liu.seSök publikationer i DiVA
Ändra sökning
Avgränsa sökresultatet
1 - 28 av 28
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    Bergfors, Elisabet
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. University of Gothenburg, Sweden.
    Hermansson, Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Nyström Kronander, Ulla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Valter, Lars
    Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Trollfors, Birger
    Sahlgrenska University Hospital-East, Gothenburg, Sweden .
    How common are long-lasting, intensely itching vaccination granulomas and contact allergy to aluminium induced by currently used pediatric vaccines? A prospective cohort study2014Ingår i: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 173, nr 10, s. 1297-1307Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The frequency of long-lasting, intensely itching subcutaneous nodules at the injection site for aluminium (Al)-adsorbed vaccines (vaccination granulomas) was investigated in a prospective cohort study comprising 4,758 children who received either a diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (Infanrix®, Pentavac®) alone or concomitant with a pneumococcal conjugate (Prevenar). Both vaccines were adsorbed to an Al adjuvant. Altogether 38 children (0.83 %) with itching granulomas were identified, epicutaneously tested for Al sensitisation and followed yearly. Contact allergy to Al was verified in 85 %. The median duration of symptoms was 22 months in those hitherto recovered. The frequency of granulomas induced by Infanrix® was >0.66 % and by Prevenar >0.35 %. The risk for granulomas increased from 0.63 to 1.18 % when a second Al-adsorbed vaccine was added to the schedule. Conclusion: Long-lasting itching vaccination granulomas are poorly understood but more frequent than previously known after infant vaccination with commonly used diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b and pneumococcal conjugate vaccines. The risk increases with the number of vaccines given. Most children with itching granulomas become contact allergic to aluminium. Itching vaccination granulomas are benign but may be troublesome and should be recognised early in primary health care to avoid unnecessary investigations, anxiety and mistrust.

  • 2.
    Bergfors, Elisabet
    et al.
    Univ Gothenburg, Sweden.
    Inerot, Annica
    Univ Gothenburg, Sweden.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Nyström Kronander, Ulla
    Region Östergötland, Hjärt- och Medicincentrum, Allergicentrum US.
    Trollfors, Birger
    Sahlgrens Univ Hosp, Sweden.
    Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation2019Ingår i: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 81, nr 2, s. 81-88Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: According to studies on adults, patch testing with aluminium chloride hexahydrate 2% pet. is insufficient to detect aluminium allergy, and a 10% preparation is recommended. Other studies suggest that a 2% preparation is sufficient for testing children. Objectives: To review three previously published Swedish studies on patch testing children with aluminium chloride hexahydrate 2% pet. Patients/Methods: Altogether, 601 children with persistent itching subcutaneous nodules (granulomas) induced by aluminium-adsorbed vaccines were patch tested with aluminium chloride hexahydrate 2% pet. and metallic aluminium in (a) a pertussis vaccine trial, (b) clinical practice, and (ca) prospective study. Results: Overall, 459 children had positive reactions to the 2% pet. preparation. Another 10 reacted positively only to metallic aluminium. An extreme positive reaction (+++) was seen in 65% of children aged 1 to 2 years as compared with 22% of children aged 7 years. From 8 years onwards, extreme positive reactions were scarce. Conclusions: Aluminium chloride hexahydrate 2% pet. is sufficient to trace aluminium allergy in children. Small children are at risk of extreme reactions. We thus suggest that aluminium chloride hexahydrate 10% pet. should not be used routinely in children before the age of 7 to 8 years.

  • 3.
    Edberg, Andreas
    et al.
    Central Hospital, Karlstad.
    Jurstrand, Margaretha
    University Hospital, Örebro.
    Johansson, Eva
    Central Hospital, Karlstad.
    Wikander, Elisabeth
    Central Hospital, Karlstad.
    Höög, Anna
    Central Hospital, Karlstad.
    Ahlqvist, Thomas
    Central Hospital, Karlstad.
    Falk, Lars
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för dermatologi och venereologi. Linköpings universitet, Hälsouniversitetet.
    Skov Jensen, Jørgen
    Statens Serum Institute, Denmark.
    Fredlund, Hans
    University Hospital, Örebro.
    A comparative study of three different PCR assays for detection of Mycoplasma genitalium in urogenital specimens from men and women2008Ingår i: Journal of Medical Microbiology, ISSN 0022-2615, E-ISSN 1473-5644, Vol. 57, s. 304-309Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to compare conventional 16S rRNA gene PCR, real-time 16S rRNA gene PCR and real-time Mycoplasma genitalium adhesin protein (MgPa) gene PCR as detection methods for M. genitalium infection. The study also determined the prevalence of M. genitalium in male and female patients attending a sexually transmitted infections clinic in a rural area in the west of Sweden. First void urine (FVU) and/or urethral swabs were collected from 381 men, and FVU and/or cervical swabs and/or urethral swabs were collected from 298 women. A total of 213 specimens were used in the PCR comparative study: 98 consecutively sampled specimens from patients enrolled in the prevalence study, 36 consecutively sampled specimens from patients with symptoms of urethritis and 79 specimens from patients positive for M. genitalium by real-time MgPa gene PCR in the prevalence study. A true-positive M. genitalium DNA specimen was defined as either a specimen positive in any two PCR assays or a specimen whose PCR product was verified by DNA sequencing. The prevalence of M. genitalium infection in men and women was 27/381 (7.1 %) and 23/298 (7.7 %), respectively. In the PCR comparative study, M. genitalium DNA was detected in 61/76 (80.3 %) of true-positive specimens by conventional 16S rRNA gene PCR, in 52/76 (68.4 %) by real-time 16S rRNA gene PCR and in 74/76 (97.4 %) by real-time MgPa gene PCR. Real-time MgPa gene PCR thus had higher sensitivity compared with conventional 16S rRNA gene PCR and had considerably increased sensitivity compared with real-time 16S rRNA gene PCR for detection of M. genitalium DNA. Real-time MgPa gene PCR is well suited for the clinical diagnosis of M. genitalium.

