Biomedical subjects

M Madsen

Publications and source records attributed to M Madsen.

At least 91 records · Page 5Linked to original sources

PubMed1999

The Danish National Hospital Register. A valuable source of data for modern health sciences.

The Danish National Hospital Register (LPR) has collected nationwide data on all somatic hospital admissions since 1977, and since 1995 data on outpatients and emergency patients have been included as well. Numerous research projects have been undertaken in the national Danish context as well as in collaboration with international teams, and the LPR is truly a valuable source of data for health sciences, especially in epidemiology, health services research and clinical research. Nearly complete registration of somatic hospital events in Denmark is combined with ideal conditions for longterm follow-up due to the existence of a national system of unique person identification in a population of relative demographic stability. Examples of studies are provided for illustration within three main areas: I: Using LPR for surveillance of the occurrence of diseases and of surgical procedures, II: Using the Register as a sampling frame for longitudinal population based and clinical research, and III: Using the Register as a data source for monitoring outcomes. Data available from the Register as well as studies of the validity of the data are mentioned, and it is described how researchers may get access to the Register. The Danish National Hospital Register is well suited to contribute to international comparative studies with relevance for evidence-based medicine.

Denmark↗

PubMed1999

Design of a system for monitoring antimicrobial resistance in pathogenic, zoonotic and indicator bacteria from food animals.

DANMAP is a Danish programme for integrated monitoring of and research on antimicrobial resistance in bacteria from food animals, food and humans. The paper describes how bacteria from broilers, pigs, and cattle are collected, as well as the procedures for data handling and presentation of results. The bacteria from animals include certain pathogens, selected so that they are representative for submissions to Danish diagnostic laboratories, as well as zoonotic bacteria (Campylobacter, Salmonella and Yersinia) and indicator bacteria (E. coli, E. faecium and E. faecalis), from samples collected at abattoirs. The latter samples are selected so that they are representative of the respective animal populations. Therefore, the apparent prevalence of antimicrobial resistance in the populations may be calculated. The isolates are identified to species level and the results of susceptibility testing are stored as continuous variables. All isolates are maintained in a strain collection so that they are available for subsequent research projects. The data handling facilities makes it possible to present results as percent resistant isolates or as the apparent prevalence of resistance in the population, or alternatively as graphical distributions of mm inhibition zones or MIC values. Computer routines have been established that make it possible to detect specific phenotypic expressions of resistance that may be of particular interest.

Animals↗

PubMed1998

[Mortality during the first six years after cholecystectomy. A review of all cholecystectomies in women in Denmark during 1977-1981].

It has been a prevailing assumption that cholecystectomy patients by and large follow a pattern of survival similar to that of the normal population. This paper presents a population-based study of the long-term survival after cholecystectomy in order to reassess this assumption. Based on data available in the Danish National Hospital Register, the records of all Danish women who were operated between 1977 and 1981 were examined and studied up to six years subsequent to surgery. Cholecystectomy patients who were free of diagnosed cancer and who had no major co-surgery (n = 11,123) were compared to both hysterectomy patients and a sample of the female population. Adjusting for age and other covariates, patients with psychiatric hospital admissions prior to surgery experienced a threefold risk of dying within six years after surgery. Patients with prior somatic admissions and patient with acute admissions had a relative risk (RR) of about 1.5. Cholecystectomy patients had a significantly increased mortality when compared to hysterectomy patients, RR = 1.3 (1.1-1.6), and to the population sample. Heart diseases and cancer occurred significantly more often as causes of death among cholecystectomy patients when compared to hysterectomy patients, but our data suggest that the occurrence of many other causes of death may be increased among cholecystectomy patients as well. The authors concluded that cholecystectomy patients are subject to relatively higher levels of mortality than previously assumed in parts of the literature. Furthermore, the increase seems to be attributable to a multitude of causes of death. The most likely explanation of the excess mortality among cholecystectomy patients is that gallbladder patients are relatively fragile. Indeed, with this vulnerable group of patients the potential trauma of the surgical intervention itself needs careful consideration.

