Biomedical subjects

A Månsson

Publications and source records attributed to A Månsson.

At least 19 recordsLinked to original sources

PubMed2006

Inadvertent malposition of a transvenous pacing lead in the left ventricle.

We report the case of inadvertent malpositioning of a pacemaker lead in the left ventricle. The lead went through an open foramen ovale from the right to the left atrium and through the mitral valve into the left ventricle. After a review of the literature, we decided to anticoagulate the patient and leave the electrode in place. During a follow-up period of 16 months, there were no clinical complications.

Arrhythmia, Sinus↗

PubMed2006

Impact of extended written information on patient anxiety and image motion artifacts during magnetic resonance imaging.

PURPOSE: To evaluate whether increased written information to patients prior to magnetic resonance imaging (MRI) decreases patient anxiety and image motion artifacts. MATERIAL AND METHODS: A two-group controlled experimental design was used. Of 242 patients, 118 received routinely given basic written information (control group) while 124 were given increased written information (intervention group). To measure patient anxiety before and during scanning, the self-report psychometric test State-Trait Anxiety Inventory (STAI) was used. After MR examination, the patients answered a questionnaire on satisfaction with the written information. The images were assessed with regard to motion artifacts. RESULTS: Motion artifacts were present in fewer patient images in the intervention group than in the control group (4.0% versus 15.4%,; P=0.003). There was no significant difference between the control and the intervention group regarding patient anxiety and satisfaction with the information. Women in both groups showed a higher level of anxiety than the men did. CONCLUSION: Increased information about the MRI scanning procedure and expected experiences during the scan may help patients to lie still during the sequences, with a decrease in motion artifacts. However, further research is needed to evaluate the effect of other interventions on patient anxiety during MRI scanning.

Anxiety↗

PubMed2004

Neutral third party versus treating institution for evaluating quality of life after radical cystectomy.

OBJECTIVE: To evaluate the possible impact of a neutral third party on the patients' responses to health-related quality of life (HRQL) instruments. METHODS: 119 patients operated at the Department of Urology in Lund with radical cystectomy and continent urinary tract reconstruction (continent cutaneous diversion or orthotopic bladder substitution) for locally advanced bladder cancer were included in the study. They were randomly divided in two groups, similar with regard to gender, age, length of follow-up, and type of reconstruction. The EORTC instruments QLQ-C30 and QLQ-BLM30 were sent to the patients. One group; "Lund patients", received the instruments from the Department of Urology in Lund, while the other group; "Stockholm patients", received the instruments from a neutral third party, i.e. "The Project Health and Well-Being" at the Karolinska Institutet in Stockholm. RESULTS: Response rates were high in both groups, 59 out of 60 among Lund patients and 57 out of 59 among Stockholm patients. There were statistically significantly more bowel problems reported in the Stockholm patients than in the Lund patients (p<0.05) in the QLQ-C30 instrument. Regarding type of reconstruction, the Stockholm patients with continent cutaneous diversion scored higher for constipation than the Lund patients (p<0.05), and the Stockholm patients with bladder substitution scored lower for emotional functioning and higher for dyspnoea and economical problems than the Lund patients (p<0.05. There were no statistically significant differences between the Lund patients and the Stockholm patients in the QLQ-BLM30 instrument. CONCLUSION: Though few factors differed between the two groups, the results may indicate that different results are obtained when a study is totally administered and analyzed by a neutral third party as compared with the surgeon or his or her institution. Larger studies are needed to further test this hypothesis.

Adult↗

PubMed2004

Xenoreactivity and engraftment of human mesenchymal stem cells transplanted into infarcted rat myocardium.

