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Hebbelstrup Jensen B, Jokelainen P, Nielsen ACY, Franck KT, Rejkjær Holm D, Schønning K, Petersen AM, Krogfelt KA. Children Attending Day Care Centers are a Year-round Reservoir of Gastrointestinal Viruses. Sci Rep 2019; 9:3286. [PMID: 30824842 PMCID: PMC6397223 DOI: 10.1038/s41598-019-40077-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/29/2019] [Indexed: 12/22/2022] Open
Abstract
Viral gastroenteritis causes high morbidity worldwide. In this study, stool samples from 179 children aged 0–6 years attending Danish day care centers were investigated for gastrointestinal viruses. Each child was observed for one year with submission of samples and questionnaires every two months. Adenovirus, norovirus, rotavirus, and sapovirus were detected in samples using real-time PCR. A total of 229 (33%) of the 688 samples collected tested positive for at least one virus. At the first sampling point, adenovirus was shed by 6%, norovirus genotype I by 3% and genotype II by 12%, rotavirus A by 9%, and sapovirus by 21% of the 142 children included in the risk factor analyses. Increasing age was identified as a protective factor against testing positive for gastrointestinal virus, whereas nausea during the previous two months was positively associated with testing positive. Odds of shedding adenovirus were 9.6 times higher among children treated with antibiotics within the previous two months than among children who were not. Gastrointestinal viruses were shed year-round and high viral loads were observed in samples from both symptomatic and asymptomatic children, suggesting children in day care as a reservoir and a possible source of spreading of viruses into the community.
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Affiliation(s)
- Betina Hebbelstrup Jensen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Internal Medicine, Amager Hospital, Copenhagen, Denmark
| | - Pikka Jokelainen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark
| | - Alex Christian Yde Nielsen
- Copenhagen University Hospital, Rigshospitalet, Department of Clinical Microbiology, Copenhagen, Denmark.,Statens Serum Institut, Department of Virus and Microbiology Special Diagnostics, Copenhagen, Denmark
| | - Kristina Træholt Franck
- Statens Serum Institut, Department of Virus and Microbiology Special Diagnostics, Copenhagen, Denmark.,Hvidovre Hospital, Department of Clinical Microbiology, Hvidovre, Denmark
| | - Dorthe Rejkjær Holm
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark
| | - Kristian Schønning
- Hvidovre Hospital, Department of Clinical Microbiology, Hvidovre, Denmark
| | - Andreas M Petersen
- Hvidovre Hospital, Department of Clinical Microbiology, Hvidovre, Denmark.,Hvidovre Hospital, Department of Gastroenterology, Hvidovre, Denmark
| | - Karen A Krogfelt
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Copenhagen, Denmark. .,Statens Serum Institut, Department of Virus and Microbiology Special Diagnostics, Copenhagen, Denmark.
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Mortensen MS, Hebbelstrup Jensen B, Williams J, Brejnrod AD, O'Brien Andersen L, Röser D, Andreassen BU, Petersen AM, Stensvold CR, Sørensen SJ, Krogfelt KA. Stability and resilience of the intestinal microbiota in children in daycare - a 12 month cohort study. BMC Microbiol 2018; 18:223. [PMID: 30579350 PMCID: PMC6303881 DOI: 10.1186/s12866-018-1367-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 12/04/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND We performed a 12-month cohort study of the stability and resilience of the intestinal microbiota of healthy children in daycare in Denmark in relation to diarrheal events and exposure to known risk factors for gastrointestinal health such as travelling and antibiotic use. In addition, we analyzed how gut microbiota recover from such exposures. RESULTS We monitored 32 children in daycare aged 1-6 years. Fecal samples were submitted every second month during a one-year observational period. Information regarding exposures and diarrheal episodes was obtained through questionnaires. Bacterial communities were identified using 16S rRNA gene sequencing. The core microbiota (mean abundance > 95%) dominated the intestinal microbiota, and none of the tested exposures (diarrheal events, travel, antibiotic use) were associated with decreases in the relative abundance of the core microbiota. Samples exhibited lower intra-individual variation than inter-individual variation. Half of all the variation between samples was explained by which child a sample originated from. Age explained 7.6-9.6% of the variation, while traveling, diarrheal events, and antibiotic use explained minor parts of the beta diversity. We found an age-dependent increase of alpha diversity in children aged 1-3 years, and while diarrheal events caused a decrease in alpha diversity, a recovery time of 40-45 days was observed. Among children having had a diarrheal event, we observed a 10x higher relative abundance of Prevotella. After travelling, a higher abundance of two Bacteroides species and 40% less Lachnospiraceae were seen. Antibiotic use did not correlate with changes in the abundance of any bacteria. CONCLUSION We present data showing that Danish children in daycare have stable intestinal microbiota, resilient to the exposures investigated. An early age-dependent increase in the diversity was demonstrated. Diarrheal episodes decreased alpha diversity with an estimated recovery time of 40-45 days.
