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Biomedical subjects

P Lidbrink

Publications and source records attributed to P Lidbrink.

At least 19 recordsLinked to original sources

Relationship of Ureaplasma urealyticum biovar 2 to nongonococcal urethritis.

The aim of this study was to determine the frequency of Ureaplasma urealyticum biovars 1 and 2 among 340 men with or without nongonococcal urethritis (NGU) attending a venereal disease clinic in Sweden. NGU was defined by the presence of at least four polymorphonuclear leukocytes per microscopic field (x1,000 magnification) on a smear in which Neisseria gonorrhoeae could not be detected. Ureaplasma urealyticum was detected by polymerase chain reaction, and biovar determination was performed directly on the amplicons by liquid hybridization with biovar-specific probes. Patients with NGU were younger, had had more sexual partners, and exhibited symptoms of urethritis more often than patients without NGU. Ureaplasma urealyticum was detected with the same frequency among patients with and among those without NGU. Among patients with NGU, Ureaplasma urealyticum-positive men were more frequently symptomatic than Ureaplasma urealyticum-negative men. Among patients without NGU, Ureaplasma urealyticum-positive men had had more sexual partners than Ureaplasma urealyticum-negative men. Ureaplasma urealyticum biovar 2 was detected more often among patients with NGU than among those without (P=0.012). Logistic regression analysis was performed using detection of biovar 2 as the response variable and the following four variables as explanatory variables: presence or absence of NGU, symptoms of urethritis, number of partners, and age < or = 24 years. The only association found was that between Ureaplasma urealyticum biovar 2 and age < or = 24 years. More studies should be conducted to determine the possible pathogenic impact of Ureaplasma urealyticum biovar 2.

Adolescent↗

Mycoplasma genitalium in non-gonococcal urethritis--a study in Swedish male STD patients.

Urethral swab specimens obtained from 101 men attending an STD clinic were examined for the presence of Mycoplasma genitalium by polymerase chain reaction (PCR) amplification. Fifty patients had non-gonococcal urethritis (NGU), and 51 patients were included as controls without urethritis. M. genitalium DNA was detected in 13 (26%) of the urethritis patients and in 5 (10%) of the control patients (P=0.06). No patient positive for M. genitalium had a simultaneous chlamydial infection. Thus, in the 36 patients with non-chlamydial NGU, the prevalence of M. genitalium infection was 36% (P=0.007 compared with controls). All patients with M. genitalium positive urethritis had a high grade urethritis defined as >10 polymorphonuclear cells per high power microscopical field. Compared with the control group, those with M. genitalium positive urethritis had more often had a history of urethritis than had those with chlamydial NGU or those with M. genitalium negative, non-chlamydial NGU.

Adolescent↗

Chlamydia trachomatis PCR (Cobas Amplicor) in women: endocervical specimen transported in a specimen of urine versus endocervical and urethral specimens in 2-SP medium versus urine specimen only.

The sensitivity of Roche Cobas Amplicor Chlamydia trachomatis polymerase chain reaction (PCR) including the internal control (IC) programme to identify inhibition, was investigated on 3 different samples from women: (1) swab samples from the urethra and the cervix pooled in 2-SP transport medium, (2) swab sample from the cervix transported in a urine sample from the same patient, and (3) urine sample alone. Out of the 2412 patients, 193 (8.0%) were chlamydia positive and in 14 of these the results showed discrepancies between sampling methods. The sensitivity of PCR on urethra/cervix, urine/cervix and urine was 98.4% (190/193), 97.9% (189/193) and 93.3% (180/193) respectively. The higher sensitivity of PCR on urethra/cervix and urine/cervix as compared with urine alone was statistically significant. Without the IC, the sensitivity of PCR on urethra/ cervix, urine/cervix and urine would have been 95.9% (185/193), 94.8% (183/193) and 90.7% (175/193) respectively. Factors influencing the rate of inhibition were also studied.

Cervix Uteri↗

Antibodies against human papillomavirus type 6 capsids are elevated in men with previous condylomas.

