| 1. |
- Sourander, Birger, et al.
(author)
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No effect of remdesivir or betamethasone on upper respiratory tract SARS-CoV-2 RNA kinetics in hospitalised COVID-19 patients: a retrospective observational study
- 2022
-
In: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 54:10, s. 703-712
-
Journal article (peer-reviewed)abstract
- Background The viral kinetics of SARS-CoV-2 has been considered clinically important. While remdesivir and corticosteroids are recommended for COVID-19 patients requiring oxygen support, there is a limited number of published reports on viral kinetics in hospitalised patients with COVID-19 treated with remdesivir or corticosteroids. Methods We conducted a retrospective study by collecting longitudinal samples from the nasopharynx/throat of 123 hospitalised patients (median age 55 years, 74% male) with COVID-19, to evaluate the effects of remdesivir and corticosteroid treatment on viral RNA levels. The subjects were divided into four groups: those receiving remdesivir (n = 25), betamethasone (n = 41), both (n = 15), or neither (n = 42). Time to viral RNA clearance was analysed using Kaplan-Meier plots, categorical data were analysed using Fisher's exact test, and Kruskal-Wallis for continuous data. Viral RNA decline rate was analysed using a mixed effect model. Results We found no significant difference in SARS-CoV-2 RNA decline rate or time to SARS-CoV-2 RNA clearance between the groups. Moreover, clinical status at baseline was not correlated with time to viral clearance. Conclusions Since SARS-CoV-2 RNA kinetics was not affected by treatment, repeated sampling from the upper respiratory tract cannot be used to evaluate treatment response.
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| 2. |
- Gustavsson, Lars, et al.
(author)
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Venous lactate levels can be used to identify patients with poor outcome following community-onset norovirus enteritis
- 2012
-
In: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 44:10, s. 782-787
-
Journal article (peer-reviewed)abstract
- Background: Norovirus enteritis (NVE) can be fatal in frail patients. High blood lactate levels indicate hypoperfusion and predict mortality in many infectious diseases. The objective was to determine the frequency and association with mortality of elevated lactate levels in patients with community-onset NVE. Methods: A retrospective cohort study was performed. All hospitalized adult patients with community-onset NVE verified by polymerase chain reaction during the period August 2008 to June 2009 were included. Vital signs and venous lactate on arrival, co-morbid conditions, and time of death were registered. The outcome measure was 30-day all-cause mortality. Results: Eighty-two patients with a median age of 77 y (interquartile range (IQR) 53-86 y) were included, of whom 47 (57%) were female and 49 (60%) had at least 1 major co-morbid condition. Lactate levels were above the upper limit of normal (ULN; 1.6 mmol/l) in 45 patients (55%). The overall 30-day mortality rate was 7% (6/82). Mortality was 18% (5/28) with lactate >= 2.4 mmol/l (> 50% above the ULN) on admission compared to 2% (1/54) with lactate < 2.4 mmol/l (p < 0.05). Patients who died had a higher median lactate level compared to survivors: 4.5 (IQR 2.7-7.9) mmol/l vs 1.7 (IQR 1.3-2.5) mmol/l, respectively (p < 0.01). The adjusted odds ratio for death within 30 days for a 1 mmol/l increase in lactate was 2.5 (95% confidence interval 1.003-6.3, p = 0.049). Conclusions: We observed a high proportion of patients with elevated lactate levels in community-onset NVE. Lactate elevation could predict mortality. Measurement of blood lactate may be a valuable tool in the clinical management of patients with a suspected norovirus infection.
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| 3. |
- Olofsson, Magnus, et al.
(author)
-
Sveriges bråkiga 1800-tal
- 2011
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In: Det stora elefantupploppet och andra berättelser från Sveriges bråkiga 1800-tal. - 9789197787543 ; , s. 130-139
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Book chapter (pop. science, debate, etc.)
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| 4. |
- Andersson, Magnus, et al.
(author)
-
The Funnel Beaker Culture in action: Early and Middle Neolithic monumentality in Southwestern Scania, Sweden (4000–3000 calBC)
- 2022
-
In: Journal of Neolithic Archaeology. ; 24, s. 61-97
-
Journal article (peer-reviewed)abstract
- One of the most discussed issues in European archaeology is the significance and context of monumentality and the construction of long barrows and megaliths in the Neolithic. The construction of monuments in Neolithic Europe can, due to their often significant size and complexity, be interpreted as signs of collective building efforts, but the social and political background may vary from more egalitarian to highly stratified societies. During the last 20 years of surveys and archaeological excavations in southwest Scania, Sweden, new archaeological results have been produced, revealing many hitherto unknown settlements, central places for feasting, long barrows, megaliths, free-standing façades and other types of monumental constructions. This has disclosed a much more complex picture of the Early Neolithic (4000–3300calBC) Funnel Beaker Culture societies in the region. Large-scale excavations have documented a hierarchy of monumental places in Early Neolithic southern Scandinavia, probably reflecting different uses of monuments, mirroring a social hierarchy in polities. Recently, another central place has been excavated at Flackarp, south of Lund, Sweden, containing at least nine dolmens and free-standing façades, further supporting this hypothesis.
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| 5. |
- Eeg-Olofsson, Måns, 1967, et al.
