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| 2. |
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| 3. |
- André, Malin, et al.
(author)
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Upper respiratory tract infections in general practice: diagnosis, antibiotic prescribing, duration of symptoms and use of diagnostic tests
- 2002
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In: Scandinavian Journal of Infectious Diseases. - : Taylor & Francis. - 2374-4235 .- 0036-5548 .- 1651-1980. ; 34, s. 880-
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Journal article (peer-reviewed)abstract
- A diagnosis/antibiotic prescribing study was performed in 5 counties in Sweden for 1 week in November 2000. As part of this study, the characteristics and clinical management of patients with upper respiratory tract infections (n = 2899) in primary care were analyzed. Almost half of the patients were aged < 15 y and one-fifth of the patients consulted out of hours. Of all patients seeking primary care for upper respiratory tract infections, 56.0% were prescribed an antibiotic. Almost all patients who were given the diagnoses streptococcal tonsillitis, acute otitis media or acute sinusitis were prescribed antibiotics, compared to 10% of patients with common cold or acute pharyngitis. The most frequently prescribed antibiotic was penicillin V (79.2%) and this was even more pronounced out of hours, when the diagnoses otitis media and streptococcal tonsillitis were more frequently used. In patients with common cold and acute pharyngitis, the percentage who received antibiotics increased with increasing length of symptoms and increasing CRP levels. In patients with acute pharyngitis or streptococcal tonsillitis, antibiotics were prescribed less frequently provided streptococcal tests were performed. The management of patients with upper respiratory tract infections in general practice seems to be in good agreement with current Swedish guidelines. However, the study indicates some areas for improvement. The diagnosis of acute sinusitis seems to have been overestimated and used only to justify antibiotic treatment.
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| 9. |
- Johansen, Kari, et al.
(author)
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Estimates of Healthcare and Non-Healthcare Costs due to Severe Rotavirus Infections leading to Hospitalization in Swedish Children (<5 years)
- 2011
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Conference paper (peer-reviewed)abstract
- Introduction: Estimates of economic benefit of rotavirus vaccination depend on the accuracy of calculated country-specific costs related to rotavirus gastroenteritis (RVGE). Transmission of disease to family members adds to the economic burden through loss of caregiver productivity. The aim of this study was to assess costs related to severe RVGE.Material and methods: A prospective, observational study was conducted in a large hospital in the Stockholm region, serving a population of 66,222 children < 5 years. RVGE related health care resource use and time off work were collected from a sample of families with hospitalised children due to community- and nosocomially-derived RVGE (n=153). Health care related costs were calculated using 2008 DRG reimbursement for acute diarrhoea and productivity loss using self reported absence combined with 2008 Swedish average cost for a working hour (€28) from SCB/Statistics Sweden.Results: Median age of hospitalised children was 15 months. For caregivers, average workday loss due to children's, siblings or own disease was 4.2 days and 1.2 days, respectively. Estimated average total cost per child was €3227, €1949 (60%) for health -care related costs, €1186 (37%) productivity loss and €92 (3%) due to other indirect costs.Conclusions: Economic burden of RVGE is primarily driven by costs related to in-patient care, sensitive to unit cost used. However, loss of productivity is also significant in spite of generous parental allowance in Sweden, 12-18 months per child. A limitation of this study is that productivity loss from care for non-hospitalized children and its household members was not assessed.
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| 10. |
- Kalyanasundaram, M., et al.
(author)
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Effects of improved information and volunteer support on segregation of solid waste at the household level in urban settings in Madhya Pradesh, India (I-MISS) : protocol of a cluster randomized controlled trial
- 2021
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In: BMC Public Health. - : Springer Nature. - 1471-2458. ; 21:1
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Journal article (peer-reviewed)abstract
- Background: Segregation of household waste at the source is an effective and sustainable strategy for management of municipal waste. However, household segregation levels remain insufficient as waste management approaches are mostly top down and lack local support. The realisation and recognition of effective, improved and adequate waste management may be one of the vital drivers for attaining environmental protection and improved health and well-being. The presence of a local level motivator may promote household waste segregation and ultimately pro-environmental behaviour. The present cluster randomized control trial aims to understand if volunteer based information on waste segregation (I-MISS) can effectively promote increased waste segregation practices at the household level when compared with existing routine waste segregation information in an urban Indian setting.Methods: This paper describes the protocol of an 18 month two-group parallel,cluster randomised controlled trialin the urban setting of Ujjain, Madhya Pradesh, India. Randomization will be conducted at ward level, which is the last administrative unit of the municipality. The study will recruit 425 households in intervention and control groups. Assessments will be performed at baseline (0 months), midline (6 months), end line (12 months) and post intervention (18 months). The primary outcome will be the comparison of change in proportion of households practicing waste segregation and change in proportion of mis-sorted waste across the study period between the intervention and control groups as assessed by pick analysis. Intention to treat analysis will be conducted. Written informed consent will be obtained from all participants.Discussion: The present study is designed to study whether an external motivator, a volunteer selected from the participating community and empowered with adequate training, could disseminate waste segregation information to their community, thus promoting household waste segregation and ultimately pro-environmental behaviour. The study envisages that the volunteers could link waste management service providers and the community, give a local perspective to waste management, and help to change community habits through information, constant communication and feedback.Trial registration: The study is registered prospectively with Indian Council of Medical Research- Clinical Trial Registry of India (CTRI/2020/03/024278).
