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Biomedical subjects

J Lassen

Publications and source records attributed to J Lassen.

At least 37 records · Page 2Linked to original sources

[Health effects of climatic changes--possible consequences for Norway].

In the year 2100 a global mean temperature increase of 2 degrees C, and a 50 cm rise in sea level are expected. An escalation in the intensity and duration of heat waves will increase mortality, whilst higher temperatures in cold regions may reduce it. On a global scale, vector-borne diseases such as malaria, dengue, yellow fever and some types of viral encephalitis are likely to increase. 50 to 80 million more cases of malaria could occur annually. Elevated temperatures and more frequent floods could cause an increase in salmonellosis, cholera and giardiasis. Indirectly, shortages of freshwater and foods may cause serious health problems. The world may see more environmental refugees. For Norway a temperature increase of 3-4 degrees C during winter and 2 degrees C in summer is expected, with more precipitation, especially in western parts. The possibility of the Gulf Stream turning at 40 degrees N and causing a temperature decrease of 10 degrees C, is not very likely. Malaria could reestablish itself in Europe, but hardly in Norway. The most harmful arthropod vector in Norway, the tick Ixodes ricinus, might extend its range into the most populated parts of the country. Marine algal blooms might increase the risk of cholera. Health problems caused by greater floods, poisonous algae and certain freshwater cercaria might increase.

Animals↗

Candida norvegensis: a fluconazole-resistant species.

Candida norvegensis has been an unusual cause of infections in humans. In Norway this species was isolated from eight patients from 1990 to 1996 and was of probable pathogenic significance in four of them. All isolates were resistant to fluconazole. The same was true for two C. norvegensis isolates from before 1940, and it is therefore assumed that the fluconazole resistance is inherent.

Adult↗

Bacterial resistance following subgingival and systemic administration of minocycline.

The aim of the present study was to compare total numbers of cultivable bacteria and prevalence of resistance to minocycline among periodontal bacteria following subgingival or systemic application of minocycline in patients suffering from periodontal disease. 10 adult patients were administered 2% minocycline ointment subgingivally into their periodontal pockets at baseline, week 2 and months 1, 3, 6 and 9. Patients had scaling/root planing at baseline and month 6. In addition, 10 patients undergoing scaling/root planing followed by a 10-day course of systemic minocycline therapy, were studied and compared with the subgingival application group. Bacterial samples were taken from the 4 deepest pockets before each subgingival application of the drug. The systemic administration group was sampled at baseline and at week 2, as well as months 1 and 3 after completing the antibiotic treatment. For each patient at each sampling, bacterial samples were pooled, diluted, seeded on parallel blood agar plates and incubated aerobically and anerobically. After incubation, 30 colonies were picked at random and transferred to blood agar plates supplemented with 10 micrograms/ml minocycline, to estimate prevalence of minocycline-resistant bacteria. The results of this study indicate that subgingival application of minocycline ointment resulted in an initial reduction in total numbers of cultivable bacteria, which then remained depressed during the full year of the study. No such observation was made in the systemic administration. Both in the subgingival and the systemic administration group, the % of cultivable aerobic and anaerobic minocycline-resistant bacterial strains increased transiently following administration of the drug, but returned to baseline levels within 3 months post-treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

[Hemolytic-uremic syndrome caused by verotoxin-producing Escherichia coli intestinal infection].

Enteric infections with verotoxin-producing Escherichia coli can progress to the haemolytic-uraemic syndrome. Several reports suggest that the incidence of verotoxin-producing E coli infections is increasing in the USA and Europe. Small epidemics of haemolytic-uraemic syndrome are usually traced to the ingestion of beef or dairy products. Epidemics of diarrhoea-associated haemolytic-uraemic syndrome have not yet been reported in Norway. We describe, for the first time in Norway, a sporadic case of haemolytic-uraemic syndrome that was associated with a verotoxin infection. Despite several life-threatening relapses the patient eventually made a good recovery after treatment with supportive therapy, plasma exchange, plasma infusions, corticosteroids, vincristine and ciprofloxacin. The authors stress the importance of continuing with intensive supportive therapy even when the prognosis seems hopeless.

Bacterial Toxins↗

[Global transmission of Salmonella--increased risk in Norway. Interdisciplinary measures are necessary to maintain Norway's favourable situation].