  • 4.
    Falk, G
    et al.
    Department of Obstetrics and Gynecology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Falk, L
    Department of Dermatology and Venereology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Hanson, U
    Department of Obstetrics and Gynecology, Örebro Medical Centre Hospital, Örebro, Sweden.
    Milsom, I
    Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Young women requesting emergency contraception are, despite contraceptive counseling, a high risk group for new unintended pregnancies2001Ingår i: Contraception, ISSN 0010-7824, E-ISSN 1879-0518, Vol. 64, nr 1, s. 23-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Since its introduction in Sweden in 1994, emergency contraception has become a welcome addition to the campaign against unwanted pregnancy. In addition to an unplanned pregnancy, unprotected sexual intercourse may also involve the risk of contracting sexually transmitted diseases (STD). The aim of this study was to assess the short- and long-term risk of unintended pregnancy and to determine the frequency of chlamydia infections in women receiving emergency contraception. Between September 1998 and February 1999 young women aged 15-25 years had the opportunity to obtain emergency contraception (Yuzpe method) at a youth clinic in the city of Orebro where the opening hours were extended to include Saturdays and Sundays. A follow-up visit 3 weeks after treatment, which included contraceptive counseling, was offered to all participants. At both visits, a pregnancy test and a chlamydia test were performed, and the women completed a questionnaire. After the initial visit, the young women where monitored for new pregnancies during the following 12 months. One pregnancy occurred in the 134 young women who received emergency contraception during the study period. None of the women had a positive chlamydia test. Of those requesting emergency contraception, 54% did so because no contraception was used, 32% because of a ruptured condom, 11% because of missed oral contraceptives (OC), and 5% had mixed reasons. At long-term follow-up 1 year after the initial visit, 10 of the 134 young women had experienced an unplanned pregnancy that terminated in legal abortion in 9 women. All these women had either started and terminated OC or had never commenced the prescribed OC. Young women who request emergency contraception are, despite a planned follow-up with contraceptive counseling, a high risk group for new unintended pregnancies. In Sweden they do not seem to be a high risk group for STD.

  • 5.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Dermatologi och venerologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Anogenital Chlamydia trachomatis Infection Including Lympho­granuloma Venereum: Clinical Guidelines, Sweden2009Ingår i: Forum for Nordic Dermato-Venerology, ISSN 1402-2915, Vol. 14, nr 4, s. 101-103Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    [No abstract available]

  • 6.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Dermatologi och venerologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Challenges of treatment for urethritis and cervicitis, (SY06:5)2012Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Challenges of treatment for urethritis and cervicitis

     

    Urethritis in men caused by gonorrhoea is symptomatic. Non-gonorrhoic-urethritis (NGU) i.e. caused by Chlamydia trachomatis, Mycoplasma genitalium and occasionally other bacteria is in most cases an asymptomatic infection. Swartz’ definition of microscopic urethritis > 4 polymorphonucleated leucocytes (PML) per high power field (HPF) in > 4 HPF is the general accepted, but has limitations and is dependant on the sampling, microscope, the physician and the patient as well. Cervicitis is even more cumbersome since it is even more often asymptomatic. Other factors such as which contraception method is used, concurrent infections (bacterial vaginosis, candidosis), the microscope and the physician, may have a great impact. Brunham proposed as definition observed mucopurulent discharge from the cervix orifice combined with > 10 PML per HPF in stained endocervical smear. Lindner proposed sign of friability of the portio cervicis. Weström found a correlation of more PML than vaginal epithelial cells in wet mount. The variety of definitions causes problem in comparing scientific studies and at the clinic as well. The intention to treat also means testing and treatment of a current sexual partner as well.

     

    The ever emerging decreased susceptibility of various antibiotics especially against Neisseria gonorrhoeae and M. genitalium makes it even more important to choose whether to treat immediately without having positive tests or to miss a treatment of a potential serious infection. N. gonorrhoeae is visible microscopically in urethral stains from men, but can be missed in smears from endocervix and urethra in women. Cefixim 400 mg stat is the recommended first line antibiotic treatment. Ceftriaxone 500 mg is under consideration to become the first treatment of choice due to emerging decreased susceptibility. M.genitalium will be discussed in another speech by Jørgen Skov Jensen. There are some few reports of antibiotic resistance of Chlamydia trachomatis but this infection is generally still eradicated by tetracycline and macrolide treatment. In an NGU and or unspecific cervicitis doxycycline 100 mg bid for one week is the first treatment of choice. Azithromycin 1 g stat should be used with precaution. If there are persisting signs and or symptoms after doxycycline treatment, azithromycin 500 mg day 1 and 250 mg following four days should be prescribed. Bacterial vaginosis may give symptoms and signs of cervicitis and is also a very common concurrent infection in women with C. trachomatis and M.genitalium as well and treatment with metronidazole or clindamycin should be considered. The fast ways of communication via the Internet and the easy accessible and legal way of an individual to buy antibiotics just for safe or to avoid attending a clinic is a big threat now and even more in the future because of the potential rapid increasing antibiotic resistance of many bacterial infections including STIs

  • 7.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    The overall agreement of proposed definitions of mucopurulent cervicitis in women at high risk of chlamydia infection2010Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, ISSN 0001-5555, Vol. 90, s. 506-511Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The overall agreement between different criteria for cervicitis in women infected with Chlamydia trachomatis and/or Mycoplasma genitalium, and in women who tested negative was examined. Women attending a clinic for sexually transmitted diseases were enrolled because of sexual partners’ suspected chlamydia infection. M. genitalium was tested in a sample of first-catch urine and an endocervical specimen, whereas specimens from four different sites were used for detection of C. trachomatis. Signs of friability and purulent endocervical discharge were documented at gynaecological examination. Specimens for microscopy were taken from the endocervix and urethra as well as the vaginal discharge, and bacterial vaginosis was examined for. The criteria being evaluated included cervical friability and/or pus; polymorphonuclear leukocytes (PMNL)/epithelium cell ratio in the vaginal discharge; and more than 30 PMNL per high-power field in the endocervical smear. The overall agreement of the indicators of cervicitis in women infected with C. trachomatis and/or M. genitalium was 40.5% (15/37), and for those women with negative tests 35.3% (12/34). The criteria for cervicitis require further evaluation, including study of a control group of women at low risk of having a sexually transmitted infection.

