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Biomedical subjects

S Bergström

Publications and source records attributed to S Bergström.

At least 91 records · Page 5Linked to original sources
PubMed1997

Sonographic assessment of symphyseal joint distention intra partum.

OBJECTIVE: To elucidate whether there is a distention of the symphysis pubis intra partum and whether a history of pelvic pain during pregnancy is associated with increased distention during delivery. METHODS: Using ultrasonography, the width of the symphysis pubis was measured on two occasions during delivery; firstly, upon engagement of the fetal head in the pelvic inlet, secondly, when the largest diameter of the fetal head was at the level of the ischiadic spines. The first measurement was conducted in 24 patients, the second measurement was obtained in 16 of these patients. RESULTS: The average width of the symphysis pubis at onset of labor was 5.8 mm. The average distention of the symphysis during labor was 1.1 mm for those without pelvic pain and 0.2 mm for those with a history of pelvic pain during pregnancy (p = 0.02). Parity and ensuing birth weight had no statistically significant influence on degree of distention. CONCLUSION: The symphyseal distention during labor is minimal regardless of parity and size of the child. No added symphyseal distensibility was found in patients with a history of pelvic pain.

Adult↗
PubMed1996

Canary finches (Serinus canaria) as an avian infection model for Lyme borreliosis.

To investigate if passerine birds can be used as an avian model for Lyme borreliosis, the Borrelia burgdorferi sensu stricto strain Sh2-82 was inoculated subcutaneously on Canary finches (Serinus canaria). Spirochaetes could be detected in the blood by direct microscopy and an immunofluorescence assay (IFA) up to 2 weeks after the inoculation. DNA amplification (PCR) revealed B. burgdorferi DNA in the serum for up to 3 weeks, in the faeces up to 4 weeks, and from several internal organs at autopsy 3 months after the inoculation. Of particular interest was the finding of B. burgdorferi DNA in the liver of all birds at the end of the experiment, indicating a persistent infection. Four weeks after the primary infection, all infected birds showed an increase in anti Borrelia IgG antibodies and after 6 weeks all birds had seroconverted. Except for a brief episode of diarrhoea, none of the birds showed any signs of disease. This study shows that passerine birds experience short-term spirochaetemia after infection with B. burgdorferi, but show few clinical symptoms. This suggests that, although these birds can act as reservoirs of B. burgdorferi s.s., they may be of less importance as long lasting amplifiers for this pathogen.

Animals↗
PubMed1996

Stillbirths and intrauterine infection, histologic chorioamnionitis and microbiological findings.

OBJECTIVE: To analyze whether placental inflammation is associated with stillbirth in Zimbabwe. METHOD: Placentas from 66 stillbirths (> 22 weeks' gestation; patients with congenital malformations, diabetes or preeclampsia were excluded) and 66 term live births were studied for the presence and severity of chorioamnionitis. The morphological results were compared with earlier presented microbiological findings in the same material. RESULTS: Chorioamnionitis was present in 79% of stillbirths and 30% of live births (O.R. 8.5, 95% C.I. 4.0-18). Nine percent of stillbirths but no live births presented vasculitis of the chorionic plate, which verified an inflammatory response from the infant (O.R. 14, 95% C.I. 2.8-72). The same types of microorganisms were isolated from stillbirths and liveborns, but Escherichia coli and group B streptococci were more frequent among stillbirths. CONCLUSIONS: Morphological chorioamnionitis occurred 2.6 times more often in women with stillbirths than in women with live births. In 9% of stillbirths the infant showed an inflammatory response. Thus the infant was alive when the infection occurred and it is therefore reasonable to assume that infection was the cause of death.

Cause of Death↗
PubMed1996

Child growth during weaning depends on whether mother is pregnant again.

Few longitudinal studies are available which relate data on breastfeeding and growth of the last-born child to data on the mother's subsequent pregnancy. The purpose of the present prospective study from Bhutan was to compare growth rate of children weaned during a subsequent pregnancy, with those of children weaned at the same age, but from non-pregnant mothers. Measurements of weight of 113 children and interviews with their mothers were done monthly through 32 months during the children's first 3 years of life. The period of overlap between lactation and pregnancy had a median duration of 5 months, and increased with an average of one week for each month reduction in the subsequent birth interval (P< 0.01). Children who stopped breastfeeding during their mothers' subsequent pregnancy showed a reduced growth rate during the last months before termination of breastfeeding when compared to children weaned at the same age, but from non-pregnant mothers (P = 0.04), and when compared to children who continued breastfeeding (P = 0.06).

