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Ilchenko O, Pilhun Y, Kutsyk A, Slobodianiuk D, Goksel Y, Dumont E, Vaut L, Mazzoni C, Morelli L, Boisen S, Stergiou K, Aulin Y, Rindzevicius T, Andersen TE, Lassen M, Mundhada H, Jendresen CB, Philipsen PA, Hædersdal M, Boisen A. Optics miniaturization strategy for demanding Raman spectroscopy applications. Nat Commun 2024; 15:3049. [PMID: 38589380 PMCID: PMC11001912 DOI: 10.1038/s41467-024-47044-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Raman spectroscopy provides non-destructive, label-free quantitative studies of chemical compositions at the microscale as used on NASA's Perseverance rover on Mars. Such capabilities come at the cost of high requirements for instrumentation. Here we present a centimeter-scale miniaturization of a Raman spectrometer using cheap non-stabilized laser diodes, densely packed optics, and non-cooled small sensors. The performance is comparable with expensive bulky research-grade Raman systems. It has excellent sensitivity, low power consumption, perfect wavenumber, intensity calibration, and 7 cm-1 resolution within the 400-4000 cm-1 range using a built-in reference. High performance and versatility are demonstrated in use cases including quantification of methanol in beverages, in-vivo Raman measurements of human skin, fermentation monitoring, chemical Raman mapping at sub-micrometer resolution, quantitative SERS mapping of the anti-cancer drug methotrexate and in-vitro bacteria identification. We foresee that the miniaturization will allow realization of super-compact Raman spectrometers for integration in smartphones and medical devices, democratizing Raman technology.
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Affiliation(s)
- Oleksii Ilchenko
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark.
- Lightnovo ApS, Birkerød, Denmark.
| | - Yurii Pilhun
- Lightnovo ApS, Birkerød, Denmark
- Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Andrii Kutsyk
- Lightnovo ApS, Birkerød, Denmark
- Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
- Technical University of Denmark, Department of Energy Conversion and Storage, Kgs. Lyngby, Denmark
| | - Denys Slobodianiuk
- Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
- Institute of Magnetism, Kyiv, Ukraine
| | - Yaman Goksel
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
| | - Elodie Dumont
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
| | - Lukas Vaut
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
| | - Chiara Mazzoni
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
| | - Lidia Morelli
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
| | | | | | | | - Tomas Rindzevicius
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | | | | | | | | | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Anja Boisen
- Technical University of Denmark, Department of Health Technology, Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics, Kgs. Lyngby, Denmark
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Stærk K, Schrøder B, Jensen LK, Petersen T, Andersen TE, Nielsen LF. Catheter-associated bladder mucosal trauma during intermittent voiding: An experimental study in pigs. BJUI Compass 2024; 5:217-223. [PMID: 38371199 PMCID: PMC10869658 DOI: 10.1002/bco2.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/23/2023] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
Objective The objective of this study is to characterize bladder mucosal trauma associated with intermittent catheterization with conventional eyelet catheters (CECs) and to assess if a microhole zone catheter (MHZC) design concept reduces this adverse effect. Materials and Methods A porcine model was developed to reflect human catheterization and bladder drainage. Nine pigs were randomized for catheterization with CEC (n = 6) or MHZC (n = 3). The bladder was drained repeatedly 20 times through the catheter. Cystoscopy was performed before and after the procedure, and bladders were analysed by histopathology. Two additional pigs were used for cystoscopy visualization of suction events in vivo. Cystoscopy, gross pathology, histopathological score, leucocyte infiltration, and intracatheter pressure at flow stops during voiding were compared for each group. Results A significant higher pressure gradient was measured inside the CECs compared with MHZCs during flow stop. Consequently, CECs resulted in suction events inflicting bladder trauma characterized by loss of epithelium, oedema, haemorrhage, and neutrophil tissue infiltration. No significant trauma was identified when using MHZC. Conclusions Considerable mucosal bladder trauma is inflicted by CECs which may be an overlooked risk factor for urinary tract infection. Catheters can be designed to minimize mucosal suction and reduce associated trauma. This may be a solution to reduce infection frequency and increase user comfort. Furthermore, the study demonstrates the potential of pigs as an attractive animal model for investigating urinary catheter performances.
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Affiliation(s)
- Kristian Stærk
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Department of Clinical Microbiology Odense University Hospital Odense Denmark
| | - Brit Schrøder
- Preclinical, R&D, Innovation Coloplast A/S Humlebaek Denmark
| | | | - Troels Petersen
- Preclinical, R&D, Innovation Coloplast A/S Humlebaek Denmark
| | - Thomas Emil Andersen
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Department of Clinical Microbiology Odense University Hospital Odense Denmark
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Riber SS, Clausen LL, Dahl M, Riber LPS, Andersen TE, Lindholt JS. Experimental comparative study of a novel drug-eluting arteriovenous graft in a sheep model. Front Cardiovasc Med 2024; 11:1341154. [PMID: 38468720 PMCID: PMC10925874 DOI: 10.3389/fcvm.2024.1341154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Background Arteriovenous (AV) grafts often develop severe complications of stenosis due to neointimal proliferation that occurs either at the venous anastomosis site or at the outflow receiving vein. This study compares primary patency during 12 months of follow up for a new experimental Biomodics© interpenetrating polymer network (IPN) drug-eluting graft prototype with state-of-the-art GORE® ACUSEAL (ACUSEAL) in an AV graft model in sheep. Methods and results An end-to-end bypass from the common carotid artery to the jugularis vein was performed bilaterally in 12 sheep. The usage of ACUSEAL or the IPN, both 6.0 mm in diameter, was determined via randomization. The sheep were followed up every 4 weeks with ultrasonic duplex scanning to determine patency; the experienced observer was blinded to the randomization. One sheep died after 11 days, and the final sample accordingly consisted of 11 animals. When comparing neointimal hyperplasia after 12 months in the two grafts, Fisher's exact test showed a significant difference with none out of 11 in the IPN grafts and 9 out of 11 in the ACUSEAL graft (p < 0.001). However, the Biomodics© IPN exhibited severe deterioration over time. Conclusions Almost all of the grafts occluded during the 12 months of follow up. Although the zwitterion-bounded interpenetrating drug eluting polymer network showed signs to impair neointimal hyperplasia and thrombosis, age-related degeneration hindered demonstrating a potential improvement in patency.
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Affiliation(s)
- Sara Schødt Riber
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
| | - Lene Langhoff Clausen
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
| | - Marie Dahl
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lars Peter Schødt Riber
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Jes S. Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
- Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark
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Stærk K, Langhorn L, Halle B, Andersen TE. Urinary bladder catheterisation of female pigs: Influence of bladder content and Escherichia coli urinary tract infection on procedural outcome. Lab Anim 2024:236772231169344. [PMID: 38334709 DOI: 10.1177/00236772231169344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Catheterisation of the urinary bladder is needed in many types of human disease models in pigs. Based on our extensive experience with the pig as an infection model, we here demonstrate an approach of catheterising domestic pigs (40 attempts) and Göttingen minipigs (10 attempts) using a blinded method, that is, without speculums or videoscopes to visualise the urethral opening. The procedure was tested on control animals and pigs with experimental Escherichia coli urinary tract infection (UTI) to assess the potential influence of this condition on procedural outcome. Lastly, we performed cystoscopy in three animals to visualise the route to the urethra and to localise potential anatomical obstacles. All domestic pigs were catheterised successfully in an average of 2 minutes and 23 seconds, and this was not influenced by UTI (p = 0.06) or bladder urine content at the time of catheterisation (p = 0.32). All Göttingen minipigs were successfully catheterised in an average of 4 minutes and 27 seconds. We conclude that blinded catheterisation is a fast and reliable approach that can be performed in pigs with or without UTI with minimal risk of trauma or contamination.
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Affiliation(s)
- Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Denmark
| | - Louise Langhorn
- Biomedical laboratory, University of Southern Denmark, Denmark
| | - Bo Halle
- Department of Neurosurgery, Odense University Hospital, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Denmark
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Schrøder B, Tentor F, Miclăuş T, Stærk K, Andersen TE, Spinelli M, Rendeli C, Del Popolo G, Bagi P, Nielsen LF. New micro-hole zone catheter reduces residual urine and mucosal microtrauma in a lower urinary tract model. Sci Rep 2024; 14:2268. [PMID: 38280939 PMCID: PMC10821950 DOI: 10.1038/s41598-024-52505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
Urinary tract infections (UTIs) are the main complication associated with clean intermittent catheterization (CIC) and are facilitated by post-void residual urine and trauma to the mucosa during voiding. The risk of UTI may be diminished by reducing the residual volumes and preventing microtrauma caused by mucosal suction through the eyelets of conventional eyelet catheters (CEC). A new micro-hole zone catheter (MHZC) was developed and tested in an ex vivo porcine lower urinary tract model and in vivo, in pigs, against a CEC. It was shown that, irrespective of the micro-hole diameter, the new catheter ensured increased flowrates and significantly lower residual volumes at the first flow-stop. Furthermore, with a micro-hole diameter of 0.4 mm, mucosal suction was virtually eliminated, regardless of the insertion depth or simulated intra-abdominal pressure mimicking sitting or standing humans. Pressure profile experiments and endoscopy studies indicated that the bladder gradually folds against the drainage tip of the new catheter, without blocking the flow, and, unlike with the CEC, sharp pressure variations and flow-stops did not occur during voiding. The MHZC outperformed the CEC in all tested scenarios and decreased residual volumes, thus potentially decreasing the risk of UTIs.
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Affiliation(s)
| | - Fabio Tentor
- Coloplast A/S, Holtedam 1, 3050, Humlebaek, Denmark
| | | | - Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | | | - Claudia Rendeli
- Department of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio Del Popolo
- Neuro-Urology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Per Bagi
- Department of Urology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Amundsen R, Thorarinsdottir S, Larmo A, Pedersen R, Andersen TE, Møller M, Bahr R. #ReadyToplay: hamstring injuries in women's football - a two-season prospective cohort study in the Norwegian women's premier league. SCI MED FOOTBALL 2024:1-9. [PMID: 38243669 DOI: 10.1080/24733938.2024.2305389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Abstract
In this two-season prospective cohort study (2020-2021), we aimed to describe the characteristics, clinical findings and magnetic resonance imaging (MRI) findings of hamstring injuries in the Norwegian women's premier league. Hamstring injuries were examined by team physiotherapists using a standardised clinical examination and injury form. Injury location and severity (modified Peetrons classification) were graded based on MRI by two independent radiologists. Fifty-three hamstring injuries were clinically examined, 31 of these with MRI. Hamstring injuries caused 8 days (median) lost from football (interquartile range: 3-15 days, range: 0-188 days), most were non-contact and occurred during sprinting. Gradual-onset (53%) and sudden-onset injuries (47%) were evenly distributed. The injuries examined with MRI were classified as grade 0 (52%), grade 1 (16%) or grade 2 (29%). One proximal tendinopathy case was not graded. Grade 2 injuries caused more time loss than grade 0 (19 ± 8 vs. 7 ± 7 days, p = 0.002). Of injuries with MRI changes, 60% were in the m. biceps femoris, mainly the muscle-tendon junction, and 40% in the m. semimembranosus, most in the proximal tendon. Compared to previous findings from men's football, a higher proportion of hamstring injuries in women's football had a gradual onset and involved the m. semimembranosus, particularly its proximal tendon.