  • 8.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Dermatologi och venerologi. Linköpings universitet, Hälsouniversitetet.
    Urethritis and cervicitis with special reference to Chlamydia trachomatis and Mycoplasma genitalium: diagnostic and epidemiological aspects2004Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Denna avhandling vill belysa urethrit och cervicit orsakad av sexuellt överrörd sjukdom med speciellt fokus på Chlamydia trachomatis och Mycoplasma genitalium. Trots skyldighet, enligt Smittskyddslagen, att vid klamydia spåra sexuella partners till dem med infektion har antalet rapporterade klamydiafall till Smittskyddsinstitutet (SMI), efter en markant nedgång åren 1989 till 1994, ökat med cirka 10 % årligen sedan 1997. Urethrit och cervicit som orsakas av andra mikroorganismer än C traehomalis och Neisseria gonorrhoeae utgör mer än hälften av alla fall med urethrit och cervicit på en STD-mottagning. Mycoplasma genitalium, en bakterie som upptäcktes 1980, är troligen en viktig orsak.

    I arbete I och II studerades män och kvinnor som sökt STD-mottagningen vid Universitetssjukhuset Örebro (1999-2000) och som hade en genital klamydiainfektion. En metod för att sekvensera den gen (omp 1) som kodar för ett protein i bakteriens yttermembran (MOMP) utvecklades. Metoden var framgångsrik på både invasiva prover från cervix och urethra liksom urinprov och 237 prover kunde sekvenseras från 231 personer (96 kvinnor och 135 män). Alla kända genotyper för genital klamydiainfektion fanns representerade, med en uttalad ökad förekomst av genotyp E (47%), följt av F (17%). Den genetiska stabiliteten var mycket hög. I 7 av 47 (15%) sexuella nätverk (kontaktspårningskedjor) förekom diskrepanta genotyper. 90% (n=204) av de 226 som primärt sökt STD-mottagningen (93 kvinnor och 133 män) kom på återbesök och 2% (5/204) var klamydiapositiva, varav två med annan klamydiagenotyp än vid första besöket. Sanmmanlagt 161 nätverk med 688 personer hittades. Lyckad kontaktspårning, där alla individer i ett nätverk undersökts, förekom endast i 19% (30/161) av nätverken. Orsaker till misslyckande var bristfälliga uppgifter om partners från indexpatienter och att partners sökt till annan mottagning där testresultatet förblev okänt för partnerspåraren, pga sekretesslagen.

    I arbete III och IV jämfördes, mikroskopiska tecken på infektion, symptom och forekorost mellan C trachomatis och Mycoplasma genitalium infektion bland män (III) och kvinnor (IV) som sökte STD-mottagningen (2000). En undersökning av 59 unga kvinnor, kallade för cellprovskontroll (screening), där prover för C trachomatis, M genitalium och mikroskopi togs genomfordes 2002 (IV). Det fanns ingen signifikant skillnad av mikroskopiska tecken på infektion mellan dem infekterade med C trachomatis eller med M genitalium. Däremot hade kvinnor med C trachomatis eller M genitalium infektion signifikant oftare mikroskopiska tecken på infektion än kvinnor (n=58) utan någon av dessa infektioner i jämförelsegruppen. Män med M genitalium infektion hade signifikant oftare symptom än män infekterade med klamydia. Någon signifikant skillnad fanns inte i motsvarande grupper hos kvinnor. Prevalensen av M genitalium och C trachomatis infektion bland män var 7% respektive 12% (III). Av kvinnorna som sökte på STD-mottagningen hade 10% C trachomatis och 6% M genitalium infektion, medan endast en respektive ingen av de 59 kvinnorna i jämförelsegruppen var C trachomatis eller M genitalium positiva (IV). Partners till män respektive kvinnor med C trachomatis eller M genitalium infektion var signifikant oftare infekterade med motsvarande bakterie (67% respektive 63% (=kvinnliga partners) och 59%, respektive 56% (manliga partners)) än partners till patienter med urethrit eller cervicit, men med negativt test för M genitalium och C trachomatis (p<0.001). Dessa arbeten visar att M genitalium är vanligt förekommande, på STD-mottagningar, men att den inte förekommer allmänt och att den som klamydia ofta ger infektionstecken.

    I en öppen pilotbehandlingsstudie (arbete V) av M genitalium infektion, där sedvanlig tetracyklinbehandling jämfördes med azithromycin i fem dygn, visades att tetracyklin har en otillräcklig effekt, medan azithromycin tycks fungera. Randomiserade kontrollerade behandlingsstudier (RCT) behövs.

    Delarbeten
    1. Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted sisease patients in Sweden
    Öppna denna publikation i ny flik eller fönster >>Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted sisease patients in Sweden
    Visa övriga...
    2001 (Engelska)Ingår i: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 39, nr 11, s. 3915-3919Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    A method for detection and genotyping of genital Chlamydia trachomatis infections based on omp1 gene amplification and sequencing was developed. DNA was extracted from urogenital or urine samples using a Chelex-based method, and an approximately 1,100-bp-long fragment from the omp1 gene was directly amplified and sequenced. Genotyping was performed by BLAST similarity search, and phylogenetic tree analysis was used to illustrate the evolutionary relationships between clinical isolates and reference strains. The method was used to determine the genotypes ofC. trachomatis in 237 positive urogenital and/or urine specimens collected at a Swedish sexually transmitted disease clinic during 1 year. The most common genotypes corresponded to serotypes E (47%) and F (17%). The omp1 gene was highly conserved for genotype E (106 of 112 samples without any mutation) and F (41 of 42 samples without any mutation) strains but appear slightly less conserved for genotypes G (n = 6) and H (n = 6), where the sequences displayed one to four nucleotide substitutions relative to the reference sequence. Genotyping of samples collected at the follow-up visit indicated that two patients had become reinfected, while three other patients suffered treatment failure or reinfection. One woman appeared to have a mixed infection with two different C. trachomatis strains. Thisomp1 genotyping method had a high reproducibility and could be used for epidemiological characterization of sexually transmitted Chlamydia infections.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-25864 (URN)10.1128/​JCM.39.11.3915-3919.2001 (DOI)10301 (Lokalt ID)10301 (Arkivnummer)10301 (OAI)
    Tillgänglig från: 2009-10-08 Skapad: 2009-10-08 Senast uppdaterad: 2017-12-13
    2. Genotyping of Chlamydia trachomatis would improve contact tracing
    Öppna denna publikation i ny flik eller fönster >>Genotyping of Chlamydia trachomatis would improve contact tracing
    Visa övriga...
    2003 (Engelska)Ingår i: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 30, nr 3, s. 205-210Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: The reported number of genital Chlamydia trachomatis infections has increased 15% annually since 1997 in Sweden. Inaccurate partner notification might be one reason.

