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At least 757 records · Page 42Linked to original sources
PubMed2002

Feedback microwave thermotherapy versus TURP for clinical BPH--a randomized controlled multicenter study.

OBJECTIVES: To compare the outcome of a microwave thermotherapy feedback system that is based on intraprostatic temperature measurement during treatment (ProstaLund Feedback Treatment or PLFT) with transurethral resection of the prostate (TURP) for clinical benign prostatic hyperplasia (BPH) in a randomized controlled multicenter study. The safety of the two methods was also investigated. METHODS: The study was performed at 10 centers in Scandinavia and the United States. A total of 154 patients with clinical BPH were randomized to PLFT or TURP (ratio 2:1); 133 of them completed the study and were evaluated at the end of the study 12 months after treatment. Outcome measures included the International Prostate Symptom Score (IPSS), urinary flow, detrusor pressure at maximal urinary flow (Qmax), prostate volume, and adverse events. Patients were seen at 3, 6, and 12 months. Responders were defined according to a combination of IPSS and Qmax: IPSS 7 or less, or a minimal 50% gain, and/or Qmax 15 mL/s or greater or a minimal 50% gain. RESULTS: No significant differences in outcome at 12 months were found between PLFT and TURP for IPSS, Qmax, or detrusor pressure. The prostate volume measured with transrectal ultrasonography was reduced by 30% after PLFT and 51% after TURP. Serious adverse events related to the given treatment were reported in 2% after PLFT and in 17% after TURP. Mild and moderate adverse events were more common in the PLFT group. With the criteria mentioned above, 82% and 86% of the patients were characterized as responders after 12 months in the PLFT and TURP groups, respectively. The post-treatment catheter time was 3 days in the TURP group and 14 days in the PLFT group. CONCLUSIONS: The outcome of microwave thermotherapy with intraprostatic temperature monitoring was comparable with that seen after TURP in this study. From both a simplicity and safety point of view, PLFT appears to have an advantage. Taken together, our findings make us conclude that within a 1-year perspective microwave thermotherapy with PLFT is an attractive alternative to TURP in the treatment of BPH.

Humans↗
PubMed1999

Attempting to control mite allergens with mechanical ventilation and dehumidification in British houses.

BACKGROUND: Allergen avoidance is of considerable interest in the treatment and even prevention of asthma. Attempts to control house dust mites have included environmental manipulation in homes in an attempt to reduce humidity below a level that favors mite survival. This appears to have some benefit in Scandinavia, but a previous attempt with mechanical ventilation heat pump recovery (MVHR) units in the UK failed to achieve the desired results. OBJECTIVE: We report a study using an additional central dehumidification modification of the MVHR (MVHRcd) in an attempt to reduce allergen levels in houses of asthmatic subjects. METHODS: Ten houses of asthmatic patients allergic to dust mites and 10 architectural control houses were studied. The active houses were fitted with an MVHRcd unit in November/December 1994 and activated in January 1995. The active and control houses were monitored continuously for internal temperature and humidity by using digital sensors in the asthmatic and control bedrooms. Dust samples were collected to determine allergen levels at baseline (January 1994) and 3, 6, 9, and 15 months after switching on the units. RESULTS: The winter seasonal average humidity fell from 50% relative humidity (RH) in control bedrooms to 37% RH in asthmatic bedrooms compared with 72% RH in the ambient air as measured on the intake of the MVHRcd systems. There was no corresponding change in seasonal mean temperature within the houses. Although the temperature and humidity weekly and seasonal means remained below the study target of 45% RH or 7 g/kg absolute humidity at 21 degrees C, there were transient rises in humidity detected by the sensors in the houses with MVHRcd systems. Allergen levels fell both in active and control houses during the study period, but there was no significant advantage gained from the installation of MVHRcd systems. CONCLUSION: The MVHRcd system failed to confer a benefit in terms of mite allergen reduction despite apparently adequate control of temperature and humidity.

Air Pollution, Indoor↗
PubMed2000

Assisted reproductive technology in canid species.

