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Biomedical subjects

E Osterberg

Publications and source records attributed to E Osterberg.

34 records · Page 2Linked to original sources

[Scandinavian alcohol policy and future Europe].

Among the measures pertinent to Nordic alcohol policy neither age limits, information campaigns nor the issue of licences will be affected by a possible membership of EC. The Nordic countries stricter rules in this regard will be accepted. On the other hand it will probably be difficult to sustain the alcohol monopoly, the price policy, and the ban on advertisements. If the alcohol policy in the EC countries is imported to the Nordic area there is reason to believe that this will have dramatic consequences for the consumption of alcohol and alcohol-related problems in Finland, Iceland, Norway and Sweden.

Advertising↗

Efficacy of single-dose versus seven-day trimethoprim treatment of cystitis in women: a randomized double-blind study.

Single-dose trimethoprim treatment of cystitis was compared with 7-day treatment in a randomized double-blind study in primary health care. Consecutive female patients (613) with symptoms of lower urinary tract infection (UTI) and positive bacteriuria screening tests were enrolled. In 502 cases UTI was confirmed by urine culture. Follow-up was performed twice, after 2-3 and 5-6 weeks. Short-term efficacy could be evaluated in 425 cases and accumulated efficacy in 344. Short-term efficacy was 82% for single-dose and 94% for 7-day treatment (P less than .001). Accumulated efficacy was 71% for single-dose and 87% for 7-day therapy (P less than .001). Fewer adverse reactions were noted with single-dose therapy (not significant). The cure rate for UTI caused by P-fimbriated Escherichia coli was not different from that of other E. coli infections. Infections with Staphylococcus saprophyticus showed a lower cure rate than E. coli infections with the single-dose regimen (P less than .05 for short-term efficacy).

Adolescent↗

Female urinary tract infection in primary health care: bacteriological and clinical characteristics.

Female patients with symptoms of urinary tract infection (n = 1136) were studied in primary health care with respect to (a) clinical symptoms as predictors of bacteriuria; (b) relation between aetiological agent and clinical picture, especially for P-fimbriated Escherichia coli; and (c) clinical findings in cases with 10(2)- less than 10(5) CFU/ml of E. coli. Prevalence of bacteriuria (greater than or equal to 10(5) CFU/ml) was 61%. Concurrence of urgency/frequency and dysuria, short duration of symptoms and hematuria increased the probability of bacteriuria and were also significantly more frequent among cases with low counts of E. coli (10(2) less than 10(5) CFU/ml in pure culture or mixed flora) than among cases with sterile urine, indicating an aetiological role of E. coli in many of those cases. Infections with P-fimbriated E. coli were as benign as the P-fimbriae-negative. The rate of P-fimbriation was 29% in specimens containing greater than or equal to 10(5) CFU/ml of E. coli, 30% among specimens with less than 10(5) CFU/ml in pure culture and 10% in specimens containing less than 10(5) CFU/ml of E. coli in mixed culture. Patients infected with Klebsiella, Enterobacter or Proteus did not show a higher rate of previous urinary tract disease or anomalies.

Adolescent↗

Bacteriuria testing by the ATP method as an integral part in the diagnosis and therapy of urinary tract infection (UTI).

Rapid tests for bacteriuria have the highest value, if the test result is available while the patient is with the doctor. At the bacteriological laboratory rapid testing of samples obtained by mail may be cost-effective but is of little clinical value. In a previous study performed at a health care centre using conventional urine culture as a reference the ATP test came out as the most reliable one among several rapid bacteriuria tests. The present study was performed to see how the ATP test could be fitted into the routine of the health care centre. Female patients with UTI symptoms were asked to deliver a urine sample to the health care centre laboratory and to wait for the result before seeing the doctor. After having the symptoms confirmed the doctor based the diagnosis on the ATP value. A low ATP value ruled out UTI and a high ATP value confirmed UTI. In patients with an intermediary ATP value (10-50 nmol/l) a positive nitrite test was used to confirm UTI. Only those patients with intermediary ATP values and negative nitrite test had to wait for conventional urine culture. Thus in most patients the decision on antibiotic therapy or not was based on clinical symptoms and ATP results only. Antibiotics (trimethoprim) were given as single dose or as a conventional 7-day regime in a double-blind comparison. The correlation between the ATP method and conventional culture was good.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗

Health for all by the year 2000: alcohol and the Nordic countries.

One of the European targets in the "Health for all by the year 2000" programme is to reduce alcohol consumption significantly by the turn of the century. This article describes how this target, and especially the 25% goal included in it, has been adopted in the Nordic countries. With the exception of Denmark, alcohol has for a long time been regarded as a serious public health problem, and the reduction of total consumption of alcohol has been held as one of the most important ways of combating alcohol problems. In the 1980s Sweden and Norway have accepted the European 25% goal with the least reservations. In Finland the target has been regarded as unrealistic. Yet Finland, like Iceland, has accepted the goal of reducing total alcohol consumption but left the amount unspecified. In Denmark, controlling total alcohol consumption has been consistently held to be an irrelevant way to reduce alcohol problems. The alcohol policy measures suggested to reach the targets are the classical ones: price increases, restrictions in alcohol availability, and more efficient information and education. One cannot, however, avoid the observation that very few concrete measures have been taken so far and that many forces work against a reduction in alcohol consumption. The European alcohol target has affected alcohol policy in the Nordic countries in terms of target setting and programme design. It remains to be seen whether the forces advocating more restrictive alcohol control policy will be strong enough to generate concrete action plans and implement the accepted targets in actual alcohol policy measures.

