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Biomedical subjects

A Strömberg

Publications and source records attributed to A Strömberg.

11 recordsLinked to original sources
PubMed1992

Empiric treatment of acute diarrheal disease with norfloxacin. A randomized, placebo-controlled study. Swedish Study Group.

OBJECTIVE: To evaluate the clinical and microbiologic efficacy and safety of norfloxacin for acute diarrhea. DESIGN: Double-blind, placebo-controlled, randomized clinical multicenter trial. SETTING: Six departments of infectious disease. PARTICIPANTS: Patients 12 years of age or older with a history of acute diarrhea lasting 5 or fewer days. Eighty-five percent of patients (511/598) were evaluable for efficacy. Of these evaluable patients, 70% had traveled abroad within the previous 6 weeks. INTERVENTIONS: Patients received either norfloxacin, 400 mg, or placebo twice daily for 5 days. MEASUREMENTS: Enteric pathogens were isolated in 51% of the evaluable patients: Campylobacter species in 29%, Salmonella species in 16%, Shigella species in 3.5%, and other pathogens in 2.6%. RESULTS: Norfloxacin had a favorable overall effect compared with placebo (cure rate, 63% compared with 51%; P = 0.003). There were statistically favorable effects in culture-positive patients, patients with salmonellosis, and severely ill patients but not in culture-negative patients or patients with campylobacteriosis or shigellosis. A significant difference was noted between norfloxacin and placebo in median time to cure among all evaluable patients (3 compared with 4 days, P = 0.02) and in patients with campylobacteriosis (3 compared with 5 days, P = 0.05) but not in patients. Culture-positive, but not culture-negative patients, in the norfloxacin group had significantly fewer loose stools per day compared with patients in the placebo group from day 2 onward (P less than or equal to 0.01). Norfloxacin was significantly less effective than placebo in eliminating Salmonella species on days 12 to 17 (18% compared with 49%, P = 0.006), whereas the opposite was true for Campylobacter species (70% compared with 50%, P = 0.03). In six of nine patients tested, norfloxacin-resistant Campylobacter species (MIC, greater than or equal to 32 micrograms/mL) appeared after norfloxacin treatment. CONCLUSION: Empiric treatment reduced the intensity and, to some extent, the duration of symptoms of acute diarrhea. The effect was restricted to patients who had bacterial enteropathogens or who were severely ill. The clinical usefulness of this treatment is limited by the fact that norfloxacin seems to delay the elimination of salmonella and to induce resistance in campylobacter.

Acute Disease↗
PubMed1992

Rapid emergence of quinolone resistance in Campylobacter jejuni in patients treated with norfloxacin.

15/60 subjects from one center, who all took part in a multicenter double-blind, placebo-controlled study to evaluate the effect of norfloxacin on acute enteritis, had norfloxacin sensitive strains of Campylobacter jejuni in pre-study stool specimens. Eight of the 15 subjects received active drug. In 3 of these 8, high-level quinolone resistant Campylobacter strains of the same serotype as in pre-treatment samples were isolated 4-90 days after the initiation of treatment.

Adult↗
PubMed1991

Outbreak of group A streptococcal bacteremia in Sweden: an epidemiologic and clinical study.

The nationwide incidence of group A streptococcal bacteremia in Sweden was 1.8 per 100,000 population in 1987. During the winter season 1988-1989, the reported cases rate doubled and then declined to the previous level. The peak was due to a type T1/M1 Streptococcus pyogenes strain associated with an increased case fatality rate (33% vs. 15% for other T types). The highest incidence rates were found in the age groups less than 12 months and greater than 70 years. Among a sample of 79 patients hospitalized in November or December 1988, a portal of entry, mainly cutaneous, was recognized in 89% of the patients and concomitant conditions in 67%. Among the clinical findings were signs of skin or soft tissue infection (41%), local or generalized pain (41%), vomiting or diarrhea (24%), cough (18%), and upper respiratory tract symptoms (12%). A fatal outcome was associated with high age, lower respiratory tract or unknown focus, leukopenia on admission, start of antibiotic therapy greater than 6 h after the patient's initial contact with a physician, and a rapid clinical course including multiple organ failure. Renewed awareness of the many facets of fulminant streptococcal infection represents one approach to minimize the case fatality rate.