Assisted reproductive technologies in dogs began as early as the 18th century. The first scientifically recorded artificial insemination (AI) was performed in Italy by Spallanzani and lead to the birth of three pups. Progress in the area was slow, and subsequent development included AI equipment and methods for short-term preservation of fresh, and later, for frozen semen which led to the world's first litter produced from frozen semen in 1969. Improvement of freezing methods and AI equipment from 1970 onwards has rendered AI useful as a breeding technique for dogs. In parallel, AI in foxes was developed in Scandinavia in the early 1980's; this resulted in the economically valuable crossbreeding of silver and blue foxes for the production of bluefrost pelts. Unfortunately, due to the particular physiology of the canine female, progress in other artificial breeding techniques has lagged behind. Only in the last few years have these techniques been successfully applied in basic research to study oocyte maturation, in vitro fertilization, embryo cryopreservation and embryo transfer in canids.

Animals↗
PubMed2004

HABITS (hormonal replacement therapy after breast cancer--is it safe?), a randomised comparison: trial stopped.

In the 1990s, two randomised clinical trials started in Scandinavia addressing whether hormone replacement therapy (HRT) is safe for women with previous breast cancer. We report the findings of the safety analysis in HABITS (hormonal replacement therapy after breast cancer--is it safe?), an open randomised clinical trial with allocation to either HRT or best treatment without hormones. The main endpoint was any new breast cancer event. All analyses were done according to intention-to-treat. Until September, 2003, 434 women were randomised; 345 had at least one follow-up report. After a median follow-up of 2.1 years, 26 women in the HRT group and seven in the non-HRT group had a new breast-cancer event. All women with an event in the HRT group and two of those in the non-HRT group were exposed to HRT and most women had their event when on treatment. We decided that these findings indicated an unacceptable risk for women exposed to HRT in the HABITS trial, and the trial was terminated on Dec 17, 2003.

Breast Neoplasms↗
PubMed1980

Poisoning by Cortinarius speciosissimus.

Severe renal failure caused by the mushroom Cortinarius speciosissimus was first recognised in 1972 and has been reported only from Scandinavia. In the summer of 1979 and following the consumption of the wild mushroom in Scotland, three previously healthy young adults developed the recognised features of cortinarius poisoning-namely, gastrointestinal upset after 36-38h, followed by nausea, anorexia, headache, rigors, severe burning thirst, muscle aching, and oliguria. One patient had a diuresis after 8 days and recovered completely. The two other patients did not present to hospital until 10 days after ingestion and severe renal failure had already developed. Both had a severe interstitial nephritis and neither recovered renal function. They were maintained on intermittent haemodialysis until they received renal transplants 9 months later. This form of mushroom poisoning has not so far been reported in the British Isles. With the increasing popularity of wild-mushroom eating, posters and publications on wild edible foods should contain warnings about the toxic nature of species of the genus Cortinarius.

Adult↗
PubMed1994

Enzyme replacement treatment in type 1 and type 3 Gaucher's disease.

The development of intravenous enzyme-replacement treatment for Gaucher's disease has changed life expectancy in cases without neurological involvement (type 1). The effects in patients with neurological involvement are unknown. We treated 12 Italian patients, types 1 (9) and 3 (3), with intravenous alglucerase: 70-120 IU/kg per month for type 3 and 30-60 IU/kg per month for type 1. Maintenance infusions were biweekly in patients without neurological symptoms, whereas in one symptomatic type 3 patient, infusion was weekly. All patients improved; a resumption of growth in children with growth retardation was observed and spleen and liver reduced in size. In one type 3 patient, a bone callus formed during treatment and enabled the patient to walk. Laboratory tests showed rapid increase of haemoglobin in anaemic patients, and a slower response in patients with thrombocytopaenia. In 4 patients there was temporary hypocalcaemia immediately after the beginning of treatment. Neurological symptoms were present in 1 of the type 3 patients, and electroencephalogram was abnormal in another. After 2 years of treatment, the patient with symptoms showed an improvement of psychomotor skills and of IQ from 50 to 60. Genotype analysis showed a high frequency of the 1448C mutation (54.5%). The 9 patients carrying this allele came from Italian regions which in the past had been invaded from north Europe and Scandinavia. Enzyme replacement in Gaucher's type 1 can also be effective at low doses and even with a 2-week interval between infusions. This makes treatment cheaper, and reduces hospital stay for patients.

