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Tärnvik, Arne
Publications (10 of 19) Show all publications
Tärnvik, A. (2018). Management of complicated skin and skin structure infections: a call for infectious disease specialists. Infectious Diseases, 50(2), 117-118
Open this publication in new window or tab >>Management of complicated skin and skin structure infections: a call for infectious disease specialists
2018 (English)In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 50, no 2, p. 117-118Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Infectious Medicine
Identifiers
urn:nbn:se:umu:diva-144851 (URN)10.1080/23744235.2017.1363405 (DOI)000423482600004 ()28812401 (PubMedID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-06-09Bibliographically approved
Eneslätt, K., Rietz, C., Rydén, P., Stöven, S., House, R. V., Wolfraim, L. A., . . . Sjöstedt, A. (2011). Persistence of cell-mediated immunity three decades after vaccination with the live vaccine strain of Francisella tularensis. European Journal of Immunology, 41(4), 974-980
Open this publication in new window or tab >>Persistence of cell-mediated immunity three decades after vaccination with the live vaccine strain of Francisella tularensis
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2011 (English)In: European Journal of Immunology, ISSN 0014-2980, E-ISSN 1521-4141, Vol. 41, no 4, p. 974-980Article in journal (Refereed) Published
Abstract [en]

The efficacy of many vaccines against intracellular bacteria depends on the generation of cell-mediated immunity, but studies to determine the duration of immunity are usually confounded by re-exposure. The causative agent of tularemia, Francisella tularensis, is rare in most areas and, therefore, tularemia vaccination is an interesting model for studies of the longevity of vaccine-induced cell-mediated immunity. Here, lymphocyte proliferation and cytokine production in response to F. tularensis were assayed in two groups of 16 individuals, vaccinated 1-3 or 27-34 years previously. As compared to naïve individuals, vaccinees of both groups showed higher proliferative responses and, out of 17 cytokines assayed, higher levels of MIP-1β, IFN-γ, IL-10, and IL-5 in response to recall stimulation. The responses were very similar in the two groups of vaccinees. A statistical model was developed to predict the immune status of the individuals and by use of two parameters, proliferative responses and levels of IFN-γ, 91.1% of the individuals were correctly classified. Using flow cytometry analysis, we demonstrated that during recall stimulation, expression of IFN-γ by CD4(+) CCR7(+) , CD4(+) CD62L(+) , CD8(+) CCR7(+) , and CD8(+) CD62L(+) cells significantly increased in samples from vaccinated donors. In conclusion, cell-mediated immunity was found to persist three decades after tularemia vaccination without evidence of decline.

Place, publisher, year, edition, pages
Weinheim: Wiley-VCH Verlagsgesellschaft, 2011
Keywords
Cell-mediated immunity, Francisella tularensis, Persistence, Vaccination
National Category
Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-50333 (URN)10.1002/eji.201040923 (DOI)000288821000011 ()21442618 (PubMedID)
Available from: 2011-12-06 Created: 2011-12-06 Last updated: 2018-06-08Bibliographically approved
Tärnvik, A. & Stenberg, B. (2010). Suitability of the multiple case method when applied on dermatology and infectious diseases at the clinical stage of medical education. The Internet Journal of Medical Education, 1(1)
Open this publication in new window or tab >>Suitability of the multiple case method when applied on dermatology and infectious diseases at the clinical stage of medical education
2010 (English)In: The Internet Journal of Medical Education, ISSN 2155-6725, Vol. 1, no 1Article in journal (Refereed) Published
Abstract [en]

Background: By mimicking situations relevant to future work conditions, the multiple case method aims to trigger student interest in a subject and to induce familiarity with subject knowledge. Objectives: Our main aim was to assess the suitability of the multiple case method when applied at the clinical stage of medical education. Moreover, we wished to define the maximum group size with which students felt comfortable. Methods: Between 2001 and 2007, during 24 runs of a course in dermatology and infectious diseases, student assessments of the multiple case method were rated. Between 1993 and 2007, 1323 student evaluations were scrutinized for comments on group size. Results: On a 1-5 scale (1= value poor, 5= value high), student ratings of the multiple case method remained consistent at 4.4 to 4.7. When the number of participants in the discussion groups was 18 - 25, no comments on group size occurred. When size increased to 26 - 33 participants, 4/605 (0.7%) commented spontaneously that they would prefer discussing in a smaller group. At a size of 34 – 37, 20/396 (5.1%) expressed such a concern.

