Biomedical subjects

S Osser

Publications and source records attributed to S Osser.

At least 19 recordsLinked to original sources

PubMed2000

The frequency of salpingitis and ectopic pregnancy as epidemiologic markers of Chlamydia trachomatis.

BACKGROUND: To study the incidence of non-gonococcal salpingitis, gonococcal salpingitis and ectopic pregnancy in a defined population over a 28-year period on the assumption that the frequency of salpingitis and ectopic pregnancy may indirectly illustrate the epidemiological pattern of Chlamydia trachomatis. DESIGN: A retrospective epidemiological study. SETTING: University hospital with an urban catchment area. PATIENTS: Five thousand two hundred and thirty-three patients admitted to the hospital between 1969 and 1996 with a diagnosis of ectopic pregnancy, non-gonococcal salpingitis, or gonococcal salpingitis. RESULTS: The frequencies of both non-gonococcal and gonococcal salpingitis increased steeply early in the period under study, rising to a peak in the early 1970s, then decreasing throughout the period except for the last 3 years when a slight increase was seen again. The frequency of ectopic pregnancy showed a steady increase, peaking in the late 1980s and early 1990s and then declining at the end of the study period. While the introduction of more sensitive pregnancy tests and programs for assisted fertility would increase the rate of ectopic frequency the decline during the 'nineties cannot be accounted for in this way. The peak of salpingitis cases in the early 'seventies seems to be mirrored exactly by the peak of ectopic pregnancies fifteen years later in the late 'eighties. CONCLUSION: The frequencies of salpingitis and of ectopic pregnancy can probably be used to estimate the incidence of preceding Chlamydia trachomatis. Thus the incidence of C. trachomatis has probably declined since the early 'seventies like that of N. gonorrheae.

Adult↗

PubMed1999

Antibodies to Chlamydia trachomatis heat shock proteins in women with tubal factor infertility are associated with prior infection by C. trachomatis but not by C. pneumoniae.

The antibody response to heat shock proteins 60 and 10 were studied in 163 patients with tubal factor infertility and in 163 age-matched pregnant women. The associations of these antibodies with specific antibodies to Chlamydia trachomatis and to Chlamydia pneumoniae as well as with antibodies to the common chlamydial lipopolysaccharide antigen were studied. Patients with tubal factor infertility had significantly higher frequencies and titres of all antibodies except to C. pneumoniae. In a logistic regression model an association was found between the prevalence of antibodies to the heat shock proteins and to C. trachomatis but no independent influence of antibodies to C. pneumoniae. No interaction between C. trachomatis and C. pneumoniae suggesting a synergistic effect was found although the heat shock proteins from these two organisms are immunologically similar. Antibodies to the chlamydial lipopolysaccharide also seemed to be related to C. trachomatis and not to C. pneumoniae in these women.

Adult↗

PubMed1996

Chlamydial antibodies in women who suffer miscarriage.

OBJECTIVE: To ascertain the relation between previous chlamydial infection and miscarriage. DESIGN: A prospective study of 349 women who had a miscarriage. PARTICIPANTS: Women surgically treated for spontaneous pregnancy loss on an outpatient basis at a hospital. SUBJECTS: Three hundred and forty-nine women who miscarried, of whom 91 had at least one previous miscarriage and 33 had had two or more miscarriages previously. Age-matched women who had a normal pregnancy served as controls. INTERVENTIONS: Blood samples were drawn from patients and controls for antibody determination. MAIN OUTCOME MEASURES: Patients and controls were compared regarding the frequency of Chlamydia trachomatis IgG antibodies (titre > or = 1/32). Antibodies to C. pneumoniae were also analysed to study cross reactivity. RESULTS: The frequency of IgG antibodies among the patients was 137/349 (39.3%) which was not statistically different from that among controls (116/349; 33.2%). Even among those who had miscarried previously the antibody frequencies did not differ significantly between patients and controls. The rate of C. trachomatis antibodies was about the same whether or not antibodies to C. pneumoniae were present in both patients and controls. CONCLUSION: No association was found serologically between previous chlamydial infection and miscarriage and no significant cross reactivity between C. pneumoniae and C. trachomatis could be detected.

Abortion, Spontaneous↗

PubMed1996

Efficacy and safety of azithromycin versus lymecyline in the treatment of genital chlamydial infections in women.