Adolescent↗
PubMed1994

Necrotising fasciitis due to group A streptococci in western Norway: incidence and clinical features.

During November, 1992, to May, 1994, 13 patients were treated at Haukeland University Hospital, Norway, for necrotising fasciitis due to group A beta-haemolytic streptococci. 3 patients died, 1 before admission. Mucoid group A streptococci were isolated from affected tissue (12 patients) and/or blood (5). Strains from 11 patients were serotype M-1 (5 patients), M-3 (2), M-6 (2), M-28 (1), and M-untypable (T-1, opacity factor negative) (1). For the 12 patients admitted alive, the following preoperative events were recorded: 8 had clinical signs of shock with systolic blood pressure of 90 mm Hg or less, 8 had impaired renal function, and 7 had biochemical markers of disseminated intravascular coagulation. At least 6 patients fulfilled the criteria for streptococcal toxic shock syndrome. Preoperative C-reactive protein was substantially raised ( > 200 mg/L) in 10 patients. The 12 patients were given high doses of antibiotics and were operated on with aggressive debridement of necrotic skin and fascia, 7 of them within 24 h of admission. The increasing incidence of necrotising fasciitis in western Norway reflects the resurgence of invasive group A streptococcal infections documented in Scandinavia since 1987. The high case-fatality rate can be reduced by early diagnosis and aggressive surgery combined with adequate antibiotic therapy.

Adult↗
PubMed1999

Association of Rickettsia helvetica with chronic perimyocarditis in sudden cardiac death.

BACKGROUND: Rickettsia helvetica is the only non-imported rickettsia found in Scandinavia. It was first detected in Ixodes ricinus ticks, but has never been linked to human disease. We studied two young Swedish men who died of sudden cardiac failure during exercise, and who showed signs of perimyocarditis similar to those described in rickettsial disease. METHODS: Samples from the heart and other organs were analysed by PCR and DNA sequencing. May-Grünwald-Giemsa, Grocott, and acridine-orange stains were used for histopathological examinations. Staining of R. helvetica grown on shell-vials in vero cells, and the early descriptions of R. rickettsii by H T Ricketts and S B Wohlbach served as controls. Immunohistochemistry was done with Proteus OX-19 rabbit antisera as the primary antibody. The structure of rickettsia-like organisms was investigated by transmission electron microscopy. Serological analyses were carried out by indirect immunofluorescence with R. helvetica as the antigen. FINDINGS: By use of a semi-nested PCR, with primers specific for the 16S rRNA and 17-kDa outer-membrane-protein genes, and sequence analysis of the amplified products, genetic material from R. helvetica was detected in the pericardium and in a lymph node from the pulmonary hilum in case 1, and in a coronary artery and the heart muscle in case 2. A serological response in case 1 revealed an endpoint titre for R. helvetica of 1/320 (1/256 with R. rickettsii as the antigen). Examination of PCR-positive tissue showed chronic interstitial inflammation and the presence of rickettsia-like organisms predominantly located in the endothelium. These organisms reacted with Proteus OX-19 antisera, and their size and form were consistent with rickettsia. Electron microscopy confirmed that the appearance of the organisms was similar to that described for spotted-fever rickettsia. INTERPRETATION: R. helvetica, transmitted by I. ricinus ticks, may be an important pathogen in the aetiology of perimyocarditis, which can result in sudden unexpected cardiac death in young people.

Adult↗
PubMed1996

Latanoprost, a prostaglandin analog, for glaucoma therapy. Efficacy and safety after 1 year of treatment in 198 patients. Latanoprost Study Groups.

