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Biomedical subjects

H Westh

Publications and source records attributed to H Westh.

53 records · Page 3Linked to original sources
PubMed1990

Antibiotic susceptibility and phage-type pattern of Staphylococcus aureus strains isolated from patients in general practice compared to strains from hospitalized patients.

Phage-type patterns and antibiotic susceptibility have been examined in 904 Staphylococcus aureus strains from general practice in the Copenhagen municipality, in 1107 strains from hospitals in the Copenhagen municipality and in 18,028 strains isolated in 1988 from inpatients all over Denmark. The phage-type patterns of the 3 materials were very similar except for a slightly higher frequency of group II strains among isolates from general practice (24% compared to 19%). Penicillin resistance was high (86-87%) in all materials. Resistance to tetracycline and erythromycin was more frequent in strains from general practice (8.6% and 3.8%) than in strains both from hospitals in the same area (3.6% an 2.2%) and in all Danish hospitals (5.3% and 2.4%). This indicates that the restrictive use of antibiotics in hospitals seems to have eliminated the previous preponderance of multiresistant staphylococci in hospitals compared to community acquired staphylococci. It even seems as if the less restrictive use of tetracycline and erythromycin in general practice has now inversed the situation.

Anti-Bacterial Agents↗
PubMed1990

Splenic abscesses: a review of 20 cases.

Splenic abscesses are rare. We present 20 new cases diagnosed in Denmark from 1982 to 1987. Five cases were diagnosed at autopsy. 10 were initially treated with splenectomy, 1 died. Five were treated with drainage and antibiotics resulting in 1 treatment failure who survived after splenectomy, and 1 death. The incidence of splenic abscesses in Denmark was 0.056% per 1,000 somatic hospital discharges per year or for the 5 cases discovered at autopsy 0.0049% per year of all hospital deaths. Splenic abscess should be suspected in the febrile patient with left upper quadrant tenderness and splenomegaly and the diagnosis confirmed by ultrasonography or computerized tomography. Treatment of choice is still splenectomy and antibiotics although favorable results have been achieved with drainage procedures in combination with antibiotics.

Abscess↗
PubMed1989

[Immune prophylaxis against hepatitis B virus].

Hepatitis-B infections can be prevented by vaccination. Although a safe and efficacious plasma-derived vaccine has been available in Denmark since 1983, only approximately 7,000 persons have been vaccinated. This was among other things due to an unwarranted suspicion that the vaccine could harbour HIV. A new hepatitis B vaccine produced by a recombinant yeast cell is without this stigma and the vaccine is cheaper. It is now time for an assessment of hepatitis B vaccination of employees and intensification of vaccination programs for high-risk persons. Screening procedures, vaccination schedules, efficacy studies and follow up programs are reviewed. Prospectives for new hepatitis B vaccines are described.

Hepatitis B↗
PubMed1989

[Hepatitis B prevention after occupational exposure].

The course of a programme for protection from hepatitis B after occupational exposure is assessed. Passive/active prophylaxis from hepatitis B was offered to 51 persons but only 28% completed the entire regimen. The programme for vaccination of staff prior to exposure must be intensified and not only this programme but also the protective programme after exposure must include reminders to individuals who do not follow the programme.

Health Workforce↗
PubMed1989

Development of erythromycin-resistance in Staphylococcus aureus as a consequence of high erythromycin consumption.

In a mixed ward for skin and venereology patients the erythromycin consumption was 6-8 fold higher than in other wards at the same hospital. Erythromycin-resistance occurred in 15.5% of the infecting Staphylococcus aureus strains isolated from this ward, compared with 3.5% in other wards of the hospital and 2.3% in Denmark as a whole. The resistant strains belonged to different phage-type patterns, but 18 out of 19 strains contained a 1.5 MDa plasmid and had an erythromycin-inducible resistance mechanism. Erythromycin resistance was frequent (approximately 10%) among Danish S. aureus strains in the years 1963 to 1969, mainly due to the spread of multiply-resistant strains of the 83A complex. During the last ten years, however, only 1-2% of the strains have been resistant, but a slow increase in resistance has taken place during the last three years among strains of all phage patterns including strains of group II, the 94, 96 complex and type 95.

