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- Adolfsson, Ann-Sofie, et al.
(författare)
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Applicability of general grief theory to Swedish women’s experiences after early miscarriage, with factor analysis of Bonanno´s taxonomy, using the Perinatal Grief Scale.
- 2010
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 115:3, s. 201-209
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Tidskriftsartikel (refereegranskat)abstract
- Background. Grief is a normal phenomenon but showing great variation depending on cultural and personal features. Bonanno and Kaltman have nonetheless proposed five aspects of normal grief. The aim of this study was to investigate if women with miscarriage experience normal grief. Material and methods. Content analyses of 25 transcribed conversations with women 4 weeks after their early miscarriages were classified depending on the meaning-bearing units according to Bonanno and Kaltman's categories. In the factor analyses, these categories were compared with the Perinatal Grief Scale and women's age, number of children and number of miscarriages, and gestational weeks. Results. Women with miscarriage fulfill the criteria for having normal grief according to Bonanno and Kaltman. All of the 25 women had meaning-bearing units that were classified as cognitive disorganization, dysphoria, and health deficits, whereas disrupted social and occupational functioning and positive aspects of bereavement were represented in 22 of 25 women. From the factor analysis, there are no differences in the expression of the intensity of the grief, irrespective of whether or not the women were primiparous, younger, or had suffered a first miscarriage. Conclusion. Women's experience of grief after miscarriage is similar to general grief after death. After her loss, the woman must have the possibility of expressing and working through her grief before she can finish her pregnancy emotionally. The care-giver must facilitate this process and accept that the intensity of the grief is not dependent on the woman's age, or her number of earlier miscarriages.
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| 2. |
- Charonis, Georgios, et al.
(författare)
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Prolonged use of intrauterine contraceptive device as a risk factor for tubo-ovarian abscess
- 2009
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Ingår i: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - : Wiley. - 0001-6349 .- 1600-0412. ; 88:6, s. 680-684
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The intrauterine contraceptive device (IUCD) is the most preferred method of reversible contraception in the world today. The Swedish Medical Products Agency currently recommends that women who had a copper IUCD inserted around age 40 do not need to have it extracted until one year after the menopause. Design. Retrospective study. Setting. Skovde Central Hospital, Sweden. Population. All 114 women receiving in-patient treatment for pelvic inflammatory disease (PID) over five years between January 2001 and December 2005. Methods. Comparison between cases of tubo-ovarian abscesses and salpingitis with focus on the effects of IUCDs used continually for andgt; 5 years after insertion. Main outcome measures. Age-adjusted risk of PID within or after five years of use, microbiological findings in blood, intraabdominal pus, cervical secretions or on extracted IUCDs. Results. There were 31 cases of tubo-ovarian abscesses, 63 of salpingitis, four of endometritis, and 16 of mild genital infection. When comparing women with the same IUCD andgt; 5 years to women having the same IUCD andlt;= 5 years, the risk of tubo-ovarian abscess was higher than the risk of salpingitis (OR 19.7; 95% CI 4.5-87.2). The risk remained significant after adjustment for age, both on multiple regression analysis (OR 13.5; 95% CI 2.5-72.9) and in stratified analysis for the age group 35-50 years (OR 12.0; 95% CI 1.8-81.7). Blood or abdominal cultures from patients operated upon were positive in 47.7% of the sampled cases. Intestinal tract microbes and upper respiratory tract microbes were more common than sexually transmitted infection microbes. Conclusions. The current Medical Products Agency recommendation that a woman nearing the end of her reproductive phase can safely use the same IUCD for a period exceeding five years is challenged.
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| 3. |
- Eriksson, Katarina, et al.
