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1.
BMC Womens Health ; 18(1): 158, 2018 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-30253769

RESUMO

BACKGROUND: Induced abortion is one of the most common gynecological procedures in Sweden, but there is still little knowledge about the adverse effects. The aims of this study are to provide an overview of complications of medical and surgical abortions and to evaluate the impact of bacterial screening to prevent postabortal infections. METHODS: All women who underwent induced abortion at Skaraborg Hospital between 2008 and 2015 are included in the study. Bacterial screening for chlamydia, gonorrhea, mycoplasma, and bacterial vaginosis was performed prior to the abortions. Abortion complications, categorized as bleeding, infection, or incomplete abortion were assessed in women who came in contact with the gynecological clinic within 30 days after the procedure. RESULTS: A total of 4945 induced abortions were performed during the study period. Nearly all, 4945 (99.7%) were eligible for inclusion in the study. Medical abortions < 12 weeks were the most common procedure (74.7%), followed by surgical abortions (17.5%), and medical abortion > 12 weeks (7.8%). Complications were registered in 333 (6.7%) of all abortions. Among medical abortions < 12 weeks, the complication frequency increased significantly, from 4.2% in 2008 to 8.2% in 2015 (RR 1.49, 95% 1.04-2.15). An incomplete abortion was the most common complication related to medical abortions < 12 weeks. Of all women who tested positive for one or several bacteria at the screening and therefore received antibiotics, 1.4% developed a postabortal infection. Among those who tested negative at the screening, 1.7% developed infectious complications. CONCLUSIONS: The share of complications related to medical abortions < 12 weeks increased significantly during 2008-2015 without any evident cause. Women who tested positive for one or several bacteria upon screening and received antibiotics experienced almost an equal proportion of postabortal infections compared to women who tested negative upon screening. The screening process seems to fulfill its purpose of reducing the risk of infectious complications.


Assuntos
Aborto Incompleto/epidemiologia , Aborto Induzido/efeitos adversos , Aborto Induzido/métodos , Infecções Bacterianas/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Abortivos/uso terapêutico , Aborto Incompleto/etiologia , Aborto Induzido/tendências , Adulto , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/tratamento farmacológico , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/epidemiologia , Feminino , Seguimentos , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Humanos , Incidência , Estudos Longitudinais , Programas de Rastreamento , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/epidemiologia , Complicações Pós-Operatórias/etiologia , Gravidez , Período Pré-Operatório , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Suécia/epidemiologia , Vaginose Bacteriana/diagnóstico , Vaginose Bacteriana/tratamento farmacológico , Vaginose Bacteriana/epidemiologia
2.
Diabetologia ; 56(4): 867-74, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23344730

RESUMO

AIMS/HYPOTHESIS: Enterovirus (e.g. Coxsackie B virus serotypes [CVBs]) infections may be associated with development of type 1 diabetes. Studies conducted in several European countries have, however, shown an inverse correlation between the incidence of type 1 diabetes and the prevalence of enterovirus infections. These findings could in part be explained by an extension of the poliovirus hypothesis, suggesting that the absence of maternally transferred antibodies protecting offspring from early infection increases the risk for diabetes development. Experimental evidence supporting this hypothesis in type 1 diabetes is, however, lacking. As maternally transferred protection from infection is a crucial component of the extended poliovirus hypothesis, we here tested the hypothesis that previously infected females transfer protection against infection and diabetes to offspring. METHODS: The induction of CVB-specific maternal antibodies and transfer of protection from virus infection, replication and development of virus-induced diabetes to offspring was assessed using NOD and Socs1-transgenic NOD mice. RESULTS: Infected mice produced neutralising antibodies to CVB. Offspring from infected females were positive for neutralising antibodies and were strongly protected from both infection and experimental diabetes. CONCLUSIONS/INTERPRETATION: Our study shows that maternally transferred antibodies protect offspring from enterovirus infection and virus-induced diabetes. This suggests that the absence of maternally provided protection increases the risk for severe outcomes after an enterovirus infection in offspring. Moreover, our findings may have implications for the design of prospective studies aimed at investigating the possible role of enterovirus infections in the aetiology of human type 1 diabetes.


