首页 > 最新文献

Scandinavian journal of infectious diseases. Supplementum最新文献

英文 中文
Comparison of nasopharyngeal and throat swabs for the detection of Chlamydia pneumoniae and Mycoplasma pneumoniae by polymerase chain reaction. 聚合酶链反应检测肺炎衣原体和肺炎支原体的鼻咽拭子比较。
J Gnarpe, A Lundbäck, H Gnarpe, B Sundelöf

Nasopharyngeal and throat swabs taken from 66 patients presenting at the Department of Infectious Disease with symptoms of upper and lower respiratory tract infection were analysed by use of the polymerase chain reaction (PCR) for Chlamydia pneumoniae and Mycoplasma pneumoniae. A total of 18 patients (27%) were positive by PCR for C. pneumoniae. All 18 patients were positive from throat swabs, and three were also positive from nasopharyngeal specimens. The difference between the outcome of PCR using throat and nasopharyngeal swabs was statistically significant. A total of 7 patients (10.6%) were positive for M. pneumoniae and of these, 6 were positive from throat swabs and 2 were positive from nasopharyngeal swabs. This difference was not statistically significant, probably due to the low numbers of positive patient specimens.

采用聚合酶链反应(PCR)对66例出现上呼吸道和下呼吸道感染症状的传染病科患者的鼻咽和咽喉拭子进行肺炎衣原体和肺炎支原体的分析。PCR检测肺炎原体阳性18例(27%)。所有18例患者咽拭子均呈阳性,其中3例鼻咽标本也呈阳性。喉部和鼻咽拭子PCR结果差异有统计学意义。肺炎支原体阳性7例(10.6%),其中咽拭子检出阳性6例,鼻咽拭子检出阳性2例。这种差异没有统计学意义,可能是由于阳性患者标本数量少。
{"title":"Comparison of nasopharyngeal and throat swabs for the detection of Chlamydia pneumoniae and Mycoplasma pneumoniae by polymerase chain reaction.","authors":"J Gnarpe,&nbsp;A Lundbäck,&nbsp;H Gnarpe,&nbsp;B Sundelöf","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nasopharyngeal and throat swabs taken from 66 patients presenting at the Department of Infectious Disease with symptoms of upper and lower respiratory tract infection were analysed by use of the polymerase chain reaction (PCR) for Chlamydia pneumoniae and Mycoplasma pneumoniae. A total of 18 patients (27%) were positive by PCR for C. pneumoniae. All 18 patients were positive from throat swabs, and three were also positive from nasopharyngeal specimens. The difference between the outcome of PCR using throat and nasopharyngeal swabs was statistically significant. A total of 7 patients (10.6%) were positive for M. pneumoniae and of these, 6 were positive from throat swabs and 2 were positive from nasopharyngeal swabs. This difference was not statistically significant, probably due to the low numbers of positive patient specimens.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"104 ","pages":"11-2"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20202593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Swedish telephone herpes helpline. 瑞典电话疱疹求助热线。
A Hallén, A Strand, H Juserius

To increase the accessibility of qualified and anonymous advice on herpes infections in Sweden, a telephone counselling service was initiated in November 1994. The nucleus of the service is an answering machine that works around the clock. A caller can choose one of 3 different messages dealing with labial or genital herpes infection or herpes zoster--each message is approximately 3 min long. Those wanting written information can register and have material sent to them. For 2 h daily, 4 days a week, calls pass directly to the staff of the sexually transmitted diseases clinic of the University Hospital in Uppsala, Sweden--the caller pays only a single telephone unit charge. The personal calls deal with all aspects of herpes infections. During the first 3 months of the counselling service more than 4,500 calls were received.

为了在瑞典增加获得关于疱疹感染的合格和匿名咨询的机会,1994年11月开始提供电话咨询服务。这项服务的核心是一台24小时工作的答录机。打电话的人可以从3条不同的短信中选择一条,每条短信大约3分钟,内容涉及唇部或生殖器疱疹感染或带状疱疹。那些需要书面信息的人可以注册,并向他们发送材料。每周4天,每天2小时,电话直接转到瑞典乌普萨拉大学医院性传播疾病诊所的工作人员那里——打电话者只需支付一个电话费。私人电话处理疱疹感染的所有方面。在咨询服务的头3个月里,接到了4500多个电话。
{"title":"The Swedish telephone herpes helpline.","authors":"A Hallén,&nbsp;A Strand,&nbsp;H Juserius","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To increase the accessibility of qualified and anonymous advice on herpes infections in Sweden, a telephone counselling service was initiated in November 1994. The nucleus of the service is an answering machine that works around the clock. A caller can choose one of 3 different messages dealing with labial or genital herpes infection or herpes zoster--each message is approximately 3 min long. Those wanting written information can register and have material sent to them. For 2 h daily, 4 days a week, calls pass directly to the staff of the sexually transmitted diseases clinic of the University Hospital in Uppsala, Sweden--the caller pays only a single telephone unit charge. The personal calls deal with all aspects of herpes infections. During the first 3 months of the counselling service more than 4,500 calls were received.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"100 ","pages":"33-4"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20110513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnosis of Epstein-Barr virus-related diseases. eb病毒相关疾病的诊断。
A Linde