Bhutan↗
PubMed1996

A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique.

OBJECTIVE: To evaluate the outcome of caesarean delivery performed by assistant medical officers and specialists in obstetrics and gynaecology with particular attention to post-operative complications. DESIGN: We performed a nonrandomised analysis of 2071 consecutive caesarean deliveries at Maputo Central Hospital. Of these, 958 (46.3%) were performed by assistant medical officers (medical assistants trained for surgery) and the rest (53.7%) by specialists in obstetrics and gynaecology. The age and parity distributions of women in the two groups were almost identical. SETTING: University Hospital in Maputo, covering all emergency obstetrics with about 48,000 deliveries per year. POPULATION: Two thousand and seventy-one consecutive caesarean deliveries. MAIN OUTCOME MEASURES: Post-operative complications and the duration of post-operative hospital stay. RESULTS: There were no differences in the indications for caesarean delivery. The surgical interventions associated with caesarean delivery did not differ in the two groups. The only significant difference was in the group of superficial wound separation due to haematoma, which was slightly more common (0.35% vs 0.05%) in the group operated on by assistant medical officers (Odds Ratio 2.2; 95% Confidence Interval 1.3-3.9). CONCLUSION: Training selected medical assistants to perform caesarean delivery, even on women in poor general condition, is justified in settings in which doctors are scarce.

Adult↗
PubMed1996

Frequent diarrhoeas in early childhood have sustained effects on the height, weight and head circumference of children in East Bhutan.

Episodes of diarrhoea and nutritional status of 113 children in East Bhutan were recorded monthly from 7 to 36 months of age. A re-examination was carried out 20 months later. The load of diarrhoeal diseases in early childhood was negatively associated with the parameters of children's long-term nutritional status 20 months later. Also, when early nutritional status and socioeconomic factors are included in the model, the diarrhoea variable explains a significant part of the variation in height for age (p = 0.04, delta R2 = 0.035), weight for age (p = 0.03, delta R2 = 0.030) and head circumference (p = 0.0007, delta R2 = 0.077). This is not so for the variation in weight for height or mid-upper arm circumference (p > 0.1, delta R2 < 0.005). Stunting is widespread in the area, and the effects of diarrhoea on nutritional status are more likely to be sustained in settings where dietary intake is marginal.

Bhutan↗
PubMed1996

Surface exposure and species specificity of an immunoreactive domain of a 66-kilodalton outer membrane protein (P66) of the Borrelia spp. that cause Lyme disease.

A chromosomally encoded 66-kDa protein (P66) of Borrelia spp. that cause Lyme disease has previously been shown to be associated with the spirochetal outer membrane. A topological model of P66 predicts a surface-exposed fragment which links the N- and C-terminal intramembranous domains of the protein (J. Bunikis, L. Noppa, and S. Bergström, FEMS Microbiol. Lett. 131:139-145, 1995). In the present study, an immunogenic determinant of P66 was identified by a comparison of the immunoreactivities of different fragments of P66 generated either by proteolytic treatment of intact spirochetes or as recombinant proteins expressed in Escherichia coli. The immune response to P66 during natural infection was found to be directed against the predicted surface domain which comprises amino acids at positions 454 through 491. A sequence comparison revealed considerable polymorphism of the surface domains of P66 proteins of different Lyme disease-causing Borrelia species. Five sequence patterns of this domain were observed in the B. garinii strains studied. In contrast, sequences of the relevant part of P66 of the B. afzelii and B. burgdorferi sensu stricto isolates studied were identical within the respective species. In immunoblotting, 5 of 17 (29.4%) sera from North American patients with early disseminated or persistent Lyme disease reacted against P66 of B. burgdorferi sensu stricto B31. These sera, however, failed to recognize P66 of B. afzelii and B. garinii, as well as an analog of P66 in the relapsing fever agent, B. hermsii. In conclusion, the topological model of P66 is supported by the demonstration of an apparent surface localization of an immunoreactive domain of this protein. Furthermore, analogous to the plasmid-encoded borrelial outer surface proteins, the predicted surface-exposed portion of chromosomally encoded P66 appears to be antigenically heterogenous.

Amino Acid Sequence↗
PubMed1996

Molecular polymorphism of the lyme disease agent Borrelia garinii in northern Europe is influenced by a novel enzootic Borrelia focus in the North Atlantic.