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Affiliation(s)
- Martin Steen Mortensen
- Department of Biology, Section of Microbiology, Copenhagen University, Copenhagen, Denmark
| | - Betina Hebbelstrup Jensen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, DK2300, Copenhagen S, Artillerivej 5, Denmark.,Department of Internal Medicine, Amager Hospital, Copenhagen, Denmark
| | - Jeanne Williams
- Department of Biology, Section of Microbiology, Copenhagen University, Copenhagen, Denmark
| | - Asker Daniel Brejnrod
- Department of Biology, Section of Microbiology, Copenhagen University, Copenhagen, Denmark
| | - Lee O'Brien Andersen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, DK2300, Copenhagen S, Artillerivej 5, Denmark
| | - Dennis Röser
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, DK2300, Copenhagen S, Artillerivej 5, Denmark.,Department of Pediatrics, Hvidovre Hospital, Copenhagen, Denmark
| | | | - Andreas Munk Petersen
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark.,Department of Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
| | - Christen Rune Stensvold
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, DK2300, Copenhagen S, Artillerivej 5, Denmark
| | | | - Karen Angeliki Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, DK2300, Copenhagen S, Artillerivej 5, Denmark.
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Hebbelstrup Jensen B, Adler Sørensen C, Hebbelstrup Rye Rasmussen S, Rejkjær Holm D, Friis-Møller A, Engberg J, Mirsepasi-Lauridsen HC, Struve C, Hammerum AM, Porsbo LJ, Petersen RF, Petersen AM, Krogfelt KA. Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults-Antibiotic Treatment Does Not Reduce Duration of Diarrhea. Front Cell Infect Microbiol 2018; 8:306. [PMID: 30319991 PMCID: PMC6170641 DOI: 10.3389/fcimb.2018.00306] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/08/2018] [Indexed: 01/18/2023] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been discussed. Since the level of antibiotic resistance is increasing, it is essential to restrict the use of antibiotics to prevent further resistance development. We aimed to investigate EAEC strains in adult Danish patients suffering from diarrhea and from healthy controls. We examined the antibiotic resistance in EAEC strains, the clinical response to antibiotic treatment in EAEC diarrheal cases, and the distribution of virulence genes in diarrheal cases. The EAEC strains were collected from patients suffering from diarrhea in a Danish multicenter study. A medical doctor interviewed the patients by using a questionnaire regarding gastrointestinal symptoms, exposures, and use of antibiotic and over-the-counter antidiarrheal drugs. Follow-up was performed after 3–5 months to inquire about differential diagnosis to gastrointestinal disease. A multiplex polymerase chain reaction characterized virulence genes in diarrheal cases. Finally, the level of antibiotic resistance was examined by using the disc diffusion method. Asymptomatic carriage of EAEC in the adult Danish population was rare, in contrast to findings in healthy Danish children. The duration of diarrhea was not shortened by antibiotic treatment, specifically ciprofloxacin treatment, or by over-the-counter antidiarrheal drugs. Follow-up revealed no pathology in diarrheal patients apart from irritable bowel syndrome in two patients. A high number of patients suffered from long-term diarrhea, which was associated with the enterotoxin EAST-1 and a high virulence factor score. A high level of antibiotic resistance was observed and 58% of the EAEC strains were multidrug resistant. Multidrug resistance was most pronounced in cases of travelers' diarrhea, and it was seen that antibiotic treatment did not reduce the duration of diarrhea.
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Affiliation(s)
- Betina Hebbelstrup Jensen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Dorthe Rejkjær Holm
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Alice Friis-Møller
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark
| | - Jørgen Engberg
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | | | - Carsten Struve
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anette M Hammerum
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Lone Jannok Porsbo
- National Food Institute, Technical University of Denmark, Copenhagen, Denmark
| | - Randi Føns Petersen
- Department of Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Andreas Munk Petersen
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark.,Department of Gastroenterology, Hvidovre Hospital, Copenhagen, Denmark
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Adler Sørensen C, Rosbjerg A, Hebbelstrup Jensen B, Krogfelt KA, Garred P. The Lectin Complement Pathway Is Involved in Protection Against Enteroaggregative Escherichia coli Infection. Front Immunol 2018; 9:1153. [PMID: 29896194 PMCID: PMC5986924 DOI: 10.3389/fimmu.2018.01153] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/08/2018] [Indexed: 02/05/2023] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) causes acute and persistent diarrhea worldwide. Still, the involvement of host factors in EAEC infections is unresolved. Binding of recognition molecules from the lectin pathway of complement to EAEC strains have been observed, but the importance is not known. Our aim was to uncover the involvement of these molecules in innate complement dependent immune protection toward EAEC. Binding of mannose-binding lectin, ficolin-1, -2, and -3 to four prototypic EAEC strains, and ficolin-2 binding to 56 clinical EAEC isolates were screened by a consumption-based ELISA method. Flow cytometry was used to determine deposition of C4b, C3b, and the bactericidal C5b-9 membrane attack complex (MAC) on the bacteria in combination with different complement inhibitors. In addition, the direct serum bactericidal effect was assessed. Screening of the prototypic EAEC strains revealed that ficolin-2 was the major binder among the lectin pathway recognition molecules. However, among the clinical EAEC isolates only a restricted number (n = 5) of the isolates bound ficolin-2. Using the ficolin-2 binding isolate C322-17 as a model, we found that incubation with normal human serum led to deposition of C4b, C3b, and to MAC formation. No inhibition of complement deposition was observed when a C1q inhibitor was added, while partial inhibition was observed when ficolin-2 or factor D inhibitors were used separately. Combining the inhibitors against ficolin-2 and factor D led to virtually complete inhibition of complement deposition and protection against direct bacterial killing. These results demonstrate that ficolin-2 may play an important role in innate immune protection against EAEC when an appropriate ligand is exposed, but many EAEC strains evade lectin pathway recognition and may, therefore, circumvent this strategy of innate host immune protection.