Epstein-Barr virus (EBV) is present, as both latent and replicating virus, in most healthy individuals, and disturbance of the normal host-virus balance may cause a variety of diseases. A number of diagnostic tools can he used, depending upon the particular condition investigated, however, serology is the best method for diagnosis of primary EBV infections. In approximately 85% of cases of mononucleosis, the primary EBV infection can he diagnosed by an assay for heterophile antibodies. The presence of immunoglobulin G (IgG) and IgM to antigens from the replicative cycle of the virus, in combination with absence of antibodies to the EBV nuclear antigens (EBNA 1-6), is a diagnostic for a primary EBV infection. Serological tests for elevated IgA levels to various EBV antigens have been used to screen for EBV-associated nasopharyngeal carcinoma. In those with AIDS with EBV-associated lymphomas of the brain, EBV genomes can always be detected with polymerase chain reaction on cerebrospinal fluid. Epstein-Barr virus involvement in tumours, other than those of the brain and solid organs, can be verified by in situ demonstration of EBV-DNA or by immunocytochemical techniques for viral antigens.

eb病毒(Epstein-Barr virus, EBV)以潜伏和复制两种形式存在于大多数健康人体内,破坏正常的宿主-病毒平衡可引起多种疾病。根据所调查的具体情况,可以使用许多诊断工具,但是,血清学是诊断原发性EBV感染的最佳方法。在大约85%的单核细胞增多症病例中,可以通过检测嗜异性抗体来诊断原发性EBV感染。免疫球蛋白G (IgG)和对病毒复制周期抗原的IgM的存在,加上缺乏对EBV核抗原(EBNA 1-6)的抗体,是原发性EBV感染的诊断。不同eb病毒抗原IgA水平升高的血清学检测已被用于筛查eb病毒相关鼻咽癌。在伴有eb病毒相关脑淋巴瘤的艾滋病患者中,总能通过脑脊液聚合酶链反应检测到eb病毒基因组。EBV-DNA的原位演示或病毒抗原的免疫细胞化学技术可以证实eb - barr病毒累及肿瘤,而不是脑和实体器官的肿瘤。
{"title":"Diagnosis of Epstein-Barr virus-related diseases.","authors":"A Linde","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Epstein-Barr virus (EBV) is present, as both latent and replicating virus, in most healthy individuals, and disturbance of the normal host-virus balance may cause a variety of diseases. A number of diagnostic tools can he used, depending upon the particular condition investigated, however, serology is the best method for diagnosis of primary EBV infections. In approximately 85% of cases of mononucleosis, the primary EBV infection can he diagnosed by an assay for heterophile antibodies. The presence of immunoglobulin G (IgG) and IgM to antigens from the replicative cycle of the virus, in combination with absence of antibodies to the EBV nuclear antigens (EBNA 1-6), is a diagnostic for a primary EBV infection. Serological tests for elevated IgA levels to various EBV antigens have been used to screen for EBV-associated nasopharyngeal carcinoma. In those with AIDS with EBV-associated lymphomas of the brain, EBV genomes can always be detected with polymerase chain reaction on cerebrospinal fluid. Epstein-Barr virus involvement in tumours, other than those of the brain and solid organs, can be verified by in situ demonstration of EBV-DNA or by immunocytochemical techniques for viral antigens.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"100 ","pages":"83-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19826021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Melioidosis; a treatment challenge. 类鼻疽;治疗挑战。
W Chaowagul

Ceftazidime has reduced the mortality of severe disease by half, but melioidosis remains a difficult and expensive infection to treat. Empirical treatment of septicemia with aminoglycosides combined with penicillin, ampicillin, or second-generation cephalosporins is ineffective. The response to appropriate antibiotic treatment is slow, and most patients require a minimum of 2 weeks of high-dose parenteral treatment. Large abscesses should be drained if possible. Ceftazidime remains the drug of choice, but co-amoxyclav is an effective alternative (although treatment failure rates are slightly higher), and preliminary experience with imipenem is encouraging. The relapse rate following 8 weeks of treatment is approximately 28%, and this is reduced to 9% with 20 weeks of treatment. The relapse rate is determined by the extent of the infection and not the underlying predisposing condition. Resistance to all treatment antimicrobials has been documented, but this has not proved a major problem to date. Patients who survive the acute phase of melioidosis require life-long follow-up.

