Biomedical subjects

B Andersch

Publications and source records attributed to B Andersch.

At least 19 recordsLinked to original sources

PubMed1999

Factors influencing vaginal fetal fibronectin concentrations during pregnancy.

In order to evaluate factors influencing fetal fibronectin concentrations during pregnancy a total of 312 vaginal samples for fetal fibronectin measurements and microbiological culture were collected and later included in a stepwise regression analysis. Preterm premature rupture of membranes, a modified Bishop score >/=6 (p < 0.0001), a low vaginal polymorphonuclear leukocyte count (p < 0. 002), the presence of Enterococcus faecalis (p < 0.0001), Prevotella species (p < 0.05), a bacterial vaginosis-associated flora (p < 0. 05), and a non-lactobacilli-dominated vaginal flora (p < 0.05) were associated with an elevated vaginal fetal fibronectin concentration.

Adult↗

PubMed1998

Citalopram in premenstrual dysphoria: is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle?

In a double-blind trial, the selective serotonin reuptake inhibitor citalopram was administered to women with severe irritability and/or depressed mood in the luteal but not in the follicular phase of the menstrual cycle (premenstrual dysphoria). Treatment continued for three consecutive menstrual cycles. One group (N = 17 completers) was administered citalopram continuously at a constant dosage (20+/-10 mg/day) throughout the menstrual cycle. A second group (N = 17) also received citalopram continuously throughout the cycle, but at a lower dosage in the follicular phases (5 mg/day) than in the luteal phases (20+/-10 mg/day) (semi-intermittent treatment). A third group (N = 18) received citalopram (20+/-10 mg/day) in the luteal phase only and placebo during the follicular phase (intermittent treatment). A fourth group (N = 17) received placebo throughout the cycles. The side effects of active treatment were generally mild and transient. Intermittent administration of citalopram was clearly more effective than placebo with respect to both reduction in self-rated irritability and self-rated global improvement; it is of interest that intermittent treatment with citalopram also seemed more effective than continuous or semi-intermittent administration of the drug.

Adult↗

PubMed1998

Objective methods cannot predict anal incontinence after primary repair of extensive anal tears.

BACKGROUND: An increased awareness of anal incontinence after delivery tears has developed during the last years. The aim of this study was to compare complaints with the results of physiological methods in women with complete sphincter ruptures primarily repaired at delivery. METHODS: Twenty-seven women, 16 with total rupture of the external anal sphincter and 11 who also had a ruptured internal anal sphincter were studied. Interviews on pelvic floor function, investigation with recto-anal manometry, single fiber EMG and anal endosonography were performed at 11.9 (2.5) months after delivery. Fifteen women vaginally delivered without sphincter rupture served as controls. RESULTS: Pelvic floor dysfunction was admitted in 74%, in particular gas incontinence (59%). Maximum squeeze pressure was significantly reduced (p<0.01) compared to controls, while resting anal pressure was unaffected. Fiber density was increased in 81% of patients and 91% had detectable defects on endosonography. Neither the degree of rupture nor the presence of complaints significantly correlated to the objective methods. CONCLUSIONS: A majority of women with primarily repaired anal sphincter ruptures at delivery were incontinent. Sphincter defects and signs of neuropathy could not precisely predict symptoms.

Adult↗

PubMed1997

A longitudinal study of birth control and pregnancy outcome among women in a Swedish population.

