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Follin, Per
Publications (10 of 14) Show all publications
Schilling, S., Follin, P., Jarhall, B., Tegnell, A., Lastilla, M., Bannister, B., . . . Puro, V. (2009). European concepts for the domestic transport of highly infectious patients. Clinical Microbiology and Infection, 15(8), 727-733
Open this publication in new window or tab >>European concepts for the domestic transport of highly infectious patients
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2009 (English)In: Clinical Microbiology and Infection, ISSN 1198-743X, E-ISSN 1469-0691, Vol. 15, no 8, p. 727-733Article, review/survey (Refereed) Published
Abstract [en]

Highly infectious diseases involve clinical syndromes ranging from single to multiorgan infections and pose a constant threat to the public. In the absence of a definite treatment for most causative agents, patients benefit from maximum supportive care as clinical conditions may deteriorate in the short term. Hence, following initial case identification and isolation, rapid transportation to a specialized treatment unit must be considered in order to minimize the risk of secondary infections, but this is limited by available infrastructure, accessible care en route and the patients clinical condition. Despite the development of consensus curricula for the clinical management of highly infectious patients, medical transportation lacks a common European approach. This article describes, as examples, three current European concepts for the domestic relocation of highly infectious patients by ground vehicles and aircraft with respect to national legislation and geography.

Place, publisher, year, edition, pages
Elsevier, 2009
Keywords
Aeromedical evacuation, domestic relocation, ground vehicles, highly infectious diseases, transportation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20412 (URN)10.1111/j.1469-0691.2009.02871.x (DOI)000269086200006 ()
Available from: 2009-09-08 Created: 2009-09-07 Last updated: 2017-12-13
Brouqui, P., Puro, V., Fusco, F., Bannister, B., Schilling, S., Follin, P., . . . Ippolito, G. (2009). Infection control in the management of highly pathogenic infectious diseases: consensus of the European Network of Infectious Disease. The Lancet Infectious Diseases, 9(5), 301-311
Open this publication in new window or tab >>Infection control in the management of highly pathogenic infectious diseases: consensus of the European Network of Infectious Disease
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2009 (English)In: The Lancet Infectious Diseases, ISSN 1473-3099, Vol. 9, no 5, p. 301-311Article, review/survey (Refereed) Published
Abstract [en]

The European Network for Infectious Diseases (EUNID) is a network of clinicians, public health epidemiologists, microbiologists, infection control, and critical-care doctors from the European member states, who are experienced in the management of patients with highly infectious diseases. We aim to develop a consensus recommendation for infection control during clinical management and invasive procedures in such patients. After an extensive literature review, draft recommendations were amended jointly by 27 partners from 15 European countries. Recommendations include repetitive training of staff to ascertain infection control, systematic use of cough and respiratory etiquette at admission to the emergency department, fluid sampling in the isolation room, and analyses in biosafety level 3/4 laboratories, and preference for point-of-care bedside laboratory tests. Children should be cared for by paediatricians and intensive-care patients should be cared for by critical-care doctors in high-level isolation units (HLIU). Invasive procedures should be avoided if unnecessary or done in the HLIU, as should chest radiography, ultrasonography, and renal dialysis. Procedures that require transport of patients out of the HLIU should be done during designated sessions or hours in secure transport. Picture archiving and communication systems should be used. Post-mortem examination should be avoided; biopsy or blood collection is preferred.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18751 (URN)10.1016/S1473-3099(09)70070-2 (DOI)
Available from: 2009-06-03 Created: 2009-06-03 Last updated: 2010-05-24
Fusco, F., Puro, V., Baka, A., Bannister, B., Brodt, H.-R., Brouqui, P., . . . Ippolito, G. (2009). Isolation rooms for highly infectious diseases: an inventory of capabilities in European countries. Journal of Hospital Infection, 73(1), 15-23
Open this publication in new window or tab >>Isolation rooms for highly infectious diseases: an inventory of capabilities in European countries
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2009 (English)In: Journal of Hospital Infection, ISSN 0195-6701, Vol. 73, no 1, p. 15-23Article in journal (Refereed) Published
Abstract [en]