头孢他啶使严重疾病的死亡率降低了一半,但类鼻疽病仍然是一种治疗困难和昂贵的感染。氨基糖苷类药物联合青霉素、氨苄西林或第二代头孢菌素治疗败血症无效。对适当抗生素治疗的反应缓慢,大多数患者需要至少2周的高剂量肠外治疗。如有可能,应排出大脓肿。头孢他啶仍然是首选药物,但联合阿莫昔克拉夫是一种有效的替代药物(尽管治疗失败率略高),亚胺培南的初步经验令人鼓舞。治疗8周后复发率约为28%,治疗20周后复发率降至9%。复发率取决于感染的程度,而不是潜在的易感条件。对所有抗微生物药物的耐药性均有记录,但迄今为止尚未证明这是一个主要问题。急性期存活的类鼻疽患者需要终身随访。
{"title":"Melioidosis; a treatment challenge.","authors":"W Chaowagul","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ceftazidime has reduced the mortality of severe disease by half, but melioidosis remains a difficult and expensive infection to treat. Empirical treatment of septicemia with aminoglycosides combined with penicillin, ampicillin, or second-generation cephalosporins is ineffective. The response to appropriate antibiotic treatment is slow, and most patients require a minimum of 2 weeks of high-dose parenteral treatment. Large abscesses should be drained if possible. Ceftazidime remains the drug of choice, but co-amoxyclav is an effective alternative (although treatment failure rates are slightly higher), and preliminary experience with imipenem is encouraging. The relapse rate following 8 weeks of treatment is approximately 28%, and this is reduced to 9% with 20 weeks of treatment. The relapse rate is determined by the extent of the infection and not the underlying predisposing condition. Resistance to all treatment antimicrobials has been documented, but this has not proved a major problem to date. Patients who survive the acute phase of melioidosis require life-long follow-up.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"101 ","pages":"14-6"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20015750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective study of clinical characteristics of acinetobacter bacteremia. 不动杆菌菌血症临床特点的回顾性研究。
T K Ng, J M Ling, A F Cheng, S R Norrby

High rates of acinetobacter bacteremia were observed in a large teaching hospital in Hong Kong. A retrospective study of 94 acinetobacter bacteremic episodes in patients in 1993-94 revealed 70 episodes of significant bacteremia. 53% of the patients were over 60 years with a male to female ratio of 1.5:1. Cases were most rare during the fourth quarter. The intensive care unit was the commonest location of acquisition of bacteremia. Most infections were hospital acquired. Intravascular catheters, urinary catheters, antibiotic therapy and respiratory tract manipulations were common risk factors. Lower respiratory tract infections and catheter-related sepsis were predominant foci of bacteremia. One-third of the patients received appropriate antibiotics within 48 hours after bacteremia onset. Mortality attributable to acinetobacter infection was 27%. Prognosis of underlying diseases, location in intensive care unit, lower respiratory tract infection as foci of infection as well as diabetes mellitus were associated with mortality.

香港某大型教学医院的不动杆菌菌血症发生率较高。对1993- 1994年间94例不动杆菌菌血症患者的回顾性研究显示,有70例明显的菌血症。60岁以上的患者占53%,男女比例为1.5:1。第四季度的病例最为罕见。重症监护病房是获得菌血症最常见的地点。大多数感染是医院获得的。血管内导尿管、导尿管、抗生素治疗和呼吸道操作是常见的危险因素。下呼吸道感染和导管相关性脓毒症是主要的菌血症灶。三分之一的患者在菌血症发生后48小时内接受了适当的抗生素治疗。不动杆菌感染导致的死亡率为27%。基础疾病的预后、重症监护病房的位置、感染灶为下呼吸道感染以及糖尿病与死亡率相关。
{"title":"A retrospective study of clinical characteristics of acinetobacter bacteremia.","authors":"T K Ng,&nbsp;J M Ling,&nbsp;A F Cheng,&nbsp;S R Norrby","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>High rates of acinetobacter bacteremia were observed in a large teaching hospital in Hong Kong. A retrospective study of 94 acinetobacter bacteremic episodes in patients in 1993-94 revealed 70 episodes of significant bacteremia. 53% of the patients were over 60 years with a male to female ratio of 1.5:1. Cases were most rare during the fourth quarter. The intensive care unit was the commonest location of acquisition of bacteremia. Most infections were hospital acquired. Intravascular catheters, urinary catheters, antibiotic therapy and respiratory tract manipulations were common risk factors. Lower respiratory tract infections and catheter-related sepsis were predominant foci of bacteremia. One-third of the patients received appropriate antibiotics within 48 hours after bacteremia onset. Mortality attributable to acinetobacter infection was 27%. Prognosis of underlying diseases, location in intensive care unit, lower respiratory tract infection as foci of infection as well as diabetes mellitus were associated with mortality.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"101 ","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20015753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evidence for antibiotic-mediated endotoxin release as a contributing factor to lethality in experimental gram-negative sepsis. 证据表明抗生素介导的内毒素释放是实验性革兰氏阴性败血症致死的一个促进因素。
D C Morrison, S E Bucklin