(författare)
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The prevalence of BV in the population on the Åland Islands during a 15-year period
- 2010
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - Malden, USA : John Wiley & Sons. - 0903-4641 .- 1600-0463. ; 118:11, s. 903-908
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe the prevalence and age distribution of bacterial vaginosis (BV) during an observation period of 15 years in a population study with cross-sectional samples of adult women living on the Åland Islands. The Åland Islands form an archipelago in the Baltic Sea and are a province of Finland. Every fifth year, specific age groups in the adult female population are invited to participate in a screening program for early diagnosis of cervical cancer using a papanicolaou (PAP)-stained vaginal smear. Women in the age groups of 20, 25, 30, 35, 40, 45, 50, 55, and 60 years are called each year. BV diagnosis of the PAP-stained smears uses the classification according to Nugent. The PAP-stained smears from the screening program of cervical cancer 1993, 1998, 2003, and 2008 were used in this study. A total of 3456 slides were investigated and 271 women could be followed for the 15-year observation period. The prevalence of BV declined from 15.6% in 1993 to 8.6% in 2008. The highest prevalence occurred among the age groups of 35 and 50 years. Among the 271 women who could be followed for the 15-year observation period, two-third showed normal/intermediate flora and one-third were infected with BV at least once. As this is a cross-sectional population study spanning 15 years, the prevalence of BV in the female adult population of the Åland Islands can be estimated. The prevalence has declined between 1993 and 2008 from 15.6% to 8.6%.
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| 4. |
- Eriksson, Katarina, et al.
(författare)
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Vaginal retention of locally administered clindamycin
- 2011
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : John Wiley & Sons. - 0903-4641 .- 1600-0463. ; 119:6, s. 373-376
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Tidskriftsartikel (refereegranskat)abstract
- Since bacterial vaginosis (BV) is characterized by a lack of, or very few, lactobacilli and high numbers of small, mostly anaerobic bacteria, an obvious treatment modality would be eradication of the BV-associated bacterial flora followed by reintroduction of lactobacilli vaginally. As probiotic treatment with lactobacilli is one tool for improving the cure rate when treating BV, it is necessary to know the length of time after treatment that clindamycin can be found in the vagina and if this could interfere with the growth of the probiotic lactobacilli. We evaluated the vaginal concentration of clindamycin in 12 women for 8 days to obtain data on the concentration of clindamycin in the vagina after intravaginal treatment with the drug. The participants were examined five times between two menstrual periods: before treatment, the day after treatment was finished, and 3, 5 and 8 days post-treatment. The first day post-treatment clindamycin 0.46 x 10-3 to 8.4 x 10-3 g/g vaginal fluid (median 2.87 x 10-3) was found. Thereafter, the concentration of clindamycin decreased rapidly. In 10 patients clindamycin was found after 3 days. A very low concentration was still present 5 days after treatment in four patients. After 8 days no clindamycin was found. Clindamycin is rapidly eliminated from the vagina, within 3-8 days, after local administration. Our results indicate that treatment with probiotic lactobacilli could be problematic if carried out within 5 days after cessation of clindamycin treatment.
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| 5. |
- Larsson, Per-Göran, et al.
(författare)
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Extended antimicrobial treatment of bacterial vaginosis combined with human lactobacilli to find the best treatment and minimize the risk of relapses
- 2011
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Ingår i: BMC Infectious Diseases. - : BioMed Central. - 1471-2334. ; 11:223
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Tidskriftsartikel (refereegranskat)abstract
- Background: The primary objective of this study was to investigate if extended antibiotic treatment against bacterial vaginosis (BV) together with adjuvant lactobacilli treatment could cure BV and, furthermore, to investigate factors that could cause relapse. less thanbrgreater than less thanbrgreater thanMethods: In all, 63 consecutive women with bacterial vaginosis diagnosed by Amsel criteria were offered a much more aggressive treatment of BV than used in normal clinical practice with repeated antibiotic treatment with clindamycin and metronidazole together with vaginal gelatine capsules containing different strains of lactobacilli both newly characterised and a commercial one (10(9) freeze-dried bacteria per capsule). Oral clindamycin treatment was also given to the patients sexual partner. less thanbrgreater than less thanbrgreater thanResults: The cure rate was 74.6% after 6 months. The patients were then followed as long as possible or until a relapse. The cure rate was 65.1% at 12 months and 55.6% after 24 months. There was no significant difference in cure rate depending on which Lactobacillus strains were given to the women or if the women were colonised by lactobacilli. The most striking factor was a new sex partner during the follow up period where the Odds Ratio of having a relapse was 9.3 (2.8-31.2) if the patients had a new sex partner during the observation period. less thanbrgreater than less thanbrgreater thanConclusions: The study shows that aggressive treatment of the patient with antibiotics combined with specific Lactobacillus strain administration and partner treatment can provide long lasting cure. A striking result of our study is that change of partner is strongly associated with relapse of BV.
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