Serum samples from 47 men with current condylomas, 32 men with a history of condylomas and from 205 men with no history of genital wart disease, who were attending sexually transmitted disease (STD) clinics at two different hospitals in Stockholm, were analyzed for the presence of immunoglobulin G (IgG) and A (IgA) antibodies to capsids of human papillomavirus types 6 and 11. IgG to HPV type 6 was found among 35% of patients with a history of condylomas compared to 10% of controls (p = 0.0003), but only among 27% of patients with current condylomas. Antibodies to HPV 6 and to HPV 11 showed a very limited correlation, suggesting that the antibodies are HPV-type restricted. The results strengthen conclusions from a previous serological study indicating that IgG antibodies against HPV 6 develop late during condylomatous disease and mostly reflect previous exposure to the virus.

Antibodies, Viral↗

Mucocutaneous manifestations in 22 consecutive cases of primary HIV-1 infection.

Twenty-two consecutive patients presenting with symptomatic human immunodeficiency virus 1 (HIV-1) seroconversion were studied. Most of the patients had a glandular fever-like illness. All patients had fever and pharyngitis, and eight of them also suffered from ulcers of the oral, genital or anal mucosa. Uniform skin eruptions were observed in 17 of the 22 patients. The exanthem consisted of varying numbers of macular or maculopapular lesions that were oval or rounded in shape, ranging from a few millimetres to 1 cm in diameter. The lesions were distributed on the upper thorax in all cases, and were particularly profuse in the collar region. The face, forehead and scalp were involved in most cases, but the eruption was sparse or absent at the periphery of the extremities. In the majority of patients, the exanthem appeared after 2 or 3 days of fever. The exanthem developed during the first day, persisted for 5-8 days, and then cleared concurrently with the general recovery of the patients. Histopathological studies of skin punch biopsy specimens from four patients showed a sparse lymphocytic cell infiltrate distributed around vessels of the dermal superficial plexus. The infiltrates predominantly consisted of equally represented T-helper/inducer and T-suppressor/cytotoxic cells. A vacuolar aberration of basal layer cells was found in two of the four cases studied histologically. The microscopic findings correspond to the histopathological patterns seen in toxicodermia and in the interface dermatitis of morbilliform viral exanthems. The exanthem is a frequent and characteristic sign of primary HIV infection, which is further indicated if mucosal ulcers are present.

Adolescent↗

Levels of immunoglobulin G antibodies against defined epitopes of the L1 and L2 capsid proteins of human papillomavirus type 6 are elevated in men with a history of condylomata acuminata.

Sera from 159 men attending the sexually transmitted disease clinic at Karolinska Hospital, Stockholm, Sweden, were analyzed for the presence of immunoglobulin A (IgA) and IgG antibodies to a panel of synthetic peptides derived from the E2, L1, and L2 regions of the human papillomavirus types 1 (HPV 1), 6, 8, 11, 16, 18, 31, and 33. The study subjects were divided into three groups: (i) asymptomatic men with no history of genital warts who served as controls, (ii) men with visible condylomata, and (iii) men who had previously been afflicted with condylomata. There were no significant differences in antibody titers for any of the HPV 6- or 11-derived peptides among patients with current condylomata and the controls. For the peptide from L1 of HPV 6, there was an increase in the IgG titers among men with previous condylomata compared with the titers for the controls (52% versus 27% seropositivity; P less than 0.05). Also, for the peptide from L2 of HPV 6, there was an increase in the IgG titers among men who had been afflicted with condylomata previously (P less than 0.05). Increased IgA antibody titers against an HPV 16-derived peptide and an HPV 18-derived peptide were also detected. For the peptides from L1 and L2 of HPV 6, the study was extended to an additional group of 127 males attending the sexually transmitted disease clinic at Huddinge Hospital in southern Stockholm. Again, significantly increased antibody levels were detected only for IgG and only among asymptomatic men with a history of condylomata (P < 0.01 for the L1 peptide and P < 0.05 for the L2 peptide). The results suggest that the IgG response against the late proteins of HPV 6 reflects mainly previous exposure to the virus rather than ongoing viral disease.