Endotoxic lipopolysaccharide (LPS) is a major constituent of the outer membrane of the Gram-negative microbe. Following its release from the bacterium, LPS serves as a potent proinflammatory stimulus by interacting with humoral and cellular mediator systems to stimulate production of an array of inflammatory molecules. Cell-wall active antibiotics are known to promote endotoxin release. To assess the contribution of antibiotic-induced endotoxin release in the pathogenesis of Gram-negative sepsis, we have developed several experimental models in which mice have been pretreated with various agents to make them sensitive to Gram-negative (E. coli, pseudomonas) infection and/or the lethal effects of endotoxin. For the former, both cyclophosphamide (which renders mice neutropenic) and the reversible hepatotoxin D-galactosamine (D-gal) have been used. D-gal also sensitized mice to the lethal effects of LPS. Infected mice treated with cell-wall active antibiotics are protected approximately five- to 10-fold (as assessed by increases in LD50) if they are sensitive to LPS lethality (D-gal treatment) but 500-fold if they are resistant to LPS lethality. Importantly, different antibiotics that have been documented to cause different amounts of endotoxin release in vitro also differ in their protective efficacy in vivo. Thus, imipenem, which causes relatively low endotoxin release, is significantly more protective (8-fold) than ceftazidime or meropenem (3-fold, P < 0.005) under conditions of equivalent MICs. Lethality data correlate well with circulating levels of interleukin-6 (Il-6) in vivo and with induction of Il-6 in ex vivo studies in which anticoagulated mouse blood is incubated with bacteria and antibiotics. Finally, antiendotoxin agents manifest additional levels of protection in vivo under conditions in which antibiotics alone are not protective. Collectively, these results strongly implicate antibiotic-induced endotoxin release as a significant contributing factor in experimental Gram-negative sepsis.

内毒素脂多糖(LPS)是革兰氏阴性菌外膜的主要成分。从细菌中释放后,LPS通过与体液和细胞介质系统相互作用来刺激一系列炎症分子的产生,从而成为一种有效的促炎刺激剂。已知细胞壁活性抗生素可促进内毒素释放。为了评估抗生素诱导的内毒素释放在革兰氏阴性脓毒症发病机制中的作用,我们开发了几个实验模型,在这些模型中,用各种药物预处理小鼠,使它们对革兰氏阴性(大肠杆菌、假单胞菌)感染和/或内毒素的致死效应敏感。对于前者,已经使用了环磷酰胺(使小鼠中性粒细胞减少)和可逆的肝毒素d -半乳糖胺(D-gal)。D-gal也使小鼠对LPS的致死效应敏感。用细胞壁活性抗生素治疗的感染小鼠,如果对LPS (D-gal处理)致死性敏感,其保护效果约为5至10倍(根据LD50的增加来评估),但如果对LPS致死性有抵抗力,则保护效果为500倍。重要的是,不同的抗生素在体外引起不同量的内毒素释放,在体内的保护效果也不同。因此,在同等mic条件下,亚胺培南的内毒素释放量相对较低,其保护作用(8倍)明显高于头孢他啶或美罗培南(3倍,P < 0.005)。在体外研究中,将抗凝小鼠血液与细菌和抗生素孵育,死亡率数据与体内白细胞介素-6 (Il-6)的循环水平和Il-6的诱导密切相关。最后,抗内毒素药物在体内表现出额外的保护水平,在这种情况下,抗生素本身没有保护作用。总的来说,这些结果强烈暗示抗生素诱导的内毒素释放是实验性革兰氏阴性脓毒症的重要促成因素。
{"title":"Evidence for antibiotic-mediated endotoxin release as a contributing factor to lethality in experimental gram-negative sepsis.","authors":"D C Morrison,&nbsp;S E Bucklin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Endotoxic lipopolysaccharide (LPS) is a major constituent of the outer membrane of the Gram-negative microbe. Following its release from the bacterium, LPS serves as a potent proinflammatory stimulus by interacting with humoral and cellular mediator systems to stimulate production of an array of inflammatory molecules. Cell-wall active antibiotics are known to promote endotoxin release. To assess the contribution of antibiotic-induced endotoxin release in the pathogenesis of Gram-negative sepsis, we have developed several experimental models in which mice have been pretreated with various agents to make them sensitive to Gram-negative (E. coli, pseudomonas) infection and/or the lethal effects of endotoxin. For the former, both cyclophosphamide (which renders mice neutropenic) and the reversible hepatotoxin D-galactosamine (D-gal) have been used. D-gal also sensitized mice to the lethal effects of LPS. Infected mice treated with cell-wall active antibiotics are protected approximately five- to 10-fold (as assessed by increases in LD50) if they are sensitive to LPS lethality (D-gal treatment) but 500-fold if they are resistant to LPS lethality. Importantly, different antibiotics that have been documented to cause different amounts of endotoxin release in vitro also differ in their protective efficacy in vivo. Thus, imipenem, which causes relatively low endotoxin release, is significantly more protective (8-fold) than ceftazidime or meropenem (3-fold, P < 0.005) under conditions of equivalent MICs. Lethality data correlate well with circulating levels of interleukin-6 (Il-6) in vivo and with induction of Il-6 in ex vivo studies in which anticoagulated mouse blood is incubated with bacteria and antibiotics. Finally, antiendotoxin agents manifest additional levels of protection in vivo under conditions in which antibiotics alone are not protective. Collectively, these results strongly implicate antibiotic-induced endotoxin release as a significant contributing factor in experimental Gram-negative sepsis.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"101 ","pages":"3-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20017747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to measure and reduce the burden of zoster-associated pain. 如何衡量和减轻带状疱疹相关疼痛的负担。
M J Wood