(author)
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TTCOV19: timing of tracheotomy in SARS-CoV-2-infected patients: a multicentre, single-blinded, randomized, controlled trial
- 2022
-
In: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 26:1
-
Journal article (peer-reviewed)abstract
- Background: Critically ill COVID-19 patients may develop acute respiratory distress syndrome and the need for respiratory support, including mechanical ventilation in the intensive care unit. Previous observational studies have suggested early tracheotomy to be advantageous. The aim of this parallel, multicentre, single-blinded, randomized controlled trial was to evaluate the optimal timing of tracheotomy. Methods: SARS-CoV-2-infected patients within the Region Vastra Gotaland of Sweden who needed intubation and mechanical respiratory support were included and randomly assigned to early tracheotomy (<= 7 days after intubation) or late tracheotomy (>= 10 days after intubation). The primary objective was to compare the total number of mechanical ventilation days between the groups. Results: One hundred fifty patients (mean age 65 years, 79% males) were included. Seventy-two patients were assigned to early tracheotomy, and 78 were assigned to late tracheotomy. One hundred two patients (68%) underwent tracheotomy of whom sixty-one underwent tracheotomy according to the protocol. The overall median number of days in mechanical ventilation was 18 (IQR 9; 28), but no significant difference was found between the two treatment regimens in the intention-to-treat analysis (between-group difference:- 1.5 days (95% CI -5.7 to 2.8); p= 0.5). A significantly reduced number of mechanical ventilation days was found in the early tracheotomy group during the per-protocol analysis (between-group difference: - 8.0 days (95% CI - 13.8 to - 2.27); p= 0.0064). The overall correlation between the timing of tracheotomy and days of mechanical ventilation was significant (Spearman's correlation: 0.39, p < 0.0001). The total death rate during intensive care was 32.7%, but no significant differences were found between the groups regarding survival, complications or adverse events. Conclusions: The potential superiority of early tracheotomy when compared to late tracheotomy in critically ill patients with COVID-19 was not confirmed by the present randomized controlled trial but is a strategy that should be considered in selected cases where the need for MV for more than 14 days cannot be ruled out.
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| 6. |
- Hammarsten, Ola, et al.
(author)
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The ratio of cardiac troponin T to troponin I may indicate non-necrotic troponin release among COVID-19 patients
- 2022
-
In: Clinica Chimica Acta. - : Elsevier. - 0009-8981 .- 1873-3492. ; 527, s. 33-37
-
Journal article (peer-reviewed)abstract
- Background: Although cardiac troponin T (cTnT) and troponin I(cTnI) are expressed to similar amount in cardiac tissue, cTnI often reach ten-times higher peak levels compared to cTnT in patients with myocardial necrosis such as in acute myocardial infarction (MI). In contrast, similar levels of cTnT and cTnI are observed in other situations such as stable atrial fibrillation and after strenuous exercise.Objective: Examine cTnT and cTnI levels in relation to COVID-19 disease and MI. Methods: Clinical and laboratory data from the local hospital from an observational cohort study of 27 patients admitted with COVID-19 and 15 patients with myocardial infarction (MI) that were analyzed with paired cTnT and cTnI measurement during hospital care.Results: Levels of cTnI were lower than cTnT in COVID-19 patients (TnI/TnT ratio 0.3, IQR: 0.1-0.6). In contrast, levels of cTnI were 11 times higher compared to cTnT in 15 patients with MI (TnI/TnT ratio 11, IQR: 7-14). The peak cTnI/cTnT ratio among the patients with MI following successful percutaneous intervention were 14 (TnI/ TnT ratio 14, IQR: 12-23). The 5 COVID-19 patient samples collected under possible necrotic events had a cTnI/ cTnT ratio of 5,5 (IQR: 1,9-8,3).Conclusions: In patients with COVID-19, cTnT is often elevated to higher levels than cTnI in sharp contrast to patients with MI, indicating that the release of cardiac troponin has a different cause in COVID-19 patients.
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| 7. |
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| 8. |
- Rögnvaldsson, Thorsteinn, 1963-, et al.
(author)
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ARC13 – Assessment of Research and Coproduction : Reports from the assessment of all research at Halmstad University 2013
- 2014
-
Reports (pop. science, debate, etc.)abstract
- During 2013, an evaluation of all the research conducted at Halmstad University was carried out. The purpose was to assess the quality of the research, coproduction, and collaboration in research, as well as the impact of the research. The evaluation was dubbed the Assessment of Research and Coproduction 2013, or ARC13. (Extract from Executive Summary)
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| 9. |
- Almeida, João R.M., et al.
(author)
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Physiological and Molecular Characterization of Yeast Cultures Pre-Adapted for Fermentation of Lignocellulosic Hydrolysate
- 2023
-
In: Fermentation. - : MDPI AG. - 2311-5637. ; 9:1
-
Journal article (peer-reviewed)abstract
- Economically feasible bioethanol process from lignocellulose requires efficient fermentation by yeast of all sugars present in the hydrolysate. However, when exposed to lignocellulosic hydrolysate, Saccharomyces cerevisiae is challenged with a variety of inhibitors that reduce yeast viability, growth, and fermentation rate, and in addition damage cellular structures. In order to evaluate the capability of S. cerevisiae to adapt and respond to lignocellulosic hydrolysates, the physiological effect of cultivating yeast in the spruce hydrolysate was comprehensively studied by assessment of yeast performance in simultaneous saccharification and fermentation (SSF), measurement of furaldehyde reduction activity, assessment of conversion of phenolic compounds and genome-wide transcription analysis. The yeast cultivated in spruce hydrolysate developed a rapid adaptive response to lignocellulosic hydrolysate, which significantly improved its fermentation performance in subsequent SSF experiments. The adaptation was shown to involve the induction of NADPH-dependent aldehyde reductases and conversion of phenolic compounds during the fed-batch cultivation. These properties were correlated to the expression of several genes encoding oxidoreductases, notably AAD4, ADH6, OYE2/3, and YML131w. The other most significant transcriptional changes involved genes involved in transport mechanisms, such as YHK8, FLR1, or ATR1. A large set of genes were found to be associated with transcription factors (TFs) involved in stress response (Msn2p, Msn4p, Yap1p) but also cell growth and division (Gcr4p, Ste12p, Sok2p), and these TFs were most likely controlling the response at the post-transcriptional level.
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| 10. |
- Andersson Hagiwara, Magnus, et al.