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Affiliation(s)
- Camilla Adler Sørensen
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anne Rosbjerg
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | | | | | - Peter Garred
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
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Sørensen CA, Rosbjerg A, Jensen BH, Krogfelt KA, Garred P. Ficolin-2 from the lectin pathway of complement recognizes enteroaggregative Escherichia coli and contributes to innate complement dependent immune protection. Mol Immunol 2017. [DOI: 10.1016/j.molimm.2017.06.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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6
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Hebbelstrup Jensen B, Poulsen A, Hebbelstrup Rye Rasmussen S, Struve C, Engberg JH, Friis-Møller A, Boisen N, Jønsson R, Petersen RF, Petersen AM, Krogfelt KA. Genetic Virulence Profile of Enteroaggregative Escherichia coli Strains Isolated from Danish Children with Either Acute or Persistent Diarrhea. Front Cell Infect Microbiol 2017; 7:230. [PMID: 28611957 PMCID: PMC5447714 DOI: 10.3389/fcimb.2017.00230] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/17/2017] [Indexed: 11/13/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) is frequently found in diarrheal stools worldwide. It has been associated with persistent diarrhea, weight loss, and failure to thrive in children living in developing countries. A number of important EAEC virulence genes are identified; however, their roles in acute and persistent diarrhea have not been previously investigated. The aim of this study was to identify specific EAEC virulence genes associated with duration and type of diarrhea in Danish children. We aimed to improve the current diagnostics of EAEC and enable targeting of strains with an expected severe disease course. Questionnaires answered by parents provided information regarding duration of diarrhea and presence of blood or mucus. A total of 295 EAEC strains were collected from children with acute (≤7 days) and persistent diarrhea (≥14 days) and were compared by using multiplex PCR targeting the genes sat, sepA, pic, sigA, pet, astA, aatA, aggR, aaiC, aap, agg3/4C, ORF3, aafA, aggA, agg3A, agg4A, and agg5A. Furthermore, the distribution of EAEC genes in strains collected from cases of bloody, mucoid, and watery diarrhea was investigated. The classification and regression tree analysis (CART) was applied to investigate the relationship between EAEC virulence genes and diarrheal duration and type. Persistent diarrhea was associated with strains lacking the pic gene (p = 0.002) and with the combination of the genes pic, sat, and absence of the aggA gene (p = 0.05). Prolonged diarrhea was associated with the combination of the genes aatA and astA (p = 0.03). Non-mucoid diarrhea was associated with strains lacking the aatA gene (p = 0.004). Acute diarrhea was associated with the genes aggR, aap, and aggA by individual odds ratios. Resistance toward gentamicin and ciprofloxacin was observed in 7.5 and 3% of strains, respectively. Multi-drug resistance was observed in 38% of strains. Genetic host factors have been associated with an increased risk of EAEC-associated disease. Therefore, we investigated a panel of risk factors in two groups of children—EAEC-positive and EAEC-negative—to identify additional factors predisposing to disease. The duration of breastfeeding was positively correlated with the likelihood of belonging to the EAEC-negative group of children.
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Affiliation(s)
| | - Anja Poulsen
- Department of Gastroenterology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | | | - Carsten Struve
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Jørgen H Engberg
- Department of Clinical Microbiology, Slagelse HospitalSlagelse, Denmark
| | - Alice Friis-Møller
- Department of Clinical Microbiology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Nadia Boisen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Rie Jønsson
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Randi F Petersen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
| | - Andreas M Petersen
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark.,Department of Gastroenterology, Copenhagen University Hospital HvidovreCopenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Karen A Krogfelt
- Department of Bacteria, Parasites and Fungi, Statens Serum InstitutCopenhagen, Denmark
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7
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Sydenham TV, Jensen BH, Petersen AM, Krogfelt KA, Justesen US. Antimicrobial resistance in the Bacteroides fragilis group in faecal microbiota from healthy Danish children. Int J Antimicrob Agents 2017; 49:573-578. [DOI: 10.1016/j.ijantimicag.2017.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/02/2017] [Accepted: 01/06/2017] [Indexed: 10/19/2022]
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Hebbelstrup Jensen B, Stensvold CR, Struve C, Olsen KEP, Scheutz F, Boisen N, Röser D, Andreassen BU, Nielsen HV, Schønning K, Petersen AM, Krogfelt KA. Enteroaggregative Escherichia coli in Daycare-A 1-Year Dynamic Cohort Study. Front Cell Infect Microbiol 2016; 6:75. [PMID: 27468409 PMCID: PMC4942469 DOI: 10.3389/fcimb.2016.00075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 06/29/2016] [Indexed: 12/24/2022] Open
Abstract
Enteroaggregative Escherichia coli (EAEC) has been associated with persistent diarrhea, reduced growth acceleration, and failure to thrive in children living in developing countries and with childhood diarrhea in general in industrialized countries. The clinical implications of an EAEC carrier-status in children in industrialized countries warrants clarification. To investigate the pathological significance of an EAEC carrier-state in the industrialized countries, we designed a 1-year dynamic cohort study and performed follow-up every second month, where the study participants submitted a stool sample and answered a questionnaire regarding gastrointestinal symptoms and exposures. Exposures included foreign travel, consumption of antibiotics, and contact with a diseased animal. In the capital area of Denmark, a total of 179 children aged 0–6 years were followed in a cohort study, in the period between 2009 and 2013. This is the first investigation of the incidence and pathological significance of EAEC in Danish children attending daycare facilities. Conventional microbiological detection of enteric pathogens was performed at Statens Serum Institute, Copenhagen, Denmark, and at Hvidovre Hospital, Copenhagen, Denmark. Parents completed questionnaires regarding gastrointestinal symptoms. The EAEC strains were further characterized by serotyping, phylogenetic analysis, and susceptibility testing. EAEC was detected in 25 (14%) of the children during the observational period of 1 year. One or more gastrointestinal symptoms were reported from 56% of the EAEC-positive children. Diarrhea was reported in six (24%) of the EAEC positive children, but no cases of weight loss, and general failure to thrive were observed. The EAEC strains detected comprised a large number of different serotypes, confirming the genetic heterogeneity of this pathotype. EAEC was highly prevalent (n = 25, 14%) in Danish children in daycare centers and was accompanied by gastrointestinal symptoms in 56% of the infected children. No serotype or phylogenetic group was specifically linked to children with disease.
