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- Kvist, Linda J, 1952-, et al.
(author)
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A descriptive study of Swedish women with symptoms of breast inflammation during lactation and their perceptions of the quality of care given at a breastfeeding clinic
- 2007
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In: International Breastfeeding Journal. - : Springer Science and Business Media LLC. - 1746-4358. ; 2:2
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Journal article (peer-reviewed)abstract
- BackgroundWomen's perceptions of quality of care during episodes of breast inflammation have been scantily explored. It was the objective of the present study to describe a cohort of breastfeeding women with inflammatory symptoms of the breast during lactation regarding demographical variables, illness history and symptoms at first contact with a breastfeeding clinic and to explore their physical health status, psychological well-being and perceptions of quality of care received, at a six-week postal follow-up.MethodsThis is a descriptive study set at a midwife-led breastfeeding clinic in Sweden, which included a cohort of women with 210 episodes of breast inflammation. The women had taken part in a RCT of acupuncture and care interventions and were recruited between 2002 and 2004. Of the total cohort, 176 (84 %) responded to a postal questionnaire, six weeks after recovery.ResultsOf the 154 women for whom body temperature was recorded at the first visit, 80 (52%) had fever ranging from 38.1°C to 40.7°C. There was no significant difference between those with favourable outcomes (5 or less contact days) and those with less favourable outcomes (6 or more contact days) for having fever or no fever at first contact. Thirty-six percent of women had damaged nipples. Significantly more women with a less favourable outcome (6 or more contact days) had damaged nipples. Most women recovered well from the episode of breast inflammation and 96% considered their physical health and 97% their psychological well-being, to be good, six weeks after the episode. Those whose illness lasted 6 days or more showed less confidence in the midwives and in the care given to them. Twenty-one (12%) women contacted health care services because of recurring symptoms and eight of the 176 responders (4.5%) were prescribed antibiotics for these recurring symptoms. A further 46 women (26% of the responders) reported recurring symptoms that they managed without recourse to health care services.ConclusionInitial fever may not be indicative of outcomes for women with inflammatory breast symptoms and treatment by antibiotic therapy may be necessary less often than has been supposed. Women who are also suffering from damaged nipples may need special attention. Those with protracted symptoms were less satisfied with care and showed less confidence in caregivers. International research collaboration might help us find the optimal level of antibiotic therapy for this group of women. This is an important consideration for the global community.
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| 2. |
- Kvist, Linda J, 1952-, et al.
(author)
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A randomised-controlled trial in Sweden of acupuncture and care interventions for the relief of inflammatory symptoms of the breast during lactation
- 2007
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In: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 23:2, s. 184-195
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Journal article (peer-reviewed)abstract
- Objectivesto further compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms.Designrandomised, non-blinded, controlled trial of acupuncture and care interventions.Settinga midwife-led breast feeding clinic in Sweden.Participants205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture among the care interventions and one without acupuncture. All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe).Findingsno significant difference was found in numbers of mothers in the treatment groups, with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. No statistically significant differences were found between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast feeding clinic or for number of mothers prescribed antibiotics. Significant differences were found in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (⩾6 contact days, n=61) were, at first contact with the midwife, more often given advice on correction of the baby's attachment to the breast. An obstetrician was called to examine 20% of the mothers, and antibiotic treatment was prescribed for 15% of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes.Key conclusions and implications for practiceif acupuncture treatment is acceptable to the mother, this, together with care interventions such as correction of breast feeding position and babies’ attachment to the breast, might be a more expedient and less invasive choice of treatment than the use of oxytocin nasal spray. Midwives, nurses or medical practitioners with specialist competence in breast feeding should be the primary care providers for mothers with inflammatory symptoms of the breast during lactation. The use of antibiotics for inflammatory symptoms of the breast should be closely monitored in order to help the global community reduce resistance development among bacterial pathogens.
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| 3. |
- Lutz, JM, et al.
(author)
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Occupational risks for uveal melanoma results from a case-control study in nine European countries
- 2005
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In: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 1573-7225 .- 0957-5243. ; 16:4, s. 437-447
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Journal article (peer-reviewed)abstract
- Objective Uveal melanoma is a rare disease with poor prognosis and largely unknown etiology. We studied potential occupational risk factors. Methods A population based case-control study was undertaken during 1995-1997 in nine European countries using population and colon cancer controls with personal interviews. Occupational exposure to sunlight and artificial UV radiation was assessed with a job exposure matrix. In total, 320 uveal melanoma cases were eligible at pathology review, and 292 cases were interviewed, participation 91%. Out of 3357 population controls, 2062 were interviewed, 61%, and out of 1272 cancer controls 1094 were interviewed, 86%. Results Using population controls, occupational exposure to sunlight was not associated with an increased risk (RR=1.24, 95% CI=0.88-1.74), while an excess risk found with use of colon cancer controls was attributed to confounding factors. An excess risk in welders was restricted to the French part of the data. Cooks, RR=2.40; cleaners, RR 2.15; and laundry workers, RR=3.14, were at increased risk of uveal melanoma. Conclusion Our study does overall not support an association between occupational sunlight exposure and risk of uveal melanoma. The finding of an excess risk of eye melanoma in cooks in several European countries is intriguing.