(author)
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A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service
- 2018
-
In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 137:5, s. 523-530
-
Journal article (peer-reviewed)abstract
- ObjectivesWe compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. Materials & methodsThe Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital. ResultsOf 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient's decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital. ConclusionsPatients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.
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| 11. |
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| 12. |
- Beal, Jacob, et al.
(author)
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Robust estimation of bacterial cell count from optical density
- 2020
-
In: Communications Biology. - : Springer Science and Business Media LLC. - 2399-3642. ; 3:1
-
Journal article (peer-reviewed)abstract
- Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data.
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| 13. |
- Bolmsjö, Gunnar, et al.
(author)
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Task Programming of Welding Robots
- 1995
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In: Proceedings of the International Conference on the Joining of Materials, JOM-7. ; , s. 573-585
-
Conference paper (peer-reviewed)
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| 14. |
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| 15. |
- Brink, A., et al.
(author)
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Fast and reversible insertion of carbon dioxide into zirconocene-alkoxide bonds. A mechanistic study
- 2014
-
In: Dalton Transactions. - : Royal Society of Chemistry (RSC). - 1477-9226 .- 1477-9234. ; 43:23, s. 8894-8898
-
Journal article (peer-reviewed)abstract
- In two consecutive equilibria the compound (Cp*)(2)Zr(OMe)(2) undergoes insertion of CO2 to form the mono- and bis-hemicarbonates. Both equilibria are exothermic but entropically disfavoured. Magnetisation transfer experiments gave kinetic data for the first equilibrium showing that the rate of insertion is overall second order with a rate constant of 3.20 +/- 0.12 M-1 s(-1), which is substantially higher than those reported for other early transition metal alkoxides, which are currently the best homogeneous catalysts for dimethyl carbonate formation from methanol and CO2. Activation parameters for the insertion reaction point to a highly ordered transition state and we interpret that as there being a substantial interaction between the CO2 and the metal during the C-O bond formation. This is supported by DFT calculations showing the lateral attack by CO2 to have the lowest energy transition state.
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| 16. |
- Brink, Ebba, et al.
(author)
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On the road to research municipalities : Analysing transdisciplinarity in municipal ecosystem services and adaptation planning
- 2018
-
In: Sustainability Science. - : Springer. - 1862-4065 .- 1862-4057. ; 13:3, s. 765-784
-
Journal article (peer-reviewed)abstract
- Transdisciplinary research and collaboration is widely acknowledged as a critical success factor for solution- oriented approaches that can tackle complex sustainability challenges, such as biodiversity loss, pollution, and climate-related hazards. In this context, city governments’ engagement in transdisciplinarity is generally seen as a key condition for societal transformation towards sustainability. However, empirical evidence is rare. This paper presents a self-assessment of a joint research project on ecosystem services and climate adaptation planning (ECOSIMP) undertaken by four universities and seven Swedish municipalities. We apply a set of design principles and guiding questions for transdisciplinary sustainability projects and, on this basis, identify key aspects for supporting university–municipality collaboration. We show that: (1) selecting the number and type of project stakeholders requires more explicit consideration of the purpose of societal actors’ participation; (2) concrete, interim benefits for participating practitioners and organisations need to be continuously discussed; (3) promoting the ‘inter’, i.e., interdisciplinary and inter-city learning, can support transdisciplinarity and, ultimately, urban sustainability and long-term change. In this context, we found that design principles for transdisciplinarity have the potential to (4) mitigate project shortcomings, even when transdisciplinarity is not an explicit aim, and (5) address differences and allow new voices to be heard. We propose additional guiding questions to address shortcomings and inspire reflexivity in transdisciplinary projects.
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| 17. |
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| 18. |
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| 19. |
- Brink, Johan, 1976, et al.
(author)
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Why do firms change? Sequences of opportunity and changes in business models and capabilities in bioscience firms
- 2007
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In: RIDE working paper series. ; :84426-015, s. 47-
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Conference paper (peer-reviewed)abstract
- Our paper sets out to explain how firms change and acts upon additional opportunities by analysing the development of three young bioscience firms by focusing on the relationship between experimentation of their business models and the capabilities that these firms gradually develop over time. We show that only by combining the initial technological capability with a more generic business capability, these firms were able to fully develop and pursue the initially perceived opportunity. Our analysis of these bioscience firms also reveal that the linkages between the initial technological capabilities that these companies develop are only indirectly related to subsequent opportunities acted upon. As the initial opportunity increasingly becomes economically or technologically irrelevant, the more recently acquired generic capabilities provided the firms with the ability to act upon new technological opportunities. That is, the initial technological capability of the firm is frequently not directly linked to the second pursued opportunity. We infer that as these initial capabilities generally are very technologically based they are also rather specific. Instead the link is by the necessary creation of the additional, and indeed more generic, capability within the firm. As these firms develop they are hence continuously leveraging only parts of their accumulated capabilities, meaning that they are both path-dependent and path-breaking in their development. The paper argues that a firm-based analysis of the development of capabilities and business models is warranted as a complement to the numerous sector-level studies of the biosciences. The internalist perspective of the co-evolution of capabilities and business models developed here cannot be substituted by industry or environmental explanations.
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| 20. |
- Brink, Magnus, 1960, et al.