OBJECTIVE: It is thought that adult human mesenchymal stem cells do not induce immunoreactivity even to xenografts. We wanted to study whether adult human mesenchymal stem cells survive and engraft in experimentally induced ischemic rat myocardium. METHODS: Bone marrow-derived adult human mesenchymal stem cells (2.5 x 10(6)) were injected into the myocardium of 4 Sprague-Dawley rats. One week after injection, peripheral blood rat lymphocytes were added to adult human mesenchymal stem cells in a mixed lymphocyte reaction. Furthermore, an infarction was created by left anterior descending artery ligation of 8 Sprague-Dawley rats, 4 of which were immunosuppressed with tacrolimus (0.1 mg/kg/d) and 4 RNU athymic rats. One week after left anterior descending artery ligation, 2.5 to 3.5 x 10(6) adult human mesenchymal stem cells were injected around the infarcted area. The adult human mesenchymal stem cells were identified with fluorescence in situ hybridization technique and myocardial antigens by immunohistochemistry. The immune response was studied by hematoxylin and eosin staining and by antibodies directed toward macrophages. RESULTS: Significant rat lymphocyte proliferation was observed when adult human mesenchymal stem cells were added to peripheral blood from Sprague-Dawley rats previously exposed to adult human mesenchymal stem cells. No reactivity was seen in lymphocytes from untreated Sprague-Dawley rats and athymic rats. Adult human mesenchymal stem cells could only be identified in the myocardium of athymic rats. Further, in normal Sprague-Dawley rats, there was a significant myocardial infiltration of round cells, mostly macrophages, in the area of injection of adult human mesenchymal stem cells. In RNU rats, this reaction was less intense. CONCLUSION: Adult human mesenchymal stem cells did not induce xenoreactivity in vitro in previously unexposed immunocompetent Sprague-Dawley rats. However, although mesenchymal stem cells are transplantable across allogeneic barriers, transplant rejection can occur in a xenogenic model. When transplanted into an immunoincompetent host, adult human mesenchymal stem cells showed persistent engraftment.

Animals↗

PubMed2003

Multivariate statistics in analysis of data from the in vitro motility assay.

A novel approach is described for classification of filaments as stationary or moving and for extraction of velocity data for smooth actin filament sliding in vitro. Moving and stationary filaments were effectively classified using four discriminating variables in a multivariate statistical analysis. The variables were (1) two different measures of the average filament distance from its starting point, (2) a measure of the variability in sliding direction, and (3) the coefficient of variation (CV) of the frame-to-frame sliding velocity (v(mean)). On the basis of this multivariate analysis we obtained correct classification of 98% of the stationary filaments and 94% of the moving filaments in a cross-validation data set. The same classification functions were useful throughout despite a 10-fold variation in the average sliding velocity in the cross-validation data. Further analysis of motile filaments suggested that the velocity of smooth sliding should, ideally, be obtained from the intercept on the velocity axis of a plot of v(mean) against CV. The velocity, so obtained, was between 10 and 30% (mean 20+/-3%; n=7; p<0.001) higher than if average sliding velocity was obtained for all moving filaments with CV<0.5.

Actin Cytoskeleton↗

PubMed2003

Cardiotonic bipyridine amrinone slows myosin-induced actin filament sliding at saturating [MgATP].

Previously reported effects of amrinone on skeletal muscle function suggest that the drug reduces the rate constant of myosin cross-bridge dissociation. We have used the in vitro motility assay to further elucidate the mechanism underlying this effect and to aid these studies a new, improved, filament tracking software was developed in the Matlab environment. The experiments were carried out at 30 degrees C using heavy meromyosin from fast rabbit muscle and rhodamine-phalloidin labeled actin filaments. A slowing effect of amrinone on filament sliding velocity at 1 mM MgATP was observed at drug concentrations >0.3 mM. This effect showed signs of saturation at the highest drug concentrations (1-2 mM) that could be readily tested. The sliding velocity exhibited hyperbolic dependence on [MgATP] with a Vmax of 7.2 +/- 0.9 microm/s and a KM of 0.18 +/- 0.02 mM. Amrinone (1 mM) reduced Vmax by 32 +/- 5% (P < 0.01) and KM by 42 +/- 8% (P < 0.05; n=4). These results are accounted for in the most straightforward way by a model where amrinone acts directly on the actomyosin system and reduces the rate constant of MgADP release. Such a well-defined effect on the myosin cross-bridge cycle makes the drug a potentially useful pharmacological tool for further studies of myosin function both in vitro and in the ordered filament array of a living muscle fiber.

Actin Cytoskeleton↗

PubMed2003

Continent urinary tract reconstruction - the Lund experience.

