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Biomedical subjects

Hasse Melbye

Publications and source records attributed to Hasse Melbye.

8 recordsLinked to original sources

The FEV1/FEV6 ratio is a good substitute for the FEV1/FVC ratio in the elderly.

AIMS: To determine the agreement between the FEV1/FEV6 ratio and the FEV1/FVC ratio in an elderly population. METHOD: The study sample consisted of 3874 participants in a cross-sectional population survey in Tromsö, Norway, aged 60 years or more, in whom acceptable spirometry had been obtained. Mean differences between the FEV1/FEV6 ratio (%) and the FEV1/FVC ratio (%) were calculated according to age, sex, smoking habit, and the degree of airflow limitation. ROC-curve analysis and Kappa-statistics were used to estimate the utility of the FEV1/FEV6 ratio in predicting an FEV1/FVC ratio < 70%. RESULTS: The mean difference between FEV1/FEV6% and FEV1/FVC% was 2.7% in both men and women. The difference between the two measures increased somewhat with increasing age, and was more pronounced with smoking and decreasing FEV1/FVC ratio. The value for the FEV1/FEV6 ratio which best predicted an FEV1/FVC ratio of 70%, was 73%, and a very good agreement was found between these two cut-off values (kappa = 0.86). CONCLUSION: The FEV1/FEV6 ratio appears to be a good substitute for the FEV1/FVC ratio in an elderly population.

Age Factors↗

Point of care testing for C-reactive protein - a new path for Australian GPs?

BACKGROUND: New approaches are needed to reduce antibiotic usage in respiratory tract infections in general practice without compromising patient safety. Point of care tests for C-reactive protein (CRP) are now being used for this purpose in some European countries. OBJECTIVE: Current knowledge about the CRP response in respiratory tract infections is presented, as well as the usefulness of applying the test when sinusitis and pneumonia may be suspected. DISCUSSION: A promising ability of the test in ruling in or out severe infection has been demonstrated in clinical studies. There are still controversies about the use of the CRP test in respiratory tract infections, however clinical research supports its use for some conditions, and therefore introduction into Australian general practice should be considered. Further evaluation of its utility is needed.

Australia↗

The course of C-reactive protein response in untreated upper respiratory tract infection.

BACKGROUND: High C-reactive protein (CRP) values are frequently found in patients with bacterial respiratory infection, and CRP testing has been shown to be useful in differentiating pneumonia from other respiratory infections. Raised CRP values may also be found in viral respiratory infection, and as a result there is a risk that antibiotics may be wrongly prescribed. AIMS: To describe the course of the CRP response during untreated upper respiratory tract infections and associations between the development of CRP values, erythrocyte sedimentation rate (ESR) and respiratory symptoms. DESIGN OF STUDY: Prospective study. SETTING: Seven general practices in northern Norway. METHOD: Patients with upper respiratory tract infection aged 16 years or over, who were not treated with antibiotics and who had been ill for no more than 3 days, were recruited. Microbiological examinations were undertaken, together with measurements of CRP, ESR and recording of symptoms daily during the first week of illness and on days 10, 14 and 21. RESULTS: An aetiological agent was established in 23 of the 41 included subjects. These were: influenza A, influenza B, rhinovirus, and other agents. Among the 15 patients examined on both the second and the third day of illness, the median CRP value increased from 7-10 mg/l, and the mean value was from 19-24 mg/l between day 2 and day 3. Peak CRP values were reached on days 2 to 4. Higher CRP values were found in those infected with influenza A and B than in the other subjects (P <0.001). A CRP value >10 mg/l was found in 26 subjects during the first 7 days, compared to five subjects after 1 week. Evidence of a secondary infection with group A streptococci was found in two of these five subjects. The development of the symptoms of sore throat, fatigue, clamminess, and pain from muscles and joints followed a similar course as the CRP response, while stuffy nose, cough, sputum production, and dyspnoea tended to persist after the CRP values had approached the normal range. CONCLUSION: A moderately elevated CRP value (10-60 mg/l) is a common finding in viral upper respiratory tract infection, with a peak during days 2-4 of illness. Moderately elevated CRP values cannot support a diagnosis of bacterial infection when the illness has lasted less than 7 days, but may indicate a complication of viral infection after a week.

Adolescent↗

[Asymptomatic bacteriuria in pregnant women].

BACKGROUND: We wanted to determine the usefulness of chemical dipstick tests and office culture in diagnosing asymptomatic bacteriuria in pregnant women in general practice. MATERIAL AND METHODS: Dipstick and office urine culture were compared with standard culture results from a microbiology laboratory. The comparison was based on 294 urine samples obtained from pregnant women in a standard general practice setting. RESULTS: Asymptomatic bacteriuria was found in 16 out of 294 urine samples. The sensitivity of dipstick tests was less than 30%. The positive predictive value was 100% for the nitrite test and 40% for office culture. INTERPRETATION: Standard urine culture is the only way to diagnose asymptomatic bacteriuria.

Bacteriological Techniques↗