(author)
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A series of severe necrotising soft-tissue infections in a regional centre in Sweden
- 2014
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In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 58:7, s. 882-890
-
Journal article (peer-reviewed)abstract
- Background: Necrotising soft-tissue infections (NSTIs) are rare conditions with high morbidity and mortality. Patients with NSTIs are often transferred to tertiary hospitals, but the question of whether the potential benefits of highly specialised care outweigh the risks associated with inter-hospital transfers has been raised. Methods: Prospective study including all patients with NSTIs treated at the intensive care unit at Sahlgrenska University Hospital/East between January 2008 and December 2011. Results: Twenty-nine patients with NSTIs were identified. Their median age was 54 years and 69% were men. Major co-morbidities were present in 45%. Seventeen patients (59%) were referred from other hospitals. Only 33% of the patients were correctly diagnosed or suspected of having NSTIs in the emergency department. Group A Streptococcus was the most common microbiological finding (41%), followed by Enterobacteriaceae (17%). The median time from hospitalisation to the first dose of antibiotics was 6 h and the median time to primary surgery was 16 h. Hyperbaric oxygen therapy was given to 86%, and intravenous immunoglobulin was given in 52% of the cases. The 30-day mortality was 14% (4/29). The times to the first dose of antibiotics, intensive care unit admission and primary surgery did not differ between transferred and directly admitted patients, and there was no difference in outcome between the groups. Conclusions: Patients with NSTIs develop severe local and systemic symptoms and require extremely resource-demanding hospitalisation. Inter-hospital transfer was not associated with a delay in key interventions and could not be identified as a risk factor for adverse outcome.
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| 21. |
- Brink, Magnus, 1960, et al.
(author)
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Meropenem versus cefotaxime and ampicillin as empirical antibiotic treatment in adult bacterial meningitis: A quality registry study, 2008 to 2016
- 2019
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In: Antimicrobial Agents and Chemotherapy. - : AMER SOC MICROBIOLOGY. - 0066-4804 .- 1098-6596. ; 63:11
-
Journal article (peer-reviewed)abstract
- © 2019 American Society for Microbiology. All Rights Reserved. Cefotaxime, alone or with ampicillin, is frequently used in empirical treatment of acute bacterial meningitis (ABM). Meropenem is a less extensively investigated alternative. The aim of the study was to investigate the effects of empirical treatment with meropenem compared to cefotaxime plus ampicillin on outcome in ABM. The study was based on data from the Swedish quality register for ABM collected between January 2008 and December 2016. Propensity score matching was performed to adjust for baseline differences between the groups. Mortality within 30 days was the primary outcome. The treatment regimens of interest were administered to 623 patients; 328 were given cefotaxime plus ampicillin whereas 295 received meropenem. Using propensity score matching, the 30-day mortality rates were 3.2% in the cefotaxime plus ampicillin group and 3.6% in the meropenem group. For matched cases, the odds ratio (OR) for 30-day mortality for meropenem versus cefotaxime plus ampicillin was 1.15 (confidence interval [CI], 0.41 to 3.22; P = 0.79). The OR for 90-day mortality was 1.47 (CI, 0.62 to 3.52; P = 0.38) and for unfavorable outcome was 1.10 (CI, 0.75 to 1.63; P = 0.62). The findings of our study indicate that meropenem is an effective empirical treatment option for adults with community-acquired ABM. However, to spare carbapenems, guidelines should continue to recommend third-generation cephalosporins as an empirical treatment for the majority of patients with ABM.
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| 22. |
- Brink, Magnus, et al.
(author)
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New definition of and diagnostic criteria for sepsis - : Swedish use of Sepsis-3
- 2018
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 115
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Journal article (peer-reviewed)abstract
- A working group representing the Swedish Society for Infectious Diseases, the Swedish Society for Anaesthesiology and Intensive Care, the Swedish Society for Emergency Medicine, and the Swedish Intensive Care Registry have reached consensus on how to adopt the new sepsis definition, Sepsis-3, in Sweden. The recommendation is to implement the new definitions and diagnostic criteria for sepsis and septic shock, but not the use of the new screening tool for sepsis, quick-SOFA, as it needs prospective validation and since it is not clear if quick-SOFA is more useful than the currently used general triage and early warning score systems. The group recommends the use of the sfollowing ICD-10 codes: R65.1 for sepsis and R57.2 for septic shock.
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| 23. |
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| 24. |
- Brink, Magnus, 1960
(author)
-
On community acquired infections requiring intensive care
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- Acute bacterial meningitis (ABM), influenza, and necrotizing soft-tissue infections (NSTIs) are diseases that in a short period of time can progress to become life threatening. Individuals with severe forms of these infections must be treated in an intensive care unit were monitoring and support of failing organs improve the chances of survival. The overall aims of this thesis were to elucidate some aspects of the clinical presentation, diagnosis and intensive care treatment of ABM, severe influenza, and NSTIs. In paper I, we investigated the outcome of 79 episodes of adult ABM. All patients were given β-lactam antibiotics according to the Swedish tradition with 8-hour intervals between the doses. This is less frequent compared with recommendations in most international guidelines. We found a high survival rate (94%), which suggests that other factors than antibiotic dosing intervals are more important. Streptococcus pneumoniae was the most common pathogen (48%). In paper II, we explored the over-time performance for ABM diagnosis with broadrange polymerase chain reaction and immunochromatographic test. Both tests were highly sensitive for detection of bacteria in cerebrospinal fluid sampled up to one week into antibiotic therapy. In paper III, we investigated the clinical characteristics and outcomes among the 126 Swedish cases of pandemic influenza A (H1N1) that required intensive care treatment. Risk factors were obesity, chronic pulmonary disease, and diabetes. The mortality was similar to what has been reported from other comparable countries. The use of non-invasive ventilation was not associated with improved outcomes compared with immediate invasive ventilation. In paper IV, we studied patients with NSTIs treated at Sahlgrenska University Hospital/East during the period 2008–2011. The 30-day mortality was 14% and the incidence of amputation 24%. Group A streptococcus was the most common pathogen followed by Enterobacteriacae and colonic anaerobe bacteria. Inter-hospital transfer was not associated with a delay in key interventions and could not be identified as a risk factor for adverse outcome.
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| 25. |
- Brink, Magnus, 1960, et al.