UNLABELLED: The Department of Urology in Lund, Sweden, has a long association with innovations in reconstructive urology. The authors from that department describe their experience over a long period with orthotopic bladder substitution and continent cutaneous urinary diversion. They conclude that continent urinary tract reconstruction is associated with a high incidence of early and late complications. They also found that for storage and emptying, their Lundiana pouch was superior to the Goldwasser neobladder. OBJECTIVE: To assess the early and late complications and functional results in patients undergoing continent reconstruction of the urinary tract, i.e. orthotopic bladder substitution (OBS) or continent cutaneous diversion (CCD). PATIENTS AND METHODS: The medical records of all patients undergoing OBS (Goldwasser technique) or CCD ('Lundiana' technique) for malignant or benign disease during 1987-1999 and followed to December 2001 were reviewed. There were 67 patients with neobladders, 77 with a Lundiana pouch who had undergone radical cystectomy and 22 with a Lundiana pouch operated for benign disorders. RESULTS: Early complications requiring reoperation occurred in 12% of the cystectomy group, with no difference with type of reconstruction, and in 10% with benign diseases. Four patients (3%) undergoing radical cystectomy died from early cardiovascular complications, two after surgery for intra-abdominal complications. Intestinally related complications and wound dehiscence requiring re-operation occurred in nine and six patients, respectively. The incidence of late complications requiring open surgery was 22% and 23% after cystectomy with OBS and CCD, respectively. The value in patients with benign diseases undergoing CCD was also 23%. Stone formation in the pouch was common, occurring in 12% in patients with OBS and in 10% after CCD. The pouch perforated or ruptured in four patients. The incidence of uretero-intestinal stricture using the Le Duc technique was 2.4% and renal function was well preserved. The incidence of revisional surgery of the Lundiana pouch outlet for incontinence was low and all patients but four were continent. The functional outcome in patients with OBS was less good; some needed pouch augmentation or an artificial urinary sphincter. Most patients used incontinence products and many needed clean intermittent self-catheterization. CONCLUSION: Continent urinary tract reconstruction is associated with a high incidence of early and late complications. For storage and emptying, the CCD Lundiana pouch is superior to the OBS of Goldwasser.

Aged↗

PubMed2002

The quality of life in men after radical cystectomy with a continent cutaneous diversion or orthotopic bladder substitution: is there a difference?

OBJECTIVE: To compare the quality of life (QoL) in men after radical cystectomy who had either a continent cutaneous diversion or orthotopic bladder substitution. PATIENTS AND METHODS: Eighty men with at least 6 months of follow-up and with no signs of recurrent disease after radical cystectomy for bladder carcinoma, and who had either a continent cutaneous diversion or orthotopic bladder substitution, were sent two types of questionnaire, the Functional Assessment of Cancer Therapy-Bladder Cancer (FACT-Bl) and the Hospital Anxiety and Depression Scale (HADS), to determine their QoL. RESULTS: The FACT-Bl and HADS questionnaires were returned by 90% and 71% of the patients, respectively (P < 0.05). In the replies to the generic version of FACT-Bl there were no differences between the groups in any domain, the scores being high in all. In questions covering intestinal, urinary and sexual items, patients with continent diversion had less trouble controlling urine (P < 0.0001), had to empty less often (P < 0.001), and had fewer symptoms when emptying (P < 0.05). Patients with neobladders had a better appreciation of appearance and better preserved erectile function (both P < 0.05). In the answers to the HADS, the mean scores were low (within the normal ranges) and did not differ between the groups. CONCLUSION: Using two instruments tested for validity and reliability, there were no differences between patients with continent diversion and those with orthotopic substitution.

Aged↗

PubMed2001

Prediction of affinity and kinetics in biomolecular interactions by affinity chromatography.

Computer simulation of affinity chromatography is a valuable tool for accurate prediction of column performance. In our study affinity pairs based on lectin and antibody interactions with carbohydrates have been used as model systems. In this well-characterized system we have demonstrated the usefulness of the simulation approach for determination of affinity and kinetics. These properties are typically difficult to obtain for many weakly interacting molecular species (i.e., when dissociation constants (K(D)) are greater than 10(-5) M). The influence of affinity and kinetics on peak broadening in affinity chromatography has also been investigated.

Acetylglucosamine↗

PubMed2001

Food-related gastrointestinal symptoms in the irritable bowel syndrome.