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| 11. |
- Kimbowa, IM, et al.
(author)
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Antimicrobial stewardship: Attitudes and practices of healthcare providers in selected health facilities in Uganda
- 2022
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:2, s. e0262993-
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Journal article (peer-reviewed)abstract
- Though antimicrobial stewardship (AMS) programmes are the cornerstone of Uganda’s national action plan (NAP) on antimicrobial resistance, there is limited evidence on AMS attitude and practices among healthcare providers in health facilities in Uganda. We determined healthcare providers’ AMS attitudes, practices, and associated factors in selected health facilities in Uganda. We conducted a cross-sectional study among nurses, clinical officers, pharmacy technicians, medical officers, pharmacists, and medical specialists in 32 selected health facilities in Uganda. Data were collected once from each healthcare provider in the period from October 2019 to February 2020. Data were collected using an interview-administered questionnaire. AMS attitude and practice were analysed using descriptive statistics, where scores of AMS attitude and practices for healthcare providers were classified into high, fair, and low using a modified Blooms categorisation. Associations of AMS attitude and practice scores were determined using ordinal logistic regression. This study reported estimates of AMS attitude and practices, and odds ratios with 95% confidence intervals were reported. We adjusted for clustering at the health facility level using clustered robust standard errors. A total of 582 healthcare providers in 32 healthcare facilities were recruited into the study. More than half of the respondents (58%,340/582) had a high AMS attitude. Being a female (aOR: 0.66, 95% CI: 0.47–0.92, P < 0.016), having a bachelor’s degree (aOR: 1.81, 95% CI: 1.24–2.63, P < 0.002) or master’s (aOR: 2.06, 95% CI: 1.13–3.75, P < 0.018) were significant predictors of high AMS attitude. Most (46%, 261/582) healthcare providers had fair AMS practices. Healthcare providers in the western region’s health facilities were less likely to have a high AMS practice (aOR: 0.52, 95% CI 0.34–0.79, P < 0.002). In this study, most healthcare providers in health facilities had a high AMS attitude and fair AMS practice.
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| 12. |
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| 13. |
- Kimbowa, IM, et al.
(author)
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Characteristics of antimicrobial stewardship programmes in hospitals of Uganda
- 2022
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:5, s. e0268032-
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Journal article (peer-reviewed)abstract
- While interest in antimicrobial stewardship programmes (ASPs) is growing in most low- and middle-income countries (LMICs), there is a paucity of information on their adoption or implementation in Africa, particularly Uganda. The study assessed the presence and characteristics of ASPs, implemented antimicrobial stewardship (AMS) strategies and the challenges to their implementation in hospitals in Uganda. We conducted a cross-sectional study among heads of infection prevention committees (IPCs) in regional referral hospitals, general hospitals, and private-not-for-profit (PNFP) hospitals from November 2019 to February 2020. An interviewer-administered questionnaire was used to collect data. We analysed data using descriptive statistics. A total of 32 heads of IPCs were enrolled in the study. Of these, eight were from regional referral hospitals, 21 were from general hospitals, and three were from PNFPs. Most heads of IPC were pharmacists (17/32, 53.1%) with a mean age and standard deviation (sd) of 36.1 (±1.1) years. A formal ASP was adopted or implemented in 14 out of the 32 (44%, 95% CI 26–62) studied hospitals. Thirty out of 32 hospitals implemented at least one type of AMS strategy. Sixty-eight percent (22/32) of the hospitals implemented pre-authorisation and approval as their primary AMS core strategy to optimise antibacterial use. The most commonly reported challenges to the implementation of ASP across all 32 hospitals (with or without ASP) were lack of time for the ASP team (29/32, 90.6%) and lack of allocated funding for antimicrobial stewardship team (29/32, 90.6%). In this study, most hospitals in Uganda implemented at least one AMS strategy despite the low implementation of ASPs in hospitals. The ministry of health needs to sensitise and support the establishment of ASP in hospitals across the country.
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| 16. |
- Lanzetta, M, et al.
(author)
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Early use of artificial sensibility in hand transplantation
- 2004
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In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 38:2, s. 106-111
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Journal article (peer-reviewed)abstract
- Hands were transplanted from brain-dead donors for the treatment of two male unilateral amputees, aged 35 years and 32 years, involved in the Italian Hand Transplantation Programme. Each had lost his right dominant hand, in a farming accident and an explosion, respectively. In one case artificial sensibility was applied postoperatively using a Sensor Glove that transformed vibrotactile stimuli induced by touch, to stereophonic vibroacoustic stimuli perceived through earphones. The principle is based on the brain's capacity for multimodal plasticity, implying that deprivation of one sense (somatosensory) can be compensated for by another sense (auditory). Functional magnetic resonance images (fMRI) taken at regular intervals showed that cortical remodelling of the transplanted hand within the sensory-motor maps occurred early in the patient who used the artificial sensibility regimen compared with the one who did not. We conclude that postoperative use of a device using hearing as a substitution for sensation in hand transplantation may have considerable potential value for speeding up cortical integration of a transplanted hand.
