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Biomedical subjects

L Forssman

Publications and source records attributed to L Forssman.

At least 19 recordsLinked to original sources

The relationship between knowledge about sexually transmitted diseases and actual sexual behaviour in a group of teenage girls.

PURPOSE: To assess longitudinally the relationship between knowledge about sexually transmitted diseases (STDs) and sexual behaviour, contraceptive use, STD protection and social class in a group of Swedish teenage girls. METHODS: Girls starting their upper secondary school education were invited to attend a teenage clinic during a period of 2 years (5 visits). Questions were asked about family situation, sexual activity, contraceptives, STD protection and knowledge about STD. Gynaecological examinations were performed on entry and completion, and when necessary during the observation period. RESULTS: Eighty-eight girls completed all visits during the observation period. At 16 years of age there were no significant differences in knowledge about various STD and STD protection between girls from different social classes or with respect to coital experience, age of coitarche and the subsequent number of sexual partners at 18 years of age. At 18 years of age there was a better knowledge about STDs and the need for STD protection (p < 0.01) among girls with coital experience compared with those who had no coital experience. Girls reporting many lifetime partners were best informed, but in spite of solid knowledge they did not protect themselves from infection. Even though 34% of the girls with coital experience were found to harbour a STD during the course of this study, almost all girls denied the possibility of having acquired or transmitted an infection. CONCLUSIONS: Although girls were well-informed about sexually transmitted diseases and knew how to avoid infections this knowledge had little influence on behaviour.

Adolescent↗

Age of sexual debut related to life-style and reproductive health factors in a group of Swedish teenage girls.

AIM: To compare life-style and reproductive health care factors in girls with a coitus debut < 15 years of age and girls with a later debut. METHODS: Girls resident in the municipality of Karlstad, Sweden, starting their upper secondary school education were invited to attend the teenage clinic during two years (five visits). Gynecological examinations were performed and questions were asked about possible symptoms, sexual activity, contraception and sexually transmitted diseases. RESULTS: Ninety-eight girls accepted the invitation to participate and 88 girls completed all visits (mean age on admission 16 years). Median age for coitarche was 16 years. A sexual debut < 15 years was reported by 17 girls (19.3%), 54 (61.4%) had their debut > or = 15 years and 17 girls (19.3%) had not had their sexual debut on completion of this study. Girls with an early sexual debut had a greater number of sexually transmitted diseases (p < 0.05) and more cervical atypias (p < 0.05), and more often had a menarcheal age < 13 years (p < 0.05), > two brothers and/or sisters (p < 0.01), were more often not living with their parents (p < 0.01) and reported a greater number of life-time partners (p < 0.06) than the remainder, Girls with a sexual debut < 15 years started drinking alcohol earlier than others (p < 0.01). There was a greater proportion of smokers among girls with an early sex debut compared to the remainder (p < 0.05). CONCLUSIONS: Early sexual debut is associated with an earlier menarche and a more premature adult life-style and is an important indicator for continued risk behavior regarding reproductive health.

Abortion, Legal↗

The influence of social class on parity and psychological reactions in women coming for induced abortion.

OBJECTIVE: To test the hypothesis that the correlation between legal abortion and socio-economic conditions, known from the time when abortion was restricted, has current validity. To evaluate the effect of social class on network support and psychological reactions. DESIGN: Consecutive sampling and semistructured personal interviewing. SUBJECTS: 444 women living in the city of Gothenburg and applying for legal termination of pregnancy in the first trimester. SETTING: The department of gynaecology at a university hospital with primary care responsibility for legal abortions. RESULTS: The 667 health administration districts of Gothenburg were ranked into four groups according to the mean income. Women living in lower socio-economic districts were younger. Irrespective of age, previous experience of induced abortion was more common among them (p < 0.001). Unsatisfactory network response or support was common (37%), but equally shared between the social classes. Discontinuation of oral contraception during the previous six months was twice as common among teenagers (40.0%) as among other women (p < 0.001) but without social differences. Pitman's permutation test was used for statistical analyses. CONCLUSION: Socio-economic conditions have a strong and inverse correlation to previous experience of induced abortion. Psychological reactions and needs did not vary with class.

Abortion Applicants↗

Prevalence of antibodies to herpes simplex virus types 1 and 2, Epstein-Barr virus and cytomegalovirus in teenage girls.

Seropositivity to herpes virus type 1 (HSV-1), herpes virus type 2 (HSV-2), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) was estimated in a group of 98 16-year-old Swedish girls. Antibodies to HSV-1 were seen in 41% of the girls and to HSV-2 in 1%, and antibodies to CMV in 45 and to EBV in 82%. In girls with coitus experience, there was significantly higher prevalence of HSV-1 and EBV antibodies, compared with girls with no sexual contact. The age of coitarche or number of coitus partners did not affect the rate of seropositivity. During 2 years of follow-up, 13 girls seroconverted. All but one EBV-seroconverting girl, were sexually active, and no girl converted for more than one type of virus. We concluded that transmission of herpes viruses is common in adolescence, and sexuality, even with regard to its close association with kissing, is one important determinant.

