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Biomedical subjects

M Forsgren

Publications and source records attributed to M Forsgren.

At least 109 records · Page 6Linked to original sources
PubMed1987

Comparison of four serological tests for the detection of specific immunoglobulin M in cord sera of infants congenitally infected with cytomegalovirus.

Four serological tests (3 immunoassays using enzyme-labelled antigen and 1 radioimmunoassay) were compared as regards the detection of cytomegalovirus (CMV) immunoglobulin M in cord sera. 68 cord sera from infants congenitally infected by CMV were included in the study. The infections were primarily diagnosed by virus isolation close to birth. Four laboratories in 3 countries were involved, each laboratory using its own or a commercial test. Of the sera tested in the different laboratories 50-80% were found to be reactive. Both qualitatively and quantitatively there was a good correlation between the 3 enzyme-immunoassays. The RIA results differed to some extent from the enzyme tests as regards the quantification of IgM. The advantage of prospective IgM screening in undiluted cord sera followed by confirmatory virus isolation test in the neonatal period in IgM-positive cases is discussed.

Cytomegalovirus↗
PubMed1986

Effects of hay-feeding on acid/base balance, renal sodium excretion, aldosterone and vasopressin secretion in the goat.

Effects of 30 min intense hay-feeding on acid/base and sodium homeostasis were studied in semi-starved goats during hyper- and euhydration. Parallel analyses of carotid and jugular blood samples revealed that feeding induced metabolic acidosis, which to some extent was subjected to respiratory compensation. The acidosis was accompanied by renal sodium retention and urinary acidification persisting for 2-3 h. The sodium retention was succeeded by an increase in renal Na excretion above the initial level. This natriuresis was most accentuated during hyperhydration. Blood samples taken for hormone assays during euhydration revealed a 15% increase in haematocrit and a significant rise in plasma aldosterone at termination of feeding. Inhibition of the water diuresis in hyperhydrated animals, and moderate increases in renal arginine vasopressin (AVP) excretion and plasma AVP were inconsistent effects of feeding. It is concluded, that simply jugular vein blood provides reliable information on the acid/base status of goats, but that the feeding schedule has to be considered in all experiments where small ruminants are used to investigate the integrated control of acid/base and sodium homeostasis.

Acid-Base Equilibrium↗
PubMed1986

Influence of heat exposure on acid/base and fluid balance in hyperhydrated goats.

Hyperhydrated goats were exposed to an environmental temperature of 45 degrees C (relative humidity 70%) for 120 min. After 90 min, rectal temperature and respiratory frequency reached plateau levels of 40.5 degrees C and 280 respirations min-1, respectively. Measurements of arterial and venous blood acid-base parameters revealed that respiratory alkalosis had started to develop after 60 min, and had become obvious at the end of the heat exposure period. Renal compensation (evidenced by gradual increases in urinary pH and renal Na excretion) developed in parallel with the respiratory alkalosis. The heat exposure elicited a moderate, temporary inhibition of the water diuresis, but no obvious increase in the renal excretion of arginine vasopressin (antidiuretic hormone, ADH). Preliminary determinations of plasma aldosterone did not show any change during the actual heat exposure period, but a 50% temporary decrease in plasma aldosterone 30 min thereafter. The study confirms the susceptibility of goats to develop respiratory alkalosis during thermoregulatory panting, and shows that this is not to any appreciable extent diminished during hyperhydration. It can further be concluded that a heat-induced rise in body temperature to 40.5 degrees C is no powerful stimulus for vasopressin release in the hyperhydrated goat. The determinations of plasma aldosterone suggest that reduced liberation of the hormone does not contribute to the immediate renal compensation of respiratory alkalosis, but that respiratory alkalosis reaching a certain intensity inhibits aldosterone secretion.

Acid-Base Equilibrium↗
PubMed1986

Accuracy of computed tomography in the diagnosis of herpes simplex encephalitis.

The accuracy of computed tomography (CT) in the diagnosis of herpes simplex encephalitis (HSE) was assessed in 121 patients who during a 2 1/2 year period entered a prospective Swedish joint study with participation of six University Centres. The patients presented with symptoms and signs of febrile focal encephalopathy. The age ranged from 1 month to 76 years (mean 37.3 years). Only 6 were infants less than one year old. HSE was diagnosed in 50 patients by the demonstration of intrathecal HSV antibody production and/or by HSV isolation or antigen detection in brain tissue specimens. A total of 308 CT examinations--the majority performed during the first 5 days after onset of CNS symptoms--were evaluated under blind conditions. The correct diagnosis of HSE was usually suggested within 5 days after onset of neurologic symptoms yielding a sensitivity of 0.73 and a specificity of 0.89. Predominant location of the HSE lesions was the temporal lobes (88%), which rarely were involved in the non-HSE group (11%). Haemorrhage was a rare finding (12% ) and enhancement after intravenous contrast administration was insignificant. Repeat examinations further increased accuracy. It is concluded that the good reliability of high resolution CT, further improvement of immunologic techniques and the advent of new atoxic antiviral drugs all are factors which may in the future obviate the need for brain biopsy.