The prevalence of contraception and pregnancy outcome in the same women, at 19, 24, and 29 years of age, was assessed in a longitudinal cohort study using a postal questionnaire technique. A one-in-four random sample of all women born in 1962 and resident in the city of Göteborg in 1981, was obtained from the population register (n = 656). Respondents from 1981 were re-assessed in 1986 and 1991. Four hundred thirty women (66%) answered the questionnaire on all three occasions and are included in the analysis. Contraceptive usage was as follows (at 19, 24, and 29 years of age, respectively): oral contraception (OC) 47%/51%/22%; intrauterine device 3%/11%/19%; barrier methods 12%/12%/20%; depot gestagen 0/0.2%/0.4%; no contraception 39%/26%/25%. OCs had been taken at some time by 93%. Reasons give for cessation of OC were: contraception not required 10%/21%/20%; fear of OC 28%/32%/35%; menstrual disorder 17%/13%/14%; weight increase 20%/16%/15%; mental side effects 14%/ 21%/20%; desire to become pregnant 7%/33%/52%. Pregnancy outcome was as follows: Ever pregnant 17%/42%/ 71%; children 5% had 1-2 children/27% had 1-3 children/ 59% had 1-5 children; 12%/25%/30% > or = 1 legal abortion; 3%/8%/15% > or = 1 miscarriage; and > or = 1 ectopic pregnancy 0.2%/1.2%/2.1%. On all three survey occasions, more than 97% of the legal abortions were performed < or = 12 weeks gestation. The complication rate following legal abortion was 7%. The proportion of live births to the total number of pregnancies was 25%, 45%, and 61%. The relationship between method of contraception, history of pregnancy, legal abortion, and smoking habits was analyzed in detail. Despite the availability of effective contraception, the ratio of legal abortions to live births was high. Fear of side effects was the commonest reason for discontinuing OC.

Adult↗

PubMed1997

A naturalistic study of paroxetine in premenstrual syndrome: efficacy and side-effects during ten cycles of treatment.

Eighteen women with severe premenstrual syndrome (PMS) (premenstrual dysphoric disorder, PMDD) were treated openly with paroxetine for 10 consecutive menstrual cycles. Dosage was flexible (5-30 mg/day); also, the patients were free to chose between continuous medication and medication in the luteal phase only. The rating of premenstrual irritability, depressed mood, increase in appetite, and anxiety/tension was markedly lower during treatment with paroxetine than before, and this reduction in symptomatology appeared unabated for the entire treatment period. Sedation, dry mouth, and nausea were common side-effects but declined during the course of the trial; in contrast, reduced libido and anorgasmia, which were reported by almost 50% of the participants, were not improved with time. The results indicate that the beneficial effects as well as the sexual side-effects of serotonin reuptake inhibitors persist unchanged for at least 10 consecutive cycles of treatment.

Adult↗

PubMed1997

Microorganisms in vaginal fluid from women in prolonged pregnancy.

In order to compare the vaginal microflora of women in prolonged pregnancy with that of women who delivered at term, samples for quantitative aerobic and anaerobic microbiological culture were collected from 100 women at 42 weeks of gestation and from 60 women at term. The occurrence of lactobacilli-dominated flora was similar in women at term and women with prolonged pregnancy. However, non-hydrogen-peroxide-producing lactobacilli (p < 0.01) were significantly more common and Peptostreptococci species (p < 0.05) significantly less common in postterm women as compared with term controls. In postterm women, Candida albicans was more common (p < 0.001) in microfloras dominated by non-hydrogen-peroxide-producing lactobacilli than in floras dominated by hydrogen-peroxide-producing lactobacilli. The ecosystem of the vagina in asymptomatic postterm women was disrupted concerning the composition of lactobacilli as compared with term controls.

Adult↗

PubMed1997

Fetal fibronectin in vaginal fluid of women in prolonged pregnancy.

The aim of this study was to determine fetal fibronectin in vaginal fluid of women in prolonged pregnancy, its relationship to a modified Bishop score and its predictiveness of delivery within 3 days. Vaginal samples were collected from 80 women at 42 weeks of gestation for the fetal fibronectin assay. A modified Bishop score was estimated. Fetal fibronectin was determined by a quantitative enzyme immunoassay. The concentration of fetal fibronectin in vaginal fluid was elevated in only 36 of the 80 women. The Bishop score and the time between sampling and delivery were not associated with an elevated fetal fibronectin (> or = 0.05 mg/l). We conclude that fetal fibronectin is not a good indicator of delivery within 3 days. The findings add to our understanding of the complexity of the etiology of postterm labor.