Adult↗

PubMed1998

Perioperative thirst: a patient perspective.

Many institutions continue to require surgery patients to take nothing by mouth after midnight despite current research that supports allowing most patients to drink fluids up to 3 hours before surgery. This study of 50 elective surgery patients describes their perceptions of discomfort caused by thirst. Results show that thirst caused significantly more discomfort to the patient than not being able to eat or sleep or worrying about the surgery itself. Given these results, nurses are urged to work within their institutions to change the current practice regarding preoperative fluid restriction.

Adult↗

PubMed1998

Validity of SmaI-defined genotypes of Campylobacter jejuni examined by SalI, KpnI, and BamHI polymorphisms: evidence of identical clones infecting humans, poultry, and cattle.

We describe here an examination of the validity of molecular types of Campylobacter jejuni as defined by separation of SmaI-digested DNA using pulsed-field gel electrophoresis (PFGE), recently suggested as part of a molecular subtyping scheme. Thirty-four Danish strains from humans, water, poultry and cattle were assigned to one of six SmaI 'profile groups' (PGs), with two additional strains included as genotypically distinct controls. The interstrain relationships were reexamined by PFGE of SalI, KpnI and BamHI-digested DNA, and also by serotyping with heat-stable antigens. All outbreak-related strains were indistinguishable by all criteria, as were two sets of two randomly-isolated human strains. Two groups of indistinguishable isolates contained randomly isolated strains from more than one source (poultry, humans and/or cattle), a finding with significant epidemiological connotations. All 'genetically identical' strains belonged to the same serotype, whereas genetic differences were detected between strains assigned to the same SmaI PG but differing in serotype. We conclude that PFGE-based genetic fingerprinting can yield invaluable data for epidemiological studies of sporadic C. jejuni infection, but that results based on one restriction site polymorphism must be checked with another enzyme.

Animals↗

PubMed1998

Subbandage pressure measurements comparing a long-stretch with a short-stretch compression bandage.

Forty-three patients with venous leg ulcers were randomized into treatment with either a long- or a short-stretch compression bandage. Subbandage pressure was regularly measured during rest and walking for a period of up to 1 year. The long-stretch bandage was kept on as long as possible, often up to 1 week. It maintained a significantly higher subbandage pressure in the upright position and during passive dependency as well as during walking than the short-stretch bandage after both 2 and 24 h. The difference between maximum and minimum subbandage pressures during walking did not differ between the two groups. Thus, in contrast to general opinion, the short-stretch bandage did not produce a higher peak working pressure than the long-stretch bandage. The pressure decreased in the supine position in both groups.

Bandages↗

PubMed1998

Antiemetic efficacy of prednisolone: a placebo-controlled trial in patients with advanced prostatic cancer treated with estramustine phosphate.

The antiemetic effect of prednisolone on nausea/vomiting was investigated in 67 patients with advanced prostatic cancer and a performance status of < or = 2. The study was a double-blind, placebo-controlled, randomized trial with a parallel group design. The objective was to compare the incidence and severity of nausea/vomiting between the two groups. Prednisolone or placebo was given twice daily for 3 weeks with the dose decreased during the third week from 15 mg/day to 10 mg for 3 days and finally to 5 mg/day during the last 4 days. EMP was given as two 140 mg capsules daily for 3 days at the beginning, then as four capsules for 4 days followed by six capsules for 21 days. Areas under curves (AUCs) for nausea and for nausea/vomiting scores were calculated based on the patient's diary notes: nausea (0-3), vomiting (0-6), nausea/vomiting (0-9). Control of emesis in terms of complete, moderate or poor control was registered. Pretreatment characteristics were evenly balanced. The results indicated that no statistical differences between the two groups of patients were present in AUCs for weeks 1-3 or weeks 1-4. We conclude that it was not possible to demonstrate a significant antiemetic efficacy of prednisolone. However, in all but one case the patients in the prednisolone group could be treated for at least 3 weeks without any major incidents of nausea/vomiting.

