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Biomedical subjects

B Trollfors

Publications and source records attributed to B Trollfors.

At least 127 records · Page 7Linked to original sources
PubMed1986

Symptomatic treatment of acute infectious diarrhoea: loperamide versus placebo in a double-blind trial.

One hundred and twelve patients with acute infectious diarrhoea were entered in a double-blind randomised study in order to compare loperamide with a placebo. Of 82 evaluable patients, 38 received loperamide and 44 placebo for a maximum of 5 days. There were no significant differences in the number of loose stools during the first day of treatment, in the total number of tablets taken or in the total duration of the period of diarrhoea between the two treatment groups. The loperamide-treated patients had significantly fewer loose stools during the observation period of 5 days than did the placebo treated patients, median five vs. seven, a difference of little clinical importance. Excretion of bacterial pathogens was followed weekly in 13 of the loperamide treated patients (median 35.5 days) and in 18 of the placebo treated patients (median 22.5 days). This difference in the duration of excretion was not significant.

Acute Disease↗
PubMed1986

Diagnostic potential of urinary enzymes and beta 2-microglobulin in acute urinary tract infection.

Urinary excretions of beta 2-microglobulin (beta 2M), N-acetyl-beta-D-glucosaminidase (NAG), alanine aminopeptidase, beta-glucuronidase, acid and neutral alpha-glucosidase as indicators of proximal tubular dysfunction were measured in patients with acute upper and lower urinary tract infection (UTI) and fever of non-renal origin. The sensitivity of beta 2M was 67% and of NAG 49% as assessed in more than 100 episodes of acute pyelonephritis. Combined use of beta 2M and NAG increased the sensitivity to 75%. The degree of beta 2-microglobulinuria and enzymuria was comparable in patients with acute pyelonephritis and fever due to non-renal infections. The excretion of beta 2M and the various enzymes was too variable and unpredictable in individual cases to be useful as diagnostic indicator. In localizing an acute UTI, tests for proximal tubular dysfunction seem to be of no more clinical value than properly measured body temperature.

Acetylglucosaminidase↗
PubMed1986

Serotype distribution of Streptococcus pneumoniae strains isolated from blood and cerebrospinal fluid in Sweden.

215 strains of Streptococcus pneumoniae isolated from blood or cerebrospinal fluid at 3 different laboratories in Sweden were serotyped by coagglutination and subtyped by the capsular reaction test. 78% of the strains belonged to serotypes which are included in or completely cross-immunogenic with serotypes included in the 14-valent vaccine while serotypes included in the 23-valent vaccine covered 89% of the isolates. Types 7F, 14 and 33F, which cannot be detected by counterimmunoelectrophoresis constituted 19% of all strains.

Adolescent↗
PubMed1986

The carrier state in pertussis.

In order to determine whether healthy adults can be of importance for the spread of pertussis the nasopharyngeal flora of 391 healthy individuals working in close contact with children was investigated during the height of a pertussis epidemic. Only 1 carrier of Bordetella pertussis was found, even though all individuals were exposed to the organism during the study period through their work.

Adolescent↗
PubMed1986

Comparative toxicity of gentamicin and cefotetan.

In a prospective, randomized, comparative study, the renal, hepatic and gastrointestinal toxicity and effects on the vitamin K dependent coagulation factors of gentamicin and cefotetan were compared. Gentamicin, which in all but one patient was combined with a penicillin, was found to cause a significant decrease of glomerular filtration rate (GFR) after 1 week of treatment. In 6/14 patients a further decrease of GFR was found during the week following the last treatment day. The renal proximal tubular cells were affected by gentamicin, as evident from significant increases in urinary activity of 2 tubular enzymes, alanine aminopeptidase (AAP) and N-acetyl-beta-D-glucosaminidase (NAG), as well as rises of urinary beta 2-microglobulin. Changes in GFR and tubular function were reversible. No statistically significant changes of these variables were seen with cefotetan. One cefotetan treated patient developed diarrhoea of moderate severity and 2 patients in the same group developed minor increases of liver transaminases. A small but statistically significant decrease of the activity of the vitamin K dependent coagulation factors occurred during cefotetan treatment. No gastrointestinal or hepatic adverse reactions were observed in the gentamicin treated patients.

Aged↗
PubMed1985

Etiology of community-acquired pneumonia in patients requiring hospitalization.

The etiology of community-acquired pneumonia was studied in 127 patients with roentgenologically verified pneumonia who needed hospitalization. Etiology was determined on the basis of a positive blood culture and/or a significant antibody titer increase. Streptococcus pneumoniae was the probable etiological agent in 69 patients, nontypeable Haemophilus influenzae in five patients, Streptococcus pyogenes in two patients, and Legionella pneumophila and Staphylococcus aureus in one patient each. Evidence of Mycoplasma pneumoniae infection was found in 18 patients and of Chlamydia psittaci infection in three patients. Influenza virus type A was the cause of infection in 15 patients. One patient had infection with influenza virus type B, one patient with parainfluenza virus type 1, and three patients with respiratory syncytial virus. In 20 patients there was evidence of infection with more than one microorganism. No etiological agent was found in 27 patients. Since Streptococcus pneumoniae was the predominant etiological agent penicillin should be drug of first choice in patients with pneumonia who need treatment in hospital. In young adults, however, the high frequency of Mycoplasma pneumoniae infection would justify the use of erythromycin or doxycycline as drug of first choice.

Adolescent↗
PubMed1985

Susceptibility of Bordetella pertussis to doxycycline, cinoxacin, nalidixic acid, norfloxacin, imipenem, mecillinam and rifampicin.