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Affiliation(s)
- R Amundsen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - S Thorarinsdottir
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - A Larmo
- Radiology Department, Evidia Norge AS, Oslo, Norway
| | - R Pedersen
- Radiology Department, Unilabs Norge AS, Oslo, Norway
| | - T E Andersen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association Medical Centre (Idrettens helsesenter), The Norwegian Football Association, Oslo, Norway
| | - M Møller
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - R Bahr
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Kern K, Delaroque N, Boysen A, Puder M, Wendt R, Kölsch A, Ehrentreich-Förster E, Stærk K, Andersen TE, Andersen K, Lund L, Szardenings M. Glycosylation of bacterial antigens changes epitope patterns. Front Immunol 2023; 14:1258136. [PMID: 37954588 PMCID: PMC10637626 DOI: 10.3389/fimmu.2023.1258136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/21/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Unlike glycosylation of proteins expressed in mammalian systems, bacterial glycosylation is often neglected in the development of recombinant vaccines. Methods Here, we compared the effects of glycosylation of YghJ, an Escherichia coli protein important for mucus attachment of bacteria causing in urinary tract infections (UTIs). A novel method based on statistical evaluation of phage display for the identification and comparison of epitopes and mimotopes of anti-YghJ antibodies in the sera was used. This is the first time that the effect of glycosylation of a recombinant bacterial antigen has been studied at the peptide epitope level. Results The study identifies differences in the immune response for (non)-glycosylated antigens in rabbits and pigs and compares them to a large group of patients with UTI, which have been diagnosed as positive for various bacterial pathogens. We identified glycosylation-specific peptide epitopes, a large immunological similarity between different UTI pathogens, and a broad peptide epitope pattern in patients and animals, which could result in a variable response in patients upon vaccination. Discussion This epitope analysis indicates that the vaccination of rabbits and pigs raises antibodies that translate well into the human immune system. This study underlines the importance of glycosylation in bacterial vaccines and provides detailed immune diagnostic methods to understand individual immune responses to vaccines.
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Affiliation(s)
- Karolin Kern
- Ligand Development Unit, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
- Epitopic, Leipzig, Germany
| | - Nicolas Delaroque
- Ligand Development Unit, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
| | | | | | - Ralph Wendt
- Department of Nephrology, St. Georg Hospital Leipzig, Leipzig, Germany
| | - Andreas Kölsch
- MicroDiagnostics Unit, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
| | - Eva Ehrentreich-Förster
- Molekulare und Zelluläre Bioanalytik Unit, Fraunhofer Institute for Cell Therapy and Immunology, Branch Bioanalytics and Bioprocesses (IZI-BB), Golm, Germany
| | - Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Karin Andersen
- Department of Urology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lars Lund
- Department of Urology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Michael Szardenings
- Ligand Development Unit, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
- Epitopic, Leipzig, Germany
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Grønnemose RB, Tornby DR, Riber SS, Hjelmager JS, Riber LPS, Lindholt JS, Andersen TE. An Antibiotic-Loaded Silicone-Hydrogel Interpenetrating Polymer Network for the Prevention of Surgical Site Infections. Gels 2023; 9:826. [PMID: 37888399 PMCID: PMC10606314 DOI: 10.3390/gels9100826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
Surgical site infections (SSIs) are among the most frequent healthcare-associated infections, resulting in high morbidity, mortality, and cost. While correct hygiene measures and prophylactic antibiotics are effective in preventing SSIs, even in modern healthcare settings where recommended guidelines are strictly followed, SSIs persist as a considerable problem that has proven hard to solve. Surgical procedures involving the implantation of foreign bodies are particularly problematic due to the ability of microorganisms to adhere to and colonize the implanted material and form resilient biofilms. In these cases, SSIs may develop even months after implantation and can be difficult to treat once established. Locally applied antibiotics or specifically engineered implant materials with built-in antibiotic-release properties may prevent these complications and, ultimately, require fewer antibiotics compared to those that are systemically administered. In this study, we demonstrated an antimicrobial material concept with intended use in artificial vascular grafts. The material is a silicone-hydrogel interpenetrating polymer network developed earlier for drug-release catheters. In this study, we designed the material for permanent implantation and tested the drug-loading and drug-release properties of the material to prevent the growth of a typical causative pathogen of SSIs, Staphylococcus aureus. The novelty of this study is demonstrated through the antimicrobial properties of the material in vitro after loading it with an advantageous combination, minocycline and rifampicin, which subsequently showed superiority over the state-of-the-art (Propaten) artificial graft material in a large-animal study, using a novel porcine tissue-implantation model.
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Affiliation(s)
- Rasmus Birkholm Grønnemose
- Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark; (R.B.G.); (D.R.T.)
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense, Denmark;
| | - Ditte Rask Tornby
- Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark; (R.B.G.); (D.R.T.)
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense, Denmark;
| | - Sara Schødt Riber
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, 5000 Odense, Denmark; (S.S.R.); (L.P.S.R.); (J.S.L.)
- Research Unit of Cardiothoracic and Vascular Surgery, University of Southern Denmark, 5000 Odense, Denmark
| | - Janni Søvsø Hjelmager
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense, Denmark;
| | - Lars Peter Schødt Riber
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, 5000 Odense, Denmark; (S.S.R.); (L.P.S.R.); (J.S.L.)
- Research Unit of Cardiothoracic and Vascular Surgery, University of Southern Denmark, 5000 Odense, Denmark
| | - Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, 5000 Odense, Denmark; (S.S.R.); (L.P.S.R.); (J.S.L.)
- Research Unit of Cardiothoracic and Vascular Surgery, University of Southern Denmark, 5000 Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark; (R.B.G.); (D.R.T.)
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense, Denmark;
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9
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Rasmussen M, Møller FT, Gunalan V, Baig S, Bennedbæk M, Christiansen LE, Cohen AS, Ellegaard K, Fomsgaard A, Franck KT, Larsen NB, Larsen TG, Lassaunière R, Polacek C, Qvesel AG, Sieber RN, Rasmussen LD, Stegger M, Spiess K, Tang MHE, Vestergaard LS, Andersen TE, Hoegh SV, Pedersen RM, Skov MN, Steinke K, Sydenham TV, Hoppe M, Nielsen L, Krause TG, Ullum H, Jokelainen P. First cases of SARS-CoV-2 BA.2.86 in Denmark, 2023. Euro Surveill 2023; 28:2300460. [PMID: 37676147 PMCID: PMC10486197 DOI: 10.2807/1560-7917.es.2023.28.36.2300460] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 09/08/2023] Open
Abstract
We describe 10 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant BA.2.86 detected in Denmark, including molecular characteristics and results from wastewater surveillance that indicate that the variant is circulating in the country at a low level. This new variant with many spike gene mutations was classified as a variant under monitoring by the World Health Organization on 17 August 2023. Further global monitoring of COVID-19, BA.2.86 and other SARS-CoV-2 variants is highly warranted.
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Affiliation(s)
- Morten Rasmussen
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
- These authors contributed equally to this work and share first authorship
| | - Frederik Trier Møller
- These authors contributed equally to this work and share first authorship
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Vithiagaran Gunalan
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Sharmin Baig
- Sequencing and Bioinformatics, Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Marc Bennedbæk
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Kirsten Ellegaard
- Sequencing and Bioinformatics, Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Fomsgaard
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Kristina Træholt Franck
- Virus Surveillance and Research Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | | | - Tine Graakjær Larsen
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Ria Lassaunière
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Charlotta Polacek
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Amanda Gammelby Qvesel
- Virus Surveillance and Research Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Raphael Niklaus Sieber
- Sequencing and Bioinformatics, Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Lasse Dam Rasmussen
- Virus Surveillance and Research Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Marc Stegger
- Sequencing and Bioinformatics, Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
- Antimicrobial Resistance and Infectious Diseases Laboratory, Harry Butler Institute, Murdoch University, Perth, Australia
| | - Katja Spiess
- Virus Research and Development Laboratory, Virus & Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Man-Hung Eric Tang
- Sequencing and Bioinformatics, Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | | | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Silje Vermedal Hoegh
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Rune Micha Pedersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Marianne Nielsine Skov
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Kat Steinke
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Thomas Vognbjerg Sydenham
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Morten Hoppe
- Department of Clinical Microbiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Lene Nielsen
- Department of Clinical Microbiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Tyra Grove Krause
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | | | - Pikka Jokelainen
- Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
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10
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Stærk K, Jensen LK, Andersen TE. Evaluation of urine dipstick tests in experimental porcine urinary tract infection with uropathogenic Escherichia coli. Sci Rep 2023; 13:12404. [PMID: 37524716 PMCID: PMC10390499 DOI: 10.1038/s41598-023-39239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/21/2023] [Indexed: 08/02/2023] Open
Abstract
Urinary tract infection is a common disease in pigs and a major reason for sows to be culled. The disease, however, is difficult to diagnose due to lack of distinct clinical signs in the animals. We evaluated the diagnostic value of two commercial urine dipstick tests in 10 pigs using an experimental model of Escherichia coli urinary tract infection. Urine collected at baseline and 48 h after inoculation were analyzed. We show that dipstick tests positive of blood, leucocytes and particularly nitrite are very specific for E. coli UTI with a 100% positive predictive value.
