| 1. |
- Holmberg, Martin, et al.
(författare)
-
Evaluation of human seroreactivity to Bartonella species in Sweden
- 1999
-
Ingår i: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 37:5, s. 1381-1384
-
Tidskriftsartikel (refereegranskat)abstract
- Among the species that compose the expanding genus Bartonella, thus far only B. henselae and B. quintana have reportedly been isolated from humans in Europe. To evaluate the prevalence of Bartonella infection in Sweden,we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies to B. henselae, B. quintana, and B. elizabethae, Serum samples from 100 blood donors, who spanned the ages of 20 to 60 and had no apparent clinical signs of illness, were also studied as a control group. An immunoglobulin G indirect fluorescence antibody assay revealed 4 and 8.3% Bartonella positivity rates for the blood donor and patient group, respectively, when a cutoff titer of greater than or equal to 64 was chosen. Among the blood donors, four were seropositive to B, elizabethae; one of these also had concordant positive titer to B. henselae, In the patient group, 14 serum samples were positive against Bartonella spp, These serum specimens represented nine patients. In three of these seropositive patients, paired serum samples displayed a fourfold increase in antibody titer to at least one of the three antigens, These three patients are discussed. In this report we also present a case study of a 60-year-old Swedish male with fatal myocarditis, Postmortem serological analysis revealed a high titer against B. elizabethae, PCR and nucleotide sequencing of the myocardial tissue from this patient, and of Liver tissue from one of the other three patients, showed sequences similar to B. quintana, The age, geographical origin, animal contacts, and serological response pattern to the different Bartonella antigens differed among the four patients. This study substantiates the presence of Bartonella spp, in Sweden, documents the seroreactivity to three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden.
|
|
| 2. |
|
|
| 3. |
- Andersson, Roland, 1950-
(författare)
-
Appendicitis : Epidemiology and diagnosis
- 1998
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The study concerns appendicitis, its epidemiology and diagnosis, and the outcome of appendectomy. A population based cohort of 9,274 patients undergoing appendectomy in 1969 to 1990 in Jönköping County was retrospectively studied, and 502 patients admitted for suspected appendicitis to the hospitals in Jönköping and Eksjö between October 1992 and December 1993 were prospectively studied.Appendicitis was found to occur in outbreaks and space-time clusters, indicating an infectious etiology. The incidence of non-perforating appendicitis was strongly age-dependent, with a peak in adolescence, whereas the incidence of perforating appendicitis was stable at all ages. This suggests that perforating and non-perforating appendicitis are separate entities.There was a high rate of negative appendectomies, but during the study period an increasing diagnostic accuracy and decreasing incidence of negative appendectomies was observed, indicating a trend towards a more restrictive attitude to exploration in patients with suspected appendicitis. This was accompanied by a decreasing incidence of non-perforating appendicitis, whereas the incidence of perforating appendicitis was stable. An analysis of population based studies showed a strong relation between surgeons' attitude to exploration and the incidence of non-perforating ap9endicitis, whereas the incidence of perforating appendicitis was unrelated. This is consistent with a high proportion of potentially resolving appendicitis.A conservative management decreases the munber of negative explorations and saves a number of patients with resolving appendicitis from an unnecessary operation. This leads to a high proportion of perforations among the operated patients but the number of perforations is not increased. The perforation rate, therefore, should not be used as a quality measure of the management of patients with suspected appendicitis.The rate of negative explorations is higher in women. This gender difference is found at all ages and is not due to gynecological diseases alone. The explanation is the larger number of women attending for nonsurgical abdominal pain, whereas the rate of diagnostic errors among these patients is similar in men and women.Patients with a negative appendectomy are characterized by high intensity of pain and tenderness without signs of a systemic inflammatory response. Surgeons pay too much attention to pain and tenderness in their decision to operate, and underestimate the importance of temperature, laboratory variables and duration of symptoms.No single clinical or laboratory variable has sufficiently high discriminating power to be used as a true diagnostic test. The inflammatory variables are as important predictors as the clinical findings, and they are especially important in advanced appendicitis. Their diagnostic value is higher at a repeat examination after a few hours of observation.The study show for a need of an improved management of patients with suspected appendicitis, and the potential for improved clinical diagnosis. Inflammatory variables should be given more attention, and pain and tenderness should be interpreted more cautiously. An expectant management, with repeated clinical and laboratory examinations, is advisable once advanced appendicitis has been ruled out.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Hafström, Lars-Olof, 1936, et al.
(författare)
-
Treatment of primary liver cancer.