Adult↗

PubMed1997

Fetal fibronectin and microorganisms in vaginal fluid of women with complicated pregnancies.

OBJECTIVES: To determine vaginal fetal fibronectin in women with pregnancies complicated by preterm labor (PTL), preterm premature rupture of the membranes (PPROM) or bleeding; to investigate possible relationships to the vaginal microflora; and to assess the ability to predict preterm delivery from these measures. MATERIAL AND METHODS: Group comparative study between women of the same gestational age with a normal pregnancy (n = 28) and consecutive women admitted with PTL (n = 63), PPROM (n = 18) and bleeding (n = 21). Samples of vaginal fluid were collected at the time of admission in complicated pregnancies and from the women with normal pregnancies. Fetal fibronectin was determined by enzyme immunoassay and quantitative aerobic and anaerobic microbiological cultures were performed. RESULTS: The number of positive (> or = 0.05 mg/L) vaginal fetal fibronectin values was higher among women with PTL, PPROM and bleeding compared to controls (p < 0.001). A positive fibronectin value was predictive of delivery < or = 34 weeks (sensitivity 64%, specificity 87%). The absence of hydrogen peroxide-producing lactobacilli was predictive for preterm delivery < 34 weeks (sensitivity of 100%, specificity 35%). CONCLUSIONS: The presence of vaginal fibronectin and the absence of hydrogen peroxide-producing lactobacilli was indicative of an increased risk for preterm delivery < 34 weeks.

Adult↗

PubMed1997

Does simple hysterectomy alter bowel function?

BACKGROUND AND AIMS: Hysterectomy is believed to be associated with disturbed defecation, mainly constipation. This study longitudinally describes bowel function in women submitted for hysterectomy. MATERIAL AND METHODS: Rectoanal manovolumetry, whole gut transit time and detailed interviews on bowel function and dyspareunia were performed preoperatively and at 3 and 11-18 months after hysterectomy in 42 women. Twenty healthy women matched for age and parity served as manovolumetry controls. RESULTS: No significant changes in anal sphincter pressures could be demonstrated, neither early nor late after hysterectomy. Transit time was unaffected. All but one of the patients claimed that they had been suffering from one or more of the following symptoms; abdominal pain, distension, constipation and dysparenuia. While postoperative interviews revealed a significant improvement with respect to abdominal pain and dyspareunia (P < 0.01) after 3 and 11-18 months, improvement of abdominal distension and constipation proved to be transient only. CONCLUSION: Simple abdominal hysterectomy appears not to interfere adversely with bowel function. On the contrary many patients were relieved from abdominal pain present before operation.

Adult↗

PubMed1996

A comparison of contraceptive habits and pregnancy outcome at 19 years of age in two cohorts of Swedish women born 1962 and 1972.

The prevalence of contraception and pregnancy outcome in two representative samples of 19-year-old women resident in the city of Göteborg, born in 1962 (n = 596) and 1972 (n = 641), respectively, was assessed and compared using a postal questionnaire technique. The prevalence of different contraceptive techniques was as follows (62/72): Oral contraception (OC) alone 44%/35%, (p < 0.001); OC + condom 1%/12%, p < 0.001; intrauterine device 4%/1%, p < 0.001; condom only 11%/14%; depot gestagen 0%/0.3%; no contraception 40%/38%. The median duration of OC use was 15 and 14 months, respectively. Fear of OCs was the commonest reason given for cessation of OC in the 62 cohort and that contraception was no longer required in the 72 cohort. The proportion of women who gave the latter explanation for cessation of OC had increased (p < 0.001) from 10% in 1981 to 57% in 1991, indicating that young women in Sweden now tend not to continue with OCs when a relationship ends. Although the prevalence of cigarette smoking was reduced (p < 0.05 in the 72 cohort compared to the 62 cohort), there was still an over-representation of smokers in both cohorts among contraceptive users (p < 0.001) and in women who had been pregnant (p < 0.001) or undergone an abortion (p < 0.001). Pregnancies were reported by 11% of the women from the 62 cohort and by 13% from the 72 cohort. A greater proportion (p < 0.001) of pregnancies terminated in legal abortion in the 72 cohort (61%) compared to the 62 cohort (50%). The medical complication rate following legal abortion was lower (p < 0.05) in the 72 cohort compared to the 62 cohort.

