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Biomedical subjects

S G Gundersen

Publications and source records attributed to S G Gundersen.

At least 37 records · Page 2Linked to original sources
PubMed1996

Urine reagent strips for diagnosis of schistosomiasis haematobium in women of fertile age.

Hematuria, proteinuria and leukocyturia were semiquantitatively assessed by reagent strips in single morning urine of women of fertile age visiting the outpatient department of the Mangochi district hospital, Malawi. This was part of a diagnostic approach to female genital schistosomiasis (FGS). In 51 women ova of Schistosoma haematobium were detected in urine by a filtration technique. In 33 of these women ova were also present in genital tissue as demonstrated by microscopic examination of biopsies. In 209 women no ova were found in the single urine filtered. There were significantly higher scores for hematuria, proteinuria and leukocyturia as well as of the combined reagent strip index (RSI) in egg-excreting than in egg-negative women. The sensitivity of a single hematuria, proteinuria and leukocyturia reading was 98, 84 and 73%, respectively. However, the respective specificity was only 24, 22 and 23%. The best prediction of urinary schistosomiasis was achieved by a +2 score for hematuria, of which the sensitivity was 94% and the specificity was 61%. The high false-positive rates can probably be explained by contamination of urine by vaginal secretion. Moreover, cases of schistosomiasis have probably been overlooked because only a single morning urine sample was examined. The total absence of hematuria, proteinuria and leukocyturia, however, may be used to rule out heavy infections in community surveys. There was no difference in reagent strip scores between women with genital and urinary schistosomiasis as compared with those with urinary tract lesions alone. Thus urine analysis reagent strip readings do not help to discriminate between S. haematobium infected women with and without FGS.

Adolescent↗
PubMed1996

Reversibility of lower reproductive tract abnormalities in women with Schistosoma haematobium infection after treatment with praziquantel--an interim report.

Little is known whether and to what extent antiparasitic treatment cures female genital schistosomiasis (FGS). Using a standard protocol, of twenty-one women with FGS nine were re-examined at two to nine weeks after they had been treated with praziquantel at a single dose of 40 mg/kg. Symptoms related to pathology of the urinary tract and to a lesser extent of genital pathology subsided in most patients. Schistosoma haematobium ova were no longer detectable in urine of any of the patients post-treatment. Efficiency of chemotherapy against adult worms was confirmed by the disappearance of circulating anodic antigen (CAA) in serum. Sandy patches showed resolution in two of four cases after chemotherapy. Papillomata due to schistosomiasis alone improved, but persisted in mixed infection with human papilloma virus (HPV) or when HPV was the only underlying cause. In one patient ulcera could not be related with certainty to schistosomiasis at admission, but resolved after treatment with parziquantel. Leukoplakia (two cases) was not influenced by chemotherapy, or even increased during follow-up, regardless of whether ova had been detected or not. Although the follow-up period was rather short, time intervals were not standardized, and a relatively small number of patients was investigated, it could be shown that genital pathology due to sequestered S. haematobium ova is, at least partially, reversible already two to nine weeks after killing the adult worms by praziquantel. This is paralleled by a normalization of inflammatory immune responses detectable in histological sections and vaginal lavage.

Adolescent↗
PubMed1995

Optimization of the Magnetic Bead Antigen Capture Enzyme Immuno Assay for the detection of circulating anodic antigens in mixed Schistosoma infections.

In the present study, simplification and adaptation of the Magnetic Bead Antigen Capture Enzyme Immuno Assay (MBAC-EIA) technique for detection of circulating anodic antigens (CAA) under field conditions was achieved. It was shown that the assay could be performed successfully within the broad temperature range of 18-37 degrees C. The slightly lower sensitivity observed at low temperatures could be adjusted for by prolonging the incubation period. Shaking the plate by hand was as good as automatic mechanical shaking, aspiration of the supernatant before the addition of conjugate was not necessary, and the use of whole blood and serum offered similar assay sensitivity. Furthermore incubation times could be considerably shortened without loss of sensitivity. A major advantage of the MBAC-EIA was that the beads, after elution of bound components, were found to be reusable. The study also showed that the sensitivity of the MBAC-EIA technique in diagnosis of schistosomiasis in a Zimbabwean community endemic for both urinary and intestinal schistosomiasis, was 94%.