Adolescent↗
PubMed1985

Long-term persistence of intrathecal virus-specific antibody responses after herpes simplex virus encephalitis.

Paired sera and cerebrospinal fluids (CSF) from nine surviving patients were collected 4.5 to 8 years after acute herpes simplex (HS) virus encephalitis. Oligoclonal bands of IgG were detected in the CSF of all, and seven patients had an elevated CSF IgG index. Antibodies to HS, varicella-zoster (VZ), measles, and cytomegalo viruses were analysed by enzyme-linked immunosorbent assay (ELISA) and by imprint immunofixation (IIF) of specimens separated by electrophoresis and by thin-layer electrofocusing. Intrathecal synthesis of HS and VZ IgG antibodies was demonstrated in all and of measles IgG antibodies in one patient by both methods. Intrathecal synthesis of HS IgA antibodies was demonstrated by ELISA in three and by IIF in seven patients; the latter method also disclosed intrathecal synthesis of VZ IgA antibodies in two. No patient had intrathecal synthesis of viral IgM antibodies. The intrathecally synthesized antibodies demonstrated by IIF displayed oligoclonal characteristics. The IIF analyses as well as virus absorption tests indicated that the intrathecally synthesized VZ IgG and IgA antibodies could be explained as HS antibodies cross-reacting with VZV. The results indicate that a long-term persistence of intrathecal antibody responses to HS virus is a common feature after acute HS encephalitis. The intrathecal production of measles IgG antibodies in one case may reflect a similar persistence of non-specific immune responses induced during the acute infection.

Adult↗
PubMed1985

Comparison between a commercial ELISA, Rubazyme, and hemolysis-in-gel test for determination of rubella antibodies.

A commercial enzyme-linked immunosorbent assay, Rubazyme, was compared with the hemolysis-in-gel (HIG) test for antibodies to rubella in 826 sera. The results were in agreement for 99.4% of the 725 sera tested for immunity. However, the Rubazyme assay was no more efficient that either the hemagglutination-inhibition or HIG test in discriminating between sera with low levels of antibody and negative sera. Thus, it was concluded that the HIG test is the method of choice for immunity testing because of the low cost and simplicity. Rubazyme may be of value to confirm equivocal HIG results.

Antibodies, Viral↗
PubMed1985

Subclinical rubella reinfection in vaccinated women with rubella-specific IgM response during pregnancy and transmission of virus to the fetus.

This report concerns 2 cases of documented rubella reinfection during pregnancy in previously vaccinated women. The antibody response at reinfection comprised not only anti-rubella IgG but also IgM. In the first case the reinfection occurred between the 13th and 19th week of pregnancy and was followed by transmission of virus to the fetus (anti-rubella IgM in cord blood and persisting antibody activity). The child had no clinical signs of congenital rubella and is normally developed without hearing impairment at 41/2 years of age. In the second case the reinfection resulted from exposure in the 15th week of pregnancy; there were neither serological nor clinical signs of congenital rubella in the child. The reported case of fetal infection in spite of previous rubella vaccination of the mother does not discourage the use of rubella vaccine. Rubella vaccine induces long lasting immunity and protection from viremia in the vast majority of individuals.

Adult↗
PubMed1985

Acyclovir versus vidarabine in herpes simplex encephalitis.

One hundred and twenty-seven patients with suspected herpes simplex encephalitis were entered in a randomised, controlled comparative study of therapy with acyclovir 10 mg/kg, 8-hourly, versus vidarabine, 15 mg/kg daily, for 10 days. Consecutive patients were included and nearly all diagnosed cases of HSV-encephalitis in Sweden were enrolled in the study. The diagnosis of HSV-encephalitis was verified by demonstration of intrathecal herpes simplex virus (HSV) antibody production and by HSV cultivation, or antigen detection, in brain biopsy or necropsy material. Of 53 confirmed cases of HSV-encephalitis (corresponding to 2.3 cases per million inhabitants per year in Sweden), 51 (27 acyclovir, 24 vidarabine) were evaluable for therapeutic efficacy. The mortality was 19% in the acyclovir-treated group versus 50% in the vidarabine group (p = 0.04). At 12 month of observation 15 of 27 (56%) acyclovir recipients had no, or mild, sequelae compared with 3 of 24 (13%) vidarabine recipients (p = 0.002). Nineteen of 24 (79%) vidarabine-treated patients died or suffered severe sequelae, compared with 9 of 27 (33%) acyclovir-treated patients (p = 0.005). The effect of treatment was influenced by the level of consciousness at the start of therapy. The outcome for 20 vidarabine-treated patients above 30 years of age with HSE was similar to that for the 53 patients reported by an American collaborative study.

Acyclovir↗
PubMed1984

Acyclovir versus vidarabine in herpes simplex encephalitis. Randomised multicentre study in consecutive Swedish patients.