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Affiliation(s)
| | - Christen R Stensvold
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Carsten Struve
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Katharina E P Olsen
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Flemming Scheutz
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Nadia Boisen
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Dennis Röser
- Department of Microbiology and Infection Control, Statens Serum InstituteCopenhagen, Denmark; Department of Pediatrics, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Bente U Andreassen
- Department of Pediatrics, H.C. Andersen's Hospital, University of Odense Odense, Denmark
| | - Henrik V Nielsen
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
| | - Kristian Schønning
- Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre Copenhagen, Denmark
| | - Andreas M Petersen
- Department of Microbiology and Infection Control, Statens Serum InstituteCopenhagen, Denmark; Department of Clinical Microbiology, Copenhagen University Hospital HvidovreCopenhagen, Denmark; Department of Gastroenterology, Copenhagen University Hospital HvidovreCopenhagen, Denmark
| | - Karen A Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institute Copenhagen, Denmark
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Hebbelstrup Jensen B, Röser D, Andreassen BU, Olsen KEP, Nielsen HV, Roldgaard BB, Schjørring S, Mirsepasi-Lauridsen HC, Jørgensen SL, Mortensen EM, Petersen AM, Krogfelt KA. Childhood diarrhoea in Danish day care centres could be associated with infant colic, low birthweight and antibiotics. Acta Paediatr 2016; 105:90-5. [PMID: 26355526 DOI: 10.1111/apa.13209] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/13/2015] [Accepted: 09/07/2015] [Indexed: 12/11/2022]
Abstract
AIM Diarrhoea is very common in children attending day care centres. The aim of this study was to examine certain predisposing risk factors for an association with diarrhoea, including foreign travel, treatment with antibiotics, having household pets, infant colic, bottle feeding, using a pacifier and low birthweight. METHODS A dynamic one-year follow-up cohort study comprising 179 children from 36 day care centres was conducted from September 2009 to July 2013 in Copenhagen, Denmark. Questionnaires were sent to the children's parents or legal guardians every two months for a year, requesting information on gastrointestinal symptoms and exposure. A logistic regression was performed to identify the odds ratios of different risk factors for diarrhoea. RESULTS The odds ratios for diarrhoea were 1.97 (0.93-4.20) for children with a history of infant colic, 1.91 (0.90-4.04) for low birthweight children and 1.45 (0.74-2.82) for children who had used antibiotics. Having a pet in the household had a possible protective effect towards diarrhoeal events, with an odds ratio of 0.47 (0.20-1.09). CONCLUSION A history of infant colic, low birthweight, and to a lesser extent antibiotic use, possibly increased the risk of diarrhoea in Danish children in day care centres.
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Affiliation(s)
| | - Dennis Röser
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
- Department of Paediatrics; Hvidovre University Hospital; Copenhagen Denmark
| | | | - Katharina E. P. Olsen
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Henrik Vedel Nielsen
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Bent Bjørn Roldgaard
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Susanne Schjørring
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | | | - Steffen L. Jørgensen
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Esben Munk Mortensen
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
| | - Andreas Munk Petersen
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
- Department of Gastroenterology; Hvidovre University Hospital; Copenhagen Denmark
- Department of Clinical Microbiology; Hvidovre University Hospital; Copenhagen Denmark
| | - Karen Angeliki Krogfelt
- Department of Microbiology and Infection Control; Statens Serum Institut; Copenhagen Denmark
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Gadsbøll N, Rasmussen S, Jensen BH, Leth A, Giese J, Høilund-Carlsen PF. Divergent cardiac response to exercise in essential hypertension vs. normotension and the effect of enalapril. Clin Physiol 1998; 18:245-53. [PMID: 9649912 DOI: 10.1046/j.1365-2281.1998.00098.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aims of this study were to examine (1) the cardiac response to exercise in essential hypertension and (2) the effect of long-term enalapril treatment on cardiac reserve. Ten normotensive control subjects and 15 patients with moderate, essential hypertension underwent radionuclide ventriculography during graded, supine exercise (0 W-50 W-100 W). The hypertensive patients were studied during monotherapy using hydrochlorothiazide and 3 and 12 months after supplementation with enalapril 10-40 mg o.d. During exercise, the control subjects demonstrated a 17% increase in left ventricular ejection fraction (LVEF) mediated by a 30% decrease in end-systolic volume, a small increase in stroke volume and a minor biphasic (increase-decrease) change in end-diastolic volume. In the hypertensive patients, both the end-diastolic and the end-systolic volume increased substantially with no increase in LVEF, although stroke volume increased by 33%. Long-term therapy with enalapril induced only a minor change towards a more normal pattern of cardiac response to exercise. The hypertensive patients increased their stroke volume during exercise by recruiting preload reserve instead of increasing contractility. Long-term treatment with enalapril had little, if any, effect on this abnormal cardiac response.