Bacteriophage Typing↗
PubMed1989

Bacteraemia following orotracheal intubation and oesophageal balloon dilatation.

Asymptomatic bacteraemia following balloon dilatation was assessed in 20 adults with oesophageal stricture. Asymptomatic bacteraemia occurred in 12 of 19 patients. The source of the bacteraemia appeared to be the patients' oropharyngeal flora. The bacteraemia was not of clinical importance in our patients, but might lead to endocarditis in predisposed individuals.

Aged↗
PubMed1989

Erythromycin resistance in Danish Staphylococcus aureus hospital strains with emphasis on erythromycin consumption.

Erythromycin resistance was analyzed in 280,415 Danish Staphylococcus aureus strains isolated from hospitalized patients and phage-typed in the period 1967 to 1987. Multiresistant, erythromycin-resistant strains decreased during the whole period, while strains resistant only to penicillin and erythromycin increased after 1972. This increase coincided with an increase in erythromycin consumption in Denmark from 0.4 DDD/1000 persons/day in 1978 to 1.9, in 1987. Erythromycin consumption in nine large Danish hospitals was significantly associated with the level of erythromycin-resistant S. aureus at the hospitals.

Animals↗
PubMed1988

Prostaglandin E2 is a mediator of 5-hydroxytryptamine induced water and electrolyte secretion in the human jejunum.

Studies in the rat jejunum in vivo have shown that 5-hydroxytryptamine (5-HT) causes secretion of fluid and luminal release of prostaglandin (PG) E2. These effects can be blocked by indomethacin and ketanserin, which suggests that PGE2 may be an important intermediate in the transduction mechanism leading to 5-HT induced fluid secretion. To test this hypothesis in man 'steady state' perfusions (9 ml/min) were done in eight healthy volunteers using the triple lumen technique. The proximal jejunum was perfused with Ringer's solution which contained 51Cr-EDTA as a non-absorbable marker. Before and after the administration of indomethacin (1.0 mg/kg iv) the effects of exogenous 5-HT (10 micrograms/kg/min iv) on jejunal net transport of fluid and electrolytes and jejunal flow rate (JFR) of PGE2 were measured in 15-min periods for 2 x 60 minutes after a 60 minute control period. 5-HT reversed fluid and electrolyte absorption into profuse secretion (p less than 0.01, Duncan's multiple range test) and significantly increased JFR of PGE2 (p less than 0.01). Indomethacin partly restored fluid and electrolyte absorption (p less than 0.01) and inhibited JFR of PGE2 (p less than 0.05). These results provide further evidence in favour of the theory that PGs are involved in 5-HT induced intestinal fluid secretion.

Adult↗
PubMed1987

Pituitary-thyroid axis in critical illness.

Severe nonthyroidal illness has been claimed to cause secondary hypothyroidism. We reevaluated this concept measuring serum free T4 and free T3 by an ultrafiltration method and serum TSH by an ultrasensitive technique (detection limit, and serum TSH by an ultrasensitive technique (detection limit, 0.05 mU/L). Forty-five critically ill patients suffering from hepatic coma (n = 10), terminal cancer (n = 9), stroke (n = 8), and respiratory insufficiency not treated (n = 7) and treated (n = 11) with dopamine were studied. The mortality rate was 80%. No patients received glucocorticoids, and only patients in the last group received dopamine. Serum total as well as free thyroid hormone index values were grossly reduced in the majority of the patients. The 34 patients not receiving dopamine in general had normal values of serum free T4 (32 of 34) and free T3 (31 of 34), measurable TSH (33 of 34), and detectable TSH responses to iv TRH (33 of 34). In contrast, the dopamine-treated patients had reduced serum free T4 and TSH levels compared to normal subjects (P less than 0.05), as well as reduced TSH responses to TRH (P less than 0.01). Serum free T4 and free T3 were below the normal range in 3 patients and 1 patient, respectively, and serum TSH was below the detection limit in 2 patients. We conclude that critically ill patients with nonthyroidal illness not receiving dopamine have normal pituitary-thyroid function, whereas dopamine induces some degree of secondary hypothyroidism.

