| 1. |
- Elmståhl, Sölve, et al.
(author)
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Precipitating and Predisposing Factors of Acute Confusional State Among Emergency Department Patients
- 1995
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In: International Psychogeriatrics. - 1041-6102. ; 7:4, s. 519-526
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Journal article (peer-reviewed)abstract
- The aim of this study was to examine predisposing and precipitating factors of acute confusional state (ACS) retrospectively in medical records of patents examined in an acute medical unit (AMU) who had a preliminary diagnosis of confusion/anxiety. The study comprised all 221 patients who were 65 years old and older among the 18,015 patients examined in the AMU during 1 year who, after a preliminary examination in the AMU, received a diagnosis of confusion/anxiety without any other etiologic diagnosis. Fifty-six cases fulfilled the DSM-III-R criteria for ACS. The control group comprised 165 patients, with anxiety, depression, or psychosis the main finding in 135 cases. Among patients further examined in other departments or for whom consultations were made, the medical records showed that the ACS group had on average 2.6 predisposing factors for ACS, with dementia, cerebrovascular disease, and sensory deficits the most common. Three to six predisposing factors were found among 46% of the ACS patients, compared to 4% of the control group. A precipitating factor of ACS was found in 78% of the ACS cases, and the average number of precipitating factors was 1.6. Dementia (32%), metabolic disturbances (30%), and cardiovascular diseases (16%) were the most frequent precipitating factors among the ACS group. The mortality rates 2 years after examination in the AMU were 32% for the ACS group and 20% for the control group (p <.05). The study suggests that the causes of ACS are often multifactorial and that it is important to seek several precipitating factors when treating this potentially reversible condition.
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| 2. |
- Thorven, Maria, et al.
(author)
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A homozygous nonsense mutation (428G ->A) in the human secretor (FUT2) gene provides resistance to symptomatic norovirus (GGII) infections
- 2005
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In: Journal of Virology. - 0022-538X .- 1098-5514. ; 79:24, s. 15351-5
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Journal article (peer-reviewed)abstract
- Noroviruses (formerly Norwalk-like viruses) are a major cause of acute gastroenteritis worldwide and are associated with a significant number of nosocomial and food-borne outbreaks. In this study we show that the human secretor FUT2 gene, which codes for an alpha(1,2)-fucosyltransferase synthesizing the H-type 1 antigen in saliva and mucosa, is associated with susceptibility to norovirus infections. Allelic polymorphism characterization at nucleotide 428 for symptomatic (n = 53) and asymptomatic (n = 62) individuals associated with nosocomial and sporadic norovirus outbreaks revealed that homozygous nonsense mutation (428G-->A) in FUT2 segregated with complete resistance for the disease. Of all symptomatic individuals, 49% were homozygous (SeSe) and 51% heterozygous (Sese428) secretors, and none were secretor negative (se428se428), in contrast to 20% nonsecretors (se428se428) among Swedish blood donors (n = 104) (P < 0.0002) and 29% for asymptomatic individuals associated with nosocomial outbreaks (P < 0.00001). Furthermore, saliva from secretor-positive and symptomatic patients but not from secretor-negative and asymptomatic individuals bound the norovirus strain responsible for that particular outbreak. This is the first report showing that the FUT2 nonsecretor (se428se428) genotype is associated with resistance to nosocomial and sporadic outbreaks with norovirus.
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