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Biomedical subjects

K Melby

Publications and source records attributed to K Melby.

At least 37 records · Page 2Linked to original sources
PubMed1994

Reactive arthritis: incidence, triggering agents and clinical presentation.

OBJECTIVE: To study the incidence and presenting clinical and microbiological features in subgroups of reactive arthritides. METHODS: In a defined community and during a 2-year period, we studied prospectively patients between 18 and 60 years with onset of suspected reactive arthritis, primarily seen by general practitioners. RESULTS: Annual minimum incidence of Chlamydia induced arthritis (n = 25) was 4.6 and of arthritis triggered by enterobacteria (n = 27) 5.0/100,000 individuals between 18 and 60 years. Triggering infections were asymptomatic in 36 and 26%, respectively. Patients with self-limiting arthritis without identified triggering agents (n = 60, incidence 11.0/100,000) had a normal prevalence of HLA-B27 and a more heterogeneous pattern of arthritis. CONCLUSION: Our epidemiological study confirms suggested high incidence rates of reactive arthritides. Reactive arthritides must be considered in early arthritis, even without symptoms of triggering infections.

Adolescent↗
PubMed1993

[Prevalence of Chlamydia trachomatis in women applying for abortion in Oslo 1985-91].

The prevalence of Chlamydia trachomatis was investigated in a retrospective study of 17,215 women who requested termination of pregnancy at Ullevål and Aker hospitals in Oslo during the years 1985-89 and 1991. The overall prevalence of C trachomatis decreased from 11.3% (267/2,354) in 1985 to 3.8% (112/2,958) in 1991. The reduction was considerable from 1985 to 1989 but only slight at the end of the period. The prevalence was higher in younger women during the whole period. In women < 25 years old the prevalence decreased from 16.7% in 1985 to 6.3% in 1991, and in women > or = 25 years old from 5.9% in 1985 to 1.8% in 1991.

Abortion Applicants↗
PubMed1993

Release of cartilage macromolecules into the synovial fluid in patients with acute and prolonged phases of reactive arthritis.

OBJECTIVE: Extensive changes in articular cartilage metabolism occur during the acute phase of reactive arthritis, as indicated by altered release of cartilage macromolecules into synovial fluid (SF) demonstrated immunochemically. Nevertheless, permanent cartilage lesions are rare in this disease. To monitor specific events during the evolution of reactive arthritis, we investigated the content of cartilage macromolecules in sequentially obtained SF samples from 22 patients. METHODS: Two groups of proteoglycan epitopes, the glycosaminoglycan-rich region of aggrecan (referred to as proteoglycan) and its hyaluronan-binding region (HABr), as well as one matrix protein, cartilage oligomeric matrix protein (COMP), were quantified by immunoassay. RESULTS: SF proteoglycan concentrations, which were initially elevated, decreased significantly with prolonged arthritis, whereas COMP levels changed less markedly and levels of HABr remained stable. There was a positive correlation between SF and serum concentrations of COMP in samples obtained during the early phase of the disease. CONCLUSION: Cartilage involvement in reactive arthritis is transient, in contrast to findings in rheumatoid arthritis. Reactive arthritis should therefore be a suitable model for studies of repair processes in cartilage, which will facilitate understanding of the pathophysiology of cartilage involvement in arthritis.

Adult↗
PubMed1993

Evidence for absence of the MPB64 gene in some substrains of Mycobacterium bovis BCG.

Substrains of Mycobacterium bovis BCG have been divided in two major groups, high producers and low producers of the secreted proteins MPB64 and MPB70. Of these, Mycobacterium tuberculosis secretes only the analog MPT64 during growth on Sauton medium. It has been confirmed that high-producer and low-producer substrains of BCG as well as M. tuberculosis contain the gene for the MPB/MPT70 protein. By contrast, polymerase chain reaction and hybridization experiments are reported here which indicate that the MPB64 gene is absent in the BCG substrains Copenhagen, Pasteur, Glaxo, and Tice, in which previous methods did not permit distinction between secretion of small amounts or absence of the protein in culture fluids.