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Affiliation(s)
- Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark.
| | | | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
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11
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Tentor F, Grønholt Schrøder B, Nielsen S, Schertiger L, Stærk K, Emil Andersen T, Bagi P, Feldskov Nielsen L. Author Correction: Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters. Sci Rep 2023; 13:6443. [PMID: 37081107 PMCID: PMC10119277 DOI: 10.1038/s41598-023-32920-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Affiliation(s)
- Fabio Tentor
- Coloplast A/S, Holtedam 1, 3050, Humlebæk, Denmark.
| | | | | | | | - Kristian Stærk
- Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000, Odense, Denmark
- Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000, Odense, Denmark
- Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000, Odense, Denmark
| | - Per Bagi
- Department of Urology, Centre for Cancer and Organ Diseases, Rigshospitalet, Blegdamsvej 9, 2100, København, Denmark
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12
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Stærk K, Grønnemose RB, Palarasah Y, Lund L, Andersen TE. Intracellular uropathogenic Escherichia coli are undetectable in urinary bladders after oral mecillinam treatment: An experimental study in a pig model of cystitis. Microb Pathog 2022; 173:105817. [DOI: 10.1016/j.micpath.2022.105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
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13
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Tentor F, Grønholt Schrøder B, Nielsen S, Schertiger L, Stærk K, Emil Andersen T, Bagi P, Feldskov Nielsen L. Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters. Sci Rep 2022; 12:17818. [PMID: 36280778 PMCID: PMC9592621 DOI: 10.1038/s41598-022-21122-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/22/2022] [Indexed: 01/19/2023] Open
Abstract
Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract infections, and that may impact the quality of life for urinary catheter users. Examples of such parameters include, urine flowrate, occurrence of flow-stops, and residual urine left in the bladder after flow-stop. Reliable in-vitro and/or ex-vivo laboratory models represent a strong asset to assess the performance of urinary catheters, preceding and guiding in-vivo animal studies and/or human clinical studies. Existing laboratory models are generally simplified, covering only portions of the catheterization process, or poorly reflect clinical procedures. In this work, we developed an ex-vivo porcine lower urinary tract model that better reflects the catheterization procedure in humans and allows to investigate the performance of standard of care catheters. The performance of three standard of care catheters was investigated in the developed model showing significant differences in terms of flowrate. No differences were detected in terms of residual volume in the bladder at first flow-stop also when tuning the abdominal pressure to mimic a sitting down and standing up position. A newly discovered phenomenon named hammering was detected and measured. Lastly, mucosal suction was observed and measured in all standard of care catheters, raising the concern for microtrauma during catheterization and a need for new and improved urinary catheter designs. Results obtained with the ex-vivo model were compared to in-vivo studies, highlighting similar concerns.
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Affiliation(s)
- Fabio Tentor
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | | | - Simon Nielsen
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | - Lars Schertiger
- grid.424097.c0000 0004 1755 4974Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark
| | - Kristian Stærk
- grid.10825.3e0000 0001 0728 0170Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000 Odense, Denmark
| | - Thomas Emil Andersen
- grid.10825.3e0000 0001 0728 0170Research Unit of Clinical Microbiology, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløws Vej 21, 5000 Odense, Denmark
| | - Per Bagi
- grid.475435.4Department of Urology, Centre for Cancer and Organ Diseases, Rigshospitalet, Blegdamsvej 9, 2100 København, Denmark
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14
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Thomsen BL, Christensen JB, Rodenko O, Usenov I, Grønnemose RB, Andersen TE, Lassen M. Accurate and fast identification of minimally prepared bacteria phenotypes using Raman spectroscopy assisted by machine learning. Sci Rep 2022; 12:16436. [PMID: 36180775 PMCID: PMC9524333 DOI: 10.1038/s41598-022-20850-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/20/2022] [Indexed: 11/09/2022] Open
Abstract
The worldwide increase of antimicrobial resistance (AMR) is a serious threat to human health. To avert the spread of AMR, fast reliable diagnostics tools that facilitate optimal antibiotic stewardship are an unmet need. In this regard, Raman spectroscopy promises rapid label- and culture-free identification and antimicrobial susceptibility testing (AST) in a single step. However, even though many Raman-based bacteria-identification and AST studies have demonstrated impressive results, some shortcomings must be addressed. To bridge the gap between proof-of-concept studies and clinical application, we have developed machine learning techniques in combination with a novel data-augmentation algorithm, for fast identification of minimally prepared bacteria phenotypes and the distinctions of methicillin-resistant (MR) from methicillin-susceptible (MS) bacteria. For this we have implemented a spectral transformer model for hyper-spectral Raman images of bacteria. We show that our model outperforms the standard convolutional neural network models on a multitude of classification problems, both in terms of accuracy and in terms of training time. We attain more than 96% classification accuracy on a dataset consisting of 15 different classes and 95.6% classification accuracy for six MR-MS bacteria species. More importantly, our results are obtained using only fast and easy-to-produce training and test data.
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Affiliation(s)
| | | | - Olga Rodenko
- Danish Fundamental Metrology, Kogle Allé 5, 2970, Hørsholm, Denmark
| | - Iskander Usenov
- Institute of Optics and Atomic Physics, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany.,Art photonics GmbH, Rudower Ch 46, 12489, Berlin, Germany
| | - Rasmus Birkholm Grønnemose
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, J.B. Winsløws Vej 21.2, 5000, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, J.B. Winsløws Vej 21.2, 5000, Odense, Denmark
| | - Mikael Lassen
- Danish Fundamental Metrology, Kogle Allé 5, 2970, Hørsholm, Denmark.
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15
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Stærk K, Hjelmager JS, Alm M, Thomsen P, Andersen TE. A new catheter-integrated drug-delivery system for controlled intravesical mitomycin C release. Urol Oncol 2022; 40:409.e19-409.e26. [PMID: 35753849 DOI: 10.1016/j.urolonc.2022.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/01/2022] [Accepted: 05/24/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Intravesical treatment of bladder cancer is preferred over systemic administration. However, the efficacy of intravesical instillations is challenged by the periodic voiding that flushes out the instilled drug and ultimately reduces drug exposure to the bladder epithelium. Here, we demonstrate a new catheter-integrated drug-delivery concept that utilizes a silicone-based interpenetrating polymer network (IPN) as material for the catheter balloon, to facilitate continuous release of the bladder cancer adjuvant, Mitomycin C, from a balloon-reservoir to the urinary bladder. METHODS Long-term release properties and anti-carcinoma cell efficacy of released drug was investigated in vitro. Short-term release experiments were performed in live pigs to evaluate the IPN prototype catheter in a physiological relevant environment in vivo. RESULTS Sustained zero-order release of Mitomycin C was achieved for 12 days in vitro without refilling the balloon. Mitomycin C was released from the IPN-balloons into the urinary bladder of live pigs in concentrations adequate to inhibit carcinoma cell growth. CONCLUSION The IPN catheter represents a new drug-delivery concept for prolonged Mitomycin C delivery to the urinary bladder.
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Affiliation(s)
- Kristian Stærk
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Thomas Emil Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
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16
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Andersen K, Arenholt LTS, Stærk K, Andersen TE, Lund L. [Simple, recurrent, and complicated urinary tract infections]. Ugeskr Laeger 2022; 184:V03220200. [PMID: 35959824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Urinary tract infection is a colonisation of the urinary tract with uropathogenic bacteria, leading to an inflammatory response. The increasing antimicrobial resistance presents major challenges for both the individual and our society. The goal is to reduce antimicrobial resistance and pave the way for a new era in the management of recurrent urinary tract infections. This review describes the definitions of urinary tract infection (simple, recurrent, and complicated) as well as examination and treatment recommendations. The future and most common non-antibiotic alternatives are discussed.
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Affiliation(s)
| | | | - Kristian Stærk
- Forskningsenheden Klinisk Mikrobiologisk Afdeling, Klinisk Institut, Syddansk Universitet
| | - Thomas Emil Andersen
- Forskningsenheden Klinisk Mikrobiologisk Afdeling, Klinisk Institut, Syddansk Universitet
| | - Lars Lund
- Urologisk Afdeling, Odense Universitetshospital
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17
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Abstract
Urinary tract infection (UTI) is one of the most common bacterial infections worldwide. Experimental models that accurately reflect the high susceptibility to UTI in humans have, however, been lacking. This situation has limited detailed research into the early bladder colonization by uropathogens and the early innate defence mechanisms elicited to prevent this. We recently presented a model of urinary tract infection in pigs, animals that are naturally susceptible to UTI and have greater similarity to the physiology and anatomy of the human urinary tract than traditional rodent UTI models. In the current study, we used the pig model to investigate the minimal infectious inoculum of uropathogenic Escherichia coli, the most common cause of urinary tract infection. We show that in this animal a few individual bacteria that come into contact with the urothelium can give rise to fulminant cystitis, indicating the high infectious potential of uropathogenic E. coli.
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Affiliation(s)
- Kristian Stærk
- Research unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | | | - Thomas Emil Andersen
- Research unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark.,Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
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18
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Andersen TE, Ravn SL, Meildal A, Roessler KK. Values-based Cognitive Behavioral Therapy for the Prevention of Chronic Whiplash Associated Disorders: A Randomized Controlled Trial. Eur J Pain 2022; 26:1256-1268. [PMID: 35364620 PMCID: PMC9322531 DOI: 10.1002/ejp.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Background Whiplash is a common traffic‐related injury with up to 50% of those affected continuing to experience symptoms one‐year post‐injury. Unfortunately, treatments have not proven highly effective in preventing and treating chronic symptomatology. The overall aim of this study was to test the effectiveness of an early values‐based cognitive‐behavioural therapeutic intervention (V‐CBT) delivered within 6 months post‐injury in preventing chronic symptomatology compared to wait list controls. Methods The study was a two‐armed randomized controlled trial. Participants (n = 91) experienced pain, disability and at least one psychological risk factor (e.g. enhanced pain‐catastrophizing) after a whiplash trauma no later than 6 months prior. Participants were randomized to 10 sessions of V‐CBT starting 1 week (group A) or 3 months (group B) post‐randomization. The primary outcome was pain‐related disability, while secondary outcomes were pain intensity, neck‐pain related disability, depression, anxiety, PTSD symptoms, pain‐catastrophizing and kinesiophobia. These were evaluated at baseline and at 3, 6, 9 and 12 months post‐randomization. Results At 3 months, group A demonstrated clinically important effects on all outcomes that were significantly better than group B (waitlist). When group B received the intervention at 6 months, they also demonstrated clinically important effects on all outcomes. However, there was a significant difference at 12 months for the primary outcome, in which group B increased their disability levels, while group A remained stable. Conclusions While this indicates that an intervention window for early prevention of disability after whiplash injury may exist, this needs to be tested in a truly early intervention. Significance An early Values‐based Cognitive Behavioural Therapeutic intervention delivered within 6 months post‐injury (mean days 117) was effective in reducing pain‐related disability and psychological distress compared to the control group that received the intervention later after a three months wait‐list period. The effects were sustained at 12 months follow‐up. The early intervention was significantly more effective in reducing pain‐related disability compared to the control group, indicating that an intervention window for early prevention of disability after whiplash injury may exist.