Assuntos
Diabetes Mellitus Experimental/prevenção & controle , Infecções por Enterovirus/complicações , Infecções por Enterovirus/prevenção & controle , Animais , Anticorpos Antivirais/imunologia , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/imunologia , Infecções por Enterovirus/imunologia , Feminino , Imunoglobulina G/imunologia , Masculino , Exposição Materna , Camundongos , Camundongos Endogâmicos NOD , Camundongos Transgênicos , Gravidez , Prenhez
3.
Acta Neurol Scand ; 126(5): 336-43, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22360378

RESUMO

OBJECTIVES: The most widely used and studied neurostimulation procedure for medically refractory epilepsy is vagus nerve stimulation (VNS) Therapy. The goal of this study was to develop a computational model for improved understanding of the anatomy and neurophysiology of the vagus nerve as it pertains to the principles of electrical stimulation, aiming to provide clinicians with a systematic and rational understanding of VNS Therapy. MATERIALS AND METHODS: Computational modeling allows the study of electrical stimulation of peripheral nerves. We used finite element electric field models of the vagus nerve with VNS Therapy electrodes to calculate the voltage field for several output currents and studied the effects of two programmable parameters (output current and pulse width) on optimal fiber activation. RESULTS: The mathematical models correlated well with strength-duration curves constructed from actual patient data. In addition, digital constructs of chronic versus acute implant models demonstrated that at a given pulse width and current combination, presence of a 110-µm fibrotic tissue can decrease fiber activation by 50%. Based on our findings, a range of output current settings between 0.75 and 1.75 mA with pulse width settings of 250 or 500 µs may result in optimal stimulation. CONCLUSIONS: The modeling illustrates how to achieve full or nearly full activation of the myelinated fibers of the vagus nerve through output current and pulse width settings. This knowledge will enable clinicians to apply these principles for optimal vagus nerve activation and proceed to adjust duty cycle and frequency to achieve effectiveness.


Assuntos
Simulação por Computador , Modelos Neurológicos , Modelos Teóricos , Estimulação do Nervo Vago , Nervo Vago/fisiologia , Potenciais de Ação/fisiologia , Epilepsia/fisiopatologia , Epilepsia/terapia , Humanos
4.
Acta Neurol Scand ; 123(1): 48-53, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20199515

RESUMO

OBJECTIVES: The prognostic value of acute postoperative seizures (APS) after epilepsy surgery is much debated. This study evaluated APS, defined as seizures in the first week post-surgery, as a predictor of long-term seizure outcome, and investigated the utility of other potential outcome predictors. MATERIALS AND METHODS: Medical records of 48 patients with temporal and extra-temporal epilepsy surgery were studied. Forty patients had lesional surgery. All had at least 2 year postoperative follow-up. RESULTS: At 2 year follow-up, 25 patients (53%) were seizure free. Univariate analysis showed that APS (P = 0.048), using ≥ six AEDs prior to surgery (P = 0.03), pathological postoperative EEG (P = 0.043) and female gender (P = 0.012) were associated with seizure recurrence. CONCLUSIONS: Univariate analysis indicate that APS, a high number of AEDs used prior to surgery, and pathological postoperative EEG are possible predictors of seizure recurrence after epilepsy surgery. Only gender retained significance in the multivariate analysis.


Assuntos
Complicações Pós-Operatórias/fisiopatologia , Convulsões/etiologia , Adulto , Epilepsia/cirurgia , Feminino , Humanos , Estudos Longitudinais , Masculino , Noruega , Razão de Chances , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Convulsões/diagnóstico , Resultado do Tratamento , Adulto Jovem
6.
Acta Neurol Scand Suppl ; 187: 55-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17419830

RESUMO

BACKGROUND: The value of vagus nerve stimulation (VNS) for treating patients with drug-resistant idiopathic generalized epilepsy (IGE) is not well documented. PATIENTS AND METHODS: Twelve patients (2 males, 10 females) with a mean age of 31 years (11-48 years) and with drug-resistant IGE had VNS implanted in the period 1995-2006. All had generalized seizures documented by video-electroencephalogram. Mean follow-up period was 23 months (9-54 months). RESULTS: There was a total seizure reduction of 61% (P = 0.0002). There was 62% reduction of generalized tonic-clonic seizures (P = 0.0020), 58% of absences (P = 0.0003) and 40% of myoclonic seizures (P = 0.0156). Eight patients were considered responders (>50% seizure reduction); two of these patients became seizure-free. Five out of seven patients with juvenile myoclonic epilepsy were responders. At the last follow-up visit, the patients had reduced the anti-epileptic drug (AED) usage from an average of 2.3 to 1.7 AED per patient (P = 0.0625). Two patients are currently being treated with VNS therapy only. Nine patients reported side effects, which were mostly mild and tended to diminish over time. CONCLUSION: Our results indicate that adjunctive VNS therapy is a favourable treatment option for patients with drug-resistant IGE. Rapid cycling seems worth trying in some of the non-responders.


