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Biomedical subjects

B Bjerre

Publications and source records attributed to B Bjerre.

At least 19 recordsLinked to original sources
PubMed2000

The community safety approach in Falun, Sweden--is it possible to characterise the most effective prevention endeavours and how long-lasting are the results?

The safe community concept was put into practice in order to reduce the number of unintentional injuries occurring in the Falun municipality. A community-based injury prevention programme was initiated in 1989 and has been gradually built up since that time. The prevention endeavours were based primarily on active intervention strategies through the provision of information, supervision, education and training. After 5 years of an active intervention programme, a significant effect was found as regards the injury rates for both outpatients as well as patients discharged from hospitals. The objectives of this study were: to examine whether the character of the prevention endeavours was a determining factor on the outcome (recorded as in-patient injury cases); to evaluate the effects of this programme, which is still in practice, compared to long-term historical trends; and to draw comparisons with other community-based programmes. A category of 'most targeted risks' was identified as being different with respect to how the injury mechanisms involved were targeted through the programme activities. The development within the injury rates for this group, comprised predominantly of injuries caused by falls at the same level, was significantly different than those for the groups categorized as 'less targeted' and 'non-targeted'. The general effect of the programme appeared to be a neutralization of an otherwise upward trend in the injury rates. A particular effect was demonstrated in the number of fall injuries, including femoral fractures. It was also noted that there was still a reduction in injuries after 7 years. However, it was possible to surmise a waning effect during the last 2 years of the programme while still in progress. This observation suggests that a community-based injury prevention programme must be continuously renewed and reinforced.

Accident Prevention↗
PubMed1999

[Time to take the regional program for prevention of injuries seriously. Reduced number of hip fractures is the most obvious benefit of the Falun project].

The article consists in a report of the community safety programme to reduce the prevalence of non-intentional injuries that was launched in Falun in 1989 and built up gradually. Evaluation of the results was based on data elicited by a local surveillance system (out-patients) and hospital discharge data (in-patients), both of which registers indicated significant reductions in injury rates. Although the reduction was most prominent in the targeted risk categories (particularly in falls due to slipping or stumbling, resulting in femoral fractures), spin-off benefits were also observed. The manifest potential for economy in health care costs is also discussed.

Accident Prevention↗
PubMed1997

Dementia and driving: an attempt at consensus.

The number of older drivers in Sweden will be rapidly increasing during the next decades. A possible relationship exists between the increased relative crash risk of older drivers and the prevalence of age-related diseases such as dementia. However, a clear-cut policy for evaluating driving competence in demented persons is still lacking. In recognition of this fact, the Swedish National Road Administration invited a group of researchers to formulate a consensus on the issue of driving and dementia. This consensus document is aimed at providing primary care physicians with practical advice concerning the assessment of cognitive status in relation to driving. Suggestions are based on a review of existing research and discuss the use of general and driving-specific sources of information available to the physician. Consensus was reached on the statement that a diagnosis of moderate to severe dementia precludes driving and that certain individuals with mild dementia should be considered for a specialized assessment of their driving competence.

Aged↗
PubMed1996

Cervical mucus antibodies against human papillomavirus type 16, 18, and 33 capsids in relation to presence of viral DNA.

To investigate whether cervical mucus antibodies against human papillomavirus (HPV) capsids are associated with the detection of HPV DNA or HPV-related cytological diagnoses, 611 samples of cervical secretions from 359 women referred to a colposcopy clinic were tested by an enzyme-linked immunosorbent assay for the presence of immunoglobulin A (IgA) antibodies against HPV capsids of HPV type 16, 18, or 33 and for the presence of cervical HPV DNA by PCR. Among subjects with at least one cervical sample positive for HPV type 16 (HPV-16) DNA, 28.1% also had at least one HPV-16 IgA-positive cervical sample (odds ratio [OR] = 2.9; P = 0.0003). IgA to HPV-18 was also more common among HPV-18 DNA-positive subjects (OR = 3.1; P = 0.0325) and IgA to HPV-33 was more common among HPV-33 DNA-positive subjects (OR = 4.2; P = 0.0023). Cervical IgA antibodies to HPV-16 were also more common among patients with cervical intraepithelial neoplasia, particularly among patients with cervical intraepithelial neoplasia grade I (P < 0.0005). The data indicate that an HPV type-restricted IgA antibody response against HPV capsids is detectable in cervical mucus and is associated with a concomitant cervical HPV infection.