Place, publisher, year, edition, pages
Internet Scientific Publications, 2010
Keywords
Case methodology, Clinical medicine, group size
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-35727 (URN)
Available from: 2010-09-01 Created: 2010-09-01 Last updated: 2018-06-08Bibliographically approved
Tärnvik, A. & Chu, M. C. (2007). New approaches to diagnosis and therapy of tularemia.. Annals of the New York Academy of Sciences, 1105, 378-404
Open this publication in new window or tab >>New approaches to diagnosis and therapy of tularemia.
2007 (English)In: Annals of the New York Academy of Sciences, ISSN 0077-8923, Vol. 1105, p. 378-404Article in journal (Refereed) Published
Keywords
Animals, Anti-Bacterial Agents/therapeutic use, Drug Resistance; Bacterial, Francisella tularensis/genetics/physiology, Humans, Molecular Diagnostic Techniques, Tularemia/diagnosis/pathology/physiopathology/therapy
Identifiers
urn:nbn:se:umu:diva-7177 (URN)17468229 (PubMedID)
Available from: 2008-01-04 Created: 2008-01-04 Last updated: 2018-06-09Bibliographically approved
Tärnvik, A. (2007). Revival of the case method: a way to retain student-centred learning in a post-PBL era.. Medical Teacher, 29(1), e32-6
Open this publication in new window or tab >>Revival of the case method: a way to retain student-centred learning in a post-PBL era.
2007 (English)In: Medical Teacher, ISSN 1466-187X, Vol. 29, no 1, p. e32-6Article in journal (Refereed) Published
Keywords
Education; Medical/*methods, Educational Measurement, Humans, Models; Educational, Problem-Based Learning, Teaching/*methods
Identifiers
urn:nbn:se:umu:diva-7178 (URN)17538830 (PubMedID)
Available from: 2008-01-12 Created: 2008-01-12 Last updated: 2018-06-09Bibliographically approved
Palo, T. R., Ahlm, C. & Tärnvik, A. (2005). Climate variability reveals complex events for tularemia dynamics in man and mammals. Ecology & society, 10(1), Article ID 22.
Open this publication in new window or tab >>Climate variability reveals complex events for tularemia dynamics in man and mammals
2005 (English)In: Ecology & society, ISSN 1708-3087, E-ISSN 1708-3087, Vol. 10, no 1, article id 22Article in journal (Refereed) Published
Abstract [en]

Tularemia is caused by the bacterium Francisella tularensis, but the natural reservoir is unknown and environmental conditions for outbreaks in mammals and man are poorly understood. The present study analyzed the synchrony between the North Atlantic Oscillation (NAO) index, the number of human cases of tularemia reported in Sweden, and the density of hares. Climate variation at a lag of 2 yr explained as a single factor similar to 27% of the variation in the number of tularemia cases over time. A low NAO index, indicating cold winters, and low water flow in rivers during the coming summer were associated with high numbers of human cases of tularemia 2 yr later. The number of mountain hares was not related to NAO or to the number of cases of tularemia. The change in mountain hare numbers was negatively associated with the number of human cases, showing the sensitivity of this species to the disease. Low turnover in water environments may at some point in time trigger a chain of events leading to increased replication of F. tularensis via unknown reservoirs and/or vectors that affect humans and mammals. A possible increase in the NAO index with a future warmer climate would not be expected to facilitate a higher frequency of tularemia outbreaks in Sweden.