To compare the clinical and microbiological efficacy of azithromycin in curing chlamydial infections in women with that of lymecycline, and with a view of the possibility of minimizing the problem of compliance by means of single-dose administration, 146 women with culture-positive Chlamydia trachomatis infections were randomly assigned to treatment with a 1 g bolus dose of azithromycin or a 10-day course of lymecycline 300 mg twice daily. Clinical and microbiological evaluations were performed and adverse effects monitored at check-ups after 15-35 and 40-65 days. Of the 146 patients enrolled in the study, 120 were evaluable. At the second check-up, C. trachomatis was found to have been eradicated in all patients in both treatment groups. Of the 51 patients who had clinical signs and symptoms of genital infection at enrolment, 96% (22/23) of those in the azithromycin group were considered cured (n = 18) or improved (n = 4), as compared with 100% (28/28) of those considered cured (n = 22) or improved (n = 6) in the lymecycline group. Adverse events related, or possibly related, to treatment were reported by 16 (21.6%) of the lymecycline group, but by only 6 (8.3%) of the azithromycin group. The 2 drugs were comparable with regard to microbiological and clinical efficacy in the treatment of genital chlamydial infection in women. The markedly lower rate of side-effects associated with azithromycin may be a feature conducive to patient compliance.

Adult↗

PubMed1993

Lack of evidence of a relationship between genital symptoms, cervicitis and salpingitis and different serovars of Chlamydia trachomatis.

Isolates of Chlamydia trachomatis from 424 women were serotyped, and signs and symptoms related to the infecting serovar. Symptoms suggesting genital chlamydial infection were present in 37% of the women, while 15% had clinical findings consistent with lower genital tract infection or ascending infection. Cervicitis, adnexal tenderness and salpingitis were not associated with any specific serovar. On the contrary, the various clinical manifestations tended to occur at similar rates with the different serovars, suggesting a similar pathogenic potential of the serovars detected.

Adult↗

PubMed1992

Chlamydial antibodies and deoxyribonucleic acid in patients with ectopic pregnancy.

OBJECTIVE: To evaluate the importance of previous and persisting chlamydial infection for ectopic pregnancy (EP). DESIGN: A prospective study of women with EP. SETTING: Hospitalized patients. PATIENTS AND CONTROLS: Eighty-six women with EP with (group I; n = 35) or without (group II; n = 51) risk factors for EP and chlamydial infection. Age-matched normally pregnant women served as controls. INTERVENTIONS: Blood samples were drawn from patients and controls for antibody determination. MAIN OUTCOME MEASURES: The frequency of immunoglobulin G antibodies was compared between patients and controls, and the polymerase chain reaction (PCR) was used to detect chlamydial deoxyribonucleic acid (DNA) in tubal tissue from 33 patients (70 specimens). RESULTS: Immunoglobulin G antibodies (titer greater than or equal to 32) were significantly more common among patients than in controls (51% versus 31%, P less than 0.025). The difference was more pronounced between group I and controls (69% versus 31%, P less than 0.005). Chlamydial DNA was not detected in any tubal specimen. CONCLUSIONS: An association was found between previous chlamydial infection (serologically) and EP, especially in women with risk factors, but no evidence of persisting chlamydial infection in the tubes could be demonstrated using PCR.

Adult↗

PubMed1992

Semen quality of smoking and non-smoking men in infertile couples in a Swedish population.

A study of semen quality, using conventional semen analysis, was undertaken. 186 male smokers were compared with 164 non-smoking men undergoing infertility investigation. The cigarette smokers were subdivided into three groups according to the number of cigarettes they smoked: less than 10 (n = 27), 10-19 (n = 84) and greater than 19 cigarettes per day (n = 75). No statistically significant effect of cigarette smoking on sperm density, motility or morphologic features of sperm was detected. Nor was any significant difference in sperm quality, except for semen volume and total sperm count, disclosed between men in the different smoking categories or between heavy smokers and non-smoking men. Thus, the present study does not corroborate reports of detrimental effects of cigarette smoking alone on sperm concentration, motility or morphology on the bases of this population of Swedish men in infertile couples.

Adult↗

PubMed1991

Treatment of candidal vaginitis. A prospective randomized investigator-blind multicenter study comparing topically applied econazole with oral fluconazole.

Two hundred and thirty-five women with clinically and microbiologically proven candidal vaginitis were randomly allocated for treatment with either one topically applied vaginal tablet of 150 mg econazole (114 women) or one orally administered capsule of 150 mg fluconazole (121 women). The women returned for follow-up visits 7-10, 28-35, and 80-100 days after the recruitment visit. Women with clinical and/or mycological failures and/or a recurrence were successively excluded from the follow-up. At the 28-35-day follow-up visit, the women treated with fluconazole had a significantly higher clinical/microbiological cure rate than those given econazole (P = 0.022; Fisher's exact 2-tail test). No significant such differences were observed at the 7-10 and the 80-100-day follow-up visits, although fluconazole tended to be more efficacious. Nine women administered fluconazole, and 2 women given econazole reported minor systemic side effects of the treatment. Three women out of 4 preferred oral to local therapy of candidal vaginitis.

Administration, Intravaginal↗

PubMed1990

Dose previous Chlamydia trachomatis infection influence the pregnancy rate of in vitro fertilization and embryo replacement?