Aged↗

PubMed1998

Typhaea stercorea (Coleoptera: Mycetophagidae), a carrier of Salmonella enterica serovar Infantis in a Danish broiler house.

In December 1994, Salmonella enterica serovar Infantis (S. Infantis) was accidentally introduced into a Danish broiler house by stocking an S. Infantis-infected broiler flock of 39,900 day-old chicks. At the time of the study, the infection had persisted through 6 broiler cycles. Typhaea stercorea (L.), the hairy fungus beetle, was found in large quantities inside and around the broiler house. Various attempts to control the beetle had failed; T. stercorea had been uncontrollable on the farm since Alphitobius diaperinus (Panzer), the lesser mealworm, was eradicated approximately 10 yr earlier. We investigated the ability of T. stercorea to act as a carrier of S. Infantis in the broiler house between 2 broiler cycles. We examined the empty, cleaned, and disinfected broiler house for S. Infantis 3 d before stocking the 7th broiler flock, and S. Infantis was isolated from the beetles only. Of 20 singly examined T. stercorea, 9 (45%) were S. Infantis positive. A rapid spread of the infection was seen in the 7th broiler flock; 100% of the culled chicks were S. Infantis positive 3 d after stocking. Under experimental conditions chicks were observed eating beetles, and when 5 d-old, specified pathogen-free chicks were fed with S. Infantis-positive T. stercorea collected from the broiler house, all 5 chicks became infected in 4 d. We conclude that T. stercorea may act as a potential carrier of S. Infantis between successive broiler cycles.

Animal Feed↗

PubMed1998

Desulfobulbus rhabdoformis sp. nov., a sulfate reducer from a water-oil separation system.

A mesophilic, Gram-negative, rod-shaped, marine, propionate-oxidizing sulfate reducer (strain M16T) was isolated from a water-oil separation system on a North Sea oil platform. The optimum conditions for growth were 31 degrees C, pH 6.8-7.2 and 1.5-2.0% (w/v) NaCl and 0.1-0.3% (w/v) MgCl2.6H2O in the medium. The growth yield with sulfate was 4.6 g cell biomass (mol propionate oxidized)-1. Strain M16T is nutritionally related to members of the genus Desulfobulbus, but differs in that it has no vitamin requirement and is able to utilize fumarate and malate as carbon and energy sources. Hydrogenase activity measured as hydrogen uptake was mainly membrane-bound and varied with the growth substrate. Highest activity [28 mumol min-1 (mg protein)-1] was found in cells grown with hydrogen and lowest [50 nmol min-1 (mg protein)-1] in cells grown with propionate as electron donors for sulfate reduction. Desulforubidin, menaquinone-5(H2) and cytochromes of the c- and b-type were present. The fatty acid pattern was similar to that found for Desulfobulbus propionicus. The DNA base composition was 50.6 mol% G + C. Strain M16T is equidistantly related to D. propionicus and Desulfobulbus elongatus with 96.1% 16S rDNA similarity. On the basis of differences in genotypic, phenotypic and immunological characteristics, strain M16T (= DSM 8777T) is proposed as the type strain of a new species, Desulfobulbus rhabdoformis.

Bacterial Proteins↗

PubMed1998

Petrotoga mobilis sp. nov., from a North Sea oil-production well.

Rod-shaped, thermophilic bacteria with a sheath-like outer structure (toga) were isolated from hot oilfield water of a North Sea oil reservoir. One of the isolates, designated SJ95(T), is an obligately anaerobic, sheathed, Gram-negative, fermentative bacterium capable of reducing elemental sulfur to hydrogen sulfide and tolerating high salt concentrations. The optimum growth conditions for this isolate are 58-60 degrees Celsius and pH 6.5-7.0 with 3-4% NaCl and 0.7% MgSO(4). 7H(2)O in the medium. Vitamins are required for growth. Growth is stimulated by yeast extract. Cells of strain SJ95(T) vary in size from 1-2 to 40-50 micron in length and are motile with a subpolar flagellation. Cels grown on xylan have xylanase activity, presumably associated with the toga, and glucose isomerase activity was detected in xylose-grown cells. The DNA G+C content is 31 and 34 mol%, determined by the thermal denaturation and HPLC methods, respectively. Phylogenetically, strain SJ95(T) is most closely related to Petrotoga miotherma with a 97.7% similarity level between their 165 rDNA sequences. The DNA-DNA reassociation value between the two DNAs was 35.6%. On the basis of differences in genotypic, phenotypic and immunological characteristics, strain SJ95t (=DSM 10674t) is proposed as the type strain of a new species, Petrotoga mobilis. It can be readily distinguished from P. miotherma by its motility.

