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Biomedical subjects

C Avnstorp

Publications and source records attributed to C Avnstorp.

At least 37 records · Page 2Linked to original sources

Prognostic significance of digital blood pressure in leg ulcer patients.

In a consecutive series of patients with ulceration of the lower leg referred to the dermatological in-patient department during a 9-month period, a systolic digital blood pressure level (SDBP) below 60 mmHg was used to identify patients with complicating arterial occlusive disease (AOD) of the legs. AOD was diagnosed in 25 patients and stasis ulcers from venous disease (SDBP greater than or equal to 60 mmHg) in 38 patients of the same ages. Patients with ulceration from other causes were excluded. After 1 year, 48% of the patients with AOD and 5% of those with stasis ulcers had died. In the AOD group, 11 legs were amputated. Our figures show that the SDBP is valuable in identifying high-risk patients.

Adult↗

[Treatment of gonorrhea at the Venereal Disease Clinic in Copenhagen in 1985. A study of the efficacy of standardized treatment compared with the sensitivity of Gonococcus to penicillin in vitro].

In 1985, a total of 1,140 patients (907 men and 503 women) were treated for gonorrhoea at the Copenhagen County Outpatients Clinic at Rudolph Berghs Hospital. Failure of the standard treatment regimen (pivampicillin plus probenecid; patients stating penicillin allergy received a Sulfotrim-regimen) occurred in 79 (5.6%). A significant association between the in vitro susceptibility to penicillin and the efficacy of the standard treatment regimen was found; among 1,139 patients with uncomplicated urogenital gonorrhoea caused by penicillin susceptible gonococci, the failure rate was low (0.4-1.9%); the failure rate was high in patients infected with penicillin resistant gonococci. Continued surveillance of the in vitro antimicrobial susceptibility of gonococci is recommended as a basis for the choice of standard treatment regimen.

Drug Resistance, Microbial↗

[A mini epidemic of varicella zoster virus reinfection at a department of hematology].

Whereas primary infection with varicella zoster virus (VZV) (chickenpox) and reactivation of VZV (shingles) are common and recognized, clinical reinfection with VZV is rare. A little epidemic of presumed reinfection with VZV in six immune-compromised adults is presented here. The epidemic lasted for three months, during which a healthy young woman also developed a primary VZV infection in the form of chickenpox. In the immune-compromised patients, the clinical picture was dominated by disseminated, prolonged and frequently haemorrhagic and necrotic eruptions which may cause diagnostic difficulties. Skin biopsy proved helpful in the diagnosis while demonstration of the VZV antigen in the skin elements was specific and sensitive. All of the patients, with one exception, were treated with acyclovir and dissemination of the infection to the inner organs did not occur. One patient may have died on account of the VZV infection. In conclusion, immune-incompetent patients must be warned against infection from chickenpox or disseminated herpes zoster. In cases of proved exposure, prophylactic treatment with acyclovir should be considered and, in cases of clinical disease, immediate treatment with 10 mg acyclovir per kg body weight should be administered intravenously thrice daily.

Adult↗

Kinetics and characterization of intercellular adhesion molecule-1 (ICAM-1) expression on keratinocytes in various inflammatory skin lesions and malignant cutaneous lymphomas.

The kinetics of expression of the intercellular adhesion molecule-1 (ICAM-1) were studied on keratinocytes in skin biopsy specimens of sensitive persons in whom the haptens were applied in a standardized format for allergic contact dermatitis testing. There was no ICAM-1 expressed on keratinocytes of normal skin; ICAM-1 was induced as early as 4 hours after the application of the patch in some subjects. By 48 hours after the application of the patch, all specimens contained ICAM-1-positive keratinocytes. This was concurrent with a heavy mononuclear cell dermal infiltrate and maximum clinical manifestations. Expression of human lymphocyte antigen (HLA)-DR or other inducible surface proteins on keratinocytes under these conditions was much less frequent. When specimens from primary irritant dermatitis were used, only 1 of 14 cases had keratinocytes expressing ICAM-1 at 48 hours, the time of maximum clinical manifestation. Among benign inflammatory lesions, most cases resembled the allergic patch test specimens in that ICAM-1 was expressed to a large degree on keratinocytes. Again, the expression of HLA-DR was variable. Malignant skin lesions, on the other hand, were much less consistent and generally lower in terms of ICAM-1 expression on keratinocytes. Furthermore, in contrast to the benign cutaneous conditions, some malignant skin lesions contained keratinocytes that expressed class II antigens or other inducible surface proteins in the absence of ICAM-1. These data suggest that ICAM-1 plays a role in the specific immune response by facilitating either antigen presentation or lymphocytic infiltration.

