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Biomedical subjects

A Schwan

Publications and source records attributed to A Schwan.

At least 37 records · Page 2Linked to original sources

Traditional risk-factor profile fails to explain striking geographical differences in IHD mortality among middle-aged men. The project "myocardial infarction in mid-Sweden".

An east-west gradient in cardiovascular mortality has been reported from the region of mid-Sweden. Postal questionnaire studies found that the risk factor distributions among middle-aged men were similar in areas with striking differences in cardiovascular mortality. In this study, 120 randomly selected 50-year-old men in two high mortality communities in the west and 120 men from two low mortality communities in the east were invited to a health survey in which serum lipids and other risk factors were analysed. Total serum cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels were similar. Among fatty acids, stearic acid was high and arachidonic acid was low in the high mortality area. The levels of other traditional risk factors were the same. After taking these differences into account, the mortality differences remain large.

Coronary Disease↗

The role of a commercial latex agglutination test in the diagnosis of group B streptococcal infection in neonates.

An open prospective multicenter study was conducted in order to evaluate the Wellcogen Strep B latex agglutination test in the diagnosis of group B streptococcal (GBS) infections in neonates. Twenty-three (5.9%) of 391 urine specimens and 5 (1.2%) of 404 sera assayed were positive. The results of the urine tests corresponded to a sensitivity of 0.78 for bacteremic, 0.50 for non-bacteremic and 0.53 for all GBS associated (bacteremic, non-bacteremic and suspected) infections. After 20-25-fold concentration of urine specimens the sensitivity increased to 1.0 for bacteremic, 0.67 for non-bacteremic and 0.78 for all GBS associated infections. The specificity of the test was high (0.93 for concentrated urines), and the predictive value of a positive test (Pvpos) was 0.68. A positive latex test was highly predictive of positive surface cultures for GBS (Pv pos = 0.83 after concentration).

C-Reactive Protein↗

Streptococcal throat infection: calculation of test standards and a comparison between an antigen detection test and culture.

The standard minimum sensitivity (94%) and minimum specificity (89%) of a group A streptococcus (GAS) test were calculated, assuming that no more than 10% false positive and no more than 2% false negative test results should be allowed. The clinical judgement of the need for immediate antibiotic treatment in tonsillitis/pharyngitis was an unreliable indicator of a GAS aetiology, 20-29% of the results being false positive and 2-10% false negative. The rapid antigen detection test Tandem Icon Strep A was not sensitive enough to be used as a single test, though it was specific enough. The sensitivity of culture almost reached the standard demand. Two combinations of rapid test and culture (sequence testing) were superior to the rapid test, but were not significantly better than culture.

Anti-Bacterial Agents↗

Inoculation of barrier-born pigs with Helicobacter pylori: a useful animal model for gastritis type B.

At the age of 8 weeks, 15 barrier-born pigs, specific pathogen free, were inoculated intragastrically with suspensions of 10(7) to 10(10) CFU of Helicobacter pylori after pretreatment with omeprazole. The pigs were observed for up to 12 weeks, endoscopic biopsy specimens were taken, and serum samples were drawn. H. pylori was identified by routine culturing and by staining with an H. pylori-specific monoclonal antibody on cryostat sections of gastric biopsy specimens. In 11 of 15 inoculated pigs, H. pylori was detected throughout the observation period. In these infected pigs, there was an antibody response to H. pylori, as determined in serum by an enzyme immunoassay. Furthermore, the development of superficial, focal gastritis with infiltrates of mononuclear class II antigen-expressing lymphocytes was observed immunohistologically. H. pylori was never detected and an antibody response to H. pylori was not observed in two control pigs. The development of gastritis and the systemic antibody response to H. pylori support the usefulness of this animal model for studies of H. pylori-related human diseases.

Animals↗

Antibody response to Staphylococcus saprophyticus in urinary tract infection.

The serological response towards Staphylococcus saprophyticus in young women with symptomatic urinary tract infection was measured with an enzyme-linked immunosorbent assay (ELISA) and a direct agglutination (DA) test. In both assays a marked antibody response was found in 2 of 3 patients with acute pyelonephritis caused by S. saprophyticus. Patients with acute cystitis due to S. saprophyticus or Escherichia coli showed antibody titers comparable to those of healthy controls.

Acute Disease↗

Change in posture during sleep causes errors in non-invasive automatic blood pressure recordings.

When measured with automatic non-invasive monitors blood pressure is seen to fluctuate during sleep. The recorded blood pressure is influenced by the vertical distance between the heart level (zero reference) and the level of the brachial artery at the point of compression by the inflated cuff. In 20 randomly selected men, blood pressure was measured every 20 min during the night. The difference between consecutive recordings was 7.6 mmHg +/- 5.7/5.0 (s.d.), range 0-23/0-20 mmHg. The maximum blood pressure difference was 19 +/- 6.8/15 +/- 6.0, range 7-32/6-26 mmHg. These results were compared with the difference in blood pressure recorded on the left arm in 20 volunteers changing posture between four standardized recumbent postures. The posture change caused an average blood pressure difference of 9 +/- 6.1/9 +/- 6.5 mmHg, range 0-28/0-30 mmHg. The maximum blood pressure difference was 15 +/- 5.1/12 +/- 5.5 mmHg, range 5-27/(-)2-23 mmHg recorded between lying supine and lying on the right side. The similarity between differences and the variation in blood pressure during the recumbent posture indicates that changes in posture cause most of the night-time blood pressure variation recorded with non-invasive devices.

