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Biomedical subjects

I Lind

Publications and source records attributed to I Lind.

At least 19 recordsLinked to original sources
PubMed2006

The meaning of depression: Swedish nurses' perceptions of depressed inpatients.

People suffering from depressive disorder are affected by one of the western world's largest medical groups of disorders in both psychiatric and general medicine. Drug treatment is usually the first-line intervention and has been shown to be an effective treatment. Other therapies, including nursing interventions that could be implemented in care, are infrequently used. It is therefore important to understand whether nurses' perceptions of depressed people could be explained from the medical model by defining the nurses' view of psychiatric inpatients. Therefore, the aim of this study was, with the clinical picture as the starting point, to investigate the nurses' view of hospitalized patients with a diagnosis of depression. In this prospective study, 155 nurses' opinion of depression among depressive inpatients was assessed using a questionnaire based on the Montgomery-Asberg Depression Rating Scale. To elucidate the relationship between the variables in the questionnaire, factor analysis rotated by the Varimax method with Kaiser's normalization was used. The factor analysis identified five factors. The number of variables was reduced from 61 to 34. Based on the factor interpretation, an initial factor structure for the depressive inpatient was defined. The identified factors were interpreted and labelled to create the nurses' fused "picture" or meaning of the depressed inpatient as an individual who experienced feelings of annihilation, alienation, fatigue, emptiness and affliction, an individual who is disconnected from the whole of temporality.

Acute Disease↗
PubMed2005

Epidemiology of meningococcal disease in Denmark 1974-1999: contribution of the laboratory surveillance system.

The Danish meningococcal disease laboratory surveillance system was established in 1974, based on close collaboration between local Departments of Clinical Microbiology and the Reference Laboratory at Statens Serum Institut. The completeness of the clinical notification system integrated with the laboratory surveillance system has been estimated to be more than 95%. Overall 4257 (79%) of 5356 cases of meningococcal disease notified during 1974-1999 were confirmed by culture of Neisseria meningitidis. The proportion of culture-confirmed cases ranged from 70% in 1989 to 89% in 1980. Only 26 patients (0.6%) with culture-confirmed meningococcal disease were not notified. Serological phenotype and susceptibility to penicillin and sulphonamide were determined for all isolates. Multilocus enzyme electrophoresis and/or DNA-based analyses were used for the assessment of clusters and outbreaks. Meningococcal antibody tests and counter-immunoelectrophoresis were used for the ascertainment of suspected cases. These combined systems allowed timely and reliable management of outbreaks and identification of clusters.

DNA, Bacterial↗
PubMed2005

The meningococcal antibody test: how useful in the diagnosis of meningococcal disease?

Based on 9257 [correction] blood samples received from 7365 patients with a request for a meningococcal antibody test (MAT) during a 10-year period (1986-1995), the usefulness of the test in the diagnosis of meningococcal disease was assessed. Of 635 patients with culture-confirmed meningococcal disease, 88% were seronegative on admittance to hospital and 90% were seropositive 10-15 days after onset of disease. The humoral immune response in children <2 years of age was weaker than in older children and adults. Among 893 MAT-positive patients without culture-confirmed meningococcal disease, 261 (29%) had been notified as cases of meningococcal disease. Among 228 patients notified as serologically confirmed the MAT results were consistent with the clinical diagnosis in 86%. MAT is a reliable tool for establishing a diagnosis in patients with suspected meningococcal disease. Key factors facilitating appropriate interpretation of negative as well as positive test results were: time(s) of sampling(s) after onset of disease, age of the patient and clinical features.

Adolescent↗
PubMed2002

Period prevalence and case-fatality rate associated with distinctive clone complexes of Neisseria meningitidis serogroups B and C.

In a recent 20-year Danish survey, Neisseria meningitidis phenotypes B:15:P1.7,16 and C:2a:P1.2,5 were associated with an increased case-fatality rate of meningococcal disease - 15% and 23% - compared to the case-fatality rate of 8% for any other strain. The aim of the present study was to investigate (i) the mutual genetic relatedness of strains with phenotype B:15:P1.7,16, phenotype C:2a:P1.2,5 or serologically related phenotypes; (ii) the changes in the prevalence of distinctive clone complexes over time; and (iii) whether distinctive clone complexes are associated with an increased case-fatality rate. During the period 1980-1999, 181 of a total of 315 invasive strains obtained in North Jutland County, Denmark, were chosen on the basis of serological characteristics for characterization by multilocus enzyme electrophoresis and ribotyping. Two major complexes were identified on the basis of electrophoretic type (ET): the ET-4/23 complex ( n=111), which included all B:15:P1.7,16 strains ( n=100), and the ET-15/25 complex ( n=44), which included all C:2a:P1.2,5 strains ( n=31). Two ribotype complexes were identified within the ET-4/23 complex and one within the ET-15/25 complex, all of which were designated clone complexes. All three clone complexes were associated with an increased case-fatality rate (13-20%). The results show that, among invasive Neisseria meningitidis B:15:P1.7,16, C:2a:P1.2,5 and phenotypically related strains, three distinctive clone complexes are more virulent than any other ET/ribotype combination.

