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H Thejls

Publications and source records attributed to H Thejls.

7 recordsLinked to original sources
PubMed1995

Diagnostic efficacy of chlamydial antibodies in cervical secretions from pregnant women and adolescent girls.

OBJECTIVE: To assess the prevalence of cervical antibodies to Chlamydia trachomatis in two different populations and to correlate the findings to culture, direct fluorescent antibody test (DFA) and serum antibodies. SETTING: Antenatal clinics and clinic for teenage counselling in Gävle. PATIENTS: 1078 pregnant women attending for routine follow up in the third trimester of pregnancy and 256 teenage girls. OUTCOME MEASURES: Cervical IgG and IgA antibodies to Chlamydia trachomatis. Cervical cultures for chlamydia. Serum IgG antibodies. DFA tests were used only in the teenage group. RESULTS: The prevalence of positive culture was 2.0% in pregnant women and 8.6% in teenage girls. In pregnant women cervical IgG > or = 8 and IgA > or = 8 were found in 7.2% and 5.8% respectively and in teenage girls in 6.6% and 2.0% respectively. The agreement between cervical IgG > or = 8 and humoral IgG > or = 32 was 0.76 in the pregnant group and 0.95 in the teenage group. The sensitivity, specificity and positive predictive value (PPV) for cervix IgG > or = 8 to predict a positive culture was 0.64, 0.94 and 0.18 respectively in pregnant women and 0.41, 0.97, 0.53 respectively in teenage girls. Of 31 teenage girls with either positive culture or positive DFA 12 had cervical IgG > or = 8 while five of 225 with negative chlamydia tests had cervical IgG > or = 8 (sensitivity 0.40 and PPV of 0.71). Cervical IgG > or = 16 was found in eight of 31 with positive chlamydia tests and in one of 225 with negative tests (sensitivity 0.26 and PPV 0.89). CONCLUSIONS: The finding of cervical IgG > or = 16 predicts current chlamydia (culture or DFA) in nearly 90% in a teenage population. It might indicate current infection in spite of negative culture in some cases. For low titres and in a low prevalence pregnant population cervical IgG are not useful for the diagnosis of chlamydia. As the sensitivity is low cervical antibodies cannot be used for screening purposes.

Adolescent↗
PubMed1994

Expanded gold standard in the diagnosis of Chlamydia trachomatis in a low prevalence population: diagnostic efficacy of tissue culture, direct immunofluorescence, enzyme immunoassay, PCR and serology.

OBJECTIVE: To evaluate the diagnostic efficacy of chlamydia culture, direct immunofluorescence (DFA), direct enzyme immunoassay (EIA), polymerase chain reaction (PCR) and serology by defining positive culture or at least two positive non-culture tests as true positive. SETTING: Three gynaecological departments located in separate areas of Sweden. PATIENTS AND DESIGN: All pregnant women requesting abortion during a six month period were included. In cases with unconfirmed non-culture tests, reculture with multiple passage and PCR on the culture transport medium was performed for confirmation. Serum was analysed for chlamydial antibodies type IgG, IgM and IgA using microimmunofluorescence. RESULTS: 18 of 419 (4.3%) patients were positive for chlamydia according to the defined criteria. Twelve of 419 (2.9%) were positive in standard culture (primary inoculation). The sensitivity of standard culture, DFA, EIA and PCR were 66.7%, 77.8%, 64.7% and 71.4% respectively. The specificity 100% (by definition), 99.5%, 100%, 100% respectively. The positive predictive value 100% (by definition), 87.5%, 100%, 100% respectively. Negative predictive value 98.5%, 99.0%, 98.5%, 98.9% respectively. Serum IgG titre of > or = 64 and > or = 1024 gave positive predictive values of 10% and 21% respectively. CONCLUSIONS: When an expanded gold standard is used, the specificity and positive predictive value of the non-culture tests used are comparable with that of standard culture even in this low prevalence population. Standard culture underestimated the chlamydia prevalence by 33%. The prevalence found represents a decrease from 10 to 2.9% of culture verified chlamydia during four years in comparable populations. Chlamydial antibodies of certain immunological classes are not necessarily present in cases with chlamydia.