BACKGROUND/AIMS: Postprandial symptoms are common in patients with irritable bowel syndrome (IBS). However, existing studies have come to different conclusions about the role of food in the pathophysiology of IBS. We explored the prevalence of subjective food-related gastrointestinal (GI) symptoms and its relationship to clinical characteristics and psychological factors in IBS. METHODS: 330 patients with IBS and 80 healthy volunteers completed a food questionnaire developed for this study. The subjects graded their subjective symptoms after 35 different foods and a food score was obtained by adding the item scores. The relationship between subjective food-related GI symptoms and referral status, IBS subgroup (predominant bowel pattern), sex, anxiety, depression and body mass index (BMI) was estimated. RESULTS: In 209 (63%) of the patients the GI symptoms were related to meals. Gas problems and abdominal pain were the most frequently reported symptoms. Foods rich in carbohydrates, as well as fatty food, coffee, alcohol and hot spices were most frequently reported to cause symptoms. The food score was higher in patients than in controls (p < 0.0001). In the IBS group higher scores were observed in patients with anxiety (p = 0.005), and females (p < 0.001), but the results were unrelated to IBS subgroup, referral status or BMI. The BMI did not differ between groups. CONCLUSION: A majority of IBS patients consider their symptoms to be related to meals. Especially foods rich in carbohydrates and fat cause problems. Nevertheless, the majority of IBS patients are normal or overweight. Female sex and anxiety predict a high degree of food-related symptoms in IBS.

Adult↗

PubMed2000

Urinary diversion and bladder substitution in patients with bladder cancer.

For the majority of patients with invasive bladder carcinoma, radical cystectomy remains the gold standard of care. As a result the twentieth century has seen the continuous development of methods for reconstructing the urinary tract. Two decades ago the ileal conduit was by far the most commonly used method, whereas today methods geared toward patient continence are first choices in most centers. Some of these methods are unquestionably more complex than the ileal conduit, yet whether they actually yield uniformly improved quality of life is the cause of much debate. Many different variables play a role in determining the best type of reconstruction for an individual bladder cancer patient. This review analyzes the different factors that must be considered to obtain an optimal match between patient and reconstructive method.

Journal Article↗

PubMed2000

Cross-bridge movement and stiffness during the rise of tension in skeletal muscle--a theoretical analysis.

Predictions for the time courses of cross-bridge attachment. N(t), stiffness, S(t), and force, T(t), during the tetanus rise were analysed for a special class of cross-bridge models where cross-bridges initially attach in a non-stereospecific weak-binding state, AW. This state is in rapid equilibrium (equilibrium constant K) with detached states and the force generating transition (rate constant F+) is delayed. One model (model IA) which assumed step-function rise of activation at onset of tetanus, gave a poor fit to the experimental data (judged by root mean square error, RMSe approximately 0.038) but the experimentally observed lead of N(t) over T(t) was reproduced qualitatively. An activation mechanism where K increased towards its maximum value according to an exponential function (Model IB) improved the fit considerably (RMSe approximately 0.013). However, the activation time constant (r = 30 ms) derived in the fit was too high to reflect Ca2+ binding to troponin. In a further developed model (model II) both Ca2+ -binding to troponin and cross-bridge attachment were assumed to be required for full activation. This more complex model gave a good fit to the experimental data (RMSe approximately 0.013) with a realistic time constant for Ca2+ binding to troponin (9 ms). In both model IB and model II the best fit was obtained with F+ approximately 40 s(-1). An extended version of model IB, with distributed cross-bridge attachment and a series elastic element, gave a fit of similar quality (RMSe approximately 0.009) as obtained with model IB and model II and with a similar value of F+. The results support the view that weakly bound cross-bridges (state AW) may account for the lead of cross-bridge movement over force during tension rise. It is also shown that, if the stiffness of the myofilaments is non-linear (stiffness increasing with tension) the experimentally observed lead of S(t) over T(t) may, to a significant degree, be attributed to cross-bridges in the state AW.

Animals↗

PubMed2000

Quality of life after radical cystectomy and orthotopic bladder substitution: a comparison between Italian and Swedish men.

OBJECTIVE: To investigate possible differences between Italian and Swedish men in health-related quality of life (HRQL) after cystectomy and orthotopic bladder substitution for bladder cancer. PATIENTS AND METHODS: Thirty-three men in Padua, Italy and 33 in Lund, Sweden were assessed after respective mean postoperative periods of 42 and 52 months. Three questionnaires were used: (i) dealing with view-of-life issues; (ii) the core questionnaire QLQ-C30(+3) from the European Organization for Research and Treatment of Cancer, with added questions on urinary symptoms and sexuality; and (iii) one focusing on postoperative psychosocial and sexual adjustment. RESULTS: While Italian and Swedish men did not differ in their central values, they differed significantly in belief-related values, such as religion. Urinary problems and erectile dysfunction were common in both groups, the former possibly commoner in the Swedish men and the latter in the Italians. Changes in mood and self-esteem were common in both groups. On a visual analogue scale, the Italian men reported a worse present mood than the Swedish men, but expressed a more favourable outlook on their future. CONCLUSION: Despite differences in philosophical attitudes between Italian and Swedish men, there were no major differences in HRQL. Caution is required in interpreting these findings because there were few participants and the possible inadequacy of the methods used to evaluate the complex concept of quality of life.