Isolation of patients with highly infectious diseases (HIDs) in hospital rooms with adequate technical facilities is essential to reduce the risk of spreading disease. The European Network for Infectious Diseases (EUNID), a project co-funded by European Commission and involving 16 European Union member states, performed an inventory of high level isolation rooms (HIRs, hospital rooms with negative pressure and anteroom). In participating countries, HIRs are available in at least 211 hospitals, with at least 1789 hospital beds. The adequacy of this number is not known and will depend on prevailing circumstances. Sporadic HID cases can be managed in the available HIRs. HIRs could also have a role in the initial phases of an influenza pandemic. However, large outbreaks due to natural or to bioterrorist events will need management strategies involving healthcare facilities other than HIRs.

Keywords
Bioterrorism; Communicable disease control; Disease outbreaks; Healthcare facilities
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-21247 (URN)10.1016/j.jhin.2009.06.009 (DOI)
Available from: 2009-09-30 Created: 2009-09-30 Last updated: 2010-01-19
Askling, H. H., Lesko, B., Vene, S., Berndtson, A., Björkman, P., Bläckberg, J., . . . Struwe, J. (2009). Serologic Analysis of Returned Travelers with Fever, Sweden. Emerging Infectious Diseases, 15(11), 1805-1808
Open this publication in new window or tab >>Serologic Analysis of Returned Travelers with Fever, Sweden
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2009 (English)In: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 15, no 11, p. 1805-1808Article in journal (Refereed) Published
Abstract [en]

We studied 1,432 febrile travelers from Sweden who had returned from malaria-endemic areas during March 2005-March 2008. In 383 patients, paired serum samples were blindly analyzed for influenza and 7 other agents. For 21% of 115 patients with fever of unknown origin, serologic analysis showed that influenza was the major cause.

Place, publisher, year, edition, pages
Atlanta, GA, USA: U.S. Department of Health and Human Services * Centers for Disease Control and Prevention, 2009
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-52381 (URN)10.3201/eid1511.091157 (DOI)000271696600016 ()19891870 (PubMedID)
Note

Original Publication: Helena H Askling, Birgitta Lesko, Sirkka Vene, Angerd Berndtson, Per Bjorkman, Jonas Blackberg, Ulf Bronner, Per Follin, Urban Hellgren, Maria Palmerus, Karl Ekdahl, Anders Tegnell and Johan Struwe, Serologic Analysis of Returned Travelers with Fever, Sweden, 2009, EMERGING INFECTIOUS DISEASES, (15), 11, 1805-1808. http://dx.doi.org/10.3201/eid1511.091157 Copyright: National Center for Infectious Diseases http://www.cdc.gov/ncidod/eid/index.htm

Available from: 2009-12-18 Created: 2009-12-18 Last updated: 2017-12-12Bibliographically approved
Theilgaard-Mönch, K., Knudsen, S., Follin, P. & Borregaard, N. (2004). The transcriptional activation program of human neutrophils in skin lesions supports their important role in wound healing. Journal of Immunology, 172(12), 7684-7693
Open this publication in new window or tab >>The transcriptional activation program of human neutrophils in skin lesions supports their important role in wound healing
2004 (English)In: Journal of Immunology, ISSN 0022-1767, E-ISSN 1550-6606, Vol. 172, no 12, p. 7684-7693Article in journal (Refereed) Published
Abstract [en]

