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Biomedical subjects

A Voss

Publications and source records attributed to A Voss.

At least 109 records · Page 6Linked to original sources
PubMed1998

Diminished ability of erythrocytes from patients with systemic lupus erythematosus to limit opsonized immune complex deposition on leukocytes and activation of granulocytes.

OBJECTIVE: To compare the ability of normal erythrocytes and erythrocytes from systemic lupus erythematosus (SLE) patients to bind immune complexes (IC), thereby inhibiting IC deposition on polymorphonuclear leukocytes (PMN) and the consequent induction of a PMN respiratory burst (RB). METHODS: The binding of fluorescein isothiocyanate-labeled IC in 75% autologous serum to whole blood cells or isolated leukocytes from 17 SLE patients and 10 controls was assessed by flow cytometry. Reactive oxygen metabolite (ROM) production by PMN was measured as the intracellular oxidation of dihydrorhodamine 123, on stimulation with unlabeled IC. RESULTS: Erythrocyte-mediated inhibition of IC uptake by PMN reached a mean +/- SD maximum of 68 +/- 18% in controls and 29 +/- 51% in SLE patients (P < 0.05) and, in the patients, correlated inversely with disease activity. In the presence of erythrocytes from various donors, IC binding to a standard preparation of PMN and their ROM production were inversely proportional to the number of type 1 complement receptors (CR1) per donor erythrocyte. Thus, the ROM production was higher in the presence of SLE patients' erythrocytes (125 +/- 67 CR1/erythrocyte) than with erythrocytes from controls (235 +/- 118 CR1/erythrocyte). CONCLUSION: Erythrocytes from SLE patients are defective in protecting their PMN against IC deposition and induction of the RB.

Adolescent↗
PubMed1998

A multicentre study of 513 Danish patients with systemic lupus erythematosus. I. Disease manifestations and analyses of clinical subsets.

A Danish multicentre study was undertaken of the manifestations, infections, thrombotic events, survival and predictive factors of survival in 513 Danish patients with systemic lupus erythematosus (SLE) according to the 1982 classification criteria of the American College of Rheumatology. The mean duration of follow-up was 8.2 years from diagnosis and 12.8 years from first symptom. This paper describes the most common clinical and laboratory manifestations and their relationship to sex and age at the time of onset and diagnosis. Cluster analysis revealed three clinically defined clusters at the time of disease onset. Cluster 1 (57% of patients) consisted of relatively elderly patients without nephropathy or malar rash, but with a high prevalence of discoid lesions. Cluster 2 (18%) consisted of patients with nephropathy, a third of whom also developed serositis and lymphopenia. The patients of the third cluster (25%) all had malar rash and half were photosensitive. Follow-up showed that the patients of cluster 2 developed azotaemia, large proteinuria, arterial hypertension and myositis significantly more often than did the rest of the patients, but the mortality was not increased. The risk of developing renal end-stage disease was highest in men with early-onset disease.

Adolescent↗
PubMed1998

A multicentre study of 513 Danish patients with systemic lupus erythematosus. II. Disease mortality and clinical factors of prognostic value.

In this Danish multicentre study, predictive clinical factors of mortality and survival were calculated for 513 patients with systemic lupus erythematosus (SLE), 122 of whom died within a mean observation period of 8.2 years equalling a mortality rate of 2.9% per year. Survival rates were 97%, 91%, 76% and 64% after 1, 5, 10 and 15 years, respectively. The direct causes of death included SLE (n = 35), infections (n = 25), malignancy (n = 9), cardiovascular disease (n = 32) and other causes (n = 21). Uni- and multivariate analyses of survival and mortality were performed for all deaths and for SLE-related deaths. Azotaemia (one-fifth of the patients) was a strong predictor of increased overall and SLE-related mortality, but nephropathy per se (one-half of the patients) and large proteinuria (one-sixth of the patients) were unrelated to survival. Haemolytic anaemia had a significant negative influence on survival related to mortality caused by infections. Diffuse central nervous system disease and myocarditis were related to increased SLE-related mortality, whereas photosensitivity predicted a decreased mortality. Non-fatal infections and thrombotic events predicted a decreased overall survival. Since 1980 the mortality caused by SLE manifestations has decreased significantly.