Adult↗

PubMed1999

When the bladder is gone: quality of life following different types of urinary diversion.

Methods aiming for continence after radical cystectomy for bladder cancer, e.g., continent cutaneous urinary diversion and orthotopic bladder substitution, have become clinically accepted alternatives to ileal conduit diversion in the past decade. The a priori assumption has been that improvement in the postoperative quality of life would be greater following the new methods than after ileal conduit diversion. Studies on the validity of this assumption have been hampered by a lack of consensus on what should be measured and how this should be done: in no two studies have identical test instruments been used. The frequent inclusion of patients with nonmalignant disease has also impeded comparative evaluation of reports. By and large, published studies do not seem to confirm that the new types of urinary tract reconstruction improve the quality of life of bladder cancer patients. Common for all methods are psychosocial and sexual problems.

Adaptation, Psychological↗

PubMed1998

Can preoperative psychological defensive strategies, mood and type of lower urinary tract reconstruction predict psychosocial adjustment after cystectomy in patients with bladder cancer?

OBJECTIVES: To assess if there is relationship between: (i) preoperative psychological defensive strategies, mood and type of lower urinary tract reconstruction, and (ii) psychosocial adaptation after radical cystectomy for bladder cancer. PATIENTS AND METHODS: Fifty-seven consecutive patients (44 men and 13 women, mean age 62 years, range 34-81) undergoing radical cystectomy (ileal conduit urinary diversion in 17, continent cutaneous diversion in 22 and orthotopic bladder replacement in 18) were assessed preoperatively using the meta-contrast technique (MCT), a projective test to reveal individual defensive strategies. From the results the patients were classified as hypothetical 'at risk' or 'no risk' patients for postoperative psychosocial complications. An 'at risk' patient was designated as one who showed neurotic defensive strategies in coping with threats, i.e. primitive, immature or regressive strategies or even lack of defence in connection with pronounced anxiety. All patients completed a questionnaire and were interviewed; 10 questions dealt with mood, five reflecting anxiety and five the depressive states. The questionnaire and the interview were repeated 3 and 12 months, and 5 years after surgery. RESULTS: The remembered difficulties during the first month after discharge from hospital differed between the 'risk' and 'no risk' groups after 1 and 5 years. On a visual analogue scale (VAS) the 'risk' patients had very low scores (less difficulty) or very high, while the 'no risk' patients had intermediate scores. VAS score were also higher, although not significantly so, in patients using primitive defence strategies. The psychosocial situation did not differ between the groups in the first year, but at 5 years there were differences in self-esteem and interpersonal contact-seeking. High depression scores before surgery were associated with high VAS scores at 3 months when recalling the first month after discharge, but the anxiety score was not predictive. Men with orthotopic bladder replacement adapted less well throughout the 5 year follow-up. Elderly patients with stereotypy (the commonest defensive strategy at these ages) adapted relatively well to ileal conduit diversion. About 20% of patients had difficulty in accepting the postoperative situation, regardless of urinary diversion modes. CONCLUSION: The combination of defensive strategies assessed using the MCT and selected on hypothetical grounds was less discriminatory than expected for those at risk of postoperative psychosocial problems. However, those with primitive strategies apparently had a long-term risk of poor adaptation. The search for an optimal instrument for the identification of patients at risk is warranted. In this study, patients with a 'wet' stoma did not seem to fare less well than those with a continent reconstruction.

Adaptation, Psychological↗

PubMed1997

The biphasic force-velocity relationship in frog muscle fibres and its evaluation in terms of cross-bridge function.