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| 4. |
- Guan, J, et al.
(author)
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Cohesin protein SMC1 is a centrosomal protein
- 2008
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In: Biochemical and biophysical research communications. - : Elsevier BV. - 1090-2104 .- 0006-291X. ; 372:4, s. 761-764
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Journal article (peer-reviewed)
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| 6. |
- Kvist, Linda J, 1952-, et al.
(author)
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The role of bacteria in lactational mastitis and some considerations of use of antibiotic treatment
- 2008
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In: International Breastfeeding Journal. - : BioMed Central (BMC). - 1746-4358. ; 3
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Journal article (peer-reviewed)abstract
- BackgroundThe role of bacterial pathogens in lactational mastitis remains unclear. The objective of this study was to compare bacterial species in breast milk of women with mastitis and of healthy breast milk donors and to evaluate the use of antibiotic therapy, the symptoms of mastitis, number of health care contacts, occurrence of breast abscess, damaged nipples and recurrent symptoms in relation to bacterial counts.MethodsIn this descriptive study, breast milk from 192 women with mastitis (referred to as cases) and 466 breast milk donors (referred to as controls) was examined bacteriologically and compared using analytical statistics. Statistical analyses were also carried out to test for relationships between bacteriological content and clinical symptoms as measured on scales, prescription of antibiotics, the number of care contacts, occurrence of breast abscess and recurring symptoms.ResultsFive main bacterial species were found in both cases and controls: coagulase negative staphylococci (CNS), viridans streptococci, Staphylococcus aureus (S. aureus), Group B streptococci (GBS) and Enterococcus faecalis. More women with mastitis had S. aureus and GBS in their breast milk than those without symptoms, although 31% of healthy women harboured S. aureus and 10% had GBS. There were no significant correlations between bacterial counts and the symptoms of mastitis as measured on scales. There were no differences in bacterial counts between those prescribed and not prescribed antibiotics or those with and without breast abscess. GBS in breast milk was associated with increased health care contacts (p = 0.02). Women with ≥ 107 cfu/L CNS or viridans streptococci in their breast milk had increased odds for damaged nipples (p = 0.003).ConclusionMany healthy breastfeeding women have potentially pathogenic bacteria in their breast milk. Increasing bacterial counts did not affect the clinical manifestation of mastitis; thus bacterial counts in breast milk may be of limited value in the decision to treat with antibiotics as results from bacterial culture of breast milk may be difficult to interpret. These results suggest that the division of mastitis into infective or non-infective forms may not be practically feasible. Daily follow-up to measure the subsidence of symptoms can help detect those in need of antibiotics.
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| 7. |
- Kvist, Sebastian, et al.
(author)
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Two new species of Tubificoides (Annelida: Clitellata: Naididae) from the Blake Ridge methane seep in the northwest Atlantic Ocean
- 2008
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In: Proceedings of the Biological Society of Washington. - : The Biological Society of Washington. - 0006-324X. ; 121:4, s. 531-540
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Journal article (peer-reviewed)abstract
- Tubificoides blakei and T. methanicus, both new species of oligochaetes, are described from 2156 and 2170 m depth on the Blake Ridge Diapir, near the intersection of the Carolina Rise and the Blake Ridge, off the continental shelf of North and South Carolina (U.S.A. East Coast). Tubificoides blakei is characterized by the long, parallel teeth of its bifid crotchets, and its mushroom-shaped, cuticular penis sheaths. It appears most closely related to two other deep-water species reported from the northwest Atlantic Ocean, T. bruneli Erséus, 1989 and T. aculeatus (Cook, 1969) but differs from these in the detailed morphology of the penis sheaths. Tubificoides methanicus lacks hair chaetae but is recognized by its numerous bifid chaetae, which have long, somewhat diverging teeth, the upper teeth often being longer than the lower ones, and its smooth, funnel-shaped penis sheaths. It does not seem to be closely related to any other known deep-sea species of Tubificoides, but it resembles the littoral, holarctic, T. pseudogaster (Dahl, 1960), differing from the latter mainly by its greater number and larger size of the posterior chaetae.
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