Blood Pressure↗

Association of Campylobacter pylori with induced expression of class II transplantation antigens on gastric epithelial cells.

Campylobacter pylori was identified with immunoperoxidase staining and a mouse monoclonal antibody directed against C. pylori in gastric biopsy specimens from 24 patients with gastritis. C. pylori was not found in gastric biopsy specimens from six subjects with histologically normal mucosa. The monoclonal antibody, which was reactive with a surface protein of approximately 20 kilodaltons, was found to be specific for C. pylori, and the immunoperoxidase staining proved to be more sensitive and rapid than culture in detecting the organism. In the tissue specimens where C. pylori was detected with the monoclonal antibody, there was a strong expression of class II transplantation antigens on the epithelial cells and an increased number of T lymphocytes. These findings indicate that C. pylori may initiate local immune responses.

Antibodies, Monoclonal↗

Colonization with potentially pathogenic respiratory tract bacteria. A household study.

A group of 235 persons (180 adults and 55 children 0-15 years old) recorded symptoms of upper respiratory tract infection daily during two three-month periods (autumn 1986 and spring 1987). Samples for culture were taken from the nasopharynx and throat once during each period. Fifteen per cent of asymptomatic subjects harboured respiratory pathogens in the nasopharynx, as did 28% of those subjects with minor respiratory tract infections and 46% of those with more severe respiratory tract infections. Of children up to seven years of age, 58% were colonized with potential respiratory pathogens, which is important to keep in mind when evaluating culture reports from young children. Adults living with young children were colonized significantly more often than other adults. Branhamella catarrhalis was the most common pathogen.

Adolescent↗

Bacteriological and serological aspects of group A streptococcal pharyngotonsillitis caused by group A streptococci.

Several bacteriological and serological variables were studied in connection with a clinical treatment trial in 212 patients with group A streptococcal pharyngotonsillitis. Anaerobic incubation was not superior to incubation in 5% CO2 in air for the detection of group A streptococci. Saliva cultures were inferior to conventional throat cultures in detecting group A streptococci. No strains from patients with recurrences were found to be tolerant to penicillin. In several patients (all asymptomatic), group C and G streptococci were found in follow-up cultures. Group A streptococci serology was more often positive after two months than after one month, also in patients without recurrence.

Adolescent↗

Throat carrier rates of beta-hemolytic streptococci among healthy adults and children.

In order to investigate the carrier rate of beta-hemolytic streptococci throat cultures were obtained every third month from 382 asymptomatic adults and schoolchildren during a 2-year period, altogether 2226 samples. In addition, 300 asymptomatic 4-year-olds were sampled once. The carrier rate of beta-hemolytic streptococci was 19.4%; group A streptococci alone 5.0%. There was no season-dependent variation. In the 3 age groups the carrier rates of group A streptococci were 0.8%, 5.9%, and 11.3%, respectively, with the highest rate among the 4-year-olds. Some of the individuals that were sampled repeatedly seemed to be pharyngeal carriers of group A streptococci, while others never became carriers. Group A streptococci were found significantly more often among 4-year-olds not attending day-care centres compared to those attending such institutions. For group C and G streptococci the influence of age on carrier rates was not similar to that found for group A streptococci. Throat carriership of beta-hemolytic streptococci does not result in clinical infections.

Adolescent↗

Five versus ten days treatment of group A streptococcal pharyngotonsillitis: a randomized controlled clinical trial with phenoxymethylpenicillin and cefadroxil.

216 patients aged greater than or equal to 7 years with febrile group A streptococcal pharyngotonsillitis were randomly assigned to 3 treatment groups receiving either phenoxymethylpenicillin for 5 days followed by placebo for 5 days, phenoxymethylpenicillin for 10 days, or cefadroxil for 10 days. 209 patients completed treatment, 70 subjects in each phenoxymethylpenicillin group and 69 in the cefadroxil group. Within 1 week after completion of the antibiotic treatment significantly more recurrences with the same T-type as the initial streptococcal strain occurred in the 5-day treatment group (27%) as compared with the two 10-day groups (6% and 3%, respectively). The cumulative rate of recurrences (irrespective of T-type) within 2 months from the start of therapy was 55% among patients treated with phenoxymethylpenicillin for 5 days, 24% among those treated for 10 days with this drug and 19% among patients receiving cefadroxil. Obviously, one important factor to avoid recurrence of group A streptococcal pharyngotonsillitis is the length of antibiotic treatment and, in our opinion, it is not advisable to change the current recommendation of 10 days treatment.

Adolescent↗

Age related variations of serum concentrations of normally occurring IgG antibodies to Clostridium perfringens.

In studies using indirect immunofluorescence IgG antibodies to Clostridium perfringens were found in sera from healthy adults. Sera from 236 healthy children were examined. The normally occurring IgG antibodies to C perfringens were found to have an age related variation. Preliminary data suggest that they are not correlated to C perfringens alpha toxin. The antigen(s) against which the antibodies are directed is/are probably part of the cell wall, but its/their exact nature is not known.

Adolescent↗