Adolescent↗
PubMed1998

Sepsis puerperalis caused by a genotypically proven cat-derived Pasteurella multocida strain.

We report a disseminated intrauterine Pasteurella multocida infection in a puerperal woman who could not remember any traumatic exposure to her cat. An oral swab taken from the cat, just 2 days after the patient's admission, grew Pasteurella multocida, with an PCR-fingerprinting pattern identical to the patient's isolate. Hand-washing after every contact with cats and dogs and if feasible separation of in-house pets from mother and infant should be applied to prevent this uncommon but serious occurrence of post-partum infections. To our knowledge this is the first case of Pasteurella multocida 'child-bed fever', with a genotypically identical strain isolated from the in-house cat.

Adult↗
PubMed1998

Particle detected Fourier transform NMR at single crystal surfaces--6Li on Ru(001).

Fourier transform nuclear magnetic resonance at single crystal surfaces is described. The adsorption of 6Li on Ru(001) is investigated by newly developed techniques utilizing atomic beam sample preparation and optical detection of the NMR signal on desorbing atoms (laser induced fluorescence) or ions (beamfoil spectroscopy). In complete analogy to magnetically detected NMR, the transverse magnetisation is coherently recorded. This allows pulse NMR to be applied to surface problems.

Crystallization↗
PubMed1998

Characterization of pathogenetic determinants of Candida albicans strains.

The study was an attempt to correlate phenotypic pathogenetic determinants of clinical Candida albicans strains with their genotype as determined by PCR fingerprinting. A total of 25 C. albicans strains was tested. Adherence capacity, hydrophobicity and proteinase production were compared with the genotypes of the particular Candida strains. The fungal strains represented eleven genotypes. No correspondence relationship was found between genotype and the markers of pathogenicity.

Candida albicans↗
PubMed1998

Nosocomial outbreak of colonization and infection with Stenotrophomonas maltophilia in preterm infants associated with contaminated tap water.

Between March and May 1996 Stenotrophomonas maltophilia was cultured from endotracheal aspirate samples from five preterm infants in a neonatal intensive care unit (NICU). Four infants were superficially colonized, but a fifth died due to S. maltophilia septicaemia. S. maltophilia was cultured from tap water from three outlets in the NICU including one with a previously unnoticed defective sink drain. Water from these outlets was used to wash the preterm infants. Environmental and clinical S. maltophilia isolates yielded identical banding patterns on random arbitrary polymorphic DNA (RAPD) PCR analysis. The outbreak was controlled by reinforcement of hand disinfection, limitation of the use of tap water for hand washing and by using sterile water to wash the preterm infants. We conclude that tap water should not be used for washing preterm infants in the NICU, unless steps are taken to prevent microbial growth in the outlets.

Cross Infection↗
PubMed1998

Systemic lupus erythematosus in Denmark: clinical and epidemiological characterization of a county-based cohort.

A population based cohort of patients with systemic lupus erythematosus (SLE) was recruited from a for epidemiological purposes representative Danish region. Patients were ascertained from 4 different sources with a high degree of completeness as estimated by using capture-recapture analysis. The diagnosis was verified by means of case records, patient interviews, and clinical examinations. Patients were classified according to the 1982 revised ACR criteria as Definite SLE (D-SLE) fulfilling > or = 4 criteria and Incomplete SLE (I-SLE) with < 4 criteria. As of January 1, 1995, the point prevalences of D-SLE and I-SLE were 21.7 and 5.2 per 100000 respectively. The cohort comprised 98% white Europeans. The annual incidence of D-SLE increased from 1.0/100,000 to 3.6/100,000 during the study period 1980-94. D-SLE patients had clinical profiles comparable to other Western European study populations. The I-SLE subclass had milder disease manifested by lower criterial load and absence of cerebral and kidney involvement. Tissue and organ damage expressed as SLICC-score increased in the order of live I-SLE, live D-SLE, and deceased patients.

Adolescent↗
PubMed1998

Multiparametric analysis of heart rate variability used for risk stratification among survivors of acute myocardial infarction.