127 patients with suspected herpes simplex encephalitis (HSE) were entered in a prospective randomised study of acyclovir 10 mg/kg 8-hourly versus vidarabine 15 mg/kg daily for 10 days. The patients were consecutive and nearly all Swedish cases of HSE were included; they were treated in six university infectious diseases departments. The diagnosis of HSE was verified by brain biopsy and/or antibody responses in serum and cerebrospinal fluid. Of 53 confirmed cases of HSE (corresponding to 2 X 3 cases per million inhabitants per year in Sweden), 51 (27 acyclovir, 24 vidarabine) were evaluable for analysis of efficacy. The mortality was 19% in the acyclovir-treated group versus 50% in the vidarabine group (p = 0.04). At 6 months of observation 15 (56%) of 27 acyclovir-treated patients had returned to normal life compared with 3 (13%) of 24 vidarabine-treated patients (p = 0.002); and the numbers who died or had severe sequelae were 9 (33%) and 19 (76%), respectively (p = 0.005). No important or new adverse events were recognised.

Acyclovir↗
PubMed1984

Isolation of pathogenic bacteria from the nasopharynx of children with respiratory syncytial virus infection. Predictive value of chest roentgen examination and laboratory tests.

Potentially pathogenic bacteria were isolated from the nasopharynx in 33/66 hospitalized infants and children with verified respiratory syncytial virus (RSV) infection. The value of chest roentgenograms and blood counts for the prediction of concomitant bacterial infection was evaluated. Abnormal chest roentgenograms were found in 89% whether pathogenic bacteria were present or not. The most common finding was general hyperinflation of the lungs, with or without infiltrates. This occurred more frequently in the group with isolated RSV infection. Fever, leucocytosis and an elevated ESR were found during the illness in more than half the cases. These findings were more frequent in children who harboured potential pathogenic bacteria, though the difference was not significant. For optimal evaluation of a case all available information about it should be taken into consideration.

Bacterial Infections↗
PubMed1983

Evaluation of serum gamma-glutamyl transferase as a screening method for excessive alcohol consumption during pregnancy.

Serum gamma-glutamyl transferase was analyzed in 669 pregnant women. They were interviewed with special emphasis on their consumption of alcohol during the first trimester. Thirteen percent admitted a consumption of greater than 30 gm of pure alcohol per day, and 3%, greater than 125 gm per day. One child with a complete fetal alcohol syndrome and one with a partial one were born to mothers with a high consumption of alcohol and elevated serum gamma-glutamyl transferase. The ninety-fifth percentile for serum gamma-glutamyl transferase in women classified as low consumers (less than 30 gm of alcohol per day) was 0.44 mukat/L. With this 95% specificity level used as a cutoff, the sensitivity of the serum gamma-glutamyl transferase test in identifying those who consumed more than 30 gm of alcohol per day was 25%. The conclusion was that screening based on analyses of serum gamma-glutamyl transferase is not to be recommended for routine use in prenatal care.

Adolescent↗
PubMed1983

Elevated antibody titers to Epstein-Barr virus and low natural killer cell activity in patients with Chediak-Higashi syndrome.

Four Venezuelan patients with the autosomal recessive Chediak-Higashi syndrome (CHS) were studied. The results confirm the severe reduction in natural killer (NK) cell activity, as previously described and showed also a decline in the activity of cells involved in antibody-dependent cellular cytotoxicity (ADCC). No defect was found in the production of immunoglobulins and of specific antibodies to measles, varicella, herpes simplex, and cytomegalo viruses. Two of the patients had extremely high antibody titers to the Epstein-Barr virus (EBV) specific viral capsid antigen (VCA), to the restricted (R) component of the EBV-induced early antigen complex, and to the EBV-associated nuclear antigen (EBNA). These two patients had enlarged livers, spleens, and lymph nodes indicative of the lymphoproliferative phase. The other two patients were initially negative for all EBV-associated antibodies but seroconverted subsequently and, in the course of a year, also developed high antibody titers to VCA and R. In one of these patients the primary infection was accompanied by moderate signs of infectious mononucleosis (IM) followed after more than 6 months by persistent hepatosplenomegaly. The other patient also developed signs of a lymphoproliferative syndrome with hepatosplenomegaly and jaundice and died 8 months later. Such high anti-R titers are seen frequently in Burkitt's lymphoma, but rarely in other conditions. It is likely that the high antibody titers reflect an increased production of VCA and R due to defective NK and ADCC cell activities so that productively infected B lymphocytes are no longer eliminated before they have synthesized maximal amounts of antigens. The high anti-EBNA titers suggest normal T lymphocyte function. The possibility that the accelerated, lymphoma-like phase of the CHS involves EBV-transformed cells is discussed.

Adult↗
PubMed1983

Respiratory syncytial virus infection in young hospitalized children. Identification of risk patients and prevention of nosocomial spread by rapid diagnosis.

Detection of RSV by immunofluorescence was used for rapid confirmation of the diagnosis in 89 infants during an epidemic. This made it possible to plan the care of the patients and use the personnel in an optimal way in order to maintain nosocomial infection at a low level. Somatic and environmental risk factors connected with serious disease were also identified. The course of the disease was more severe in children with chronic illnesses or those who had had perinatal complications. Allergy was more frequently reported by these families. Breast feeding for at least two months was practised in most families.

Child, Hospitalized↗