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Affiliation(s)
- T E Andersen
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
| | - S L Ravn
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
| | - A Meildal
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
| | - K K Roessler
- University of Southern Denmark: Syddansk Universitet, Odense, Denmark
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19
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Marbjerg L, Stougaard CL, Sørensen SAG, Thomsen AV, Wang L, Andersen L, Andersen TE, Kallipolitis B, Kemp M. A New Tool for Analyses of Whole Genome Sequences Reveals Dissemination of Specific Strains of Vancomycin-Resistant Enterococcus faecium in a Hospital. Front Med (Lausanne) 2021; 8:733676. [PMID: 34778297 PMCID: PMC8578741 DOI: 10.3389/fmed.2021.733676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/05/2021] [Indexed: 12/03/2022] Open
Abstract
A new easy-to-use online bioinformatic tool analyzing whole genome sequences of healthcare associated bacteria was used by a local infection control unit to retrospectively map genetic relationship of isolates of E. faecium carrying resistance genes to vancomycin in a hospital. Three clusters of isolates were detected over a period of 5 years, suggesting transmission between patients. Individual relatedness between isolates within each cluster was established by SNP analyses provided by the system. Genetic antimicrobial resistance mechanisms to antibiotics other than vancomycin were identified. The results suggest that the system is suited for hospital surveillance of E. faecium carrying resistance genes to vancomycin in settings with access to next Generation Sequencing without bioinformatic expertise for interpretation of the genome sequences.
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Affiliation(s)
- Lis Marbjerg
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Amalie Vørs Thomsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lis Wang
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lise Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Birgitte Kallipolitis
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Michael Kemp
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Regional Department of Clinical Microbiology, Zealand University Hospital, Slagelse, Denmark
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20
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Pedersen RM, Tornby DS, Bang LL, Madsen LW, Skov MN, Sydenham TV, Steinke K, Jensen TG, Johansen IS, Andersen TE. Rectally shed SARS-CoV-2 in COVID-19 inpatients is consistently lower than respiratory shedding and lacks infectivity. Clin Microbiol Infect 2021; 28:304.e1-304.e3. [PMID: 34763059 PMCID: PMC8575534 DOI: 10.1016/j.cmi.2021.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/17/2021] [Accepted: 10/30/2021] [Indexed: 12/18/2022]
Abstract
Objectives Assessment of whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been propagated during intestinal passage and infectivity is conserved when shed rectally by hospitalized individuals. Methods An exploratory cohort study including 28 inpatients with coronavirus disease 2019 with estimation of RNA levels by RT-PCR and of viral infectivity by culturing of viral material sampled concomitantly and identically from pharynx and rectum. Results SARS-CoV-2 RNA was detected more frequently (91%, 30/33 versus 42%, 14/33, p <0.0001) and at higher concentrations (median levels 2 190 186 IU/mL versus 13 014 IU/mL, p <0.0001) in the pharyngeal swabs than in the rectal swabs. For all sample pairs (n = 33) the rectal swabs contained undetectable or lower SARS-CoV-2 RNA concentrations than their paired pharyngeal swabs. Replicative virus was found in 37% (11/30) of the PCR-positive pharyngeal swabs, whereas none of the PCR-positive rectal swabs could be cultured (0%, 0/14) despite containing SARS-CoV-2 RNA concentrations up to 1 544 691 IU/mL. Conclusions Our data draw into question whether SARS-CoV-2 is transmitted readily from faeces.
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Affiliation(s)
- Rune Micha Pedersen
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Ditte Sandfeld Tornby
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Line Lundegård Bang
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Lone Wulff Madsen
- Department of Infectious Diseases, Odense University Hospital and Research Unit of Infectious Diseases, University of Southern Denmark, Odense, Denmark
| | - Marianne Nielsine Skov
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thomas Vognbjerg Sydenham
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Kat Steinke
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thøger Gorm Jensen
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Isik Somuncu Johansen
- Department of Infectious Diseases, Odense University Hospital and Research Unit of Infectious Diseases, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital and Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark.
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21
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Stærk K, Grønnemose RB, Nielsen TK, Petersen NA, Palarasah Y, Torres-Puig S, Møller-Jensen J, Kolmos HJ, Lund L, Andersen TE. Escherichia coli type-1 fimbriae are critical to overcome initial bottlenecks of infection upon low-dose inoculation in a porcine model of cystitis. Microbiology (Reading) 2021; 167. [PMID: 34623231 PMCID: PMC8698211 DOI: 10.1099/mic.0.001101] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Most uropathogenic Escherichia coli (UPEC) express type-1 fimbriae (T1F), a key virulence factor for urinary tract infection (UTI) in mice. Evidence that conclusively associates this pilus with uropathogenesis in humans has, however, been difficult to obtain. We used an experimental porcine model of cystitis to assess the role of T1F in larger mammals more closely related to humans. Thirty-one pigs were infected with UPEC strain UTI89 or its T1F deficient mutant, UTI89ΔfimH, at inoculum titres of 102 to 108 colony forming units per millilitre. Urine and blood samples were collected and analysed 7 and 14 days post-inoculation, and whole bladders were removed at day 14 and analysed for uroepithelium-associated UPEC. All animals were consistently infected and reached high urine titres independent of inoculum titre. UTI89ΔfimH successfully colonized the bladders of 1/6 pigs compared to 6/6 for the wild-type strain. Intracellular UPEC were detectable in low numbers in whole bladder explants. In conclusion, low doses of UPEC are able to establish robust infections in pigs, similar to what is presumed in humans. T1F are critical for UPEC to surpass initial bottlenecks during infection but may be dispensable once infection is established. While supporting the conclusions from mice studies regarding a general importance of T1F in successfully infecting the host, the porcine UTI models’ natural high, more human-like, susceptibility to infection, allowed us to demonstrate a pivotal role of T1F in initial establishment of infection upon a realistic low-inoculum introduction of UPEC in the bladder.
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Affiliation(s)
- Kristian Stærk
- Research Unit of Clinical Microbiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rasmus Birkholm Grønnemose
- Research Unit of Clinical Microbiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Kastberg Nielsen
- Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nicky Anúel Petersen
- Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Yaseelan Palarasah
- Department of Cancer and Inflammation Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Sergi Torres-Puig
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Jakob Møller-Jensen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lars Lund
- Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Urology, Odense University Hospital, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
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22
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Niyonkuru M, Pedersen RM, Assing K, Andersen TE, Skov MN, Johansen IS, Madsen LW. Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report. BMC Infect Dis 2021; 21:743. [PMID: 34344321 PMCID: PMC8330202 DOI: 10.1186/s12879-021-06429-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/12/2021] [Indexed: 01/05/2023] Open
Abstract
Background The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses and further addresses the immunological aspects. Case presentations Oropharyngeal swaps were collected continuously during hospitalization for two immunocompromised patients infected with SARS-CoV-2 and sent for analysis to real time reverse transcription polymerase chain reaction (RT-PCR), viral culture assessed by plaque assay and full genome sequencing. Blood samples for flow cytometry and further immunological analysis were taken once during admission. One patient was without symptoms of Coronavirus disease 2019 (COVID-19) whereas the other had severe respiratory symptoms requiring a stay at an intensive care unit (ICU) and treatment with remdesivir and dexamethasone. Despite their difference in clinical courses, they both continuously shed SARS-CoV-2 with high viral loads in culture. Both patients had undetectable anti SARS-CoV-2 IgG levels about 2 weeks after the first positive real time RT-PCR test of SARS-CoV-2, marked expansions of virus reactive CD8+ T cells but cellular markers indicative of attenuated humoral immunity. Conclusions Our case illustrates the importance of distinguishing isolation guidelines for patients infected with SARS-CoV-2 according to their immunological status. Furthermore, it demonstrates the need for immune markers relating to viral shedding in immunocompromised patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06429-5.
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Affiliation(s)
- Melissa Niyonkuru
- Department of Infectious Diseases, Odense University Hospital, J.B Winsløws Vej 4, 5000, Odense C, Denmark. .,Research Unit for Infectious Diseases, University of Southern Denmark, Odense, Denmark.
| | - Rune Micha Pedersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.,Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Kristian Assing
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.,Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Marianne Nielsine Skov
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.,Research Unit for Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Isik Somuncu Johansen
- Department of Infectious Diseases, Odense University Hospital, J.B Winsløws Vej 4, 5000, Odense C, Denmark.,Research Unit for Infectious Diseases, University of Southern Denmark, Odense, Denmark
| | - Lone Wulff Madsen
- Department of Infectious Diseases, Odense University Hospital, J.B Winsløws Vej 4, 5000, Odense C, Denmark.,Research Unit for Infectious Diseases, University of Southern Denmark, Odense, Denmark
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Stærk K, Grønnemose RB, Palarasah Y, Kolmos HJ, Lund L, Alm M, Thomsen P, Andersen TE. A Novel Device-Integrated Drug Delivery System for Local Inhibition of Urinary Tract Infection. Front Microbiol 2021; 12:685698. [PMID: 34248906 PMCID: PMC8267894 DOI: 10.3389/fmicb.2021.685698] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Catheter-associated urinary tract infection (CAUTI) is a frequent community-acquired infection and the most common nosocomial infection. Here, we developed a novel antimicrobial catheter concept that utilizes a silicone-based interpenetrating polymer network (IPN) as balloon material to facilitate a topical slow-release prophylaxis of antibacterial agents across the balloon to the urinary bladder. Methods: The balloon material was achieved by modifying low shore hardness silicone tubes with a hydrogel interpenetrating polymer in supercritical CO2 using the sequential method. Release properties and antibacterial efficacy of the IPN balloon treatment concept was investigated in vitro and in a porcine CAUTI model developed for the study. In the latter, Bactiguard Infection Protection (BIP) Foley catheters were also assessed to enable benchmark with the traditional antimicrobial coating principle. Results: Uropathogenic Escherichia coli was undetectable in urinary bladders and on retrieved catheters in the IPN treatment group as compared to control that revealed significant bacteriuria (>105 colony forming units/ml) as well as catheter-associated biofilm. The BIP catheters failed to prevent E. coli colonization of the bladder but significantly reduced catheter biofilm formation compared to the control. Conclusion: The IPN-catheter concept provides a novel, promising delivery route for local treatment in the urinary tract.