A multiparametric heart rate variability analysis was performed to prove if combined heart rate variability (HRV) measures of different domains improve the result of risk stratification in patients after myocardial infarction. In this study, standard time domain, frequency domain and non-linear dynamics measures of HRV assessment were applied to 572 survivors of acute myocardial infarction. Three parameter sets each consisting of 4 parameters were applied and compared with the standard measurement of global heart rate variability HRVi. Discriminant analysis technique and t-test were performed to separate the high risk groups from the survivors. The predictive value of this approach was evaluated with receiver operator (ROC) and positive predictive accuracy (PPA) curves. Results--The discriminant analysis shows a separation of patients suffered by all cause mortality in 80% (best single parameter 74%) and sudden arrhythmic death in 86% (73%). All parameters of set 1 show a high significant difference (p < 0.001) between survivors and non-survivors based on two-tailed t-test. The specificity level of the multivariate parameter sets is at the 70% sensitivity level (ROC) about 85-90%, whereas HRVi shows maximum levels of 70%. The PPA in the all cause mortality group is at the 70% sensitivity level twice as high as the univariate HRV measure and increases to more than fourfold as high within the VT/VF group. In conclusion, in this population, the multiparametric approach with the combination of four parameters from all domains especially from NLD seems to be a better predictor of high arrhythmia risk than the standard measurement of global heart rate variability.

Arrhythmias, Cardiac↗
PubMed1997

[Infections in elderly patients].

Infections are an increasing problem in the elderly population, because of the often atypical presentation and the more frequent occurrence of complications, which lead to increased morbidity and mortality. The increased prevalence of infections in the elderly is due to a number of factors: increased exposure to micro-organisms (especially in nursing homes); degeneration of various organs (atherosclerosis, pulmonary emphysema, diverticulosis, prolapse); decreased immune response; concomitant diseases (e.g. diabetes mellitus) and (or) use of medication. There is often a delay in the diagnosis because the presentation of infection in the elderly is frequently atypical and symptoms are attributed to old age, rather than to infection. Treatment may be hampered by increased resistance of micro-organisms, interaction with other drugs and toxicity problems.

Age Factors↗
PubMed1997

[Hospital Infection Epidemiology Nederland (ZIEN): from club to study group].

Medical care is increasingly a technical business, and hospitalised patients are more and more susceptible to infections, notably due to the application of aggressive therapies for all kinds of disorders. As a consequence the epidemiology of hospital infections requires serious attention. Following the initiative of some medical microbiologists in the Netherlands, a study group was established to tackle this epidemiology and to initiate relevant research (Working party on Hospital Infections and Epidemiology of the Netherlands; WHEN). Recent subjects include fungemia in hospitalised patients, risk factors for acquiring methicillin-resistant Staphylococcus aureus during a stay abroad, and prevalence of vancomycin-resistant enterococci.

Cross Infection↗
PubMed1997

VRE and meat.

Explore the source record for details and available documents.

Animals↗
PubMed1997

Pseudo-outbreak of multiresistant Pseudomonas aeruginosa in a hematology unit.

OBJECTIVE: To describe the investigation of a pseudo-outbreak of multiresistant Pseudomonas aeruginosa fecal colonization in a hematology unit. DESIGN: Retrospective chart review; prospective environmental sampling and observation of stool culture technique; genotyping by random arbitrary primer polymorphic DNA polymerase chain reaction (RAPD-PCR). SETTING: An academic tertiary-care hospital. PATIENTS: Between August and October 1994, P aeruginosa resistant to imipenem, ceftazidime, ciprofloxacin, and all aminoglycosides was isolated from surveillance stool cultures from 10 neutropenic patients cared for in the hematology unit. P aeruginosa, with an identical susceptibility pattern, was isolated from three patients admitted to the same unit in the year before the "outbreak." Two months before the outbreak, 12 healthcare workers had been added to the staff. RESULTS: Observation of stool sampling techniques as performed by healthcare workers revealed that samples for surveillance cultures were taken from feces in the toilet. When the proper sampling technique was used, P aeruginosa was not isolated from stool samples from 8 of 10 patients with previously positive cultures. P aeruginosa also was isolated from two wash basins, toilet flushing water, and a toilet brush. Genotyping by RAPD-PCR showed that the isolate from the toilet flushing water was identical to the P aeruginosa strains of eight patients from the outbreak. CONCLUSIONS: This pseudo-outbreak emphasizes the importance of proper sampling techniques and that periodic observation may be necessary to verify proper sampling techniques.

Cross Infection↗