(author)
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Respiratory support during the influenza A (H1N1) pandemic flu in Sweden
- 2012
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In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 56:8, s. 976-986
-
Journal article (peer-reviewed)abstract
- Background Acute respiratory insufficiency characterised critically ill patients during the influenza A (H1N1) pandemic 20092010. Detailed understanding of disease progression and outcome in relation to different respiratory support strategies is important. Methods Data collected between August 2009 and February 2010 for a national intensive care unit influenza registry were combined with cases identified by the Swedish Institute for Infectious Disease Control. Results Clinical data was available for 95% (126/136) of the critically ill cases of influenza. Median age was 44 years, and major co-morbidities were present in 41%. Respiratory support strategies were studied among the 110 adult patients. Supplementary oxygen was sufficient in 15% (16), non-invasive ventilation (NIV) only was used in 20% (22), while transition from NIV to invasive ventilation (IV) was seen in 41% (45). IV was initiated directly in 24% (26). Patients initially treated with NIV had a higher arterial partial pressure of oxygen/fraction of oxygen in inspired gas ratio compared with those primarily treated with IV. Major baseline characteristics and 28-day mortality were similar, but 90-day mortality was higher in patients initially treated with NIV 17/67 (25%) as compared with patients primarily treated with IV 3/26 (12%), relative risk 1.2 (95% confidence interval 0.34.0). Conclusions Critical illness because of 2009 influenza A (H1N1) in Sweden was dominated by hypoxic respiratory failure. The majority of patients in need of respiratory support were initially treated with NIV. In spite of less severe initial hypoxemia, initiation of ventilatory support with NIV was not associated with improved outcome.
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| 26. |
- Brink, Magnus, 1960, et al.
(author)
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Time window for positive cerebrospinal fluid broad-range bacterial PCR and Streptococcus pneumoniae immunochromatographic test in acute bacterial meningitis
- 2015
-
In: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 47:12, s. 869-877
-
Journal article (peer-reviewed)abstract
- Background: Reliable microbiological tests are essential for the diagnosis of acute bacterial meningitis (ABM). In this study we investigated the time period after the start of antibiotic therapy during which culture, polymerase chain reaction (PCR) and the immunochromatographic test (ICT) are able to detect bacteria in cerebrospinal fluid (CSF). Methods: The study was performed on CSF samples from adults with ABM admitted to the Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden, from January 2007 to April 2014. In addition to the initial lumbar puncture (LP), the participants underwent one or two more LPs during 10 days following the start of antibiotics. The analyses performed on the CSF samples were culture, PCR and ICT. Results: The study comprised 70 CSF samples from 25 patients with ABM. A bacterium could be identified by CSF culture in 44%, by blood culture in 58% and by PCR in 100% of the patients. There were no positive CSF cultures in samples taken later than the day of starting antibiotics. PCR was positive in 89% on days 1-3, 70% on days 4-6 and 33% on days 7-10. For cases of pneumococcal meningitis, the ICT was positive in 88% on days 1-3, 90% on days 4-6 and 75% on days 7-10. Conclusions: This study shows that PCR is highly sensitive for bacterial detection in CSF samples taken up to 1 week into antibiotic therapy. The ICT is highly sensitive for the detection of pneumococci in CSF samples taken during the first week of antibiotic treatment.
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| 27. |
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| 28. |
- Dulio, Valeria, et al.
(author)
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The NORMAN Association and the European Partnership for Chemicals Risk Assessment (PARC) : let’s cooperate!
- 2020
-
In: Environmental Sciences Europe. - : Springer. - 2190-4707 .- 2190-4715. ; 32:1
-
Journal article (peer-reviewed)abstract
- The Partnership for Chemicals Risk Assessment (PARC) is currently under development as a joint research and innovation programme to strengthen the scientific basis for chemical risk assessment in the EU. The plan is to bring chemical risk assessors and managers together with scientists to accelerate method development and the production of necessary data and knowledge, and to facilitate the transition to next-generation evidence-based risk assessment, a non-toxic environment and the European Green Deal. The NORMAN Network is an independent, well-established and competent network of more than 80 organisations in the field of emerging substances and has enormous potential to contribute to the implementation of the PARC partnership. NORMAN stands ready to provide expert advice to PARC, drawing on its long experience in the development, harmonisation and testing of advanced tools in relation to chemicals of emerging concern and in support of a European Early Warning System to unravel the risks of contaminants of emerging concern (CECs) and close the gap between research and innovation and regulatory processes. In this commentary we highlight the tools developed by NORMAN that we consider most relevant to supporting the PARC initiative: (i) joint data space and cutting-edge research tools for risk assessment of contaminants of emerging concern; (ii) collaborative European framework to improve data quality and comparability; (iii) advanced data analysis tools for a European early warning system and (iv) support to national and European chemical risk assessment thanks to harnessing, combining and sharing evidence and expertise on CECs. By combining the extensive knowledge and experience of the NORMAN network with the financial and policy-related strengths of the PARC initiative, a large step towards the goal of a non-toxic environment can be taken.
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| 29. |
- Ericsdotter, A. C., et al.
(author)
-
Reactivation of herpes simplex type 1 in pneumococcal meningitis
- 2015
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In: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 66, s. 100-102
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Journal article (peer-reviewed)abstract
- Background: Acute bacterial meningitis (ABM) and herpes simplex type 1 (HSV-1) encephalitis are two rare but serious infections affecting the central nervous system (CNS). Concurrent bacterial and viral CNS infection has occasionally been reported. Objectives: To illustrate the possibility of intrathecal infection with both Streptococcus pneumonia and HSV-1 by presenting a case and to examine whether herpesvirus reactivation is common in ABM. Study design: We report a case diagnosed with HSV-1 reactivation in the cerebrospinal fluid (CSF) during treatment for pneumococcal ABM. A retrospective analysis of CSF samples from 21 patients with ABM was performed, with analysis of DNA from HSV-1 and four other neurotropic herpesviruses. Results: All 21CSF samples were negative for HSV-1, HSV-2, varicella zoster-virus, Epstein-Barr virus and human herpesvirus 6 DNA by PCR. Conclusions: Although herpesvirus infection does not seem to be a common phenomenon in ABM we suggest that HSV-1 reactivation could be kept in mind if patients with ABM show symptoms or signs compatible with encephalitis. (C) 2015 Elsevier B.V. All rights reserved.
