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Biomedical subjects

G Anestad

Publications and source records attributed to G Anestad.

At least 19 recordsLinked to original sources

IL-6 cerebrospinal fluid levels are related to laryngeal IgA and epithelial HLA-DR response in sudden infant death syndrome.

The objective was to investigate whether there is any correlation between signs of central and peripheral immune stimulation in victims of sudden infant death syndrome (SIDS), the former expressed by IL-6 in cerebrospinal fluid (CSF), the latter by IgA, IgG, and IgM immunocytes, T lymphocytes, and HLA-DR expression in laryngeal mucosa. Seventeen SIDS cases with low CSF IL-6 levels (< or =5 pg/mL) and 20 cases with high CSF IL-6 levels (> or =30 pg/mL) were subjected to immunohistochemical quantitation of IgA, IgG, and IgM immunocytes; semiquantitative scoring of T lymphocytes in the mucosa of epiglottis and larynx, and semiquantitative evaluation of HLA-DR expression. SIDS cases with IL-6 levels > or =30 pg/mL had a significantly higher number of IgA immunocytes in laryngeal mucosa (p = 0.007) and in epiglottis (p = 0.03) than cases with IL-6 levels < or =5 pg/mL. Furthermore, laryngeal HLA-DR expression was significantly more extensive in SIDS cases with IL-6 levels > or =30 pg/mL than in those with levels < or =5 pg/mL (p = 0.05). No differences were found for IgG and IgM immunocytes or for T cells. In addition, babies found prone more often had symptoms of slight infection before death and had a higher number of IgA immunocytes in the larynx (p = 0.02) than babies sleeping on their side or back. Because IL-6 levels > or =30 pg/mL correspond to the levels found in infants who die from infectious diseases such as meningitis/septicemia and pneumonia, the findings favor the hypothesis that many SIDS cases may be caused by an "overreaction" of the immune system to an otherwise harmless infection.

Epithelium↗

[Chlamydia pneumoniae infections in Norway].

During the last 5-6 years our understanding of Chlamydia pneumoniae has changed radically. C. pneumoniae is no longer considered a dangerous, obligatory pathogen. Rather, it is a common, highly contagious intracellular opportunist, inducing poor immunity and with a tendency to repeated reinfections. At present, a possible role in the formation of atheromatous plaques is being discussed. There is a significantly higher prevalence of antibodies against C. pneumoniae in coronary heart disease patients than in controls. Another unsolved problem is that of therapy, since chronic lung infection resists long-term macrolide antibiotic treatment. Should additional treatment with cortisone be given? Here we clearly need clinical trials before we move in a totally new direction.

Chlamydia Infections↗

[Homeopathy--time for official authorization?].

The Norwegian government has recently appointed a committee to scrutinise alternative therapies and distinguish between serious and nonserious practitioners in preparation for future authorisation. Homoeopathy seems to be the most popular of alternative therapies in Norway, and counts Prime Minister Thorbjørn Jagland among contented patients. For this reason we have taken a closer look at the principles of homoeopathy, and the documentation. Just as in a recent report on documentation and the effect of selected alternative therapies, we too were unable to find studies of reasonable quality that were confirmed by others. Homoeopathists use theoretical physics to explain how water "remembers" the information from molecules no longer existing in the solution, when the liquid is shaken in a special way between every dilution. It does not matter whether the homoeopathist is serious or not as long as the remedy consists only of pure water. We conclude, therefore, that homoeopathy should not be authorised as a serious medical treatment in the Norwegian Health Service.

Certification↗

False-negative results of a ligase chain reaction assay to detect Chlamydia trachomatis due to inhibitors in urine.

The aim of this study was to assess the presence of inhibitors in urine specimens causing false-negative results in a commercial Chlamydia trachomatis gap-filling ligase chain reaction (Gap-LCR) assay. On testing of urine samples by the Gap-LCR assay and urethral swab specimens by cell culture, 73 (19%) Chlamydia trachomatis positive subjects were detected among 382 men attending a clinic for sexually transmitted diseases. In 56 subjects, the agent was detected in both the urine and the urethral samples, while 309 subjects were negative in both tests. In seven subjects urine samples were Gap-LCR positive (confirmed by a different Gap-LCR assay), but the corresponding urethral swab samples were cell culture-negative. In another ten subjects the urethral swab samples were cell culture positive, but their urine samples were Gap-LCR negative. Subsequent re-analysis of the urine samples including the addition of external Chlamydia trachomatis DNA indicated full or partial inhibition in nine of the cell culture-positive Gap-LCR negative subjects. When urine preparations were freeze-thawed and diluted prior to testing, Chlamydia trachomatis was detected in six of the ten initially Gap-LCR-negative samples. Gap-LCR inhibitors were present in at least nine (12%) of the 73 urine preparations from the Chlamydia trachomatis positive individuals. Identification of samples containing Gap-LCR inhibitors and subsequent processing to reduce the inhibition increased the sensitivity of the test from 86% to 95%.