1. The relationship between force and velocity of shortening was studied during fused tetani of single fibres isolated from the anterior tibialis muscle of Rana temporaria (1.5-3.3 degrees C; sarcomere length, 2.20 microns). Stiffness was measured as the change in force that occurred in response to a 4 kHz length oscillation of the fibre. 2. The results confirmed the existence of two distinct curvatures of the force-velocity relationship located on either side of a breakpoint in the high-force, low-velocity range. Reduction of the isometric force (P0) to 83.4 +/- 1.7% (mean +/- S.E.M., n = 5) of the control value by dantrolene did not affect the relative shape of the force-velocity relationship. The breakpoint between the two curvatures was located at 75.9 +/- 0.9% of P0 and 11.4 +/- 0.6% of maximum velocity of shortening (Vmax) in control Ringer solution and at 75.6 +/- 0.7% of P0 and 12.2 +/- 0.7% of Vmax in the presence of dantrolene. These results provide evidence that the transition between the two curvatures of the force-velocity relationship is primarily related to the speed of shortening, not to the actual force within the fibre. 3. The instantaneous stiffness varied with the speed of shortening forming a biphasic relationship with a breakpoint near 0.15 Vmax and 0.8 P0, respectively. The force/stiffness ratio (probably reflecting the average force per cross-bridge), increased with force during shortening. The increase of the force/stiffness ratio with force was less steep at forces exceeding 0.8 P0 than below this point. 4. A four-state cross-bridge model (described in the Appendix) was used to evaluate the experimental results. The model reproduces with great precision the characteristic features of the force-stiffness-velocity relationships recorded in intact muscle fibres.

Animals↗

PubMed1997

Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer?

OBJECTIVES: To investigate: (i) if early psychosocial intervention after cystectomy for bladder cancer can assist psychosocial rehabilitation; (ii) if the outcome of such intervention correlates with the patient's psychological defensive strategies as revealed with the meta-contrast technique (MCT); and (iii) if the patient's general philosophical outlook is important in this context. PATIENTS AND METHODS: Of 50 patients who had undergone radical cystectomy for bladder cancer, 17 received an ileal conduit, 17 a continent urinary reservoir with abdominal stoma and 16 an orthotopic neobladder. Twenty-four of the patients were randomized to psychosocial intervention, comprising weekly counselling 4-9 weeks after surgery. All patients were then evaluated with the Sickness-Impact Profile (SIP) standard questionnaire and the MCT (a projective test of percept-genetic model) was used to reflect individual defensive strategies at the subconscious or unconscious level. The patient's general philosophical outlook was recorded before and after surgery. RESULTS: There was no significant difference in the results of the SIP between the intervention and the non-intervention group, as a whole or in its psychosocial dimension. However, intervention benefited patients with continent cutaneous diversion, whose scores on the psychosocial SIP dimension were lower than in the groups with ileal conduit diversion or orthotopic bladder replacement (P < 0.05). The MCT analysis of defensive strategies identified three clusters of patients characterized mainly by isolation and repression, repression and stereotypy or sensitivity and stereotypy. Analysis for cluster identification showed no significant SIP score differences between intervention and non-intervention groups. In an analysis of single defensive strategies, stereotypy was associated with higher total SIP score, but not significantly. Three clusters of philosophical outlook were identified; in one cluster, characterized by a belief in a supernatural power and philosophical interest, the psychosocial SIP scores were lower in the patients who obtained emotional support and the reverse in a cluster with contrary attitudes, although neither differences were significant. CONCLUSION: Psychosocial intervention assisted the psychosocial rehabilitation of patients with continent cutaneous urinary diversion. Defensive strategies and philosophical outlook generally did not influence the outcome of intervention. However, such programmes may be helpful for some patients, mainly those with a basically pessimistic disposition, a general interest in philosophical questions and often using defensive strategies of stereotypy and repression.

Aged↗

PubMed1995

Decline of herpes simplex virus type 2 and Chlamydia trachomatis infections from 1970 to 1993 indicated by a similar change in antibody pattern.

Antibodies to herpes simplex virus type 2 (HSV-2) and Chlamydia trachomatis (Ct) were determined in sera from pregnant women from 1970 and at intervals up to 1993. The trends for HSV-2 and Ct infections were deduced from the observed antibody rates in different age groups during the observation period. Total antibody rates for HSV-2 tended to decline toward the end of the period when age-matched groups were compared, while the Ct antibody rates peaked in 1979 and then declined gradually. Age-specific antibody rates showed declining frequencies in women younger than 20 years for both HSV-2 and Ct over the study period. Women 35 years of age and older in the early 1990s had significantly higher antibody rates than younger women at that time or than women of similar age in the early 1970s. This group of slightly older women with high antibody rates in the 1990s were 15-20 years of age in 1970 when a high antibody frequency was noted in this age group. High antibody rates against both HSV-2 and Ct in older pregnant women in the early 1990s may thus reflect a high incidence of these infections around 1970. The declining rates of antibodies in the youngest women would suggest a declining incidence of primary infections in this group.

Adult↗