PubMed Health⌕ Search

Biomedical subjects

Rune Andersson

Publications and source records attributed to Rune Andersson.

6 recordsLinked to original sources

Pneumocystis pneumonia--a retrospective study 1991-2001 in Gothenburg, Sweden.

OBJECTIVES: Pneumocystis pneumonia (PCP) is a severe opportunistic infection in immunosuppressed patients, caused by Pneumocystis jiroveci. The incidence among HIV negative patients is considered to have increased during the last decade. METHODS: We collected data retrospectively from the cases with PCP diagnosed at Sahlgrenska University Hospital between January 1991 and December 2001. RESULTS: 118 episodes of PCP were registered in 108 patients. The most common underlying immunosuppressions were HIV and solid organ transplantation with 29 and 26 cases, respectively. The number of PCP cases did not increase during the study period. Out of the 118 episodes of PCP 89 (75%) were in patients not infected with HIV. No clusters were found among HIV positive patients. We found 5 smaller clusters among non-HIV patients. Among the cases with proven PCP, 17% were on prophylaxis: 30% of the HIV infected patients and 13% of the non-HIV patients. CONCLUSIONS: The number of PCP cases is not increasing, 75% of the patients are HIV negative, Only 17% of the patients were on prophylaxis before the episode of PCP, indicating that not all patients at risk are identified.

AIDS-Related Opportunistic Infections↗

Food 21: a research program looking for measures and tools to increase food chain sustainability.

Food 21, an interdisciplinary research program encompassing the whole agro-food chain, was conducted in Sweden during 1997-2004. The challenges undertaken were to come up with environmental tools and solutions to existing nonsustainable practices along the entire food chain. This required close collaboration between the scientists and the food chain stakeholders. A set of goals characterizing sustainable food production is presented in this paper. Synthesis and systems analysis were the main tools used to analyze the sustainability of proposed changes. In this introduction we give an overview of the Food 21 concept and highlight some results. For example, we found that organic farming and organic products were not in general superior to conventional products and practices with respect to environmental impact and product quality. We also summarize the management experiences in this article, since we consider them to be rather unique and since they contributed to the overall success of the program.

Agriculture↗

Pacemaker endocarditis during 18 years in Göteborg.

Pacemaker endocarditis is a rare but serious complication. Few studies addressing its treatment have been published. Clinical characteristics and outcome were retrospectively studied in 38 patients with 44 episodes of pacemaker infective endocarditis (PMIE) in Göteborg, during 1984-2001. The male/female ratio of episodes was 27/17 and the mean age 69 y. Transthoracic echocardiography (TTE) showed vegetation in 4/22 (18%) episodes and transoesophageal echocardiography (TEE) in 22/33 (67%). Staphylococci were isolated in 66% of blood cultures. The pacemaker system (PS) was removed in 28 episodes and in 18 of these there were no signs of reinfection at follow-up. In 16 episodes the PS was not removed, and in 13 of these, signs of infection were found at follow-up. Thus, the present study of PMIE showed staphylococci to be predominant causative agents and demonstrated a high diagnostic sensitivity of TEE. According to our results, PM removal rather than conservative treatment should be considered in all cases.

Adult↗

Bartonella and Coxiella antibodies in 334 prospectively studied episodes of infective endocarditis in Sweden.

Bartonella spp. have been identified as aetiological agents in culture-negative infective endocarditis (IE). Coxiella burnetii may cause chronic Q-fever with endocarditis, 334 blood samples collected from 329 patients (334 episodes) with IE diagnosed between 1984 and 1996 in Göteborg, Sweden, were investigated for antibodies to Bartonella spp. and C. burnetii. 71 of the episodes (21%) were blood culture negative. A microimmunofluorescence assay revealed immunoglobulin G (IgG) antibodies to Bartonella in 13 of the culture verified episodes and in 2 of the culture-negative episodes. Three of the patients had IgG antibodies to > or = 200 in the blood culture-verified group, but none had a titre > or = 800, the cut-off level for Bartonella endocarditis. One patient had elevated antibodies to C. burnetii, diagnosing chronic Q-fever endocarditis. In conclusion, serologically verified Bartonella endocarditis is not prevalent in western Sweden and Q-fever endocarditis is rare.

Antibodies, Bacterial↗

A clinical study of culture-negative endocarditis.

Culture-negative infective endocarditis (CNE) is a diagnostic problem in spite of improved echocardiographic and blood culturing techniques. We conducted the present study to estimate the proportion of CNE in patients with infective endocarditis, to investigate data regarding risk factors, and to evaluate the Duke and the modified Beth Israel criteria in patients with CNE. We evaluated 820 consecutive suspected episodes of infective endocarditis in adults at the Departments of Infectious Diseases in Göteborg and Borås, Sweden (1984-1996). All patients were diagnosed and treated according to a protocol; 487 episodes were identified as infective endocarditis. Episodes with absence of bacterial growth at blood culture were defined as CNE and were classified with the Duke and the modified Beth Israel criteria. We identified 116 CNE episodes (median age, 67 yr). Mortality was 7%, and in 15%, cardiac surgery was performed. The Duke criteria classified 20 definite, 80 possible, and 16 reject episodes. The modified Beth Israel criteria distinguished 13 definite, 15 probable, 27 possible, and 61 reject episodes. The proportion of CNE among patients with infective endocarditis varied from 19% to 27% at the 2 departments. Antibiotic treatment preceded blood culture in 45% of the CNE episodes. About 20% in a Scandinavian population of infective endocarditis patients have CNE. Antibiotic pretreatment explains less than 50% of all CNE episodes. The Duke criteria are more sensitive but less specific than the modified Beth Israel criteria in classifying patients with CNE.

Adult↗

Awareness of and attitudes towards HIV among pregnant women at the Antenatal Clinic, Port Moresby General Hospital.

BACKGROUND: The prevalence of HIV (human immunodeficiency virus) among pregnant women in Port Moresby has increased tenfold, from 0.08% in 1994 to 0.8% in 2002. To stop a further epidemic spread as seen in sub-Saharan Africa it is urgent to identify and intervene to reduce risk behaviours. In order to do so it is important to evaluate current awareness of and attitude towards HIV. METHODS: Interviews with 122 pregnant women were conducted at the Antenatal Clinic, Port Moresby General Hospital, Papua New Guinea. We assessed the women's HIV awareness and relate the results to education and socioeconomic factors. RESULTS: 4 out of 122 women did not know about HIV. 97% knew that HIV is spread by sexual contacts, 96% knew about mother-to-child transmission and 69% knew about infection through breastfeeding. However, there were many misconceptions; 36% believed that HIV can be spread by mosquitoes and 17% believed that caring for an AIDS (acquired immune deficiency syndrome) patient is a risk. Among the women with no education or primary school education only, 51% knew for sure that HIV is not spread by caring for an AIDS patient, compared to 86% for the women with higher education. 47% of the women received their first information about HIV through the media. CONCLUSIONS: The AIDS campaigns have been successful in making almost all the women aware of HIV as a sexually transmitted disease. However, the high frequency of misconceptions makes it probable that patients are stigmatized. This is particularly true for the lower educated women. To more effectively fight the HIV epidemic it is important to improve the general level of education of both men and women, to encourage women to be more in charge of their own sexuality and to increase their status in society. It is also important to make men aware of their responsibility to practise safe sex.

Acquired Immunodeficiency Syndrome↗