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Biomedical subjects

B Hagström

Publications and source records attributed to B Hagström.

18 recordsLinked to original sources
PubMed1998

Asthma in adult life--is there an association with birth weight?

OBJECTIVE: To determine whether birth weight is associated with asthmatic disorders in adult life. DESIGN: A case-control study which compared birth weight and other indicators of pregnancy outcome in a group of adult asthmatic patients and in matched healthy controls. The diagnosis of asthma was verified using defined criteria. All asthmatic subjects were excluded from the control group. SETTING: Four primary health care centres in Lund, Sweden. SUBJECTS: 55 asthma patients and 92 healthy controls, all born between 1948 and 1973 in Lund. MAIN OUTCOME MEASURES: Birth weight, birth height, head circumference, placental weight, and gestational age. Data from a self-administered questionnaire on social and medical background factors including smoking, educational level, and a self-reported history of frequent severe respiratory infections in childhood. RESULTS: No significant differences were found between asthma patients and controls in birth weight, 3529 (SD 533) g versus 3536 (501) g, or in other variables associated with pregnancy outcome. There were no differences in current smoking habits or in educational level between the groups. The asthma patients, however, reported a higher number of childhood respiratory infections (p < 0.001) than the controls. CONCLUSIONS: These epidemiological findings do not lend support to the hypothesis that a reduced birth weight is associated with a "programming" factor for asthma. Environmental factors in childhood seem more important than fetal malnutrition for the development of asthma in adult life.

Adult↗
PubMed1998

[The dying patient--a challenge to health care personnel].

What are doctors and nurses experiences in their work with dying patients? Interviews with six nurses and four doctors from Norway, Sweden and Denmark were analysed using Grounded Theory as the qualitative method. A model is presented consisting of basic trust divided into two main categories--internal and external trust. Internal trust is characterised by confidence, competence and personal growth. External trust is based on communication, time for care, continuity in care and rituals. The two categories are dependent on each other, meaning that a good caring organisation can make it possible for even an insecure person to do their job. To work with dying patients gives an opportunity of personal growth.

Death↗
PubMed1991

Induction of anti-idiotypic (ab2) and anti-anti-idiotypic (ab3) antibodies in patients treated with the mouse monoclonal antibody 17-1A (ab1). Relation to the clinical outcome--an important antitumoral effector function?

Forty-three patients with metastatic colorectal carcinoma (CRC) were treated with the unconjugated mouse monoclonal antibody (MAb) 17-1A (ab1) only. The presence of antiidiotypic antibodies (ab2) and anti-antiidiotypic antibodies (ab3) were analyzed using an ELISA technique and a mixed hemadsorption assay respectively. Ninety-five percent (41/43) of the patients developed ab2 both of the IgM and the IgG classes. Forty-seven percent (20/43) of the patients had detectable ab3 after therapy, two of them also before administration of MAb 17-1A. Binding in vitro of ab3 (ab1) to CRC cells could be specifically inhibited by ab1. Ab3 bound to human monoclonal antiidiotypic antibodies and to a goat antiidiotypic antibody (ab2). Both these ab2 were directed against MAb 17-1A (ab1). There was a strong correlation between the presence of ab3 and the clinical outcome. Ab3+ patients survived significantly longer than those who did not develop ab3 antibodies, 80 weeks vs 38 weeks (p less than 0.001). A statistically significant correlation was found between the presence of ab3 and the anti-tumor response (CR + PR + MR + SD) (p = 0.01). Thus, induction of an antiidiotypic cascade seems to be an important antitumor effector function of MAb in the treatment of cancer patients.

Antibodies, Anti-Idiotypic↗
PubMed1988

Effect of human blood mononuclear cell populations in antibody dependent cellular cytotoxicity (ADCC) using two murine (CO17-1A and Br55-2) and one chimeric (17-1A) monoclonal antibodies against a human colorectal carcinoma cell line (SW948).