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Affiliation(s)
- Kristian Stærk
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Rasmus Birkholm Grønnemose
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Yaseelan Palarasah
- Department of Cancer and Inflammation Research, University of Southern Denmark, Odense, Denmark
| | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Lars Lund
- Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
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Nielsen TK, Petersen NA, Stærk K, Grønnemose RB, Palarasah Y, Nielsen LF, Kolmos HJ, Andersen TE, Lund L. A Porcine Model for Urinary Tract Infection. Front Microbiol 2019; 10:2564. [PMID: 31824442 PMCID: PMC6882375 DOI: 10.3389/fmicb.2019.02564] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 10/23/2019] [Indexed: 12/23/2022] Open
Abstract
Urinary tract infection (UTI) is the most common bacterial infectious disease with a high frequency of recurrence and the leading cause of septicemia. In vivo experimentation has contributed significantly to the present-day knowledge on UTI pathogenesis. This research has traditionally been based on murine models of UTI. Occasional conflicting results between UTI in mice and humans and increasing skepticism toward small rodent models in general warrant the need of novel large-animal infection models that better resemble the anatomy and physiology of humans, and thus better mimic the course of infection in humans. Here, we report, to our knowledge, the first large-animal model of cystitis. The model is based on pigs, and the protocol supports the establishment of persistent, non-ascending infection in this animal and is established without invasive surgical procedures, pain, and discomfort for the animal. The course of infection is monitored by cystoscopy, microscopy of bladder biopsies, and biochemical analysis of urine and blood samples. At termination, harvested whole bladders from infected pigs are analyzed for microbiological colonization using microscopy, histology, and viable bacterial counts. The model is a useful tool in future studies of UTI pathogenesis and opens up novel possibilities to bridge the current knowledge obtained from small-animal UTI models to UTI pathogenesis in humans.
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Affiliation(s)
- Thomas Kastberg Nielsen
- Research Unit of Urology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Nicky Anúel Petersen
- Research Unit of Urology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Kristian Stærk
- Research Unit of Clinical Microbiology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Rasmus Birkholm Grønnemose
- Research Unit of Clinical Microbiology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Yaseelan Palarasah
- Department of Cancer and Inflammation, University of Southern Denmark, Odense, Denmark
| | | | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Lars Lund
- Research Unit of Urology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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25
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Christiansen AA, Hendricks RC, Primdahl J, Roessler KK, Andersen TE, Hørslev-Petersen K, Hendricks O. 'Isn't biological treatment something healthy?' Lay people's perceptions of medical terms. Scand J Rheumatol 2018; 48:253-255. [PMID: 30422729 DOI: 10.1080/03009742.2018.1522667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A A Christiansen
- a Department of Rheumatology , King Christian X Hospital for Rheumatic Diseases , Graasten , Denmark.,b Institute for Regional Health Research , University of Southern Denmark , Odense , Denmark
| | - R C Hendricks
- a Department of Rheumatology , King Christian X Hospital for Rheumatic Diseases , Graasten , Denmark.,d Department of Psychology , University of Southern Denmark , Odense , Denmark
| | - J Primdahl
- a Department of Rheumatology , King Christian X Hospital for Rheumatic Diseases , Graasten , Denmark.,b Institute for Regional Health Research , University of Southern Denmark , Odense , Denmark.,c Hospital of Southern Jutland , Aabenraa , Denmark
| | - K K Roessler
- d Department of Psychology , University of Southern Denmark , Odense , Denmark
| | - T E Andersen
- d Department of Psychology , University of Southern Denmark , Odense , Denmark
| | - K Hørslev-Petersen
- a Department of Rheumatology , King Christian X Hospital for Rheumatic Diseases , Graasten , Denmark.,b Institute for Regional Health Research , University of Southern Denmark , Odense , Denmark.,c Hospital of Southern Jutland , Aabenraa , Denmark
| | - O Hendricks
- a Department of Rheumatology , King Christian X Hospital for Rheumatic Diseases , Graasten , Denmark.,b Institute for Regional Health Research , University of Southern Denmark , Odense , Denmark.,c Hospital of Southern Jutland , Aabenraa , Denmark
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26
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Andersen-Civil AIS, Ahmed S, Guerra PR, Andersen TE, Hounmanou YMG, Olsen JE, Herrero-Fresno A. The impact of inactivation of the purine biosynthesis genes, purN and purT, on growth and virulence in uropathogenic E. coli. Mol Biol Rep 2018; 45:2707-2716. [PMID: 30377949 DOI: 10.1007/s11033-018-4441-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022]
Abstract
De novo synthesis of purines has been suggested to be an important factor for the pathogenesis of uropathogenic E. coli (UPEC). We analyzed the role of the redundant purine biosynthesis genes purN and purT, responsible for the third step in the purine biosynthesis, during UPEC infection. Growth experiments in M9 (minimal media), MOPS (rich media), filtered urine, and human serum with E. coli UTI89 and ΔpurN, ΔpurT, and ΔpurN/T mutants revealed that UPEC relies on de novo purine synthesis for growth in minimal medium. Mutants in individual genes as well as the double mutant grew equally well as the wild type in urine, rich media, and serum. However, during competition for growth in urine, the wild type UTI89 strain significantly outcompeted the purine auxotrophic ΔpurN/T mutant from late exponential growth phase. Inactivation of purN and/or purT significantly affected UPEC invasion of human bladder cells, but not the intracellular survival. Cytotoxicity levels to bladder cells were also diminished when both purN and purT were deleted, while single gene mutants did not differ from the wild type. When infecting human macrophages, no differences were observed between UTI89 and mutants in uptake, survival or cytotoxicity. Finally, the lack of the pur-gene(s), whether analysed as single or double gene knock-out, did not affect recovery rates after in vivo infection in a mouse model of UTI. These findings suggest that de novo synthesis of purines might be required only when UPEC is fully deprived of nucleotides and when grown in competition with other microorganisms in urine.
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Affiliation(s)
- Audrey Inge Schytz Andersen-Civil
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Shahana Ahmed
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Priscila Regina Guerra
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Yaovi Mahuton Gildas Hounmanou
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - John Elmerdahl Olsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Ana Herrero-Fresno
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
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27
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Stenger M, Behr-Rasmussen C, Klein K, Grønnemose RB, Andersen TE, Klitgaard JK, Kolmos HJ, Lindholt JS. Systemic thioridazine in combination with dicloxacillin against early aortic graft infections caused by Staphylococcus aureus in a porcine model: In vivo results do not reproduce the in vitro synergistic activity. PLoS One 2017; 12:e0173362. [PMID: 28278183 PMCID: PMC5344393 DOI: 10.1371/journal.pone.0173362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/20/2017] [Indexed: 11/19/2022] Open
Abstract
Introduction Conservative treatment solutions against aortic prosthetic vascular graft infection (APVGI) for inoperable patients are limited. The combination of antibiotics with antibacterial helper compounds, such as the neuroleptic drug thioridazine (TDZ), should be explored. Aim To investigate the efficacy of conservative systemic treatment with dicloxacillin (DCX) in combination with TDZ (DCX+TDZ), compared to DCX alone, against early APVGI caused by methicillin-sensitive Staphylococcus aureus (MSSA) in a porcine model. Methods The synergism of DCX+TDZ against MSSA was initially assessed in vitro by viability assay. Thereafter, thirty-two pigs had polyester grafts implanted in the infrarenal aorta, followed by inoculation with 106 CFU of MSSA, and were randomly administered oral systemic treatment with either 1) DCX or 2) DCX+TDZ. Treatment was initiated one week postoperatively and continued for a further 21 days. Weight, temperature, and blood samples were collected at predefined intervals. By termination, bacterial quantities from the graft surface, graft material, and perigraft tissue were obtained. Results Despite in vitro synergism, the porcine experiment revealed no statistical differences for bacteriological endpoints between the two treatment groups, and none of the treatments eradicated the APVGI. Accordingly, the mixed model analyses of weight, temperature, and blood samples revealed no statistical differences. Conclusion Conservative systemic treatment with DCX+TDZ did not reproduce in vitro results against APVGI caused by MSSA in this porcine model. However, unexpected severe adverse effects related to the planned dose of TDZ required a considerable reduction to the administered dose of TDZ, which may have compromised the results.
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Affiliation(s)
- Michael Stenger
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
- * E-mail:
| | | | - Kasper Klein
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Rasmus B. Grønnemose
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Janne K. Klitgaard
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Jes S. Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
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28
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Abstract
We wanted to explore whether change in LA (left atrium) size would influence LA function, or increase regurgitation in the atrioventricular valves. 595 male elite football players and 47 non-athletic controls were included. End-systolic LA volume and RA area and end-diastolic LV volume and RV area were measured by 2-dimensional (2D) echocardiography Pulsed and colour Doppler were used to estimate tricuspid and mitral regurgitations. 2D longitudinal strain of the 50 football players with the largest LA volumes were compared with the 50 players with the smallest LA volumes. The LA volumes in some athletes with large atria were more than tripled, compared to athletes with small atria. 2D strain however, could not reveal any impairment of LA function in the players with the largest atria, compared to those with the smallest LA. Tricuspid valve regurgitation was found in 343 (58%) of the athletes, compared to 17 (36%) of the controls (p<0.01), while mitral regurgitation was found in 116 (20%) football players and 7 (15%) controls (NS). Furthermore, the RA area was significantly larger in athletes with tricuspid regurgitation compared to athletes without. The present study demonstrated a huge variation in atrial size between the athletes. This variation, however, had no impact on LA function. Tricuspid regurgitation was significantly more prevalent among the athletes, than among the controls.
