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Biomedical subjects

L Bjerrum

Publications and source records attributed to L Bjerrum.

At least 19 recordsLinked to original sources
PubMed2006

Effects of a Campylobacter jejuni infection on the development of the intestinal microflora of broiler chickens.

The effect of a Campylobacter jejuni colonization on the development of the microflora of the cecum and the ileum of broiler chickens was studied using molecular methods. The infection did affect the development and complexity of the microbial communities of the ceca, but we found no permanent effect of a C. jejuni infection on the ileal microflora of the broilers. In addition, denaturant gradient gel electrophoresis (DGGE) profiles generated from cecal and ileal contents revealed several DGGE bands that were present in the control chickens, but not in the chickens colonized with C. jejuni. Some of these DGGE bands could be affiliated with Lactobacillus reuteri, Clostridium perfringens, and the genus Klebsiella.

Animals↗
PubMed2006

Microbial community composition of the ileum and cecum of broiler chickens as revealed by molecular and culture-based techniques.

The microbial communities of the ileum and cecum of broiler chickens from a conventional and an organic farm were investigated using conventional culture techniques as well as cloning and sequencing of 16S rRNA genes. Eighty-five percent of the 557 cloned sequences were <97% related to known cultured species. The chicken ileum was dominated by lactobacilli, whereas the cecum harbored a more diverse microbial community. The cecum was dominated by a large group of bacteria with hitherto no close cultured relatives but most closely related to Faecalibacterium prausnitzii. Approximately 49 and 20% of the cecal clones belonged to this cluster in conventional and organic broiler chickens, respectively. We were, however, able to recover a number of these phylotypes by cultivation, and the isolates were shown to be butyric acid producers. The investigation was a descriptive rather than a comparative study of 2 different rearing systems; however, several differences were observed. For instance, Clostridium perfringens was found in significantly higher numbers in the birds from the organic farm compared with the conventional broilers, probably due to the addition of salinomycin to the conventional feed. In the ileum, the abundance of the different Lactobacillus species differed between the 2 broiler types. The culture-based and culture-independent techniques complemented each other well. Strengths and limitations of the different methods are discussed.

Animal Feed↗
PubMed2006

Trends in utilization of antiepileptic drugs in Denmark.

OBJECTIVES: To describe utilization of antiepileptic drugs (AEDs) in Denmark during 1993-2002, with special emphasis on oxcarbazepine, and to assess probable indications for AED use. MATERIALS AND METHODS: We retrieved prescription data from Odense University Pharmacoepidemiological Database, in Funen County, Denmark (population in 2002: 472,869). Within each calendar year we estimated period prevalence, incidence rate and monotherapy rate. Based on co-medication we defined 'epilepsy' when only AEDs were prescribed, 'pain' with co-prescription of opioids, and 'mood disorder' with co-prescription of antipsychotics or antidepressants. RESULTS: We identified 15,604 AED users. The prevalence of using AED increased from 9.3 (95% CI, 9-9.5) to 12.1 (11.8-12.4)/1000 persons. The incidence rate increased from 1.4 (1.3-1.6) to 1.7 (1.6-1.9)/1000 personyears. The monotherapy rate was 79-82%. AED use for 'epilepsy' declined by 19.7%, whereas the proportion of 'pain' and 'mood disorder' treatment increased by 11.2% and 8.4% respectively. CONCLUSIONS: Antiepileptic drug utilization increased during the study period, the increase probably caused by expanding use in areas other than epilepsy.

Adolescent↗
PubMed2005

The influence of whole wheat feeding on Salmonella infection and gut flora composition in broilers.