Peripheral blood mononuclear cells (PBMC) from healthy individuals were studied for their lytic capability in ADCC using SW948 (a human colorectal carcinoma cell line) as target cells. Three monoclonal antibodies (MAbs) were used: two mouse MAbs (IgG2A) against the antigenic structures CO17-1A and BR55-2 respectively and one chimeric MAb 17-1A (IgG1) (mouse-human). Three kinds of effector cells were prepared. PBMC were purified on a Ficoll-Isopaque gradient (FIP cells) (a mixture of lymphocytes and monocytes). To obtain pure monocytes (greater than 90%), PBMC were centrifuged on a Nycodenz gradient (Nycodenz cells). Highly purified lymphocytes (greater than 98%) were obtained by treatment of FIP cells with iron powder and removal of phagocytic cells (PBL cells). Monocytes had the highest lytic capability. FIP cells were less effective than monocytes. PBL cells had the poorest killing activity. In reconstitution experiments addition of increasing amount of monocytes to PBL resulted in an augmented cytotoxicity. The numbers of Leu-M3+ cells, Leu-M5+ cells (monocytes) and CD16+ cells correlated positively to cytotoxicity. Higher concentration of MAb 17-1A was required to reach the same level of cytotoxicity using FIP cells as effector cells as compared to monocytes. MAb BR55-2 induced the same cytotoxic activity as MAb 17-1A. Combination of these two MAbs did not increase the lytic capability. Chimeric MAb 17-1A mediated ADCC in a dose-dependent fashion. The chimeric MAb was consistently more effective than the mouse MAb.

Animals↗
PubMed1987

Systemic concentrations of metronidazole and its main metabolites after intravenous oral and vaginal administration.

Metronidazole kinetics was studied in 5 healthy women after a single dose given intravenously, orally or vaginally, 500, 400 and 500 mg, respectively. Serum levels of the drug and of its hydroxy and acid metabolites were assessed. The results after intravenous and oral boluses were consistent with previous reports. After vaginal dose maximum serum levels of about 1 microgram/ml of the drug were obtained between 9 and 24 h after the dose. Maximum concentration of the hydroxy metabolite was about 0.3 microgram/ml after 24 h. Bioavailability of the drug was 19 +/- 3% after the vaginal dose as compared to 100 +/- 5% after the oral dose. Daily insertion into the vagina of 500 mg metronidazole resulted in a maximum serum concentration of 1.2 +/- 0.2 microgram/ml of the parent drug and of 0.6 +/- 0.1 microgram/ml of the hydroxy metabolite after about 3 days (range 2-4) after which no accumulation was noted. Urinary excretion of the metabolites was considerably lower after vaginal than after intravenous or oral administration, but the proportion between the two metabolites in the urine was constant.

Administration, Intravaginal↗
PubMed1986

Comparison of oral and vaginal metronidazole therapy for nonspecific bacterial vaginosis.

A prospective, randomized, nonblind study was performed to compare the efficacy of a 7-day vaginal regimen with 500 mg metronidazole (Flagyl) once a day and that of oral treatment with 400 mg metronidazole twice daily for 7 days in the treatment of nonspecific bacterial vaginosis. No treatment was given to the sexual partners and there was no restriction of sexual intercourse. 38 women completed the study and at follow-up after 4 weeks, women receiving vaginal therapy had a cure rate of 79% compared with 74% in the women on oral therapy. Cure rates were lower among users of an intrauterine contraceptive device (57 versus 88% among nonusers). The occurrence of lactate-producing bacteria (lactobacilli and aerobic streptococci) in the vagina was significantly higher in women after vaginal compared with oral therapy. Gardnerella vaginalis was isolated in 58% of the women after vaginal and in 44% of the women after oral treatment. It is concluded that vaginal application of 500 mg metronidazole daily for 7 days is equally effective as oral administration in the treatment of bacterial vaginosis.

Administration, Oral↗
PubMed1986

Bacterial vaginosis treated with metronidazole. Effects on the vaginal microbiology by a single dose versus a five days regimen.