Adult↗

Follow-up of workers from the prefabricated concrete industry after the addition of ferrous sulphate to Danish cement.

Ferrous sulfate has been added to cement manufactured in Denmark, reducing the water soluble chromate content to not more than 2 ppm, since September 1981. A comparison is made between the medical and employment status of a cohort of workers engaged, or who had been engaged, in the manufacture of prefabricated concrete building components in 1981 and in 1987. Workers who had allergic cement eczema in 1981 appeared to show no improvement 6 years after the reduction of chromate in the cement. Improvement was seen, however, in the eczema of those workers with irritant cement eczema. The 1987 study showed that a larger number of chromate-sensitized workers required medical services and topical steroid treatment than did those who were not sensitized to chromate. This difference was statistically significant. The worse medical prognosis of the chromate-sensitized workers could in part be due to the fact that some of these had secondary contact sensitivity to cobalt and rubber chemicals. The chromate-sensitized workers also took earlier retirement. Younger workers with allergic and irritant cement eczema continued to work and their employment status was not influenced by chromate sensitization.

Adult↗

Reinfection with varicella-zoster virus in immunocompromised patients.

A small epidemic of varicella/atypical generalized zoster among 6 immunocompromised patients and one previously healthy person is described. The 6 immunocompromised patients suffered from lymphoproliferative diseases in terminal stages treated with chemotherapy and reported varicella in their childhood. They developed a generalized maculopapular rash with hemorrhagic bullae and necroses. The infection passed from one patient to another during a 3-month period in the department. They were placed in adjacent rooms and nursed by the same staff. The most specific diagnostic tool was the detection of varicella-zoster virus antigen from vesicles by ELISA technique. The epidemic was supposed to be caused by exogenous reinfection with varicella-zoster virus, and illustrated that generalized zoster may be even so infectious as varicella and that immunocompromised patients should be protected against reinfection.

Adult↗

Prevalence of cement eczema in Denmark before and since addition of ferrous sulfate to Danish cement.

This is a study of the prevalences of chromate allergy and hand eczema among workers engaged in the manufacture of pre-fabricated concrete building components in Denmark in 1981 and again in 1987. In September 1981 the chromate content of cement manufactured and sold in Denmark was reduced to not more than 2 ppm (parts per million) of water-soluble chromate. This was accomplished by adding ferrous sulfate, thus increasing the cost of the cement by about 1%. There was a statistically significant decrease in the prevalence of chromate allergy and hand eczema following the addition of ferrous sulfate, but there was no change in the frequency of skin irritation. The economic benefit of adding ferrous sulfate was demonstrated by a decrease in the need for dermatological services and topical steroid treatment. Cement eczema as a result of chromate allergy is a common occupational dermatitis among workers in the building and construction industries and a reduction in the chromate content of cement would appear to be a reasonable preventive measure in areas where there is a large concentration of construction industries.

Adolescent↗

Seroconversion to human immunodeficiency virus (HIV) in persons attending an STD clinic in Copenhagen.

1,182 males and 155 females attending an STD clinic from June 1984 to October 1985 were investigated for the presence of antibodies to human immunodeficiency virus (HIV). 348 (29.5%) of the males and 5 (3.2%) of the females were antibody positive (ab+). 237 of the males were initially antibody negative (ab-) and were tested more than once, and during a 16-month period 40 of these seroconverted from ab- to antibody positive. The mean follow-up period of these 40 patients was 7.1 months, and thus the seroconversion rate is estimated to be 2.4% per month. Samples from 37 of these were available for HIV antigen testing. 19 of the patients were antigen positive in the latest ab- sample and accordingly, 18 patients were antigen negative in the latest ab- sample. No difference was found between the mean follow-up periods of those with and those without HIV antigen in the latest ab- serum and the presence of HIV antigen in serum was not associated with symptoms of acute HIV infection. After 20 months of follow-up, none (0.0-8.8%, 97.5% confidence limits) of the 40 patients have developed AIDS or AIDS-related complex.