Adolescent↗
PubMed1995

A longitudinal study of the perimenopausal transition: altered profiles of steroid and pituitary hormones, SHBG and bone mineral density.

From a longitudinal prospective study, 160 women with spontaneous menopause and without steroid medication were followed during the transition from pre- to postmenopause. After 12 years 152 women were still participating in the study. Blood samples were drawn every 6 months until 1 year after the menopause and every 12 months thereafter. Measurements of bone mineral density (BMD) on the forearm were performed every second year. All women routinely completed a questionnaire concerning symptoms frequently attributed to the climacteric period. All data were grouped around the onset of the menopause, thereby allowing longitudinal evaluation of the changes in the variables from the premenopausal to the postmenopausal period. The beginning of the perimenopausal period was characterized by transitory elevations of follicle-stimulating hormone (FSH). A significant increase in serum levels of gonadotropins was observed for both FSH and luteinizing hormone (LH) from about 5 years before the menopause. Within the 6 month period around the menopause there was a further increase which culminated within the first postmenopausal year for LH and 2-3 years postmenopause for FSH. Thereafter, a continuous decrease in LH occurred over the following 8 years. With respect to FSH, there was a slight decline starting about 4 years postmenopause. During the premenopausal period an increasing frequency of inadequate luteal function or anovulation occurred and, in the postmenopausal years, the serum levels of progesterone (P) were invariably low. Gradually, the ratio between estrone (E1) and 17-beta-estradiol (E2) increased, reflecting the declining follicular steroidogenesis. A marked decrease in estrogen levels occurred during the 6 month period around the menopause, most pronounced in E2. During the next 3 years, the levels of E2 and E1 showed an essentially parallel, moderate decline. Around the menopause, serum levels of testosterone (T), delta 4-androstenedione (A) and sex hormone-binding globulin (SHBG) showed small but significant decreases. From about 3 years postmenopause, the levels were relatively constant over the following 5 years. A decrease in BMD was observed in the postmenopause, and from about 3 years postmenopause, estradiol correlated positively with BMD. Before, as well as after the menopause, body mass index (BMI) showed an inverse correlation with SHBG. Postmenopausal androstenedione correlated positively with E1, E2 and T. BMI correlated positively with E1 and E2. The concentrations of the free fraction of E2 and T are dependent on the levels of SHBG, which in turn has a negative correlation with BMI. The impact of this will influence the severity of symptoms, the degree of bone loss and the need for supplementary therapy.

Androstenedione↗
PubMed1994

Typing of human papillomaviruses by consensus polymerase chain reaction and a non-radioactive reverse dot blot hybridization.

A non-radioactive reverse dot blot hybridization method was developed for typing of human papillomavirus (HPV) consensus primer generated polymerase chain reaction (PCR) products in a single test. In the PCR biotin-14-dATP was incorporated into the amplified DNA, which was then used as a probe in hybridization with a membrane, on which different genital HPV types had been immobilized. Of cervical brush samples from women referred to a colposcopy clinic (n = 58) and from women attending a health control program (n = 14) which had been found positive by PCR with consensus HPV primers but negative using primers specific for the HPV types 6, 11, 16, 18, 31, 33 and 35, 25 (43%) and 3 (21%), respectively, could be typed by this method. The additional HPV types found were 34, 39, 40, 45, 52, 53, 56 and 58. Of the samples from the colposcopy clinic (n = 33) and the health control group (n = 11) which could not be typed, 23 and 5, respectively, showed HPV X which cross-hybridized with various HPV types under conditions of low stringency. It is possible to type by this fast and easy method consensus primer-generated PCR products of a wide range of HPV types or to verify the presence of HPV DNA of unknown types.