Over the last 20 years, Salmonella infections in humans have increased considerably in the industrialized world, including Norway. The situation has been characterized as a serious problem, with considerable economic, political and public health implications. In contrast to the situation in most other countries, a large majority of the Norwegian patients have contracted the infection abroad. The endemic level of salmonellosis in Norway is low, and the prevalence of Salmonella in Norwegian food products is negligible. Appropriate intersectorial actions are required to maintain Norway's favourable status. Such actions include: preventing import of infected food, feed, and live animals; ensuring good hygienic practices at all stages of production, processing, and preparation of food; maintaining the present good health status of meat producing animals; providing consumers with drinking water of adequate hygienic quality; and intensifying national and international collaboration to prevent and control salmonellosis.

Animals↗

Prevalence of antibodies to Yersinia enterocolitica O:3 among Norwegian military recruits: association with risk factors and clinical manifestations.

IgG antibody activity to Yersinia enterocolitica serogroup O:3 was detected in sera from 56 (7.4%) of 755 Norwegian military recruits, using an enzyme-linked immunosorbent assay. The highest prevalence was found among recruits from Oslo city (12/56, 21.4%). The recruits answered a questionnaire which covered demographic data, specific exposures, and clinical information. The following risk factors were found to be independently associated with IgG activity in logistic regression analysis: receiving drinking water from a private well (odds ratio (OR) = 3.40; p = 0.004), being a resident of Oslo city (OR = 2.99; p = 0.006), and living in eastern Norway (OR = 2.25; p = 0.015). By univariate analysis, living in an urban area was associated with IgG activity, but this factor did not independently affect risk. Present or previous contact with animals, including pigs, and travels abroad were not associated with an increased risk. Yersinia enterocolitica O:3 seropositive recruits were more likely to report previous surgery for suspected appendicitis than seronegative individuals (OR = 4.26; p = 0.0024). Among recruits with previous appendectomy, mesenteric lymphadenitis as the sole peroperative finding was more common in patients with IgG activity to Y. enterocolitica O:3 (4/7) than in seronegative patients (1/19) (p = 0.01). Recurrent diarrhea, steatorrhea or joint complaints were not associated with antibody activity.

Adult↗

Sources of sporadic Yersinia enterocolitica infections in Norway: a prospective case-control study.

Yersinia enterocolitica is a recognized cause of gastroenteritis in northern Europe. During October 1988-January 1990, a prospective case-control study was performed to address risk factors associated with sporadic Y. enterocolitica infections in southeastern Norway. Sixty-seven case-patients (mean age 23.4 years, range 8 months-88 years) and 132 age-, sex- and geographically-matched controls were enrolled in the study. Multivariate analysis of the data showed that persons with Y. enterocolitica infection reported having eaten significantly more pork items (3.79 v. 2.30 meals, P = 0.02) and sausage (2.84 v. 2.20 meals, P = 0.03) in the 2 weeks before illness onset than their matched controls; only one patient had eaten raw pork. Patients were also more likely than controls to report a preference for eating meat prepared raw or rare (47 v. 27%, P = 0.01), and to report drinking untreated water (39 v. 25%, P = 0.01) in the 2 weeks before illness onset. Each of these factors was independently associated with disease, suggesting a link between yersiniosis and consumption of undercooked pork and sausage products and untreated water. Efforts should be directed towards developing techniques to reduce Y. enterocolitica contamination of pork and educating consumers about (1) proper handling and preparation of pork items and (2) the hazards of drinking untreated water.

Adolescent↗

Topical metronidazole treatment in pouchitis.

Patients with pouchitis usually respond to oral metronidazole treatment, but side effects of the treatment are common. Eleven patients with pouchitis were given local treatment by instillation of metronidazole in doses of 40-160 mg daily into the reservoir. The effects of the treatment on the bacterial flora and short-chain fatty acids in reservoir contents, morphology of the ileal mucosa, and serum concentrations of metronidazole were studied. All patients responded to local administration of metronidazole. Three patients with chronic pouchitis remained well for 6 months, 3 years, and 4 years, taking 40 mg metronidazole daily. Three patients had one single treatment course, and four had repeated courses when they had recurrences. In one patient a continent reservoir had to be removed owing to a persistent ulcer causing chronic blood loss. The bacterial flora of reservoir contents showed no significant differences between patients with and without pouchitis. The number of anaerobic microorganisms and the concentration of short-chain fatty acids were reduced after metronidazole treatment. Serum concentrations of metronidazole were very low, and no patients experienced any side effects of the treatment. In conclusion, topical application of small doses of metronidazole relieved symptoms in most cases of pouchitis and was well tolerated, even as long-term treatment.

Adenomatous Polyposis Coli↗

Mixed bacteremia with Vibrio metschnikovii in an 83-year-old female patient.