Bacterial Typing Techniques↗
PubMed2002

Relationship of Ureaplasma urealyticum biovar 2 to nongonococcal urethritis.

The aim of this study was to determine the frequency of Ureaplasma urealyticum biovars 1 and 2 among 340 men with or without nongonococcal urethritis (NGU) attending a venereal disease clinic in Sweden. NGU was defined by the presence of at least four polymorphonuclear leukocytes per microscopic field (x1,000 magnification) on a smear in which Neisseria gonorrhoeae could not be detected. Ureaplasma urealyticum was detected by polymerase chain reaction, and biovar determination was performed directly on the amplicons by liquid hybridization with biovar-specific probes. Patients with NGU were younger, had had more sexual partners, and exhibited symptoms of urethritis more often than patients without NGU. Ureaplasma urealyticum was detected with the same frequency among patients with and among those without NGU. Among patients with NGU, Ureaplasma urealyticum-positive men were more frequently symptomatic than Ureaplasma urealyticum-negative men. Among patients without NGU, Ureaplasma urealyticum-positive men had had more sexual partners than Ureaplasma urealyticum-negative men. Ureaplasma urealyticum biovar 2 was detected more often among patients with NGU than among those without (P=0.012). Logistic regression analysis was performed using detection of biovar 2 as the response variable and the following four variables as explanatory variables: presence or absence of NGU, symptoms of urethritis, number of partners, and age < or = 24 years. The only association found was that between Ureaplasma urealyticum biovar 2 and age < or = 24 years. More studies should be conducted to determine the possible pathogenic impact of Ureaplasma urealyticum biovar 2.

Adolescent↗
PubMed2002

Syphilis, gonorrhoea and chlamydial infection among women undergoing legal or illegal abortion in Maputo.

Our objectives were to compare the prevalence of sexually transmitted infections (STIs) in 103 women undergoing induced legal abortion (LA) and in 101 women with confirmed, recent illegal abortion (IA), in Maputo, Mozambique. For the purpose of this study, LA was considered the abortion provided in the Maputo Central Hospital with the approval of the Ministry of Health, and IA the one not provided through the approved facility, mentioned above. Women with IA were recruited in the outpatient gynaecology ward and women with LA in the emergency gynaecology ward in the Maputo Central Hospital, during the same time period. Serological tests for syphilis (rapid plasma reagin, ELISA-IgG and fluorescent treponemal antibody absorption), gonorrhoea (indirect haemagglutination) and chlamydia (microimmunofluorescence) were carried out. Direct immunofluorescence for detection of Chlamydia trachomatis antigen was done on endocervical smears from all the women. The prevalence of syphilis seropositivity in IA women is twice that of LA women (odds ratio [OR] 2.13; 95% confidence interval [CI] 0.55-9.95), with 10.9% and 4.9%, respectively. Exposure to gonorrhoea in these 2 groups is similar (OR 1.18; 95% CI 0.63-2.20), with seroprevalence of 31.1% in the LA and 34.7% in the IA group. The high titres are also similar in both groups. Serology findings for C. trachomatis indicate prevalence of seropositivity of 40.6% in the LA and 44.4% in the IA group with no significant difference (OR 1.17; 95% CI 0.64-2.13). In conclusion, STIs are highly prevalent in both IA and LA groups in Maputo. Urgent interventions are needed to reduce their prevalence and consequently their adverse consequences.

Abortion, Induced↗
PubMed2002

Antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in Nuuk, Greenland during 1998-1999.