Place, publisher, year, edition, pages
Wolfville: Resilience alliance, 2005
Keywords
tularemia, climate, North Atlantic Oscillation index, disease transmission, global warming, Francisella tularensis, Lepus timidus
National Category
Environmental Sciences Ecology
Identifiers
urn:nbn:se:umu:diva-120418 (URN)000230237900010 ()
Available from: 2016-06-08 Created: 2016-05-16 Last updated: 2018-06-07Bibliographically approved
Lindgren, H., Stenman, L., Tärnvik, A. & Sjöstedt, A. (2005). The contribution of reactive nitrogen and oxygen species to the killing of Francisella tularensis LVS by murine macrophages.. Microbes and infection, 7(3), 467-475
Open this publication in new window or tab >>The contribution of reactive nitrogen and oxygen species to the killing of Francisella tularensis LVS by murine macrophages.
2005 (English)In: Microbes and infection, ISSN 1286-4579, E-ISSN 1769-714X, Vol. 7, no 3, p. 467-475Article in journal (Refereed) Published
Abstract [en]

Intracellular killing of Francisella tularensis by macrophages depends on interferon-gamma (IFN-gamma)-induced activation of the cells. The importance of inducible nitric oxide synthase (iNOS) or NADPH phagocyte oxidase (phox) for the cidal activity was studied. Murine IFN-gamma-activated peritoneal exudate cells (PEC) produced nitric oxide (NO), measured as nitrite plus nitrate, and superoxide. When PEC were infected with the live vaccine strain, LVS, of F. tularensis, the number of viable bacteria was at least 1000-fold lower in the presence than in the absence of IFN-gamma after 48 h of incubation. PEC from iNOS-gene-deficient (iNOS-/-) mice killed F. tularensis LVS less effectively than did PEC from wild-type mice. PEC from phox gene-deficient (p47phox-/-) mice were capable of killing the bacteria, but killing was less efficient, although still significant, in the presence of NG-monomethyl-L-arginine (NMMLA), an inhibitor of iNOS. A decomposition catalyst of ONOO-, FeTPPS, completely reversed the IFN-gamma-induced killing of F. tularensis LVS. Under host cell-free conditions, F. tularensis LVS was exposed to S-nitroso-acetyl-penicillamine (SNAP), which generates NO, or 3-morpholinosydnonimine hydrochloride (SIN-1), which generates NO and superoxide, leading to formation of ONOO-. During 6 h of incubation, SNAP caused no killing of F. tularensis LVS, whereas effective killing occurred in the presence of equimolar concentrations of SIN-1. The results suggest that mechanisms dependent on iNOS and to a minor degree, phox, contribute to the IFN-gamma-induced macrophage killing of F. tularensis LVS. ONOO- is likely to be a major mediator of the killing.

Keywords
Animals, Francisella tularensis/*immunology, Macrophage Activation/physiology, Macrophages/*physiology, Mice, Mice; Inbred C57BL, Mice; Knockout, Nitric Oxide Synthase/genetics/physiology, Nitric Oxide Synthase Type II, Oxidoreductases/genetics/physiology, Reactive Nitrogen Species/*physiology, Reactive Oxygen Species/*metabolism
Identifiers
urn:nbn:se:umu:diva-7175 (URN)10.1016/j.micinf.2004.11.020 (DOI)15788155 (PubMedID)
Available from: 2008-01-04 Created: 2008-01-04 Last updated: 2018-06-09Bibliographically approved
Lindgren, H., Stenmark, S., Chen, W., Tärnvik, A. & Sjöstedt, A. (2004). Distinct roles of reactive nitrogen and oxygen species to control infection with the facultative intracellular bacterium Francisella tularensis.. Infection and Immunity, 72(12), 7172-7182
Open this publication in new window or tab >>Distinct roles of reactive nitrogen and oxygen species to control infection with the facultative intracellular bacterium Francisella tularensis.
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2004 (English)In: Infection and Immunity, ISSN 0019-9567, E-ISSN 1098-5522, Vol. 72, no 12, p. 7172-7182Article in journal (Refereed) Published
Abstract [en]