Assuntos
Terapia por Estimulação Elétrica/normas , Epilepsia Generalizada/terapia , Nervo Vago/fisiologia , Potenciais de Ação/fisiologia , Adolescente , Adulto , Anticonvulsivantes/uso terapêutico , Encéfalo/fisiopatologia , Criança , Resistência a Medicamentos/fisiologia , Terapia por Estimulação Elétrica/efeitos adversos , Terapia por Estimulação Elétrica/estatística & dados numéricos , Eletrodos Implantados/efeitos adversos , Eletrodos Implantados/normas , Eletroencefalografia , Epilepsias Mioclônicas/fisiopatologia , Epilepsias Mioclônicas/terapia , Epilepsia Generalizada/fisiopatologia , Epilepsia Tônico-Clônica/fisiopatologia , Epilepsia Tônico-Clônica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Fibras Aferentes Viscerais/fisiologia
7.
APMIS ; 115(7): 809-13, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17614847

RESUMO

Papanicolaou-stained cervicovaginal smears (Pap smears) are used to screen for cervical cancer. Since there is a lack of consensus in published reports respecting the efficacy of Pap-stained smears in BV diagnostics, there is a need to validate their use for diagnosis of BV. Slides from the international BV00 workshop were Pap stained and independently analyzed by four investigators under a phase-contrast microscope. All workshop slides--whether Pap-stained, Gram-stained or rehydrated air-dried smears--were scored according to the same Nugent classification. The diagnostic accuracy of Pap smears for diagnosis of BV had a sensitivity of 0.85 and a specificity of 0.92, with a positive and negative predictive value of 0.84 and 0.93, respectively. The interobserver weighted kappa index was 0.86 for Pap-stained smears compared to 0.81 for Gram-stained smears, and 0.70 for rehydrated air-dried smears using the mean Nugent score as the criterion standard. Provided that the samples are taken from equivalent locations (the vaginal fornix) and analyzed according to the same scoring criteria, there is no discernable difference in the diagnostic accuracy of the three smear-staining methods. The Pap-stained vaginal smears can be used as a wholly adequate alternative to Gram-stained smears for BV diagnosis.


Assuntos
Teste de Papanicolaou , Esfregaço Vaginal , Vaginose Bacteriana/diagnóstico , Adulto , Feminino , Humanos
8.
BMC Womens Health ; 7: 20, 2007 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-17953762

RESUMO

BACKGROUND: Bacterial vaginosis (BV) during pregnancy is associated with an increased risk of preterm delivery but little is known about factors that could predict BV. We have analyzed if it is possible to identify a category of pregnant women that should be screened for BV, and if BV would alter the pregnancy outcome at term; we have also studied the treatment efficacy of clindamycin. METHODS: Prospective BV screening and treatment study of 9025 women in a geographically defined region in southeast Sweden. BV was defined as a modified Nugent score of 6 and above. Data was collected from the Swedish Medical Birth Register. Women allocated to treatment were supplied with vaginal clindamycin cream. The main outcome goals were to identify factors that could predict BV. RESULTS: Vaginal smears were consistent with BV criteria in 9.3%. Logistic regression indicates a significant correlation between smoking and BV (p < 0.001) and a greater prevalence of BV in the lower age groups (p < 0.001). We found no correlation between BV and history of preterm deliveries, previous miscarriages, extra-uterine pregnancies, infertility problems or reported history of urinary tract infections-factors that earlier have been associated with BV. Treatment with clindamycin cream showed a cure rate of 77%. Less than 1% of women with a normal vaginal smear in early pregnancy will develop BV during the pregnancy. There was no association between BV and the obstetric outcome among women who delivered at term. Women with BV, both treated patients and nontreated, had the same obstetric outcome at term as women with normal vaginal flora. CONCLUSION: BV is more than twice as common among smokers, and there is a higher prevalence in the younger age group. However these two markers for BV do not suffice as a tool for screening, and considering the lack of other risk factors associated with BV, screening of all pregnant women might be a strategy to follow in a program intended to reduce the number of preterm births.