Antigens, Bacterial↗
PubMed1992

[Myocarditis and pericarditis in connection with Campylobacter jejuni infection].

We describe a case of myo/pericarditis related to infection with C. jejuni. The microbe was repeatedly isolated from faeces and the patient had specific IgA, IgM and IgG antibodies, detected in serum samples by means of a DIG-ELISA method. The condition is rare and the pathogenesis unclear. The case described may be the result of a primary infection or a reactive immune response.

Adult↗
PubMed1992

Ophthalmia neonatorum in northern Norway. I: Epidemiology and risk factors.

During one year, 1928 of all 1958 neonates born in the county of Troms in Northern Norway were followed until 6 weeks of age, regarding the development of ophthalmia neonatorum. Conjunctivitis was found in 364 cases (189 per 1000 neonates), including mild and self-limiting cases. In 14.5 cases per 1000 neonates the ophthalmia neonatorum was recorded as severe. Boys were more often affected than girls (P = 0.001). The age of the mother and obstetric events did not significantly influence the occurrence of conjunctivitis. 31.4% of the neonates received silver nitrate instillation. The frequency of conjunctivitis in the group with and without prophylaxis was 15.9 and 20.3%, respectively (P = 0.023). The incidence of chlamydial ophthalmia was 8 per 1000 neonates. At present, chlamydial ophthalmia is a common disease in neonates. Efforts should be made to screen fertile women for chlamydial genital infection and to encourage prompt microbiological examination in cases of ophthalmia neonatorum.

Adolescent↗
PubMed1992

Ophthalmia neonatorum in northern Norway. II. Microbiology with emphasis on Chlamydia trachomatis.

In a population of 1928 neonates in Northern Norway, ophthalmia neonatorum was diagnosed in 18.9%, including mild and self-limiting cases. Sixteen out of 269 (6.0%) cultured cases were positive for Chlamydia trachomatis. No gonococcal ophthalmia was seen. In neonates whose symptoms began in the maternity wards, the distribution of the isolated microorganisms (mainly Staphylococcus aureus) was different from those in whom symptoms began after discharge (mainly S. aureus, Staphylococcus species (coagulase-negative), Streptococcus viridans and C. trachomatis). Growth of C. trachomatis was significantly associated with the intensity of conjunctivitis (P less than 0.001). However, no sequelae could be demonstrated in the eyes at the age of 6 months. 60% of the neonates with chlamydial ophthalmia also suffered from rhinitis. 31.4% of the neonates received silver nitrate instillation, which had no significant influence on the frequency of chlamydial ophthalmia. General practitioners are often faced with chlamydial ophthalmia. In cases of ophthalmia neonatorum, a microbiological examination is recommended, as a guide to appropriate antibiotic treatment. The result of microbiological examination may also indicate other infections in mother and child. In areas with a readily available health service, including an adequate microbiological laboratory service, prophylaxis in the eyes does not seem to be necessary.

Adolescent↗
PubMed1992

Fasting hypochlorhydria with gram positive gastric flora is highly prevalent in healthy old people.

Fifteen healthy old people mean age 84 years (range 80-91 years), were examined to assess the effect of advanced age on the microecology of the upper gastrointestinal tract. Twelve of 15 (80%) were hypochlorhydric with pH 6.6 (0.3) (mean (SEM) and a mean bacterial count of 10(8) colony forming units (CFU) per ml (range 10(5)-10(10)) in fasting gastric aspirate. Normochlorhydric subjects had low counts (< or = 10(1) CFU/ml). The microbial flora was dominated by viridans streptococci, coagulase negative staphylococci, and Haemophilus sp. Only one subject harboured significant concentrations of Gram negative bacilli with Escherichia coli (10(4-5) CFU/ml) and Klebsiella (10(4-5)). Strict anaerobes were not found. The total concentration of short chain fatty acids in gastric aspirate was 10.6 (2.9) mmol/l (mean (SEM). Absence of significant, intraluminal fermentation of xylose to CO2 was shown by the 14C-d Xylose breath test, and ambulatory manometry showed preserved fasting motility pattern of the small intestine. Serum immunoglobulins were normal. Advanced age is accompanied by fasting hypochlorhydria and colonisation with mainly Gram positive flora in the upper gut. Other factors than old age and fasting hypochlorhydria are required for colonisation with Gram negative bacilli.

