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Biomedical subjects

G Pedersen

Publications and source records attributed to G Pedersen.

At least 55 records · Page 3Linked to original sources
PubMed1997

Patients with bacteremia dying before notification of positive blood cultures: a 3-year clinical study.

In a 3-year prospective survey of bacteremia in a Danish county, 102 patients (4.6%) died before notification of positive blood cultures. Clinical records were available for 99 patients (ED group) with a male/female ratio of 1.15 and a median age of 74 years. The predominant pathogens were Escherichia coli (32%), Streptococcus pneumoniae (17%) and Staphylococcus aureus (16%). Streptococcus pneumoniae was the only pathogen found to be more frequently in the ED group than among patients who were alive when notification was issued (ALIVE group) (17% vs 10%). All but 2 patients with meningococcal disease had a predisposing condition. Infection was deemed to be the direct cause of death in 62%, a contributory factor in 31% and of marginal significance in 6%. Compared with the ALIVE group, the ED group was older and more frequently had a focus within the respiratory tract. Conversely, the urogenital tract and intravascular devices were less common foci. The detection time was similar for the ED and ALIVE groups (median 22 and 24 h, respectively). 78% of ED patients had received antibiotic therapy and the coverage was appropriate in 59%. The possibility of bacteremia had not been responded to by institution of antibiotic therapy in the remaining patients. We conclude that physicians must consider antibiotic therapy when ordering sampling of blood for culture and empirical antibiotic therapy should basically provide coverage for pneumococci, S. aureus and E. coli.

Bacteremia↗
PubMed1997

Antibiotic therapy and outcome of monomicrobial gram-negative bacteraemia: a 3-year population-based study.

Within the 3-y period 1992-94 a total of 815 episodes of monomicrobial bacteraemia caused by Enterobacteriaceae not including Salmonella were registered in the County of Northern Jutland. The 30-d case fatality rate was 24%, ranging from 21% for Enterobacter spp. (n = 43), 22% for E. coli (n = 577) to 32% for both Klebsiella spp. (n = 138) and a group of miscellaneous enterobacteria (n = 57). In 16% of the bacteraemias, antibiotic treatment was not instituted before notification of positive blood cultures; in 9% empirical antibiotic treatment was inappropriate. Antibiotic regimens mainly included beta-lactams, ampicillin or mecillinam in combination with an aminoglycoside. The following factors were independently associated with case fatality: age > or = 75 y, high comorbidity index, admission to a medical ward or an intensive care unit, nosocomial acquisition, a source of infection outside the urinary tract or an undetermined focus, Klebsiella spp., inappropriate coverage or lack of antibiotic treatment before notification of positive blood culture. It is a matter of concern that in one-sixth of patients the physicians had not responded to the possibility of bacteraemia with institution of empirical antibiotic therapy.

Adolescent↗
PubMed1996

Influence of occupational accidents and deaths related to lifestyle on mortality among merchant seafarers.

OBJECTIVES: The aim of the present historical cohort study was to enhance the understanding of the unusual mortality pattern seen among seafarers. The main object was to describe the mortality pattern of Danish seafarers in recent years with special reference to the influence of accidents in the maritime workplace and ashore and the influence of diseases related to lifestyle. SUBJECTS: A cohort of 24,132 male seafarers of all job categories employed on a Danish merchant ship between 1986 and 1993, was followed up. Mortality among those who left the occupation before the end of the follow-up period was analysed separately. RESULTS: The standardized mortality ratio was 1.43 (95% CI: 1.33-1.54) from all causes and 3.05 (95% CI: 2.62-3.52) from accidents. An excess mortality from natural causes was attributable mostly to an excess among deck and engine room crew and was mainly caused by diseases related to lifestyle. While active as seafarers, the SMR for accidents was 2.62 (95% CI: 2.12-3.20), accidents at the workplace explaining almost half the deaths. Among those who left shipping, the risk of fatal accidents increased. All categories of seafarers continued to have a high risk of fatal accidents into older age. CONCLUSION: Merchant seafarers were shown to have a higher mortality than the general population. Despite a very high risk of fatal accidents in the workplace, these accidents could only explain a proportion of the observed excess mortality. Accidents ashore and diseases related to lifestyle factors such as drinking and smoking made a major contribution to the observed excess mortality. The results indicate that people in occupations with a high risk of fatal accidents at the workplace also seem to have a high risk of accidents away from the workplace after leaving the occupation. The high risk lifestyle seems to be linked to lifestyle in general and hence the related diseases and high risk of death.

Accidents, Occupational↗
PubMed1994

[Treatment of acute myeloid leukemia in the elderly with low-dose cytosine arabinoside].