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| 17. |
- Lundborg, G, et al.
(author)
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Can sensory and motor collateral sprouting be induced from intact peripheral nerve by end-to-side anastomosis?
- 1994
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In: Journal of Hand Surgery: European Volume. - : SAGE Publications. - 0266-7681. ; 19:3, s. 82-277
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Journal article (peer-reviewed)abstract
- The possibility that collateral sprouting could occur from intact axons in an undamaged sciatic nerve was studied in the rat by suturing either a 7-day predegenerated or a fresh nerve segment in an end-to-side fashion to the sciatic nerve proper. Following a 14- or 35-day recovery period, the pinch reflex test was performed on the transplanted segment to demonstrate the presence of sensory axons. The majority of cases, using a predegenerated nerve segment but not a fresh segment, responded positively. Neurofilament staining and histological examination confirmed the presence of axons in the attached nerve segment. In another series of experiments, the proximal peroneal fascicle was ligated and cut. Following a 7-day predegeneration period the distal stump was sutured end-to-side to the ipsilateral tibial fascicle. After 90 days, stimulation of the tibial nerve proximal to the attached site induced substantial contraction in both the native gastrocnemius muscle and the foreign tibialis anterior muscle. These findings suggest that collateral sprouting may occur from intact axons, perhaps induced by factors emanating from the attached nerve segment, and subsequently make functional peripheral connections.
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| 18. |
- Lundborg, M, et al.
(author)
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Maintenance plus reliever budesonide/formoterol compared with a higher maintenance dose of budesonide/formoterol plus formoterol as reliever in asthma: an efficacy and cost-effectiveness study
- 2006
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In: Current Medical Research and Opinion. - 1473-4877. ; 22:5, s. 809-821
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Journal article (peer-reviewed)abstract
- Objective: To evaluate efficacy and cost-effectiveness of budesonide/formoterol (Symbicort*) maintenance (one dose once or twice daily) plus additional doses as needed (Symbicort Maintenance And Reliever Therapy, SMART) compared with a higher fixed dose of budesonide/ formoterol with formoterol as needed in patients with persistent asthma. Study design and methods: 6-month, open, randomised study of 465 patients either not well controlled on an inhaled corticosteroid (ICS), or well controlled on a combination of ICS and a long-acting beta(2)-agonist (LABA). Treatments: budesonide/ formoterol 160/4.5 mu g, one inhalation, once or twice daily maintenance plus additional doses as- needed (1 x SMART or 2 x SMART), or budesonide/ formoterol 160/4.5 mu g two inhalations twice daily plus formoterol 4.5 mu g as needed (2 x 2 FIX + F). Children 6-11 years old used an 80/4.5 mu g dose strength. Primary variables of efficacy were the changes in the Asthma Control Questionnaire (ACQ(5)) and morning peak expiratory flow (PEF). Results: Mean age of patients 40 years (range 6-82 years); 53% female. No differences between the groups were found in ACQ(5) scores or asthma exacerbation rates. Morning PEF was higher in the 2 x 2 FIX + F group vs. the 1 x SMART and 2 x SMART groups ( differences 13L/min and 9 L/min, respectively; p < 0.002). The 1 x SMART group showed a significant decrease in asthma controlled days compared with the two other groups. No difference was seen between the 2 x SMART group and the 2 x 2 FIX + F group. Treatment costs were significantly lower in the SMART groups compared with the 2 x 2 FIX + F group. Conclusion: Compared with the 2 x 2 FIX + F treatment the use of budesonide/formoterol was 30-40% lower in the SMART groups while maintaining equal ACQ5 scores. Daily asthma control improved equally with 2 x SMART compared to 2 x 2 FIX + F with a reduction in asthma medication cost. The one dose once daily maintenance treatment (1 x SMART) resulted in a low level of treatment failure (exacerbations) but led to more days with symptoms. Therefore, a daily dose of two inhalations seems to be the lowest appropriate dose in patients with moderate persistent asthma.
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| 19. |
- Machowska, A, et al.