Adult↗

Screening urine samples by leukocyte esterase test and ligase chain reaction for chlamydial infections among asymptomatic men.

Urine samples from 358 asymptomatic males were screened for urethral inflammation by the leukocyte esterase (LE) test and for Chlamydia trachomatis by the ligase chain reaction (LCR). LE and LCR positivity rates were 7.5% (27 of 358 samples) and 2.8% (10 of 358 samples), respectively. Eight of the 10 LCR-positive samples were detected by the LE screening test. The urine LE prescreening test in combination with the LCR assay may be a reasonable approach for genitourinary chlamydial disease control.

Bacteriological Techniques↗

Detection of Chlamydia trachomatis in the urine of young Norwegian males by enzyme immunoassay.

First-void urine samples from 392 Norwegian military conscripts were investigated for the presence of Chlamydia trachomatis by enzyme immunoassay (EIA) on day 1 and day 5 after collection. Positive samples were subsequently investigated by direct immunofluorescence (IF) microscopy for the presence of chlamydial elementary bodies (EBs) in the urine pellet, and urethral swab material taken from the EIA-positive individuals was cultured. 4.8% (19/392) of the urine samples were EIA-positive on day 1, and 5.4% (21/392) were positive on day 5, with a combined total of 6.6% (26/392). Twenty-four of the 26 urine samples were confirmed as positive on IF microscopy. Urethral swabs were taken from 21 EIA-positive individuals. Six of the swabs were positive on cell culture, whereas nine were positive on IF microscopy of swab material, suggesting that these techniques perform better in symptomatic cases than in male Chlamydia trachomatis carriers. In the urine samples a notable discrepancy in EIA results was seen when the same refrigerated samples were retested on day 5 compared to day 1. This discrepancy was probably due to storage-related factors.

Adult↗

Ectopic pregnancy and chlamydial serology.

OBJECTIVES: To determine the prevalence of humoral IgG antibodies to Chlamydia trachomatis in women with tubal pregnancies. METHODS: A study was made of 49 women with tubal pregnancies. The control group consisted of 50 pregnant women without any known fertility problems. RESULTS: Compared with the pregnant group of women, a statistically significant higher prevalence of chlamydial IgG antibody titer > or = 64 was observed among the patients with gross abnormalities in the fallopian tube contralateral to the ectopic gestation (P = 0.002). The differences in geometric mean titer (GMT) were also statistically significant (P = 0.0004) between those two groups. The recall frequency of past pelvic inflammatory disease (PID) was increased 5-6-fold in patients with ectopic pregnancy, compared with the intrauterine pregnant women. Twenty-five of 30 patients (83%) with ectopic pregnancy and macroscopic tubal sequelae recalled a history of PID. The prevalence of chlamydial IgG antibody titer > or = 64 among women with a past history of PID was 75.6% (34/45), compared with 44.4% (24/54) among the women without any history of past PID history (P = 0.002). Concerning GMT, the numbers were 27 and 154 among women with and without a past history of PID, respectively (Fig. 2). CONCLUSIONS: These findings suggest that C. trachomatis is a major cause of oviductal damage, which predisposes to ectopic pregnancy.

Adult↗

A double blind study of single dose azithromycin and doxycycline in the treatment of chlamydial urethritis in males.