    Goal: The goals were to determine if genotyping of C trachomatis would improve partner notification and to study the duration of infection.

    Study Design: Sexual networks were constructed. C trachomatis isolates from 231 individuals attending the Örebro STD clinic during 1 year were typed by sequencing of the omp1 gene.

    Results: All individuals were traced and diagnoses were established in 30 of 161 networks. More than one genotype was seen in seven networks. The mean duration of C trachomatis infection in each network was calculated to be 23 weeks.

    Conclusion: Genotyping could be a useful tool in partner notification when there are discrepant or uncommon genotypes. Limited clinic catchment areas create information difficulties that obstruct accurate contact tracing.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-26459 (URN)10.1097/00007435-200303000-00005 (DOI)11007 (Lokalt ID)11007 (Arkivnummer)11007 (OAI)
    Tillgänglig från: 2009-10-08 Skapad: 2009-10-08 Senast uppdaterad: 2017-12-13
    3. Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis
    Öppna denna publikation i ny flik eller fönster >>Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis
    2004 (Engelska)Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 80, nr 4, s. 289-293Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in men attending a Swedish STD clinic and to study the criteria for urethritis.

    Methods: A cross sectional study among STD clinic attendees in Örebro, Sweden. Attendees were examined for microscopic urethritis and first void urine (FVU) was tested for M genitalium and C trachomatis.

    Results: The prevalence of M genitalium and C trachomatis was 7% (34/512) and 12% (61/512), respectively. Dual infection was diagnosed in four men. In both infections 90% of the patients had signs of microscopic urethritis. M genitalium positive men had symptomatic urethritis significantly more often than those infected with C trachomatis (73% v 40%, RR 1.8; 95% CI 1.2 to 2.7). 63% of female partners of men infected with M genitalium were infected with M genitalium compared with chlamydial infection in 67% of female partners of men infected with C trachomatis. Non-chlamydial non-gonococcal urethritis without evidence of M genitalium infection was diagnosed in 180 men (35%). Symptoms and/or visible discharge were reported in 49% in this group.

    Conclusions:M genitalium is a common infection associated with symptomatic urethritis and with a high prevalence of infected sexual partners supporting its role as a sexually transmitted infection.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-85062 (URN)10.1136/sti.2003.006817 (DOI)
    Tillgänglig från: 2012-11-01 Skapad: 2012-11-01 Senast uppdaterad: 2017-12-07
    4. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection
    Öppna denna publikation i ny flik eller fönster >>Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection
    2005 (Engelska)Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 81, nr 1, s. 73-78Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme.

    Methods: A cross sectional study among female STD clinic attendees in Örebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis.

    Results: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80).

    Conclusions:M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-32379 (URN)10.1136/sti.2004.010439 (DOI)18278 (Lokalt ID)18278 (Arkivnummer)18278 (OAI)
    Tillgänglig från: 2009-10-09 Skapad: 2009-10-09 Senast uppdaterad: 2017-12-13
    5. Tetracycline treatment does not eradicate Mycoplasma genitalium
    Öppna denna publikation i ny flik eller fönster >>Tetracycline treatment does not eradicate Mycoplasma genitalium
    2003 (Engelska)Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 79, nr 4, s. 318-319Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: To study the treatment efficacy of tetracyclines and azithromycin in Mycoplasma genitalium positive patients attending an STD clinic.

    Methods: All M genitalium positive patients (34 men and 26 women) attending an STD clinic during a 6 month period were treated with antibiotics. All patients known to be partners of M genitalium positive patients and those who were M genitalium positive, but not initially treated, were treated with azithromycin. Patients with urethritis and/or cervicitis were treated with tetracyclines before their M genitalium status was known.

    Results: 10 of 14 women (71%) and 10 of 16 men (63%) treated with tetracyclines were M genitalium positive at follow up, whereas all patients treated with azithromycin (16 men and 20 women) were M genitalium negative, at the 4 week follow up visit.

    Conclusions: These results suggest that tetracyclines are not sufficient to eradicate M genitalium. Randomised controlled treatment trials are urgently needed.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-85063 (URN)10.1136/sti.79.4.318 (DOI)
    Tillgänglig från: 2012-11-01 Skapad: 2012-11-01 Senast uppdaterad: 2017-12-07
  • 9.
    Falk, Lars
    et al.
    Östergötlands Läns Landsting, Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Linköpings universitet, Hälsouniversitetet.
    Coble, Britt-Inger
    Östergötlands Läns Landsting, Medicincentrum, Hudkliniken i Östergötland.
    Mjörnberg, Per-Anders
    Ryhov County Hospital, Jönköping.
    Fredlund, Hans
    Örebro Universitet.
    Sampling for Chlamydia trachomatis infection – a comparison of vaginal, first-catch urine, combined vaginal and first-catch urine and endocervical sampling2010Ingår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, ISSN 0956-4624, Vol. 21, nr 4, s. 283-287Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to evaluate the sensitivity of patients' self-sampled vaginal specimens, first-catch urine (FCU), combined vaginal/FCU specimens and endocervical specimens for detecting chlamydial infection in women. Women attending sexually transmitted disease clinics, youth clinics and a women's health clinic were enrolled. They self-collected a vaginal specimen with two swabs, which were placed into a sterile tube and into a tube containing a buffer medium, respectively. An FCU sample was collected and aliquoted into both an empty tube and the tube containing the vaginal swab. A clinician collected an endocervical swab. The samples were sent to laboratories for analysis using polymerase chain reaction testing and strand displacement amplification testing, respectively. The sensitivities calculated in all 171 Chlamydia trachomatis-infected women were equal for endocervical specimens (97.1%), vaginal specimens (96.5%) and combined vaginal/FCU specimens (95.3%), whereas the sensitivity for FCU was significantly lower (87.7%). The sensitivity of vaginal specimens for the detection of C. trachomatis is as high as that of combined vaginal/FCU specimens.