(author)
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Containment of Antibiotic REsistance-measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR
- 2020
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In: BMJ open. - : BMJ. - 2044-6055. ; 10:11, s. e040334-
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Journal article (peer-reviewed)abstract
- Antibiotics are essential to treat infections during pregnancy and to reduce both maternal and infant mortality. Overall use, but especially non-indicated use, and misuse of antibiotics are drivers of antibiotic resistance (ABR). High non-indicated use of antibiotics for uncomplicated vaginal deliveries is widespread in many parts of the world. Similarly, irrational use of antibiotics is reported for children. There is scarcity of evidence regarding antibiotic use and ABR in Lao PDR (Laos). The overarching aim of this project is to fill those knowledge gaps and to evaluate a quality improvement intervention. The primary objective is to estimate the proportion of uncomplicated vaginal deliveries where antibiotics are used and to compare its trend before and after the intervention.Methods and analysisThis 3-year, prospective, quasiexperimental study without comparison group includes a formative and interventional phase. Data on antibiotic use during delivery will be collected from medical records. Knowledge, attitudes and reported practices on antibiotic use in pregnancy, during delivery and for children, will be collected from women through questionnaires. Healthcare providers’ knowledge, attitudes and practices of antibiotics administration for pregnant women, during delivery and for children, will be collected via adapted questionnaires. Perceptions regarding antibiotics will be explored through focus group discussions with women and individual interviews with key stakeholders. Faecal samples for culturing of Escherichia coli and Klebsiella spp. and antibiotic susceptibility testing will be taken before, during and 6 months after delivery to determine colonisation of resistant strains. The planned intervention will comprise training workshops, educational materials and social media campaign and will be evaluated using interrupted time series analysis.Ethics and disseminationThe project received ethical approval from the National Ethics Committee for Health Research, Ministry of Health, Laos. The results will be disseminated via scientific publications, conference presentations and communication with stakeholders.Trail registration numberISRCTN16217522; Pre-results.
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| 20. |
- Rana, A. K. M. M., et al.
(author)
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Health education improves both arthritis-related illness and self-rated health : An intervention study among older people in rural Bangladesh
- 2010
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In: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 124:12, s. 705-712
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Journal article (peer-reviewed)abstract
- Objectives: To examine changes in self-reported arthritis-related illness and self-rated health as a result of a health education intervention, and the association between self-reported arthritis-related illness and self-rated health. Study design: A quasi-experimental study was conducted in eight randomly selected villages in rural Bangladesh (intervention = 4; control = 4). Methods: The intervention consisted of home-based physical activities, health advice and aspects of healthcare management over 15 months followed by a 3-month latent period. Data were collected before the intervention and after the latent period. Analyses included 839 participants (>= 60 years of age) who participated in both surveys. Participants in the intervention area were further categorized into two groups who self-reported compliance or non-compliance with recommended health advice. Self-rated health was assessed using a single global question. Self-reported arthritis-related illness was indicated by the presence of arthritis, back and joint pain, biting sensation, swelling and inflammation in the joints. Results: Hierarchical logistic regression analyses revealed that positive effects on episodes of arthritis-related illness [ odds ratio (OR) 1.9, 95% confidence interval (CI) 1.3-2.8] and self-rated health (OR 1.4, 95% CI 1.0-1.9) were more likely among the compliant group compared with the control group. Furthermore, positive self-rated health was more likely among participants reporting a positive change in their arthritis-related illness (OR 2.2, 95% CI 1.5-3.2). The results also showed that literate and non-poor participants were more likely to report positive health, and participants with advancing age were less likely to report positive health. Conclusion: Community-based health education is effective in reducing the burden of arthritis-related illness and in enhancing general health in old age.
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| 21. |
- Rana, A.K.M. Masud, et al.
(author)
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The impact of health education in managing self-reported arthritis-related illness among elderly persons in rural Bangladesh
- 2008
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In: Health Education Research. - Oxford : Oxford University Press. - 0268-1153 .- 1465-3648. ; 23:1, s. 94-105
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Journal article (peer-reviewed)abstract
- This study examines the impact of health education on prevalenceof and expenditure on treatment of self-reported arthritis-relatedillness among elderly persons in rural Bangladesh. An interventionstudy was conducted, including 1135 elderly persons (60 years)from eight randomly selected villages, four each of an interventionand a control area. The analyses include 839 elderly personswho participated in both pre- and post-intervention surveys(intervention area: n = 425, control area: n = 414). Participantsof the intervention area were further categorized as compliant(n = 315) and non-compliant (n = 110) based on adherence tothe intervention instructions. The intervention that lastedfor 15 months comprised home-based physical exercise, dietaryinstructions and other aspects of management. Results show thatalthough there was no significant difference in self-reportedarthritis-related illness between the compliant and non-compliantgroups at baseline, it was significantly lower in the compliantgroup (71%) at post-intervention compared with the non-compliant(81%). Related monthly expenditure on treatment was significantlyreduced in the compliant group (from Taka 104 to Taka 52) butnot in the other two groups. Logistic regressions further showedthat the control group had a higher probability of increasedtreatment-related expenditure compared with the compliant group(OR 2.0, 95% CI 1.4–2.8).
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| 22. |
- Sychareun, V, et al.
