| 1. |
- Schalén, Lucyna, et al.
(author)
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High isolation rate of Branhamella catarrhalis from the nasopharynx in adults with acute laryngitis
- 1980
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In: Scandinavian Journal of Infectious Diseases. - 1651-1980. ; 12:4, s. 277-280
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Journal article (peer-reviewed)abstract
- Branhamella catarrhalis was isolated from the nasopharynx in 55% of 40 noncompromised adult patients suffering from acute laryngitis. Diplococcus pneumoniae and haemophilus influenzae were found in another 5 and 8%, respectively; one patient had group A streptococci in the throat specimen. In 90% of the patients the laryngitis complaints were preceded by symptoms of an acute respiratory tract infection. Two of the patients with B. catarrhalis showed a significant titre conversion against influenza B and parainfluenza type e virus, respectively. Attempts to isolate virus failed in all cases. The results indicate that B. catarrhalis, known to cause acute otitis media in small children and respiratory tract infections in adult compromised hosts, may be involved in the etiology of acute laryngitis in otherwise healthy adults.
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| 4. |
- Högstedt, Erika, 1980-, et al.
(author)
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'It's like it is designed to keep me stressed' - Working sustainably with ADHD or autism
- 2023
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In: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Group. - 1103-8128 .- 1651-2014. ; 30:8, s. 1280-1291
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Journal article (peer-reviewed)abstract
- Background Adults with attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) face multiple challenges in obtaining and maintaining employment. Aims To identify and describe how adults with ADHD or ASD experienced their ability to work and what factors affected their ability to find a sustainable work situation over time. Methods Individual in-depth interviews were performed with 20 purposively sampled participants with ADHD/ASD. Data were analysed inductively using reflexive thematic analysis. Results Three themes were identified, describing (1) one's own cognitive abilities and challenges, (2) enablement by flexibility and acceptance in the work environment, and (3) accumulated stress that makes the work situation unsustainable over time. Conclusions Over time, a lack of continuity and predictability of support measures caused great stress and exhaustion, with severe consequences for working life and in life in general. Adaptations needed to be individually tailored and include nonoccupational factors. Significance The study shows that adults with ADHD/ASD need long-term interventions that flexibly adapt to individual needs, as they vary over time. The findings suggest that occupational therapists and other health care providers, employers, employment services and other involved agencies should pay a greater deal of attention to stability and predictability over time.
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| 5. |
- Ackefors, M., et al.
(author)
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Peg-IFN and ribavirin treatment for recurrence of genotype 2 and 3 hepatitis C after liver transplantation
- 2015
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In: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 47:4, s. 209-217
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Journal article (peer-reviewed)abstract
- Background: Relapse of hepatitis C virus (HCV) infection after liver transplantation (LT) is universal. Tolerance for treatment with pegylated-interferon (peg-IFN) and ribavirin (RBV) is suboptimal and withdrawals due to adverse events frequent. We sought to improve tolerance for treatment to improve outcome. Methods: We used concentration-guided RBV dosing to achieve an intended 10 mu mol/L concentration with darbepoetin support in combination with peg-IFN alfa-2a, 180 mu g for genotype 1 and 135 mu g for genotype 2/3 to improve tolerance. Results: A total of 51/54 patients (94%) completed a full treatment course. In the per-protocol analysis 43% of patients (22/51) achieved sustained virological response (SVR), 82% with HCV genotype 2/3 and 22% with genotype 1, p = 0.0001. Patients with IL28B CC achieved SVR in 73% (8/11) and patients with non-CC in 33% (14/43), p = 0.016. Patients with mild fi brosis (fi brosis stage 1-2) achieved SVR in 56% (15/27), and patients with advanced fi brosis (fi brosis stage 3 -4) in only 26% (7/27), p = 0.0267. Conclusions: Concentration-guided RBV dosing with darbepoetin support substantially improves tolerance and offers high adherence to a full peg-IFN and RBV treatment course in patients with post-transplant HCV relapse. With this approach genotype 2 and 3 infections can be treated cost-effectively post-transplant. Genotype 1, IL28B non-CC genotype, and advanced fi brosis predicted a low SVR rate.
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| 7. |
- Ljungquist, Oskar, et al.
(author)
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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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In: Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 2374-4235 .- 2374-4243. ; 54:3, s. 163-169
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Journal article (peer-reviewed)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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| 8. |
- Ljungquist, Oskar, et al.
