Biomedical subjects

A Krook

Publications and source records attributed to A Krook.

88 records · Page 5Linked to original sources

PubMed1987

Pneumococcal antigens in sputa: ELISA for the detection of pneumococcal C-polysaccharide in sputa from pneumonia patients.

An improved ELISA, the LKB UltroBact Pneumococcus Kit detecting pneumococcal C-polysaccharide, has been tested. Sputum samples from 72 patients with community acquired pneumonia were included in the study. The sensitivity obtained was 96.1% and the specificity 92.6%. This ELISA might offer a useful diagnostic method in major clinical microbiologic laboratories for demonstrating Streptococcus pneumonia in sputa from patients with pneumonia.

Diagnosis, Differential↗

PubMed1987

Antibiotic therapy in pneumonia: a comparative study of parenteral and oral administration of penicillin.

An open, randomized study of treatment of radiologically verified community-acquired pneumonia is described. 33 patients were treated with phenoxymethylpenicillin orally in an average dose of 2 g every 8 h, and 36 patients were treated intravenously with benzylpenicillin 3 g every 8 h. When temperature was normalized the antibiotic dose was reduced in both groups to oral phenoxymethylpenicillin in an average dose of 1 g every 8 h. 24 and 26 patients in respective groups completed 10 days of therapy. No statistically significant differences between the two groups were found when compared for duration of fever, hospital stay, CRP, ESR, leukocyte counts and X-ray normalization. In spite of the low number of patients included in this study it gives a clear indication that treatment of pneumonia with penicillin by the oral route results in the same outcome as parenteral treatment when patients suffering from vomiting, diarrhoea and severe illness with respiratory distress are excluded. In addition, oral treatment is cheaper than parenteral and more simple to manage.

Administration, Oral↗

PubMed1987

Primary meningococcal arthritis.

Arthritis in meningococcal disease is not uncommon and can be caused by either septic invasion of joints or allergic manifestations. Primary meningococcal arthritis (PMA) is, on the other hand, a rare form of meningococcal disease presenting as an isolated septic arthritis without other signs of meningococcal disease. We describe here the first two cases of PMA reported from Scandinavia. The patients were males, 3 and 47 years old, both with arthritis in an ankle joint. PMA is most commonly seen among male infants. Large joints, mainly knee joints, are most often involved and not seldom is the disease polyarthritic. PMA may appear with a previous or on-going upper respiratory tract infection and/or a maculopapular skin rash. If properly treated the prognosis is good.

Arthritis, Infectious↗

PubMed1986

Diagnosis of pneumococcal pneumonia by detection of antigen in saliva.

A sandwich enzyme-linked immunosorbent assay was used for the detection of pneumococcal C polysaccharide in saliva samples from patients with radiologically verified pneumonia. In 16 of 29 patients (55%) with pneumococcal pneumonia, as verified by conventional culture methods, the antigen was present in saliva specimens. The test was negative in 35 of 36 patients (97%) with non-pneumococcal pneumonia and in all saliva samples from a control group, consisting of 25 patients with no signs of respiratory disease. It is concluded that the detection of pneumococcal C polysaccharide in saliva offers a valuable complement to conventional diagnostic methods for pneumococcal pneumonia.

Antigens, Bacterial↗

PubMed1986

Comparison of enzyme-linked immunosorbent assay with coagglutination and latex agglutination for rapid diagnosis of pneumococcal pneumonia by detecting antigen in sputa.

A sandwich enzyme-linked immunosorbent assay detecting the species-specific pneumococcal C polysaccharide was compared to latex agglutination and a coagglutination test which detected capsular pneumococcal antigens in sputum specimens with regard to specificity and sensitivity. Specimens from 52 patients with clinical and radiological evidence for pneumonia were tested. Twenty-one patients with Streptococcus pneumoniae isolated in sputum and 31 patients with a non-pneumococcal etiology were included. The predictive values for a positive test by enzyme-linked immunosorbent assay was 0.91 and for a negative test 0.97, by latex agglutination 0.90 and 0.91, and by coagglutination 0.84 and 0.85 respectively; these values did not show a statistically significant difference. Whereas agglutination tests are technically more simple and can be performed more rapidly, the enzyme-linked immunosorbent assay has the advantage of detecting pneumococcal C polysaccharide, an antigen common to all pneumococci. Thus it provides an interesting alternative to tests based on serum containing antibodies to all 83 different capsular polysaccharides.

Adolescent↗

PubMed1985

Cross-reactions between alpha-streptococci and Omniserum, a polyvalent pneumococcal serum, demonstrated by direct immunofluorescence, immunoelectroosmophoresis, and latex agglutination.

