Upsala journal of medical sciences最新文献

{"title":"Serum concentrations of Thymidine kinase 1 measured using a novel antibody-based assay in patients with Hodgkin Lymphoma.","authors":"Johan Mattsson Ulfstedt,&nbsp;Per Venge,&nbsp;Sofia Holmgren,&nbsp;Gunilla Enblad,&nbsp;Staffan Eriksson,&nbsp;Daniel Molin","doi":"10.48101/ujms.v126.6119","DOIUrl":"https://doi.org/10.48101/ujms.v126.6119","url":null,"abstract":"<p><strong>Background: </strong>Thymidine kinase 1 (TK1) is an intracellular protein associated with DNA synthesis, expressed during the G1 phase and remained elevated through the M phase, with a potential as a biomarker for cell proliferation. In this study, we explore the possible use of TK1 in Hodgkin lymphoma (HL).</p><p><strong>Methods: </strong>Serum concentrations of TK1 (S-TK1) were measured in 46 newly diagnosed HL patients using prospectively collected biobanked serum samples. The samples were analyzed using a novel antibody-based TK1 immunosorbent assay (ELISA).</p><p><strong>Results: </strong>The concentrations of S-TK1 were elevated in HL patients compared with healthy controls (median 0.32 μg/L vs. 0.24 μg/L, <i>P</i> = 0.003). A further increase in S-TK1 was observed during the treatment. The S-TK1 concentrations were higher in patients with advanced stage disease, low B-Hb, elevated P-LD and in those with B-symptoms. A high ESR correlated with low S-TK1.</p><p><strong>Conclusions: </strong>The study results suggest that S-TK1, measured using a novel antibody-based assay, has the potential to be a biomarker in HL. However, while S-TK1 levels are elevated at baseline compared with healthy controls, a limited number of patients and comparatively short follow-up time render reliable conclusions difficult.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39378310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the diagnosis of eosinophilic esophagitis based on histopathology reports in Sweden.","authors":"Lovisa Röjler,&nbsp;Ida Glimberg,&nbsp;Marjorie M Walker,&nbsp;John J Garber,&nbsp;Jonas F Ludvigsson","doi":"10.48101/ujms.v126.7687","DOIUrl":"https://doi.org/10.48101/ujms.v126.7687","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a relatively new diagnosis, where until recently a specific international classification of disease code was missing. One way to identify patients with EoE is to use histopathology codes. We validated the clinicopathological EoE diagnosis based on histopathology reports and patient charts to establish these data sources as the basis for a nationwide EoE patient cohort.</p><p><strong>Methods: </strong>Through the Epidemiology Strengthened by histoPathology Reports in Sweden (ESPRESSO) study, we randomly selected 165 patients from five Swedish health care regions with a histopathologic diagnosis of EoE. Patients were assigned a histopathology diagnosis of EoE if they had ≥15 eosinophils per high-power field or, in the absence of eosinophil quantification, the pathologist interpreted the biopsy as consistent with EoE. Patient charts were scrutinized to see if the other diagnostic criteria were fulfilled. Of the 131 received patient charts, 111 (85%) had sufficient information to be included in the study.</p><p><strong>Results: </strong>Of the 111 validated patients, 99 had EoE, corresponding to a positive predictive value of 89% (95% confidence interval = 82-94%). Dysphagia was the most common symptom (<i>n</i> = 78, 70%), followed by food impaction (<i>n</i> = 64, 58%) and feeding difficulties (<i>n</i> = 37, 33%). Twelve patients had coexisting asthma (11%) and 16 allergic rhinitis (14%). Seventeen patients underwent esophageal dilatation (15%), of which seven had more than one dilatation. Ninety-seven (87%) patients had a proton-pump inhibitor treatment ≤2 years before or after the diagnosis. Forty-two patients (38%) had been prescribed inhalation steroids and 64 (58%) had undergone esophageal radiology.</p><p><strong>Conclusion: </strong>Histopathology reports from the ESPRESSO cohort with esophageal eosinophilic inflammation are suggestive of EoE.