Disease Outbreaks↗
PubMed1978

Neutrophil and eosinophil granulocytes in bacterial infection: sequential studies of cellular and serum levels of granule proteins.

The intraneutrophilic concentrations of lactoferrin, myeloperoxidase, collagenase and chymotrypsin-like cationic proteins were measured sequentially during acute bacterial infection. The serum levels of lactoferrin and myeloperoxidase were also followed as well as the 'eosinophil' cationic protein as a marker for eosinophil leucocytes. During the early course of infection there was a profound but reversible decrease of intraneutrophilic lactoferrin. The levels of cellular collagenase and chymotrypsin-like cationic proteins also tended to decrease reversibly during day 2-8 in most cases; myeloperoxidase levels were normal except for two cases. Serum myeloperoxidase and lactoferrin correlated with blood neutrophil counts. In spite of the absence of peripheral eosinophils the 'eosinophil' cationic proteins of serum were increased on the first day of infection, which may reflect increased eosinophil turnover.

Bacterial Infections↗
PubMed1978

Serum ferritin during infection. A longitudinal study.

Serum ferritin, transferrin, iron and haptoglobin have been investigated in a longitudinal study in 18 patients hospitalized for various acute infections. Within a couple of days after the onset of an infection, a rise in serum ferritin was seen, the magnitude of which was not dependent on the type of infection (bacterial or viral). The serum ferritin level remained elevated for several weeks in some patients, and 7 out of the 18 patients still had abnormally high values 5 weeks after the onset of illness. The mean curves for serum ferritin and the acute phase reactant haptoglobin were parallel. Possible mechanisms causing the elevation in serum ferritin are discussed.

Acute Disease↗
PubMed1977

Myalgia nuchae as a manifestation of epidemic influenza.

Two cases of acute cervical myalgia in connection with symptoms of malaise and fever are presented. Both patients had serologically proven influenza infections, types A and B. No previous reports have been found of any association of the present syndrome with influenza infection.

Acute Disease↗
PubMed1975

Alpha-1-antitrypsin deficiency, mitochondrial antibodies and possible primary biliary cirrhosis. A case report and family study.

A case of a 70-year-old woman with a history of gastric ulcer and several pneumonias is presented. She was found to have pulmonary emphysema, severe alpha-1-antitrypsin (alpha1AT) deficiency and raised serum mitochondrial antibodies. Surgical liver biopsy showed portal liver cirrhosis, PAS-positive, diastaseresistant globules in the hepatocytes and changes interpreted as florid duct lesion of primary biliary cirrhosis. A brother has severe alpha1AT deficiency. Two daughters had raised mitochondrial antibodies. One of the latter had a granulomatous hepatitis, a common finding in primary biliary cirrhosis. The association of alpha1AT deficiency and primary biliary cirrhosis does not seem to have been described previously.

Adolescent↗
PubMedDate not supplied

Ciprofloxacin does not achieve radical cure of Plasmodium falciparum infection in Sierra Leone.

Recently, activity in vivo of norfloxacin has been reported against Plasmodium falciparum and, in vitro, ciprofloxacin has been found to be even more potent than norfloxacin. We therefore treated one patient infected with chloroquine-resistant P. falciparum at relatively low parasite density with ciprofloxacin, 200 mg intravenously twice daily for 3 d. This treatment failed to produce radical cure, although some suppressive effect was probably obtained. The growth of the P. falciparum isolate in vitro was inhibited at 12.5 micrograms/ml, whereas the plasma concentration recorded 1 h after infusion was only 1.2 microgram/ml. It is concluded that, if ciprofloxacin is to be used for treatment of malaria, a higher dose than that normally used for bacterial infections is necessary.

Animals↗