Lyme disease Borrelia species are distributed in temperate areas of North America and Eurasia. To elucidate the distribution of borreliae in subarctic regions, strains isolated from Ixodes ricinus and Ixodes uriae ticks found on islands in the northern Atlantic and Baltic Sea were molecularly characterized. All isolates were verified as Borrelia garinii by 16S rRNA gene analysis and immunoblotting with monoclonal antibodies specific for the outer surface proteins A and C. Three ribotypes (RTs) of B. garinii were delineated. I. ricinus complex-associated RT1 was phenotypically most heterogeneous. Two newly identified ribotypes were shared by different tick species and conformed to two established OspA serotypes. RT2 was restricted to the islands in the northern Baltic Sea, whereas RT3 was recovered also from ticks found in the North Atlantic. In conclusion, molecular polymorphism of the studied borrelia isolates suggests a complex enzootic potential of B. garinii in northern Europe and implies a novel, seabird tick I. uriae-associated enzootic focus of Lyme disease borreliae in the North Atlantic.

Animals↗
PubMed1996

Syphilis seroprevalence among pregnant women and its role as a risk factor for stillbirth in Maputo, Mozambique.

OBJECTIVE: To elucidate the role of current syphilis as a risk factor for foetal death. METHODS: Sera were obtained from 57 women with third trimester foetal death (cases) and 58 women with foetus alive (controls) matched for age and parity. All sera reactive in qualitative Rapid Plasma Reagin (RPR) analyses were tested with serial twofold dilutions to determine endpoint flocculation titres and tested with the micro-haemagglutination assay for Treponema pallidum (MHA-TP). Placental biopsies were sectioned and stained by haematoxylin-eosin and Warthin-Starry for light microscopy. SETTING: Central Hospital, in Maputo, Mozambique, from January 1990 to June 1991. RESULTS: The MHA-TP was reactive in 42% of cases and in 12% of controls (OR = 5.3; 95% CI: 1.9-15.4). The RPR card test was reactive at the dilution of 1.32 or greater in 28% of cases and in 7% of controls. All these results were confirmed by MHA-TP (OR = 5.3; 95% CI: 1.5-15.4). In 9/28 (32%) MHA-TP seroreactive women (7 cases and 2 controls) placental morphological changes indicated syphilitic infection. CONCLUSION: MHA-TP seroreactivity and high titre RPR were associated with stillbirth. Morphological changes presumptive of syphilis infection were found in 32% placentas histologically studied. Syphilis is a risk factor for foetal death in Maputo, Mozambique.

Case-Control Studies↗
PubMed1996

Amniotic fluid antibacterial activity and nutritional parameters in term Mozambican and Swedish pregnant women.

Randomly selected parturients with term singleton pregnancies from two different settings, 83 from Mozambique and 90 from Sweden, entered the study. All of them underwent elective cesarean section, which enabled sterile harvesting of amniotic fluid (AF). AF samples were then tested for antibacterial activity (ABA). Background data and nutritional status were compared. Average age was 32.7 and 30.7 years (n.s.), average parity 6.6 and 1.6 (p < 0.0001), average number of antenatal visits 4.9 and 11.6 (p < 0.0001), and average birthweight 3,194 and 3,688 g (p < 0.01), respectively. Body mass index, mid-upper-arm circumference and hemoglobin did not show any significant differences. The average ABA of AF was more than 50% higher in Swedish than in Mozambican specimens (p < 0.0001). Less than one-sixth of MoZambican women reached the average ABA of AF from Swedish women. Bacterial outgrowth delay equal to or above 3 h was encountered in 13% of Mozambican AF as against 61% of Swedish AF (OR 0.10; 95% CI 0.05-0.19). Histopathological examinations of the placenta, nonplacental membranes and umbilical cord showed inflammatory lesions in 29% of the Mozambican parturients and in 13% of Swedish parurients (OR 2.65; 95% 1.00-6.98). It is probable that the lower antibacterial activity in Mozambican AFs reflects an increased vulnerability to ascending genital infections during late pregnancy.

Adolescent↗
PubMed1996

Ultrasonographic measurement of the symphysis pubis: a potential method of studying symphyseolysis in pregnancy.

The width of the symphysis pubis was measured in a skeleton model using slide rule, ultrasonography and x-ray. Ultrasonography gave a 0.5-mm and x-ray a 1.0-mm narrower gap than the slide rule. Further, 15 nonpregnant females undergoing urography volunteered for an extra ultrasonography of the symphysis pubis. The widths of the symphysis as measured from the x-ray exposures and the ultrasonography were compared. Regression analysis gave a regression coefficient of 0.979 and a correlation coefficient of 0.850. Ultrasonography offers at least the same precision as x-ray for assessing the width of the symphyseal gap.