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Affiliation(s)
- N Gadsbøll
- Department of Clinical Physiology, Glostrup University Hospital, Copenhagen, Denmark
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Petersen CL, Gadsbøll N, Stadeager C, Torp-Petersen C, Nielsen JR, Jensen BH, Høilund-Carlsen PF, Dige-Petersen H. Changes in left and right ventricular performance and volumes in seven-year survivors of acute myocardial infarction. Am J Cardiol 1995; 75:659-64. [PMID: 7900656 DOI: 10.1016/s0002-9149(99)80649-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We describe the spontaneous long-term changes in right (RV) and left (LV) ventricular performance during a 7-year period after acute myocardial infarction (AMI). Radionuclide ventriculography was performed in the second week after AMI in 201 patients. RV and LV ejection fractions, and LV end-diastolic and end-systolic volumes were determined. A follow-up after 7 years was performed in 55 survivors. Of these, 16 patients were also examined after 1 year. During the 7-year follow-up period, LV ejection fraction decreased from 0.49 to 0.45 (p < 0.01). LV end-diastolic volume increased from 161 to 210 ml (30%) (p < 0.01), and LV end-systolic volume from 83 to 123 ml (48%) (p < 0.01). In patients without recurrent AMI, coronary artery bypass grafting surgery, or angiotensin-converting enzyme inhibitor therapy (n = 37) during follow-up, no change in average LV ejection fraction was observed. Nevertheless, this subgroup had substantial increases in LV end-diastolic volume, from 157 to 190 ml (21%) (p = 0.002) and in LV end-systolic volume, from 80 to 105 ml (31%) (p < 0.001). In a subgroup of patients also reinvestigated after 1 year (n = 16), there was a 15% increase in LV end-diastolic volume the first year after AMI with an additional 10% increase in LV end-diastolic volume between years 1 and 7. Corresponding figures for LV end-systolic volume were 20% and 12%, respectively. Hardly any association was apparent between LV ejection fraction, LV end-diastolic volume, and LV stroke volume at discharge for subsequent LV dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C L Petersen
- Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Denmark
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12
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Christrup LL, Bonde J, Rasmussen SN, Sonnergaard JM, Jensen BH. Single-dose and steady-state pharmacokinetics of diltiazem administered in two different tablet formulations. Pharmacol Toxicol 1992; 71:305-7. [PMID: 1454755 DOI: 10.1111/j.1600-0773.1992.tb00989.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Single-dose and steady state pharmacokinetics of diltiazem administered in two different oral formulations were assessed with particular reference to rate and extent of absorption. Following single dose administration a significant difference in tmax was observed (2.9 +/- 1.9 and 6.8 +/- 2.6 hr respectively) whereas differences in AUC, t1/2 and Cmax were not significant. The AUC (mean +/- S.D.) values following single dose administration of Cardil and Cardizem were 678.4 +/- 321.5 and 948.6 +/- 580.6 ng.ml-1.hr respectively. The mean and the 95% confidence limits for the observed ratio AUCCardil/AUCCardizem are 0.89 and 0.44-1.34 respectively. At steady-state a significant difference between Cmax/Cmin and tmax was seen Cmax/Cmin being 4.9 and 3.2 respectively and Tmax being 2.7 +/- 2.0 and 6.0 +/- 2.8 hr respectively, whereas Cmax and AUC did not differ significantly. The AUC (mean +/- S.D.) values in steady state of Cardil and Cardizem were 880.1 +/- 399.8 and 1056.8 +/- 509.8 ng.ml-1.hr respectively. The mean and the 95% confidence limits for the observed ratio AUCCardil/AUCCardizem are 0.96 and 0.66-1.26 respectively. Although the observed ratios AUCCardil/AUCCardizem in both the single-dose and the steady-state study do not differ significantly from 1.0, the confidence limits exceed the acceptable values given by Poulsen & Juul (personal communication 1990) (a 20% decrease or increase of the ratio to 0.8 or 1.2).
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Affiliation(s)
- L L Christrup
- Department of Pharmaceutics, Royal Danish School of Pharmacy, Copenhagen
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13
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Larsen F, Jensen BH, Olesen HP, Larsen C. Multiple oral administration of a ketoprofen-dextran ester prodrug in pigs: assessment of gastrointestinal bioavailability by deconvolution. Pharm Res 1992; 9:915-9. [PMID: 1279651 DOI: 10.1023/a:1015805000595] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Deconvolution has been applied to estimate the in vivo dissolution/release process of ketoprofen from a ketoprofen-dextran ester prodrug in pigs. The prodrug was given to three pigs at intervals of 12 hr and in seven doses corresponding to 4 mg ketoprofen/kg body weight. Frequent blood sampling was carried out at the first, third, and seventh intervals. Plasma steady-state concentrations of ketoprofen following the prodrug administration were between 2 and 4 micrograms/ml. The reference consisted of a single p.o. dose of parent ketoprofen (4 mg/kg body weight). For each pig the response following the multiple dosing was deconvolved with the reference response using an algebraic deconvolution procedure adopted from the literature. The obtained cumulated in vivo dissolution/release profiles revealed similar release rates for the three pigs and similar extents of release (59, 70, and 65%). The mean in vivo dissolution/release times (MDT) were calculated to be 5.4, 6.1, and 5.7 hr, respectively. In conclusion, following administration of the dextran prodrug the plasma concentration curves and the dissolution/release profiles are uniform, with small interindividual variations.