Adolescent↗

Comparison of Pharmacia Chlamydia EIA, IDEIA and cell culture in the detection of urogenital chlamydial infection.

Two commercial test kits, Pharmacia Chlamydia EIA (PhEIA) and IDEIA Chlamydia Test, for the identification of Chlamydia trachomasis and McCoy cell culture were compared in urogenital specimens. The sediments of the transportation buffers of specimens with discordant results were investigated for elementary bodies (EB) with fluorescein-labelled antichlamydial antibodies. The prevalence of chlamydial infection among the men was 16% (48 of 293), 47 culture positive and one EB positive, and among the women 10% (10 of 97), 10 culture positive. In men, the sensitivity of PhEIA, IDEIA and culture was 71%, 40% and 98%, respectively. In women, irrespective of site, corresponding figures were 100%, 80% and 100%. The specificity and positive predictive values were 100% for both enzyme immunoassays in men and women. The low sensitivity of IDEIA could not be explained by the degree of infection as measured by the number of inclusion bodies in cell culture, the presence of antigen as measured by the number of EBs or the sampling order.

Adult↗

Influence of storing urogenital specimens at -20 degrees C before testing by enzyme amplified immunoassay (IDEIA) to detect Chlamydia trachomatis antigen.

Urogenital specimens from 445 patients, 174 women and 271 men, were tested for antigen to Chlamydia trachomatis by an enzyme amplified immunoassay, IDEIA. The test results for specimens stored at -20 degrees C for means of 9.6 weeks (from each of the first 376 patients) and eight months (from the remaining 69) were compared with results for specimens stored at 4 degrees C and tested within five days. Of 617 specimens (one from the urethra of each patient and one from the cervices of 172 women) cultured for C trachomatis, 90 (15%) gave positive results. The IDEIA results for specimens stored at -20 degrees C were identical with those of specimens analysed without such storage in 96.4% (595/617) of all cases. No difference was seen between urethral specimens from men or women or cervical specimens or between specimens stored for 9.6 weeks compared with those stored for eight months. In 22 cases in which the IDEIA results differed, culture positive results were missed in stored as well as unstored specimens. The median absorbance value above the cut off point for a positive IDEIA result in stored specimens was no lower than in those not stored. The few differences noted probably depended on the sampling technique rather than on the way of storing the specimens.

Adolescent↗

Sexually transmitted diseases including genital papillomavirus infection in male sexual partners of women treated for cervical intraepithelial neoplasia III by conization.

History and clinical prevalence of sexually transmitted diseases (STD), including genital human papillomavirus (HPV) infection, were studied in 60 sexual partners of 60 women previously treated for cervical intraepithelial neoplasia (CIN) III by conization. Investigations included serological and bacteriological screening, histopathology and colposcopy. A history of STD was reported by 20 men (33%), and 34 (57%) had signs of STD including genital HPV infection, 2 (3%) had a chlamydial infection, one had molluscum contageosum, 7 (12%) had genital warts and 24 (40%) had abnormal acetowhite epithelium, indicating HPV infection. The HPV lesions were principally subclinical and located on the glans penis and the prepuce. Colposcopy and application of acetic acid are essential for detection. The gynaecologist and venereologist must recognize the sexually transmitted nature of CIN, and the causal link between CIN and HPV infection. Assessment and treatment of the male sexual partner of women treated for CIN might be an essential part in disease control with the aim of preventing cervical cancer.

Cross-Sectional Studies↗

HIV transmission by blood transfusions in Stockholm 1979-1985: nearly uniform transmission from infected donors.