(author)
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Convalescent plasma treatment in severely immunosuppressed patients hospitalized with COVID-19 : an observational study of 28 cases
- 2022
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In: Infectious Diseases. - : Taylor & Francis Group. - 2374-4235 .- 2374-4243 .- 1651-1980. ; 54:4, s. 283-291
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Journal article (peer-reviewed)abstract
- Background: Immunosuppressed patients are particularly vulnerable to severe infection from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), risking prolonged viremia and symptom duration. In this study we describe clinical and virological treatment outcomes in a heterogeneous group of patients with severe immunosuppression due to various causes suffering from COVID-19 infection, who were all treated with convalescent plasma (CCP) along with standard treatment.Methods: We performed an observational, retrospective case series between May 2020 to March 2021 at three sites in Skåne, Sweden, with a population of nearly 1.4 million people. All patients hospitalized for COVID-19 who received CCP with the indication severe immunosuppression as defined by the treating physician were included in the study (n = 28).Results: In total, 28 severely immunocompromised patients, half of which previously had been treated with rituximab, who had received in-hospital convalescent plasma treatment of COVID-19 were identified. One week after CCP treatment, 13 of 28 (46%) patients had improved clinically defined as a decrease of at least one point at the WHO-scale. Three patients had increased score points of whom two had died. For 12 patients, the WHO-scale was unchanged.Conclusion: As one of only few studies on CCP treatment of COVID-19 in hospitalized patients with severe immunosuppression, this study adds descriptive data. The study design prohibits conclusions on safety and efficacy, and the results should be interpreted with caution. Prospective, randomized trials are needed to investigate this further.
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| 9. |
- Nygren, David, et al.
(author)
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Association between SARS-CoV-2 and exposure risks in health care workers and university employees – a cross-sectional study
- 2021
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In: Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 2374-4235 .- 2374-4243. ; 53:6, s. 460-468
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Journal article (peer-reviewed)abstract
- BackgroundIn health care workers SARS-CoV-2 has been shown to be an occupational health risk, often associated with transmission between health care workers. Yet, insufficient information on transmission dynamics has been presented to elucidate the precise risk factors for contracting SARS-CoV-2 in this group.MethodsIn this cross-sectional study, we investigated association between questionnaire answers on potential exposure situations and SARS-CoV-2-positivity. Health care workers with and without COVID-19-patient contact at nine units at Skåne University Hospitals in Malmö and Lund, Sweden and university employees from Lund University, Sweden were enrolled. To limit impact of health care worker to health care worker transmission, units with known outbreaks were excluded. A SARS-CoV-2-positive case was defined by a previous positive PCR or anti-SARS-CoV-2 IgG in the ZetaGene COVID-19 Antibody Test.ResultsSARS-CoV-2-positivity was detected in 11/51 (22%) health care workers in COVID-19-units, 10/220 (5%) in non-COVID-19-units and 11/192 (6%) University employees (p = .001, Fischer’s exact). In health care workers, SARS-CoV-2-positivity was associated with work in a designated COVID-19-unit (OR 5.7 (95CI 2.1–16)) and caring for COVID-19-patients during the majority of shifts (OR 5.4 (95CI 2.0–15)). In all participants, SARS-CoV-2-positivity was associated with a confirmed COVID-19 case (OR 10 (95CI 2.0–45)) in the household.ConclusionOur study confirmed previous findings of elevated risk of acquiring SARS-CoV-2 in health care workers in COVID-19-units, despite exclusion of units with known outbreaks. Interestingly, health care workers in non-COVID-19-units had similar risk as University employees. Further measures to improve the safety of health care workers might be needed.
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| 10. |
- Wågström, Per, et al.
(author)
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Does the frequency of respiratory tract infections help to identify humoral immunodeficiencies in a primary health-care cohort?
- 2015
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In: Scandinavian Journal of Infectious Diseases. - : Informa Healthcare. - 0036-5548 .- 1651-1980. ; 47:1, s. 13-19
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Journal article (peer-reviewed)abstract
- Background: Primary immune deficiency (PID) due to humoral defects is associated with recurrent respiratory tract infections (RTIs). Reliable clinical warning signs of PID would facilitate early diagnosis and thereby reduce long-term complications. The aim of the present study was to evaluate the accuracy of the warning sign, 'four or more antibiotic-treated RTIs annually for 3 or more consecutive years,' for detecting PID among adults in a primary health-care setting. Methods: Fifty-three cases with 'four or more antibiotic-treated RTIs annually for 3 or more consecutive years' were selected from a Swedish primary health-care registry of RTIs. In addition, 66 age- and sex-matched controls were selected having a maximum of one antibiotic-treated RTI during the period covered by the study. Levels of immunoglobulin (Ig) IgG, IgA, IgM, IgG subclasses, and IgG antibodies against Haemophilus influenzae and Streptococcus pneumoniae as well as the inflammatory markers, C-reactive protein, interleukin (IL)-6 and IL-8 were determined. Results: IgG subclass deficiencies (IgGsd) were found in 5/53 (9.4%) of the cases and in 7/66 (10.6%) controls. The most frequent deficiency was IgG3sd and this was found in three participants in the case group and seven in the control group. The mean level of IgG3 was lower in the control group (p = 0.02). The mean level of IL-8 was lower in the case group (p = 0.02). Conclusion: The results show that physicians working in primary health care cannot solely rely on the frequency of antibiotic-treated RTIs as a warning sign for the detection of common humoral immune deficiencies.
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