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Affiliation(s)
- F Larsen
- Department of Biological Sciences, Pharmacology and Toxicology, Royal Danish School of Pharmacy, Copenhagen
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14
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Chraemmer-Jørgensen B, Høilund-Carlsen PF, Marving J, Strøm J, Nielsen MD, Jensen BH, Lønborg-Jensen H, Schmidt K. Left-ventricular performance, volumes, and catecholamine responses during anaesthesia induction--monitoring by combined radionuclide cardiography and right heart catheterization. Ugeskr Laeger 1991; 8:437-43. [PMID: 1765041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sequential radionuclide imaging and continuous recording of arterial and right heart pressures were carried out during anaesthesia with midazolam 0.2 mg kg-1, pancuronium 0.15 mg kg-1 and fentanyl 10 micrograms kg-1 in eight patients with normal cardiopulmonary status scheduled for craniotomy. The aim was to examine how a stress-free anaesthetic induction tailored to protect against the hypertension and tachycardia provoked by laryngoscopy and intubation influenced left-ventricular performance, left-ventricular loading conditions and plasma catecholamine concentrations. During the 20-min study period no significant changes were observed in heart rate, left-ventricular ejection fraction, ratio of peak systolic pressure to left-ventricular end-systolic volume, pulmonary capillary wedge pressure, left-ventricular end-systolic volume, cardiac output, dopamine and noradrenaline concentrations. Except for a minor increase in mean arterial pressure after laryngoscopy and intubation, mean arterial pressure decreased 24%, left-ventricular end-diastolic volume decreased 15%, and left-ventricular stroke volume decreased 21%. Central venous pressure increased by 75% but there was no parallel increase in pulmonary wedge pressure, which in turn did not reflect the alterations in ventricular end-diastolic volume. Plasma adrenaline concentrations decreased significantly (66%). The chosen induction regimen preserved global left-ventricular pump function during laryngoscopy and intubation without any activation of the sympathetic nervous system. Central venous and pulmonary wedge pressures were unreliable in the assessment of ventricular preload during induction of general anaesthesia.
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15
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Gadsbøll N, Høilund-Carlsen PF, Badsberg JH, Lønborg-Jensen H, Stage P, Marving J, Jensen BH. Left ventricular peak filling rate, heart failure and 1-year survival in patients with acute myocardial infarction. Eur Heart J 1991; 12:194-202. [PMID: 2044553 DOI: 10.1093/oxfordjournals.eurheartj.a059868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Radionuclide left ventricular (LV) peak filling rate (PFR) was determined in 185 survivors of acute myocardial infarction (AMI) and expressed in units of (1) end-diastolic volume per second (EDV s-1). (2) stroke volume per second (SV s-1), or (3) actual millilitres of blood filled into the left ventricle per second (ml s-1). The purpose of the study was to assess the interrelationship between the three expressions of PFR, and to analyse their significance with regard to signs of congestive heart failure and 1-year survival in patients with AMI. PFR EDV s-1, PFR SV s-1 and PFR ml s-1 had a poor relationship to each other, were all influenced by LV volumes and ejection fraction, and supplied contradictory information with regard to LV filling in patients with heart failure. None of the three expressions of LV peak filling rate had an association to heart failure that was independent of LV volume and ejection fraction. A low PFR EDV s-1 in contrast to a high PFR SV s-1 was associated with a high 1-year cardiac mortality, suggesting that these 'normalized' indices of LV peak filling rate signalled LV size and stroke volume rather than actual LV filling behaviour. No association was present between PFR ml s-1 and 1-year mortality. We conclude that the clinical use of radionuclide LV PFR in patients with AMI may lead to spurious results, unless the influence of LV size and ejection fraction is taken into consideration.
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Affiliation(s)
- N Gadsbøll
- Department of Cardiology C, Glostrup Hospital, Denmark
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16
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Gadsbøll N, Høilund-Carlsen PF, Badsberg JH, Marving J, Lønborg-Jensen H, Jensen BH. Left ventricular volumes in the recovery phase after myocardial infarction: relation to infarct location, left ventricular function and one-year cardiac mortality. Eur Heart J 1990; 11:791-9. [PMID: 2146122 DOI: 10.1093/oxfordjournals.eurheartj.a059799] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Absolute left ventricular volumes, normalized to body surface area, were determined by a count-based radionuclide technique in 189 patients with myocardial infarction (MI). All examinations were performed in the second week after MI. Fifty-three percent of the patients had an increased end-diastolic volume index (EDVI) and 72% an increased end-systolic volume index (ESVI). Patients with anterior MI had the same median EDVI as patients with inferoposterior MI, but significantly higher median ESVI and significantly lower median stroke volume index (SVI). SVI was subnormal in 19% of the 189 patients and left ventricular ejection fraction (LVEF) was subnormal in 67%. A non-linear, inverse relationship was present between EDVI and LVEF and between ESVI and LVEF, but LVEF varied greatly for any degree of ventricular dilatation. During a 1-year follow-up period, death from cardiac causes occurred in 29 patients. A strong relationship was present between the degree of ventricular dilatation and 1-year mortality, as well as between the degree of SVI or LVEF reduction and 1-year mortality but, next to clinical heart failure, LVEF was the single most powerful predictor of cardiac death, and various combinations of EDVI, ESVI and SVI did not add more prognostic information to that obtained by heart failure than did LVEF.