Several parameters of shingles' pain can be measured and each provides meaningful information. Generally, the more comprehensive the assessment the better, but there are significant difficulties in measuring the duration of post-herpetic neuralgia (PHN). Patients with herpes zoster usually feel pain as a continuum and, although acute pain and PHN have different qualities and pathophysiologies, we lack the sophistication to determine when PHN commences. Use of an arbitrarily defined starting point is meaningless for the patient and may introduce statistical bias (particularly if acute pain and PHN are divided by the point of rash healing). Thus, measurement of the pain as a continuum ('zoster-associated pain') is advocated. We also need to decide what degree of pain intensity is meaningful and whether complete cessation of pain or loss of pain (or only 'moderate/severe' pain) for a finite period is a better assessment. This approach to pain measurement was recently adopted in a meta-analysis of the placebo-controlled trials of oral aciclovir in herpes zoster. When 'time to complete cessation of all pain' was assessed, the hazard ratio was 2.13 in favour of aciclovir, with a 95% confidence interval (CI) of 1.42 to 3.19. For 'time to complete cessation of moderate/severe pain' the hazard ratio was 1.46 (95% CI; 1.11, 1.93); for 'time to first pain-free period' it was 1.31 (95% CI; 1.08, 1.60). These results indicate that aciclovir significantly speeds pain resolution in shingles.

可以测量带状疱疹疼痛的几个参数,每个参数都提供有意义的信息。一般情况下,评估越全面越好,但在评估带状疱疹后神经痛(PHN)持续时间方面存在很大困难。带状疱疹患者通常感觉疼痛是连续的,尽管急性疼痛和PHN具有不同的性质和病理生理,但我们缺乏确定PHN何时开始的复杂性。使用任意定义的起始点对患者来说是没有意义的,并且可能会引入统计偏差(特别是如果急性疼痛和PHN除以皮疹愈合点)。因此,疼痛的测量作为一个连续体(带状疱疹相关的疼痛)被提倡。我们还需要确定什么程度的疼痛强度是有意义的,以及是否在有限的时间内完全停止疼痛或疼痛消失(或只有“中度/重度”疼痛)是更好的评估。这种疼痛测量方法最近在口服阿昔洛韦治疗带状疱疹的安慰剂对照试验的荟萃分析中被采用。当评估“完全停止所有疼痛的时间”时,支持阿昔洛韦的风险比为2.13,95%置信区间(CI)为1.42至3.19。对于“中度/重度疼痛完全停止的时间”,风险比为1.46 (95% CI;1.11、1.93);“到第一次无痛期的时间”为1.31 (95% CI;1.08, 1.60)。这些结果表明阿昔洛韦显著加速了带状疱疹疼痛的消退。
{"title":"How to measure and reduce the burden of zoster-associated pain.","authors":"M J Wood","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several parameters of shingles' pain can be measured and each provides meaningful information. Generally, the more comprehensive the assessment the better, but there are significant difficulties in measuring the duration of post-herpetic neuralgia (PHN). Patients with herpes zoster usually feel pain as a continuum and, although acute pain and PHN have different qualities and pathophysiologies, we lack the sophistication to determine when PHN commences. Use of an arbitrarily defined starting point is meaningless for the patient and may introduce statistical bias (particularly if acute pain and PHN are divided by the point of rash healing). Thus, measurement of the pain as a continuum ('zoster-associated pain') is advocated. We also need to decide what degree of pain intensity is meaningful and whether complete cessation of pain or loss of pain (or only 'moderate/severe' pain) for a finite period is a better assessment. This approach to pain measurement was recently adopted in a meta-analysis of the placebo-controlled trials of oral aciclovir in herpes zoster. When 'time to complete cessation of all pain' was assessed, the hazard ratio was 2.13 in favour of aciclovir, with a 95% confidence interval (CI) of 1.42 to 3.19. For 'time to complete cessation of moderate/severe pain' the hazard ratio was 1.46 (95% CI; 1.11, 1.93); for 'time to first pain-free period' it was 1.31 (95% CI; 1.08, 1.60). These results indicate that aciclovir significantly speeds pain resolution in shingles.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"100 ","pages":"55-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19826017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cytomegalovirus infections in transplant patients. 移植患者巨细胞病毒感染。
P Ljungman