Sixty-one gonococcal strains isolated in Greenland during 1998-1999 were tested locally for susceptibility to penicillin and ciprofloxacin by a disc diffusion method (Rosco) and at the reference laboratory in Copenhagen by the agar dilution method and the E-test, showed that more than 60% of the strains were less susceptible or resistant to penicillin (minimum inhibitory concentration [MIC] > or = 0.25 mg/L), indicating that penicillin should not be used as a first line drug for the treatment of gonorrhoea in Greenland. The Rosco disc diffusion method only identified 8% of strains as less susceptible to penicillin. Ciprofloxacin can still be used as a first line drug for treatment of gonorrhoea in Greenland since decreased susceptibility was only seen in one imported strain. However, the decreased susceptibility in this strain was not identified by the Rosco disc diffusion test, therefore the future local surveillance of antibiotic resistance in Neisseria gonorrhoeae will be based on MIC determinations.

Adolescent↗
PubMed2001

[Prevalence of Chlamydia among young men. A screening among men liable for military service and coming before the military board].

INTRODUCTION: Chlamydia is the most common sexually transmitted bacterial infection in Denmark. Each year 13-14,000 cases are diagnosed; of these about 3000 occur in men. In order to describe the prevalence of chlamydia among young men, screening for chlamydia was conducted in those liable for military service and coming before the medical board. MATERIALS AND METHODS: Of 2500 men coming before the medical boards in North Jutland State County, Arhus State County, and Copenhagen County during the winter of 1996-97, 1345 men aged 17-32 (median 18 years) were entered in the study. The participants sent a urine sample and a filled-in questionnaire to Statens Serum Institut. The urine samples were analysed by an in-house PCR and the test results were sent to the participant; if permission had been granted, the positive test results were further sent to the general practitioner, along with a second questionnaire. RESULTS: Chlamydia was found in 4.8% (65/1345) of all participants and in 6.9% of those sexually active. In North Jutland State County 7.1 and 9.8%, respectively, had chlamydia, whereas the corresponding figures for Arhus State County and Copenhagen County were about 4% and 6%. Two-thirds of the patients had no symptoms of urethritis. DISCUSSION: The results of this study indicate that a considerable reservoir of unrecognised chlamydia must exist in young men. The prevalence of chlamydia was higher in North Jutland State County than in the other two districts. One explanation could be that there is more focus on sexually transmitted infections and contact tracing in the largest cities than in the rest of the country.

Adolescent↗
PubMed2001

Relationship of Ureaplasma urealyticum biovars to the presence or absence of bacterial vaginosis in pregnant women and to the time of delivery.

In a nested case-control study, the occurrence of Ureaplasma urealyticum in cervical specimens from 84 women with idiopathic preterm delivery and from 400 women delivering at term was investigated. The two potential risk factors for preterm delivery, colonization with Ureaplasma urealyticum and bacterial vaginosis, were found to be interdependent variables. The association between these factors and preterm delivery was assessed by regression analysis. Neither colonization with Ureaplasma urealyticum (odds ratio [OR] 0.7, 95% confidence interval [CI] 0.4-1.2) nor bacterial vaginosis (OR 0.8, 95% CI 0.3-1.8) was associated with preterm delivery. In women who delivered preterm, biovar 2 was found significantly more often in those with the clinical diagnosis of bacterial vaginosis (43%) than in those without (5%) (OR 15, 95% CI 1.2-209).

Birth Weight↗
PubMed2001

Cluster analysis of Neisseria meningitidis type 22 strains isolated in Poland.

The aim of this study was to investigate the genetic relationships among strains belonging to Neisseria meningitidis serotype 22 recovered in Poland from 1995 to 1998. Phenotypical characterisation of meningococcal strains isolated from patients with meningococcal disease has been performed since 1995. Strains belonging to Neisseria meningitidis type 22 were most frequently recovered from severe cases of meningitis and septicaemia. The type 22 strains were separated into clusters by serosubtyping and DNA analyses by pulsed-field gel electrophoresis and ribotyping. However, the grouping according to serosubtypes was quite different from that obtained by ribotyping and pulsed-field gel electrophoresis. Furthermore, the two genotyping methods seldom identified the same clusters, nor were clusters identified among 26 Neisseria meningitidis type 22 strains recovered from patients hospitalised in five cities. Determination of the susceptibility to penicillin showed that a single strain was resistant (MIC, 2 mg/l) and that one-third (24/71) of the strains tested had reduced susceptibility (MIC range, 0.1-1 mg/l).

Adult↗
PubMed2001

Phenotypical and genotypical characterization of Neisseria meningitidis carrier strains isolated from Polish recruits in 1998.