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Affiliation(s)
- N Gadsbøll
- Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen., Denmark
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17
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Gadsbøll N, Høilund-Carlsen PF, Nielsen GG, Berning J, Brunn NE, Stage P, Hein E, Marving J, Løngborg-Jensen H, Jensen BH. Symptoms and signs of heart failure in patients with myocardial infarction: reproducibility and relationship to chest X-ray, radionuclide ventriculography and right heart catheterization. Eur Heart J 1989; 10:1017-28. [PMID: 2591393 DOI: 10.1093/oxfordjournals.eurheartj.a059414] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
102 patients with myocardial infarction (MI) were examined by three clinicians, who independently recorded the following symptoms and signs: dyspnoea, a displaced apex beat, S3-gallop, rales, neck vein distension, hepatomegaly, and dependent oedema. Chest X-ray, radionuclide ventriculography, and (in 40 patients) right heart catheterization were carried out immediately after the physical examination. The clinicians frequently disagreed as to the presence of physical signs of heart failure in individuals. Moreover, these signs were of limited value in identifying patients with pulmonary vascular congestion on chest X-ray, reduced left or right radionuclide ventricular ejection fractions, enlarged ventricular volumes or haemodynamic evidence of ventricular dysfunction. We conclude that clinicians frequently disagree in the recognition of physical signs of heart failure, and that these signs have an unpredictable relationship to radiographic, radionuclide and haemodynamic measures of ventricular performance in patients with MI. Nevertheless, physical signs are useful in identifying patients with high risk of cardiac death.
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Affiliation(s)
- N Gadsbøll
- Department of Cardiology, Glostrup Hospital, University of Copenhagen, Denmark
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18
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Gadsbøll N, Høilund-Carlsen PF, Madsen EB, Marving J, Pedersen A, Lønborg-Jensen H, Dige-Petersen H, Jensen BH. Right and left ventricular ejection fractions: relation to one-year prognosis in acute myocardial infarction. Eur Heart J 1987; 8:1201-9. [PMID: 3691556 DOI: 10.1093/oxfordjournals.eurheartj.a062193] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Right and left ventricular ejection fractions (RVEF and LVEF) were measured by radionuclide angiography in 423 patients with acute myocardial infarction (AMI). All investigations were performed at hospital discharge. Of 304 patients with first AMI, 26% had normal ejection fractions, 10% had a decrease in RVEF only, 46% a decrease in LVEF only, and 18% decrease in both RVEF and LVEF. Death from cardiac causes occurred in 52 patients in a one-year follow-up period. A reduced RVEF at hospital discharge had little, if any, relation to one-year mortality. In contrast, there was an inverse curvilinear relationship between LVEF and one-year cardiac mortality.
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Affiliation(s)
- N Gadsbøll
- Department of Cardiology, Glostrup Hospital, Copenhagen, Denmark
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19
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Astrup G, Jensen BH, Nielsen PT, Hassing H, Dahl JB, Blicher J, Jensen RT, Jacobsen F. [Postoperative hypoxemia]. Ugeskr Laeger 1987; 149:365-8. [PMID: 3824616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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20
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Krebs B, Møller BN, Jensen BH. Gas-producing infections after lower-limb amputation because of ischemia. Arch Orthop Trauma Surg (1978) 1986; 104:374-6. [PMID: 3964046 DOI: 10.1007/bf00454434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
During the period 1972-1982, 22 patients with gas-producing infections after lower-limb amputation because of ischemia were reviewed. In 16 cases bacteria of the genus Clostridium could be cultured. Treatment consisted of hyperbaric oxygen, surgical debridement, and antibiotics. The incubation period was 1-11 days after the primary amputation, and the duration of the infection 2-31 days, significantly lower among 14 patients with diabetes mellitus. There was no difference in the course of clostridial and nonclostridial infections. No deaths were attributable to gas-forming infection.
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21
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Andersen M, Jensen BH. [Bronchopulmonary dysplasia treated with continuous positive pressure (super-CPAP)]. Ugeskr Laeger 1985; 147:3602-4. [PMID: 3907077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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22
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Jensen BH, Andersen JO, Poulsen SS, Skov Olsen P, Nørby Rasmussen S, Hansen SH, Hvidberg EF. The prophylactic effect of 5-aminosalicylic acid and salazosulphapyridine on degraded-carrageenan-induced colitis in guinea pigs. Scand J Gastroenterol 1984; 19:299-303. [PMID: 6146186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Experimental colitis was induced in guinea pigs by administration of 5% degraded carrageenan for 5 days. The prophylactic effect of a slow-release preparation of 5-aminosalicylic acid (5-ASA; 13 mg/100 g/day) was compared with approximately equimolar amounts of salazosulphapyridine (SASP; 26 mg/100 g/day) and placebo. Treatment was started 2 days before initiation of carrageenan administration. The drugs were administered through a chronic gastric fistula. At the end of the study concentrations of 5-ASA and acetylated 5-ASA (Ac-5-ASA) in cecal contents and in plasma were determined. In the placebo group, all guinea pigs developed many small punctiform ulcerations in the cecum (median, 30/cm2). In the 5-ASA group no protective effect was demonstrated, since the number of ulcerations was 37/cm2. The difference is not statistically significant. However, the SASP group presented significantly fewer ulcerations (4/cm2). The concentrations of 5-ASA and/or its acetylated metabolite were several times higher in the cecum content and twice as high in plasma in the SASP group, indicating a difference in the absorption patterns of 5-ASA and the two drugs. These results and the etiological difference between the human ulcerative colitis and the carrageenan model may account for the lack of prophylactic effect of the slow-release 5-ASA in this experiment.