We report the outcome of 95 patients older than 60 years with de novo acute non-lymphocytic leukaemia (ANLL), treated in two institutions during a 10 year period. Thirty-two patients, mean age 78 years, did not receive any chemotherapy, and their median survival was 38 days. Five patients in good clinical condition, aged 60-63 years, were treated conventionally with an anthracycline and cytarabine, and three patients obtained a complete remission (CR) lasting 73, 417, and 1050 days. Fifty-eight patients were treated with low-dose cytarabine (LDC) for remission-induction and maintenance. Eighteen patients obtained CR, yielding a remission rate of 31%. The median duration of remission was 380 days and median survival of the same group was 498 days. LDC is valuable in the treatment of ANLL in the elderly. Controlled studies are warranted to define the indications for LDC versus conventional therapy in the large grey zone of elderly patients.

Age Factors↗
PubMed1994

[Long-term carrier state of methicillin resistant Staphylococcus aureus after hospitalization].

In Denmark, strains of methicillin-resistant (MR) Staphylococcus aureus constitute less than 0.1% of all S. aureus isolates and are often acquired abroad. A strain of MR S. aureus phage type 77+ was isolated from a patient, who had been hospitalized in a Portuguese hospital three months earlier. In Denmark, the patient had been admitted to a private clinic for replacement of the aortic valve and a coronary bypass operation. The strain did not produce detectable soluble coagulase, and it was multiply resistant, including resistance to gentamicin, tetracycline, erythromycin, and rifampicin. It was probably non-invasive. Thirty-seven members of the staff were screened for MR S. aureus with negative results. The patient was treated with chlorhexidine to eliminate carriage, but, eight weeks after treatment, he was still colonized. Thus, in the current epidemiological situation in Denmark, it is important to take into consideration that carriage of MR S. aureus may last several months. We therefore suggest, that specific guidelines for hospital hygiene should be upheld not only for patients, who are transferred directly from hospitals in other countries, but also for patients, who have been hospitalized abroad within the last three to six months.

Aged↗
PubMed1993

[Human Parvovirus B19 infection and aplastic crisis].

Human Parvovirus B19 (B19-virus) is the most frequent cause of aplastic crisis in patients with underlying hereditary haemolytic anaemia. B19-virus interrupts erythropoiesis by lytic damage of erythroid precursors in the bone marrow. Patients with hereditary haemolytic anaemia have a shortened red cell life span and a compensatory increased activity of the erythroid precursors in the bone marrow. Temporary interruption of erythropoiesis leads to a precipitous fall in haematocrit and absence of reticulocytes in the circulation. The symptoms of the illness are anaemia and fever. The treatment is red cell transfusion. The infection is diagnosed either by direct demonstration of B19-virus-DNA or by demonstration of specific IgM-antibodies to B19-virus. The natural infectivity of B19-virus is high, and infection is presumably followed by lasting immunity. Because the infectivity of cases of aplastic crisis caused by B19-virus is especially high, control guidelines are necessary for pregnant seronegative staff. A review of the literature is presented.

Anemia, Aplastic↗
PubMed1993

[Occult hereditary spherocytosis in aplastic crisis of unknown cause].

We describe two cases of aplastic crisis of unknown origin, occurring within one week in a 49-year old man and his 20 year old son. They both had undiagnosed hereditary spherocytosis, and both of them had earlier had a B19-parvo infection without having symptoms of aplastic crisis at the same time. Chronic haemolytic anaemia should be considered in adult patients with acute severe anaemia caused by aplastic crisis.

Adult↗
PubMed1993

Capnocytophaga canimorsus bacteraemia demonstrated by a positive blood smear. A case report.

The observation of bacteria in a peripheral blood smear was conducive to the diagnosis of Capnocytophaga canimorsus septicaemia in a patient with no definite record of animal bites. Multiple rods were seen extracellularly and within the cytoplasm of neutrophils. The blood culture became positive after 18 h of incubation. Disseminated intravascular coagulation (DIC) was manifest and infarction of the spleen was suspected. Direct examination of peripheral blood smears could be a valuable adjunct in the diagnosis of overwhelming bacteraemia.

Bacteremia↗
PubMed1993

Pseudomonas aeruginosa bacteraemia detected with a new blood culture system Colorbact: a note of caution.