(author)
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Knowledge, Attitudes, Perception and Reported Practices of Healthcare Providers on Antibiotic Use and Resistance in Pregnancy, Childbirth and Children under Two in Lao PDR: A Mixed Methods Study
- 2021
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In: Antibiotics (Basel, Switzerland). - : MDPI AG. - 2079-6382. ; 10:12
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Journal article (peer-reviewed)abstract
- Background: Overuse and misuse of antibiotics contribute unnecessarily to antibiotic resistance (ABR), and are thereby global health threats. Inappropriate prescriptions of antibiotics during pregnancy, delivery and early childhood are widespread across the world. This study aimed to assess knowledge, attitudes, and reported practices of healthcare providers (HCPs) and to explore their perceptions regarding antibiotic use and ABR related to pregnancy, childbirth, and children under two in Lao PDR. Methods: This is a mixed methods study with data collection in 2019 via structured interviews among 217 HCPs (medical doctors/assistant doctors, midwives/nurses, pharmacists/assistant pharmacists and drug sellers), who prescribed/dispensed antibiotics in one rural and one urban district in Vientiane province and individual qualitative interviews with 30 HCPs and stakeholders. Results: Of the HCPs, 36% had below average knowledge regarding antibiotic use and ABR, and 67% reported prescribing antibiotics for uncomplicated vaginal delivery. Half of the HCPs did not believe that their prescribing contributed to ABR, and only 9% had participated in antibiotic education. Conclusion: A substantial number of HCPs had suboptimal knowledge and prescribed antibiotics unnecessarily, thereby contributing to ABR. Continuous education and regular supervision of HCPs is recommended to improve the use of antibiotics related to pregnancy, childbirth, and young children.
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| 23. |
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| 24. |
- von der Lieth, Claus-Wilhelm, et al.
(author)
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EUROCarbDB : an open-access platform for glycoinformatics
- 2011
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In: Glycobiology. - : Oxford University Press (OUP). - 0959-6658 .- 1460-2423. ; 21:4, s. 493-502
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Journal article (peer-reviewed)abstract
- The EUROCarbDB project is a design study for a technical framework, which provides sophisticated, freely accessible, open-source informatics tools and databases to support glycobiology and glycomic research. EUROCarbDB is a relational database containing glycan structures, their biological context and, when available, primary and interpreted analytical data from high-performance liquid chromatography, mass spectrometry and nuclear magnetic resonance experiments. Database content can be accessed via a web-based user interface. The database is complemented by a suite of glycoinformatics tools, specifically designed to assist the elucidation and submission of glycan structure and experimental data when used in conjunction with contemporary carbohydrate research workflows. All software tools and source code are licensed under the terms of the Lesser General Public License, and publicly contributed structures and data are freely accessible. The public test version of the web interface to the EUROCarbDB can be found at http://www.ebi.ac.uk/eurocarb.
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| 25. |
- Yan, WR, et al.
(author)
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Antibiotic Prescribing in Connection to Childbirth: An Observational Study in Two Districts in Lao PDR
- 2022
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In: Antibiotics (Basel, Switzerland). - : MDPI AG. - 2079-6382. ; 11:4
-
Journal article (peer-reviewed)abstract
- Overuse and misuse of antibiotics has frequently been reported for obstetric conditions and procedures, which may impact both the mother and the unborn baby and increase antibiotic resistance. This study aimed to investigate the antibiotic prescribing pattern in connection to childbirth in two districts in Lao PDR. It is a cross-sectional observational study. Antibiotic prescription data related to childbirth was collected via reviews of medical records in two district hospitals and five health centers in Lao PDR from September 2019 to November 2020. In total, antibiotic prescription data for 1777 women were extracted from their medical records. It was found that all women received antibiotics during in-patient care irrespective of delivery mode. When in hospital, 85.5% of the women who underwent a caesarean section got antibiotic treatment for 5 days and women who had a vaginal delivery usually had antibiotic treatment for one day or less. All the women got oral antibiotics for an additional 4–5 days upon discharge. Antibiotic prescription rate in connection to childbirth was very high in comparison with the WHO guidelines, and antibiotics were used extensively in the participating health facilities. Interventions to guide appropriate prescribing behavior in relation to childbirth are urgently needed in Lao PDR.
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| 26. |
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| 27. |
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| 28. |
- Alga, A, et al.
(author)
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Perceptions of Healthcare-Associated Infection and Antibiotic Resistance among Physicians Treating Syrian Patients with War-Related Injuries
- 2018
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 15:12
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Journal article (peer-reviewed)abstract
- Healthcare-associated infections (HAIs) constitute a major contributor to morbidity and mortality worldwide, with a greater burden on low- and middle-income countries. War-related injuries generally lead to large tissue defects, with a high risk of infection. The aim of this study was to explore how physicians in a middle-income country in an emergency setting perceive HAI and antibiotic resistance (ABR). Ten physicians at a Jordanian hospital supported by Médecins Sans Frontières were interviewed face-to-face. The recorded interviews were transcribed verbatim and analyzed by qualitative content analysis with an inductive and deductive approach. The participants acknowledged risk factors of HAI and ABR development, such as patient behavior, high numbers of injured patients, limited space, and non-compliance with hygiene protocols, but did not express a sense of urgency or any course of action. Overuse and misuse of antibiotics were reported as main contributors to ABR development, but participants expressed no direct interrelationship between ABR and HAI. We conclude that due to high patient load and limited resources, physicians do not see HAI as a problem they can prioritize. The knowledge gained by this study could provide insights for the allocation of resources and development of hygiene and wound treatment protocols in resource-limited settings.
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| 29. |
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| 30. |
- Ali, E. S., et al.