Abortion, Legal↗

PubMed1996

Fetal fibronectin and microorganisms in vaginal fluid of healthy pregnant women.

OBJECTIVE: To determine fetal fibronectin in vaginal fluid from healthy women during uncomplicated pregnancy and to investigate possible relationships to gestational age and the vaginal microflora. MATERIALS AND METHODS: Samples of vaginal fluid were collected for fetal fibronectin determination and for quantitative aerobic and anaerobic microbiological culture from 22 women followed longitudinally at 12, 28 and 37 weeks gestation cross-sectionally in women at 12 weeks (n = 10), 28 weeks (n = 10), 37 weeks (n = 10), and 39 weeks (n = 30) gestation, respectively. Fetal fibronectin was determined by a quantitative enzyme immunoassay (Adeza Biomedical). RESULTS: There were no significant differences between the concentrations of fetal fibronectin in vaginal secretions at any of the four measurement points (12, 28, 37 and 39 weeks gestation). Women with elevated fetal fibronectin concentration (> or = 0.05 mg/L) had less often hydrogen peroxide-producing facultative lactobacilli (p < 0.0001), and more often bacterial vaginosis (p < 0.02) and Peptostreptococcus species (p < 0.002). Bacterial vaginosis (p < 0.01) and Candida albicans (p < 0.01) were more frequently found in women lacking hydrogen peroxide-producing lactobacilli. CONCLUSION: Fetal fibronectin in vaginal fluid was more associated with the vaginal microflora than with the gestational age of the pregnancy. Presence of hydrogen peroxide-producing lactobacilli seems to be the most important factor for a stable vaginal microflora.

Cross-Sectional Studies↗

PubMed1995

The serotonin reuptake inhibitor paroxetin is superior to the noradrenaline reuptake inhibitor maprotiline in the treatment of premenstrual syndrome.

Recent studies indicate that antidepressant drugs with potent serotonin reuptake inhibiting properties are effective in reducing the symptoms of premenstrual syndrome (PMS). In order to elucidate whether all antidepressant drugs are equally effective in the treatment of PMS or whether potent serotonin reuptake inhibition is a prerequisite for reducing premenstrual complaints, women suffering from severe PMS were treated daily for three menstrual cycles with a selective serotonin reuptake inhibitor, paroxetine (n = 22), or with a selective noradrenaline reuptake inhibitor, maprotiline (n = 21); in addition, a placebo group was included (n = 22). Six symptoms (irritability, depressed mood, tension/anxiety, increased appetite/craving for carbohydrates, bloating, and breast tenderness) were rated by the participants daily throughout the study. With respect to all outcome measurements, the symptom reduction obtained with paroxetine was significantly superior to that obtained with placebo; with respect to irritability, increased appetite/carbohydrate craving, bloating, and breast tenderness, as well as global self-rating, paroxetine was significantly superior also to maprotiline. The clear-cut superiority of paroxetine over maprotiline indicates that not all antidepressant drugs are equally effective in the treatment of PMS; rather, like panic disorder and obsessive compulsive disorder, but in contrast to depression, PMS apparently responds better to serotonin reuptake inhibitors than to antidepressants with a noradrenergic profile.

Double-Blind Method↗

PubMed1994

Cerebrospinal fluid levels of monoamine metabolites. A preliminary study of their relation to menstrual cycle phase, sex steroids, and pituitary hormones in healthy women and in women with premenstrual syndrome.