Cytomegalovirus (CMV) infections are a major problem in transplant recipients, although recent advances in diagnosis, prevention and therapy have reduced the risk of CMV disease. To illustrate these advances, the risks of CMV disease and subsequent death were analyzed in 482 consecutive bone marrow transplant (BMT) patients transplanted between 1975 and 1994. No CMV-seronegative patient with seronegative donor marrow developed disease. Among the remaining 384 patients, the risk for CMV disease was reduced from 13.0% in patients transplanted between 1975 and 1985 to 2.2% in those transplanted between 1991 and 1994 (p = 0.06). The corresponding risks for death due to CMV disease were reduced from 13.0% to 0% (p = 0.002). Significant factors in multivariate analysis for the reduction of death from CMV disease were acute graft-versus-host disease and pre-emptive therapy based on rapid diagnosis with polymerase chain reaction. These data are discussed in relation to previously published results in BMT and solid organ transplant patients.

巨细胞病毒(CMV)感染是移植受者的一个主要问题,尽管最近在诊断、预防和治疗方面的进展降低了巨细胞病毒疾病的风险。为了说明这些进展,我们分析了1975年至1994年间482例连续骨髓移植(BMT)患者CMV疾病和随后死亡的风险。供体骨髓血清阴性的cmv血清阴性患者无发病。在其余384例患者中,发生巨细胞病毒疾病的风险从1975年至1985年移植患者的13.0%降低到1991年至1994年移植患者的2.2% (p = 0.06)。CMV疾病导致的相应死亡风险从13.0%降至0% (p = 0.002)。在多因素分析中,急性移植物抗宿主病和基于聚合酶链反应快速诊断的先发制人治疗是降低巨细胞病毒疾病死亡率的重要因素。这些数据与先前发表的BMT和实体器官移植患者的结果有关。
{"title":"Cytomegalovirus infections in transplant patients.","authors":"P Ljungman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cytomegalovirus (CMV) infections are a major problem in transplant recipients, although recent advances in diagnosis, prevention and therapy have reduced the risk of CMV disease. To illustrate these advances, the risks of CMV disease and subsequent death were analyzed in 482 consecutive bone marrow transplant (BMT) patients transplanted between 1975 and 1994. No CMV-seronegative patient with seronegative donor marrow developed disease. Among the remaining 384 patients, the risk for CMV disease was reduced from 13.0% in patients transplanted between 1975 and 1985 to 2.2% in those transplanted between 1991 and 1994 (p = 0.06). The corresponding risks for death due to CMV disease were reduced from 13.0% to 0% (p = 0.002). Significant factors in multivariate analysis for the reduction of death from CMV disease were acute graft-versus-host disease and pre-emptive therapy based on rapid diagnosis with polymerase chain reaction. These data are discussed in relation to previously published results in BMT and solid organ transplant patients.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"100 ","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19826018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and parasitological studies on immunity to Plasmodium falciparum malaria in children. 儿童恶性疟原虫免疫的临床及寄生虫学研究。
B Høgh

Malaria remains one of the major health problems in many tropical countries. Plasmodium falciparum is the most common malaria parasite in Africa, and it causes much more severe and progressive illness than any of the other types of malaria parasite. Children living in sub-Saharan Africa are bearing the major burden of the disease and the mortality. Whatever parameter is used to measure the mortality or the morbidity from malaria, the true problem is likely to be underestimated. The pattern of morbidity and mortality depends on the transmission intensity; the more intensity of malaria transmission is increased, the earlier and more confined the age range of symptomatic malaria. The asymptomatic carrier status is common, and 60-80% of the children in highly endemic areas have P. falciparum parasitaemia at any given time. Consequently a case definition based on the mere presence of parasites in the blood is non-informative in terms of measuring morbidity. Recognizing that there are no specific diagnostic clinical parameters for malaria, but that fever is very common, and that morbidity is to some extent dependent on the parasite density, we described using a logistic regression model the probability of being sick from malaria in relation to body temperature and parasite density. Acquired clinical and parasitological immunity develop progressively over several years after repeated exposure to infection. Protection is acquired first against death or severe clinical disease, then against milder clinical attacks, but protection against infection is never complete. Clinical and parasitological immunity develop concomitantly, as demonstrated by relating the parasite densities to measured body temperature. However, the ability to control the disease and parasite density develops earlier than the ability to prevent the parasite infection. The individual immune mechanisms that are responsible for the acquired immunity remain uncertain, but classical transfer experiments with polyvalent gamma globulin from immune donors to non-immune individuals showed that antibodies play an important role. Potential targets for malarial vaccines include antigens on the surface of the sporozoites and the merozoites. Several protein antigens from P. falciparum have been characterized at the molecular level, and most of the characterized antigens have the common characteristic that they are recognized by immune sera from individuals living in malaria endemic areas. Working on the approach that potentially useful targets for protective vaccine development can be identified by correlating the naturally acquired immune responses with defined P. falciparum antigens, we examined antigens from both the sporozoite stage (CS-protein) and the blood stages (Pf155/RESA, GLURP, and MSP1), as well as P. falciparum induced neoantigens on the red blood cell (band-3 neoantigens). The relationship between the immune response to these defined P. falciparum antigens and clinical and parasi