  • 10.
    Falk, Lars
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Linköpings universitet, Medicinska fakulteten.
    Enger, Martin
    Vastervik Hosp, Vastervik, Sweden.
    Jensen, Jorgen Skov
    Statens Serum Institut Köpenhamn.
    Time to eradication of Mycoplasma genitalium after antibiotic treatment in men and women.2015Ingår i: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 70, nr 11, s. 3134-3140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:

    The objectives of this study were to evaluate the time to a Mycoplasma genitalium-negative test after start of treatment and to monitor if and when antibiotic resistance developed.

    METHODS:

    Sexually transmitted disease (STD) clinic attendees with suspected or verified M. genitalium infection were treated with azithromycin (5 days, 1.5 g; n = 85) or moxifloxacin (n = 5). Subjects with symptomatic urethritis or cervicitis of unknown aetiology were randomized to either doxycycline (n = 49) or 1 g of azithromycin as a single dose (n = 51). Women collected vaginal specimens and men collected first-catch urine 12 times during 4 weeks. Specimens were tested for M. genitalium with a quantitative MgPa PCR and for macrolide resistance-mediating mutations with a PCR targeting 23S rRNA.

    CLINICAL TRIALS REGISTRATION:

    NCT01661985.

    RESULTS:

    Ninety M. genitalium cases were enrolled. Of 56 patients with macrolide-susceptible strains before treatment with azithromycin (1.5 g, n = 46; 1 g single oral dose, n = 10), 54 (96%) had a negative PCR test within 8 days. In four patients, M. genitalium converted from macrolide susceptible to resistant after a 10 day lag time with negative tests (azithromycin 1.5 g, n = 3; 1 g single oral dose, n = 1). Moxifloxacin-treated subjects (n = 4) were PCR negative within 1 week. Six of eight (75%) remained positive despite doxycycline treatment.

    CONCLUSIONS:

    PCR for M. genitalium rapidly became negative after azithromycin treatment. Macrolide-resistant strains were detected after initially negative tests. Test of cure should be recommended no earlier than 3-4 weeks.

  • 11.
    Falk, Lars
    et al.
    Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Fredlund, Hans
    Örebro University Hospital.
    Letter: Re: Sampling for Chlamydia trachomatis infection2010Ingår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 21, nr 12, s. 847-847Artikel i tidskrift (Övrigt vetenskapligt)
  • 12.
    Falk, Lars
    et al.
    Department of Dermatology and Venereology, University Hospital, Örebro, Sweden .
    Fredlund, Hans
    Department of Clinical Microbiology and Immunology, University Hospital, Örebro, Sweden .
    Jensen, J. S.
    Mycoplasma Laboratory, Statens Serum Institut, Copenhagen, Denmark .
    Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection2005Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 81, nr 1, s. 73-78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme.

    Methods: A cross sectional study among female STD clinic attendees in Örebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis.

    Results: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80).

    Conclusions:M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection.

  • 13.
    Falk, Lars
    et al.
    Department of Dermatology and Venereology, Örebro University Hospital, Sweden .
    Fredlund, Hans
    Department of Clinical Microbiology and Immunology, Örebro University Hospital, Sweden.
    Jensen, J. S.
    Mycoplasma Laboratory, Statens Serum Institut, Copenhagen, Denmark.
    Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis2004Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 80, nr 4, s. 289-293Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in men attending a Swedish STD clinic and to study the criteria for urethritis.

    Methods: A cross sectional study among STD clinic attendees in Örebro, Sweden. Attendees were examined for microscopic urethritis and first void urine (FVU) was tested for M genitalium and C trachomatis.

    Results: The prevalence of M genitalium and C trachomatis was 7% (34/512) and 12% (61/512), respectively. Dual infection was diagnosed in four men. In both infections 90% of the patients had signs of microscopic urethritis. M genitalium positive men had symptomatic urethritis significantly more often than those infected with C trachomatis (73% v 40%, RR 1.8; 95% CI 1.2 to 2.7). 63% of female partners of men infected with M genitalium were infected with M genitalium compared with chlamydial infection in 67% of female partners of men infected with C trachomatis. Non-chlamydial non-gonococcal urethritis without evidence of M genitalium infection was diagnosed in 180 men (35%). Symptoms and/or visible discharge were reported in 49% in this group.

    Conclusions:M genitalium is a common infection associated with symptomatic urethritis and with a high prevalence of infected sexual partners supporting its role as a sexually transmitted infection.

  • 14.
    Falk, Lars
    et al.
    Department of Dermatology and Venereology, Örebro University Hospital, Örebro, Sweden.
    Fredlund, Hans
    Department of Clinical Microbiology and Immunology, Örebro University Hospital, Örebro, Sweden .
    Jensen, J. S.
    Statens Serum Institut, Mycoplasma Laboratory, Copenhagen, Denmark .
    Tetracycline treatment does not eradicate Mycoplasma genitalium2003Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 79, nr 4, s. 318-319Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To study the treatment efficacy of tetracyclines and azithromycin in Mycoplasma genitalium positive patients attending an STD clinic.

    Methods: All M genitalium positive patients (34 men and 26 women) attending an STD clinic during a 6 month period were treated with antibiotics. All patients known to be partners of M genitalium positive patients and those who were M genitalium positive, but not initially treated, were treated with azithromycin. Patients with urethritis and/or cervicitis were treated with tetracyclines before their M genitalium status was known.

    Results: 10 of 14 women (71%) and 10 of 16 men (63%) treated with tetracyclines were M genitalium positive at follow up, whereas all patients treated with azithromycin (16 men and 20 women) were M genitalium negative, at the 4 week follow up visit.