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| 30. |
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| 31. |
- Glimaker, M., et al.
(author)
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Early lumbar puncture in adult bacterial meningitis-rationale for revised guidelines
- 2013
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In: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 45:9, s. 657-663
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Journal article (peer-reviewed)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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| 32. |
- Hansson, Per-Olof, 1958, et al.
(author)
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Prehospital assessment of suspected stroke and TIA: An observational study
- 2019
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 140:2, s. 93-99
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Journal article (peer-reviewed)abstract
- Background Symptoms related to stroke diverge and may mimic many other conditions. Aims To evaluate clinical findings among patients with a clinical suspicion of stroke in a prehospital setting and find independent predictors of a final diagnosis of stroke or transient ischemic attack (TIA). Methods An observational multicenter study includes nine emergency hospitals in western Sweden. All patients transported to hospital by ambulance and in whom a suspicion of stroke was raised by the emergency medical service clinician before hospital admission during a four-month period were included. Results Of 1081 patients, a diagnosis of stroke was confirmed at hospital in 680 patients (63%), while 69 (6%) were diagnosed as TIA and 332 patients (31%) received other final diagnoses. In a multiple logistic regression analysis, factors independently associated with a final diagnosis of stroke or TIA were increasing age, odds ratio (OR) per year: 1.02, P = 0.007, a history of myocardial infarction (OR: 1.77, P = 0.01), facial droop (OR: 2.81, P < 0.0001), arm weakness (OR: 2.61, P < 0.0001), speech disturbance (OR: 1.92, P < 0.0001), and high systolic blood pressure (OR: 1.50, P = 0.02), while low oxygen saturation was significantly associated with other diagnoses (OR: 0.41, P = 0.007). More than half of all patients among patients with both stroke/TIA and other final diagnoses died during the five-year follow-up. Conclusions Seven factors including the three symptoms included in the Face Arm Speech Test were significantly associated with a final diagnosis of stroke or TIA in a prehospital assessment of patients with a suspected stroke.
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| 33. |
- Hansson, Per-Olof, 1958, et al.
(author)
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Prehospital identification of factors associated with death during one-year follow-up after acute stroke
- 2018
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In: Brain and Behavior. - : Wiley. - 2162-3279. ; 8:6
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Journal article (peer-reviewed)abstract
- Objectives: In acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke. Material and Methods: All patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1.6 million inhabitants) during a four-month period were included. There were no exclusion criteria. Results: In all, 1,028 patients with a confirmed diagnosis of stroke who used the EMS were included in the analyses. Among these patients, 360 (35%) died during the following year. Factors that were independently associated with an increased risk of death were as follows: (1) high age, per year OR 1.07; 95% CI 1.05-1.09; (2) a history of heart failure, OR 2.08; 95% CI 1.26-3.42; (3) an oxygen saturation of < 90%, OR 8.05; 95% CI 3.33-22.64; and (4) a decreased level of consciousness, OR 2.19; 95% CI 1.61-3.03. Conclusions: Among patients with a stroke, four factors identified before arrival at hospital were associated with a risk of death during the following year. They were reflected in the patients' age, previous clinical history, respiratory function, and the function of the central nervous system.
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| 34. |
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| 35. |
- Humborg, Christoph, et al.
(author)
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Nutrient variations in boreal and subarctic Swedish rivers : Landscape control of land–sea fluxes
- 2004
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In: Limnology and Oceanography. - 0024-3590 .- 1939-5590. ; 49:5, s. 1871-1883
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Journal article (peer-reviewed)abstract
- We examined the hypothesis that the extent of vegetation cover governs the fluxes of nutrients from boreal and subarctic river catchments to the sea. Fluxes of total organic carbon (TOC) and dissolved inorganic nitrogen, phosphorus, and dissolved silicate (DIN, DIP, and DSi, respectively) are described from 19 river catchments and subcatchments (ranging in size from 34 to 40,000 km2) in northern Sweden with a detailed analysis of the rivers Lulea¨lven and Kalixa¨lven. Fluxes of TOC, DIP, and DSi increase by an order of magnitude with increasing proportion of forest and wetland area, whereas DIN did not follow this pattern but remained constantly low. Principal component analysis on landscape variables showed the importance of almost all land cover and soil type variables associated with vegetation, periglacial environment, soil and bedrock with slow weathering rates, boundary of upper tree line, and percentage of lake area. A cluster analysis of the principal components showed that the river systems could be separated into mountainous headwaters and forest and wetland catchments. This clustering was also valid in relation to river chemistry (TOC, DIP, and DSi) and was confirmed with a redundancy analysis, including river chemistry and principal components as environmental variables. The first axis explains 89% of the variance in river chemistry and almost 100% of the variance in the relation between river chemistry and landscape variables. These results suggest that vegetation change during interglacial periods is likely to have had a major effect on inputs of TOC, DIP, and DSi into the past ocean.
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| 36. |
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| 37. |
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| 38. |
- Linder, Adam, et al.