Assuntos
Clindamicina/administração & dosagem , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Vaginose Bacteriana/tratamento farmacológico , Vaginose Bacteriana/epidemiologia , Adulto , Antibacterianos/administração & dosagem , Feminino , Humanos , Modelos Logísticos , Programas de Rastreamento/estatística & dados numéricos , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Prevalência , Estudos Prospectivos , Fatores de Risco , Suécia/epidemiologia , Resultado do Tratamento , Cremes, Espumas e Géis Vaginais/administração & dosagem , Esfregaço Vaginal/estatística & dados numéricos
9.
Epilepsy Res ; 69(1): 80-6, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16516443

RESUMO

OBJECTIVE: To evaluate the sensitivity of a simultaneous whole-head 306-channel magnetoencephalography (MEG)/70-electrode EEG recording to detect interictal epileptiform activity (IED) in a prospective, consecutive cohort of patients with medically refractory epilepsy that were considered candidates for epilepsy surgery. METHODS: Seventy patients were prospectively evaluated by simultaneously recorded MEG/EEG. All patients were surgical candidates or were considered for invasive EEG monitoring and had undergone an extensive presurgical evaluation at a tertiary epilepsy center. MEG and EEG raw traces were analysed individually by two independent reviewers. RESULTS: MEG data could not be evaluated due to excessive magnetic artefacts in three patients (4%). In the remaining 67 patients, the overall sensitivity to detect IED was 72% (48/67 patients) for MEG and 61% for EEG (41/67 patients) analysing the raw data. In 13% (9/67 patients), MEG-only IED were recorded, whereas in 3% (2/67 patients) EEG-only IED were recorded. The combined sensitivity was 75% (50/67 patients). CONCLUSION: Three hundred and six-channel MEG has a similarly high sensitivity to record IED as EEG and appears to be complementary. In one-third of the EEG-negative patients, MEG can be expected to record IED, especially in the case of lateral neocortical epilepsy and/or cortical dysplasia.


Assuntos
Eletroencefalografia , Epilepsias Parciais/patologia , Magnetoencefalografia , Cuidados Pré-Operatórios , Adolescente , Adulto , Criança , Epilepsias Parciais/fisiopatologia , Epilepsias Parciais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade
10.
APMIS ; 113(5): 305-16, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-16011656

RESUMO

The syndrome bacterial vaginosis (BV) is characterized by a disturbed vaginal microflora in which the normally occurring lactobacilli yield quantitatively to an overgrowth of mainly anaerobic bacteria. As BV is a possible cause of obstetrics complications and gynaecological disease--as well as a nuisance to the affected women--there is a strong impetus to find a cure. In BV treatment studies, the diagnosis criteria for diagnosis of BV vary considerably and different methods are used for cure evaluation. The design of study protocols varies and there is no consensus respecting a suitable time for follow-up visits. For the purpose of this review, available data were recalculated for 4-week post treatment cure rates. For oral metronidazole the 4-week cure rate was found not to exceed 60-70%. Treatment regimens with topical clindamycin or topical metronidazole have the same cure rates. It can thus be said that no sound scientific basis exists for recommending any particular treatment. There is no evidence of beneficial effects on BV engendered by partner treatment, or by addition of probiotics or buffered gel. Long-term follow-up (longer than 4 weeks) shows a relapse rate of 70%. With a primary cure rate of 60-70%, and a similar relapse rate documented in the reviewed literature, clinicians simply do not have adequate data for determining treatment or designing clinical studies. This is unfortunate since--apart from the obvious patient benefits--clinical studies can often serve as a guide for more basic studies in the quest for underlying disease mechanisms. In the case of BV there is still a need for continued basic studies on the vaginal flora, local immunity to the flora and host-parasite interactions as an aid when designing informative clinical studies.