In an experiment with broilers infected with a rifampicin-resistant Salmonella Typhimurium strain at 15 days of age, it was demonstrated that whole wheat feeding influenced the course of infection. The pH in the contents of the gizzard decreased as the amount of whole wheat in the diet increased over time. Following infection, lower numbers of Salmonella Typhimurium were found in the gizzard and ileum of birds receiving whole wheat compared to pellet-fed birds. However, there was no difference with respect to the numbers of Salmonella Typhimurium in the ceca and rectum between the two experimental groups. Quantitative cultivation of different groups of bacteria belonging to the natural intestinal microflora showed that whole wheat feeding significantly reduced the numbers of Clostridium perfringens in the intestinal tract of the birds. The present results indicate that the gizzard has an important function as a barrier organ, one that prevents pathogenic bacteria from entering the distal digestive tract.

Animal Husbandry↗
PubMed2001

[How many prescription drugs does a general practitioner handle? A prescription database study].

INTRODUCTION: General practitioners must know of treatments for a broad range of diseases, but it may be difficult to keep abreast of the effects and adverse reactions of a large spectrum of drugs, and a good quality of prescribing implies the use of a limited number of analogue products. The aims were to investigate the number of different drugs prescribed per practice and to analyse the influence of practice characteristics on this number. MATERIAL AND METHODS: The study comprised 173 general practices (99 single and 74 group practices in the County of Funen, Denmark. All prescription registered on the Odense Pharmaco-epidemiological Database (OPED) were analysed. The main outcome measure was the number of different drugs prescribed per dispensing unit. RESULTS: The number of different drugs prescribed per dispensing unit varied almost fourfold (range: 102 to 381) and four practice characteristics were able to predict 74% of this variation. Practices with several doctors, a high number of patients listed per doctor, a high percentage of elderly patients, and a heavy workload showed the highest number of different drugs prescribed. CONCLUSION: There is almost a fourfold variation in the number of different drugs used in general practice, and three-quarters of this variation is associated with factors related to the practice.

Databases, Factual↗
PubMed2001

Guidelines accompanied by changes in reimbursement rules. Effects on lipid-lowering drug prescribing.

OBJECTIVE: To analyse the effect of guidelines accompanied by changes in reimbursement rules for the prescription of lipid-lowering drugs (LLDs). DESIGN: Observational study focusing on LLD use before (1994-98) and after an intervention (1999). SETTING: Guidelines were developed by the Danish College of General Practitioners and focused on prevention of cardiovascular heart disease (CHD). Guidelines were sent out and changes in reimbursement took place in December 1998. Prescriptions for LLDs were extracted from a population-based prescription database (Odense University Pharmacoepidemiological Database, OPED) covering 10% of the Danish population (470,000 inhabitants). MAIN OUTCOME MEASURES: Incidence rate and 1 year prevalence rate (annual prevalence) of LLD use. RESULTS: The incidence of LLD use increased significantly in the year following the intervention. Incidence rate ratio (after/before) was 1.43 (CI 1.35-1.52). The annual prevalence of LLD use in the population increased by 0.4% after the intervention (0.2% before). The corresponding figure for patients with diabetes mellitus (treated with insulin or oral anti-diabetics) was 2.3% after the intervention (1.2% before), and for patients with CHD (treated with vasodilators) 8.1% after the intervention (5.0% before). CONCLUSION: Guidelines accompanied by a change in reimbursement rules had a significant influence on the prescribing of lipid-lowering drugs.

Aged↗
PubMed2001

Nitrification in sequencing biofilm batch reactors: lessons from molecular approaches.