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39378309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of nutritional state on the fatty acid composition of circulating lipid fractions: implications for their use as biomarkers of dietary fat intake.","authors":"Sion A Parry, Fredrik Rosqvist, Sarah Peters, Rebecca K Young, Thomas Cornfield, Pamela Dyson, Leanne Hodson","doi":"10.48101/ujms.v126.7649","DOIUrl":"10.48101/ujms.v126.7649","url":null,"abstract":"<p><strong>Background: </strong>The fatty acid (FA) composition of blood can be used as an objective biomarker of dietary FA intake. It remains unclear how the nutritional state influences the FA composition of plasma lipid fractions, and thus their usefulness as biomarkers in a non-fasted state.</p><p><strong>Objectives: </strong>To investigate the associations between palmitate, oleate and linoleate in plasma lipid fractions and self-reported dietary FA intake, and assess the influence of meal consumption on the relative abundance of these FA in plasma lipid fractions (i.e. triglyceride [TG], phospholipids [PLs] and cholesterol esters [CEs]).</p><p><strong>Design: </strong>Analysis was performed in plasma samples collected from 49 (34 males and 15 females) participants aged 26-57 years with a body mass index (BMI) between 21.6 and 34.2 kg/m², all of whom had participated in multiple study visits, thus a pooled cohort of 98 data sets was available for analysis. A subset (<i>n</i> = 25) had undergone nutritional interventions and was therefore used to investigate the relationship between the FA composition of plasma lipid fractions and dietary fat intake.</p><p><strong>Results: </strong>Significant (<i>P</i> < 0.05) positive associations were observed between dietary polyunsaturated fat and linoleate abundance in plasma CE. When investigating the influence of meal consumption on postprandial FA composition, we found plasma TG palmitate significantly (<i>P</i> < 0.05) decreased across the postprandial period, whereas oleate and linoleate increased. A similar pattern was observed in plasma PL, whereas linoleate abundance decreased in the plasma CE.</p><p><strong>Conclusion: </strong>Our data demonstrate that the FA composition of plasma CE may be the lipid fraction to utilise as an objective biomarker when investigating recent (i.e. previous weeks-months) dietary FA intakes. In addition, we show that the consumption of a high-fat meal influences the FA composition of plasma TG, PL and CE over the course of the postprandial period, and therefore, suggest that fasting blood samples should be utilised when using FA composition as a biomarker of dietary FA intake.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39378312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between open-angle glaucoma and Alzheimer's disease in Sweden: a long-term population-based follow-up study.","authors":"Curt Ekström,&nbsp;Ida Puhto,&nbsp;Lena Kilander","doi":"10.48101/ujms.v126.7819","DOIUrl":"https://doi.org/10.48101/ujms.v126.7819","url":null,"abstract":"<p><strong>Background: </strong>Open-angle glaucoma (OAG) and Alzheimer's disease (AD) are two age-related neurodegenerative diseases of significant public health importance. Epidemiological studies have indicated that there might be an association between the disorders.</p><p><strong>Methods: </strong>Predictors of AD, including mixed and unspecified dementia, were analysed in a cohort of 712 residents aged 65-74 years, examined in a population survey in the rural district of Tierp, Sweden, from 1984 to 1986. To expand the sample size, 821 people were recruited by means of glaucoma case records established at the Eye Department in Tierp from 1978 to 2007. In this way, the cohort comprised 1,533 people, representing more than 21,000 person-years at risk. Medical records were reviewed to identify subjects diagnosed with dementia. Those with a follow-up duration shorter than 2 years were excluded.</p><p><strong>Results: </strong>By the conclusion of the study, in August 2020, 307 subjects had received a diagnosis of AD, including mixed and unspecified dementia. Of these cases, 55 were affected with definite OAG at baseline. Higher age and ischemic heart disease were the only predictors of AD identified. In multivariate analysis, adjusting for age, participation in the population survey and competing events, no association was found between OAG and AD (hazard ratio 1.08; 95% confidence interval: 0.80-1.47).</p><p><strong>Conclusion: </strong>In this long-term follow-up study of subjects aged 65-74 years old in Sweden, OAG was not associated with AD.