PURPOSE: To determine efficacy and safety of latanoprost, a prostaglandin analog for glaucoma, during 1 year of treatment. METHODS: After baseline measurements, 0.005% latanoprost was topically applied once daily for 12 months in patients from Scandinavia, the United Kingdom, and the United States who had elevated intraocular pressure (IOP). Diagnoses included ocular hypertension, chronic open-angle glaucoma, exfoliation syndrome, and pigment dispersion syndrome. Treatment was masked for the first 6 months and open-label during the second 6 months. RESULTS: Of the 272 patients initially enrolled, withdrawals were due to inadequate IOP control (1%), increased iris pigmentation (5%), other ocular problems (3%), systemic medical problems (3%), and nonmedical reasons (14%). Latanoprost significantly (P < 0.0001) reduced diumal IOP from 25.3 +/- 3.0 mmHg (mean +/- standard deviation) at baseline to 17.4 +/- 2.7 mmHg (32% reduction) at 12 months in the 198 patients who completed 1 year of treatment. The IOP reduction was maintained at a consistent level throughout the 12 months without evidence of drift, and was not affected by sex, age, race, or eye color. Overall, latanoprost caused a possible or definite increase in iris pigmentation in 12% of the 272 patients, all of whom had multicolored irides at baseline. One half of these patients with increased pigmentation withdrew before completing 1 year of therapy. Visual field, optic disc cupping, visual acuity, refractive error, conjunctival hyperemia, aqueous flare, anterior chamber cellular response, lens examination, blood pressure, heart rate, blood tests, and urinalysis were not appreciably altered. CONCLUSION: Latanoprost safely and effectively reduces IOP for 1 year in patients of diverse nationalities, providing further evidence for its usefulness in chronic glaucoma therapy.

Administration, Topical↗
PubMed1993

Dose response study of an inactivated hepatitis A virus vaccine.

In this dose-response study evaluating 3 different doses and 2 time schedules, the highest dose, 25 units of viral protein antigen, induced a seroconversion antibody response against hepatitis A virus (anti-HAV) over 10 mIU in all vaccinees by week 3 after one dose, indicating rapid onset of protective antibody levels. Following the second dose, given 4 weeks later, rising titers were observed for 20 weeks, when the third and final dose of 25 units was given. The GMT of anti-HAV at 24 weeks (before the third vaccine injection) was 398 mIU/ml for the 25-unit dose, compared to 42 and 65 mIU/ml, respectively, for the 12.5 unit and 6.25 unit doses. The third vaccine dose at 24 weeks gave a booster response in all vaccinees, but the increase in titers was most pronounced in the 25 unit group, which had reached a GMT of 6593 mIU/ml when tested 4 weeks later. Side-effects included mainly local reactions and a few cases of mild diarrhoea, and did not differ for the 3 doses studied. In Scandinavia, hepatitis A vaccines will probably be used mainly for vaccination of foreign travellers. This category usually requires a rapid immunization schedule with few doses. Two doses approximately 3-4 weeks apart will probably be accepted by most travellers, and a single dose may provide short-term protection for most individuals. The need and timing for a booster dose will have to be further studied.

Adult↗
PubMed1996

Preventing sudden infant deaths--the slow diffusion of an idea.

The sudden infant death syndrome (SIDS) is among the leading causes of post-neonatal mortality in industrialised countries. Research has highlighted that many of these deaths are avoidable by adopting a few simple precautions. These include sleeping in the supine position, avoiding exposure to tobacco smoke, breast feeding where possible, and avoiding over heating. The paper traces the development of understanding of the role of sleeping position in the aetiology of SIDS and the diffusion of this knowledge among and within industrialised countries. In retrospect, evidence began to become available in the early 1980s but it was several years before it was acted upon, initially in The Netherlands and subsequently in New Zealand, the United Kingdom and Scandinavia. Several countries have mounted major national preventive campaigns, of various kinds, each of which has been associated with a reduction in deaths from SIDS, but others have not. The reasons for these differences are explored. The evidence for a causal link between sleeping position and SIDS is now very strong and the costs of implementing a policy to change behaviour is small, compared with other health care interventions. This information is now widely available in the international literature. The example of SIDS provides information on the barriers to adoption of knowledge as well as the factors that promote it.

Developed Countries↗
PubMed1986

Occurrence of human T cell lymphotropic virus (type I) antibodies in cutaneous T cell lymphoma.

Of 315 patients from Scandinavia and West Germany with cutaneous T cell lymphoma, thirty-six (11.4%) had specific antibodies reactive against human T cell lymphotropic virus type I (HTLV-I). Among the HTLV-I antibody-positive patients, one had Sézary syndrome; five, mycosis fungoides, plaque stage; sixteen, mycosis fungoides, plaque stage with nondiagnostic histologic features; and three, lymphomatoid papulosis. All the patients from the Copenhagen area had several samples taken during the course of their disease, but the HTLV-I antibody titer was unaltered independent of the clinical stage the individual patient had at the time of the study. Eighty-three patients with non-Hodgkin's lymphoma were tested for HTLV-I antibodies, and all except two showed negative results. The finding of specific antibodies reactive against HTLV-I in cutaneous T cell lymphoma suggests that a retrovirus related to HTLV-I plays an important role in the pathogenesis of cutaneous T cell lymphoma.