Adult↗
PubMed1996

A randomised study on the impact of peroral amoxicillin in women with prelabour rupture of membranes preterm.

One hundred and six third trimester pregnant women with prelabour rupture of membranes preterm were randomised to either peroral amoxicillin 0.75 g 3 times daily (n = 50) or placebo (n = 56) in a blinded way. The patients were hospitalised in bed for 7 days unless contractions started and delivery ensued. Only 1 patient was discharged after 7 days of treatment, while the remaining ones delivered within 1 week after admission. The average rupture-to-expulsion interval was 68.4 h in the placebo group and 91.7 h in the amoxicillin group, implying a significantly prolonged stay by 43% in the amoxicillin group (p = 0.03). The other outcome variables registered (birth weight, stillbirth prevalence, vaginal haemorrhage and postpartum endometritis-myometritis) did not differ significantly in the two treatment groups. There was a trend towards a longer duration of stay in the neonatal ward among newborns in the amoxicillin group suffering neonatal death (p = 0.06). It is concluded that antibiotic treatment of this group of women may be justified in settings were sexually transmitted diseases and other genital infections are prevalent, whereas such treatment is less likely to have an effect when genital infection is rare.

Adult↗
PubMed1996

Impact of intrapartum intravenous ampicillin on pregnancy outcome in women with preterm labor: a randomised, placebo-controlled study.

The purpose of this study was to elucidate whether the use of intravenous ampicillin (vs. placebo therapy) in women in early active-phase preterm labor reduces infectious complications postpartum in mothers and their newborns. A randomised, double-blind, placebo-controlled study was carried out on 102 women with gestational age < 37 completed weeks in the active phase of labor (dilatation of cervix > or = 4 cm). Enrolled women received a loading dose of 5 g of ampicillin (n = 44) or placebo (n = 58) in intravenous infusion twice, 4 h apart. In a few cases, this interval was shortened in order to obtain a minimum interval of 1 h between the last dose and delivery. There was a significant reduction in the ampicillin group (vs. the placebo group) of the prevalence of neonatal infection (OR 19.0; 95% CI 5.5-80.8), histological chorioamnionitis (OR 5.9; 95% CI 2.0-19.4) and puerperal endometritis-myometritis (OR 3.7; 95% CI 1.3-10.3). It is concluded that women in the active phase of preterm labor and their newborns benefit from treatment with intravenous ampicillin. Antibiotic treatment reduces the incidence of neonatal infectious morbidity, of puerperal endometritis and of histological chorioamnionitis.

Adult↗
PubMed1996

Ampicillin in the treatment of preterm labor: a randomised, placebo-controlled study.

This study was performed in order to assess whether the use of oral ampicillin vs. placebo therapy in women with latent-phase preterm labor delays delivery and improves pregnancy outcome. A prospective, randomised, double-blind, placebo-controlled study was performed of 110 women at 22-34 weeks of gestation. Patients received oral ampicillin 1 g (n = 59) or placebo (n = 51) every 8 h for 7 days. Outcome measures comprised gestational age at delivery, birth weight, Apgar score, perinatal death, neonatal infection, fetal growth restriction, histological chorioamnionitis and puerperal infection. In the ampicillin and placebo groups, respectively, the average gestational age at birth was 36.6 and 33.8 weeks (p < 0.05) and average birth weight 2,885 and 2,336 g (p < 0.05). Odds ratio (OR) for gestational age > 35 weeks and for birth weight > or = 2,500 g was 3.9 (95% CI 1.6-9.4). Neonatal infection (OR 15.5; 95% CI 4.6-65.7), intrauterine growth retardation (OR 9.6; 95% CI 2.8-41.3), histological chorioamnionitis (OR 13.0; 95% CI 3.4-72.2) and puerperal endometritis-myometritis (OR 65.3; 95% CI 9.3-2,715.7) occurred significantly less frequently among ampicillin-treated than among placebo-treated women. It is concluded that women in latent phase of preterm labor benefit from treatment with oral ampicillin, which prolongs the gestational age at delivery with ensuing increase in birth weight, reduction in the prevalence of histological chorioamnionitis and in neonatal and puerperal infectious morbidity.

Adult↗