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39276005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between NLRP3 rs10159239 and Vaspin rs2236242 gene variants and obstructive sleep apnea.","authors":"Buğra Kerget,&nbsp;Ferhan Kerget,&nbsp;Çiğdem Yüce Kahraman,&nbsp;Alperen Aksakal,&nbsp;Ömer Araz","doi":"10.48101/ujms.v126.7603","DOIUrl":"https://doi.org/10.48101/ujms.v126.7603","url":null,"abstract":"<p><strong>Background: </strong>In obstructive sleep apnea (OSA), recurrent upper airway obstruction and apnea/hypopnea episodes result in endothelial dysfunction, which leads to the release of many proinflammatory cytokines and reactive oxygen species (ROS). ROS induces NLRP3, a protein involved in the synthesis of interleukin (IL)-1 and IL-18; vaspin is a serine protease inhibitor that has an important role in suppressing the activation of NLRP3 inflammasome. In this study, we aimed to investigate the effect of NLRP3 rs10159239 (rs9239) and vaspin rs2236242 (rs6242) single nucleotide polymorphisms (SNPs) on OSA development.</p><p><strong>Methods: </strong>This study included 220 individuals who underwent polysomnography (118 patients with OSA and 102 healthy controls). NLRP3 rs9239 and vaspin rs6242 mutation frequencies were analyzed.</p><p><strong>Results: </strong>The NLRP3 rs9239 SNP genotype analysis revealed no statistically significant differences between the OSA and control groups. In the vaspin gene analysis, the rs6242 AA genotype was significantly more frequent in the OSA group compared with the control group, while the AT genotype was more frequent in controls (<i>P</i> = 0.004, <i>P</i> = 0.02). Comparison of rs6242 allele levels showed that the A allele was significantly more frequent in OSA patients than in controls (<i>P</i> = 0.03). The AA genotype was significantly more frequent in patients with severe OSA than in patients with mild or moderate OSA and the control group (<i>P</i> = 0.001 for all). Serum vaspin levels were significantly lower in carriers of the AA genotype than those with AT and TT genotypes (<i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>The vaspin rs6242 SNP AA genotype increased susceptibility to OSA, while the AT genotype appeared to be protective. The lower plasma vaspin levels in OSA compared with the control group and in patients with the AA genotype suggest that vaspin may be a protective biomarker for OSA.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39276006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are ECG changes in heart-healthy individuals of various ages related to cardiac disease 20 years later?","authors":"Sofia Erelund,&nbsp;Kjell Karp,&nbsp;Urban Wiklund,&nbsp;Rolf Hörnsten,&nbsp;Sandra Arvidsson","doi":"10.48101/ujms.v126.6064","DOIUrl":"https://doi.org/10.48101/ujms.v126.6064","url":null,"abstract":"<p><strong>Background: </strong>This research study aimed at assessing the electrocardiographic (ECG) changes caused by ageing in a cohort of healthy subjects with normal echocardiographic examinations.</p><p><strong>Methods: </strong>A total of 219 healthy individuals (119 males and 100 females) were evaluated for possible arrhythmias with a standard 12-lead resting ECG and 24-h Holter ECG. As the recordings were performed between 1998 and 2000, a 20-year follow-up study was carried out by assessing the local medical records to investigate whether the subjects had experienced any cardiovascular health complications or disease since the baseline assessment.</p><p><strong>Results: </strong>Eighty-three subjects (45 males and 38 females) presented with pathological ECG findings at baseline. The most common finding on analysis of Holter ECG recordings was premature atrial contractions, and the most severe pathological finding was episodes of ventricular tachycardia (eight subjects). Regarding the analysis of the standard 12-lead ECG, the most common finding was left ventricular hypertrophy, and the most severe pathological findings were ST-T changes and prolongation of the QT interval. Despite other cardiac examinations performed on these patients showing normal results, in combination with a strict inclusion criterion, this study showed that 28% of all subjects had pathological resting 12-lead ECGs at rest and 35% had pathological heart rhythms when assessed by 24-h Holter ECG. At follow-up, 21% of females and 43% of males had presented with ECG abnormalities, and 30% of females and 36% of males had cardiovascular disease. There was hypertension in 45% of females and in 58% of males. However, no association was found between the follow-up findings and ECG changes seen at baseline.