The nitrifying microbial diversity and population structure of a sequencing biofilm batch reactor receiving sewage with high ammonia and salt concentrations (SBBR 1) was analyzed by the full-cycle rRNA approach. The diversity of ammonia-oxidizers in this reactor was additionally investigated using comparative sequence analysis of a gene fragment of the ammonia monooxygenase (amoA), which represents a key enzyme of all ammonia-oxidizers. Despite the "extreme" conditions in the reactor, a surprisingly high diversity of ammonia- and nitrite-oxidizers was observed to occur within the biofilm. In addition, molecular evidence for the existence of novel ammonia-oxidizers is presented. Quantification of ammonia- and nitrite-oxidizers in the biofilm by Fluorescent In situ Hybridization (FISH) and digital image analysis revealed that ammonia-oxidizers occurred in higher cell numbers and occupied a considerably larger share of the total biovolume than nitrite-oxidizing bacteria. In addition, ammonia oxidation rates per cell were calculated for different WWTPs following the quantification of ammonia-oxidizers by competitive PCR of an amoA gene fragment. The morphology of nitrite-oxidizing, unculturable Nitrospira-like bacteria was studied using FISH, confocal laser scanning microscopy (CLSM) and three-dimensional visualization. Thereby, a complex network of microchannels and cavities was detected within microcolonies of Nitrospira-like bacteria. Microautoradiography combined with FISH was applied to investigate the ability of these organisms to use CO2 as carbon source and to take up other organic substrates under varying conditions. Implications of the obtained results for fundamental understanding of the microbial ecology of nitrifiers as well as for future improvement of nutrient removal in wastewater treatment plants (WWTPs) are discussed.

Ammonia↗
PubMed2000

[Resistance testing in general practice--is it valid?].

Resistance of uropathogenic bacteria to antibiotics is an increasing problem in primary health care. The aim of this study was to evaluate antibacterial susceptibility testing of uropathogenic when performed in general practice. Urine specimens with a known quantity of typically uropathogenic bacteria were sent to 25 general practices. The predictive values of testing a bacterial strain as susceptible ranged from 0.89 (nitrofurantoin) to 1.00 (sulphamethizole), and the predictive value of testing a bacterial strain as resistant ranged from 0.55 (trimethoprim) to 0.90 (nitrofurantoin). If susceptibility testing is to be widely implemented in general practice it would be necessary to improve the validity.

Anti-Bacterial Agents↗
PubMed2000

[Big differences in the frequency of polypharmacy between physicians].

Polypharmacy, the simultaneous use of multiple drugs, is associated with adverse drug reactions, medication errors, and increased risk of hospitalisation. When the number of drugs is five or more (major polypharmacy), a significant risk may be present. We analysed the prevalence of major polypharmacy among listed patients, and identified possible predictors of major polypharmacy related to the practice. Prescription data were retrieved from the Odense Pharmaco-epidemiological Database and the age and sex standardised prevalence rate of major polypharmacy was calculated for each practice (n = 173). Possible predictors of major polypharmacy related to the GPs were analysed by backward stepwise linear multiple regression. A six-fold variation between practices in the prevalence of major polypharmacy was found, i.e. from 16 to 96 per 1000 listed patients (median: 42). Predictors related to the practice structure, workload, clinical work profile, and prescribing profile could explain 56% of the variation.

Adult↗
PubMed2000

Deviations from evidence-based prescribing of non-steroidal anti-inflammatory drugs in three European regions.

OBJECTIVE: We examined to what extent the evidence of the relative gastrointestinal toxicity with non-steroidal anti-inflammatory drugs (NSAIDs) was implemented in clinical practice in Bologna, Italy, Funen, Denmark, and Stockholm, Sweden, areas with accurate computerised information on prescriptions purchased by defined populations. METHODS: We ranked each NSAID by purchased volume in defined daily doses during September 1996 and compared it with the ranking of gastrointestinal complications from a meta-analysis of controlled epidemiological studies published between 1986 and 1994. We restricted our comparison to those NSAIDs that accounted for 90% of the use and within this DU90% segment we determined the proportion of "high risk" (azapropazone, ketoprofen, piroxicam) and "low risk" (ibuprofen, diclofenac) drugs with respect to gastrointestinal toxicity. RESULTS: In Funen, Denmark, we found the best NSAID profile (63% low risk/11% high risk) while Bologna, Italy, had the other extreme (26% low risk/38% high risk), with Stockholm, Sweden, in between (43% low risk/20% high risk). CONCLUSION: Our study suggests that factors other than evidence-based medicine had a dominating impact on the use of prescription NSAIDs in 1996.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Standardised procedures can improve the validity of susceptibility testing of uropathogenic bacteria in general practice.