Achlorhydria↗
PubMed1991

Waterborne campylobacteriosis in northern Norway.

A suspected waterborne outbreak of presumed campylobacteriosis involving approximately 680 of the 1000 inhabitants in a community is described. Twenty-two strains of Campylobacter jejuni were isolated from patients. Ten randomly chosen isolates were identified as biotype 1 LAU 0:1 (n = 9) and biotype 2 PEN 0:6, 7 (n = 1) and one from tap water as biotype 1 PEN 0:19, 22. The majority of cases occurred within a period of 1 week. Examination of human sera obtained during the first 2 weeks of the epidemic (n = 38) revealed two patients producing antibodies directed only against the water isolate. The majority (89%) of sera collected 4 weeks later (n = 18) had antibodies directed against the most common human isolate. We suggest that all three serotypes of C. jejuni were involved in this outbreak, stressing the need for continuous surveillance and treatment of public drinking water sources.

Antibodies, Bacterial↗
PubMed1990

[Mastitis in general practice. Is bacteriologic examination useful?].

For a period of 22 months, postpartial women in Oslo were asked to consult one of several specific general practitioners in the event of mastitis. Clinical symptoms, bacteriological findings in breast milk and treatment were recorded in 43 patients. Patients with a favourable (n = 35) and with an unfavourable outcome (n = 8) defined as abscess, relapse and/or relief of symptoms after more than seven days, were compared. Unfavourable outcome was characterized by higher score of clinical symptoms and a higher isolation frequency of Staphylococcus aureus. The occurrence of fever did not differ between the groups. Bacteriological findings in milk from both breasts were compared with the findings from 100 milk donors. Staphylococcus aureus was more frequently isolated in milk from affected breasts than from unaffected and control breasts (17/40 versus 4/40 versus 4/100). Most of the Staphylococcus aureus strains (70%) were betalactamase producers. Coagulase negative staphylococci were a frequent finding in all milk samples, whereas Gram-negative bacteria were frequent only in the controls. The presence of pathogenic bacteria, as well as high bacterial counts, were associated with a higher number of symptoms. However, the predictive value of the bacteriological examination was low. Our study indicates that bacteriological examination of breast milk is justified only in patients with severe, acute symptoms and recurrences when betalactamase producing Staphylococcus aureus are suspected.

Family Practice↗
PubMed1990

Clinical and serological manifestations in patients during a waterborne epidemic due to Campylobacter jejuni.

A clinical and serological investigation of an epidemic due to Campylobacter jejuni in a community with a population of 1026 is presented. Altogether, 22 faecal samples from 27 patients were positive, with serotypes O 2 (n = 21) and O 6, 7 (n = 1) being identified. Serotype O 19, 21 was isolated from drinking water which had been consumed by 89.5% households answering a questionnaire, thereby indicating an attack rate of 66.5% (i.e. 680 persons). Mean duration of illness was 6.5 +/- 4.6 days. Diarrhoea (82.3%), abdominal pains (62.8%) and fever (41.8%) were the most common symptoms. Acute stage samples of serum from Campylobacter-positive patients had lower concentrations of IgG antibodies against the most common serotype (O 2) than against serotype O 6, 7 (P = 0.05), which had previously been implicated in epidemics in the region. More than 80% samples drawn after 1-2 weeks of illness were positive for either IgA, IgM or IgG antibodies to serotype O 2 with a dominance of IgA. In the convalescent group (n = 24), serum from only one patient who developed a long-lasting reactive arthritis had antibodies to all serotypes.