Adolescent↗

Sequential immunophenotypic study of lymphoid infiltrate in allergic and irritant reactions.

Sequential biopsies (4-72 h) of early allergic and irritant patch test reactions have been examined immunohistologically for reactivity with 19 monoclonal antibodies against antigens on lymphoid cells in order to investigate the nature/origin of the infiltrating lymphoid cells and assess their state of activation/proliferation. The composition of the infiltrates was similar in allergic and irritant reactions and consisted of T-lymphocytes of helper/inducer types in association with T-cell accessory cells, i.e., Langerhans cells and HLA-DR-positive macrophages. No differences in expression of T-cell or macrophage associated antigens were seen in early as opposed to late biopsies. In contrast, the proportion of cells positive for markers associated with activation (interleukin-2 receptor) or proliferation (transferrin receptor, the Ki-67 nuclear antigen) of lymphoid cells was found to increase with time in both types of reaction. These data substantiate the view that T-cell immune reactions are implicated in both allergic and toxic patch test lesions, and indicate that the lymphocytes in the infiltrates are activated and proliferate.

Adult↗

Transcutaneous PO2 and laser Doppler blood flow measurements in 40 patients with venous leg ulcers.

The study included 40 patients with clinically venous leg ulcer(s) in one leg only and with a systolic toe blood pressure above 50 mmHg in both legs. Transcutaneous oxygen tension was measured on both lower legs at equivalent sites, on the affected leg immediately proximal to the ulcer(s). Similarly, skin blood flow was measured in both legs at a skin temperature of 32 degrees C and 44 degrees C by means of laser Doppler velocimetry, and for each leg the index of blood flow 44 degrees C/flow 32 degrees C was calculated to express the degree of blood flow increment following local hyperthermia. Transcutaneous oxygen tension measurements were significantly lower on affected legs (p less than 0.01) as was flow increment (p less than 0.01), mainly due to a high flow measurement at 32 degrees C on affected legs rather than to a low measurement at 44 degrees C. The results of our flow measurements suggest a state of (relative) hyperemia in the vicinity of venous leg ulcers, also confirmed by the clinical findings. This could be interpreted as an arteriolar response to lowered oxygen tension or (it could) be part of reactive reparative processes leading to increased O2 consumption in the tissues.

Aged↗

Plasmapheresis in hyperviscosity syndrome.

Three patients with Waldenström's macroglobulinaemia developed circulatory complications due to increased plasma viscosity, i.e. relative viscosity value above 4. Plasmapheresis was performed either in a Haemonetics 30 S cell separator, by plasma filtration through a CPS 10 TM filter or by a double-double pack Fenwal system. All three methods reduced the plasma viscosity and abolished the clinical symptoms. In cases of acute hyperviscosity syndrome, apheresis of small amounts of plasma by the double-double pack system may serve as an alternative to the more advanced techniques.

Adult↗

Erythromycin against Chlamydia trachomatis infections. A double blind study comparing 4- and 7-day treatment in men and women.

In a double-blind controlled study the treatment of erythromycin 500 mg twice daily for seven days was compared with erythromycin 500 mg twice daily for four days in 73 men and women with uncomplicated genito-urinary chlamydia trachomatis infections. At the start of the treatment, 34 of 42 men (81%) and 15 of 31 women (48%) had symptoms suggesting the presence of chlamydial infections. There was a significantly higher bacteriological cure rate with the seven-days treatment in both men and women compared with the four days treatment at the second control visit two weeks after the start of the treatment (p less than 0.0005). The bacteriological cure rate of the women was higher than that of the men, but the results for men and women did not differ significantly. It is concluded that a four day treatment with erythromycin 500 mg twice daily can not be recommended, whereas 500 mg twice daily for seven days was shown to be effective, especially in women.

Chlamydia Infections↗