OBJECTIVE: To investigate whether the validity of susceptibility testing in general practice would improve when preceded by an intervention. INTERVENTION: Instruction in standardised susceptibility testing procedures given by laboratory instructors. METHOD: Urine specimens containing monocultures of typical uropathogenic bacteria were sent to 23 general practices before and after the intervention. Practices performed susceptibility testing by the Sensicult and the Iso-Res agar methods and the validity of the results before and after the intervention was compared. Results from susceptibility testing at the bacteriological laboratory, Odense University Hospital, were used as gold standard. RESULTS: The median frequency of correct results increased from 82% to 98% for susceptibility testing based on Sensicult (p = 0.001) and from 90% to 96% based on Iso-Res agar (p = 0.05). CONCLUSION: The validity of susceptibility testing in general practice improves when preceded by instruction in standardised procedures.

Denmark↗
PubMed2000

Wide variation in the number of different drugs prescribed by general practitioners. A prescription database study.

OBJECTIVES: To investigate the number of different drugs prescribed per dispensing unit and to analyse the influence of practice characteristics on this number. DESIGN: Register analysis based on the Odense Pharmacoepidemiological Database (OPED). SETTING: General practices in the County of Funen, Demnark. SUBJECTS: 173 general practices (99 single-handed and 74 group practices). MAIN OUTCOME MEASURES: Number of different drugs prescribed per dispensing unit. RESULTS: The number of different drugs prescribed per dispensing unit varied nearly fourfold (range 102-381) and four practice characteristics were able to predict 74% of this variation. Practices with several doctors, a high number of patients listed per doctor, a high percentage of elderly individuals, and a heavy workload showed the highest number of different drugs prescribed. CONCLUSION: As the quality of drug prescribing is associated with the use of a limited number of drugs, it is suggested that GPs should agree on a formulary containing the most essential drugs in primary health care.

Age Factors↗
PubMed1999

[Polypharmacy estimated by means of a population-based prescription database].

The aim was to investigate estimators of polypharmacy (PP) from a population based prescription database. Data were retrieved from Odense Pharmacoepidemiological Database and contained a 10% random sample (n = 26,977) of drug users in 1994. PP was defined as simultaneous treatment with different drugs, and the duration of treatment was calculated from the date of purchase and the number of defined daily doses prescribed. This estimator was compared with an estimator based on the number of drugs purchased during a three month period. On an average day 8.7% were exposed to minor PP (two to four drugs) and 1.2% to major PP (five or more drugs). Purchase of five or more drugs during a three month period predicted episodes of major PP with a positive predictive value of 80%. Epidemiological measures of multiple drug use can be estimated from a prescription database. Conceptually, an estimator based on the number of simultaneously used drugs is preferable, but the number of drugs purchased during a three month period may be a useful alternative estimator.

Databases, Factual↗
PubMed1999

Polypharmacy in general practice: differences between practitioners.

BACKGROUND: Polypharmacy, the simultaneous use of multiple drugs, is associated with adverse drug reactions, medication errors, and increased risk of hospitalization. When the number of concurrently used drugs totals five or more (major polypharmacy), a significant risk may be present. AIM: To analyse the interpractice variation in the prevalence of major polypharmacy among listed patients, and to identify possible predictors of major polypharmacy related to the practice. METHOD: Prescription data were retrieved from the Odense Pharmacoepidemiological Database, and individuals subject to major polypharmacy were identified. The age- and sex-standardized prevalence rate of major polypharmacy was calculated for each practice in the County of Funen in Denmark (n = 173), using the distribution of age and sex of the background population as a reference. The practice characteristics were retrieved from the Regional Health Insurance System. Possible predictors of major polypharmacy related to the general practitioners (GPs) were analysed using backward stepwise linear multiple regression. RESULTS: A six-fold variation between the practices in the prevalence of major polypharmacy was found (16 to 96 per 1000 listed patients; median = 42). Predictors related to the practice structure, workload, clinical work profile, and prescribing profile could explain 56% of the variation. CONCLUSION: A substantial part of the variation in major polypharmacy between practices can be explained by predictors related to practice.