The aim of this study was to investigate the Neisseria meningitidis carriage rate among two cohorts of Polish recruits upon entry to the military and during the first 2 months of their service, i.e. in the spring and autumn of 1998, and to characterize the meningococcal strains isolated. Pharyngeal swabs were taken four and five times from 151 and 168 men, respectively. Altogether, 81 and 180 meningococcal isolates representing 54 and 102 different strains were recovered. The overall rates of carriage in the spring and in the autumn were 36% and 61%, and, among recruits who submitted to sampling on at least three occasions, 39% and 55%. Eighty-three of 156 (53%) meningococcal carrier strains were nongroupable; among the remaining strains, serogroup B was predominant (32% of all carrier strains). In both surveys the predominant phenotype was Neisseria meningitidis NG:21:P1.7.

Adult↗
PubMed2001

Occurrence of trichomoniasis in women in Denmark, 1967-1997.

BACKGROUND: The Neisseria Unit at Statens Serum Institut (SSI), Copenhagen, Denmark administers laboratory surveillance systems for gonorrhea and chlamydia, however, no similar system has been available for trichomoniasis. OBJECTIVES: To describe changes in the occurrence of trichomoniasis in women and in the distribution according to age, and to compare these changes with those observed in women with gonorrhea or chlamydia. STUDY DESIGN: Data on the epidemiology of trichomoniasis were based on the annual laboratory records at the Neisseria Unit at SSI. Data on gonorrhea (1967-1997) and chlamydia (1994-1997) originated from the National Laboratory Surveillance Systems. RESULTS: During the period 1967 to 1997, the percentage of Trichomonas vaginalis-positive specimens showed a constant decrease from 19 to fewer than 2. The annual number of specimens received varied between a maximum of 31,626 in 1975 and a minimum of 3,291 in 1997. The median age of women with trichomoniasis increased from 31 to 39 years as compared with a change from 21 to 24 years in women with gonorrhea (1967-1997) and a median age of 22 years in women with chlamydia (1994-1997). CONCLUSIONS: A significant decline in the occurrence of trichomoniasis in women concurrent with a significant rise in the median age of women with the disorder was observed. During the periods investigated, women with trichomoniasis were significantly older than women with gonorrhea or chlamydia.

Adolescent↗
PubMed2001

Molecular basis of high-level ciprofloxacin resistance in Neisseria gonorrhoeae strains isolated in Denmark from 1995 to 1998.

In Denmark surveillance of the in vitro susceptibility to ciprofloxacin of Neisseria gonorrhoeae was established in 1990. The proportion of N. gonorrhoeae strains with decreased susceptibility or resistance to ciprofloxacin (MIC >/= 0.06 microg/ml) was low (0.3 to 2.3%) up to 1995. Between 1995 and 1998 the rate of less-susceptible and resistant strains rose from 6.9 to 13.2%. Among ciprofloxacin-resistant strains (MIC >/= 1 microg/ml), 81% were highly resistant (MIC >/= 4 microg/ml). Thirty-five N. gonorrhoeae strains (40 isolates) for which ciprofloxacin MICs were 4 to 32 microg/ml were investigated for the frequency and patterns of mutations within the gyrA and parC genes. The quinolone resistance-determining regions of the gyrA and parC genes were amplified by PCR, and the amplicons were directly sequenced. Alterations at Ser-91 and Asp-95 in GyrA and a single or double alteration in ParC were identified in 32 strains (91%). Ser-91-to-Phe and Asp-95-to-Gly alterations in GyrA were detected in 28 strains (80%). The most common ParC alteration, Asp-86 to Asn, was found in 19 strains (54%). The strains were analyzed for genetic relationship by pulsed-field gel electrophoresis (PFGE). The analysis showed that nine strains with the same mutation pattern in the gyrA and parC genes, originating from different geographical areas over 3 years, had the same PFGE patterns after SpeI as well as NheI digestion (only one strain with one band difference in the NheI pattern), suggesting that a resistant clone had spread worldwide. The results from this study strongly suggest that double gyrA mutations plus a parC mutation(s) play an important role in the development of high-level fluoroquinolone resistance in N. gonorrhoeae.

Anti-Infective Agents↗
PubMed2001

Diagnostic assessment of haemorrhagic rash and fever.