In recent years several groups have used serological methods to demonstrate pneumococcal capsular antigens in sputum. In the present study 123 strains of alpha-hemolytic streptococci (including 97 strains from sputum or pharyngeal specimens) were tested for cross-reactions with a polyvalent antipneumococcal serum (Omniserum). Representatives of the following species were included: Streptococcus bovis, S. equinus, S. intermedius, S. lactis, S. milleri, S. mitis, S. mutans, S. sobrinus, S. salivarius, S. sanguis, S. suis, and Aerococcus viridans. Serological reactions were detected by direct immunofluorescence, immunoelectroosmophoresis, and latex agglutination. Fifteen (12%) of the strains gave positive reactions by all three methods. Positive reactions were also observed with another 32 strains (26%) with two of the methods, whereas 37 strains (30%) gave positive reactions by just one technique. Altogether 84 (68%) strains gave positive reactions with one or more of the methods. Latex agglutination gave positive reactions with 26 (21%) strains compared with 57 (46%) in immunofluorescence and 63 (51%) in immunoelectroosmophoresis. Absorption of the antiserum with one alpha-hemolytic strain reduced but did not entirely eliminate the cross-reactions with five tested strains. These findings indicate a potential risk of cross-reactions with polyvalent antipneumococcal serum in tests carried out on sputa or other specimens which may be contaminated with alpha-hemolytic streptococci.

Cross Reactions↗

PubMed1985

Detection of C polysaccharide in Streptococcus pneumoniae in the sputa of pneumonia patients by an enzyme-linked immunosorbent assay.

The pneumococcal C polysaccharide (PnC) is species specific and believed to be a cell wall component of all pneumococcal types. A sandwich enzyme-linked immunosorbent assay (ELISA) for detection of PnC in sputa has been developed by using a monoclonal antiphosphorylcholine antibody and a polyclonal rabbit anti-PnC antiserum in the test system. A 1-year study of adult hospitalized patients with community-acquired pneumonia was performed. A total of 147 patients with clinical and radiological evidence for pneumonia were accepted for the study. Of these, 105 patients provided a sputum sample upon admission to the ward. The sputa were cultured semiquantitatively as well as tested for the presence of antigen. Of the sputum samples from patients with Streptococcus pneumoniae, 27 of 33 (accounting for a sensitivity of 82%) were positive in the ELISA test. Of the sputum samples from patients with pneumonia of some other known or suspected etiology, 32 of 34 (accounting for a specificity of 94%) were negative. In addition, 7 sputum samples from 31 patients with pneumonia of unknown etiology were positive. The ELISA test described here is in our opinion a sensitive and specific test for detecting PnC from S. pneumoniae in sputa from patients with untreated pneumonia.

Adult↗

PubMed1985

Determination of antibodies to pneumococcal C polysaccharide in patients with community-acquired pneumonia.

The pneumococcal C polysaccharide (PnC) is species specific and believed to be a cell wall component of all capsular types. Antibodies against PnC in human sera have been demonstrated previously, but the question of whether a rise in these antibodies occurs during pneumococcal infections has not been investigated. We used an indirect enzyme-linked immunosorbent assay (ELISA) for the estimation of PnC antibodies in 124 hospital-treated patients with pneumonia. In 3 of 6 patients with pneumococcal bacteremia and in 17 of 44 patients with S. pneumoniae isolated in the blood, sputum, or nasopharynx, a significant rise in antibody levels was recorded, accounting for a sensitivity of 38.6%. Of 35 patients with pneumonia of other known or suspected etiology, 1 gave a positive result, corresponding to a specificity of 97.1%. In addition, 3 of 8 patients with PnC antigen in the sputum as the only etiological finding and 5 of 37 patients with unknown etiology gave positive results. The PnC antibodies did not seem to have any protective capacity against pneumonia caused by pneumococci. The ELISA, in which only one antigen preparation was used, was more simple than other tests in which traditional capsular antigen preparations are used. It might therefore be used as a supplemental method in the diagnosis of pneumococcal pneumonia. The problems involved in expressing serum titers obtained with the ELISA are discussed.

Antibodies, Bacterial↗

PubMed1982

Susceptibility of bacteroides species to metronidazole during treatment of patients with Crohn's disease and healthy individuals.

Patients with Crohn's disease are usually treated with metronidazole for long periods with the risk of selecting resistant bowel bacteria. This could have serious clinical and epidemiological implications, especially with regard to Bacteroides fragilis which is the most common cause of severe anaerobic infections. An investigation was therefore undertaken with the use of an agar dilution method to examine the susceptibility to metronidazole of B. fragilis and other common Bacteroides species isolated from faeces before, during and after treatment of patients with Crohn's disease amd healthy individuals. Before treatment, or during medication with sulphasalazine, 88% of the strain tested showed minimum inhibitory concentrations (MIC values) of less than or equal to 1 mg/l and none had MIC values greater than 4 mg/l. The MIC values were significantly increased during metronidazole treatment (p less than 0.02), with a maximum value of 8 mg/l. No significant changes were noted for the MIC values of strains isolated before and 1 week to 1 month after treatment (p greater than 0.1). It is concluded that it is important to examine the MIC values of bacteroides isolates from patients with long term treatment with metronidazole, especially with regard to treatment failure.