Alcohol Drinking↗

Incidence of aerobactin-positive Escherichia coli strains in patients with symptomatic urinary tract infection.

A total of 323 Escherichia coli strains from children with primary acute non-obstructive pyelonephritis (n = 144) or cystitis (n = 56) and from adults with acute non-obstructive pyelonephritis (n = 66) or cystitis (n = 57) were examined for presence of the aerobactin-mediated iron uptake system and expression of P-fimbriae. Overall, pyelonephritogenic Escherichia coli strains were significantly more often aerobactin-positive (72%) than cystitis strains (42%) (p less than 0.001). Seventy-three percent of the isolates from children with acute pyelonephritis were aerobactin-positive compared to 54% of the cystitis strains (p less than 0.05). Pyelonephritogenic Escherichia coli strains from adults were also significantly more often aerobactin-positive (70%) than cystitis strains (30%) (p less than 0.001). The cystitis strains from children were more often aerobactin-positive than cystitis strains from adult patients (p less than 0.05). There was a significant correlation between presence of the aerobactin-mediated iron uptake system and expression of P-fimbriae in all strains (p less than 0.001).

Adolescent↗

Alcohol and traffic in Finland.

This paper describes historical trends in drunken driving and traffic accidents in Finland since 1930 and discusses the relationship between alcohol policy, alcohol consumption, and drunken driving. It first describes the development of laws dealing with drunken driving and actual punishments for drunken driving. Secondly, it describes quantitative changes in drunken driving and traffic accidents, giving particular attention to alcohol-related traffic accidents. Thirdly, it analyses the connection between alcohol consumption and drunken driving. Finally, the relationship between alcohol policy and alcohol consumption in Finland is discussed. The role of the alcoholic beverages industry is also scrutinized. The paper shows that there are links among alcohol control policy, alcohol consumption, drinking habits, drunken driving, and alcohol-related traffic accidents. However, these ties are manifested through numerous mediating factors and alcohol is not the sole decisive factor. The paper also shows that drunken driving in Finland has increased and that alcohol-related traffic accidents are an important social problem.

Accidents, Traffic↗

Evaluation of rapid methods for the detection of bacteriuria (screening) in primary health care.

The diagnostic performance of six methods for bacteriuria testing has been studied in 781 urine specimens obtained in primary health care, using conventional culture as reference method. The cut-off limits for classification of test results into positive and negative have been optimized with respect to diagnostic performance in primary health care. With optimized tests the following diagnostic efficiencies were obtained: Bacterial ATP, 0.94; Bacterial count in sediment, 0.93; Nitrite test, 0.92; Dipslide test, 0.92; White cell count in sediment; 0.87; Goffulocyte esterase test; 0.83. The diagnostic performance was also studied for all combinations of two tests. The highest diagnostic efficiency (0.96) was obtained by combining the ATP and dipslide tests. High diagnostic efficiencies can be obtained by a rapid primary test, using other tests for follow-up testing of specimens with intermediate or uninterpretable primary results. The most promising results were obtained by using ATP as the primary test, with follow-up testing of specimens with 3-25 nmol/l of ATP (12 per cent of the specimens). Follow-up testing by conventional culture resulted in overall diagnostic efficiency of 0.98. By performing the nitrite test on specimens with intermediary ATP-results, 81 per cent of the patients with UTI can be classified without culture. Only patients with intermediary ATP and negative nitrite results (10 per cent of the total number) will have to wait for final diagnosis based on conventional culture. Some alternative strategies to combine available methods are discussed in detail. Major advantages of the ATP test are that the test can be performed while the patients are waiting; it provides a numerical and objective result, and, in contrast to culture, it is not influenced by adhesion of bacteria to somatic cells.

Adenosine Triphosphate↗

Alcohol policy measures and the consumption of alcoholic beverages in Finland, 1950 - 1975.

The relationship between changes in alcohol policy measures and alcohol consumption is discussed on the basis of experiences in Finland during the period 1950 - 1975. Our examples of the effects of changes in alcohol policy measures on the consumption of alcohol show that these changes clearly affect the level of alcohol consumption. Alcohol policy measures which have visible short-term effects on consumption also frequently have long-term effects which are not revealed by consumption statistics. Changes in control measures clearly mould the structure of alcohol consumption by beverage class. When using the structure of the consumption as an indicator of drinking patterns one should, therefore, first examine if changes in the beverage structure are reflections of changing alcohol policy measures and the extent to which this happens.

Alcohol Drinking↗

Schizophrenia and rheumatic disease. A study on the concurrence of inflammatory joint diseases and a review of 58 case-records.

The coincidental occurrence of schizophrenia and rheumatoid arthritis is considered to be low in relation to the prevalence of the two diseases. In the present study, data from the patient statistics prepared by the Swedish Social Welfare Board were examined for the occurrence of rheumatic disease in schizophrenic patients. With the aid of the statistics and of questionnaires, 58 case-records were collected and studied. Very few cases were found of co-existing schizophrenia and inflammatory joint disease, rheumatoid arthritis in particular. There were, however, some cases of genuine schizophrenia and definite seropositive rheumatoid arthritis in the same patient. Rheumatoid arthritis is possibly uncommon also in combination with other psychiatric diseases that require hospital care. The ankylosing-spondylitis cases were over-represented in relation to the rheumatoid-arthritis cases included in the statistics from psychiatric care. Most of the 13 ankylosing-spondylitis patients whose case-records were studied had schizoaffective psychosis or atypical psychosis. The results of the investigation should be confirmed by epidemiological studies; this may contribute to the understanding of the aetiology of rheumatoid arthritis and of schizophrenia.

Adult↗