The cerebrospinal fluid (CSF) levels of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA), the noradrenaline metabolite 3-methoxy-4-hydroxyphenylethylene glycol (MHPG), and the dopamine metabolite homovanillic acid (HVA) were measured in a group of drug-free non-depressed women with premenstrual syndrome (PMS) (late luteal phase dysphoric disorder) (n = 13) and in controls with no premenstrual complaints (n = 13). In six patients and eight controls, CSF samples from both the luteal and the follicular phase were obtained, whereas in the remainder of the subjects, samples from either the follicular phase (patients: 4, controls: 2) or the luteal phase (patients: 3, controls: 3) were taken. The following observations were made: (1) Neither in the follicular phase nor in the luteal phase did the mean concentrations of CSF monoamine metabolites in the PMS group differ from the corresponding values in the control group. (2) Neither in the PMS group nor in the control group did the mean concentrations of monoamine metabolites in CSF samples obtained in the luteal phase differ from the corresponding values obtained in the follicular phase. (3) The intraindividual, intersample variations of CSF HVA and 5-HIAA concentrations were significantly smaller in the PMS group than in the control group. (4) CSF HVA correlated strongly to CSF 5-HIAA in the luteal phase of both patients and controls whereas in the follicular phase, particularly in controls, this correlation was much weaker. (5) In the luteal phase, the CSF HVA/5-HIAA ratio correlated negatively to serum levels of estradiol, progesterone, and testosterone. (6) The CSF HVA/5-HIAA ratio was significantly lower in PMS patients than in controls. (7) A positive correlation between CSF MHPG and serum luteinizing hormone was observed in the follicular phase. (8) A positive correlation between CSF HVA and serum prolactin was observed in the luteal phase. Because the study was comprised of a small number of subjects, the reported findings until replicated should be interpreted with caution.

Adult↗

PubMed1994

Bacterial vaginosis and vaginal microorganisms in idiopathic premature labor and association with pregnancy outcome.

The vaginal microflora of 49 women in idiopathic preterm labor was compared with that of 38 term controls to determine whether the presence of bacterial vaginosis (BV) and/or specific microorganisms would influence the rate of preterm delivery. Demographic factors, pregnancy outcome, and reproductive history were also studied. BV, as defined by the presence of clue cells in a vaginal wet mount and characteristic microbial findings in a stained vaginal smear and vaginal culture, was more common in women with preterm labor and delivery than in controls (P < 0.01). The condition, diagnosed in 41% of women who had both preterm labor and delivery (n = 22) and in 11% each of women who had preterm labor but term delivery (n = 27) and controls, was associated with a 2.1-fold risk (95% confidence intervals, 1.2 to 3.7) for preterm birth prior to 37 weeks of gestation. BV was associated with low birth weight. Of 49 women with preterm labor, 67% (8 of 12) of women with BV were delivered of low-birth-weight neonates (< 2,500 g) compared with 22% (8 of 37) of women without the condition (P < 0.0005). The presence of hydrogen peroxide-producing facultative Lactobacillus spp. was strongly negatively associated with both preterm delivery and BV. BV-associated microorganisms, i.e., Mobiluncus, Prevotella, and Peptostreptococcus species, Porphyromonas asaccharolytica, Fusobacterium nucleatum, Mycoplasma hominis, and high numbers of Gardnerella vaginalis were significantly associated with preterm delivery; all species also strongly associated with BV (P = 0.0001 for each comparison). Mobiluncus curtisii and Fusobacterium nucleatum were recovered exclusively from women with preterm delivery. Our study clearly indicates that BV and its associated organisms are correlated with idiopathic premature delivery.

Adult↗

PubMed1994

[Swedish women].

Explore the source record for details and available documents.

Abortion, Induced↗

PubMed1992

Clomipramine effectively reduces premenstrual irritability and dysphoria: a placebo-controlled trial.