Cervix Uteri↗
PubMed1993

Human papilloma virus types in routine cytological screening and at colposcopic examinations.

Certain types of human papillomaviruses (HPV) play a crucial role in the development of anogenital cellular dysplasia and cancer. We have searched for a broad spectrum of HPV-types by PCR in cervical cell samples from 230 women aged 20-29 years enrolled at routine gynecological health control and 506 women referred to colposcopy due to suspected cytological changes. Thirteen percent of the health control women had HPV DNA of identified types. Half of the colposcopy patients showed benign histology with corresponding HPV DNA prevalence of 18%, while among the patients with cervical intraepithelial neoplasia between 61% and 78% had HPV DNA. Among both women with normal cytology or histology and those with various degrees of cervical dysplasia, cancer-related HPV types represented about 85% of the types found. The strong correlation between HPV infections and development of cervical dysplasia is an argument for HPV DNA testing of certain patient groups.

Adult↗
PubMed1993

Human papillomavirus DNA in urine samples compared with that in simultaneously collected urethra and cervix samples.

A polymerase chain reaction was used to evaluate the occurrence of human papillomavirus (HPV) DNA in urine samples compared with that in urethra and cervix samples simultaneously collected with brushes. Of 138 presumably healthy military conscripts, 12 (8%) had HPV DNA-positive urethra samples and 8 (5%) had HPV DNA-positive urine samples. Both the urine and urethra cell samples of five men were positive, with identical types found in the paired specimens. Seven had HPV DNA-positive urethra samples only, and three had HPV DNA-positive urine samples only. Five of 7 urethra samples from males and 11 of 12 urethra samples from females, who were among patients consulting a clinic for adolescents, were positive for HPV DNA. Among those patients whose urethras were positive for HPV DNA, the corresponding urine samples of 3 of the 5 men and all the 11 women were also positive, with one or two HPV types being in common within the paired samples. Among female patients referred to a colposcopy clinic, 49% (241 of 489) of the cervical cell samples and 38% (187 of 489) of the urine specimens were found to be HPV DNA positive. Of the patients whose cervixes were positive for HPV DNA, 65% (158 of 241) of the simultaneously collected urine samples were also positive for HPV DNA. On the other hand, 84% (158 of 187) of the patients with HPV DNA in their urine also had HPV DNA in their cervical samples. Although not all individuals with genital HPV infections could be identified as HPV positive by analysis of urine samples, at least in epidemiological surveys in which invasive samples are difficult to obtain, such as from children, analysis of urine could be an alternative means of identifying HPV DNA.

Adolescent↗
PubMed1993

Blood lead concentrations of Swedish preschool children in a community with high lead levels from mine waste in soil and dust.

The lead concentration in capillary blood was investigated in 49 preschool children (0.7-7.4 years of age) visiting a day-care center in a Swedish community with high lead contamination from mining and milling in soil and dust in populated areas [up to 1400 and 14,000 micrograms.g-1 (6.76 and 67.63 mumol.g-1) of dry weight, respectively]. The blood lead levels were examined twice (in April and in September) in 33 of the children. The lead levels were low on both sampling occasions [arithmetic mean 31 (SD 13, median 30, range 13-79) micrograms.l-1, ie, arithmetic mean 0.15, (SD 0.06, median 0.14, range 0.06-0.38) mumol.l-1]. Whereas children up to four years of age showed significantly increased levels from April to September, a significant decrease was seen in older children. The level of lead in soil at home, gender, smoking habits at home, and estimated level of hand-to-mouth activity did not appear as strong determinants of lead in blood. The results indicate that lead from mine waste in soil and dust fallout does not constitute a significant health hazard for preschool children in Falun.

Child↗
PubMed1989

Hyposelenaemia: patients with gastrointestinal diseases are at risk.