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Affiliation(s)
- G F Gjerdalen
- Section of Vascular Investigations, Oslo University Hospital, Aker, Oslo, Norway and Bjorknes College, Oslo
| | - J Hisdal
- Section of Vascular Investigations, Oslo University Hospital, Aker, Oslo, Norway and Bjorknes College, Oslo
| | - E E Solberg
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - T E Andersen
- Oslo Sports Trauma Research Center, Oslo, Norway and Norwegian School of Sports Sciences, Oslo, Norway
| | - Z Radunovic
- Department of Cardiology, Oslo University Hospital, Aker, Oslo, Norway
| | - K Steine
- Department of Cardiology, Lorenskog, Akershus University Hospital, Norway
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29
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Citterio L, Franzyk H, Palarasah Y, Andersen TE, Mateiu RV, Gram L. Improved in vitro evaluation of novel antimicrobials: potential synergy between human plasma and antibacterial peptidomimetics, AMPs and antibiotics against human pathogenic bacteria. Res Microbiol 2015; 167:72-82. [PMID: 26499211 DOI: 10.1016/j.resmic.2015.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/06/2015] [Accepted: 10/10/2015] [Indexed: 11/17/2022]
Abstract
Stable peptidomimetics mimicking natural antimicrobial peptides (AMPs) have emerged as a promising class of potential novel antibiotics. In the present study, we aimed at determining whether the antibacterial activity of two α-peptide/β-peptoid peptidomimetics against a range of bacterial pathogens was affected by conditions mimicking in vivo settings. Their activity was enhanced to an unexpected degree in the presence of human blood plasma for thirteen pathogenic Gram-positive and Gram-negative bacteria. MIC values typically decreased 2- to 16-fold in the presence of a human plasma concentration that alone did not damage the cell membrane. Hence, MIC and MBC data collected in these settings appear to represent a more appropriate basis for in vivo experiments preceding clinical trials. In fact, concentrations of peptidomimetics and peptide antibiotics (e.g. polymyxin B) required for in vivo treatments might be lower than traditionally deduced from MICs determined in laboratory media. Thus, antibiotics previously considered too toxic could be developed into usable last-resort drugs, due to ensuing lowered risk of side effects. In contrast, the activity of the compounds was significantly decreased in heat-inactivated plasma. We hypothesize that synergistic interactions with complement proteins and/or clotting factors most likely are involved.
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Affiliation(s)
- Linda Citterio
- Department of Systems Biology, Matematiktorvet, Technical University of Denmark, 2800 Kgs Lyngby, Denmark.
| | - Henrik Franzyk
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | | | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark.
| | - Ramona Valentina Mateiu
- DTU CEN, Fysikvej, Center for Electron Nanoscopy, Technical University of Denmark, 2800 Kgs Lyngby, Denmark.
| | - Lone Gram
- Department of Systems Biology, Matematiktorvet, Technical University of Denmark, 2800 Kgs Lyngby, Denmark.
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Stærk K, Khandige S, Kolmos HJ, Møller-Jensen J, Andersen TE. Uropathogenic Escherichia coli Express Type 1 Fimbriae Only in Surface Adherent Populations Under Physiological Growth Conditions. J Infect Dis 2015; 213:386-94. [PMID: 26290608 DOI: 10.1093/infdis/jiv422] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/10/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Most uropathogenic Escherichia coli (UPEC) strains harbor genes encoding adhesive type 1 fimbria (T1F). T1F is a key factor for successful establishment of urinary tract infection. However, UPEC strains typically do not express T1F in the bladder urine, and little is understood about its induction in vivo. METHODS A flow chamber infection model was used to grow UPEC under conditions simulating distinct infection niches in the bladder. Type 1 fimbriation on isolated UPEC was subsequently determined by yeast cell agglutination and immunofluorescence microscopy, and the results were correlated with the ability to adhere to and invade cultured human bladder cells. RESULTS Although inactive during planktonic growth in urine, T1F expression occurs when UPEC settles on and infects bladder epithelial cells or colonizes catheters. As a result, UPEC in these sessile populations enhances bladder cell adhesion and invasion potential. Only T1F-negative UPEC are subsequently released to the urine, thus limiting T1F expression to surface-associated UPEC alone. CONCLUSIONS Our results demonstrate that T1F expression is strictly regulated under physiological growth conditions with increased expression during surface growth adaptation and infection of uroepithelial cells. This leads to separation of UPEC into low-expression planktonic populations and high-expression sessile populations.
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Affiliation(s)
- Kristian Stærk
- Research Unit of Clinical Microbiology Odense University Hospital, Denmark
| | - Surabhi Khandige
- Department of Biochemistry and Molecular Biology, University of Southern Denmark
| | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology Odense University Hospital, Denmark
| | - Jakob Møller-Jensen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark
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Klein K, Palarasah Y, Kolmos HJ, Møller-Jensen J, Andersen TE. Quantification of filamentation by uropathogenic Escherichia coli during experimental bladder cell infection by using semi-automated image analysis. J Microbiol Methods 2014; 109:110-6. [PMID: 25546841 DOI: 10.1016/j.mimet.2014.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 12/08/2014] [Accepted: 12/23/2014] [Indexed: 01/03/2023]
Abstract
Several rod-shaped pathogens including Escherichia coli, Salmonella spp. and Klebsiella pneumonia are capable of adopting highly filamentous cell shapes under certain circumstances. This phenomenon occurs as a result of continued cell elongation during growth without the usual septation into single rod-shaped cells. Evidence has emerged over the past decade suggesting that this morphological transformation is controlled and reversible and provides selective advantages under certain growth conditions, such as during infection in humans. In order to identify the factors which induce filamentation of bacterial pathogens and study the advantages of bacterial morphological plasticity, methods are needed to accurately quantify changes in bacterial cell shape. In this study, we present a method for quantification of bacterial filamentation based on automatic detection and measurement of bacterial units in focus-stacked microscopy images. Used in combination with a flow-chamber based in vitro cystitis model, we study the factors involved in filament formation by uropathogenic E. coli (UPEC) during infection. The influence of substratum surface, intracellular proliferation and flow media on UPEC filamentation is evaluated. We show that reversible UPEC filamentation during cystitis is not dependent on intracellular infection, which previous studies have suggested. Instead, we find that filamentation can be induced by contact with surfaces, both biological and artificial. Lastly our data indicate that UPEC filamentation is induced by trace-amounts of specific components in urine, rather than being a generic stress-response to high urine salt concentrations. The study shows that the combined methodology is generally useful for investigation of bacterial morphological transitions during cell infection.
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Affiliation(s)
- Kasper Klein
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense C, Denmark
| | - Yaseelan Palarasah
- Research Unit of Immunology and Microbiology, University of Southern Denmark, 5000 Odense C, Denmark
| | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense C, Denmark
| | - Jakob Møller-Jensen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, 5230 Odense M, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense C, Denmark
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32
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Berge HM, Steine K, Andersen TE, Solberg EE, Gjesdal K. MEASUREMENT METHOD IS IMPORTANT FOR INTERPRETATION OF ATHLETES' ECG. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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33
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Kristenson K, Bjørneboe J, Waldén M, Andersen TE, Ekstrand J, Hägglund M. THE NORDIC FOOTBALL INJURY AUDIT: HIGHER INJURY RATES FOR PROFESSIONAL FOOTBALL CLUBS WITH THIRD-GENERATION ARTIFICIAL TURF AT THEIR HOME VENUE. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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35
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Abstract
BACKGROUND ECG is recommended for preparticipation health examination in athletes. Owing to a lack of consensus on how to read and interpret athletes' ECGs, different criteria for abnormality are used. AIMS To compare the prevalence of abnormal ECGs and test the correlation between visual and computer-based measurements. METHODS In a preparticipation cardiac screening examination of 595 male professional soccer players aged 18-38 years, ECGs were categorised according to the European Society of Cardiology's (ESC) recommendations and the Seattle criteria, respectively. Visual measurements were conducted with callipers on-screen on the averaged PQRST complex in each lead, calculated by the trimmed mean. Computer-based measurements were derived from the medium beat. Heart rhythm and conduction were scored visually by a cardiologist. Categorical variables were compared by κ statistics (K) and continuous variables by intraclass correlation. RESULTS ECGs of good quality were available from 579 players. According to the ESC's recommendations and Seattle criteria, respectively, ECGs were categorised as abnormal in 171 (29.5%) vs 64 (11.1%) players after visual assessment, and in 293 (50.6%; K=0.395) vs 127 (21.9%; K=0.564) after computer-based measurements. Intraclass correlation was very good for measurements of R and S wave amplitudes and moderate to very good for intervals. K was very good for pathological Q wave amplitudes and moderate for T wave inversions. CONCLUSIONS Abnormal ECGs were more than twice as common after computer-based than after visual measurements. Such a difference will markedly influence the number of athletes who need further examinations. Reference values may need adjustments dependent on measurement methods.
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Affiliation(s)
- H M Berge
- Oslo Sports Trauma Research Center, The Norwegian School of Sport Sciences, , Oslo, Norway
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Pilely K, Skjoedt MO, Nielsen C, Andersen TE, Louise Aabom A, Vitved L, Koch C, Skjødt K, Palarasah Y. A specific assay for quantification of human C4c by use of an anti-C4c monoclonal antibody. J Immunol Methods 2014; 405:87-96. [PMID: 24472768 DOI: 10.1016/j.jim.2014.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/09/2014] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
The increasing evidence of the implication of the complement system in the pathogenesis of several diseases has emphasized the need for the development of specific and valid assays, optimized for quantitative detection of complement activation in vivo. In the present study, we have developed a mouse monoclonal antibody (mAb) that is able to detect fluid phase C4c without interference from other products generated from the complement component C4. The C4c specific mAb was tested in different enzyme-linked immunosorbent assay (ELISA) combinations with various types of in vitro activated sera and samples from factor I deficient patients. The specificity of the mAb was further evaluated by immunoprecipitation techniques and by analysis of eluted fragments of C4 after immunoaffinity chromatography. The anti-C4c mAb was confirmed to be C4c specific, as it showed no cross-reactivity with native (un-cleaved) C4, C4b, iC4b, or C4d. Also, no reaction was observed with C4 fragments in factor I deficient plasma or serum samples. We established and validated a sandwich ELISA based on this C4c specific antibody. The normal range of C4c in EDTA/futhan plasma collected from 100 Danish blood donors was measured, with a mean of 0.85mg/L and a range of 0.19-2.21mg/L. We believe that the C4c specific antibody and the ELISA might be important tools in the future assessment of in vivo activation in situations where the classical or the lectin complement pathways are involved in the pathogenesis.
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Affiliation(s)
- Katrine Pilely
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Mikkel-Ole Skjoedt
- Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Christian Nielsen
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anne Louise Aabom
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Lars Vitved
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Claus Koch
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Karsten Skjødt
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Yaseelan Palarasah
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark.