(author)
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Norovirus drug candidates that inhibit viral capsid attachment to human histo-blood group antigens
- 2016
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In: Antiviral Research. - : Elsevier. - 0166-3542 .- 1872-9096. ; 133, s. 14-22
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Research review (peer-reviewed)abstract
- Human noroviruses are the leading causative agents of epidemic and sporadic viral gastroenteritis and childhood diarrhoea worldwide. Human histo-blood group antigens (HBGA) serve as receptors for norovirus capsid protein attachment and play a critical role in infection. This makes HBGA-norovirus binding a promising target for drug development. Recently solved crystal structures of norovirus bound to HBGA have provided a structural basis for identification of potential anti-norovirus drugs and subsequently performed in silico and in vitro drug screens have identified compounds that block norovirus binding and may thereby serve as structural templates for design of therapeutic norovirus inhibitors. This review explores norovirus therapeutic options based on the strategy of blocking norovirus-HBGA binding.
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| 31. |
- André, Malin, et al.
(author)
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The Use of CRP Tests in Patients with Respiratory Tract Infections in Primary Care in Sweden Can Be Questioned
- 2004
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In: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 36:3, s. 192-197
-
Journal article (peer-reviewed)abstract
- A diagnosis-antibiotic prescribing study was performed in 5 counties in Sweden during 1 week in November in 2000 and 2002 respectively. As a part of the study, the use and results of C-reactive protein (CRP) tests in relation to duration of symptoms and antibiotic prescribing in 6778 patients assigned a diagnosis of respiratory tract infections were analysed. In almost half (42%) of the patients, a CRP test was performed. The majority of CRP tests (69%) were performed in patients assigned diagnosis upper respiratory tract infection, where the test is not recommended. Overall, there was a minor decrease in antibiotic prescribing when CRP was used (41%), in comparison to 44% of the patients where no CRP was performed (p<0.01). Patients assigned diagnoses implying a bacterial aetiology were prescribed antibiotics irrespective of result of CRP or length of symptoms before consultation. For patients assigned viral diagnoses, antibiotic prescribing increased with increasing duration of symptoms and increasing value of CRP. The use of CRP decreased antibiotic prescribing in patients assigned to viral diagnoses and with longstanding symptoms (p<0.001). However, 59% of the patients assigned viral diagnoses with CRP≥25 received antibiotics, which seems to indicate a misinterpretation of CRP and a non-optimal use of antibiotics.
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| 32. |
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| 33. |
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| 34. |
- Bjorkman, A, et al.
(author)
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Cortical reintegration of a replanted hand and an osseointegrated thumb prosthesis
- 2007
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In: Acta Neurochirurgica. Supplementum. - 0065-1419. ; 100, s. 109-112
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Journal article (peer-reviewed)abstract
- BACKGROUND: Following a peripheral nerve repair the injured nerve has to re-innervate its original cortical area, a process, which is poorly understood. Errors in this cortical re-innervation have been suggested as one key reason for the generally poor clinical outcome following nerve injuries in the hand. METHOD: Functional magnetic resonance imaging (fMRI) was used to assess cortical reintegration following amputation and reattachment of bodyparts in two different situations: a patient with a hand amputation followed by immediate surgical replantation and a patient with an osseointegrated thumb prosthesis. FINDINGS: The primary motor cortex rapidly returns to a normal activation pattern after amputation followed by replantation or application of an osseointegrated prosthesis. The primary somatosenory cortex changes from an initial ipsilateral to a bilateral activation pattern. Sensory stimulation of an osseointegrated prosthesis also shows a bilateral activation pattern in the primary somatosenory cortex. CONCLUSIONS: The primary motor cortex shows a more normal activation pattern possibly because most muscles controlling the hand are proximal to the injury and can be activated after an amputation. The primary somatosensory cortex reorganises more and the activation pattern is more bilateral compared to a healthy hand. This bilateral activation pattern could represent a compensatory mechanism for the inferior tactile function in the replanted hand and the osseointegrated prosthesis.
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| 35. |
- Björkman, Ingeborg, et al.
(author)
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Perceptions among Swedish hospital physicians on prescribing of antibiotics and antibiotic resistance
- 2010
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In: Quality and Safety in Healthcare. - : BMJ. - 1475-3898 .- 1470-7934 .- 1475-3901. ; 19:6, s. e8-
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Journal article (peer-reviewed)abstract
- Objective: To explore and describe perceptions of antibiotic prescribing among Swedish hospital physicians, with special reference to whether the perceptions included awareness of antibiotic resistance (AR). Design: A phenomenographic approach was used and data were collected in face-to-face interviews. Setting: Hospitals in seven different counties in central Sweden. Participants A strategic sample of 20 hospital physicians specialising in internal medicine, surgery or urology. Main outcome The variation of perceptions of antibiotic prescribing. Results: Five qualitative different perceptions were found. AR was considered in two of the perceptions. Reasons for not considering AR included a dominating focus on the care of the patient combined with lack of focus on restrictive antibiotic use, or uncertainty about how to manage infectious diseases or the pressure from the healthcare organisation. Parallels between the five perceptions and the stages in the transtheoretical model of health behaviour change were seen. Conclusions: In three of the perceptions, AR was not considered when antibiotics were prescribed. Physicians who primarily express these three perceptions do not seem to be prepared to change to restrictive prescribing. Our findings can be useful in designing activities that encourage AR prevention. Organisational changes are also needed.