(author)
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Heparin-binding protein: A diagnostic marker of acute bacterial meningitis
- 2011
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In: Critical Care Medicine. - 0090-3493. ; 39:4, s. 812-817
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Journal article (peer-reviewed)abstract
- BACKGROUND: The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis. OBJECTIVE: In this study we investigated whether heparin-binding protein levels in cerebrospinal fluid could be used as a diagnostic marker for acute bacterial meningitis. DESIGN: One prospective and one retrospective patient cohort from two university hospitals in Sweden were analyzed. SETTING AND PATIENTS: Cerebrospinal fluid samples were collected from 174 patients with suspected central nervous system infection. Thirty-seven patients with acute community-acquired bacterial meningitis, four patients with neurosurgical bacterial meningitis, 29 patients with viral meningitis or encephalitis, seven patients with neuroborreliosis, and 97 control patients were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Cerebrospinal fluid samples were analyzed for the concentrations of heparin-binding protein, lactate, protein, glucose, neutrophils, and mononuclear cells. Heparin-binding protein levels were significantly higher (p < .01) in patients with acute bacterial meningitis (median 376 ng/mL, range 12-858 ng/mL) than in patients with viral central nervous system infection (median 4.7 ng/mL, range 3.0-41 ng/mL) or neuroborreliosis (median 3.6 ng/mL, range 3.2-10 ng/mL) or in control patients with a normal cerebrospinal fluid cell count (median 3.5 ng/mL, range 2.4-8.7 ng/mL). In the prospectively studied group, a heparin-binding protein concentration exceeding 20 ng/mL gave a sensitivity of 100%, a specificity of 99.2%, and positive and negative predictive values of 96.2% and 100%, respectively, in diagnosing acute bacterial meningitis. The area under the receiver-operating characteristic curve for heparin-binding protein was 0.994, which was higher than for the other investigated parameters. CONCLUSION: Elevated cerebrospinal fluid levels of heparin-binding protein distinguish between patients with acute bacterial meningitis and patients with other central nervous system infections.
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| 39. |
- Linder, Adam, et al.
(author)
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Heparin-binding protein: A diagnostic marker of acute bacterial meningitis. : a diagnostic marker of acute bacterial meningitis
- 2011
-
In: Critical Care Medicine. - 1530-0293. ; 39:4, s. 812-817
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis.OBJECTIVE: In this study we investigated whether heparin-binding protein levels in cerebrospinal fluid could be used as a diagnostic marker for acute bacterial meningitis.DESIGN: One prospective and one retrospective patient cohort from two university hospitals in Sweden were analyzed.SETTING AND PATIENTS: Cerebrospinal fluid samples were collected from 174 patients with suspected central nervous system infection. Thirty-seven patients with acute community-acquired bacterial meningitis, four patients with neurosurgical bacterial meningitis, 29 patients with viral meningitis or encephalitis, seven patients with neuroborreliosis, and 97 control patients were included.INTERVENTIONS: None.MEASUREMENTS AND MAIN RESULTS: Cerebrospinal fluid samples were analyzed for the concentrations of heparin-binding protein, lactate, protein, glucose, neutrophils, and mononuclear cells. Heparin-binding protein levels were significantly higher (p < .01) in patients with acute bacterial meningitis (median 376 ng/mL, range 12-858 ng/mL) than in patients with viral central nervous system infection (median 4.7 ng/mL, range 3.0-41 ng/mL) or neuroborreliosis (median 3.6 ng/mL, range 3.2-10 ng/mL) or in control patients with a normal cerebrospinal fluid cell count (median 3.5 ng/mL, range 2.4-8.7 ng/mL). In the prospectively studied group, a heparin-binding protein concentration exceeding 20 ng/mL gave a sensitivity of 100%, a specificity of 99.2%, and positive and negative predictive values of 96.2% and 100%, respectively, in diagnosing acute bacterial meningitis. The area under the receiver-operating characteristic curve for heparin-binding protein was 0.994, which was higher than for the other investigated parameters.CONCLUSION: Elevated cerebrospinal fluid levels of heparin-binding protein distinguish between patients with acute bacterial meningitis and patients with other central nervous system infections.
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| 40. |
- Lindström, Johan, 1984, et al.
(author)
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Telephone follow-up as a part of the sepsis care process
- 2023
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In: Lakartidningen. - 1652-7518. ; 120
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Journal article (peer-reviewed)abstract
- In a pilot study of telephone follow-up as a part of the sepsis care process, no direct patient benefit could be demonstrated. A nurse with competency in infectious diseases called patients two to six weeks post-discharge after inpatient sepsis care to assess the need for further medical attention. Out of 51 eligible patients, only 21 telephone follow-ups could be realized. Supporting recommendations could be given in nine cases, but no direct medical advice was given. The follow-up was resource intensive; for each supporting recommendation, time used was calculated to 279 minutes. There is a lack of evidence for unselected follow-up after sepsis care, and the recommendation should be reworked. It is crucial that care processes are systematically evaluated, and there is need for a structure to revise the processes after implementation.
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| 41. |
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| 42. |
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| 43. |
- Lyngfelt, Anders, 1955, et al.
(author)
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11,000 h of chemical-looping combustion operation—Where are we and where do we want to go?