    Conclusions: These results suggest that tetracyclines are not sufficient to eradicate M genitalium. Randomised controlled treatment trials are urgently needed.

  • 15.
    Falk, Lars
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Hegic, Sabina
    Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Dermatologi och venerologi. Linköpings universitet, Hälsouniversitetet.
    Wilson, Daniel
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Primärvården i centrala länsdelen.
    Wiréhn, Ann-Britt
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Home-sampling as a Tool in the Context of Chlamydia trachomatis Partner Notification: A Randomized Controlled Trial2014Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 94, nr 1, s. 72-74Artikel i tidskrift (Övrigt vetenskapligt)
  • 16.
    Falk, Lars
    et al.
    a Department of Dermatology, Örebro University Hospital, Örebro, Sweden.
    Lindberg, Margret
    a Department of Dermatology, Örebro University Hospital, Örebro, Sweden.
    Jurstrand, Margaretha
    Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Bäckman, Anders
    Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Olcén, Per
    Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Fredlund, Hans
    Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Genotyping of Chlamydia trachomatis would improve contact tracing2003Ingår i: Sexually Transmitted Diseases, ISSN 0148-5717, E-ISSN 1537-4521, Vol. 30, nr 3, s. 205-210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The reported number of genital Chlamydia trachomatis infections has increased 15% annually since 1997 in Sweden. Inaccurate partner notification might be one reason.

    Goal: The goals were to determine if genotyping of C trachomatis would improve partner notification and to study the duration of infection.

    Study Design: Sexual networks were constructed. C trachomatis isolates from 231 individuals attending the Örebro STD clinic during 1 year were typed by sequencing of the omp1 gene.

    Results: All individuals were traced and diagnoses were established in 30 of 161 networks. More than one genotype was seen in seven networks. The mean duration of C trachomatis infection in each network was calculated to be 23 weeks.

    Conclusion: Genotyping could be a useful tool in partner notification when there are discrepant or uncommon genotypes. Limited clinic catchment areas create information difficulties that obstruct accurate contact tracing.

  • 17.
    Falk, Lars
    et al.
    Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Skov Jensen, Jorgen
    Microbiology and Infection Control, Sexually Transmitted Infections, Research and Development, Statens Serum Institut, Copenhagen, Denmark.
    Successful outcome of macrolide-resistant Mycoplasma genitalium urethritis after spectinomycin treatment: a case report2017Ingår i: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 72, nr 2, s. 624-625Artikel i tidskrift (Refereegranskat)
  • 18.
    Farsi Razavi, Monireh
    et al.
    Östergötlands Läns Landsting, Katastrofmedicinskt centrum.
    Falk, Lars
    Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Dermatologi och venerologi. Linköpings universitet, Hälsouniversitetet.
    Bjorn, Ake
    Östergötlands Läns Landsting, Katastrofmedicinskt centrum.
    Wilhelmsson, Susan
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Experiences of the Swedish healthcare system: An interview study with refugees in need of long-term health care2011Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH, ISSN 1403-4948, Vol. 39, nr 3, s. 319-325Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Refugees needing long-term health care must adapt to new healthcare systems. The aim of this study was to examine the viewpoints of nine refugees in a county in Sweden, with a known chronic disease or functional impairment requiring long-term medical care, on their contacts with care providers regarding treatment and personal needs. Methods: Semi-structured interviews with nine individuals and/or their next of kin. Inductive content analysis was used to identify experiences. Results: "Care organisations/resources" and "professional competence" were the categories extracted. Participants felt cared for due to accessibility to and regular appointments with the same care provider. Visiting different clinics contributed to a negative experience and lack of trust. The staffs interest in participants lives and health contributed to a sense of professionalism. Most participants said the problems experienced were not related to their backgrounds as refugees. Many patients did not fully understand which clinic they were attending or the purpose of the care that the specific clinic provided. Some lacked knowledge of their disease. Conclusions: Health care was perceived as equal to other Swedish citizens and problems experienced were not explained by refugee backgrounds. Lack of information from care providers and being sent to various levels of care created feelings of a lack of overall medical responsibility.

  • 19.
    Frölund, Maria
    et al.
    Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen S, Denmark.
    Falk, Lars
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi.
    Ahrens, Peter
    Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen S, Denmark.
    Jensen, Jorgen Skov
    Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen S, Denmark.
    Detection of ureaplasmas and bacterial vaginosis associated bacteria and their association with non-gonococcal urethritis in men2019Ingår i: PLoS ONE, E-ISSN 1932-6203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    No aetiology is found in up to 40% of men with symptomatic urethritis. Male partners of women with bacterial vaginosis (BV) may be at higher risk of non-gonococcal urethritis (NGU). The aim of this study was to examine the role of BV associated bacteria in first-void urine (FVU) in 97 asymptomatic men without urethritis (controls) and 44 men (cases) with NGU including 20 men with idiopathic urethritis (IU) attending a Swedish STD-clinic between January and October 2010. BV-associated bacteria and ureaplasmas were detected by quantitative PCR assays. All BV associated bacteria, except Megasphaera-like type 1, were strongly positively correlated with Uurealyticum p<0.005 and even stronger with the combined Uurealyticum and Uparvum load (p<0.0005) suggesting that ureaplasma induced elevated pH may stimulate the growth of BV associated bacteria. No statistically significant differences were found between IU cases and controls in the prevalence or load of BV associated bacteria or ureaplasmas. In multiple logistic regression, Megasphaera-like type 1 was associated with IU (p = 0.03), but most positive FVU samples contained very few bacteria and the finding may not be clinically relevant.