AIMS: To establish criteria for early distinction between meningococcal disease and other conditions with similar clinical features, and to identify other causes for haemorrhagic rashes accompanied by fever. METHODS: In a prospective study, 264 infants and children hospitalised with fever and skin haemorrhages were studied. RESULTS: We identified an aetiological agent in 28%: 15% had meningococcal disease, 2% another invasive bacterial infection, 7% enterovirus infection, and 4% adenovirus infection. Five clinical variables distinguished between meningococcal disease and other conditions on admission: (1) skin haemorrhages of characteristic appearance; (2) universal distribution of skin haemorrhages; (3) maximum diameter of one or more skin haemorrhages greater than 2 mm; (4) poor general condition (using a standardised observation scheme); and (5) nuchal rigidity. If any two or more of these clinical variables were present, the probability of identifying a patient with meningococcal disease was 97% and the false positive rate was only 12%. This diagnostic algorithm did not identify children in whom septicaemia was caused by other bacterial species.

Adenovirus Infections, Human↗
PubMed2000

Surveillance of cases of meningococcal disease associated with military recruits studied for meningococcal carriage.

Through a 14-months extended surveillance of meningococcal disease in Denmark, all 322 notified cases were investigated for possible connection with a military camp where 3 cohorts of recruits (n = 1069) were studied prospectively for meningococcal carriage. One case occurred in a recruit who was a constant non-carrier during the preceding 3 months. The invasive Neisseria meningitidis B:1:P1.1,7 strain was isolated from the pharynx only in 3 out of 17 room-mates (18%); the strains were identical as assessed by genotyping (PFGE and ribotyping). Two civilian cases outside the camp had direct contact with 2 recruits, but neither these 2 nor other recruits in the relevant divisions carried the invasive strains on any occasion. Six civilian cases had marginal relationship with the camp, but no contact with the recruits. In conclusion, pheno- and genotyping concordantly demonstrated a high carriage rate of the invasive strain among the room-mates to a recruit with meningococcal disease. Transmission to the patient most likely occurred shortly before onset of illness. The extended surveillance did, however, not identify any unexpected epidemiological links and restriction of antibiotic chemoprophylaxis to household/sleeping/kissing contacts in sporadic cases of meningococcal disease seems appropriate and relevant.

Adult↗
PubMed1999

Immunoglobulin A antibodies against Chlamydia pneumoniae are associated with expansion of abdominal aortic aneurysm.

BACKGROUND: The aim of this study was to examine the possible association between the progression of small abdominal aortic aneurysm (AAA) and chronic infection with Chlamydia pneumoniae. METHODS: Patients from a hospital-based mass screening programme for AAA with annual follow-up (mean 2.7 years) were included. After initial interview, 139 men aged 65-73 years with a small AAA underwent examination and blood sampling. Immunoglobulin (Ig) G and IgA titres against C. pneumoniae were measured by a microimmunofluorescence test. RESULTS: Some 83 (95 per cent confidence interval 74-93) per cent of the men had an IgA titre of 20 or more, or an IgG titre of 32 or more. Men with an IgA titre of 20 or more had a 48 per cent higher AAA expansion rate than those with a titre of less than 20 (3.1 versus 2.1 mm/year; P < 0.05). Multiple linear and logistic regression analyses showed that an IgA titre of 20 or more was a significant independent predictor of increased AAA expansion, adjusted for known risk factors of expansion. Initial AAA size and serum total cholesterol level were also predictors of expansion. CONCLUSION: A high proportion of men with a small AAA had signs of chronic infection with C. pneumoniae. Aneurysm progression correlated with evidence of chronic C. pneumoniae infection.

Aged↗
PubMed1999

The progression of lower limb atherosclerosis is associated with IgA antibodies against Chlamydia pneumoniae.

OBJECTIVE: to study the influence of serologically diagnosed chronic infection with Chlamydia pneumoniae on the progression of lower limb atherosclerosis in a group of disposed men. MATERIAL AND METHODS: the highest systolic brachial and lowest systolic ankle blood pressures were followed for an average of 2.7 years in 129 men aged 65-73 years with conservatively treated small abdominal aortic aneurysms. Blood samples were taken to measure low-density lipoprotein and IgA and IgG titres of antibodies against C. pneumoniae by a microimmunofluorescence test. RESULTS: the prevalences of seropositivity varied from 43 to 83% depending on the definition. The ankle-brachial blood pressure index of the IgA-seropositive [corrected] men decreases by 11%, while it decreased by 4.8% among IgA-seronegative men (p<0.05). The significant difference persisted in a multiple-regression analysis adjusting for age, smoking, initial systolic ankle BP, and initial brachial systolic or diastolic BP, but disappeared after adjusting for the level of low-density lipoprotein. CONCLUSIONS: C. pneumoniae infection is associated with the progression of atherosclerosis.

Aged↗