疟疾仍然是许多热带国家的主要健康问题之一。恶性疟原虫是非洲最常见的疟疾寄生虫,它引起的疾病比任何其他类型的疟疾寄生虫都要严重得多,进展也要严重得多。生活在撒哈拉以南非洲的儿童正承受着这种疾病和死亡率的主要负担。无论用什么参数来衡量疟疾的死亡率或发病率,真正的问题很可能被低估了。发病率和死亡率的模式取决于传播强度;疟疾传播强度越高,出现症状的疟疾的年龄范围越早和越有限。无症状的带菌者状态很常见,在高流行地区,60-80%的儿童在任何给定时间都有恶性疟原虫寄生虫病。因此,仅根据血液中寄生虫的存在来定义病例,在衡量发病率方面是没有信息的。认识到疟疾没有具体的诊断临床参数,但发烧很常见,而且发病率在某种程度上取决于寄生虫密度,我们使用逻辑回归模型描述了与体温和寄生虫密度相关的疟疾患病概率。在多次接触感染后,获得性临床和寄生虫免疫在数年内逐渐发展。首先获得的保护是针对死亡或严重的临床疾病,然后是针对较轻微的临床攻击,但针对感染的保护永远不会完全。临床免疫和寄生虫免疫同时发展,正如将寄生虫密度与测量的体温联系起来所证明的那样。然而,控制疾病和寄生虫密度的能力比预防寄生虫感染的能力发展得更早。获得性免疫的个体免疫机制尚不清楚,但经典的多价丙种球蛋白从免疫供体转移到非免疫个体的实验表明,抗体起着重要作用。疟疾疫苗的潜在靶标包括孢子子和分生子表面的抗原。恶性疟原虫的几种蛋白抗原已经在分子水平上进行了鉴定,大多数鉴定的抗原具有被疟疾流行地区个体免疫血清识别的共同特征。通过将自然获得性免疫反应与确定的恶性疟原虫抗原相关联,研究了保护性疫苗开发的潜在有用靶点,我们检测了孢子子期(cs蛋白)和血液期(Pf155/RESA, GLURP和MSP1)的抗原,以及恶性疟原虫诱导的红细胞上的新抗原(带状3新抗原)。在各个年龄组中分析了对这些确定的恶性疟原虫抗原的免疫反应与临床和寄生虫学保护之间的关系。对抗原特异性免疫反应的贡献进行了评估,并在确定的年龄组中确定了寄生虫密度或临床疟疾发作概率与对单个抗原的抗体反应呈正相关。然而,这种相关性并不适用于所有年龄组,因此,对特定抗原的总体反应不被认为是保护的可靠指标。这些发现可能有助于了解宿主对寄生虫血症和恶性疟原虫抗原的免疫学和临床反应。对无性期感染和人类免疫反应影响的研究导致了对恶性疟原虫血期寄生虫的特异性和非特异性反应的研究以及对配子体贫血的观察。我们证明了乙胺嘧啶/磺胺多辛和氯喹并没有像之前所认为的那样诱导配子细胞发生,但预先形成的配子细胞持续存在
{"title":"Clinical and parasitological studies on immunity to Plasmodium falciparum malaria in children.","authors":"B Høgh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malaria remains one of the major health problems in many tropical countries. Plasmodium falciparum is the most common malaria parasite in Africa, and it causes much more severe and progressive illness than any of the other types of malaria parasite. Children living in sub-Saharan Africa are bearing the major burden of the disease and the mortality. Whatever parameter is used to measure the mortality or the morbidity from malaria, the true problem is likely to be underestimated. The pattern of morbidity and mortality depends on the transmission intensity; the more intensity of malaria transmission is increased, the earlier and more confined the age range of symptomatic malaria. The asymptomatic carrier status is common, and 60-80% of the children in highly endemic areas have P. falciparum parasitaemia at any given time. Consequently a case definition based on the mere presence of parasites in the blood is non-informative in terms of measuring morbidity. Recognizing that there are no specific diagnostic clinical parameters for malaria, but that fever is very common, and that morbidity is to some extent dependent on the parasite density, we described using a logistic regression model the probability of being sick from malaria in relation to body temperature and parasite density. Acquired clinical and parasitological immunity develop progressively over several years after repeated exposure to infection. Protection is acquired first against death or severe clinical disease, then against milder clinical attacks, but protection against infection is never complete. Clinical and parasitological immunity develop concomitantly, as demonstrated by relating the parasite densities to measured body temperature. However, the ability to control the disease and parasite density develops earlier than the ability to prevent the parasite infection. The individual immune mechanisms that are responsible for the acquired immunity remain uncertain, but classical transfer experiments with polyvalent gamma globulin from immune donors to non-immune individuals showed that antibodies play an important role. Potential targets for malarial vaccines include antigens on the surface of the sporozoites and the merozoites. Several protein antigens from P. falciparum have been characterized at the molecular level, and most of the characterized antigens have the common characteristic that they are recognized by immune sera from individuals living in malaria endemic areas. Working on the approach that potentially useful targets for protective vaccine development can be identified by correlating the naturally acquired immune responses with defined P. falciparum antigens, we examined antigens from both the sporozoite stage (CS-protein) and the blood stages (Pf155/RESA, GLURP, and MSP1), as well as P. falciparum induced neoantigens on the red blood cell (band-3 neoantigens). The relationship between the immune response to these defined P. falciparum antigens and clinical and parasi","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"102 ","pages":"1-53"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20015755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Limiting the spread of genital herpes. 限制生殖器疱疹的传播。
G R Kinghorn