Adult↗
PubMed1984

X long-arm deletions. A review of non-mosaic cases studied with banding techniques.

A woman with secondary amenorrhoea and an X long-arm deletion (pter----q21:) is described and compared with 30 adult non-mosaic, banded cases. Approximately 50% of the patients had gonadal dysgenesis associated with a higher frequency of short stature and "Turner stigmata" than in women with indication of ovarian activity. It is suggested that preservation of bands Xq26----28 may be decisive for normal ovarian function.

Adolescent↗
PubMedDate not supplied

Bactericidal effect of penicillin, ampicillin, and amoxicillin alone and in combination with tobramycin against Enterococcus faecalis as determined by kill-kinetic studies.

Fifteen strains of Enterococcus faecalis, all clinical blood culture isolates from patients with endocarditis, were studied by kill-kinetic experiments using penicillin G, ampicillin and amoxicillin alone and in combination with tobramycin. The median minimal inhibitory concentrations (MIC), were penicillin 4 mg/l, ampicillin 2 mg/l, amoxicillin 2 mg/l and tobramycin 32 mg/l. Equipotent doses of the antibiotics (1/2 x MIC, 1 x MIC and 4 x MIC) were used in the kill-kinetic studies. Synergism was studied using a combination of 1/2 x MIC of the beta-lactam antibiotic and 8 mg/l of tobramycin. The bactericidal activity did not exceed 10(+3) cfu/ml at 5 hours for any single compound. After 5 h all three beta-lactam antibiotics in combination with tobramycin resulted in synergism, i.e. more than one hundredfold reduction of colony forming units (cfu) as compared to the most active single agent. Amoxicillin had a significantly higher bactericidal potential than ampicillin or penicillin both alone and in combination with tobramycin. The clinical significance of these findings warrants further studies in vivo.

Amoxicillin↗
PubMedDate not supplied

Hepatitis C virus antibodies in homosexual men and intravenous drug users in Denmark.

In order to evaluate the role of sexual transmission and parenteral transmission of hepatitis C virus (HCV) in homosexual men and intravenous drug users (IVDU) serum samples from 147 homosexual men and 126 IVDU were tested for anti-HCV. Anti-HCV was found in two (1.4%) of the homosexual men and in 123 (98%) of IVDU. The presence of anti-HCV could not be correlated to the presence of HBV markers or HIV-antibodies. HCV is widespread among Danish IVDU. Risk of sexual transmission seems low even though sexual contact is a much more prevalent risk factor than needle sharing.

Adult↗
PubMedDate not supplied

Streptococcus pneumoniae infections of the female genital tract and in the newborn child.

Streptococcus pneumoniae is not a part of the resident vaginal flora. However, in some women S. pneumoniae can be a transient part of the vaginal flora, and pelvic infection can occur, especially if a predisposing condition exists (e.g., use of an intrauterine contraceptive device, a recent birth, or gynecologic surgery). In the preantibiotic era, pneumococcal genital infection was more common than today, and the rate of lethality was high--26% for localized infection and 74% for peritonitis. During the last 25 years, all 24 patients reported worldwide survived their pneumococcal genital infections, including nine patients at our hospital; in contrast, five of 12 women died between 1938 and 1952. Pneumococci can rarely be isolated as the only pathogen in cases of bartholinitis. Neonatal S. pneumoniae disease with an early onset has an intrapartum pathogenesis. Of 23 reported pediatric patients (including one whom we treated), 48% died and 13% survived with neurologic sequelae. The prognosis for these children has not improved during the last 10 years.

Female↗