Reactive nitrogen species (RNS) and reactive oxygen species (ROS) are important mediators of the bactericidal host response. We investigated the contribution of these two mediators to the control of infection with the facultative intracellular bacterium Francisella tularensis. When intradermally infected with the live vaccine strain F. tularensis LVS, mice deficient in production of RNS (iNOS(-/-) mice) or in production of ROS by the phagocyte oxidase (p47(phox-/-) mice) showed compromised resistance to infection. The 50% lethal dose (LD(50)) for iNOS(-/-) mice was <20 CFU, and the LD(50) for p47(phox-/-) mice was 4,400 CFU, compared to an LD(50) of >500,000 CFU for wild-type mice. The iNOS(-/-) mice survived for 26.4 +/- 1.8 days, and the p47(phox-/-) mice survived for 10.1 +/- 1.3 days. During the course of infection, the serum levels of gamma interferon (IFN-gamma) and interleukin-6 were higher in iNOS(-/-) and p47(phox-/-) mice than in wild-type mice. Histological examination of livers of iNOS(-/-) mice revealed severe liver pathology. Splenocytes obtained 5 weeks after primary infection from antibiotic-treated iNOS(-/-) mice showed an in vitro recall response that was similar in magnitude and greater secretion of IFN-gamma compared to cells obtained from wild-type mice. In summary, mice lacking expression of RNS or ROS showed extreme susceptibility to infection with F. tularensis LVS. The roles of RNS and ROS seemed to be distinct since mice deficient in production of ROS showed dissemination of infection and died during the early phase of infection, whereas RNS deficiency led to severe liver pathology and a contracted course of infection.

Keywords
Animals, Colony Count; Microbial, Disease Susceptibility, Interferon Type II/blood, Liver/microbiology/pathology, Lymphocyte Activation, Mice, Mice; Inbred C57BL, Nitric Oxide Synthase/physiology, Nitric Oxide Synthase Type II, Reactive Nitrogen Species/*physiology, Reactive Oxygen Species/*metabolism, Skin/microbiology, Superoxides/metabolism, Tularemia/*immunology
Identifiers
urn:nbn:se:umu:diva-7172 (URN)10.1128/IAI.72.12.7172-7182.2004 (DOI)15557642 (PubMedID)
Available from: 2008-01-04 Created: 2008-01-04 Last updated: 2018-06-09Bibliographically approved
Tärnvik, A. (2004). [Importance of non-graded student case discussions]. Lakartidningen, 101(45), 3620
Open this publication in new window or tab >>[Importance of non-graded student case discussions]
2004 (Swedish)In: Lakartidningen, ISSN 0023-7205, Vol. 101, no 45, p. 3620-Article in journal (Other academic) Published
Keywords
Educational Measurement/*methods, Humans, Internship and Residency, Problem-Based Learning/*methods, Students; Medical/psychology, Teaching/methods
Identifiers
urn:nbn:se:umu:diva-7174 (URN)15575434 (PubMedID)
Available from: 2008-01-04 Created: 2008-01-04 Last updated: 2018-06-09Bibliographically approved
Tärnvik, A. (2004). [The case method--engaging teaching method. Realistic exercises make practical training of the medical profession possible]. Lakartidningen, 101(43), 3314-6, 3319
Open this publication in new window or tab >>[The case method--engaging teaching method. Realistic exercises make practical training of the medical profession possible]
2004 (Swedish)In: Lakartidningen, ISSN 0023-7205, Vol. 101, no 43, p. 3314-6, 3319Article in journal (Other academic) Published
Keywords
Clinical Competence, Education; Medical/*methods, Education; Medical; Undergraduate/methods, Humans, Internship and Residency, Problem-Based Learning/*methods, Students; Medical, Teaching/*methods
Identifiers
urn:nbn:se:umu:diva-7168 (URN)15543953 (PubMedID)
Available from: 2008-01-04 Created: 2008-01-04 Last updated: 2018-06-09Bibliographically approved
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