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| 36. |
- Brandt, J., et al.
(author)
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Acutely-dissociated Schwann cells used in tendon autografts for bridging nerve defects in rats: a new principle for tissue engineering in nerve reconstruction
- 2005
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In: Scand J Plast Reconstr Surg Hand Surg. - 0284-4311. ; 39:6, s. 321-5
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Journal article (peer-reviewed)abstract
- A new method of acute dissociation of Schwann cells was used to study the effect of addition of such cells to a tendon autograft--a recently-described graft material--on peripheral nerve regeneration in rats. Autologous Schwann cells were obtained from enzymatic dissociation of predegenerated nerves. The tendon autografts were supplied with Schwann cells through brief in vitro coincubation. Schwann cell-free tendon autografts were used as controls. Axonal outgrowth was measured immunohistochemically after four, seven, and 10 days. At seven days, outgrowth was significantly longer in the pretreated autografts. The use of acutely-dissociated Schwann cells is a new approach to tissue engineering in nerve reconstruction, and may abolish the need for time-consuming culture of Schwann cells.
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| 37. |
- Camner, P, et al.
(author)
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Experimental and calculated parameters on particle phagocytosis by alveolar macrophages
- 2002
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In: Journal of applied physiology (Bethesda, Md. : 1985). - : American Physiological Society. - 8750-7587 .- 1522-1601. ; 92:6, s. 2608-2616
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Journal article (peer-reviewed)abstract
- Phagocytosis of three types of fluorescein-labeled test particles by rat alveolar macrophages (AM) were studied: spherical silica (3.2 μm), heat-killed Candida albicans (3.8 μm), and heat-killed Cryptococcus neoformans (6.1 μm) opsonized with specific IgG. These particles should attach to scavenger, mannose, and Fc receptors, respectively. Both control AM and AM pretreated for 20 h with interferon-γ (12.5 or 50 U/ml) were studied. The sum of the number of attached and ingested particles per AM (accumulated attachment) was used as a measure of the attachment process, and the number of ingested particles per AM divided by the accumulated attachment (ingested fraction) was used as a measure of the ingestion process. The average ingestion time (IT), which is also a measure of the ingestion process, was calculated from the experimental data. The ingestion process was independent of the attachment process. IT increased with the time of observation. This is explained by the fact that IT determined from observation times shorter than the whole distribution of IT for a certain particle results in a shorter IT than the real average IT. C. albicans (mannose receptor) had the fastest ingestion process, C. neoformans opsonized with specific IgG (Fc receptor) had ingestion that was nearly as fast, and the silica particles (scavenger receptors) had the slowest ingestion process. Treatment with interferon-γ markedly impaired the attachment process for all three types of particles (and three types of receptors) but clearly impaired the ingestion process only for silica particles (scavenger receptors).
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| 38. |
- Chen, XK, et al.
(author)
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Traditional Baduanjin exercise through the eyes of patients with chronic heart failure: A qualitative content analysis study
- 2023
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In: Frontiers in cardiovascular medicine. - : Frontiers Media SA. - 2297-055X. ; 9, s. 1049036-
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Journal article (peer-reviewed)abstract
- Baduanjin (eight silken movements) is a traditional Chinese exercise that can be used as cardiac rehabilitation therapy for patients with chronic heart failure (CHF) especially when other forms of rehabilitation are scarce or unaffordable. This study explores the experiences of Chinese patients with CHF who undertook Baduanjin exercise at home as part of a pilot trial in Guangzhou, China.MethodsWe conducted seven qualitative interviews with participants who had participated in the intervention arm of a pilot randomized controlled trial (RCT) (n = 8). For data collection, we used a semi-structured interview guide with both open-ended, and follow-up questions. We audio recorded the interviews, transcribed them verbatim, and then analyzed them with content analysis.ResultsParticipants’ experiences of doing Baduanjin were classified into three categories: (1) improving practice (2) factors facilitating good exercise adherence, and (3) feeling good. Participants reported that the exercises were easy but that the correct Baduanjin execution and coordination between the mind, movements, and breathing were only achievable through practice. In addition, the training benefits which they perceived were the predominant motivation for patients to keep practicing. Finally, trust in Baduanjin, personal attitudes toward health, flexibility in practice times, as well as social support helped the participants to achieve good adherence to home-based training.ConclusionThis study’s findings indicate that Baduanjin could be a cardiac rehabilitation exercise modality for patients with CHF in China, especially in a home-based setting.
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| 39. |
- Dahlin, L B, et al.