The association between previous chlamydial infection, as reflected by the presence of chlamydial antibodies (specific serum immunoglobulin G antibodies with a titer greater than or equal to 32) and pregnancy outcome after in vitro fertilization and embryo replacement was studied in 121 infertile women with tubal damage. The antibody prevalence was 74.4%; the overall pregnancy rate was 26.4%. No difference in seropositivity was detected between those who became pregnant and those who did not (71.9% versus 75.3%). The geometric mean titers were also similar in the two groups. Even after subdivision of the cases into primary or repeated in vitro fertilization attempts, or after stratification of the material according to the number of embryos used for replacement, there was no correlation between chlamydial antibodies and pregnancy rate. Thus, past infection with Chlamydia trachomatis did not influence the outcome of in vitro fertilization and embryo replacement treatment in this study.

Adult↗

PubMed1989

Immune response to genital chlamydial infection and influence of Chlamydia pneumoniae (TWAR) antibodies.

Chlamydial IgG antibodies at a titre of at least 32 were found to occur at approximately the same frequency (76-88%) in three groups of patients who had been treated for genital chlamydial infection. Twenty-four patients who had recovered from acute salpingitis, however, had a higher geometric mean titre (GMT; 176) than 59 pregnant women (GMT 44) or 61 patients with uncomplicated genital chlamydial infection (GMT 57). The chlamydial antibody titres thus seemed to reflect the severity of inflammatory involvement. Antibodies to the new species Chlamydia pneumoniae (previously known as Chlamydia TWAR), did not influence the frequency or titre of antibodies to Chlamydia trachomatis, arguing against the possibility of cross-reactivity or shared antigens. There was assumed to be no cross-immunity, since patients with Chlamydia trachomatis infection did not have a lower frequency of antibodies to Chlamydia pneumoniae.

Adolescent↗

PubMed1989

Serovars of Chlamydia trachomatis causing postabortion salpingitis.

In a previously reported investigation, 69 women with genital chlamydial infection following legal abortion were studied prospectively. Ten cases of postabortion salpingitis and 16 cases of endometritis were identified. To ascertain whether some serovars of Chlamydia trachomatis are particularly likely to initiate an infection in the fallopian tubes and cause salpingitis, the chlamydial isolates from the patients with salpingitis and those isolates from cases free of infectious complications were serotyped using a panel of monoclonal antibodies. Six of the seven different serovars demonstrated in the symptom-free group were identified in salpingitis cases. The strains associated with salpingitis seemed to reflect the overall distribution of chlamydial serovars in the entire study group. The predominant serovars were E, F and H. A protective effect associated with chlamydial serum antibodies had previously been observed in salpingitis cases. Therefore, the antibody titres subdivided according to serovar were compared. No difference in the antibody response induced by the different serovars could be verified statistically, but the B-complex strains were associated with a higher antibody titre than the C-complex strains or the intermediate strains F and G.

Abortion, Legal↗

PubMed1989

Tubal infertility and silent chlamydial salpingitis.

Antibodies to Chlamydia trachomatis (serum IgG antibodies with a titre of at least 32) were detected in 141 (86.0%) of 164 infertile women with tubal infertility (TF group) and in 20 (28.6%) in 70 infertile women with normal tubes (NTF group). The difference was highly significant (P less than 0.001), as was the difference in geometric mean titre of antibody-positive cases, 181 and 87, respectively. Pregnant, age-matched women were used as controls. Significantly fewer of these women (P less than 0.001) had antibodies, when compared with the TF group, 60 (36.6%) of 164, but not when the comparison was made with the NTF group, 31 (44.3%) of 70. There was a history of salpingitis in 64 (39.0%) of the 164 infertile women with damaged tubes. Neither the frequency nor the geometric mean titre of chlamydial antibodies differed between tubal factor infertility patients with and without a history of salpingitis. Previous chlamydial infection, reflected by serological markers, is strongly associated with tubal damage leading to tubal infertility. A large proportion of these cases run a silent course, since a majority of the antibody-positive patients with tubal infertility have never had salpingitis.

Adult↗

PubMed1987

Postabortal Chlamydia trachomatis salpingitis: correlating risk with antigen-specific serological responses and with neutralization.

Serum antibodies to Chlamydia trachomatis were studied by microimmunofluorescence (micro-IF) testing and by immunoblotting among 52 women with C. trachomatis cervical infection. All women underwent therapeutic abortion, and 10 (19.2%) subsequently developed laparoscopically confirmed salpingitis. Women who developed salpingitis had lower geometric mean titers of micro-IF antibody before abortion (14.9 x/divided by 2.3) than did women who did not develop salpingitis (41.6 x/divided by 4.9, P less than .01). Women who developed salpingitis significantly less often had serum IgA antibodies to a 60-kilodalton (kDa) chlamydial antigen (P = .02) and IgG antibodies to antigens of 75-kDa (P = .008), 60-kDa (P = .03), and 57-kDa (P = .0003). Serum antibodies to 100-kDa, 32-kDa, and 29-kDa antigens occurred only in women who did not develop salpingitis. Differences in antibody prevalence to specific chlamydial antigens were not due to differences in serum antibody titers between the two groups. No correlation between neutralizing sera and the risk of postabortal salpingitis was detected.