Base Composition↗

PubMed1998

Resistance to antimicrobial agents used for animal therapy in pathogenic-, zoonotic- and indicator bacteria isolated from different food animals in Denmark: a baseline study for the Danish Integrated Antimicrobial Resistance Monitoring Programme (DANMAP).

This study describes the establishment and first results of a continuous surveillance system of antimicrobial resistance among bacteria isolated from pigs, cattle and broilers in Denmark. The three categories of bacteria tested were: 1) indicator bacteria (Escherichia coli, Enterococcus faecalis, Enterococcus faecium), 2) zoonotic bacteria (Campylobacter coli/jejuni, Salmonella enterica, Yersinia enterocolitica), and 3) animal pathogens (E. coli, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Staphylococcus hyicus, Actinobacillus pleuropneumoniae). A total of 3304 bacterial isolates collected from October 1995 through December 1996 were tested for susceptibility to all major classes of antimicrobial agents used for therapy in Denmark. Bacterial species intrinsically resistant to an antimicrobial were not tested towards that antimicrobial. Acquired resistance to all antimicrobials was found. The occurrence of resistance varied by animal origin and bacterial species. In general, resistance was observed more frequently among isolates from pigs than from cattle and broilers. The association between the occurrence of resistance and the consumption of the antimicrobial is discussed, as is the occurrence of resistance in other countries. The results of this study show the present level of resistance to antimicrobial agents among a number of bacterial species isolated from food animals in Denmark. Thus, the baseline for comparison with future prospective studies has been established, enabling the determination of trends over time.

Animal Diseases↗

PubMed1998

Surveillance of antimicrobial resistance in bacteria isolated from food animals to antimicrobial growth promoters and related therapeutic agents in Denmark.

This study was conducted to describe the occurrence of acquired resistance to antimicrobials used for growth promotion among bacteria isolated from swine, cattle and poultry in Denmark. Resistance to structurally related therapeutic agents was also examined. Three categories of bacteria were tested: 1) indicator bacteria (Escherichia coli, Enterococcus faecalis, Enterococcus faecium), 2) zoonotic bacteria (Campylobacter, Salmonella, Yersinia enterocolitica), and 3) animal pathogens (E. coli, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Staphylococcus hyicus, Actinobacillus pleuropneumoniae). All antimicrobials used as growth promoters in Denmark and some structurally related therapeutic agents (in brackets) were included: Avilamycin, avoparcin (vancomycin), bacitracin, carbadox, flavomycin, monensin, olaquindox, salinomycin, spiramycin (erythromycin, lincomycin), tylosin (erythromycin, lincomycin), and virginiamycin (pristinamycin). Bacterial species intrinsically resistant to an antimicrobial were not tested towards that antimicrobial. Breakpoints for growth promoters were established by population distribution of the bacteria tested. A total of 2,372 bacterial isolates collected during October 1995 to September 1996 were included in the study. Acquired resistance to all currently used growth promoting antimicrobials was found. A frequent occurrence of resistance were observed to avilamycin, avoparcin, bacitracin, flavomycin, spiramycin, tylosin and virginiamycin, whereas resistance to carbadox, monensin, olaquindox and salinomycin was less frequent. The occurrence of resistance varied by animal origin and bacterial species. The highest levels of resistance was observed among enterococci, whereas less resistance was observed among zoonotic bacteria and bacteria pathogenic to animals. The association between the occurrence of resistance and the consumption of the antimicrobial is discussed. The results show the present level of resistance to growth promoters in bacteria from food animals in Denmark. They will form the baseline for comparison with future prospective studies, thereby enabling the determination of trends over time.