To investigate the cellular fate and function of polymorphonuclear neutrophilic granulocytes (PMNs) attracted to skin wounds, we used a human skin-wounding model and microarray technology to define differentially expressed genes in PMNs from peripheral blood, and PMNs that had transmigrated to skin lesions. After migration to skin lesions, PMNs demonstrated a significant transcriptional response including genes from several different functional categories. The up-regulation of anti-apoptotic genes concomitant with the down-regulation of proapoptotic genes suggested a transient anti-apoptotic priming of PMNs. Among the up-regulated genes were cytokines and chemokines critical for chemotaxis of macrophages, T cells, and PMNs, and for the modulation of their inflammatory responses. PMNs in skin lesions down-regulated receptors mediating chemotaxis and anti-microbial activity, but up-regulated other receptors involved in inflammatory responses. These findings indicate a change of responsiveness to chemotactic and immunoregulatory mediators once PMNs have migrated to skin lesions and have been activated. Other effects of the up-regulated cytokines/chemokines/enzymes were critical for wound healing. These included the breakdown of fibrin clots and degradation of extracellular matrix, the promotion of angiogenesis, the migration and proliferation of keratinocytes and fibroblasts, the adhesion of keratinocytes to the dermal layer, and finally, the induction of anti-microbial gene expression in keratinocytes. Notably, the up-regulation of genes, which activate lysosomal proteases, indicate a priming of skin lesion-PMNs for degradation of phagocytosed material. These findings demonstrate that migration of PMNs to skin lesions induces a transcriptional activation program, which regulates cellular fate and function, and promotes wound healing.

Keywords
Human neutrophils
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-22010 (URN)1025 (Local ID)1025 (Archive number)1025 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
Follin, P. & Frydén, A. (2004). Tropiska virusinfektioner (3ed.). In: Iwarson-Norrby (Ed.), Infektionsmedicin: epidemiologi, klinik, terapi (pp. 395-408). Säve Förlag
Open this publication in new window or tab >>Tropiska virusinfektioner
2004 (Swedish)In: Infektionsmedicin: epidemiologi, klinik, terapi / [ed] Iwarson-Norrby, Säve Förlag , 2004, 3, p. 395-408Chapter in book (Other academic)
Abstract [sv]

Denna klassiska lärobok kom 2011 ut i sin 5:e, omarbetade upplaga. Boken innehåller 28 kapitel, vilka täcker hela infektionspanoramat, från influensa till AIDS. Samtliga författare är läkare och flertalet universitetslärare. Den innehåller även 16 sidor färgplanscher med fotoillustrationer av olika sjukdomar. Boken är avsedd att användas i undervisningen av blivande läkare och som uppslagsbok i sjukvården

Place, publisher, year, edition, pages
Säve Förlag, 2004 Edition: 3
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33048 (URN)19011 (Local ID)91-972689-7-6 (ISBN)978-9-1972-6897-4 (ISBN)19011 (Archive number)19011 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-10-23Bibliographically approved
Cedergren, J., Follin, P., Forslund, T., Lindmark, M., Sundqvist, T. & Skogh, T. (2003). Inducible nitric oxide synthase (NOS II) is constitutive in human neutrophils. APMIS, 111(10), 963-968
Open this publication in new window or tab >>Inducible nitric oxide synthase (NOS II) is constitutive in human neutrophils
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2003 (English)In: APMIS, ISSN 0903-4641, Vol. 111, no 10, p. 963-968Article in journal (Refereed) Published
Abstract [en]

The objective was to study the expression of inducible nitric oxide synthase (NOS II) in and NO production by human blood neutrophils and in in vivo exudated neutrophils. Cellular expression of NOS II was evaluated by flow cytometry in whole blood, in isolated blood neutrophils, and in neutrophils obtained by exudation in vivo into skin chambers. Neutrophil NOS II was also demonstrated by Western blotting. Uptake of 3H-labelled L-arginine was studied in vitro and NOS activity measured in a whole cell assay by the conversion of 3H-arginine to 3H-citrulline. In contrast to unseparated blood cells, NOS II was demonstrable both in isolated blood neutrophils and exudated cells. The failure to detect NOS II by flow cytometry in whole blood cells thus proved to be due to the quenching effect of hemoglobin. Western blotting revealed a 130 kD band corresponding to NOS II in isolated blood neutrophils, but detection was dependent on diisopropylfluorophosphate for proteinase inhibition. L-arginine was taken up by neutrophils, but enzymatic activity could not be demonstrated. We conclude that human neutrophils constitutively express NOS II, but that its demonstration by FITC-labelling is inhibited by hemoglobin-mediated quenching in whole blood samples.