The susceptibility of Bordetella pertussis to doxycycline, cinoxacin, nalidixic acid, norfloxacin, imipenem (N-formimidoyl-thienamycin), mecillinam and rifampicin was studied by agar and broth dilution. There were discrepancies between MICs registered on solid medium and in fluid medium. There seems to be a need for methodological studies on the antibiotic susceptibility of Bord. pertussis using different techniques. None of the compounds tested seemed to be realistic alternatives to the well documented erythromycin.

Amdinocillin↗
PubMed1985

Urinary beta 2-microglobulin, antimicrobial chemotherapy and infectious diseases.

A review of the literature concerning beta 2-microglobulinuria during treatment with antibiotics and during febrile conditions is presented. Aminoglycoside treatment in normally used therapeutic doses causes an impairment of the tubular reabsorptive capacity as evidenced by beta 2-microglobulinuria in the majority of patients. Increases in urinary beta 2-microglobulin can, however, not be used to predict clinical nephrotoxicity in the individual patient since the urinary concentration is dependent on several factors. The main indication for measuring urinary concentrations of this protein during aminoglycoside treatment is to compare the nephrotoxic potential of different aminoglycosides and possibly of other antimicrobial agents, e.g. cephalosporins. Fever causes a temporary impairment of the proximal tubular reabsorptive capacity with increases in the urine of several low molecular weight proteins, e.g. beta 2-microglobulin. It is therefore highly likely that this is the explanation of the beta 2-microglobulinuria seen in patients with pyelonephritis. The suggestion that measurements of urinary beta 2-microglobulin could be of value to determine renal involvement of urinary tract infections is therefore doubtful.

Aminoglycosides↗
PubMed1984

Influence of culture medium and inoculum size on susceptibility of Bordetella pertussis to antibacterial agents in vitro.

Experimental examples of different beta-lactam--organism combinations in vitro and in vivo are presented to demonstrate that a rationale for dosage regimens of antibiotics should not be based solely on pharmacokinetic parameters. The time course of the pharmacological response (onset and speed of bacterial killing) and the presence or absence of a postantibiotic effect must also be considered. such pertinent information can be derived from in vitro studies such as time-kill curves and regrowth curves of bacteria obtained at and after short exposure of the target organisms to various concentrations of the drug.

Anti-Bacterial Agents↗
PubMed1984

Incidence, predisposing factors and manifestations of invasive Haemophilus influenzae infections in adults.

A retrospective study was conducted on invasive Haemophilus influenzae infections in adults (greater than or equal to 16 years) for the period 1971-1983 in two regions in Sweden. The annual incidence was determined to be 1.1 per 100,000. Predisposing factors included advanced age, bronchopulmonary diseases, alcoholism, traumatic head injury, malignant diseases and pregnancy. Pleuropulmonary infections were the most common manifestations followed by epiglottitis, meningitis and septicaemia of unknown origin. A death rate of 8% was established. Both encapsulated and non-typable strains were found to be potentially pathogenic, but the non-typable strains had a lower virulence.

Adolescent↗
PubMed1984

Ceftazidime and renal function.

Glomerular filtration rate (GFR) as measured by 51Chrome-EDTA clearance, decreased with a mean of 10 ml/min during therapy with ceftazidime 2 g bid in 16 patients with initial GFR of 30 to 110 ml/min. A significant increase in the excretion of urinary alanine aminopeptidase was also found. In another three patients with initial GFR of 17-22 ml/min increases in serum creatinine during therapy were noted. These observations indicate that ceftazidime should be used with caution in patients with impaired renal function and not be combined with nephrotoxic drugs until the safety of such combinations has been studied.

Adult↗
PubMed1984

Bordetella pertussis whole cell vaccines--efficacy and toxicity.

The literature concerning efficacy and side effects of pertussis vaccines is reviewed. With few exceptions, most vaccines induce a protective immunity lasting for 2 to 5 years. The large-scale use of pertussis vaccines has markedly contributed to the decrease in pertussis morbidity in small children but in some countries the incidence has increased in older children. Not even countries with immunisation rates of 90-95% have managed to eradicate pertussis or prevent disease in infants below the age of immunisation. The pertussis-associated mortality is currently very low in the industrialised countries and no differences can be discerned when countries with high, low and zero immunisation rates are compared. Local and benign systemic reactions are commonly seen after immunisation. The vaccines also sometimes cause convulsions, a shock-like state and, rarely, serious neurological reactions.

Child↗
PubMed1984

Antibody responses to capsular polysaccharide, lipopolysaccharide, and outer membrane in adults infected with Haemophilus influenzae type b.

The antibody response to Haemophilus influenzae type b antigens as capsular polysaccharide, lipopolysaccharide, and outer membrane components was studied by enzyme-linked immunosorbent assay in 10 adults infected with this bacterium. Almost all patients had detectable amounts of immunoglobulins G and M antibodies specific to capsular polysaccharide, lipopolysaccharide, or outer membrane in their first serum sample. A significant antibody response in one or more antibody subclasses to capsular polysaccharide, lipopolysaccharide, and outer membrane was noted in 9 of 10, 7 of 10, and 7 of 10 patients, respectively. The occurrence of H. influenzae type b infections in adults cannot be completely explained either by the absence of antibodies against H. influenzae type b in their serum or by the failure to develop specific antibodies to the capsule or certain cell wall components even if these factors probably are important in some cases, e.g., in one patient who was splenectomized.

Adult↗
PubMed1983

In-vitro sensitivity of Bordetella pertussis.

The in-vitro effect of ampicillin, chloramphenicol, clindamycin, erythromycin, trimethoprim and trimethoprim-sulphamethoxazole against 152 strains of Bordetella pertussis was investigated. When tested against erythromycin, 96% of the isolated strains were inhibited by less than or equal to 1 mg/l. The other antibiotics did not inhibit the growth of Bord. pertussis at concentrations judged achievable in-vivo.

Ampicillin↗