  • 20.
    Hashem, Rasha
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Tynngård, Nahreen
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Ledningsstab Region Östergötland, Enheten för forskningsstöd.
    Lundmark, Katarzyna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelning för neurobiologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk patologi.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Region Östergötland, Ledningsstab Region Östergötland, Enheten för forskningsstöd.
    Microcystic adnexal carcinoma originating in a nevus sebaceous: a case report of a 16-year-old boy2019Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 99, nr 12, s. 1182-1183Artikel i tidskrift (Refereegranskat)
  • 21.
    Heed, Gunilla
    et al.
    Östergötlands Läns Landsting, Medicincentrum, Hudkliniken i Östergötland.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Det oväntade besöket-syfilisepidemi bland unga män och kvinnor2010Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, ISSN 0023-7205, Vol. 107, nr 19, s. 1314-1316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Early sexually transmissible syphilis is still an infection of major importance worldwide despite the fact that it is nowadays curable, with penicillin treatment. Syphilis has during the last decades been considered in many Western countries to appear mainly among men who have sex with men (MSM). In Sweden only 106 cases were reported (76 MSM) in 2008.In the present paper an epidemic of early syphilis among young heterosexual men and women aged 18 to 23 years is described. The suspected primary index case was a 20 year old woman who had been living for some months in a Mediterranean city. During a period of one year 10 persons living in Norrköping, a town of 128 000 inhabitants, had a confirmed infection. In all, almost 55 men and women were notified and examined. This epidemic shows the dynamic of transmission, the unawareness of care givers and common people as well, but also how efficient contact tracing can be.

  • 22.
    Hjorth, SV
    et al.
    Statens Serum Institut, DK-2300 Copenhagen .
    Björnelius, Eva
    Karolinska Institutet.
    Lidbrink, Peter
    Karolinska Institutet.
    Falk, Lars
    Örebro University Hospital.
    Dohn, B
    Statens Serum Institut, DK-2300 Copenhagen .
    Berthelsen, L
    Statens Serum Institut, DK-2300 Copenhagen .
    Ma, L
    Louisiana State University Health Sciences Center.
    Martin, DH
    Louisiana State University Health Sciences Center.
    Jensen, Jörgen Skov
    Statens Serum Institut, DK-2300 Copenhagen .
    Sequence-based typing of Mycoplasma genitalium reveals sexual transmission2006Ingår i: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 44, nr 6, s. 2078-2083Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mycoplasma genitalium causes male nonchlamydial, nongonococcal urethritis and is associated with cervicitis and pelvic inflammatory disease in women. Epidemiological studies indicate that M. genitalium is sexually transmitted, and the aim of the present study was to further substantiate this by means of a DNA typing system. A typing assay based on a diagnostic mgpB gene PCR was developed, evaluated, and applied directly to urogenital specimens. The assay had a low limit of detection and hence a high typeability. Sequences of isolates from 52 unrelated patients were divided into 29 different sequence types, giving a discriminatory index of 0.95. Two to six M. genitalium-positive specimens were collected from each of 44 patients over a median interval of 56 days (range, 11 to 1,395). Forty had the same sequence type in consecutive specimens. Specimens collected from two men were repeatedly positive at intervals of 472 and 1,395 days, respectively, but the sequence types had changed. A new strain was introduced in one sexual dyad, and the sequence types changed subsequently. Seventy-nine M. genitalium-positive specimens from 19 couples were investigated, and all partners initially had concordant sequence types, but one couple had discordant types at one time point before a newly introduced strain took over. The present typing system is simple and reproducible and has an excellent discriminatory capacity which might prove useful in studies of sexual networks and for evaluation of treatment failures. In the laboratory, this system may document the uniqueness of newly isolated M. genitalium strains.

  • 23.
    Horner, Patrick J
    et al.
    School of Social and Community Medicine, University of Bristol, UK.
    Karla, Blee
    Bristol Sexual Health Centre, University Hospitals Bristol NHS Foundation Trust, UK.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    van der Meijden, W
    Department of Dermatology, New Cross Hospital, UK..
    Moi, H.
    Olafia Clinic, Oslo University Hospital, Institute of Medicine, University of Oslo, Norway.
    2016 European Guideline on the management of non-gonococcal urethritis2016Ingår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 27, nr 11, s. 928-937Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We present the updated International Union against Sexually Transmitted Infections guideline for the management of non-gonococcal urethritis in men. This guideline recommends confirmation of urethritis in symptomatic men before starting treatment. It does not recommend testing asymptomatic men for the presence of urethritis. All men with urethritis should be tested for Chlamydia trachomatis and Neisseria gonorrhoeae and ideally M. genitalium using a NAAT as this is highly likely to improve clinical outcomes. If a NAAT is positive for gonorrhoea, a culture should be performed before treatment. In view of the increasing evidence that azithromycin 1 g may result in the development of antimicrobial resistance in Mycoplasma genitalium azithromycin 1 g is no longer recommended as first line therapy, which should be doxycycline 100 mg bd for 7 days. If azithromycin is to be prescribed an extended of 500 mg, then 250 mg daily for 4 days is to be preferred over 1 g stat. In men with persistent NGU, M. genitalium NAAT testing is recommended if not previously undertaken, as is Trichomonas vaginalis NAAT testing in populations where T. vaginalis is detectable in >2% of symptomatic women.

  • 24.
    Jurstrand, Margaretha
    et al.
    Department of Clinical Microbiology and Immunology, Örebro Medical Centre Hospital, Örebro.
    Falk, Lars
    Outpatient Sexually Transmitted Disease Clinic, Department of Dermatovenereology, Örebro Medical Centre Hospital, Örebro.
    Fredlund, Hans
    Department of Clinical Microbiology and Immunology, Örebro Medical Centre Hospital, Örebro.
    Lindberg, Margaret
    Outpatient Sexually Transmitted Disease Clinic, Department of Dermatovenereology, Örebro Medical Centre Hospital, Örebro.
    Olcén, Per
    Department of Clinical Microbiology and Immunology, Örebro Medical Centre Hospital, Örebro.
    Andersson, Sören
    Department of Clinical Microbiology and Immunology, Örebro Medical Centre Hospital, Örebro.
    Persson, Kenneth
    Department of Clinical Microbiology, Malmö University Hospital, Malmö.
    Albert, Jan
    Division of Virology, Department of Microbiology, Pathology and Immunology, Karolinska Institutet, Huddinge University Hospital, Huddinge/Stockholm, Sweden.
    Bäckman, Anders
    Department of Clinical Microbiology and Immunology, Örebro Medical Centre Hospital, Örebro.
    Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted sisease patients in Sweden2001Ingår i: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 39, nr 11, s. 3915-3919Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A method for detection and genotyping of genital Chlamydia trachomatis infections based on omp1 gene amplification and sequencing was developed. DNA was extracted from urogenital or urine samples using a Chelex-based method, and an approximately 1,100-bp-long fragment from the omp1 gene was directly amplified and sequenced. Genotyping was performed by BLAST similarity search, and phylogenetic tree analysis was used to illustrate the evolutionary relationships between clinical isolates and reference strains. The method was used to determine the genotypes ofC. trachomatis in 237 positive urogenital and/or urine specimens collected at a Swedish sexually transmitted disease clinic during 1 year. The most common genotypes corresponded to serotypes E (47%) and F (17%). The omp1 gene was highly conserved for genotype E (106 of 112 samples without any mutation) and F (41 of 42 samples without any mutation) strains but appear slightly less conserved for genotypes G (n = 6) and H (n = 6), where the sequences displayed one to four nucleotide substitutions relative to the reference sequence. Genotyping of samples collected at the follow-up visit indicated that two patients had become reinfected, while three other patients suffered treatment failure or reinfection. One woman appeared to have a mixed infection with two different C. trachomatis strains. Thisomp1 genotyping method had a high reproducibility and could be used for epidemiological characterization of sexually transmitted Chlamydia infections.