Adolescent↗
PubMed1990

Chlamydia trachomatis: in vitro susceptibility of genital and ocular isolates to some quinolones, amoxicillin and azithromycin.

The minimum inhibitory concentration (MIC) of ofloxacin, ciprofloxacin, norfloxacin, amoxicillin and a new erythromycin analogue (azithromycin or CP 62993) against Chlamydia trachomatis was determined. There was a large difference between the MICs (microgram/ml) of different quinolones (median of 3 independent measurements; range): ofloxacin (0.5; 0.5-1) less than ciprofloxacin (1; 1-2) less than norfloxacin (16; 16-32). The MIC of amoxicillin varied from 0.25 to 1 (median 0.5) in different experiments. The MIC of azithromycin (0.125; 0.063-0.25) was lower than that of erythromycin (0.25; 0.125-0.5). The minimum lethal concentration (MLC) of ofloxacin and azithromycin was determined with and without passage of the McCoy cells. Both methods gave the same results. Ofloxacin seemed to have a lethal effect on C. trachomatis, as the MIC and MLC were equal. In contrast, the effect of the MIC of azithromycin on C. trachomatis was bacteriostatic. The MLC of azithromycin was 2-4 times higher than the MIC (p less than 0.001).

Amoxicillin↗
PubMed1990

How reliable are the 14C-urea breath test and specific serology for the detection of gastric Campylobacter?

Detection of gastric Campylobacter by the 14C-urea breath test and serology were correlated to biopsy culture in 25 unselected outpatients referred for gastroscopy. All the 17 culture-positive patients had positive 14C-urea breath test, and 16 had positive serology. Of eight culture-negative patients, six patients had negative breath test and seven negative serology. A high degree of reproducibility was found when two subsequent breath tests were performed in 11 healthy volunteers. The breath test values obtained at 10 min showed a strong correlation (r = 0.97, p less than 0.001) to the accumulated values within 30 min. Breath sampling once, 10 min after intake of 2.5 microCi 14C-urea, seems sufficient for the detection of gastric Campylobacter. The 14C-urea breath test correlates well with biopsy culture and provides a sensitive tool for the detection of gastric Campylobacter. Serology also corresponds well with biopsy culture and should provide a useful tool for epidemiologic studies.

Adult↗
PubMed1990

Detection of serum antibodies against Borrelia burgdorferi with some commercially available serological tests.

Sixty-three sera were analysed for antibodies against Borrelia burgdorferi with an in-house indirect immunofluorescence assay. Thirty-nine sera were positive (titer greater than or equal to 256), seven borderline (titer 128) and 17 negative (titer less than or equal to 64). These results were compared with results obtained with four different commercial assays for detection of such antibodies. Indirect immunofluorescence tests yielded most positive results. The flagellin ELISA test detected antibodies in patients with erythema chronicum migrans (ECM) more often than the other test systems. Sera from patients with acrodermatitis chronica atrophicans (ACA) were positive in all systems. The serological diagnosis of borreliosis is difficult and direct methods for detecting the presence of the microbe are highly needed.

Antibodies, Bacterial↗
PubMed1990

Cultivation of Chlamydia trachomatis. Different methods of treating the specimens.

Specimens of Chlamydia trachomatis were treated either by five different detergents, by ultrasound sonication or by four different buffers before cultivation in cycloheximide-treated McCoy cells. The chlamydial yield by cultivation and the variance of the yield were compared to a standard method using 0.2 molar sucrose in phosphate buffered saline (2SP) without application of detergents or sonication. 2SP was superior to the other buffers. None of the detergents increased the chlamydial yield. Sonication at energy-levels above approximately 1200 Ws/ml reduced the chlamydial yield significantly. Sonication just below this threshold doubled the yield. None of the methods reduced the variance of the yield.

Analysis of Variance↗