</p><p><strong>Conclusion: </strong>Although most ECG changes found at baseline could be considered as a normal variation, they may progress to more severe heart complications as the subject ages. The results of this study also validate ECG findings of previous studies and underline that diagnostic criteria should be based on gender and age.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39276004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of extensive bleeding in pigs on laboratory biomarkers.","authors":"Anders Larsson,&nbsp;Gunnar Strandberg,&nbsp;Miklós Lipcsey,&nbsp;Mats Eriksson","doi":"10.48101/ujms.v126.6914","DOIUrl":"https://doi.org/10.48101/ujms.v126.6914","url":null,"abstract":"<p><strong>Background: </strong>During hemorrhage and resuscitation, clinical and laboratory monitoring is useful to guide further management. However, acute changes in the biochemistry due to blood loss and subsequent crystalloid fluid resuscitation have not been fully studied.</p><p><strong>Materials and methods: </strong>Twelve anesthetized, juvenile pigs were used. Atraumatic exsanguination, corresponding to a total blood loss of 40%, was performed through a catheter and completed 2 h after initiation of the experiment. Arterial samples were analyzed by point-of-care testing and venous samples were analyzed. Oxygen delivery was calculated.</p><p><strong>Results: </strong>Shortly after 40% hemorrhage and concomitant fluid supplementation, there were significant reductions in arterial hemoglobin and hematocrit (approximately 25%, respectively). Oxygen delivery was less than half of the baseline value. Lactate in arterial blood was more than doubled after 40% exsanguination. On average, no other clinically significant changes in any of the analytes were observed, but interindividual dispersion was pronounced.</p><p><strong>Conclusions: </strong>Acute exsanguination was associated with decreased hemoglobin and hematocrit levels and increased lactate levels but limited effects on the other biomarkers that were studied. Increased levels of biomarkers in severely bleeding patients could indicate tissue damage and the source should be further investigated.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39587149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized IgG4-related disease manifested on the tongue: a case report.","authors":"Helya Hashemi,&nbsp;Andreas Thor,&nbsp;Erik Hellbacher,&nbsp;Marie Carlson,&nbsp;Miklós Gulyás,&nbsp;Lena Blomstrand","doi":"10.48101/ujms.v126.6118","DOIUrl":"https://doi.org/10.48101/ujms.v126.6118","url":null,"abstract":"<p><p>Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that can affect multiple organs. IgG4-RD may show a variety of initial symptoms. In the oral mucosa, lesions present as inflammatory fibrosis with a large number of IgG4-positive plasma cells. Evaluating treatment is a well-known problem in IgG4-RD due to the absence of an established assessment system. There are difficulties in defining the severity of the disease, which is why treatment is primarily based on its clinical manifestations. We present a case report of localized IgG4-RD with ulcerative and proliferative manifestations on the tongue, which clinically mimicked oral squamous cell carcinoma. A tumor-like lesion on the tongue can indicate something else other than the malignant or reactive changes commonly found in the oral mucosa. Multiple differential diagnoses of these atypical oral lesions, including localized IgG4-RD, should be considered.