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H B Krarup

Publications and source records attributed to H B Krarup.

8 recordsLinked to original sources

[Euricterus. A European database on icterus with emphasis on the Danish contribution].

Clinical and biochemical data were collected prospectively from 8032 jaundiced patients to form a database as part of a EU-supported project on computer-aided diagnosis. Patients were recruited prospectively from centres in all EU-countries and some other countries as well. Five hundred and twenty-eight jaundiced patients were collected from four centres in Denmark. Alcoholic cirrhosis, acute alcoholic liver disease and malignancy of the pancreas or the biliary tract were more common in the Danish data base: 49% of cases in Denmark as compared to 30% of cases in the international database. Viral hepatitis was underrepresented in Denmark, 16% as compared to 23% in the international group. A crude Bayesian diagnostic programme on the total database with 17 diagnostic groups achieved 63% accuracy. For the 528 Danish cases the diagnostic accuracy was 64% when the European data base was used, whereas it increased to 81% when only the Danish data base was taken as basis for the calculations. In conclusion, we found a drop in diagnostic accuracy for the Danish patients when using the large European data base instead of the national one.

Databases, Factual

Biochemical, virological and histopathological changes in Danish blood donors with antibodies to hepatitis C virus.

BACKGROUND: Previous studies have indicated that the presence of antibodies to Hepatitis C virus (HCV) is indicative of current HCV infection irrespective of S-alanine aminotransferase (S-ALT) values. STUDY DESIGN AND METHODS: Over three years, all confirmed anti-HCV-positive blood donors form the Blood Banks of Copenhagen County were consecutively evaluated. Seven women and 14 men with a median age of 34 years were included. Serum HCV-RNA was measured with an in-house developed single PCR. Liver biopsies were classified according to standard criteria. RESULTS: All were asymptomatic at presentation with no history of liver disease. Previous intravenous drug abuse and/or tattooing were identified in 16. Seventeen blood donors were evaluated biochemically and histologically. Serum HCV-RNA was detectable in 14, all of whom had histopathological changes in their liver biopsy including chronic active hepatitis and active cirrhosis. Twelve of the 14 HCV-RNA-positive donors had elevated S-ALT. In the three HCV-RNA-negative donors, S-ALT was normal. Two of these had normal liver biopsies, whereas the third had minimal changes. CONCLUSION: To diagnose and evaluate the activity of chronic HCV infection, liver biopsy and HCV-RNA assessment are essential in confirmed anti-HCV-positive individuals irrespective of symptoms and S-ALT levels.

Adult

The seroprevalence of hepatitis B and C in hospitalized Danish patients.

Health care workers are at risk of acquiring blood-borne infections. To assess the risk of exposure to hepatitis B or C in the case of occupational blood exposure, we determined the seroprevalence of these infections in 466 patients admitted to a Copenhagen university hospital. Serological markers for hepatitis B or C were detected in 56 patients (12.0%). The seroprevalence of HBsAg and anti-HCV was 0.9% and 1.5% respectively. HCV RNA, indicating ongoing hepatitis C, was found in five of seven anti-HCV-positive patients by polymerase chain reaction. The serological findings had not previously been diagnosed in 4 of 10 potentially infectious patients and only 6 of 10 patients belonged to high-risk groups. In conclusion, health care workers should be aware of the potential the occupational risk of hepatitis B and C even in a low-prevalence country like Denmark. Management of health care workers after blood exposure should include serological testing for both hepatitis B and C. Strict adherence to universal precautions is recommended and vaccination against hepatitis B should be encouraged.

Adolescent

[Hepatitis C].

Hepatitis C virus (HCV) was recognized in 1989 as the main cause of transfusion-related hepatitis non-A, non-B (HNANB) as well as sporadically-acquired HNANB infections. The HCV genome has been sequenced but the virus has not yet been visualized. Anti-HCV antibody tests have been developed, namely enzyme-linked immunosorbent assays (ELISA) for screening and recombinant immunoblot assay (RIBA) for confirmative testing of ELISA positive results. Since May 1991 all Danish blood donations have been tested for anti-HCV antibodies. Approximately 0.04% of Danish blood donors are 4-RIBA positive and have signs of chronic HCV infection based on ALT, HCV-RNA or histological findings. High-risk groups are intravenous drug abusers, haemophiliacs, haemodialysis patients and recipients of multiple blood transfusions. Approximately one third of the cases are sporadic, i.e. without obvious risk factors. Sexual transmission of HCV may occur, but this route is uncommon. More than half of the patients with acute HCV infection progress to chronic hepatitis C. Of these a considerable proportion develops cirrhosis and some eventually hepatocellular carcinoma. At present interferon (IFN) is the only registered therapy against chronic hepatitis C. Approximately half of the patients respond to treatment. The majority, however, relapse after stopping IFN treatment and only 20% maintain their response.

Hepacivirus

Diagnostic problems with meningococcal disease in general practice.

Based on general practitioners' referral letters and hospital records, we made a retrospective analysis of a cohort of 177 consecutive cases of meningococcal disease that occurred during a period of 10 years in the County of North Jutland, Denmark. The analysis concerned diagnostic problems in general practice, prognosis, pre-hospital antibiotic treatment and its effect on subsequent cultures, and degree of obligatory notification. The referring doctor suspected meningococcal disease/central nervous infection in 123 patients (69.5%). Neck stiffness and petechiae were related to a correct referral diagnosis, in contrast to the occurrence of a non-petechial rash. The presence of disseminated intravascular coagulation was associated with the mortality rate, which was 0.062. The therapeutic recommendations of the Danish Health Authorities were followed in only 25 of the 98 patients who fulfilled the criteria for pre-hospital parenteral antibiotic treatment. Pre-hospital antibiotic treatment was related to negative culture of spinal fluid or blood. Seven of the 177 patients were not notified according to the rules. Difficulties in pre-hospital diagnosis seem not to influence the lethal course of the disease.

Adolescent