Keywords
Inflammation, nitric oxide, iNOS, granulocytes
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14587 (URN)10.1034/j.1600-0463.2003.1111008.x (DOI)
Available from: 2007-08-27 Created: 2007-08-27 Last updated: 2015-08-31
Darenberg, J., Ihendyane, N., Sjölin, J., Aufwerber, E., Haidl, S., Follin, P., . . . Streptlg Study, G. (2003). Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: A European randomized, double-blind, placebo-controlled trial. Clinical Infectious Diseases, 37(3), 333-340
Open this publication in new window or tab >>Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: A European randomized, double-blind, placebo-controlled trial
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2003 (English)In: Clinical Infectious Diseases, ISSN 1058-4838, E-ISSN 1537-6591, Vol. 37, no 3, p. 333-340Article in journal (Refereed) Published
Abstract [en]

The efficacy and safety of high-dose intravenous polyspecific immunoglobulin G (IVIG) as adjunctive therapy in streptococcal toxic shock syndrome (STSS) were evaluated in a multicenter, randomized, double-blind, placebo-controlled trial. The trial was prematurely terminated because of slow patient recruitment, and results were obtained from 21 enrolled patients (10 IVIG recipients and 11 placebo recipients). The primary end point was mortality at 28 days, and a 3.6-fold higher mortality rate was found in the placebo group. A significant decrease in the sepsis-related organ failure assessment score at days 2 (P = .02) and 3 (P = .04) was noted in the IVIG group. Furthermore, a significant increase in plasma neutralizing activity against superantigens expressed by autologous isolates was noted in the IVIG group after treatment (P = .03). Although statistical significance was not reached in the primary end point, the trial provides further support for IVIG as an efficacious adjunctive therapy in STSS.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26445 (URN)10.1086/376630 (DOI)10988 (Local ID)10988 (Archive number)10988 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
Hedlund, J., Örtquist, Å., Swedish Infectious Diseases, S. P., Augustinsson (Nilsdotter-Augustinsson), Å. & Follin, P. (2002). Management of patients with community-acquired pneumonia treated in hospital in Sweden.. Scandinavian Journal of Infectious Diseases, 34, 887-892
Open this publication in new window or tab >>Management of patients with community-acquired pneumonia treated in hospital in Sweden.
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2002 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, p. 887-892Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26363 (URN)10897 (Local ID)10897 (Archive number)10897 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
Sörensen, O., Follin, P., Johnsen, A., Calafat, J., Tjabringa, G., Hiemstra, P. & Borregaard, N. (2001). Human cathelicidin, hCAP-18, is processed to the antimicrobial peptide LL-37 by extracellular cleavage with proteinase 3. Blood, 97(12), 3951-3959
Open this publication in new window or tab >>Human cathelicidin, hCAP-18, is processed to the antimicrobial peptide LL-37 by extracellular cleavage with proteinase 3
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2001 (English)In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 97, no 12, p. 3951-3959Article in journal (Refereed) Published
Abstract [en]

Cathelicidins are a family of antimicrobial proteins found in the peroxidase-negative granules of neutrophils. The known biologic functions reside in the C-terminus, which must be cleaved from the holoprotein to become active. Bovine and porcine cathelicidins are cleaved by elastase from the azurophil granules to yield the active antimicrobial peptides. The aim of this study was to identify the physiological setting for cleavage of the only human cathelicidin, hCAP-18, to liberate the antibacterial and cytotoxic peptide LL-37 and to identify the protease responsible for this cleavage. Immunoelectron microscopy demonstrated that both hCAP-18 and azurophil granule proteins were present in the phagolysosome. Immunoblotting revealed no detectable cleavage of hCAP-18 in cells after phagocytosis. In contrast, hCAP-18 was cleaved to generate LL-37 in exocytosed material. Of the 3 known serine proteases from azurophil granules, proteinase 3 was solely responsible for cleavage of hCAP-18 after exocytosis. This is the first detailed study describing the generation of a human antimicrobial peptide from a promicrobicidal protein, and it demonstrates that the generation of active antimicrobial peptides from common proproteins occurs differently in related species.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25908 (URN)10.1182/blood.V97.12.3951 (DOI)10350 (Local ID)10350 (Archive number)10350 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
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