Bacteroides↗

PubMed1982

A comparative study of metronidazole and sulfasalazine for active Crohn's disease: the cooperative Crohn's disease study in Sweden. I. Design and methodologic considerations.

The design and execution of the Cooperative Crohn's Disease Study in Sweden are described in this paper. A double-blind, double-dummy, crossover (2 X 4 mo) technique was used to compare the suppressive efficacy of metronidazole (0.4 g b.i.d.) and sulfasalazine (1.5 g b.i.d.). The number of randomized patients (78) presented approximately one-third of the available population. The Crohn's Disease Activity Index and the plasma level of orosomucoid were the main variables for clinical evaluation. Results were analyzed primarily in the first treatment period by ranking the clinical outcome of every patient according to a uniform and detailed scheme and applying Wilcoxon nonparametric statistics. The cross-over data only served as additional information. Thirty-six patients had had earlier and mostly positive experience with sulfasalazine. Repeated plasma drug analysis indicated good compliance. The blindness of the trial was tested and appeared satisfactory. The coordination of the trial proceeded as planned. A lack of full conformity in the electroimmunoassay of orosomucoid was taken care of satisfactorily.

Adult↗

PubMed1982

A comparative study of metronidazole and sulfasalazine for active Crohn's disease: the cooperative Crohn's disease study in Sweden. II. Result.

Seventy-eight patients with active Crohn's disease participated in a randomized, double-blind, cross-over trial. The study comprised two 4-mo period. The purpose was to test the efficacy of metronidazole in comparison with that of sulfasalazine. As the main evaluation criteria the Crohn's Disease Activity Index and plasma levels of orosomucoid were chosen. In the first period no difference in efficacy as measured by Crohn's Disease Activity Index was found between the treatment groups. The reduction of the plasma orosomucoid level was significantly more pronounced in the metronidazole group. The hemoglobin concentration increased more in this group than in the sulfasalazine group, possibly due to a toxic effect of sulfasalazine. The erythrocyte sedimentation rate decreased similarly with both drugs. In 15 patients who had active disease throughout the first period, Crohn's Disease Activity Index decreased significantly in the second period for those who switched to metronidazole, but not for those who switched to sulfasalazine. After crossover, no apparent further change in Crohn's Disease Activity Index occurred in either of the treatment groups among patients who had responded favorably in the first period. The plasma concentration of orosomucoid increased significantly among the patients in the sulfasalazine group but not in the metronidazole group. It is therefore concluded that metronidazole is slightly more effective than sulfasalazine in the treatment of crohn's disease. It is worthwhile switching the drug regimen from sulfasalazine, when it fails, to metronidazole, but not from metronidazole to sulfasalazine.

Adult↗

PubMed1981

Relation between concentrations of metronidazole and Bacteroides spp in faeces of patients with Crohn's disease and healthy individuals.

Nine patients wih Crohn's disease and six healthy individuals were given 400 mg metronidazole twice daily and the concentration was measured in plasma and faeces 6 to 8 h after intake. Quantitative and qualitative bacteriological examinations were performed before and during treatment. The concentrations of metronidazole in plasma varied between 5 and 30 mg/l as measured by liquid chromatography (LC) and between 3 and 20 mg/l as measured by a bioassay (BA) method. There was no significant differences between the results of the two methods in patients but compared with BA the LC values were regularly lower in the healthy subjects. Metronidazole was detected in the faeces of most patients. These findings coincided with a significant reduction of Bacteroides spp in their faeces which was not apparent in healthy individuals in whom metronidazole was not detected in the faeces. Higher faecal metronidazole concentrations were found in patients with active disease and a total colon involvement as compared with the patients with a more quiescent disease and involvement of ileum and ascending colon only.

Adolescent↗

PubMed1981

Clinical effect of metronidazole and sulfasalazine on Crohn's disease in relation to changes in the fecal flora.