Assuntos
Antibacterianos/uso terapêutico , Vaginose Bacteriana/tratamento farmacológico , Vaginose Bacteriana/microbiologia , Antibacterianos/administração & dosagem , Ensaios Clínicos como Assunto , Feminino , Humanos , Gravidez , Recidiva , Síndrome
11.
APMIS ; 113(3): 153-61, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15799757

RESUMO

Diagnosing bacterial vaginosis (BV) has long been based on the clinical criteria of Amsel et al., whereby three of four defined criteria must be satisfied. Though there are other criteria and scoring methods which function well in comparison (i.e. Nugent scoring), it is not certain that they will always identify the same category of patients. Point-of-care methods based on various combinations of microbial products, presence of RNA, or more complex laboratory instrumentations such as sensor arrays, have also been introduced for the diagnosis of BV. No method for diagnosing BV can at present be regarded as the best. It could be that--based partly on tacit knowledge on the part of the clinical investigators scoring in the clinic--various scoring systems have been chosen to fit a particular BV-related problem in a particular population. In this review we critically examine these pertinent issues influencing clinical scoring and laboratory diagnostics of BV.


Assuntos
Vaginose Bacteriana/diagnóstico , Técnicas de Laboratório Clínico , Feminino , Humanos , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/microbiologia
12.
APMIS ; 113(4): 233-45, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15865604

RESUMO

Whether bacterial vaginosis (BV) is acquired from an endogenous or an exogenous source is subject to controversy. Despite findings of an association between sexual behaviour and BV, some data indicate that BV is not a sexually transmitted infection in the traditional sense, while other data indicate that BV is an exogenous infection. A third aspect of BV is its tendency to go unnoticed by affected women. All of this will have a strong impact on how physicians view the risks of asymptomatic BV. This review focuses on whether or not BV should be regarded as a sexually transmitted infection (STI), its role in postoperative infections and pelvic inflammatory disease (PID), and on whether or not treatment of BV during pregnancy to reduce preterm delivery should be recommended. The reviewed studies do not lend unequivocal support to an endogenous or exogenous transmission of the bacteria present in BV. For women undergoing gynaecological surgery such as therapeutic abortion, the relative risk of postoperative infection is clearly elevated (approx. 2.3-2.8). A weaker association exists between BV and pelvic inflammatory disease. Data on treatment of BV as a way of reducing preterm delivery are inconclusive and do not support recommendations for general treatment of BV during pregnancy. The discrepant associations between BV and preterm birth found in recent studies may be explained by variations in immunological response to BV. Genetic polymorphism in the cytokine response--both regarding the TNF alleles and in interleukin production--could make women more or less susceptible to BV, causing different risks of preterm birth. Thus, studies on the vaginal inflammatory response to microbial colonization should be given priority.


Assuntos
Transmissão de Doença Infecciosa , Complicações Pós-Operatórias/etiologia , Complicações Infecciosas na Gravidez , Resultado da Gravidez , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Vaginose Bacteriana/transmissão , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Clindamicina/uso terapêutico , Feminino , Humanos , Metanálise como Assunto , Metronidazol/uso terapêutico , Doença Inflamatória Pélvica/etiologia , Gravidez , Resultado da Gravidez/epidemiologia , Risco , Vaginose Bacteriana/tratamento farmacológico , Vaginose Bacteriana/epidemiologia
13.
APMIS ; 113(2): 81-90, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15723682

RESUMO

The development of bacterial vaginosis (BV) among women of childbearing age and the resulting quantitative and qualitative shift from normally occurring lactobacilli in the vagina to a mixture of mainly anaerobic bacteria is a microbiological and immunological enigma that so far has precluded the formulation of a unifying generally accepted theory on the aetiology and clinical course of BV. This critical review highlights some of the more important aspects of BV research that could help in formulating new basic ideas respecting the biology of BV, not least the importance of the interleukin mediators of local inflammatory responses and the bacterial shift from the normally occurring lactobacilli species: L. crispatus, L. gasseri, L. jensenii, and L. iners to a mixed flora dominated by anaerobic bacteria.