Animals↗

PubMed1998

Activation control of pur gene expression in Lactococcus lactis: proposal for a consensus activator binding sequence based on deletion analysis and site-directed mutagenesis of purC and purD promoter regions.

A comparison of the purC and purD upstream regions from Lactococcus lactis revealed the presence of a conserved ACCGAACAAT decanucleotide sequence located precisely between -79 and -70 nucleotides upstream from the transcriptional start sites. Both promoters have well-defined -10 regions but lack sequences resembling -35 regions for sigma70 promoters. Fusion studies indicated the importance of the conserved sequence in purine-mediated regulation. Adjacent to the conserved sequence in purC is a second and similar region required for high-level expression of the gene. A consensus PurBox sequence (AWWWCCGAACWWT) could be proposed for the three regions. By site-directed mutagenesis we found that mutation of the central G in the PurBox sequence to C resulted in low levels of transcription and the loss of purine-mediated regulation at the purC and purD promoters. Deletion analysis also showed that the nucleotides before the central CCGAAC core in the PurBox sequence are important. All results support the idea that purC and purD transcription is regulated by a transcriptional activator binding to the PurBox sequence.

Amino Acid Sequence↗

PubMed1998

Scandiatransplant: thirty years of cooperation in organ transplantation in the Nordic countries.

The Nordic organ exchange organization, Scandiatransplant was established in 1969. The organization, which covers a population of 23.9 million inhabitants, includes all 11 organ transplant centers in the 5 Nordic countries Denmark, Finland, Iceland, Norway and Sweden. The economy is solely based on transplant center fees. All Nordic patients waiting for an organ transplant are registered on one common waiting list. Rules for the exchange of organs are settled by unanimous decision, and the compliance to the rules is excellent. Kidney exchange is based on HLA matching, whereas the exchange of livers and hearts is based on clinical urgency. In 1997, 43% of the liver transplantations in Scandiatransplant were performed with an exchanged organ and the exchange rate for kidneys was 20%. Currently, the Scandiatransplant waiting list includes 1,538 patients waiting for a kidney transplant, 20 patients are waiting for a liver, 37 for a heart, and 156 patients are waiting for a lung transplant. The organ donation rate in Scandiatransplant has declined in recent years, from 16.0 per million population (PMP) in 1993 to a level of 13.5 PMP in 1997. The number of kidney transplants has varied between 800-900 per year during the past 10 years, corresponding to 33-38 transplants PMP. Approximately 30% of the renal transplants were performed with kidneys from living donors. The liver transplantation activity was approximately 7 PMP per year. Heart transplantation was performed at a rate of 4-5 PMP per year, and lung transplants at 4 PMP per year.

Cadaver↗

PubMed1998

Recovery rates, serotypes, and antimicrobial susceptibility patterns of salmonellae isolated from cloacal swabs of wild Nile crocodiles (Crocodylus niloticus) in Zimbabwe.

Samples from the cloaca and the ventral skin surface of 67 Nile crocodiles (Crocodylus niloticus) captured in four uninhabited areas at Lake Kariba, Zimbabwe, were cultured for Salmonella. All the skin samples tested negative for Salmonella, whereas 18 of 67 (26.9%) cloacal samples grew Salmonella. Significantly more males than females yielded Salmonella, but no statistically significant correlation among salmonella carriage, body size, and age was recorded. Ten different serotypes of S. enterica belonging to the subspecies enterica, salamae, and diarizonae were isolated. All isolates belonging to subspecies enterica displayed invasive properties in an experimental mouse model and thus exhibited pathogenic potential, whereas none of the other isolates were invasive. In general, isolates were sensitive to a number of commonly used antimicrobials, except for three isolates that were resistant to streptomycin.

Alligators and Crocodiles↗

PubMed1997

[Development in mortality, incidence and lethality of ischemic heart disease in Denmark 1982-1992].