Adult↗
PubMed1992

Incidence of pelvic inflammatory disease after first-trimester legal abortion in women with bacterial vaginosis after treatment with metronidazole: a double-blind, randomized study.

OBJECTIVE: The purpose of this study was to evaluate the effect of metronidazole treatment on the incidence of postoperative pelvic inflammatory disease after first-trimester abortion in women with bacterial vaginosis. STUDY DESIGN: A double-blind, randomized, multicenter study was conducted on 231 women undergoing first-trimester legal abortion and fulfilling the criteria for bacterial vaginosis. The women were randomized to either metronidazole 500 mg three times daily for 10 days or placebo. Treatment was started at the outpatient visit the week before the operation. RESULTS: Among the 174 women who could be evaluated, pelvic inflammatory disease developed in 14 after the abortion. In the treatment group there were three infections (3.8%) compared with 11 (12.2%) in the placebo group (p less than 0.05). CONCLUSION: These data suggest that patients with bacterial vaginosis should be treated in conjunction with first-trimester abortion because treatment with metronidazole reduces the postoperative infection rate more than three times.

Abortion, Induced↗
PubMed1991

Diagnosis and prevalence of persistent chlamydia infection in infertile women: tissue culture, direct antigen detection, and serology.

Specimens for chlamydial culture, direct fluorescent antibody (DFA) test, two enzyme immunoassays (EIA) for antigen detection, and serum for chlamydial antibodies were collected from 256 infertile women. Specimens were taken from the tubes during tuboplasty and from the cervix and endometrium during laparoscopy or tuboplasty. Antibodies to Chlamydia trachomatis were found four times more often in patients with signs of prior pelvic inflammatory disease (PID) than in infertile women with normal pelvic findings. Only 48 (37%) of 131 patients with signs of prior PID had a history of PID. Ten or more C. trachomatis elementary bodies (EBs) per smear were found in 21 (8.2%) of 256 patients. Six patients had a positive culture or a positive antigen EIA test. All six had high numbers of EBs in the DFA test. We conclude that routine culture and EIA antigen tests detect only a minority of persistent chlamydia infections in this population, but subjective factors in the interpretation of DFA methods must be considered.

Adult↗
PubMed1987

Correlation between chlamydia infection and clinical evaluation, vaginal wet smear, and cervical swab test in female adolescents.

Vaginal wet smear, endocervical swab test, gynecologic examination, and history were investigated in 148 healthy female adolescents. Cultures for Chlamydia trachomatis were obtained from all patients. The overall prevalence was 19/148 (13%). No significant correlation was found between chlamydia infection and any of the parameters investigated in the wet smear. Results of swab test or history showed no discrimination between young women with cultures positive for C. trachomatis and those with cultures negative for C. trachomatis. Chlamydia was found in 32% of patients when the gynecologic examination showed signs of infection and in 10% when no signs of infection were seen (p less than 0.025). Thirteen of the 19 (70%) adolescents with chlamydia infections had no signs of infection. We conclude that neither swab test, vaginal wet smear, nor the history of the patient can give conclusive evidence of a chlamydial infection. Detection of C. trachomatis in this population can be done only by culture or other specific methods.

Adolescent↗
PubMed1986

Leiomyomatosis peritonealis disseminata.

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal spread of nodules, giving the clinical impression of a widespread malignant tumor. The histopathology of LPD is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Two new case reports are presented here, suggesting that some cases of LPD are wrongly classified as metastasizing leiomyosarcoma. As the prognosis in LPD is favorable, it is of great importance to establish the correct diagnosis. When both the pathologist and the clinician become aware of the multipotentiality of the mesothelium and the adjacent stroma and thereby the multifocal character of the lesions, some of the diagnostic problems might be overcome.

Adult↗