  • 25.
    Sandberg, Klas
    et al.
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Rehab öst. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Kleist, Marie
    Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Rehab öst. Linköpings universitet, Medicinska fakulteten.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Effects of Twice-Weekly Intense Aerobic Exercise inQ1 Early Subacute Stroke: A Randomized Controlled Trial2016Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 97, nr 8, s. 1244-1253Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke.

    DESIGN:

    Randomized controlled trial.

    SETTING:

    Ambulatory care.

    PARTICIPANTS:

    Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset.

    INTERVENTIONS:

    Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise.

    MAIN OUTCOME MEASURES:

    Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up.

    RESULTS:

    The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (P<.001), SLS right and left (eyes open) (P<.001 and P=.022, respectively), and SLS right (eyes closed) (P=.019). Aerobic exercise was associated with improved EQ-5D scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up.

    CONCLUSIONS:

    Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.

  • 26.
    Strömfors, Lina
    et al.
    Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Wilhelmsson, Susan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Höst, Gunnar E.
    Linköpings universitet, Institutionen för teknik och naturvetenskap, Medie- och Informationsteknik. Linköpings universitet, Tekniska högskolan.
    Condition-related knowledge among children and adolescents with spina bifida in a Swedish county2014Ingår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 16, nr 2, s. 127-140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Spina bifida is a congenital birth defect, resulting in physical and cognitive dysfunctions. Condition-related knowledge among children and adolescents with spina bifida is essential to facilitate independent management of their condition. The aim was to describe the condition-related knowledge among children and adolescents with spina bifida in a Swedish county. Thirteen persons with spina bifida (10 to 17 years) participated. Condition-related knowledge was assessed (n = 13) using a questionnaire (KOSB) and a semi-structured interview (n = 8). Interview data were analyzed using qualitative content analysis. The participants had well-developed knowledge concerning proper bladder management, but were lacking knowledge of signs of shunt malfunctioning and etiology. Some participants were uninterested in learning about their condition, despite being aware that they lacked knowledge. The findings indicate potential areas that may be included in local educational initiatives. It should be considered that persons with spina bifida may not be motivated to learn more about their condition.

  • 27.
    Strömfors, Lina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Närsjukvården i östra Östergötland, Barn- och vuxenhabiliteringen. Linköpings universitet, Medicinska fakulteten.
    Wilhelmsson, Susan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Höst, Gunnar E.
    Linköpings universitet, Institutionen för teknik och naturvetenskap, Medie- och Informationsteknik. Linköpings universitet, Tekniska högskolan.
    Experiences among children and adolescents of living with spina bifida and their visions of the future2017Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 3, s. 261-271Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Transitioning to independence may be problematic for persons with spina bifida (SB). Experiences of young persons with SB may provide insights into this group's needs for support. Therefore, the aim of this study was to investigate children'€™s and adolescents' experiences of living with SB, their social and emotional adjustment, and their thoughts about becoming independent adults. Method: Semi-structured interviews were conducted with young persons with SB (N = 8, age range 10 - 17 years). Social and emotional problems were assessed using Beck Youth Inventories. The interview transcripts were analyzed using qualitative content analysis. Results: Three main themes were found: being a person with SB; everyday living as a person with SB; and preparing for life as an adult with SB. Indications of emotional and social problems were most prominent among participants with milder physical disability. Conclusions: The findings indicate that young persons with SB may overestimate their independence. Other potentially problematic areas were lack of motivation, planning and preparedness for becoming independent. Research on transition to independence in this group should consider assistance at an early age in planning and executing strategies for independence. In addition, the potentially difficult situation for young persons with mild SB should be investigated further.

  • 28.
    Wijkman, Magnus
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN.
    Sandberg, Klas
    Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN. Region Östergötland, Närsjukvården i östra Östergötland, Rehab öst. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Kleist, Marie
    Region Östergötland, Närsjukvården i östra Östergötland, Rehab öst. Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    The exaggerated blood pressure response to exercise in the sub-acute phase after stroke is not affected by aerobic exercise.2018Ingår i: The Journal of Clinical Hypertension, ISSN 1524-6175, E-ISSN 1751-7176, Journal of Clinical Hypertension, Vol. 20, s. 56-64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalence of an exaggerated exercise blood pressure (BP) response is unknown in patients with subacute stroke, and it is not known whether an aerobic exercise program modulates this response. The authors randomized 53 patients (27 women) with subacute stroke to 12 weeks of twice-weekly aerobic exercise (n = 29) or to usual care without scheduled physical exercise (n = 24). At baseline, 66% of the patients exhibited an exaggerated exercise BP response (peak systolic BP ≥210 mm Hg in men and ≥190 mm Hg in women) during a symptom-limited ergometer exercise test. At follow-up, patients who had been randomized to the exercise program achieved higher peak work rate, but peak systolic BP remained unaltered. Among patients with a recent stroke, it was common to have an exaggerated systolic BP response during exercise. This response was not altered by participation in a 12-week program of aerobic exercise.

1 - 28 av 28
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf