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Biomedical subjects

O Scheel

Publications and source records attributed to O Scheel.

At least 37 records · Page 2Linked to original sources
PubMed1997

[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↗
PubMed1997

Comparison of E-test with agar dilution for determining susceptibility of Streptococcus pneumoniae to penicillin.

Minimum inhibitory concentrations (MICs) of penicillin for Streptococcus pneumoniae were determined by the E-test and the agar dilution method. Ninety Streptococcus pneumoniae strains were tested, of which 16 were resistant, 33 intermediate, and 41 susceptible by agar dilution. By the E-test, 80 (88.9%) strains agreed with these determinations within one log2 dilution step, and no strains disagreed by more than two dilution steps. Sixty-eight of the 70 strains with discrepant MICs read lower in the E-test, resulting in 15 strains being placed in different susceptibility categories when classified by this test. Exact MICs rather than classification groups should be used to determine appropriate antibiotic therapy, since small differences in MICs determined by different methods can lead to a significant degree of misclassification.

Colony Count, Microbial↗
PubMed1997

Living with methicillin-resistant Staphylococcus aureus: a 7-year experience with endemic MRSA in a university hospital.

A review of our infection control records revealed 3,159 new isolations of methicillin-resistant Staphylococcus aureus (MRSA) from 1988 to 1994. Prior to this period, our approach to MRSA had changed from eradication to containment measures. We found a decline in MRSA rates from 11.4 to 5.2 first isolations per 1,000 deaths and discharges over the study period.

Cross Infection↗
PubMed1997

Epidemic patterns and carriage of Chlamydia pneumoniae in Norway.

Chlamydia pneumoniae infection, in earlier days misdiagnosed as ornithosis, is very common in Norway. The disease develops slowly, a feature that may account for the very large number of subclinical cases, which may be seven fold more common than clinical cases. Subclinical cases produce an antibody response similar to that seen in overt clinical disease. Silent carriage of C. pneumoniae in healthy individuals may be frequent. Therapy based on positive cell culture or polymerase chain reaction (PCR) in the absence of pneumonic symptoms may be questionable. PCR has, however, given the slow development of disease, revealed itself as a handy epidemiological technique useful for the survey of healthy populations.

Carrier State↗
PubMed1997

Respiratory Chlamydial infections in a Hong Kong teaching hospital and association with coronary heart disease.

The microimmunofluorescence antibody technique was used to determine the seroprevalence of antibodies to Chlamydia pneumoniae and Chlamydia psittaci from hospitalized patients in Hong Kong. Antibodies to C. pneumoniae were found in 54.8% of 157 patients hospitalized with respiratory disease, in 71.1% of 83 patients with cardiac disease and in 31.2% of 93 patients without either respiratory or cardiac disease. Antibodies to C. psittaci were found in 0.9% of the combined study groups. There was serological evidence of C. pneumoniae being the responsible agent in 24.8% of the severe respiratory cases. A significant correlation between antibody prevalence and coronary heart disease was identified during the study.

Adult↗
PubMed1996

[Bacteremia in the county of Ribe].

The Department of Microbiology at the Central Hospital of Esbjerg, established in 1987, serves the five hospitals in Ribe county, Denmark. From early on, the department has endeavoured to guide the hospital's antimicrobial policy. In order to investigate whether this involvement had any measurable impact on the antimicrobial resistance pattern in our region, we compared the resistance patterns of 212 strains isolated from the blood of bacteraemic patients in 1988 to those of 317 strains isolated in 1992. No increase in antibiotic resistance was revealed. This is noteworthy since new specialties have been established at the Central Hospital during this period, with an increased number of patients requiring antimicrobial therapy. It is important to survey the antibiotic resistance pattern closely, and that this is done locally.

Anti-Bacterial Agents↗
PubMed1996

Urinary tract infection caused by Mycobacterium terrae complex.

We describe a case of recurrent urinary tract infection caused by Mycobacterium terrae complex in a patient with obstructive nephropathy. The mycobacterium was resistant to most antituberculosis drugs and despite its apparent clearance in the urine, the patient finally died of urinary sepsis caused by multiple bacterial pathogens.

Aged↗
PubMed1996

In-vitro susceptibility of isolates of methicillin-resistant Staphylococcus aureus 1988-1993.

MICs for 423 strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated in Hong Kong during 1988-1993 were performed for 15 antimicrobial agents: erythromycin, chloramphenicol, tetracycline, minocycline, gentamicin, netilmicin, trimethoprim, rifampicin, fusidic acid, ciprofloxacin, vancomycin, teicoplanin, sparfloxacin, clinafloxacin and RP 59500 (quinupristin/dalfopristin). Susceptibility to antibiotics generally remained stable throughout the study period, with the exception of the quinolones. Resistance to ciprofloxacin (breakpoint 4 mg/L) increased from a low of 9% in 1988 to a high of 82% in 1993. For sparfloxacin the corresponding figures were 9% and 78%, respectively. Six (1%) clinafloxacin-resistant strains were found. MIC50s and MIC90s of clinafloxacin increased from < or = 0.06 mg/L and 0.25 mg/L in 1988 to 1.0 mg/L and 2.0 mg/L, respectively, in 1993. All 423 strains were phage typed (typability 70%) and a diversity of phage types which changed during the observation period, with 13 dominating types, was observed. Ciprofloxacin resistance occurred in 12 of the dominating types, in 46 non-typable strains, and also in 23 strains of different, sporadically occurring types, indicating that the emergence of quinolone resistance was not due to dissemination of a single or few MRSA clones. The usefulness of quinolones in the treatment of MRSA infections is likely to be seriously constrained by the emergence of resistance. MICs for RP-59500 were < or = 2 mg/L for all isolates, suggesting that this agent merits further evaluation as an anti-MRSA agent. All MRSA remained susceptible to vancomycin and teicoplanin throughout the study period.

Anti-Infective Agents↗
PubMed1996

Field investigations of tularemia in Norway.

In Norway, tularemia is a common disease in small rodent and hare populations, where large outbreaks can be observed. In humans, the yearly number of cases is low, usually less than ten, with peaks up to 44 recorded in recent years. Serological investigations on hunters and healthy school children nevertheless indicate, with up to 4.7% positivity in the latter group, that Francisella tularensis low-grade infection is widespread. F. tularensis in co-culture with amoebae, e.g. Achantamoeba castellanii, may grow after internalization and kill the amoeba. As with Legionella, Francisella virulence may be enhanced after protozoan ingestion. This suggests a mechanism that can explain the pattern of dissemination and infection in our region.

Adolescent↗
PubMed1996

Self-inflicted bacteraemia and fungaemia in Vietnamese migrants.

From early 1993, we received a number of blood cultures, all from Vietnamese inmates of the Whitehead Detention Centre, the biggest detention camp in Hong Kong, which grew unusual organisms. Upon follow-up, the majority of the patients were found to abscond from the hospital a few days after having been admitted with a clinical picture of septic shock. During the period from March 1993 to late 1994, we noted a total of 25 positive blood cultures from 21 previously healthy Vietnamese migrants with this syndrome. The mean age was 27.8 years and 20 were males. The organisms isolated from the blood cultures were of low pathogenicity such as Saccharomyces cerevisiae, Trichosporon spp., Baciflus spp. and Micrococcus spp. Fourteen of the patients complained of abdominal pain and 3 others had apical pneumothoraces. Eighteen had shock requiring resuscitation. Multiple puncture or needle marks were found in 11 patients, mainly involving the lower limbs. One patient admitted inducing illness by self-injection, and it was suspected that all these infections were self-inflicted. The range of hospitalization was 1-13 days (mean 3.05 days). Eighteen of the 21 patients absconded.

Adolescent↗
PubMed1996

Rapid emergence of penicillin-resistant pneumococci in Hong Kong.

The prevalence of penicillin resistance in Streptococcus pneumoniae isolated at the Prince of Wales Hospital, Hong Kong, rose from 6.6% of sputum isolates in the first quarter of 1993 to 55.8% of isolates in the second quarter of 1995. Most of the isolates were also resistant to co-trimoxazole, tetracycline, choramphenicol and erythromycin. Type 19F was the most common capsular type in 1993-1994, comprising 40.0% of typed isolates in this period. Type 23F emerged in 1995 as the predominant type, making up 62.2% of typed isolates in the first 2 quarters of 1995. A high population density and excessive community use of antibiotics are likely to be factors promoting the rapid emergence of multiply-resistant pneumococci in Hong Kong.

Drug Resistance, Microbial↗
PubMed1996

Antimicrobial susceptibility and extended-spectrum beta-lactamases of Hong Kong isolates of enterobacteriaceae.

High levels of resistance to extended-spectrum cephalosporins have been reported in the Western Pacific area but data on the prevalence of extended-spectrum beta-lactamases (ESBLs) is more scanty. 370 Hong Kong blood culture isolates of Enterobacteriaceae isolated in the years 1990 and 1995 were evaluated for resistance to 15 antibiotics and the presence of ESBLs. 1995 isolates showed increased levels of resistance for beta-lactams, trimethoprim, ciprofloxacin and aminoglycosides. The proportion of E. coli harbouring ESBLs was 1/61 (1.6%) in 1990 and 2/77 (2.6%) in 1995. The prevalence in Klebsiella spp. rose from 1/36 (2.8%) in 1990 to 5/49 (10.2%) in 1995. ESBLs were found most frequently in Enterobacter spp. and were present in 7/29 (24.1%) of 1990 isolates and 5/22 (22.7%) of 1995 isolates. ESBLs may not be detectable in routine susceptibility testing and appropriate screening methods such as double disc screening tests are necessary to accurately determine ESBL prevalence.

Drug Resistance, Microbial↗
PubMed1995

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↗
PubMed1994

Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population.

To estimate the extent of meningococcal carriage in the Norwegian population and to investigate the relationship of several characteristics of the population to the carrier state, 1,500 individuals living in rural and small-town areas near Oslo were selected at random from the Norwegian National Population Registry. These persons were asked to complete a questionnaire and to volunteer for a bacteriological tonsillopharyngeal swab sampling. Sixty-three percent of the selected persons participated in the survey. Ninety-one (9.6%) of the volunteers harbored Neisseria meningitidis. The isolates were serogrouped, serotyped, tested for antibiotic resistance, and analyzed by multilocus enzyme electrophoresis. Eight (8.8%) of the 91 isolates represented clones of the two clone complexes that have been responsible for most of the systemic meningococal disease in Norway in the 1980s. Age between 15 and 24, male sex, and active and passive smoking were found to be independently associated with meningococcal carriage in logistic regression analyses. Working outside the home and having an occupation in transportation or industry also increased the risk for meningococcal carriage in individuals older than 17, when corrections for gender and smoking were made. Assuming that our sample is representative of the Norwegian population, we estimated that about 40,000 individuals in Norway are asymptomatic carriers of isolates with epidemic potential. Thus, carriage eradication among close contacts of persons with systemic disease is unlikely to have a significant impact on the overall epidemiological situation.

Adolescent↗
PubMed1993

[Chlamydia pneumoniae--pathogenesis and perspectives].

Chlamydia pneumoniae, a Gram-negative bacterium, formerly named TWAR but identified as a distinct species since 1988, is now considered to be the most common agent of chlamydial infection in Scandinavia. C pneumoniae has a different tissue trophism from that of Chlamydia trachomatis, since C pneumoniae may infect bronchi and lungs, macrophages, monocytes, and endothelial cells. C pneumoniae, like other chlamydiae, has a slow, intracellular life cycle. An absence of reaction from the host cells, combined with scant tissual reaction owing to the low endotoxic activity of chlamydial lipopolysaccharide, may help to explain the usually discreet clinical picture. Atherosclerosis and coronary heart disease may follow chronic lung infection, and acute pneumonic episodes can trigger myocardial infarct. Asymptomatic infection with C pneumoniae is widespread. Intriguing diagnostic questions are the possible existence of a non-pathogenic carrier state, and the conceivable sensitization of the host with respect to a heterotypic, secondary chlamydial infection by, for example, C trachomatis, giving rise to an aggravated clinical picture. Early antibiotics are indicated to avoid the development of chronic disease.

Cardiovascular Diseases↗
PubMed1993

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↗
PubMed1993

Tularemia: a differential diagnosis in oto-rhino-laryngology.

Tularemia can present as an oto-rhino-laryngological disease. The clinical and radiological (CT) manifestations, diagnosis and treatment are discussed based on a case report where a patient with tonsillitis and enlarged cervical lymph nodes was admitted to the department of oto-rhino-laryngology of a hospital in Northern Norway. Francisella tularensis was isolated from the blood and there was a high titre of agglutinating serum antibodies to F. tularensis. The patient's contaminated drinking water well is the suspect source of infection.

Adult↗