Adolescent↗
PubMed1993

[Typhoid fever].

The epidemiology, clinical presentation, diagnosis and treatment of typhoid fever has been studied retrospectively in 50 hospitalized patients. Typhoid fever is increasing in Norway, owing to more travel, especially by immigrants visiting their home countries. Among 50 patients admitted to hospital for typhoid, we found no fatal complications. Fever was a main symptom, and 13 of the 50 patients had additional concomitant infections. The standard treatment was chloramphenicol for 14 days. In 1990 and 1991, however, most cases were caused by multi-resistant strains of Salmonella typhi. The adults were therefore treated with ciprofloxacin and the children with third generation cephalosporins. All the multiresistant infections had been contracted in Pakistan or India. There were no secondary cases among the more than 214 family contacts in the 47 families involved. The increase in resistant strains of typhoid fever may affect future treatment and control strategies.

Adolescent↗
PubMed1993

[Outbreak of typhoid fever in a family].

We describe a small epidemic of typhoid fever in a family who came originally from Pakistan. In 1992 six members (mother and five children) of a family of ten were admitted to our department with typhoid fever within a nine-day period. The index case was an 18 months old girl who had been hospitalized and treated elsewhere for typhoid fever. Two weeks after completing antibiotic treatment she was admitted to our hospital with a relapse. The source of her first infection is unknown. The rapid spread of typhoid fever in the family was most likely due to insufficient hygienic precautions and inadequate antibiotic treatment of the index case. Several coexisting factors such as poor housing conditions and cultural barriers may also have influenced the outcome. There is obviously a need for strict guidelines and proper coordination of treatment and follow-up of this and other similar contagious diseases.

Adult↗
PubMed1992

[Resistance problems in developing countries--use and misuse of antiinfective agents].

Widespread use and misuse of antiinfectiva have resulted in a problem of drug resistance linked to treatment of infectious diseases. In developing countries especially, the sale of such drugs is poorly controlled and the pharmaceutical industry is dumping obsolete products. Intensive marketing, lack of diagnostic facilities and receptive local cultural attitudes to new "wonder drugs" such as antibiotics, have resulted in dramatic unnecessary use of such. Therefore the ideal strategies for treatment of infectious diseases guided by microbiological diagnosis and resistance pattern are violated in most developing countries, leading to excessive use of antiinfectiva and development of resistance. This has serious consequences for the infections that cause most cases of infant mortality, namely malaria, diarrhoeas and infections of the respiratory tract. Improvements in this vicious circle of drug use and resistance can only be made by attacking several factors simultaneously. There is a need for general information, stricter legislation, essential drug lists, national drug policies, better knowledge of local resistance patterns, better diagnostic facilities, better knowledge about local beliefs about drugs and better communication to local health workers and the community.

Anti-Bacterial Agents↗
PubMed1992

Magnetic bead antigen capture enzyme-linked immunoassay in microtitre trays for rapid detection of schistosomal circulating anodic antigen.

We have developed a new magnetic bead antigen capture enzyme-linked immunoassay for the detection of schistosomal circulating anodic antigen. The assay utilizes IgG1 monoclonal antibody coated monodisperse magnetic beads in microtitre trays fitted to a special magnet. The total test time was found to be 1-2 h, using 0.05 mg beads per well. The lower detection level was 0.7 ng AWA-TCA per ml (approximately 0.07 ng CAA per ml). Validation by sera from uninfected and Schistosoma mansoni infected Africans and Norwegians resulted in an assay specificity of 100% and sensitivity was close to 90% for cases excreting more than 100 eggs per gram faeces. At such clinically relevant levels the inter-assay CV was below 10% and photometric absorbance correlated to antigen levels was nearly linear. There was a significant correlation between the magnetic bead EIA absorbance values and the titres obtained using the previously established ELISA. The new bead assay, however, was easier and less laborious because TCA pretreatment and the titration of positive results were unnecessary.

Africa↗
PubMed1992

Early detection of circulating anodic antigen (CAA) in a case of acute schistosomiasis mansoni with Katayama fever.