Assuntos
Vaginose Bacteriana/imunologia , Vaginose Bacteriana/microbiologia , Animais , Bactérias Anaeróbias/imunologia , Feminino , Humanos , Lactobacillus/imunologia
14.
Complement Ther Med ; 13(1): 4-10, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15907672

RESUMO

OBJECTIVES: To compare traditional Chinese acupuncture, minimal acupuncture at non-acupoints and conventional treatment for chronic sinusitis. DESIGN: A three-armed single blind randomised controlled study. SETTING: In an outpatient specialist clinic, we recruited 65 patients with symptoms of sinusitis >3 months and signs of sinusitis on computed tomography (CT). INTERVENTIONS: We randomised patients to one of three study arms: (1) 2-4 weeks of medication with antibiotics, corticosteroids, 0.9% sodium chloride solution, and local decongestants (n=21), (2) 10 treatments with traditional Chinese acupuncture (n=25), or (3) 10 treatments with minimal acupuncture at non-acupoints (n=19). OUTCOME MEASURES: Change in sinus soft tissue swelling on CT, symptoms of sinusitis, and health-related quality of life (HRQoL), using the two component summary scales of the Short Form 36 and a rating scale. RESULTS: In the conventional treatment group, sinus soft tissue swelling was reduced over 4 weeks (p=0.04), and HRQoL improved over 12 weeks (p=0.01-0.05). Pairwise comparisons of changes in total symptom score between the groups showed signs of a difference between conventional medication and sham over 4 weeks (p=0.06). CONCLUSION: Sinus soft tissue swelling was reduced in the conventional treatment group over 4 weeks, and HRQoL improved over 12 weeks. Only a non-significant difference in symptom score change over 4 and 12 weeks was shown between conventional medication and traditional Chinese acupuncture.


Assuntos
Acupuntura/métodos , Corticosteroides/uso terapêutico , Antibacterianos/uso terapêutico , Sinusite/terapia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Medição da Dor , Qualidade de Vida , Sinusite/tratamento farmacológico , Sinusite/fisiopatologia , Resultado do Tratamento
15.
Clin Neurophysiol ; 126(12): 2261-8, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25735477

RESUMO

OBJECTIVE: Electroencephalogram (EEG) is commonly used to monitor brain activity in preterm neonates. Long-term EEG is used to predict outcomes by total band power. This study reports effective connectivity analyses in the fronto-parietal network in preterm infants. METHOD: Directed transfer functions (DTFs) were used in fully automated calculations of effective connectivity. Continuous eight-channel EEG recordings were performed for three full days starting at a median of 5.3h (2.5-11.2h) after birth. Analyses were performed using the channels Fp1, Fp2, P3 and P4. DTF were calculated every second in every connection and channel for all frequencies from 1 Hz to 30 Hz. The median connectivity was used in the connectivity assessment. RESULTS: Parieto-frontal connectivity was significantly higher (0.22) than fronto-parietal connectivity (0.05). There was a significant decrease in parieto-frontal connectivity between day one (0.18) and three. Conversely, there was a significant increase in fronto-parietal connectivity from day one to day three (0.07). CONCLUSION: Significant changes are seen in connectivity from day one to three, but there were no certain connectivity differences between gestational ages. SIGNIFICANCE: A rapid change in fronto-parietal connectivity was seen from day one to three which may indicate fast postpartum maturation.


Assuntos
Encéfalo/fisiologia , Eletroencefalografia/tendências , Recém-Nascido Prematuro/fisiologia , Eletroencefalografia/métodos , Feminino , Humanos , Recém-Nascido , Masculino , Vias Neurais/fisiologia , Fatores de Tempo
16.
APMIS ; 100(7): 655-62, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1642854

RESUMO

A hybridization assay for direct detection and identification of Mobiluncus species has been developed and tested. A [32P]-labelled synthetic oligonucleotide probe, complementary to a nucleotide sequence in the variable region V8 of Mobiluncus 16S ribosomal RNA, was utilized. One of the advantages of using rRNA as target molecule for the hybridization assays is the copy number of rRNA, which can be as high as 10(4), and that additionally three to six sites on the minus strand of the DNA gene can be utilized. This probe was found to be sensitive and to react with 62 of 68 tested typical or atypical Mobiluncus isolates. It was also specific, and was shown not to react with 96 tested unrelated bacterial species and isolates, including taxonomically closely related species like Actinomyces or Bifidobacterium spp., or with bacteria isolated from the vagina of both healthy persons with an undisturbed flora, as well as from patients suffering from the bacterial vaginosis syndrome (BV).