Antibodies, Viral↗
PubMed2000

[Methicillin-resistant Staphylococcus aureus: factors responsible for its incidence].

INTRODUCTION: How can we explain that the proportion of methicillin-resistant Staphylococcus aureus (MRSA) varies between the European countries, ranging from < 1% in Scandinavia to > 30% in Spain, France and Italy? This paper is aimed at attempting to determine factors at the origin of the spreading of endemic MRSA strains as of the early 1980s. Those strains are characterized by their ability to develop resistance to current antibiotics and make treatment of severe and deep infections more complex. CURRENT KNOWLEDGE AND KEY POINTS: Differences in the virulence of MRSA strains and that of susceptible strains appear unlikely. MRSA prevalence seems to be a growing problem, especially in Southern Europe where rates of resistance to other anti-staphylococcal antibiotics are high. General policies for antibiotic therapy as well as the implementation of strategies for prevention and control of MRSA might be responsible for such rates. Indeed, once MRSA is introduced into a facility without control program, this multiresistant bacteria rapidly spreads within the hospital and becomes endemic, expanding its reservoir. FUTURE PROSPECTS ET PROJECTS: Due to the introduction of new methods in microbiology and communication, infection control measures including procedures for isolation and identification of MRSA reservoirs are still feasible; however, their implementation requires human and material resources. Areas requiring improvement in the detection of MRSA outbreaks are identified in this paper, with particular emphasis on the need for national surveillance of MRSA prevalence and reappraisal of MRSA control strategies in French hospitals.

Disease Reservoirs↗
PubMed2001

[Tick-born encephalitis].

INTRODUCTION: Tick-borne encephalitis (TBE), a disease contracted through tick bites, is caused by a Flavivirus. Its geographical distribution comes from the geographical distribution of the reservoir of infection--i.e., mainly the tiny mammals living in the forests and bushes. The endemic area spreads from the Rhine to the Urals, from Scandinavia to Italy and Greece. CURRENT KNOWLEDGE AND KEY POINTS: Symptoms usually evolve in three phases: at first a nonspecific phase with fever and myalgia, then an afebrile phase, and finally a phase with neurological manifestations, such as meningitis, meningoencephalitis and/or myelitis, and fever. Motor neurological sequelae are possible. The cases occurring in the East are characterized by their greater severity compared to those occurring in the West. The diagnosis, easily established given a history of a tick bite in an endemic area, is confirmed by the presence of specific IgM in the blood and/or cerebral spinal fluid. FUTURE PROSPECT AND PROJECTS: There is no specific treatment. Prevention consists of individual prophylactic measures (self-examination and systematic extraction of ticks after exposure, use of repellents), and in immunization. The vaccine, prepared from inactivated viruses, should be used for target populations, that is, for people exposed to tick bites during their professional or leisure outdoor activities.

Diagnosis, Differential↗
PubMed1979

Aspiration using prefilled dental anesthetic cartridges.

The purpose of this study was to make clear if aspiration was possible by the non-aspirating technique using non-aspirating cartridges. Four prefilled anesthetic cartridges used in Scandinavia generally were selected for study. The pressure required for aspiration varied between 130--320 mm Hg. In the majority of cases, aspiration did not occur in the pressure of 320 mm Hg. Thus, if the patient has normal blood pressure- the aspiration occurs very seldom by using non-aspirating cartridges.

Anesthesia, Dental↗
PubMed2002

Cryptosporidium andersoni from a Danish cattle herd: identification and preliminary characterisation.