- 2019
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In: International Journal of Greenhouse Gas Control. - : Elsevier BV. - 1750-5836. ; 88, s. 38-56
-
Research review (peer-reviewed)abstract
- A key for chemical-looping combustion (CLC) is the oxygen carrier. The ultimate test is obviously the actual operation, which reveals if it turns to dust, agglomerates or loses its reactivity or oxygen carrier capacity. The CLC process has been operated in 46 smaller chemical-looping combustors, for a total of more than 11,000 h. The operation involves both manufactured oxygen carriers, with 70% of the total time of operation, and less costly materials, i.e. natural ores or waste materials. Among manufactured materials, the most popular materials are based on NiO with 29% of the operational time, Fe2O3 with 16% and CuO with 13%. Among the monometallic oxides there are also Mn3O4 with 1%, and CoO with 2%. The manufactured materials also include a number of combined oxides with 11% of operation, mostly calcium manganites and other combined manganese oxides. Finally, the natural ores and waste materials include ilmenite, FeTiO3 with 13%, iron ore/waste with 9% and manganese ore with 6%. In the last years a shift towards more focus on CuO, combined oxides and natural ores has been seen. The operational experience shows a large variation in performance depending on pilot design, operational conditions, solids inventory, oxygen carrier and fuel. However, there is at present no experience of the process at commercial or semi-commercial scale, although oxygen-carrier materials have been successfully used in commercial fluidized-bed boilers for Oxygen-Carrier Aided Combustion (OCAC) during more than 12,000 h of operation. The paper discusses strategies for upscaling as well as the use of biomass for negative emissions. A key question is how scaling-up will affect the performance, which again will determine the costs for purification of CO2 through e.g. oxy-polishing. Unfortunately, the conditions in the small-scale pilots do not allow for any safe conclusions with respect to performance in full scale. Nevertheless, the experiences from pilot operation shows that the process works and can be expected to work in the large scale and gives important information, for instance on the usefulness of various oxygen-carriers. Because further research is not likely to improve our understanding of the performance that can be achieved in full scale, there is little sense in waiting with the scale-up. A major difficulty with the scaling-up of a novel process is in the risk. First-of-its-kind large-scale projects include risks of technical mistakes and unforeseen obstacles, leading to added costs or, in the worst case, failure. One way of addressing these risks is to focus on the heart of the process and build it with maximum flexibility for future use. A concept for maximum flexibility is the Multipurpose Dual Fluidized Bed (MDFB). Another is to find a suitable existing plant, e.g. a dual fluidized-bed thermal gasifier. With present emissions the global CO2 budget associated with a maximum temperature of 2 °C may be spent in around 20–25 years, whereas the CO2 budget for 1.5 °C is may be exhausted in 10 years. Thus, the need for both CO2 neutral fuels and negative emissions will become increasingly urgent as we are nearing or transgressing the maximum amount of CO2 that can be emitted without compromising the global climate agreement in Paris saying we must keep “well below” 2 °C and aim for a maximum of 1.5 °C. Thus, biomass may turn out to be a key fuel for Carbon Capture and Storage (CCS), because CO2-free power does not necessarily need CCS, but negative emissions will definitely need Bio-CCS.
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| 44. |
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| 45. |
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| 46. |
- Nikoleris, Giorgos, et al.
(author)
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Task oriented robot programming and control
- 1994
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In: EURISCON 94 : Proceedings of the European Robotics and Intelligent Systems Conference - Proceedings of the European Robotics and Intelligent Systems Conference.
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Conference paper (peer-reviewed)
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| 47. |
- Ofuji Osiro, Karen, et al.
(author)
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Assessing the effect of d-xylose on the sugar signaling pathways of Saccharomyces cerevisiae in strains engineered for xylose transport and assimilation
- 2018
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In: FEMS Yeast Research. - : Oxford University Press (OUP). - 1567-1364. ; 18:1
-
Journal article (peer-reviewed)abstract
- One of the challenges of establishing an industrially competitive process to ferment lignocellulose to value-added products using Saccharomyces cerevisiae is to get efficient mixed sugar fermentations. Despite successful metabolic engineering strategies, the xylose assimilation rates of recombinant S. cerevisiae remain significantly lower than for the preferred carbon source, glucose. Previously, we established a panel of in vivo biosensor strains (TMB371X) where different promoters (HXT1/2/4p; SUC2p, CAT8p; TPS1p/2p, TEF4p) from the main sugar signaling pathways were coupled with the yEGFP3 gene, and observed that wild-type S. cerevisiae cannot sense extracellular xylose. Here, we expand upon these strains by adding a mutated galactose transporter (GAL2-N376F) with improved xylose affinity (TMB372X), and both the transporter and an oxidoreductase xylose pathway (TMB375X). On xylose, the TMB372X strains displayed population heterogeneities, which disappeared when carbon starvation was relieved by the addition of the xylose assimilation pathway (TMB375X). Furthermore, the signal in the TMB375X strains on high xylose (50 g/L) was very similar to the signal recorded on low glucose (≤5 g/L). This suggests that intracellular xylose triggers a similar signal to carbon limitation in cells that are actively metabolizing xylose, in turn causing the low assimilation rates.
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| 48. |
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| 49. |
- Rydén, Magnus, 1975, et al.
(author)
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Negative CO2 Emissions with Chemical-Looping Combustion of Biomass - A Nordic Energy Research Flagship Project
- 2017
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In: Energy Procedia. - : Elsevier BV. - 1876-6102. ; 114, s. 6074-6082
-
Conference paper (peer-reviewed)abstract
- The Nordic countries constitute a natural location for the development and deployment of Bio-Energy with Carbon Capture and Storage (BECCS). Finland, Sweden and Denmark are world-leading with respect to heat and power generation from sustainable biomass. Norway is world-leading with respect to Carbon Capture and Storage (CCS). The Nordic countries also have ambitious targets for reductions of their CO2 emissions, host leading technology providers, and have large biomass potential per capita. System studies suggest that bioenergy could be the single largest energy carrier in the Nordic countries by 2050. Negative CO2 Emissions with Chemical Looping Combustion of Biomass is a multi-partner project with the goal to develop new technology that: i) enables CO2 capture and negative CO2 emissions at the lowest possible cost, ii) is able to produce power and steam for industrial and other applications, iii) utilizes Nordic expertise in fluidized bed technology and iv) has potential to achieve improved fuel utilization. The technology capable of achieving these goals is Chemical-Looping Combustion of biomass (Bio-CLC). The article presents the project and features some early results from its implementation.
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| 50. |
- Sartelli, Massimo, et al.
(author)
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Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action
- 2023
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In: WORLD JOURNAL OF EMERGENCY SURGERY. - 1749-7922. ; 18:1
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Research review (peer-reviewed)abstract
- Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.
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