Assuntos
Infecções por Bacteroidaceae/microbiologia , Bacteroidaceae/isolamento & purificação , Sondas de DNA/genética , DNA Ribossômico/genética , Vaginose Bacteriana/microbiologia , Bacteroidaceae/genética , Sequência de Bases , Feminino , Humanos , Dados de Sequência Molecular , Hibridização de Ácido Nucleico , RNA Ribossômico 16S/genética , Sensibilidade e Especificidade
17.
APMIS ; 110(11): 811-8, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12596717

RESUMO

An international workshop on vaginal smear-based diagnosis of bacterial vaginosis was organized where 13 investigators scoring 258 slides with smears from vaginal fluid. Interobserver reproducibility of interpretations of Nugent scores, Hay/Ison scores and wet smear scores for the diagnosis of bacterial vaginosis was shown to be high. Detailed analysis of individual scoring results however indicated that basic standards of quality control to ensure robust individual readings of slides must be adhered to.


Assuntos
Variações Dependentes do Observador , Esfregaço Vaginal , Vaginose Bacteriana/diagnóstico , Técnicas Bacteriológicas/normas , Estudos de Avaliação como Assunto , Feminino , Humanos , Esfregaço Vaginal/normas , Vaginose Bacteriana/microbiologia
18.
Obstet Gynecol ; 76(4): 727-30, 1990 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-2216211

RESUMO

Among 235 women attending an outpatient clinic, the diagnosis of bacterial vaginosis was made using three of the following four criteria: typical discharge, pH more than 4.5, positive amine sniff test, and clue cells in a wet smear. These findings were correlated with the finding of clue cells in air-dried wet smears rehydrated more than 1 month after the visit. The rehydrated specimens had the same microscopic appearance as a nonpreserved wet smear. The demonstration of clue cells in the rehydrated smears correlated with the composite diagnosis of bacterial vaginosis with a sensitivity of 96% and specificity of 98%. In a busy multi-physician setting, the scoring of clue cells in stored and rehydrated smears can be used to obtain consistent readings for wet-smear diagnostics, thus simplifying teaching and increasing the utility of wet smears in clinical research.


Assuntos
Gardnerella vaginalis/isolamento & purificação , Infecções por Haemophilus/microbiologia , Esfregaço Vaginal , Vaginite/microbiologia , Feminino , Infecções por Haemophilus/diagnóstico , Humanos , Manejo de Espécimes/métodos , Vaginite/diagnóstico
19.
Obstet Gynecol ; 77(3): 450-2, 1991 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1992415

RESUMO

Seventy women scheduled for abdominal hysterectomy were examined for the presence of clue cells in the vaginal discharge in an attempt to identify a possible risk group for development of postoperative infection. Seven of 20 women (35%) with clue cells developed vaginal cuff infections or wound infections, compared with four of 50 women (8%) without clue cells (P less than .01). Women with bacterial vaginosis, diagnosed by air-dried vaginal smears, are therefore at risk for postoperative infection.


Assuntos
Infecções Bacterianas/microbiologia , Histerectomia , Complicações Pós-Operatórias/microbiologia , Adulto , Células Epiteliais , Epitélio/microbiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Esfregaço Vaginal
20.
Int J STD AIDS ; 2(5): 362-4, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1958722

RESUMO

The sexual behaviour of 400 women with and 400 women without bacterial vaginosis from a health screening programme was investigated by a questionnaire to see if women with bacterial vaginosis had similar behaviours to women considered at risk for STDs. These patients were randomly selected from computer records. Eight hundred questionnaires were distributed and 641 women answered. The age of first sexual intercourse was lower among women with bacterial vaginosis (17.8 years) than those without (18.6 years; P less than 0.001). Number of lifetime sexual partners was higher among women with bacterial vaginosis (P less than 0.001). Women with bacterial vaginosis smoked or had smoked more often. These results indicate that women with bacterial vaginosis have similar sexual behaviour to those at risk for STDs.


Assuntos
Comportamento Sexual , Vaginose Bacteriana/transmissão , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores de Risco , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/patologia , Fumar/epidemiologia , Inquéritos e Questionários , Suécia/epidemiologia , Esfregaço Vaginal , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/patologia
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