Detection of Pseudomonas aeruginosa bacteraemia by the newly introduced Colorbact blood culture system (Statens Seruminstitut, Copenhagen) was ascertained in a Danish regional department of clinical microbiology. Ten of sixteen bacteraemias (63%, 95% CL: 35-85%) were detected within 24 h; the 48 h figure was 81% (95% CL: 54-96%). The initial bacteriological diagnosis was confounded, however, by the observation of non-motile rods or atypical motility in 8 episodes, including 4 of the 10 episodes with a positive direct microscopy during the first 24 h. This may be an untoward effect of vigorous agitation. In two episodes P. aeruginosa was isolated only from the anaerobic culture bottle, whilst in two other episodes P. aeruginosa grew in aerobic and anaerobic bottles. This observation may reflect a chance distribution of viable bacteria among the bottles in the Colorbact set.

Anti-Bacterial Agents↗
PubMed1993

Fusobacterium necrophorum septicemia complicated by liver abscess. A case report.

A previously healthy 27-year-old man developed Fusobacterium necrophorum septicemia complicated by a solitary liver abscess. This is an unusual course of necrobacillosis, in addition to Fusobacterium necrophorum being a rare cause of anaerobic liver abscesses. The patient was treated with percutaneous drainage and a prolonged course of ampicillin and metronidazole therapy. He had a successful recovery.

Adult↗
PubMed1992

[Necrobacillosis].

Necrobacillosis is an infection caused by the anaerobic Gram-negative rod Fusobacterium necrophorum. The infection is most common in previously healthy young adults and is characterised by sore throat followed by rigors, septicaemia and the formation of metastatic abscesses, often in the lungs. The infection has a certain mortality, which is reduced when early and sufficient treatment is administered. The treatment is a prolonged course of penicillin and/or metronidazole. Two case histories and a review of the literature are presented. The purpose of this article is to make the clinician aware of the syndrome, which is so characteristic that the diagnosis can be made from the clinical picture alone before bacteriological verification.

Adult↗
PubMed1992

Utilization of pulse oximetry for the study of the inhibitory effects of antiviral agents on influenza virus in mice.

Pulmonary disease in mice induced by influenza virus was monitored by measurement of oxygen saturation (SaO2) in blood with a pulse oximeter. The SaO2 declined in inverse proportion to the viral inoculum. The known antiviral agent ribavirin inhibited the SaO2 decline, prevented death, lowered lung consolidation, and reduced the level of recoverable virus. Pulse oximetry is an effective means of monitoring murine influenzal disease and can be used in the study of potential antiviral drugs.

Animals↗
PubMed1990

[Patients' acceptance of poly-soft and paper-pack X-ray film packets].

Two types of Kodak dental x-ray film packets are manufactured, paper-pack (PP) from paper, and poly-soft (PS) from vinyl. They differ in dimensions as PP measures 31.4 X 42.1 mm compared to PS measuring 33.0 x 44.3 mm. The edges of PP are rounded, while those of PS have welded, thin and sharp edges. Patients acceptance of the two types was tested among 25 adult patients during exposures for full mouth surveys. For each patient half PP and PS were used in a random sequence. The patients were asked to rate any feeling of discomfort or pain and to compare the feeling after each pair of film packets. The scores were compared by Wilcoxon's matched-pairs signed-ranks test. The results revealed with a statistical significance at the 1% level, that the patients felt more discomfort when the poly-soft packet was used. No affections of image quality were noticed. In spite of the higher level of discomfort resulting from the use of PS it seems justified to recommend this type due to its superior hygienic qualities.

Humans↗
PubMed1989

[Goodpasture's syndrome. Antiglomerular basal membrane antibody-mediated glomerulonephritis].

A review is presented of antiglomerular basal membrane antibody-mediated glomerulonephritis (anti-GBM-Ab-nephritis) which constitutes 2-5% of all cases of acute glomerulonephritis. The disease frequently commences in the age group 20-30 years but may be encountered in all age groups, in women particularly at 60 years of age. The disease is due to autoantibodies (IgG) to the basal membranes in the glomeruli and alveoli. Deposition of IgG with C3 precipitates an inflammatory reaction which causes renal and possibly also pulmonary damage. It is possible to demonstrate anti-GMB-antibodies in the blood and, by means of immunofluorescence microscopy, these and C3 may be demonstrated in the basal membranes in the glomeruli and alveoli. The disease is still serious but introduction of immune-suppressive treatment and plasmapheresis has improved the prognosis considerably.

Aged↗
PubMed1986

A carrier method for the assessment of the effectiveness of disinfectants against Mycobacterium tuberculosis.

A method for testing the effect of disinfectants against Mycobacterium tuberculosis was developed using glass slide carriers contaminated with Myco. tuberculosis from spleens of guinea-pigs. The method was found to be useful although a greater number of colony forming units, permitting calculation of a reduction factor in the range of 10(5), is desirable. In tests with various disinfectants, alcohols were the most effective agents against Myco. tuberculosis.

1-Propanol↗