Adolescent↗

Estimation of a preference matrix for women's choice of male sexual partner according to rate of partner change, using partner notification data.

Data from a study of partner notification for venereal chlamydial infection are used to estimate the contact preference matrix, according to sexual contact activity levels of the male partners, of young heterosexual women. A method for correcting data for the bias introduced by studying infected women only is presented. Results indicate that an overall proportional mixing model is not an adequate description of the mixing pattern.

Bias↗

Sexually transmitted diseases--knowledge and attitudes among young people. Developments in Sweden between 1986 and 1988.

Pupils aged 18 to 19 years at colleges and technical schools in a small town and a rural area filled in questionnaires concerning sexually transmitted diseases (STD) in May 1986 and May 1988. The questions covered knowledge and sources of information about STD. The influence of knowledge on attitudes and actual behavior was studied. Knowledge about STD was fairly good and increased between the two study periods. Schoolteachers and the media were important sources of information. Girls knew more than boys, and more often discussed STD with adults and friends. Small differences emerged between the urban and rural areas and between pupils attending theoretical and practical courses. Attitudes seemed to change with time but it is not clear whether this has resulted in changes in actual behavior.

Adolescent↗

Postabortal endometritis in chlamydia-negative women--association with preoperative clinical signs of infection.

The relations between clinical signs of infection and postoperative endometritis were studied among 429 women with negative preoperative chlamydial and gonococcal cultures. Clue cells and a vaginal smear not dominated by rods and positive amine tests were more common among the 12 patients (2.8%) with endometritis. In the stepwise logistic regression procedure the presence of greater than 20% clue cells remained statistically significant and was associated with the highest relative risk, 5.6, with 95% confidence limits 1.82-17.2. This also implies clinical significance--women with clue cells constitute a group at risk of postabortal endometritis.

Abortion, Induced↗

Factors in the infertile couple influencing the success of artificial insemination with donor semen.

Factors influencing the success of artificial insemination with donor semen (AID) were investigated in a series of 928 infertile couples. A simple approach with one insemination/cycle, timed only by cycle length and basal body temperature, was used. The overall life-table cumulative conception rate was 82% and the average fecundability was 10%. The following factors were associated with a higher success rate: women less than 36 years, azoospermic compared with oligozoospermic husband and women with no history of abdominal surgery. The success rate decreased with increasing duration of infertility and in women with an abnormal hysterosalpingography or laparoscopy, and was unrelated to menarcheal age, the distance between the couples place of residence and the clinic, or if the woman had been pregnant before starting AID treatment.

Female↗

Quality of semen after repeated ejaculation treatment in spinal cord injury men.

The study was designed to document the effects of regular drainage after penile vibrator stimulation on the quality of semen in SCI men. Twenty three tetraplegics and 9 paraplegics, 18 to 40 years of age and with neurological levels ranging from C4 to L1, were examined between 1 and 23 years after injury (median 2 years). None had ejaculated after the injury. Penile vibrator stimulation was tried in patients with cervical or thoracic lesions who showed reflex hip flexion on scratching the soles of the feet, 29 out of 32, and rectal electrostimulation in the remaining 3 low lesions with no reflex function in lumbar and sacral segments. The stimulation yielded semen in 29 (91%) of the men; 22 had antegrade and 7 retrograde ejaculation. Sixteen of the 22 patients with antegrade ejaculation entered a home programme of vibrator stimulation prescribed once weekly. Four to 6 months of stimulation resulted in a rise of semen volume and of fructose and acid phosphatase levels in the seminal plasma, suggesting improved function of the seminal vesicles and the prostate. The percentage of motile sperms was low both before and after the treatment period. Despite this, the total count of motile sperms per ejaculate was already high in the patient's first ejaculates compared to the laboratory normal standard, and further clearly increased after the stimulation period. A standardised functional test measuring sperm penetration capacity showed strong evidence of long term stimulation effect. It is suggested that the test is used in the assessment of fertility potential in SCI men.

Adolescent↗

Intermittent prophylactic treatment of recurrent vaginal candidiasis by postmenstrual application of a 500 mg clotrimazole vaginal tablet.