Forty nondepressed women displaying severe premenstrual irritability and/or dysphoria and fulfilling the DSM-III-R criteria of late luteal phase dysphoric disorder were treated daily for 3 menstrual cycles with either the potent serotonin reuptake inhibitor clomipramine (25-75 mg; flexible dosage) (n = 20) or placebo (n = 20). In both treatment groups premenstrual irritability and dysphoria (as rated daily by the patients using a visual analogue scale) were significantly reduced as compared with the rating during 2 pretreatment reference cycles; however, in the placebo group this reduction was only about 40% whereas, in the clomipramine group, the symptom decrease was greater than 80%. At all 3 treatment cycles, patients on clomipramine displayed significantly lower symptom rating than controls. Also with respect to the rating of global improvement, the results obtained with clomipramine were considerably and significantly better than those obtained with placebo. It is concluded that low doses of clomipramine effectively reduce premenstrual irritability and dysphoria with a response rate close to 100%. The possible role of serotonin in the pathophysiology of the premenstrual syndrome is discussed.

Adult↗

PubMed1991

A longitudinal study of contraception and pregnancy outcome in a representative sample of young Swedish women.

The prevalence of contraception and pregnancy history in the same women, aged 19 and 24 years, was assessed in a longitudinal cohort study by means of a postal questionnaire. A one-in-four random sample of all the women born 1962, resident in the city of Göteborg in 1981, was obtained from the population register (n = 656). The response rate was 91%. Respondents from 1981 were re-assessed in 1986 (response rate: 83%). The respondents from 1986 (n = 488) represent 74% of the original sample from 1981. Contraceptive usage in the same women aged 19 and 24 years (in brackets) was as follows: Oral contraception (OC) 47% (51%); intrauterine device 3% (11%), p less than 0.01; barrier methods 11% (11%); depot gestagen 0 (0.2%); no contraception 39% (26%), p less than 0.05. OCs were being taken or had been taken by 89%. Reasons given for cessation of OC were as follows: Contraception not required 10% (15%); fear of OC 26% (29%); menstrual disorder 17% (14%); weight increase 18% (10%), p less than 0.05; mental side effects 15% (9%); desire to become pregnant 7% (17%), p less than 0.01. Pregnancies (n = 362) were reported by 194 (43%) of the women. 44% of the pregnancies terminated in legal abortion. The medical complication rate following legal abortion was 15%. Thus, despite the availability of effective contraception, the ratio of legal abortions to live births was high. Fear of side effects was the commonest reason for discontinuing OC.

Adult↗

PubMed1991

A comparison of flurbiprofen, tranexamic acid, and a levonorgestrel-releasing intrauterine contraceptive device in the treatment of idiopathic menorrhagia.

Treatment with flurbiprofen (100 mg twice a day for 5 days), tranexamic acid (1.5 gm three times a day for 3 days and 1 gm twice a day for another 2 days), and an intrauterine contraceptive device releasing 20 micrograms levonorgestrel per day was compared in women with idiopathic menorrhagia. The menstrual blood loss during two control periods in 15 women subsequently treated with flurbiprofen and tranexamic acid was 295 +/- 52 ml and 203 +/- 25.2 ml in the 16 women later fitted with a levonorgestrel-releasing intrauterine contraceptive device. Menstrual blood loss was reduced by all three forms of treatment. The reduction in menstrual blood loss expressed as a percentage of the mean of two control cycles for each form of treatment was as follows: flurbiprofen, 20.7% +/- 9.9%; tranexamic acid, 44.4% +/- 8.3%; levonorgestrel-releasing intrauterine contraceptive device after 3 months, 81.6% +/- 4.5%; levonorgestrel-releasing intrauterine contraceptive device after 6 months, 88.0% +/- 3.1%; levonorgestrel-releasing intrauterine contraceptive device after 12 months, 95.8% +/- 1.2%. The reduction in menstrual blood loss achieved by the levonorgestrel-releasing intrauterine contraceptive device was greater than that recorded with flurbiprofen (p less than 0.001) and tranexamic acid (p less than 0.01), and was greater for tranexamic acid when compared with flurbiprofen (p less than 0.05). The levonorgestrel-releasing intrauterine contraceptive device was the only form of treatment to reduce mean menstrual blood loss below 80 ml per menstruation, the upper limit of normal menstrual blood loss.

Adult↗