In many western countries, successful control of bacterial sexually transmitted diseases (STDs) has contrasted with an increase in the prevalence of viral STDs. The continued increase in clinical and subclinical genital herpes infections is of particular concern because of the implications for the risk of coincident spread of human immunodeficiency virus infection. Advances in knowledge of the epidemiology and natural history of genital herpes must be the basis of renewed educational efforts targeted at the general public, healthcare professionals, as well as infected persons. Diagnostic techniques, such as polymerase chain reaction and type-specific serology, now allow increased detection of subclinical infection. However, infected persons must be assured of access to effective antiviral treatment and comprehensive holistic management if the clinical and epidemiological benefits of detection are to outweigh the psychological and psychosocial disadvantages of being infected with a stigmatized condition. Vaccines could offer the best prospect for both primary prophylaxis and immunotherapy of genital herpes, and may have the greatest impact in limiting the spread of this infection. Recent progress has been made in the development of effective and safe vaccines, and their successful introduction should be a major priority over the next decade.

在许多西方国家,细菌性传播疾病(STDs)得到了成功的控制,而病毒性传播疾病的发病率却在上升。临床和亚临床生殖器疱疹感染的持续增加尤其令人关注,因为这意味着人类免疫缺陷病毒感染同时传播的风险。对生殖器疱疹的流行病学和自然史知识的进步必须成为针对普通公众、保健专业人员以及感染者的新的教育努力的基础。诊断技术,如聚合酶链反应和类型特异性血清学,现在可以增加亚临床感染的检测。然而,如果要使检测的临床和流行病学益处超过因感染污名化疾病而造成的心理和社会心理上的不利影响,就必须确保感染者获得有效的抗病毒治疗和全面的综合管理。疫苗可以为生殖器疱疹的初级预防和免疫治疗提供最好的前景,并可能在限制这种感染的传播方面产生最大的影响。最近在研制有效和安全的疫苗方面取得了进展,它们的成功应用应成为今后十年的一个主要优先事项。
{"title":"Limiting the spread of genital herpes.","authors":"G R Kinghorn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In many western countries, successful control of bacterial sexually transmitted diseases (STDs) has contrasted with an increase in the prevalence of viral STDs. The continued increase in clinical and subclinical genital herpes infections is of particular concern because of the implications for the risk of coincident spread of human immunodeficiency virus infection. Advances in knowledge of the epidemiology and natural history of genital herpes must be the basis of renewed educational efforts targeted at the general public, healthcare professionals, as well as infected persons. Diagnostic techniques, such as polymerase chain reaction and type-specific serology, now allow increased detection of subclinical infection. However, infected persons must be assured of access to effective antiviral treatment and comprehensive holistic management if the clinical and epidemiological benefits of detection are to outweigh the psychological and psychosocial disadvantages of being infected with a stigmatized condition. Vaccines could offer the best prospect for both primary prophylaxis and immunotherapy of genital herpes, and may have the greatest impact in limiting the spread of this infection. Recent progress has been made in the development of effective and safe vaccines, and their successful introduction should be a major priority over the next decade.</p>","PeriodicalId":76520,"journal":{"name":"Scandinavian journal of infectious diseases. Supplementum","volume":"100 ","pages":"20-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20110510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Scandinavian journal of infectious diseases. Supplementum
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1