The therapeutic efficacy of intermittent, monthly, postmenstrual prophylaxis with a single 500 mg clotrimazole vaginal tablet (n = 33) was compared with placebo tablets (n = 29) in 62 woman (age 28.1, SD 7.2 years) with recurrent vulvovaginal candidiasis. The number of episodes of acute vulvovaginal candidiasis experienced during the year prior to inclusion was 6.3, SD 1.9. The cumulative recurrence frequency after 6 months intermittent prophylaxis with clotrimazole (30.3%) was lower (p less than 0.001) than that recorded for the women who received placebo (79.3%). After an additional 6 months observation period without treatment there was no significant difference in the cumulative recurrence frequency between the groups (clotrimazole 84.9%; placebo 86.2%). The vagina was recolonised with Candida albicans in 70% of the women after 6 months prophylactic treatment with clotrimazole and in 86% of the women who had received placebo. Thus, this study has demonstrated that postmenstrual prophylactic treatment with a single 500 mg clotrimazole vaginal tablet, applied monthly, prevents recurrence of symptoms, although it does not eliminate yeasts from the vagina.

Administration, Intravaginal↗

Effects of intravenous terbutaline on maternal circulation and fetal heart activity.

The effects of terbutaline on maternal circulation and fetal heart activity were studied in 15 healthy pregnant women admitted for external cephalic version. The two-step infusion of terbutaline (5-10 micrograms/min) resulted in increases in maternal heart rate (p less than 0.001), cardiac output (p less than 0.001), systolic arterial pressure (p less than 0.001) and pulse pressure (p less than 0.001), while diastolic arterial pressure (p less than 0.001) and total peripheral vascular resistance (p less than 0.001) were reduced. Mean arterial pressure was unchanged after the infusion. Fetal heart activity assessed by cardiotocography showed a gradual increase in baseline fetal heart rate (p less than 0.01) and an increased percentage acceleration time (p less than 0.05). Fetal movements also increased during the infusion (p less than 0.05). The terbutaline infusion had a positive inotropic effect and produced decreased systemic vascular resistance in the pregnant woman, and placental transfer of the drug resulted in increased fetal heart activity. The potential influence of the drug-induced changes in maternal hemodynamics on utero-placental perfusion require further investigation.

Adult↗

Hemodynamic changes during laparoscopy with positive end-expiratory pressure ventilation.

Hemodynamic measurements were performed in 10 healthy women undergoing elective laparoscopy for the investigation of infertility. A standardized anesthetic technique which included the application of positive end-expiratory pressure (PEEP), 0.49 kPa (3.7 mmHg) was utilized. The following variables were studied: cardiac output, stroke volume and left ventricular ejection time (determined non-invasively with impedance cardiography), heart rate, blood pressure, total peripheral vascular resistance and end-tidal carbon dioxide (ET-CO2). The combination of 25 degrees head-down tilt and PEEP ventilation during laparoscopy was associated with a pressure response that restored arterial pressures to essentially pre-anesthetic levels. Net cardiac effects were small. With this regime low pressure 0.7-1.1 kPa (5-8 mmHg) intra-abdominal insufflation with CO2 was associated with only minor cardiovascular changes. There were no indications that 0.49 kPa PEEP during laparoscopy produced adverse cardiovascular effects. The application of PEEP reduced (P less than 0.001) ET-CO2. There was no net increase in ET-CO2 after CO2-insufflation compared to the measurement after induction of anesthesia. This is in contrast to earlier studies without PEEP where a significant net increase in ET-CO2 was reported after CO2-insufflation.

Adult↗

Relationship between disorder in the stomatognathic system and general joint involvement in individuals with rheumatoid arthritis.

Seventy-one individuals with rheumatoid arthritis (RA) were examined and compared with 52 individuals without history or symptoms of joint disease (C group) with regard to disorders of the stomatognathic system. Laboratory findings and articular and functional rheumatologic indices were compared. The clinical dysfunction index of Helkimo for the stomatognathic system was positively correlated to both the articular Ritchie index and the functional Lee index. The concentration of C-reactive protein (CRP) and the Ritchie index were positively correlated to temporomandibular joint (TMJ) pain. Vertical overbite was negatively correlated to the Ritchie index. In addition, there were positive correlations among TMJ crepitus, anterior open bite, sagittal distance between retruded position and intercuspal position, and erythrocyte sedimentation rate (ESR). The concentration of CRP, the ESR, and the Ritchie and Lee indices were highest in the individuals with bilateral current TMJ symptoms and lowest in those with previous but not current TMJ symptoms. It was concluded that the severity of TMJ involvement in RA is correlated to concentration of serum acute-phase reactants and to rheumatologic indices.

Arthritis, Rheumatoid↗

Pustulotic arthro-osteitis. A report of two cases.

Pustulosis palmoplantaris (PPP) has been reported to be associated with characteristic inflammatory bone and joint lesions predominantly in the sterno-costoclavicular region and the spine. We have observed 2 patients with findings in accordance with previous reports.

Arthritis↗