A 34-year-old male developed acute Katayama fever with fever, diarrhoea, joint pains, headache, urticarial rash and eosinophilia 18 days after falling into and spending 15 min in the water during water-skiing in the outlet of the Volta river. Low anti-schistosomal antibody titres were found by the immunofluorescence assay after 4 weeks, and the first Schistosoma mansoni eggs were found in faeces after 6 weeks. Both symptoms and eosinophilia increased the first days after treatment with oxamniquine, after which he improved gradually. Examination of frozen sera by the newly developed Magnetic Beads Antigen Capture-EIA (MBAC-EIA) later demonstrated a peak in schistosomal circulating anodic antigen (CAA) levels of diagnostic significance already 4 weeks after he was infected.

Adult↗
PubMed1992

[Problems of drug resistance in developing countries--use and abuse of anti-infective agents].

Widespread use and misuse of anti-infective agents have resulted in a problem of drug resistance linked to treatment of infectious diseases. In developing countries especially, the sale of such drugs is poorly controlled and the pharmaceutical industry is dumping obsolete products. Intensive marketing, lack of diagnostic facilities and receptive local cultural attitudes to new "wonder drugs" such as antibiotics, have resulted in dramatic unnecessary use of such. Therefore the ideal strategies for treatment of infectious diseases guided by microbiological diagnosis and resistance pattern are violated in most developing countries, leading to excessive use of anti-infective agents and development of resistance. This has serious consequences for the infections that cause most cases of infant mortality, namely malaria, diarrhoeas and infections of the respiratory tract. Improvements in this vicious circle of drug use and resistance can only be made by attacking several factors simultaneously. There is a need for general information, stricter legislation, essential drug lists, national drug policies, better knowledge of local resistance patterns, better diagnostic facilities, better knowledge about local beliefs about drugs and better communication to local health workers and the community.

Anti-Bacterial Agents↗
PubMed1991

[Clinical medicine in developing countries].

Clinical medicine in developing countries is often restricted in several ways due to factors such as lack of funds, trained personnel, diagnostic facilities and appropriate drugs. Clinical judgement, knowledge of the local epidemiological pattern and simple diagnostic and therapeutic procedures are crucial under such circumstances. Based on his own experience under primitive conditions in Ethiopia, the author gives some symptom-oriented differential diagnostic reflections and guidelines for simplified management of some major health problems in the tropics.

Clinical Medicine↗
PubMed1989

Severe erythroblastopenia and hemolytic anemia during a hepatitis A infection.

A 41-year-old woman had acute hepatitis A infection complicated with severe anemia due to selective erythroblastopenia and hemolysis. A mechanism involving a cellular immune reaction is suggested. The hematological complications resolved during steroid treatment. She later developed a transient seropositive arthritis.

Adult↗
PubMed1988

Onchocerciasis in the Blue Nile Valley of western Ethiopia.

In a survey among 477 inhabitants of the Blue Nile Valley of western Ethiopia 182 (38%) were positive by skin snip investigation for microfilariae of Onchocerca volvulus. Of these only 23% had typical clinical signs and symptoms of onchocerciasis. The highest prevalence rate of microfilariae (84%) was found among Nilotics in the lowlands, where 50% of the children above 10 years, and 90% of adults above 30 years of age, were infected. The mean microfilarial density per skin snip was significantly higher in the high prevalence areas (14) than in the low prevalence areas (3). Positive skin snips from both hip and shoulder were found in 24% of the population, whereas 3% had microfilariae only in the shoulder and 11% only in the hip region. The mean microfilarial density in the hips (16) was double that in the shoulders (8). Ophthalmological evaluation, including slit lamp examination, was possible in 77 of the 182 cases with positive skin snips. Severe eye damage due to onchocerciasis was not observed. However, one 35 year old female had live microfilariae in the anterior chambers of both eyes.

Adolescent↗
PubMed1983

Mezlocillin treatment of septicemia in general hospitals.

Gramnegative septicemia in 23 patients from different Norwegian departments of general medicine or surgery was treated with mezlocillin. Most of the patients were old, and 14 patients were considered compromised due to underlying disease. In the majority of cases the septicemia originated from urinary tract infections. Uneventful recovery was accomplished in 16 patients (70%) and another 5 cases improved. In 2 patients no clinical effects were observed within 3 days of treatment. Apart from diarrhoea in 5 of the cases, no side-effects occurred. Mezlocillin proved to be a safe and efficient drug for the treatment of gramnegative septicemias of the type that is most commonly encountered in Norwegian general hospitals.

Adult↗