OBJECTIVE: To compare the efficacy and safety of azithromycin and doxycycline in the treatment of males with uncomplicated urethritis caused by chlamydia trachomatis. DESIGN: A multicentre, double-blind, randomised treatment study. SUBJECTS: 130 male outpatients with clinical signs and symptoms of urethritis. SETTING: STD clinics at four Norwegian University Hospitals. METHODS: Patients were randomly allocated to 1000 mg azithromycin as single dose or doxycycline 100 mg twice daily for 7 days. Clinical, bacteriological and safety assessments were made at entry and after 1 and 2 weeks. Safety data were also repeated after 4 weeks. RESULTS: Demographic data were similar in both groups. At the week 1 assessment bacteriological eradication was achieved in 44 of 44 evaluable azithromycintreated patients and in 42 of 42 in the doxycycline group. At the week 2 assessment the corresponding figures were 35 of 35 and 34 of 34 respectively. CONCLUSION: Azithromycin 1000 mg single dose was as effective as doxycycline 100 mg twice daily for 7 days in male patients with chlamydial urethritis.

Adolescent↗

Spread of subclinical Chlamydia pneumoniae infection in a closed community.

Chlamydia pneumoniae infections may spread subclinically. The present investigation took place in a military setting. Sera drawn when the conscripts had entered their military service 2 months previously had been kept frozen and were available. In a camp with 500 people, 35 (7%) developed clinical symptoms of pneumonia. The infection was serologically verified with C. pneumoniae-specific micro-immunofluorescence technique. Of 40 healthy controls, 21 turned out to fulfil the serological criteria of infection, thus, representing subclinical cases. These 21 cases, when extrapolated to the whole camp, equalled a rate of 49% which, added to the 7% of pneumonic cases, gave a total infection rate of 56%. Pre-existing IgG antibodies were demonstrated in 10% of the pneumonic cases, 48% of the subclinical cases, and 89% of the non-infected, healthy controls. Without the access to pre-epidemic sera permitting us to establish 4-fold titre rises, the spread of subclinical C. pneumoniae infection would have been noted at 5%, and not 49% as here demonstrated.

Adult↗

Rapid diagnosis of equine influenza.

During an epizootic of equine influenza in Norway caused by influenza A/equine (H3N8) virus the efficacy of rapid virus diagnosis by the indirect immunofluorescence technique was evaluated. The antiserum used in the test was a polyclonal influenza A virus antiserum with reactivity directed mainly against the common nucleoprotein and matrix protein. This antiserum possessed sufficient reactivity for the detection of virus-infected exfoliated nasopharyngeal cells. Nasopharyngeal smear samples from 92 horses were examined and a positive diagnosis was obtained for 57 (62 per cent). Paired serum samples were collected from 62 horses and, compared with the haemagglutination inhibition test, the rapid virus diagnosis test had a specificity and sensitivity of 95 per cent and 80 per cent, respectively.

Animals↗

[Rotavirus in stools from hospitalized children].

Electron microscopy, ELISA for rotavirus and virus cultivation in cell cultures were used to study the occurrence of rotavirus in 451 fecal samples collected from hospitalized children. Rotavirus was found in samples from 24 of 27 patients admitted with acute diarrhoea. All specimens from randomly selected patients without diarrhoea were negative. Two patients developed nosocomial rotavirus infection. ELISA was positive, but electron microscopy was negative in two specimens obtained from asymptomatic newborns. In this investigation rotavirus was the dominating agent isolated in infectious gastroenteritis. We found no rotavirus excretors without diarrhoea.

Child↗

Significance of immunoglobulin A titres in the diagnosis of urogenital chlamydial infections.

The significance of chlamydial serum IgA compared with IgM and IgG in the diagnosis of urogenital chlamydial infection was evaluated using 120 sera from different categories of patients. In urethritis patients both IgM and IgA antibodies were not found to be present consistently, whereas in patients with deep-seated chlamydial infection, IgA was more often present. Although of limited value in superficial infections, demonstration of IgA antibodies may be of value in the diagnosis of deep-seated chlamydial infections.

Adolescent↗

Norwalk virus in Norway: an outbreak of gastroenteritis studied by electron microscopy and radioimmunoassay.

An outbreak of acute gastroenteritis affected approximately half of 40 children staying at a holiday centre in Southern Norway. By direct electron microscopy Norwalk-like viruses were demonstrated in 4/8 available stool specimens. No other pathogens were detected. Antibody against these viruses was demonstrated by immune electron microscopy in all of 7 convalescent phase sera but in none of 11 acute phase sera collected. Radioimmunoassay examination showed a rise in titre of Norwalk virus antibody in 6 available paired sera. This outbreak of Norwalk virus gastroenteritis in Norway was thus documented by a combined use of direct and immune electron microscopy and radioimmunoassay.

Adolescent↗