTM patients, particularly children, have no known predisposing condition. In addition, spontaneous resolution is common among children. Diagnosis and treatment are challenging since many patients suffer from other diseases and many NTM are resistant to commonly used drugs. Therapy is, therefore, generally complex and prolonged and side effects are common.
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