An 83-year-old woman suddenly fell ill and was admitted to the hospital on suspicion of a heart attack. After admission she developed high fever, chills and malaise. Vibrio metshnikovii and Staphylococcus hominis were isolated from 2 separately obtained blood cultures. One of the cultures also yielded Escherichia coli. The patient's condition improved rapidly after treatment with ampicillin intravenously. To our knowledge, this is the fourth reported case of V. metschnikovii bacteremia in humans.

Aged↗

Yersinia enterocolitica: an inducer of chronic inflammation.

The aim of the present study was to elucidate the connection between yersiniosis and chronic inflammation. During the period 1974-83, Yersinia enterocolitica infection was diagnosed in 458 hospitalized patients by antibody response, or isolation. The patients were followed for 4-14 years (1987); 160 were readmitted with chronic disease. Fifty-three patients had persistent joint complaints, 18 developed ankylosing spondylitis, 14 rheumatoid arthritis, and 17 iridocyclitis. Thirty-eight patients suffered from chronic abdominal pain, and another 28 from chronic diarrhoea. Two who underwent proctocolectomy microscopically had ulcerative colitis. Eleven patients developed neurological disease; others developed conditions such as chronic nephritis, thyroid disease, insulin-dependent diabetes, etc. Chronic hepatitis, found in 22 patients, was significantly correlated with positive test for antinuclear antibody and rheumatoid factor, and with death. Several patients developed chronic multiorgan disease, probably with chronic hepatitis as pivot. Regarding the whole material, the difference between observed and expected cumulative survival rates remained significant for 8 years (0.9189 < 0.9456; p < 0.025), indicating a substantial impact on long-term survival exerted by chronic yersiniosis.

Adolescent↗

Could development of malignant mesothelioma be induced by Yersinia enterocolitica infection?

Two out of 458 hospitalized patients with Yersinia enterocolitica infection developed malignant mesothelioma of pleura viz. pericard; both died after a few months. Malignant mesothelioma of the pleura is commonly related to asbestos exposure, whereas pericardiac mesothelioma is an extremely uncommon neoplasm. The possible promotion of malignant mesothelioma by the Yersinia enterocolitica infection should not be disregarded, as the infection may launch chronic immunological reactions resembling those observed among asbestos workers.

Adult↗

Yersinia enterocolitica infection--an unrecognized cause of acute and chronic neurological disease? A 10-year follow-up study on 458 hospitalized patients.

The purpose of the present study was to obtain further information about nervous system involvement associated with Yersinia enterocolitica infection. During the period 1974-1983, the infection was diagnosed by antibody response (agglutination titer or ELISA) and/or isolation of the microorganism in 458 hospitalized patients. 2 patients presented with acute symptoms of the peripheral nervous system, and 6 with symptoms of the central nervous system. The 458 patients were followed for 4-14 years (until 1987). During the follow-up period another 6 patients developed chronic neurological conditions; 4 with peripheral symptoms, and 2 with central symptoms. 11 of the 14 patients experienced persistent complaints. In 1991 (10-17 years after the diagnosis of yersiniosis), 6 patients still had significant antibody response (ELISA). The possibility that the immunologically competent Yersinia enterocolitica might have initiated the chronic neurological disease in these patients should not be disregarded.

Acute Disease↗

Prevention of transmission of resistant bacteria between periodontal sites during subgingival application of antibiotics.

This study was designed to investigate whether antibiotic resistant micro-organisms are able to contaminate and survive on syringe tips used for subgingival deposition of antibiotics, and to test simple and effective means of disinfecting the syringe tip between applications. In the first part of the study, syringe tips used for application of Minocycline subgingival formula in 20 adult periodontitis patients were cultured for bacteria resistant to this drug before and after disinfecting them with ethanol. The results showed that 80% of the unwashed syringes were culture positive for minocycline resistant bacteria, whereas only 1 ethanol washed syringe tip was contaminated. In part II of the study, after dispensing minocycline periodontal formula in 20 patients, 10 of the syringe tips were washed with ethanol while 10 were left untreated. All syringes were stored in a refrigerator for 8 days, whereafter the tips were sampled for resistant bacteria. 20% of the unwashed tips were contaminated after 8 days incubation at 4 degrees C. None of the ethanol washed syringe tips were culture positive. We conclude that syringe tips may be contaminated with antibiotic resistant bacteria after dispensing the antibiotic in periodontal pockets. The transmission of these bacteria to other periodontal sites may be avoided by disinfecting the syringe tip with ethanol between applications. We have also shown that antibiotic resistant bacteria may survive on the syringe tip following 8 days storage in a refrigerator, suggesting that syringes used for subgingival deposition of an antibiotic should not be stored for reuse.

Aged↗