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Abstract
Background: It has been debated whether cardiovascular screening of athletes creates negative psychological reactions in those being screened. Neither the athletes’ level of distress towards, nor their opinion about screening has actually been examined. Therefore, the aim of this study was to assess the level of distress among Norwegian elite male football players and their experiences of screening. Methods: After screening, players completed a 10-item scale assessing their experience on a Likert scale. Their level of distress was measured with the intrusion sub-scale of Impact of Event Scale (IES) (7 items) on a six-point scale (grade 0–5). A sum score of ≥19 indicates a clinical stress problem. Twenty-five out of 28 teams, 441 of 591 players (75%, mean age 26 [18–39] years) consented to participate. Results: Sixty-four percent felt more confident when playing football and 88% were satisfied having completed the screening. The majority (77%) felt a need for the screening and 84% would strongly recommend it to others. Sixteen percent were afraid that the screening result might have consequences for their own health, and 13% were afraid of losing their license to play football. Less than 3% experienced distress (IES ≥ 19). Conclusions: The majority of the players were satisfied having completed the screening, felt more confident and would recommend it to other players. Only a marginal proportion of the players were distressed by the screening, but were at least as likely to recommend it.
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Affiliation(s)
- EE Solberg
- Diakonhjemmet Hospital, Department of Medicine, Oslo, Norway
| | | | - TE Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Ø Ekeberg
- Department of Acute Medicine, Oslo University Hospital Ullevål, Oslo, Norway
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Abstract
The aim of this prospective cohort study was to investigate the risk of acute injuries among youth male and female footballers playing on third-generation artificial turf compared with grass. Over 60,000 players 13-19 years of age were followed in four consecutive Norway Cup tournaments from 2005 to 2008. Injuries were recorded prospectively by the team coaches throughout each tournament. The overall incidence of injuries was 39.2 (SD: 0.8) per 1000 match hours; 34.2 (SD: 2.4) on artificial turf and 39.7 (SD: 0.8) on grass. After adjusting for the potential confounders age and gender, there was no difference in the overall risk of injury [odds ratio (OR): 0.93 (0.77-1.12), P=0.44] or in the risk of time loss injury [OR: 1.05 (0.68-1.61), P=0.82] between artificial turf and grass. However, there was a lower risk of ankle injuries [OR: 0.59 (0.40-0.88), P=0.008], and a higher risk of back and spine [OR: 1.92 (1.10-3.36), P=0.021] and shoulder and collarbone injuries [OR: 2.32 (1.01-5.31), P=0.049], on artificial turf compared with on grass. In conclusion, there was no difference in the overall risk of acute injury in youth footballers playing on third-generation artificial turf compared with grass.
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Affiliation(s)
- T Soligard
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
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Bjørneboe J, Flørenes TW, Bahr R, Andersen TE. Injury surveillance in male professional football; is medical staff reporting complete and accurate? Scand J Med Sci Sports 2010; 21:713-20. [PMID: 20459470 DOI: 10.1111/j.1600-0838.2009.01085.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Since the 2000 season, an injury surveillance system has been established to monitor injury risk and injury patterns in the Norwegian professional football league. The aim of this study was to assess the accuracy of routine injury registration performed by medical staff in professional football. The team medical staff completed injury registration forms on a monthly basis throughout the 2007 season (January-October). Players were interviewed at the end of the season (October/November) about all injuries that occurred from July through September. Thirteen of fourteen teams, 296 of 310 A-squad players were interviewed. An injury was recorded when a player was unable to take fully part in football training or match the day after injury. A total of 174 injuries were registered, 123 acute injuries and 51 overuse injuries. Of these, 141 were reported by medical staff and 122 by players. Eighty-nine injuries (51%) were registered using both methods, 52 (30%) by medical staff only and 33 (19%) by player interviews only. Prospective injury surveillance by team medical staff in Norwegian male professional football underestimates the incidence of time-loss injuries by at least one-fifth.
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Affiliation(s)
- J Bjørneboe
- Oslo Sports Trauma Research Center, Department of Sports Medicine Norwegian School of Sport Sciences, Oslo, Norway.
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Palarasah Y, Skjoedt MO, Vitved L, Andersen TE, Skjoedt K, Koch C. Sodium polyanethole sulfonate as an inhibitor of activation of complement function in blood culture systems. J Clin Microbiol 2010; 48:908-14. [PMID: 20042630 PMCID: PMC2832435 DOI: 10.1128/jcm.01985-09] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 11/14/2009] [Accepted: 12/17/2009] [Indexed: 11/20/2022] Open
Abstract
Sodium polyanethole sulfonate (SPS; trade name, Liquoid) is a constituent in culture media used to grow bacteria from blood samples from patients suspected of bacteremia. SPS prevents the killing of bacteria by innate cellular and humoral factors. We analyzed the effect of SPS on the three complement activation pathways: the classical, alternative, and lectin pathways, respectively. Inhibition of complement activity by SPS is caused by a blocking of complement activation and is not a result of complement consumption. The classical pathway is inhibited at SPS concentrations greater than 0.1 mg/ml, and complete inhibition is seen at 0.4 mg/ml. An SPS concentration of 0.5 mg/ml completely inhibits the binding of C1q and subsequent incorporation of C3, C4, and C9. The same was observed for the alternative pathway with an inhibition at SPS concentrations from 0.1 mg/ml and a complete inhibition from 0.4 mg/ml. Here, properdin binding was completely absent, and no incorporation of C3 and C9 was observed. In contrast, the lectin complement pathway remains unaffected at these SPS concentrations, and inhibition is first observed from 0.7 mg/ml. A complete inhibition required concentrations greater than 1 mg/ml. SPS is used in growth media (e.g., BACTEC and BacT/Alert) at concentrations from 0.3 to 0.5 mg/ml. The well-known finding that certain bacteria are growth inhibited by blood factors could therefore be a consequence of the lectin pathway, which is not inhibited at these concentrations. In addition, our findings also open up the possibility of a new assay for the assessment of the functional capacity of the lectin complement pathway.
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Affiliation(s)
- Yaseelan Palarasah
- Research Unit of Immunology and Microbiology, Institute of Medical Biology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark, Research Unit of Clinical Microbiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Mikkel-Ole Skjoedt
- Research Unit of Immunology and Microbiology, Institute of Medical Biology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark, Research Unit of Clinical Microbiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Lars Vitved
- Research Unit of Immunology and Microbiology, Institute of Medical Biology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark, Research Unit of Clinical Microbiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Research Unit of Immunology and Microbiology, Institute of Medical Biology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark, Research Unit of Clinical Microbiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Karsten Skjoedt
- Research Unit of Immunology and Microbiology, Institute of Medical Biology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark, Research Unit of Clinical Microbiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Claus Koch
- Research Unit of Immunology and Microbiology, Institute of Medical Biology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark, Laboratory of Molecular Medicine, Department of Clinical Immunology, Section 7631, Rigshospitalet, Faculty of Health Sciences, University Hospital of Copenhagen, Copenhagen, Denmark, Research Unit of Clinical Microbiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Andersen TE, Kingshott P, Palarasah Y, Benter M, Alei M, Kolmos HJ. A flow chamber assay for quantitative evaluation of bacterial surface colonization used to investigate the influence of temperature and surface hydrophilicity on the biofilm forming capacity of uropathogenic Escherichia coli. J Microbiol Methods 2010; 81:135-40. [PMID: 20188127 DOI: 10.1016/j.mimet.2010.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 02/17/2010] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
Abstract
We have established a simple flow chamber-based procedure which provides an accurate and reproducible way to measure the amount of biofilm formed on an implantable biomaterial surface. The method enables the side-by-side evaluation of different materials under hydrodynamic flow conditions similar to those found on an implanted device. We have used the method to evaluate the biofilm forming capacity of clinically isolated Escherichia coli on silicone rubber and on silicone rubber containing a hydrophilic coating. It was found that the surface chemistry influenced the colonization of the isolates very differently. In addition, the temperature was found to have a considerable influence upon the adhesion and biofilm forming capacity of some of the isolates, and that the influence of surface chemistry depended on temperature. Our results suggest that the step from using E. coli laboratory strains to clinical isolates entails a significant rise in complexity and yields results that cannot be generalized. The results should be valuable information for researchers working with pre-clinical evaluation of device-associated E. coli infections.
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Affiliation(s)
- Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark, 5000 Odense C, Denmark; Nanon A/S, 2605 Brøndby, Denmark.
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Andersen LB, Andersen TE, Andersen E, Anderssen SA. An intermittent running test to estimate maximal oxygen uptake: the Andersen test. J Sports Med Phys Fitness 2008; 48:434-437. [PMID: 18997644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM Monitoring of height and weight in children in schools has been discussed to get data on trends in obesity. Physical fitness may be just as important to monitor and a simple reliable test will therefore be important. The aim of this paper was to analyze the association between VO2max measured during maximal work on a treadmill and running distance in an intermittent running test. METHODS Three different groups conducted an intermittent running test VO2max was measured directly during treadmill running. The groups were 27 physical education students (age 20.0-27.0 years), 57 children (age 9.9-11.0 years), and 14 male elite soccer players (age 14.2-15.0 years). RESULTS The reproducibility of the Andersen test was good (r=0.84). Subjects ran 15 m (SD 61 m) longer the second time, but this difference was not significant (P=0.102). The association between running distance in the Andersen test and VO2max measured on the treadmill showed a correlation coefficient of 0.87 in university students, 0.68 in children, and 0.60 in soccer players. For the whole group: VO2max= 18.38 + (0.03301*distance) - (5.92*sex) (boys=0;girls=1) (r=0.84). CONCLUSION The test may provide teachers and health care professionals with an important tool to estimate physical fitness in children and adolescents in a fast, non-expensive and reliable way.
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Affiliation(s)
- L B Andersen
- Department of Sport Medicine, Norwegian School of Sport Sciences Oslo, Norway.
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Abstract
The purpose was to test the effect of eccentric strength training and flexibility training on the incidence of hamstring strains in soccer. Hamstring strains and player exposure were registered prospectively during four consecutive soccer seasons (1999-2002) for 17-30 elite soccer teams from Iceland and Norway. The first two seasons were used as baseline, while intervention programs consisting of warm-up stretching, flexibility and/or eccentric strength training were introduced during the 2001 and 2002 seasons. During the intervention seasons, 48% of the teams selected to use the intervention programs. There was no difference in the incidence of hamstring strains between teams that used the flexibility training program and those who did not [relative risk (RR)=1.53, P=0.22], nor was there a difference compared with the baseline data (RR=0.89, P=0.75). The incidence of hamstring strains was lower in teams who used the eccentric training program compared with teams that did not use the program (RR=0.43, P=0.01), as well as compared with baseline data for the same intervention teams (RR=0.42, P=0.009). Eccentric strength training with Nordic hamstring lowers combined with warm-up stretching appears to reduce the risk of hamstring strains, while no effect was detected from flexibility training alone. These results should be verified in randomized clinical trials.