In Denmark, as in many other Western countries, a decline in mortality from ischaemic heart disease (IHD) has been observed. The present study assesses whether the decline in IHD mortality is due to a decrease in incidence and/or case-fatality, and whether parallel changes occurred in the various manifestations of IHD requiring hospitalization. The National Patient Register of hospital discharges and the Causes-of-Death Register were linked and all cases of first admission for IHD including acute myocardial infarction (AMI) and fatal first manifestation of IHD since 1977 in the entire Danish population were identified. Cases of AMI and IHD were considered as incident cases if no admission for these diagnoses had occurred during the preceding five years for the same person. Sex-specific, age-standardized annual mortality, incidence and case-fatality rates of AMI (ICD8 code 410), narrowly defined IHD (NIHD, ICD8 codes 410-4) and broadly defined IHD (BIHD, ICD8 codes 410-4, 427 & 795-6) were calculated for the period 1982 through 1992. During the entire period the age-standardized mortality of AMI, NIHD and BIHD decreased in both men and women. The incidence of AMI and NIHD decreased, while the incidence of BIHD remained constant. Case-fatality of AMI decreased in both men and women, while case-fatality of NIHD and BIHD decreased in men and in women aged 0-64 years only. The declining mortality from IHD in Denmark may be partly due to declining incidence as well as declining case-fatality, but changes in disease manifestation or a diagnostic drift may also contribute, since more broadly defined diagnostic groups showed less or no decline in incidence.

Adult↗

PubMed1997

Isolation of vancomycin resistant Enterococcus faecium from food.

In a survey of vancomycin resistant Enterococcus faecium (VREF) in Danish meat products, VREF could be detected in 16% of 160 samples of broilers collected at slaughterhouses and in 15% of 26 samples of pork collected from the retail trade. VREF were isolated by enrichment for 24 h in nutrient broth supplemented with vancomycin (50 micrograms/ml) prior to plating on Slanetz and Bartley agar. Using direct plating on Slanetz and Bartley agar, VREF could be isolated from only 1.7% of 540 samples of broilers from slaughterhouses and 2.2% of 90 samples of broilers from retail outlets. VREF was not detected in 124 samples of pork and 128 samples of beef from retail outlets by the direct plating method. An additional enrichment step in nutrient broth supplemented with vancomycin enhanced the detection rate of VREF by approximately three times compared to the direct plating method when investigating the same 160 samples of broilers by the two methods. The implications and public health aspects of VREF in food is discussed.

Animals↗

PubMed1997

Functional analysis of immunoreceptor tyrosine-based activation motif (ITAM)-mediated signal transduction: the two YxxL segments within a single CD3zeta-ITAM are functionally distinct.

Functional analysis of the immunoreceptor tyrosine-based activation motif (ITAM) derived from the membrane-proximal ITAM of CD3zeta demonstrates that mutations at either the tyrosine or leucine residues in the N-terminal YxxL segment of the ITAM abolish all signal transduction functions of this ITAM. In contrast, mutations at the tyrosine or leucine residues in the C-terminal YxxL segment abrogate signals for interleukin (IL)-2 production but do not prevent tyrosine phosphorylation of the N-terminal tyrosine of the ITAM, lck association with the ITAM, activation of phospholipase C-gamma1 or calcium mobilization. Cross-linking of chimeric receptors containing a C-terminal YxxL leucine mutation induces tyrosine phosphorylation of ZAP70 but without stable binding to the phosphorylated ITAM. These results indicate that the two YxxL segments in an ITAM are functionally distinct and that both are essential for ZAP70 binding and IL-2 production. Furthermore, tyrosine phosphorylation of ZAP70 per se is not sufficient to trigger the downstream events leading to IL-2 production. Substitution of an alanine for the bulky side chain at the Y+1 position of the N-terminal YxxL segment reduces the receptor cross-linking requirement necessary to achieve cellular activation and the absolute dependence on lck in this process. Our results reveal that both the number of ITAM as well as the specific amino acid residues within a single ITAM determine the extent of chimeric receptor cross-linking required to trigger tyrosine phosphorylation-dependent signaling events.

Amino Acid Sequence↗