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23
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Jensen BH, Husegaard HC, Juhl B. [Comparison between the Venturi mask and the Lomholt system in the treatment of postoperative hypoxia]. Ugeskr Laeger 1983; 145:1940-1. [PMID: 6612811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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24
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Jensen BH, Wernberg M, Andersen M. Preoperative starvation and blood glucose concentrations in children undergoing inpatient and outpatient anaesthesia. Br J Anaesth 1982; 54:1071-4. [PMID: 7126401 DOI: 10.1093/bja/54.10.1071] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Blood glucose concentrations were measured in 82 children undergoing inpatient anaesthesia and in 46 children undergoing anaesthesia as outpatients. The children were aged between 6 months and 9 yr. Outpatients were fasted from bedtime, while inpatients were randomly allocated to two groups. In group A the children were fasted from bedtime, whereas in group B the children were fed 6 h before anaesthesia. There was no difference in mean blood glucose concentration between the fasted inpatients and outpatients nor between children younger than, or older than, 4 years of age. A blood glucose concentration of less than 40 mg dl-1 was found in only one of the fasted children (1%). The mean blood glucose concentration was greater in group B than A, but only significantly so for children older than 4 yr. It is concluded that to minimize the risks of hypoglycaemia and inhalation of vomit on induction of anaesthesia children older than 6 months should be fasted overnight and operated on in the morning.
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25
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Rask Pedersen E, Jensen BH, Jensen HJ, Keldsbo IL, Hylander Møller E, Nørby Rasmussen S. Lactose malabsorption and tolerance of lactose-hydrolyzed milk. A double-blind controlled crossover study. Scand J Gastroenterol 1982; 17:861-4. [PMID: 6818684 DOI: 10.3109/00365528209181106] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Eleven lactose-intolerant patients were investigated in a double-blind crossover controlled study. In random sequence they received 500 ml of either ordinary cow milk (lactose content, 25 g) or the same amount of low-lactose milk (85% of the lactose hydrolyzed), which had been processed by Lactozym 3000 L for 24 h at 4 degrees C. A significantly increased blood glucose rise from fasting levels was demonstrated in the low-lactose tests. Similarly, a significant reduction of liquid stool frequency, abdominal colics, distention, borborrhygmia, and flatulence was demonstrated. It was concluded that further studies, including long-term treatment of lactose-intolerant children, are indicated.
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26
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Jensen BH. Caudal block for post-operative pain relief in children after genital operations. A comparison between bupivacaine and morphine. Acta Anaesthesiol Scand 1981; 25:373-5. [PMID: 7340370 DOI: 10.1111/j.1399-6576.1981.tb01668.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Twenty-two children formed the basis for a controlled study of the effect and duration of the postoperatively applied caudal block on postoperative pain after genital operations. The purpose of the study was to compare the effect and duration of bupivacaine and morphine. Ten children (Group I, outpatients) underwent circumcision and 12 children (Group II, inpatients) underwent correction of hypospadias. The caudal block failed in one case. Outpatients were discharged after 4-5 h, and the caudal blocks with both bupivacaine and morphine were then still effective. In inpatients, the duration of pain relief was significantly longer using morphine (range 610-2195 min) than using bupivacaine (range 245-515 min). There were no complications of the caudal blocks.
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27
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Bondo E, Frederiksen HJ, Jensen BH, Matzen P. [Surreptitious abuse of laxatives]. Ugeskr Laeger 1981; 143:1539-40. [PMID: 7281318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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28
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Krebs B, Jensen BH. [Gas gangrene after lower-limb amputations for ischemia]. Ugeskr Laeger 1981; 143:926-7. [PMID: 7281289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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29
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Jensen BH. The hassle factor. Wis Med J 1981; 80:15. [PMID: 7281705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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30
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Jensen BH, Andersen M. [Sedation of children for CT-scanning]. Ugeskr Laeger 1980; 142:2411-2. [PMID: 7445133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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31
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Jensen BH. From here to eternity--the development of the "Supper-Rule". Wis Med J 1980; 79:23-31. [PMID: 6766598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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32
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Pedersen RS, Jensen BH. [Obstructive nephropathy]. Ugeskr Laeger 1979; 141:3369-70. [PMID: 524518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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33
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Abstract
Pre- and preoperative determination of glomerular filtration rate (GFR) was performed in 10 patients operated on during enflurane anaesthesia. The mean GFR decreased significantly by 21%. The decrease in GFR is of the same order of magnitude as that reported for most general anaesthetics.
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34
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Jensen BH, Berthelsen P, Bröchner-Mortensen J. Glomerular filtration rate during halothane anaesthesia and epidural analgesia in combination with halothane anaesthesia. Acta Anaesthesiol Scand 1977; 21:395-9. [PMID: 910612 DOI: 10.1111/j.1399-6576.1977.tb01238.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Pre- and peroperative determination of glomerular filtration rate (GFR) was performed in nine patients operated during light halothane anaesthesia (group A) and in nine patients operated during epidural analgesia in combination with light halothane anaesthesia (group B). In group A, the mean GFR decreased insignificantly by 7% and the mean arterial blood pressure increased significantly by 10%. In group B, the mean GFR decreased significantly by 19% and the mean arterial blood pressure decreased significantly by 15%. It is suggested that the difference in change in GFR between the two groups was caused by differences in mean arterial blood pressure.
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35
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Jensen BH. [Nursing education in Austria doesn't fit in a solid frame]. Sygeplejersken 1974; 74:52-4. [PMID: 4495860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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36
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Jensen BH. [Public health nurses in revolt...--and some understand them]. Tidsskr Sygepl 1966; 66:132-3. [PMID: 5176692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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