In November 1997, Cryptosporidium andersoni, for the first time, was isolated from a Danish heifer. The isolate was characterised morphologically, molecularly, and furthermore inoculated into mice and one calf. Data on the distribution of cryptosporidia in the herd of origin were obtained at two separate visits in December 1997 and April 1998. C. andersoni was detected in 27 (19.0%) of 142 cattle examined at the first visit, whereas C. parvum was found in six (4.2%). At the following visit 42 (28.0%) of 150 cattle excreted C. andersoni, while 25 (16.7%) were positive for C. parvum. Oocysts of the Danish C. andersoni isolate were ovoid, 7.3(6.5-8.0) x 5.7(5.0-7.0) microm(2) (n=25), with smooth, colourless, single layer oocyst wall and distinct oocyst residuum. The length to width ratio was 1.27 (1.14-1.40, n=25). The identification was verified by sequencing of a 246bp fragment of the rDNA, which was identical to Cryptosporidium muris, the calf genotype (AF093496). The Danish C. andersoni isolate was not transmissible to mice, whereas oocysts were detected in the faeces of one experimentally infected calf from 25 days post-infection (DPI) and shed intermittently at low numbers until 165 DPI, the day of euthanasia. No macroscopic or microscopic changes that could be attributed to infection with C. andersoni were seen in the gastro-intestinal tract of the experimentally infected calf following necropsy and histological examination. This is to our knowledge the first report of C. andersoni in Scandinavia.

Animals↗
PubMed1997

Detection of pseudorabies virus genomic sequences in apparently uninfected 'single reactor' pigs.

With a pseudorabies virus (PrV) gB ELISA, performed on 480,000 pigs on 8,900 Swedish farms, approximately 1,300 cases were observed with only one single animal reacting positively. These animals were termed 'single reactors' (SR). In order to find explanations for this peculiar phenomenon, the presence of PrV was investigated in organs of immunosuppressed and non-immunosuppressed SR animals. The virus was not detected by immunohistochemistry, virus isolation or co-cultivation. An in situ DNA hybridization test detected PrV gC gene sequences in the olfactory bulb of one sow. A nested polymerase chain reaction (PCR) assay revealed gB, gE and gD gene sequences of PrV in the tissues of trigeminal ganglia, olfactory bulb, tonsils and brain. The nucleotide sequences of the amplicons revealed 98 to 100% homology with the corresponding sequences of PrV. The large latency transcript (LLT) was not detected in the organs of the SR pigs. Transmission of the SR phenomenon to animals in contact or to the next generation was not observed. Considering the present observations and the facts that (i) PrV vaccination is not applied in Sweden; (ii) the SR animals occur not only in the South, but also in Northern Scandinavia, which has no history of PrV infection and (iii) viral reactivation was not observed under natural conditions or after experimental immunosuppression, it is concluded that the SR phenomenon should hardly be considered as a typical PrV latency. The present findings show that certain herpesviral genomic sequences exist in apparently uninfected individuals.

Animals↗
PubMed1999

Principles for eradication of bovine viral diarrhoea virus (BVDV) infections in cattle populations.

Systematic eradication of BVDV without vaccination started in Scandinavia in 1993. In principle, the schemes include; (1) identification of non-infected and infected herds using different combinations of serological herd tests such as bulk milk tests and spot tests (sample of animals in a certain age), (2) monitoring/certification of non-infected herds by repeated sampling, applying one of the above-mentioned methods and (3) virus clearance in infected herds aimed at removing persistently infected (PI) animals in a cost- and time-efficient manner. In the virus clearance protocol described, an initial test is performed on all animals with subsequent follow-up of calves born as well as of dams seronegative in the initial test. It is generally recommended to perform an initial antibody test on all samples. This should be done not only to screen for seronegative animals on which virus isolation should be attempted (i.e. possible PI animals), but more in order to identify non-immune animals in reproductive age, that is, the key animals in herd-level persistence of infection. In Sweden, a common finding has been self-clearance, where the infection ceases without any other intervention than controlled introduction of new animals. Other epidemiological observations concern the course of events following virus introduction. Important risk factors for spreading BVDV are discussed, where livestock trade is perceived as the most central to control. Live vaccines, imported semen and embryos constitute special hazards, since they may act as vehicles for the introduction of new BVDV strains. The importance of making farmers aware of herd biosecurity and their own responsibility for it is stressed, and in order to maintain a favourable situation after a scheme has been concluded, effort must be put into establishing such a persisting attitude in the farming community.

Agriculture↗