In the present investigation the clinical effect of treatment with metronidazole or sulfasalazine on patients with Crohn's disease was related to changes in the fetal flora. The clinical effect was evaluated by Crohn's Disease Activity Index (CDAI) and serum(s)-orosomucoid value. Twenty patients were included. All patients were untreated for at least 1 month before entrance to the study. None had any previous history of bowel resection. The results of CDAI, s-orosomucoid values, and the bacterial counts obtained at the start were compared to those at the end of treatment. Only changes of more than 33% of the CDAI or s-orosomucoid and changes of more than 3 log, i.e. 99.9%, of the bacterial counts are considered significant. Seventeen patients had a treatment period of 1-4 months. Their total counts of aerobic and anaerobic bacteria were unchanged. In 6 of 17 patients the Bacteroides counts decreased by more than 99.9%. In 13 of the 17 patients there was a dependence between the Bacteroides counts and s-orosomucoid values (P = 0.05) and in 9 out of 17 patients between the Bacteroides counts and CDAI (P less than 0.05). The use of CDAI and s-orosomucoid as measures for disease activity is discussed, and so are the modes of action of the two drugs in relation to the present results and the etiology and pathogenesis of Crohn's disease.

Adolescent↗

PubMed1981

Effect of metronidazole and sulfasalazine on the normal human faecal flora.

Nine healthy individuals were treated with metronidazole (Flagyl) for 2 weeks and sulfasalazine (Salazopyrin) for 2 further weeks or inversely after randomization. Before, at the day for cross-over, and the end of treatment, quantitative and qualitative studies of the aerobic and anaerobic faecal bacteria and plasma concentration studies of the drugs were performed. The total counts of aerobic and anaerobic bacteria were in close agreement with those reported by others. A comparison between pretreatment samples and those taken at the end of treatment showed a significant or almost significant increase in the count of faecal streptococci (P = 0.03) and of Escherichia coli (P = 0.06) in subjects treated with metronidazole, but not with sulfasalazine. However, the changes in the anaerobic bacterial flora reported during treatment in patients with Crohn's disease with the same drugs were not observed among the healthy individuals.

Adult↗

PubMed1979

Changes in the fecal flora of patients with Crohn's disease during treatment with metronidazole. A preliminary report.

Six patients with Crohn's disease and three healthy volunteers were treated with metronidazole. Before and during metronidazole treatment quantitative and qualitative studies of the aerobic and anaerobic fecal bacterial flora were performed, and the minimal inhibitory concentration (MIC) values for metronidazole of the isolated bacteria were determined. There was no significant change in the fecal flora of the volunteers during metronidazole treatment, but three patients who clinically responded well to treatment had drastically changed their anaerobic flora. Two patients did not respond to the metronidazole therapy. The total anaerobic count for one of them was unchanged, and the number of isolated anaerobic species was high during the treatment. The total anaerobic counts of the other non-responder decreased, but metronidazole-resistant (MIC greater than or equal to 40 microgram/ml) Gram-negative rods remained in the fecal samples. Furthermore, after 2 months his condition worsened, and he was given corticosteroids and parenteral nutrition. The result in one patient with a moderate response to therapy was intermediate. Our observations may explain why some patients benefit from metronidazole therapy and others do not.

Adult↗

PubMedDate not supplied

Human skeletal muscle fibre type variations correlate with PPAR alpha, PPAR delta and PGC-1 alpha mRNA.

AIMS: Studies from genetically modified animals have been instrumental in highlighting genes and their products involved in the regulation of muscle fibre type and oxidative phenotypes; however, evidence in humans is limited. Our aim was therefore to investigate expression of those genes implicated in the regulation of oxidative fibre phenotypes in humans. METHODS: Using quantitative polymerase chain reaction we determined mRNA expression of selected genes in skeletal muscle from three different groups, displaying physiological and pathological variations in muscle fibre type, activity and skeletal muscle metabolism respectively: (i) elite athletes (cyclists), with an increased proportion of type I slow twitch, oxidative fibres, (ii) normally active subjects with an average fibre type distribution, and (iii) spinal cord-injured subjects with a low proportion of type I fibres. RESULTS: Skeletal muscle mRNA expression of calcineurin Aalpha and Abeta, peroxisome proliferator-activated receptor (PPAR)-alpha and -delta, and PPAR gamma coactivator (PGC)-1alpha and -1beta was determined. Calcineurin Aalpha and calcineurin Abeta mRNA expression was similar between groups. In contrast, mRNA expression of PPARalpha, PPARdelta, PGC-1alpha and -1beta was increased in athletes, when compared with normally active subjects. Furthermore, mRNA expression of PPARalpha, PPARdelta, PGC-1alpha and -1beta was reduced in spinal cord-injured subjects. Additionally, PPARalpha, PPARdelta and PGC-1alpha correlated with oxidative fibre content. CONCLUSION: Skeletal muscle mRNA expression of PPARalpha, PPARdelta, PGC-1alpha and -1beta reflects differences in type I muscle fibres associated with pathologically and physiologically induced skeletal muscle fibre type differences.

Adult↗