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39276007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poorly controlled ambulatory blood pressure in outpatients with peripheral arterial disease.","authors":"Nina Dahle,&nbsp;Emma Skau,&nbsp;Jerzy Leppert,&nbsp;Johan Ärnlöv,&nbsp;Pär Hedberg","doi":"10.48101/ujms.v126.7609","DOIUrl":"https://doi.org/10.48101/ujms.v126.7609","url":null,"abstract":"<p><strong>Background: </strong>Patients with peripheral arterial disease (PAD) are generally less intensively managed than patients with coronary heart disease (CHD), despite that their risk of complications is believed to be equivalent. Identification of PAD patients at risk of poorly controlled blood pressure (BP) could lead to improved treatment, thus lowering the risk of cardiovascular (CV) complications. We aimed to describe the prevalence of poorly controlled cardiovascular (CV) risk factors, focusing on BP, in outpatients with PAD diagnosed in a vascular ultrasound laboratory.</p><p><strong>Methods: </strong>Consecutive outpatients with carotid and/or lower extremity PAD were included (<i>n =</i> 402) and examined with blood sampling, clinical BP, and 24-h ambulatory BP measurements. A poorly controlled clinical BP was defined as ≥140/90 mmHg, ambulatory BP ≥130/80 mmHg, low-density lipoprotein (LDL)-cholesterol level ≥2.5 mmol/L, and glycated hemoglobin (HbA1c) level >53 mmol/mol in those with diabetes.</p><p><strong>Results: </strong>Most of the patients had poorly controlled clinical (76.6%) and ambulatory BP (51.7%) profiles. Antihypertensive medications were prescribed in 84% of the patients. However, >40% of them used only 0-1 medication, and <25% of them used three or more agents. Clinical BP, a low number of medications, body mass index, and the presence of diabetes independently predicted a poorly controlled ambulatory BP. Nearly one-third of the patients were smokers, and most of the cohort had an LDL-cholesterol level of ≥2.5 mmol/L. An HbA1c level of >53 mmol/mol was present in 55% of diabetic patients.</p><p><strong>Conclusion: </strong>Poorly controlled clinical and ambulatory systolic BP profiles were common. In addition, suboptimal control of other important CV risk factors was detected. The findings of this study highlight the need for better preventive efforts against CV risk factors in outpatients with PAD.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38918103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Staphylococcus aureus</i> bacteremia and cardiac implantable electronic devices in a county hospital setting: a population-based retrospective cohort study.","authors":"Sara Pichtchoulin,&nbsp;Ingrid Selmeryd,&nbsp;Elisabeth Freyhult,&nbsp;Pär Hedberg,&nbsp;Jonas Selmeryd","doi":"10.48101/ujms.v126.5653","DOIUrl":"https://doi.org/10.48101/ujms.v126.5653","url":null,"abstract":"<p><strong>Background: </strong>Due to a high incidence of cardiac implantable electronic device-associated infective endocarditis (CIED-IE) in cases of <i>Staphylococcus aureus</i> bacteremia (SAB) and high mortality with conservative management, guidelines advocate device removal in all subjects with SAB. We aimed to investigate the clinical course of SAB in patients with a CIED (SAB+CIED) in a Swedish county hospital setting and relate it to guideline recommendations.</p><p><strong>Methods: </strong>All CIED carriers with SAB, excluding clinical pocket infections, in the County of Västmanland during 2010-2017 were reviewed retrospectively.</p><p><strong>Results: </strong>There were 61 cases of SAB+CIED during the study period, and CIED-IE was diagnosed in 13/61 (21%) cases. In-hospital death occurred in 19/61 (31%) cases, 34/61 (56%) cases were discharged with CIED device retained, and 8/61 (13%) cases were discharged after device removal. Subjects dying during hospitalization were elderly and diseased. No events was seen if the CIED was removed. Among four discharged cases with conservatively managed CIED-IE one relapse occured. Among 30 cases discharged with retained CIED and no evidence of IE, 22/30 (73%) cases had an uneventful follow-up, whereas adverse events secondary to overlooked CIED-IE were likely in 1/30 (3%) cases and could not be definitely excluded in additionally 4/30 (13%) cases.</p><p><strong>Conclusions: </strong>During the study period, management became more active and prognosis improved. The heterogeneity within the population of SAB+CIED suggests that a management strategy based on an individual risk/benefit analysis could be an alternative to mandatory device removal.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"126 ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2021-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25525071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}