A retrospective study of serum selenium determinations performed in a hospital laboratory revealed 47 cases of hyposelenaemia (defined as a serum selenium level below 0.74 mumol l-1). Moderate hyposelenaemia (serum selenium 0.30-0.55 mumol l-1) was found in 11 patients and seven of these suffered from gastrointestinal diseases. Furthermore severe hyposelenaemia (serum selenium below 0.30 mumol l-1) was detected in three patients, who were all affected by gastrointestinal disease. We concluded that patients with gastrointestinal diseases are especially at risk of developing selenium deficiency and should be monitored by repeated determinations of serum selenium. Patients with moderate or severe hyposelenaemia should receive selenium treatment.

Gastrointestinal Diseases↗
PubMed1987

Longitudinal study of group B streptococcal carriage during late pregnancy.

152 women were cultured for group B streptococci (GBS) weekly from the 37th week of gestation and at admission to hospital for delivery. Matched rectal, urethral and urine specimens were collected for study (mean 4 times). In the 37th week of gestation, 33 women (22%) harboured GBS in rectal specimens, 28 women (18%) in urethral specimens, 16 women (11%) in urine specimens, and 37 women (24%) in at least one of the 3 specimens. All cultures considered, a total of 46 women (30%) yielded GBS in at least one culture. In the 37th week of gestation, women subsequently found to be GBS colonized at labour (positive in at least one site) had a higher rate of positive cultures in rectal specimens (77%) than in either urethral (67%) or urine specimens (41%). Chronic GBS carriage was more frequent in rectum than in urethra or urine. The results of the present investigation support the gastrointestinal tract as being the predominant source of GBS.

Bacteriological Techniques↗
PubMed1986

Faecal carriage of group B streptococci.

A study of 1,138 primarily healthy subjects of various ages and sex was conducted to determine the faecal isolation rate of group B streptococci. Five percent of 284 neonates (less than or equal to 5 days old) and 4% of 267 healthy children (1-15 years old) were found to be faecal carriers. Adults were more frequently faecal carriers than children, group B streptococci being isolated in 15% of 361 adults and 11% of 226 pregnant patients. The isolation rate was independent of sex at all ages. Although group B streptococci were found more frequently in rectal than in faecal specimens from pregnant women (p less than or equal to 0.001), the isolation rate for faecal specimens could be increased by using a more selective broth. Forty-four percent of strains isolated from faeces of 105 subjects belonged to serotype III, 27% to type Ia, 15% to type Ib, 11% to type II and 3% were nontypeable. The same serotype of group B streptococci was usually present at different sites in each subject.

Adolescent↗
PubMed1986

A prospective long-term study in women from pre-menopause to post-menopause: changing profiles of gonadotrophins, oestrogens and androgens.

To permit a more detailed hormonal characterization of the peri-menopause, 30 healthy women were examined at regular intervals over a 7-yr period, starting about 3 yr before the menopause. Even though most of the subjects periodically experienced climacteric symptoms, no hormonal supplementation was given. The serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol and oestrone that were recorded essentially confirmed previous data obtained in cross-sectional studies. Within the 6-mth period around the menopause the serum levels of testosterone and androstenedione showed small but significant decreases of 18 and 16%, respectively. These decreases continued over the following years and amounted to about 30% after 3 yr. In contrast, neither the mean level of dehydroepiandrosterone (DHA) nor the DHA/DHA sulphate (DHAS) ratio changed significantly at the menopause, but DHA and DHAS concentrations declined slowly by about 20% over the 7-yr observation period. The mean level of DHAS showed an isolated increase during the last few months before the menopause. A similar, although not significant, increase was also seen in DHA and testosterone levels. After the first post-menopausal year a significant positive correlation was found between the levels of oestrone and androstenedione. This longitudinal study of individual women appeared to lend itself well to the investigation of even subtle hormonal fluctuations during the gradual transition to an established post-menopausal pattern.