The microbiological vaginal flora was studied in 42 women with clinical findings consistent with the concept bacterial vaginosis (BV). The women and their consorts were treated with metronidazole (Flagyl), either a single dose of 2,000 mg or 400 mg three times daily for five days. Effect of treatment was assessed four weeks after its initiation. Clinical cure was attained in more than 80% of the cases and was the same irrespective of treatment. The microbiologic flora changed by treatment in direction to normal, i.e. lactobacilli regained predominance and reduction of Gardnerella vaginalis and anaerobic grampositive cocci was evident. There was no difference evident in the microbiological changes induced by the two treatment regimens. The findings support previous conclusions that BV represents a disorder of the vaginal milieu and is not the result of an infection with pathogenic microorganisms.

Adult↗
PubMed1984

Gardnerella-associated vaginitis and anaerobic bacteria.

12 patients with mild or moderate symptoms of Gardnerella-associated vaginitis were examined clinically and microbiologically on 52 different occasions, 27 of which were asymptomatic. The symptomatic state was defined by fulfilling at least three of the following criteria: (1) subjective symptoms; (2) pH above 4.5; (3) positive amine test, and (4) clue cells in wet smear. Variation of the vaginal microflora was considerable. No causative bacterial species could be identified. Microorganisms of the genus Bacteroides were significantly (p less than 0.02) more often found in the symptomatic condition. The presence of either peptococci , peptostreptococci or anaerobic streptococci was similarly related to symptoms (p less than 0.01). Lactobacilli were significantly more often present when the patient was free of symptoms (p less than 0.05). Gardnerella vaginalis was a common isolate whether the patient suffered from symptoms or not. It is concluded that the presence of this microorganism indicates a disturbed ecologic situation within the vagina, resulting in loss of predominance of lactobacilli and hence liability to develop symptoms.

Adult↗
PubMed1983

Comparison of two different regimens of metronidazole in the treatment of non-specific vaginitis.

25 patients with symptoms of non-specific vaginitis have been treated with metronidazole either 2000 mg in a single dose or 400 mg three times daily for 5 days. Diagnosis was settled by 1) identification of G. vaginalis in culture of vaginal secretion, 2) the observation of clue cells in wet smear, 3) a positive amine test on application of potassium hydroxide, and 4) increased pH in the vaginal secretion. Most patients' symptoms and complaints disappeared and at the same time most of the tests used changed from abnormal to normal findings. No side effects were recorded. It is concluded, that metronidazole in either dose was a useful treatment of non-specific vaginitis.

Clinical Trials as Topic↗
PubMed1981

Long-term clinical experience with the Cu-7-IUD. Evaluation of a prospective study.

In a prospective Swedish three-center study, totally 1446 women wearing a Cu-7-IUD were carefully followed for a minimum 2 years. Smaller subgroups have been followed for 4 years (n=278) or for even longer periods up to 8 years (n=48) with the same Cu-7-IUD in situ. Data are given concerning continuation rate, efficiency, expulsion, removals, pain, bleeding and risk for pelvic inflammatory disease. Prolonged use of the Cu-7-IUD beyond 2 years up to 4 years seems to be associated with fewer side effects and a lower incidence of accidental pregnancies than during the first 2 years of use. The computerized data confirm our earlier impression that the Cu-7-IUD provides a substantial efficacy and is associated with a relatively low rate of adverse effects.

Adolescent↗
PubMed1979

Low risk of pelvic inflammatory disease in young never-pregnant women using Gravigard.

The present four-center investigation involves 516 never-pregnant women in whom a copper-7-intrauterine device (Cu-7-IUD) was inserted. Out of these patients 173 were teenagers at the time of insertion. A "small-sized" Cu-7-IUD (Cu-7-Nullip) - designed for nulliparous women - was randomely used instead of the commercially available Cu-7-IUD (GravigardR) in 76 - 44 of whom were teenagers - out of the 516 women. The incidence of pelvic inflammatory disease (PID) of 9,080 woman-months was reviewed. In the present study the incidence of PID varied from one center to another between 0.9 and 1.4 per cent/year in women wearing Cu-IUDs. When comparing these figures with the estimated incidence (1.2%) in the population of fertile-aged women, it was concluded that the risk for PID was not increased in never-pregnant women using Cu-IUDs, including teenagers as well as women of 20 years of age or more. No difference in the incidence of PID was observed between the GravigardR and the Cu-7 Nullip.

Adolescent↗