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Affiliation(s)
- A Arnason
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
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Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hägglund M, McCrory P, Meeuwisse WH. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med 2006; 40:193-201. [PMID: 16505073 PMCID: PMC2491990 DOI: 10.1136/bjsm.2005.025270] [Citation(s) in RCA: 681] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Variations in definitions and methodologies have created differences in the results and conclusions obtained from studies of football (soccer) injuries, making interstudy comparisons difficult. Therefore an Injury Consensus Group was established under the auspices of Fédération Internationale de Football Association Medical Assessment and Research Centre. A nominal group consensus model approach was used. A working document on definitions, methodology, and implementation was discussed by the group. Iterative draft statements were prepared and circulated to members of the group for comment before the final consensus statement was produced. Definitions of injury, recurrent injury, severity, and training and match exposures in football together with criteria for classifying injuries in terms of location, type, diagnosis, and causation are proposed. Proforma for recording players' baseline information, injuries, and training and match exposures are presented. Recommendations are made on how the incidence of match and training injuries should be reported and a checklist of issues and information that should be included in published reports of studies of football injuries is presented.
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Affiliation(s)
- C W Fuller
- Centre for Sports Medicine, University of Nottingham, Nottingham, UK.
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Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hägglund M, McCrory P, Meeuwisse WH. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scand J Med Sci Sports 2006; 16:83-92. [PMID: 16533346 DOI: 10.1111/j.1600-0838.2006.00528.x] [Citation(s) in RCA: 309] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Variations in definitions and methodologies have created differences in the results and conclusions obtained from studies of football injuries; this has made inter-study comparisons difficult. An Injury Consensus Group was established under the auspices of FIFA Medical Assessment and Research Centre. Using a nominal group consensus model approach, a working document that identified the key issues related to definitions, methodology and implementation was discussed by members of the group during a 2-day meeting. Following this meeting, iterative draft statements were prepared and circulated to members of the group for comment before the final consensus statement was produced. Definitions of injury, recurrent injury, severity and training and match exposures in football together with criteria for classifying injuries in terms of location, type, diagnosis and causation are proposed. Proforma for recording players' baseline information, injuries and training and match exposures are presented. Recommendations are made on how the incidence of match and training injuries should be reported and a checklist of issues and information that should be included in published reports of studies of football injuries is presented. The definitions and methodology proposed in the consensus statement will ensure that consistent and comparable results will be obtained from studies of football injuries.
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Affiliation(s)
- C W Fuller
- Centre for Sports Medicine, University of Nottingham, Nottingham, UK.
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Straume-Naesheim TM, Andersen TE, Dvorak J, Bahr R. Effects of heading exposure and previous concussions on neuropsychological performance among Norwegian elite footballers. Br J Sports Med 2005; 39 Suppl 1:i70-7. [PMID: 16046359 PMCID: PMC1765315 DOI: 10.1136/bjsm.2005.019646] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cross-sectional studies have indicated that neurocognitive performance may be impaired among football players. Heading the ball has been suggested as the cause, but recent reviews state that the reported deficits are more likely to be the result of head injuries. OBJECTIVE To examine the association between previous concussions and heading exposure with performance on computer based neuropsychological tests among professional Norwegian football players. METHODS Players in the Norwegian professional football league (Tippeligaen) performed two consecutive baseline neuropsychological tests (Cogsport) before the 2004 season (90.3% participation, n = 271) and completed a questionnaire assessing previous concussions, match heading exposure (self-reported number of heading actions per match), player career, etc. Heading actions for 18 players observed in two to four matches were counted and correlated with their self-reported values. RESULTS Neither match nor lifetime heading exposure was associated with neuropsychological test performance. Nineteen players scored below the 95% confidence interval for one or more subtasks, but they did not differ from the rest regarding the number of previous concussions or lifetime or match heading exposure. The number of previous concussions was positively associated with lifetime heading exposure (exponent (B) = 1.97(1.03-3.75), p = 0.039), but there was no relation between previous concussions and test performance. Self-reported number of headings correlated well with the observed values (Spearman's rho = 0.77, p < 0.001). CONCLUSION Computerised neuropsychological testing revealed no evidence of neuropsychological impairment due to heading exposure or previous concussions in a cohort of Norwegian professional football players.
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Straume-Naesheim TM, Andersen TE, Bahr R. Reproducibility of computer based neuropsychological testing among Norwegian elite football players. Br J Sports Med 2005; 39 Suppl 1:i64-9. [PMID: 16046358 PMCID: PMC1765313 DOI: 10.1136/bjsm.2005.019620] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Head injuries account for 4-22% of all football injuries. The rate of brain injuries is difficult to assess, due to the problem of defining and grading concussion. Thus computerised testing programs for cognitive function have been developed. OBJECTIVE To assess the reliability of a computerised neuropsychological test battery (CogSport) among Norwegian professional football players. METHODS Norwegian professional football league players (90.3% participation) performed two consecutive baseline Cogsport tests before the 2004 season. CogSport consists of seven different subtasks: simple reaction time (SRT), choice reaction time (ChRT), congruent reaction time (CgRT), monitoring (MON), one-back (OBK), matching (Match) and learning (Learn). RESULTS There was a small but significant improvement from repeated testing for the reaction time measurements of all seven subtasks (SRT: 0.7%, ChRT: 0.4%, CgRT: 1.2%, MON: 1.3%, OBK: 2.7%, Match: 2.0%, Learn: 1.1%). The coefficient of variation (CV) ranged from 1.0% to 2.7%; corresponding intraclass correlation coefficients ranged from 0.45 (0.34 to 0.55) to 0.79 (0.74 to 0.84). The standard deviation data showed higher CVs, ranging from 3.7% (Learn) to 14.2% (SRT). Thus, the variance decreased with increasing complexity of the task. The accuracy data displayed uniformly high CV (10.4-12.2) and corresponding low intraclass correlation coefficient (0.14 (0.01 to 0.26) to 0.31 (0.19 to 0.42)). CONCLUSION The reproducibility for the mean reaction time measures was excellent, but less good for measures of accuracy and consistency. Consecutive testing revealed a slight learning effect from test 1 to test 2, and double baseline testing is recommended to minimise this effect.
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Krosshaug T, Andersen TE, Olsen OEO, Myklebust G, Bahr R. Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities. Br J Sports Med 2005; 39:330-9. [PMID: 15911601 PMCID: PMC1725235 DOI: 10.1136/bjsm.2005.018358] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A number of different methodological approaches have been used to describe the inciting event for sports injuries. These include interviews of injured athletes, analysis of video recordings of actual injuries, clinical studies (clinical findings of joint damage are studied to understand the injury mechanism, mainly through plain radiography, magnetic resonance imaging, arthroscopy, and computed tomography scans), in vivo studies (ligament strain or forces are measured to understand ligament loading patterns), cadaver studies, mathematical modelling and simulation of injury situations, and measurement/estimation from "close to injury" situations. In rare cases, injuries have even occurred during biomechanical experiments. This review describes each research approach and assesses its strengths and weaknesses in contributing to the understanding and prevention of sports injuries.
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Affiliation(s)
- T Krosshaug
- Oslo Sports Trauma Research Center, Norwegian University of Sport and Physical Education, Oslo, Norway
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49
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Abstract
OBJECTIVES This study describes the characteristics of injuries and high risk situations in the Norwegian professional football league during one competitive season using Football Incident Analysis (FIA), a video based method. METHODS Videotapes and injury information were collected prospectively for 174 of 182 (96%) regular league matches during the 2000 season. Incidents where the match was interrupted due to an assumed injury were analysed using FIA to examine the characteristics of the playing situation causing the incident. Club medical staff prospectively recorded all acute injuries on a specific injury questionnaire. Each incident identified on the videotapes was cross referenced with the injury report. RESULTS During the 174 matches, 425 incidents were recorded and 121 acute injuries were reported. Of these 121 injuries, 52 (43%) were identified on video including all head injuries, 58% of knee injuries, 56% of ankle injuries, and 29% of thigh injuries. Strikers were more susceptible to injury than other players and although most of the incidents and injuries resulted from duels, no single classic injury situation typical for football injuries or incidents could be recognised. However, in most cases the exposed player seemed to be unaware of the opponent challenging him for ball possession. CONCLUSIONS This study shows that in spite of a thorough video analysis less than half of the injuries are identified on video. It is difficult to identify typical patterns in the playing events leading to incidents and injuries, but players seemed to be unaware of the opponent challenging them for ball possession.
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Affiliation(s)
- T E Andersen
- Oslo Sports Trauma Research Center, Norwegian University of Sport and Physical Education, PO Box 4014, Ullevål Stadion, Oslo 0806, Norway.
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50
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Abstract
OBJECTIVES The aim of this study was to describe, using video analysis, the mechanisms of head injuries and of incidents with a high risk of head injury in elite football. METHODS Videotapes and injury information were collected prospectively for 313 of the 409 matches played in the Norwegian (2000 season) and Icelandic (1999 and 2000 season) professional leagues. Video recordings of incidents where a player appeared to be hit in the head and the match was consequently interrupted by the referee were analysed and cross referenced with reports of acute time loss injuries from the team medical staff. RESULTS The video analysis revealed 192 incidents (18.8 per 1000 player hours). Of the 297 acute injuries reported, 17 (6%) were head injuries, which corresponds to an incidence of 1.7 per 1000 player hours (concussion incidence 0.5 per 1000 player hours). The most common playing action was a heading duel with 112 cases (58%). The body part that hit the injured player's head was the elbow/arm/hand in 79 cases (41%), the head in 62 cases (32%), and the foot in 25 cases (13%). In 67 of the elbow/arm/hand impacts, the upper arm of the player causing the incident was at or above shoulder level, and the arm use was considered to be active in 61 incidents (77%) and intentional in 16 incidents (20%). CONCLUSIONS This study suggests that video analysis provides detailed information about the mechanisms for head injuries in football. The most frequent injury mechanism was elbow to head contact, followed by head to head contact in heading duels. In the majority of the elbow to head incidents, the elbow was used actively at or above shoulder level, and stricter rule enforcement or even changes in the laws of the game concerning elbow use should perhaps be considered, in order to reduce the risk of head injury.
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Affiliation(s)
- T E Andersen
- Oslo Sports Trauma Research Center, Norwegian University of Sport and Physical Education, P O Box 4014, Ulleval Stadion, 0806 Oslo, Norway.
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