Androstenedione↗
PubMed1986

Group B streptococci at delivery: high count in urine increases risk for neonatal colonization.

Of 858 pregnant women studied in matched rectal, urethral and urine cultured specimens, 186 (22%) were found to be colonized by group B streptococci (GBS). GBS were detected significantly more often in rectal specimens (159) than in urethral specimens (108) or in urine specimens (64). This is supporting evidence for the gastrointestinal tract as the main habitat of GBS. Of 1786 women whose urine was sampled at delivery, GBS were isolated from 128 (7%), in 22 of whom (1% of the total) GBS were present in quantities greater than or equal to 10(4) colony forming units (cfu)/ml urine. Neonates born to women with greater than or equal to 10(4) cfu GBS/ml urine were apparently at greater risk for neonatal infection, as they were more commonly and more heavily colonized than were the newborns of women with lower quantities of GBS in urine, or if positive urethral or rectal specimens were considered. The incidence of preterm delivery or obstetric infection was not higher among women in whom GBS were isolated in specimens from any of the 3 sites; foetal distress was more common among their children, but not neonatal respiratory or infectious diseases of which the incidence was low and difficult to assess statistically.

Bacteriuria↗
PubMed1983

Invasive cervical cancer in a cytologically screened population.

In the community of Malmö, less than 10% of the 20-69-year-old women had been examined cytologically in 1960. By 1970 this figure had increased to 74% and the incidence of invasive cervical cancer decreased by 48% of th incidence prior to cytologic screening. In spite of continued screening and rescreening, no further decrease occurred during the 1970s. In 131 cases, invasive cancer was diagnosed in women previously screened. The smears of 90 of these women had shown changes more than a year before the diagnosis, but 30 women refused examination or therapy. In 60 cases of mild-moderate atypia, further examination consisted solely of a cytologic check-up. We believe that a more active examination program, including colposcopy, in cases of cytologic atypia will be the most important step towards a further reduction in the frequency of invasive cervical cancer.

Adult↗
PubMed1981

Several factors influencing the colonization of group B streptococci--rectum probably the main reservoir.

Women (1 268) attending a gynaecological clinic or a venereal disease clinic had positive cultures of group B streptococci from urethra in 27.8% and from rectum in 29.4%. The colonization rate was highest in patients from the venereal disease clinic (p less than 0.001). In a study of 405 of the females at different parts of the menstrual cycle group B streptococci were detected during the last half of the cycle in specimens from cervix in 18%, from urethra in 29% (p less than 0.005), and from rectum in 35% (p less than 0.001). The correlation between contraceptive methods and isolation of group B streptococci was investigated for 435 women. Females with intrauterine devices but not those using oral contraceptives had a significantly increased colonization rate genitally. The colonization rate of group B streptococci was also studied in 271 women using sanitary tampons and 129 women using sanitary towel. Those using tampons were significantly more often colonized. Cultures for Neisseria gonorrhoeae were performed from 380 patients but no correlation between N. gonorrhoeae and group B streptococci was found. The study supports the view that rectum and not the genito-urinary tract is the main reservoir of group B streptococci in females, that genital colonization mainly represents contamination from the gastrointestinal flora and sexual transmission is only one of many factors influencing the colonization rate.

Adult↗
PubMed1979

Prevalence of nine different micro-organisms in the female genital tract. A comparison between women from a venereal disease clinic and from a health control department.

In a study of the prevalence of nine different micro-organisms in the female genital tract in a Swedish population, significantly higher isolation rates occurred among women attending a venereal disease clinic than among those attending a gynaecological health control department. The prevalence of Candida albicans, however, was similar in different groups, individual susceptibility being the most important factor. Chlamydia trachomatis, Trichomonas vaginalis, and Mycoplasma hominis occurred concomitantly with Neisseria gonorrhoeae, indicating a similar epidemiology for all these agents. Younger patients seemed to have an increased susceptibility to C. trachomatis whereas older patients had an increased susceptibility to T. vaginalis.

Adolescent↗