(author)
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Axonal growth in mesothelial chambers : effects of a proximal preconditioning lesion and/or predegeneration of the distal nerve stump
- 1988
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In: Experimental Neurology. - : Elsevier BV. - 0014-4886. ; 99:3, s. 63-655
-
Journal article (peer-reviewed)abstract
- Preformed, autologous mesothelial chambers were utilized to study axonal growth following selective predegeneration of the distal nerve stump and/or preconditioning of the proximal nerve stump. The left and/or right sciatic nerve of rats was exposed and transected in the thigh. Two weeks after transection, the left proximal nerve stump was cross-anastomosed with the right distal nerve stump by using a mesothelial chamber leaving a 15-mm gap between the two nerve stumps. Previous studies have shown that axonal overgrowth normally does not occur over this gap distance to the distal stump. Three months after cross-anastomosing, regeneration across the 15-mm gap was evaluated by muscle action potential recordings and light microscopical examination. In experiments in which a distal nerve stump was selectively degenerated and the proximal segment was freshly cut, axons had bridged the 15-mm gap in six of seven rats. When a proximal preconditioned nerve stump was matched with a freshly cut distal stump, axonal overgrowth occurred in only 4 of 10 experiments. In experiments including a proximal preconditioned nerve stump and a distal predegenerated stump, axons bridged the gap in 6 of 8 experiments. We concluded that a priming lesion, including manipulation with proximal and/or distal stump, enhances axonal growth in mesothelial chambers.
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| 40. |
- Dahlin, Lars, et al.
(author)
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Schwann cells, acutely dissociated from a predegenerated nerve trunk, can be applied into a matrix used to bridge nerve defects in rats
- 2007
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In: Acta Neurochirurgica. Supplementum. - 0065-1419. ; 100, s. 57-60
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The gold standard to reconstruct a nerve defect is a conventional autologous nerve graft. There may be a lack of such grafts in severe nerve injuries. Alternatives to autologous nerve grafts are needed. METHODS: We have developed a technique where mainly Schwann cells are acutely dissociated from the ends of the severed nerve trunk after nerve injury. The technique does not require long-term cell culture procedures. The obtained cells, which can be dissociated within a few hours, are applied to a silicone tube or a tendon autograft used to bridge a nerve defect. FINDINGS: Dissociated cells from the ends of the severed nerve ends consist of more than 85% of Schwann cells. The remaining cells are ED1 stained macrophages. The cells survive transfer to a silicone tube or a tendon autograft which bridge the nerve defect. Axons do grow through such a graft filled with dissociated cells. CONCLUSION: Our novel model to obtain mainly Schwann cells by dissociation of the cells from the severed nerve ends after injury and add them to a matrix, thereby creating an artificial nerve graft, may be a new technique with potential clinical application in nerve reconstruction.
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| 41. |
- Damlin, A., et al.
(author)
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Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study
- 2019
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In: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 19
-
Journal article (peer-reviewed)abstract
- Background: The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. Methods: In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher's exact test was used for comparisons between categorical variables, and student's t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results: The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions: Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.
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| 42. |
- Danielsen, N, et al.
(author)
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Nerve repair and axonal transport. Distribution of axonally transported proteins during maturation period in regenerating rabbit hypoglossal nerve
- 1986
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In: Journal of the Neurological Sciences. - 0022-510X. ; 73:3, s. 77-269
-
Journal article (peer-reviewed)abstract
- The distribution of fast migrating [3H]leucine-labelled proteins was studied in transected and repaired rabbit hypoglossal nerves. The nerves were repaired 90 days earlier with mesothelial chamber or epineurial suture technique. Fast migrating radiolabelled proteins were transported into the distal nerve segment and neurophysiological recordings from the tongue as well as the presence of myelinated axons in the distal nerve segment verified successful regeneration. The total amount of radioactivity was increased in repaired nerves as compared to contralateral nerves. In both groups there was a significant accumulation of radiolabelled proteins at the site of lesion. Nerves repaired with mesothelial chambers showed significantly more radioactivity in the distal nerve segment as compared to sutured nerves. The present study indicates long-standing effects on axonal transport system after both types of nerve repair. It is our opinion that axonal transport studies are a valuable complement when evaluating experimental nerve repair.
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| 43. |
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| 44. |
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| 45. |
- Das, S, et al.
(author)
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Disinfection of Multidrug Resistant Escherichia coli by Solar-Photocatalysis using Fe-doped ZnO Nanoparticles
- 2017
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In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7:1, s. 104-
-
Journal article (peer-reviewed)abstract
- Spread of antibiotic resistant bacteria through water, is a threat to global public health. Here, we report Fe-doped ZnO nanoparticles (Fe/ZnO NPs) based solar-photocatalytic disinfection (PCD) of multidrug resistant Escherichia coli (MDR E. coli). Fe/ZnO NPs were synthesized by chemical precipitation technique, and when used as photocatalyst for disinfection, proved to be more effective (time for complete disinfection = 90 min) than ZnO (150 min) and TiO2 (180 min). Lipid peroxidation and potassium (K+) ion leakage studies indicated compromisation of bacterial cell membrane and electron microscopy and live-dead staining confirmed the detrimental effects on membrane integrity. Investigations indicated that H2O2 was the key species involved in solar-PCD of MDR E. coli by Fe/ZnO NPs. X-ray diffraction and atomic absorption spectroscopy studies showed that the Fe/ZnO NPs system remained stable during the photocatalytic process. The Fe/ZnO NPs based solar-PCD process proved successful in the disinfection of MDR E. coli in real water samples collected from river, pond and municipal tap. The Fe/ZnO NPs catalyst made from low cost materials and with high efficacy under solar light may have potential for real world applications, to help reduce the spread of resistant bacteria.
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| 46. |
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