Thirty-five out of approximately 800 known HIV-seropositive people in Stockholm by mid-1986 were blood donors during the period 1979-1986. Almost all, i.e. 349 recipients of their blood components (red blood cells, platelets, plasma) could be traced. One hundred and eighty were still alive and 112 of these on further analysis, were suspected of being infected. They were contacted and all but one agreed to be tested for HIV antibodies. Fifty recipients were found to be seropositive. They had been transfused with blood components from 14 of the 35 donors. The earliest observed transmission occurred in June 1982. The patterns of HIV transmission showed, with only one exception, that each donor who had transmitted HIV to one recipient had also transmitted it to all later recipients. Appropriate preserved sera and clinical records from five of the donors who had not transmitted the virus were found and analysed. The result indicated that these donors had acquired their HIV infection after their last blood donation. In conclusion, our study indicates that every antibody-positive donor transmits HIV to almost every recipient.

Acquired Immunodeficiency Syndrome↗

Psoriasis treatment: faster clearance when UVB-dithranol is combined with topical clobetasol propionate.

Fifty patients with plaque psoriasis were treated with dithranol and UVB 5 days per week. Twenty-six of these patients also received 13 treatments (once daily in the 1st week, every other day in the 2nd week, twice in the 3rd week and once in the 4th week) with topical clobetasol propionate. The median time for clearance was 2.5 weeks for those on the clobetasol propionate-dithranol-UVB combination compared with 4 weeks when only dithranol-UVB was used. Scaling and induration of the lesions disappeared during the first 2 weeks of treatment with clobetasol propionate-dithranol-UVB which was a significant improvement compared with dithranol-UVB alone. The time of remission in patients completely cleared was the same in the two groups. Relapses occurred slightly more often in the clobetasol propionate treated than in the control group (during treatment 5 of 26 versus 2 of 24; after 6 months 7 of 18 versus 4 of 15) but the differences were not statistically significant. The study shows that addition of topical clobetasol propionate according to our schedule to the traditional dithranol-UVB regimen of psoriasis results in a more rapid clearance of lesions without undesirable side effects.

Administration, Topical↗

The possible involvement of GABA mechanisms in the action of benzodiazepines on central catecholamine neurons.

With the use of quantitative microspectrofluorometry, it has been shown that diazepam (10 mg/kg) and chlordiazepoxide (10 mg/kg) reduce DA turnover in the tuberculum olfactorium, nuc. accumbens, the DA islands of the entorhinal cortex, and caput of nuc. caudatus, whereas DA turnover is increased in the lateral external layer of the median eminence after 10 mg/kg of diazepam. It is of considerable interest that with a dose of 1 mg/kg of diazepam a reduction of DA turnover can still be observed in the tuberculum olfactorium and nuc. accumbens but not in the nuc. caudatus, due to a high variability of the response in this area. A similar trend is also found with chlordiazepoxide. Thus, changes in limbic DA turnover are observed in doses close to the minimal effective dose (0.6 mg/kg) needed to release punished behavior and to cause anticonvulsive effects, and may therefore be related to these actions of diazepam. For various reasons it is speculated that an increased GABA receptor activity on the DA cell bodies and their dendrites could mainly be involved in causing the reduction of DA turnover observed after benzodiazepines by diminishing the firing rate in the ascending DA pathways, particularly the mesolimbic DA pathways. Evidence for a change of GABA turnover by diazepam has also been found. It is also suggested that the reduction of cortical NE turnover found after benzodiazepines can partly involve an increased GABA receptor activity on the locus ceruleus cells, although the activation of E receptors on these cells cannot be excluded. These effects on locus ceruleus may be partly responsible for the sedation found after benzodiazepines. Diazepam (1 mg/kg) mimics both clonidine and GABA-ergic drugs in reducing blood pressure and slowing respiration rate, but the effects are blocked by picrotoxin but not by piperoxane, an E receptor-blocking agent. In agreement with the view that blockade of the stress-induced increases of NE turnover by benzodiazepines may be related to their antianxiety actions, it was found that the increase in NE turnover elicited by yohimbine, a drug that causes anxiety in man, is blocked by diazepam.

Aminobutyrates↗