Adult↗
PubMed1999

Validity of susceptibility testing of uropathogenic bacteria in general practice.

Resistance of uropathogenic bacteria to antibiotics is an increasing problem in primary health care. The aim of this study was to evaluate antibacterial susceptibility testing of uropathogenic bacteria when performed in general practice. Urine specimens with a known quantity of typically uropathogenic bacteria were sent to 25 general practices. The predictive values of testing a bacterial strain as susceptible ranged from 0.89 (nitrofurantoin) to 1.00 (sulphamethizole), and the predictive value of testing a bacterial strain as resistant ranged from 0.55 (trimethoprim) to 0.90 (nitrofurantoin). Interventions to improve the validity of susceptibility testing are desirable if the test should be incorporated in the diagnostic armamentarium in general practice.

Anti-Infective Agents, Urinary↗
PubMed1998

[Antabus treatment in general practice. A pharmaco-epidemiological study of prescription patterns based on a prescription database].

Denmark has a long tradition for the use of alcohol-aversive drugs in the treatment of alcoholism, most commonly disulfiram (Antabuse). The purpose of this study was to examine the prescription patterns for disulfiram in Danish general practice on an individual level. By means of a prescription database we analysed 150,787 prescriptions on reimbursed medicine to persons who had redeemed prescriptions for alcohol-aversive drugs during the period 1.1.1993 to 31.12.1995 in the County of Funen. Prevalence of disulfiram treatment was 12 per 10,000 inhabitants, three-year prevalence 75 per 10,000 inhabitants and incidence 21 per 10,000 inhabitants per year. Eighty-seven percent of treatments were stopped at (or before) the expiration of one prescription, and relapse was frequent (46%).

Adult↗
PubMed1998

Polypharmacy: correlations with sex, age and drug regimen. A prescription database study.

OBJECTIVE: To analyse the occurrence of multiple drug use (polypharmacy, PP) in the population and to identify individuals particularly prone to PP. METHODS: Data were derived from the Odense Pharmacoepidemiological Database (OPED) and covered all subsidised prescriptions during 1994 presented by inhabitants in the county of Funen (n = 466567). The number of individuals concurrently using two to four drugs (minor PP) and five or more drugs (major PP) was calculated on a random day in 1994. Drugs were classified according to the Anatomical Therapeutical Chemical (ATC) classification index. The main therapeutic class (second level of the ATC code) was used as an indicator for the type of health problem. A stepwise backwards logistic regression was used to identify predictors of major PP. Odds ratios were calculated for different drug classes, and the age and sex of all drug users. RESULTS: On a random day, 8.3% of the population were exposed to minor PP and 1.2% to major PP. The prevalence of PP increased with age, and from the age of 70 years, two thirds of all drug users were PP users. Drug use was 50% more prevalent among women than men, but over the age of 70, the sexes did not differ in the prevalence of major PP. Many different drug combinations were found, and among major PP users (n = 5443), two thirds had their own unique drug regimen, different from all other drug users. Cardiovascular drugs and analgesics were often involved in PP among the elderly, while asthma drugs, psychotropic drugs and anti-ulcer drugs were predominant among young individuals exposed to PP. The odds ratio (OR) for major PP was substantially increased for individuals treated for cardiovascular diseases (OR, 4.5), anaemia (OR, 4.1) and respiratory diseases (OR, 3.6). CONCLUSIONS: PP is widespread in the population. Clinicians and organisers who are responsible for quality assurance programmes should intensify their surveillance of the groups most prone to PP (the elderly and those using analgesics or drugs for cardiovascular disease, anaemia, asthma and diabetes).

Adolescent↗