Abortion, Therapeutic↗

PubMed1984

Postabortal pelvic infection associated with Chlamydia trachomatis and the influence of humoral immunity.

Among 1101 women undergoing legal abortion by vacuum aspiration within 14 weeks of gestation, 69 (6.3%) harboured Chlamydia trachomatis in the cervix and/or urethra. Of the chlamydia-positive women, 16 (23.2%) developed endometritis and 10 (14.5%) developed salpingitis during the first postoperative month. The corresponding figures among the chlamydia-negative women were 59 (5.7%) and 5 (0.6%). These differences are highly significant (p less than 0.001). To study the significance of systemic and local humoral immunity to C. trachomatis in these complications, chlamydial antibodies were determined in serum and cervical secretions. No difference in frequency of local IgA antibodies in chlamydia-positive women was observed between those with and those without complications. On the other hand, there was a strong indication that chlamydia-positive women who developed salpingitis had a lower mean titer (17) of serum IgG chlamydial antibodies than carriers without symptoms (82, p less than 0.02). The group of endometritis patients did not differ in this respect from chlamydia-positive women who were free of infectious complications. These results suggest that C. trachomatis may be an etiologic agent in postabortal salpingitis and probably also in endometritis. Serum antibodies seemed to offer some protection against salpingitis in chlamydia-positive cases, whereas local antibodies did not.

Abortion, Induced↗

PubMed1984

Depressed semen quality: a study over two decades.

One hundred-eighty-five consecutive spermiograms from men of infertile couples in 1980-1981 were compared with as many spermiograms of age-matched controls from 1960-1961. The semen parameters analyzed were: volume, sperm density, and sperm morphology. The following significant changes were noted over the time period: the mean seminal volume decreased from 3.79 ml to 3.42 ml (p less than 0.05), the mean sperm count decreased from 125.4 mill/ml to 78.0 mill/ml (p less than 0.001) and the proportion of double sperm heads increased from 0.52% to 1.51% (p less than 0.001). Further analysis showed even more pronounced changes in these parameters for men living in the urban area compared those from the surrounding rural areas.

Adult↗

PubMed1983

Variation of semen parameters in fertile men.

The spermiograms of 63 fertile men (whose female partners were pregnant at the time of examination) were evaluated. A wide Gaussian distribution of the different semen parameters was found. Both parametric and nonparametric statistical tests were applied and gave almost identical results. In a subgroup of 34 men, a second semen sample was analysed, but a significant difference (p less than or equal to 0.05) between the two samples was found only regarding the proportion of abnormal forms. Between various semen parameters significant correlations were found. There was no association between follicle stimulating hormone (FSH) and sperm density with sperm counts greater than 20 mill/ml.

Adult↗

PubMed1982

Epidemiologic and serodiagnostic aspects of chlamydial salpingitis.

Cultural, serologic, and epidemiologic aspects of Chlamydia trachomatis in acute salpingitis were assessed. Of 111 patients, 52 (47%) harbored C trachomatis in the cervix urethra, or both. Neisseria gonorrhoeae was isolated in 41 patients of 209 (20%). A majority (79%) of women with gonorrhea were also infected with C trachomatis. A fourfold titer rise of chlamydial IgG antibodies or significant IgM titer, or both, was demonstrated in 37 patients of 72 (51%) from whom paired sera were obtained. The serologic response distinguished 3 different phases of chlamydial infection: acute, subacute, and chronic or reinfection. The patients' male sex partners were examined on a voluntary basis, and C trachomatis was detected in 68%, indicating a need for effective partner examination and treatment.

Acute Disease↗

PubMed1980

Risk of pelvic inflammatory disease among users of intrauterine devices, irrespective of previous pregnancy.

The use of an intrauterine device (IUD) in 690 patients hospitalized for acute salpingitis (pelvic inflammatory disease) was compared with IUD use in a sexually active age-matched control group. Two hundred and twenty (31.9%) of the patients and 114 (16.5%) of the controls were wearing IUDs. Thus, the relative risk of developing acute salpingitis was 2 among IUD users. No significant difference was found in IUD use in the two groups between nulligravid women and women who had been pregnant. It was shown furthermore that the use of the oral contraceptives decreases the risk of salpingitis by two thirds. A lower frequency of gonorrhea among PID patients who were IUD users was revealed also.

Adolescent↗