- 1998
-
Ingår i: The European journal of surgery = Acta chirurgica. - : Oxford University Press (OUP). - 1102-4151. ; 164:8, s. 569-74
-
Tidskriftsartikel (refereegranskat)abstract
- To evaluate treatment of patients with primary liver cancer.
|
|
| 9. |
- Helgesen, Fred, et al.
(författare)
-
Trends in prostate cancer survival in Sweden, 1960 through 1988 : Evidence of increasing diagnosis of nonlethal tumors
- 1996
-
Ingår i: Journal of the National Cancer Institute. - 0027-8874 .- 1460-2105. ; 88:17, s. 1216-1221
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The incidence of prostate cancer has increased during the past 30 years but has been paralleled by increases in survival rates from this disease, despite the absence of documented major improvement in curative treatment. Since a high prevalence of microscopic prostate cancer has been observed in autopsied men and because many prostate cancers may never surface clinically, increased diagnostic activities might have led to increased detection of less aggressive tumors. PURPOSE: This study was conducted to elucidate whether the trends in prostate cancer incidence and patient survival may be due to increasing diagnoses of nonlethal tumors. METHODS: We analyzed a population-based cohort comprising all cases of prostate cancer (n = 80,901) detected in Sweden during the period of 1960 through 1988. Five hundred eighteen patients (0.64% of the total number) who could not be followed because of emigration or an incomplete national registration number were excluded. Observed and relative survival rates were calculated for the entire cohort of 80,383 assessable patients per 5-year age group in 5-year periods of diagnosis and according to diagnostic method and were compared between geographic areas with differences in incidence rates. To estimate the independent effects of these determinants, multivariate analyses were performed. RESULTS: For the 80,383 patients with complete follow-up, the 10- and 20-year observed survival rates were 17.5% (95% confidence interval [CI] = 17.2%-17.9%) and 3.5% (95% CI = 3.2%-3.7%), and the relative survival rates were 41.1% (95% CI = 40.3%-41.9%) and 28.6% (95% CI = 26.5%-30.1%), respectively. Relative survival rates improved markedly over time; 10-year relative survival rates increased from 29% (95% CI = 27%-31%) among case patients diagnosed in 1960 through 1964 to 45% (95% CI = 43%-46%) among those diagnosed in 1975 through 1979. Relative survival rates leveled off after about 18 years at 18% (95% CI = 15%-20%) among patients diagnosed in 1960 through 1964 and at 31% (95% CI = 28%-34%) among those diagnosed in 1970 through 1974. An even more favorable outlook was observed in those case patients diagnosed later. In areas with a high or low incidence of prostate cancer, the 10-year relative survival rates were 45% (95% CI = 44%-47%) and 36% (95% CI = 34%-38%), respectively. In the early 1960s, the calculated loss of life expectancy after diagnosis varied from about 68% (95% CI = 61%-75%) of the expected length of life in the youngest age group to about 48% (95% CI = 46%-50%) in the oldest age group. From 1960 through 1964 to 1985 through 1988, the loss of life expectancy decreased by more than 50% in all age groups. The differences in relative survival rates between age groups were small, with a gradual decrease in age groups more than 60-64 years of age. CONCLUSIONS: Most of the great temporal improvement and geographic variation in survival rates are quantitatively consistent, with likely increases in the rate of detection of nonlethal tumors. IMPLICATIONS: The increase in relative survival rates must be taken into consideration when evaluating the outcome of treatment of prostate cancer, since nonrandomized comparisons may be confounded by time trends. Diagnosis of nonlethal tumors raises concerns because the individual would suffer from the psychologic burden of a cancer diagnosis without any therapeutic benefit.
|
|
| 10. |
- Holmberg, J.A., et al.
(författare)
-
Manufacturing and performance of RTM U-beams
- 1997
-
Ingår i: Composites. Part A, Applied science and manufacturing. - 1359-835X .- 1878-5840. ; 28:6, s. 513-521
-
Tidskriftsartikel (refereegranskat)abstract
- Geometrical limitations and robustness of resin transfer moulding were investigated for single curved laminates. The design of experiments approach was used to determine how the out of plane tensile strength is affected by variations in performing method, radius, fibre content and vacuum assistance. U-beams with an inner radius of 0.8 mm were manufactured and demonstrated good mechanical performance. The strength of these beams was in fact less sensitive to defects than the strength of beams with a 5 mm radius. Different preforming methods can have a strong influence on beam strength due to effects on the void content in the finished laminates. The particular preforming problems encountered are described and possible solutions are suggested and tested. For example utilisation of vacuum assistance during mould filling reduces void content, which in turn tends to reduce the sensitivity of the beam strength to other defects such as wrinkling.
|
|
